What Is the RN Scope of Practice? Overview and FAQ

All nurses are legally responsible for providing care that aligns with their level of education and training. There are many different levels of nursing, and each one follows a different set of professional standards. The registered nurse (RN) scope of practice, for instance, defines what an RN is authorized to do and how their role differs from that of nurse practitioners (NPs), licensed practical nurses (LPNs), and certified nursing assistants (CNAs).

If you’re a facility leader who wants to enforce appropriate care protocols, you may be looking for more information about these scope of practice guidelines. In this article, we’ll answer some of the most frequently asked questions about how RN duties are defined and carried out.

Registered Nurse Scope of Practice FAQs

Each state’s board of nursing oversees slightly different rules and regulations defining the RN role. However, we’ll answer some general scope of practice FAQs below.

What is the RN Scope of Practice?

The nursing scope of practice is the regulatory framework defining what nursing professionals can and cannot do based on their education, training, and licensure. Passing the NCLEX-RN examination demonstrates that a nurse has the competency to earn their RN license and carry out this level of work. While there are some minor differences in state-by-state practice regulations, RNs are generally responsible for:

• Assessing and monitoring a patient’s health status.
• Administering medications, therapies, and interventions.
• Monitoring vital signs and updating health records.
• Collaborating with supervising doctors and other healthcare professionals.
• Educating patients and their families about their conditions and treatments.
• Creating and implementing nursing care plans for patients.
• Ordering appropriate supplies and medications.

How does the scope of practice for RNs differ by state?

Each state enacts its own version of the Nurse Practice Act (NPA). This is a vital piece of legislation that governs everything related to the nursing profession, including credentialing requirements, delegation rules, and differences in the scope of practice.

LVNs and NPs typically have more differences in the nurse scope of practice by state than RNs, who follow fairly similar guidelines across state lines. However, some states have more intricate enforcement policies and procedures than others. For example, under the RN scope of practice, Texas RNs must undergo a peer-review process if their work assignment risks endangering a patient. This is a process that no other BON currently enforces.

LPN vs. RN scope of practice: What’s the difference?

While an LPN and RN may appear to have similar duties, they follow a different scope of practice. RN responsibilities are broader because RNs receive a higher level of education and training than LPNs do.

RNs typically have greater autonomy in their clinical decision-making, while LPNs require more supervision from RNs or other healthcare professionals. Here are a few examples of tasks that RNs can generally do that LPNs cannot:

• Perform first assessments on patients
• Administer IV push medications
• Create and change nursing care plans
• Insert NG tubes with a guide wire

RN vs. NP scope of practice: What’s the difference?

Beyond variations in the LPN scope of practice vs. RN regulations, you may also be wondering how the role of an RN differs from that of an NP. NPs undergo two to four more years of education and training than RNs do. This grants NPs a much more advanced scope of practice, and they have many overlapping duties with physicians.

While NP practice authority also differs by state, here are some general examples of what NPs can generally do that RNs cannot:

• Diagnose health conditions
• Prescribe medications
• Initiate treatment plans
• Refer patients to other providers
• Order and interpret diagnostic tests

What happens if RNs step outside of their scope of practice?

RNs who step outside of the scope of practice can face a range of penalties. Depending on the severity of each violation, an RN might lose their license, undergo remedial education, or even be held liable for malpractice or negligence. Each state’s board of nursing has its own set of disciplinary procedures, and other penalties may be applied as deemed necessary.

Where can I find more resources on scope of practice guidelines?

In order to prevent practice violations and keep patients safe, it’s important for both staff and leaders to stay up-to-date on the most current nursing rules and regulations. Below are some fundamental resources that can help you and your staff make informed practice decisions:

• State-by-state NPA repository
• Scope of practice decision-making framework
• Guidance on when to refuse a nursing assignment
• National guidelines for nursing delegation

Stay Up-To-Date on the RN Scope of Practice and More

Keeping up with healthcare regulations can seem overwhelming, especially when you’re busy running a facility. Need more practical ways to stay informed? Get expert-written tips and insights on practice guidelines, nurse management, and more, delivered straight to your inbox.

Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.