851-045-0030
Purpose of Standards and Scope of Practice

(1) To establish acceptable levels of safe practice for the Licensed Practical Nurse (LPN) and Registered Nurse (RN);

(2) To serve as a guide for the Board to evaluate safe and effective nursing care;

(3) To serve as a guide for the Board to determine when nursing practice is below the expected standard of care; and

(4) To provide a framework for evaluation of continued competency in nursing practice.

Statutory/Other Authority: ORS 678.150
Statutes/Other Implemented: ORS 678.150 & 678.010
History:
BN 8-2017, f. 7-7-17, cert. ef. 8-1-17
BN 5-2012, f. 5-7-12, cert. ef. 6-1-12
BN 4-2008, f. & cert. ef. 6-24-08

851-045-0040
Scope of Practice Standards for All Licensed Nurses

(1) Standards related to the licensee’s responsibility for safe nursing practice. The licensee shall:

(a) Practice within the laws and rules governing the practice of nursing at the level the nurse is licensed;

(b) Ensure competency in the cognitive and technical aspects of a nursing intervention or a nursing procedure prior to its performance; and

(c) Self-regulate one’s professional practice by:

(A) Adhering to professional practice and performance standards;

(B) Practicing within the context of care; and

(C) Removing one’s self from practice when unable to practice with professional skill and safety.

(d) Establish, communicate, and maintain professional boundaries.

(2) Standards related to the licensee’s responsibility for licensure and practice role disclosure. The licensee shall disclose licensure type and practice role to the client unless the disclosure creates a safety or health risk for either the licensee or the client.

(3) Standards related to the licensee’s responsibility regarding technology. The licensee shall:

(a) Acquire and maintain the competency necessary to properly use the informatics and technologies of the practice setting; and

(b) Advocate for the use of informatics and technologies that are compatible with the safety, dignity, and rights of the client.

(4) Standards related to the licensee’s responsibility for documentation of nursing practice. The licensee shall document nursing practice in a timely, accurate, thorough, and clear manner.

(5) Standards related to the licensee’s responsibility to accept and implement orders for client care and treatment.

(a) The licensee may accept and implement orders from a licensed independent practitioner (LIP) authorized by Oregon statute to independently diagnose and treat:

(A) Clinical nurse specialist licensed under ORS Chapter 678;

(B) Certified registered nurse anesthetist licensed under ORS Chapter 678;

(C) Nurse practitioner licensed under ORS Chapter 678;

(D) Medical doctor (MD) licensed under ORS Chapter 677;

(E) Doctor of osteopathic medicine (DO) licensed under ORS Chapter 677;

(F) Doctor of podiatric medicine licensed under ORS Chapter 677;

(G) Dentist licensed under chapter ORS 679;

(H) Naturopathic physician licensed under ORS Chapter 685;

(I) Optometrist licensed under ORS Chapter 683;

(J) Chiropractor physician licensed under ORS Chapter 684;

(K) MD volunteer emeritus license licensed under ORS Chapter 677; and

(L) DO volunteer emeritus license licensed under ORS Chapter 677.

(b) May accept and implement orders for client care and treatment from a Physician Assistant (PA) licensed under ORS Chapter 677, provided that the name of the supervising or agent physician is recorded with the order, in the narrative notes, or by a method specified by the health care facility. At all times the supervising or agent physician must be available to the licensed nurse for direct communication.

(c) Prior to implementation of an order, the licensee:

(A) Must have knowledge that the order is within the LIP’s or PA’s scope of practice and determine that the order is consistent with the overall plan for the client's care; and

(B) Shall question any order that is not clear, determined to be unsafe, contraindicated for the client, or is inconsistent with the overall plan for the client’s care.

(d) The licensee may accept and implement recommendations for care from the following health care professionals licensed in Oregon:

(A) Acupuncturist licensed under ORS Chapter 677;

(B) Dietitian licensed under ORS Chapter 691;

(C) Occupational therapist licensed under ORS Chapter 675;

(D) Physical therapist licensed under ORS Chapter 688;

(E) Pharmacist licensed under ORS Chapter 689;

(F) Psychologist licensed under ORS Chapter 675;

(G) Registered nurse licensed under ORS Chapter 678;

(H) Respiratory therapist licensed under ORS Chapter 688;

(I) Social worker licensed under ORS Chapter 675; and

(J) Speech therapist licensed under ORS Chapter 681.

(e) Prior to implementation of a recommendation, the licensee must have knowledge that the recommendation is within the health care professional’s scope of practice and determine that the recommendation is consistent with the overall plan for the client’s care.

(f) When the licensee has determined that an order or a recommendation is not clear, unsafe, contraindicated for the client, or inconsistent with the overall plan for the client’s care, the licensee has the responsibility to decline implementation and contact the health care professional making the order or recommendation.

Statutory/Other Authority: ORS 678.150
Statutes/Other Implemented: ORS 678.150 & 678.010
History:
BN 8-2017, f. 7-7-17, cert. ef. 8-1-17
BN 4-2008, f. & cert. ef. 6-24-08

851-045-0050
Scope of Practice Standards for Licensed Practical Nurses

(1) The Board recognizes that the LPN has a supervised practice that occurs at the clinical direction and under the clinical supervision of the RN or LIP who have authority to make changes in the plan of care, and encompasses a variety of roles, including, but not limited to:

(a) Provision of client care;

(b) Supervision of others in the provision of care;

(c) Participation in the development and implementation of health care policy;

(d) Participation in nursing research; and

(e) Teaching health care providers and prospective health care providers.

(2) Standards related to the LPN’s responsibility for ethical practice, accountability for services provided, and competency. The LPN shall:

(a) Base LPN practice on current nursing science, other sciences, and the humanities;

(b) Be knowledgeable of the statutes and regulations governing LPN practice and practice within those legal boundaries;

(c) Be knowledgeable of the professional nursing practice standards applicable to LPN practice and adhere to those standards;

(d) Demonstrate honesty, integrity and professionalism in the practice of licensed practical nursing;

(e) Be accountable for individual LPN actions;

(f) Maintain competency in one’s LPN practice role;

(g) Maintain documentation of the method that competency was acquired and maintained;

(h) Accept only LPN assignments that are within one’s individual scope of practice;

(i) Recognize and respect a client’s autonomy, dignity and choice;

(j) Accept responsibility for notifying employer of an ethical objection to the provision of a specific nursing intervention;

(k) Ensure unsafe nursing practice is addressed immediately;

(l) Ensure unsafe practice and unsafe practice conditions are reported to the appropriate regulatory agency; and

(m) Protect confidential client information and only share information in a manner that is consistent with current law.

(3) Standards related to the LPN’s responsibility for nursing practice. Applying practical nursing knowledge, at the clinical direction and under the clinical supervision of the RN or LIP, the LPN shall:

(a) Conduct focused assessments by:

(A) Collecting data through observations, examinations, interviews, and records in an accurate and timely manner as appropriate to the client's health care needs and context of care;

(B) Validating data by utilizing available resources, including interactions with the client and health care team members;

(C) Distinguishing abnormal from normal data, sorting, selecting, recording, and reporting the data discrepancies to the supervising RN or supervising LIP;

(D) Identifying potentially inaccurate, incomplete or missing data and reporting as needed;

(E) Recognizing signs and symptoms of deviation from current health status; and

(F) Evaluating data to identify problems or risks presented by the client.

(b) Select reasoned conclusions that communicate client problems or risks;

(c) Contribute to the development of a comprehensive plan of care or develop a focused plan of care. This includes:

(A) Identifying priorities in the plan of care;

(B) Setting measurable outcomes in collaboration with the client; and

(C) Selecting appropriate nursing interventions as established by the RN or consistent with the LIP’s plan of care.

(d) Implement the plan of care; and

(e) Evaluate client responses to nursing interventions, progress toward measurable outcomes, and communicate such to appropriate members of the health care team.

(4) Standards related to the LPN’s responsibility to assign and supervise care. At the clinical direction and under the clinical supervision of the RN or LIP, the LPN:

(a) May assign to an LPN, nursing interventions that fall within LPN scope of practice and that the licensee receiving the assignment possesses the competency to perform safely;

(b) May assign to the CNA and CMA the duties identified within Chapter 851 Division 63 that the certificate holder possesses the competency to perform safely;

(c) May assign to the UAP work the UAP is authorized to perform within the practice setting and that the UAP possesses the competency to perform safely;

(d) Shall ensure the assignment matches client service need;

(e) Shall provide clinical supervision of the LPN, CNA, CMA, and UAP to whom an assignment possesses been made:

(A) Provides supervision per the context of care;

(B) Ensures documentation of supervision activities occurs per the context of the assignment;

(C) Evaluates the effectiveness of the assignment; and

(D) Reports effectiveness of assignment to the supervising RN or supervising LIP.

(f) Shall revise the assignment as directed by the supervising RN or supervising LIP; and

(g) Prior to making an assignment, the LPN is responsible to know the duties, activities or procedures the recipient of the assignment is authorized to perform within the setting.

(5) Standards related to the LPN’s responsibility for client advocacy. The LPN shall:

(a) Advocate for the client’s right to receive appropriate care, including client-centered care and end-of-life care, that is respectful of the client’s needs, choices and dignity;

(b) Intervene on behalf of the client to identify changes in health status, to protect, promote and optimize health, and to alleviate suffering;

(c) Advocate for the client’s right to receive appropriate and accurate information;

(d) Communicate client’s choices, concerns and special needs to the supervising RN or supervising LIP and to other members of the health care team; and

(e) Protect the client’s right to participate or decline to participate in research.

(6) Standards related to the LPN’s responsibility for collaboration with the health care team. The LPN shall:

(a) Function as a member of the health care team;

(b) Collaborate in the development, implementation and evaluation of an integrated plan of care appropriate to the context of care;

(c) Demonstrate a knowledge of health care team members’ roles;

(d) Communicate with the supervising RN or supervising LIP and other relevant health care team members regarding the plan of care; and

(e) Make referrals as directed in a timely manner and follow up on referrals made.

(7) Standards related to the LPN’s responsibility for the environment of care. The LPN shall:

(a) Promote and advocate for an environment conducive to safety; and

(b) Identify safety and environmental concerns, take action to address those concerns, and report to the supervising RN or supervising LIP.

(8) Standards related to the LPN’s responsibility for leadership and quality of care. The LPN shall:

(a) Identify factors that affect the quality of nursing service delivery and report to the supervising RN or LIP;

(b) Implement policies, protocols, and guidelines that are pertinent to nursing service delivery;

(c) Contribute to development and implementation of policies, protocols, and guidelines that are pertinent to the practice of nursing and to health services delivery;

(d) Participate in quality improvement initiatives and activities within the practice setting; and

(e) Participate in the development and mentoring of new licensees, nursing colleagues, students, and members of the health care team.

(9) Standards related to the LPN’s responsibility for health promotion and teaching. At the clinical direction and under the clinical supervision of the RN or LIP, the LPN may participate in the development, implementation and evaluation of teaching plans appropriate to the context of care, that address the learner’s learning needs, readiness to learn, and ability to learn.

(10) Standards related to the LPN’s responsibility for cultural responsiveness. The LPN shall:

(a) Apply a basic knowledge of cultural diversity; and

(b) Recognize and respect the cultural values, beliefs, and customs of the client.

Statutory/Other Authority: ORS 678.150
Statutes/Other Implemented: ORS 678.150 & 678.010
History:
BN 8-2017, f. 7-7-17, cert. ef. 8-1-17
BN 4-2008, f. & cert. ef. 6-24-08

851-045-0060
Scope of Practice Standards for Registered Nurses

(1) The Board recognizes that the scope of practice for the RN encompasses a variety of roles, including, but not limited to:

(a) Provision of client care;

(b) Clinical direction and clinical supervision of others in the provision of care;

(c) Development and implementation of health care policy;

(d) Consultation in the practice of nursing;

(e) Nursing administration;

(f) Nursing education;

(g) Case management;

(h) Nursing research;

(i) Teaching health care providers and prospective health care providers;

(j) Nursing Informatics; and

(k) Specialization as an NP, CRNA, or CNS.

(2) Standards related to the RN’s responsibility for ethical practice, accountability for services provided, and competency. The RN shall:

(a) Base RN practice on current and evolving nursing science, other sciences, and the humanities;

(b) Be knowledgeable of the professional nursing practice and performance standards and adhere to those standards;

(c) Be knowledgeable of the Oregon statutes and regulations governing RN practice and practice within those legal boundaries;

(d) Demonstrate honesty, integrity and professionalism in the practice of registered nursing;

(e) Be accountable for individual RN actions;

(f) Maintain competency in one’s RN practice role;

(g) Maintain documentation of the method that competency was acquired and maintained;

(h) Accept only RN assignments that are within one’s individual scope of practice;

(i) Recognize and respect a client’s autonomy, dignity and choice;

(j) Accept responsibility for notifying employer of an ethical objection to the provision of a specific nursing intervention;

(k) Ensure unsafe nursing practices are addressed immediately;

(l) Ensure unsafe practice and practice conditions are reported to the appropriate regulatory agency; and

(m) Protect confidential client information and only share information in a manner that is consistent with current law.

(3) Standards related to the RN’s responsibility for nursing practice. Through the application of scientific evidence, practice experience, and nursing judgment, the RN shall:

(a) Conduct comprehensive assessments by:

(A) Collecting data from observations, examinations, interviews, and records in an accurate and timely manner as appropriate to the client's needs and context of care;

(B) Validating data by utilizing available resources, including interactions with the client, with health care team members, and by accessing scientific literature;

(C) Distinguishing abnormal from normal data, sorting, selecting, recording, evaluating, synthesizing and communicating the data;

(D) Identifying potentially inaccurate, incomplete or missing data and reporting data discrepancies as appropriate for the context of care;

(E) Identifying signs and symptoms of deviation from current health status;

(F) Anticipating changes in client status; and

(G) Evaluating the data to identify problems or risks presented by the client.

(b) Develop reasoned conclusions that identify client problems or risks;

(c) Develop a client-centered plan of care based on analysis of the client’s problems or risks that:

(A) Establishes priorities in the plan of care;

(B) Identifies measurable outcomes; and

(C) Includes nursing interventions to address prioritized diagnostic statements or reasoned conclusions.

(d) Implement the plan of care;

(e) Evaluate client responses to nursing interventions and progress toward identified outcomes; and

(f) Update and modify the plan of care based on ongoing client assessment and evaluation of data.

(4) Standards related to the RN’s responsibility to assign and supervise care.

(a) The RN may assign to the RN, nursing interventions that fall within RN scope of practice and that the licensee receiving the assignment possesses the competency to perform safely.

(b) The RN may assign to the LPN nursing interventions that fall within LPN scope of practice and that the licensee receiving the assignment possesses the competency to perform safely.

(c) The RN may assign to the CNA and CMA authorized duties identified within Chapter 851 Division 63 that the certificate holder possesses the competency to perform safely.

(d) The RN may assign to the UAP work the UAP is authorized to perform within the setting and that the UAP possesses the competency to perform safely.

(e) The RN shall ensure the assignment matches the client’s service needs with qualified personnel and available resources.

(f) The RN shall provide clinical supervision of the RN, LPN, CNA, CMA, and UAP to whom an assignment has been made:

(A) Provide clinical supervision per the context of care;

(B) Ensure documentation of supervision activities per the context of the assignment; and

(C) Evaluate the effectiveness of the assignment.

(g) The RN shall revise the assignment as indicated by client outcome data, availability of qualified personnel and available resources.

(h) Prior to making an assignment, the RN is responsible to know the duties, activities or procedures the recipient of the assignment is authorized to perform within the setting.

(5) Standards related to the RN’s responsibility for client advocacy. The RN shall:

(a) Advocate for the client’s right to receive appropriate care, including client-centered care and end-of-life care, that is respectful of the client’s needs, choices and dignity;

(b) Intervene on behalf of the client to identify changes in health status, to protect, promote and optimize health, and to alleviate suffering;

(c) Advocate for the client’s right to receive appropriate and accurate information;

(d) Communicate client’s choices, concerns and special needs to other members of the health care team; and

(e) Protect the client’s right to participate or decline to participate in research.

(6) Standards related to the RN’s responsibility for collaboration with the health care team. The RN shall:

(a) Function as a member of the health care team;

(b) Collaborate in the development, implementation and evaluation of integrated plans of care as appropriate to the context of care;

(c) Demonstrate a knowledge of health care team members’ roles;

(d) Communicate with health care team members regarding the plan of care; and

(e) Make referrals in a timely manner and ensure follow-up on referrals.

(7) Standards related to the RN’s responsibility for the environment of care. The RN shall:

(a) Promote and advocate for an environment conducive to safety; and

(b) Identify safety and environmental concerns, take action to address those concerns and report as needed.

(8) Standards related to the RN’s responsibility for leadership and quality of care. The RN shall:

(a) Identify factors that affect quality of nursing service, health services delivery, and client care, and develop quality improvement standards and processes;

(b) Interpret and evaluate policies, protocols, and guidelines that are pertinent to nursing practice and to health services delivery;

(c) Develop and implement policies, protocols, and guidelines that are pertinent to the practice of nursing and to health services delivery;

(d) Participate in quality improvement initiatives and activities within the practice setting; and

(e) Participate in the development and mentoring of new licensees, nursing colleagues, students and members of the health care team.

(9) Standards related to the RN’s responsibility for health promotion and teaching. The RN shall develop, implement and evaluate evidence-based teaching plans that address the client’s learning needs, readiness to learn and ability to learn. This includes:

(a) Client health promotion and health education;

(b) Teaching a UAP how to administer injectable emergency medications as provided in ORS 433.800 to 433.830;

(c) Teaching a UAP how to administer naloxone as authorized by ORS 689.681;

(d) Teaching school personnel how to administer premeasured doses of epinephrine as provided in ORS 339.869; and

(e) Teaching a UAP how to administer noninjectable medications to a client in a community-based setting. 

(10) Standards related to the RN’s responsibility for cultural responsiveness. The RN shall:

(a) Apply a broad knowledge and awareness of cultural diversity; and

(b) Recognize and respect the cultural values, beliefs, and customs of the client.

(11) Standards related to the RN in the role of registered nurse first assistant (RNFA) in surgery.

(a) The RN who accepts an assignment to practice in the role of RNFA shall have successfully completed an RNFA program that meets the Association of Perioperative Nurses standards for the RN first assistant programs;

(b) Intraoperatively, the RNFA shall practice at the direction of the surgeon and not concurrently function in any non-RNFA practice role; and

(c) The RNFA shall practice under the direct supervision of the surgeon who is on site in the unit of care and not otherwise engaged in any other uninterruptible procedure or activity.

(12) Pursuant to 678.038, an RN who is employed by a public or private school, or by an education service district or a local public health authority as defined in ORS 431.003 to provide nursing services at a public or private school, may accept an order from a physician licensed to practice medicine in another state or territory of the United States if the order is related to the care or treatment of a student who has been enrolled at the school for not more than 90 days.  

Statutory/Other Authority: ORS 678.150
Statutes/Other Implemented: ORS 678.150 & 678.010
History:
BN 10-2022, amend filed 07/26/2022, effective 08/01/2022
BN 8-2017, f. 7-7-17, cert. ef. 8-1-17
BN 4-2008, f. & cert. ef. 6-24-08

851-045-0070
Conduct Derogatory to the Standards of Nursing Defined

Conduct that adversely affects the health, safety, and welfare of the public, fails to conform to legal nursing standards, or fails to conform to accepted standards of the nursing profession, is conduct derogatory to the standards of nursing. Such conduct includes, but is not limited to:

(1) Conduct related to general fitness to practice nursing:

(a) Demonstrated incidents of violent, abusive, intimidating, neglectful or reckless behavior; or

(b) Demonstrated incidents of dishonesty, misrepresentation, or fraud.

(2) Conduct related to achieving and maintaining clinical competency:

(a) Failing to conform to the essential standards of acceptable and prevailing nursing practice. Actual injury need not be established;

(b) Performing acts beyond the authorized scope or beyond the level of nursing for which the individual is licensed; or

(c) Accepting an assignment when individual competency necessary to safely perform the assignment have not been established or maintained.

(3) Conduct related to the client’s safety and integrity:

(a) Developing, modifying, or implementing policies that jeopardize client safety;

(b) Failing to take action to preserve or promote the client’s safety based on nursing assessment and judgment;

(c) Failing to develop, implement or modify the plan of care;

(d) Assigning persons to perform functions for which they are not prepared to perform or that are beyond their scope of practice, authorized duties, or job functions;

(e) Failing to clinically supervise persons to whom an assignment has been made;

(f) Assuming duties and responsibilities within the practice of nursing when competency has not been established or maintained;

(g) Improperly delegating the performance of a nursing procedure to a UAP;

(h) Failing to clinically supervise a UAP to whom a nursing procedure has been delegated.

(i) Leaving or failing to complete any nursing assignment, including a supervisory assignment, without notifying the appropriate personnel and confirming that nursing assignment responsibilities will be met;

(j) Failing to report through proper channels, facts known regarding the incompetent, unethical, unsafe or illegal practice of any health care provider pursuant to ORS chapter 676;

(k) Failing to respect the dignity and rights of clients, inclusive of social or economic status, age, race, religion, gender, gender identity, sexual orientation, national origin, nature of health needs, physical attributes, or disability;

(l) Failing to report actual or suspected incidents of abuse, neglect or mistreatment;

(m) Engaging in or attempting to engage in sexual contact with a client in any setting;

(n) Engaging in sexual misconduct with a client in the workplace;

(o) Failing to establish or maintain professional boundaries with a client; or

(p) Using social media to communicate, post, or otherwise distribute protected client data including client image and client identifiers.

(4) Conduct related to communication:

(a) Failure to accurately document nursing interventions and nursing practice implementation;

(b) Failure to document nursing interventions and nursing practice implementation in a timely, accurate, thorough, and clear manner. This includes failing to document a late entry within a reasonable time period;

(c) Entering inaccurate, incomplete, falsified or altered documentation into a health record or agency records. This includes but is not limited to:

(A) Documenting nursing practice implementation that did not occur;

(B) Documenting the provision of services that were not provided;

(C) Failing to document information pertinent to a client’s care;

(D) Documenting someone else’s charting omissions or signing someone else’s name;

(E) Falsifying data;

(F) Altering or changing words or characters within an existing document to mislead the reader; or

(G) Entering late entry documentation into the record that does not demonstrate the date and time of the initial event documented, the date and time the late entry is being placed into the record, and the signature of the licensee entering the late entry to the record.

(d) Destroying a client or agency record to conceal a record of care;

(e) Directing another individual to falsify, alter or destroy an agency record, a client’s health record, or any document to conceal a record of care;

(f) Failing to communicate information regarding the client’s status to members of the health care team in an ongoing and timely manner as appropriate to the context of care; or

(g) Failing to communicate information regarding the client’s status to other individuals who are authorized to receive information and have a need to know.

(5) Conduct related to the client’s family:

(a) Failing to be respectful to the client’s family and the client’s relationship with their family.

(b) Using one’s title or position as a nurse to exploit the client’s family for personal gain or for any other reason;

(c) Stealing money, property, services or supplies from the client’s family;

(d) Soliciting or borrowing money, materials or property from the client’s family; or

(e) Engaging in unacceptable behavior towards, or in the presence of, the client’s family. Such behavior includes, but is not limited to, using derogatory names, derogatory or threatening gestures, or profane language.

(6) Conduct related to co-workers and health care team members:

(a) Engaging in violent, abusive or threatening behavior towards a co-worker; or

(b) Engaging in violent, abusive, or threatening behavior that relates to the delivery of safe nursing services.

(7) Conduct related to impaired function:

(a) Practicing nursing when unable or unfit due to:

(A) Physical impairment as evidenced by documented deterioration of functioning in the practice setting or by the assessment of an LIP qualified to diagnose physical condition or status; or

(B) Psychological or mental impairment as evidenced by documented deterioration of functioning in the practice setting or by the assessment of an LIP qualified to diagnose mental conditions or status.

(b) Practicing nursing when physical or mental ability to practice is impaired by use of a prescription or non-prescription medication, alcohol, or a mind-altering substance; or

(c) The use of a prescription or non-prescription medication, alcohol, or a mind-altering substance, to an extent or in a manner dangerous or injurious to the licensee or others or to an extent that such use impairs the ability to conduct safely the practice of nursing.

(8) Conduct related to other federal or state statute or rule violations:

(a) Aiding, abetting, or assisting an individual to violate or circumvent any law, rule or regulation intended to guide the conduct of nurses or other health care providers;

(b) Violating the rights of privacy, confidentiality of information, or knowledge concerning the client, unless required by law to disclose such information;

(c) Discriminating against a client on the basis of age, race, religion, gender, gender identity, sexual preference, national origin or disability;

(d) Abusing a client;

(e) Neglecting a client;

(f) Failing to report actual or suspected incidents of client abuse to the appropriate state agencies;

(g) Failing to report actual or suspected incidents of client abuse or neglect through the proper channels in the workplace;

(h) Engaging in other unacceptable behavior towards or in the presence of a client. Such conduct includes but is not limited to using derogatory names, derogatory gestures or profane language;

(i) Soliciting or borrowing money, materials, or property from the client;

(j) Stealing money, property, services or supplies from the client;

(k) Possessing, obtaining, attempting to obtain, furnishing, or administering prescription or controlled medications to any person, including self, except as directed by a person authorized by law to prescribe medications;

(l) Unauthorized removal or attempted removal of medications, supplies, property, or money from anyone in the work place;

(m) Unauthorized removal of client records, client information, facility property, policies or written standards from the work place;

(n) Using one’s role as a nurse to defraud a person of their personal property or possessions;

(o) Violating a person’s rights of privacy and confidentiality of information by accessing information without proper authorization or without a demonstrated need to know;

(p) Engaging in unsecured transmission of protected client data;

(q) Failing to dispense or administer medications in a manner consistent with state and federal law;

(r) Failure to release a client’s health record within 60 days from receipt of written notice for release of records. This includes requests for records after closure of practice;

(s) Improper billing practices including the submission of false claims;

(t) Failing to properly maintain records after closure of practice or practice setting;

(u) Failure to notify client of closure of practice and of the location of their health records;

(v) Failure to report to the Board the licensee’s arrest for a felony crime within 10 days of the arrest; or

(w) Failure to report to the Board the licensee’s conviction of a misdemeanor or a felony crime within 10 days of the conviction.

(9) Conduct related to licensure or certification violations:

(a) Resorting to fraud, misrepresentation or deceit during the application process for licensure or certification, while taking the examination for licensure or certification, obtaining initial licensure or certification, or renewal of licensure or certification;

(b) Practicing nursing without a current Oregon license or certificate;

(c) Practicing as an NP or CNS without a current Oregon certificate;

(d) Practicing as a CRNA without a current Oregon CRNA license;

(e) Allowing another person to use one’s nursing license or certificate for any purpose;

(f) Using another person’s nursing license or certificate for any purpose;

(g) Impersonating an applicant or acting as a proxy for the applicant in any nurse licensure or certification examination; or

(h) Disclosing the contents of a nurse licensure or certification examination or soliciting, accepting or compiling information regarding the contents of the examination before, during or after its administration.

(10) Conduct related to the licensee’s relationship with the Board:

(a) Failing to fully cooperate with the Board during the course of an investigation, including but not limited to, waiver of confidentiality privileges, except client-attorney privilege;

(b) Failing to answer truthfully and completely any question asked by the Board on an application for licensure or during the course of an investigation or any other question asked by the Board;

(c) Failing to provide the Board with any documents requested by the Board;

(d) Violating the terms and conditions of a Board order; or

(e) Failing to comply with the terms and conditions of Health Professionals’ Services Program agreements.

(11) Conduct related to advanced practice nursing:

(a) Ordering laboratory or other diagnostic tests or treatments or therapies for one’s self;

(b) Prescribing for or dispensing medications to one’s self;

(c) Using self-assessment and diagnosis as the basis for the provision of care which would otherwise be provided by a client’s professional caregiver; or

(d) Ordering unnecessary laboratory or other diagnostic test or treatments for the purpose of personal gain.

Statutory/Other Authority: ORS 678.150
Statutes/Other Implemented: ORS 678.150, 678.111 & 678.390
History:
BN 8-2017, f. 7-7-17, cert. ef. 8-1-17
BN 5-2012, f. 5-7-12, cert. ef. 6-1-12
BN 12-2010, f. & cert. ef. 9-30-10
BN 2-2010(Temp), f. & cert. ef. 4-19-10 thru 10-15-10
BN 4-2008, f. & cert. ef. 6-24-08

851-045-0090
Duty to Report

These standards provide further interpretation of reporting requirements pursuant to ORS 678.135 with application to all licensees, including one’s own practice, when behavior or practice presents a potential for, or actual danger to, a client or to the public’s health, safety and welfare.

(1) A licensee knowing of a licensed nurse whose nursing practice fails to meet accepted standards for the level at which the nurse is licensed, shall report the nurse to the person in the work setting who has authority to institute corrective action.

(2) A licensee who has knowledge or concern that a nurse's behavior or practice presents a potential for, or actual danger to, a client or to the public’s health, safety and welfare, shall initiate a report to be made to the Board.

(3) A licensee who is aware of a licensed nurse’s arrest or conviction of a crime related to a client, or related to the public’s health, safety, and welfare shall initiate a report to the Board.

(4) Any organization representing licensed nurses shall report a suspected violation of ORS chapter 678, or the rules adopted within, in the manner prescribed by sections (5) and (6) of this rule.

(5) The decision to report a suspected violation of ORS Chapter 678, or the rules adopted within, shall be based on, but not limited to, the following:

(a) The past history of the licensee's performance;

(b) A demonstrated pattern of substandard practice, errors in practice or conduct derogatory to the standards of nursing, despite efforts to assist the licensee to improve practice or conduct through a plan of correction; and

(c) The magnitude of any single occurrence for actual or potential harm to the public’s health, safety and welfare.

(6) The following shall always be reported to the Board:

(a) Practicing nursing when the license has become void due to nonpayment of fees;

(b) Practicing nursing as defined in ORS 678.010 unless licensed as an RN, LPN, or CRNA, or certified as a CNS or NP;

(c) Dismissal from employment due to unsafe practice or conduct derogatory to the standards of nursing;

(d) Client abuse or neglect;

(e) A pattern of conduct derogatory to the standards of nursing as defined by the rules of the Board or a single serious occurrence;

(f) Any violation of a disciplinary sanction imposed on the licensee by the Board;

(g) Failure of a nurse not licensed in Oregon and hired to meet a temporary staffing shortage to apply for Oregon licensure by the day the nurse is placed on staff;

(h) Practicing nursing when physical or mental ability to practice is impaired;

(i) An arrest for a felony crime which shall be reported to the Board within 10 days of the arrest; or

(j) A conviction for a misdemeanor or felony crime which shall be reported to the Board within 10 days of the conviction.

(7) Failure of a licensee to comply with these reporting standards may in itself constitute a violation of nursing standards.

Statutory/Other Authority: ORS 678.150
Statutes/Other Implemented: ORS 678.150
History:
BN 8-2017, f. 7-7-17, cert. ef. 8-1-17
BN 4-2008, f. & cert. ef. 6-24-08