The Scope and Discipline of the Practice of Professional Nursing
Authority for the practice of nursing is based on a social contract that acknowledges the professional rights and responsibilities of nursing and includes mechanisms for public accountability. Professional nursing is dynamic, rather than static, reflecting the nature of societal needs and the expanding knowledge base of its theoretical and scientific domains.
The position of the Oklahoma Nurses Association related to the scope of practice for professional nursing asserts:
- Nursing is a profession that is both an art and a science.
- Nurses accept full accountability for the oversight of the scope and standards of nursing practice
- Professional regulation of nursing practice begins with the profession’s definition of nursing and the scope of nursing practice, whichdelineates the professional responsibilities of all professional registered nurses engaged in nursing practice, regardless of setting.
- The profession defines nursing as:
the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations. (ANA).
- Standards of Practice include:
- Outcomes Identification
- Implementation, and
- Standards of Professional Performance include:
- Quality of Practice
- Professional Practice Evaluation
- Resource Utilization, and
- The Oklahoma Board of Nursing regulates the practice of nursing in Oklahoma as defined in state law (Title 59, Chapter 12, Section 567.1 et seq) by the Oklahoma Nurse Practice Act. This Act provides that the following nursing activities shall remain in the purview of the nursing profession itself:
- educational standards
- academic requirements
- licensure requirements for LPN, RN and APRN
- recognition and certification of APRN
- disciplinary processes, and
- peer review of the nursing profession
That it is the registered nurse's independent authority to practice with the rights, responsibilities, and accountability as defined in the profession's fundamental documents, the ANA Social Policy Statement, Code of Ethics for Nurses with Interpretive Statements, the Nursing Scope and Standards of Practice and the Oklahoma Nurse Practice Act.
The legal contract between society and the professions is defined by statute and by related rules and regulations. State nurse practice acts and related legislative and regulatory initiatives serve as the explicit codification of the profession’s obligation to act in the best interests of society. Nurse practice acts grant nurses the authority to practice and grant society the authority to sanction nurses who violate the norms of the profession or act in a manner that threatens the safety of the public.
Nursing, like other professions, is accountable for ensuring that its members act in the public interest by providing the unique service society has entrusted to them. Nursing regulates itself by defining its practice base, providing for research and development of that practice base, establishing a system for nursing education, establishing structures through which nursing service will be delivered and providing quality assurance mechanisms such as a code of ethics, standards of practice, structures for peer review and a system of credentialing.
Nurses are personally accountable for their own knowledge base for professional practice. Nurses develop and maintain current knowledge, skills, and abilities through formal and continuing education. Where appropriate, nurses hold certification in their area of practice to demonstrate their accountability. Nurses also regulate themselves through peer review of their practice. Continuous performance improvement fosters the refinement of knowledge, skills and clinical decision-making at all levels and in all areas of professional nursing practice (ANA, 2003).
Nursing Foundational Documents
The basic principles of safe and ethical nursing practice are detailed in three foundational documents – the code of ethics, the scope and standards of practice and a social policy. These are the documents that guide professional registered nurses throughout their careers whether they practice independently or collaboratively, in all settings at all levels. They also provide the framework for the development of policies and procedures reflective of today’s evolving scope and standards of practice. (ANA, 2001; ANA, 2003; ANA, 2004).
American Nurses Association (ANA). (2004). Nursing: Scope and standards. Washington, DC
American Nurses Association (ANA). (2003). Nursing’s social policy statement (2nd ed.). Washington, DC
American Nurses Association (ANA). (2001). Code of ethics for nurses with interpretive Statements. Washington, DC
Oklahoma Nurse Practice Act, Oklahoma State Statutes, Title 59, Chapter 12, Section 567.1 et seq.