Board of Nursing
Chapter 851
Division 45
STANDARDS AND SCOPE OF PRACTICE FOR THE LICENSED PRACTICAL NURSE AND REGISTERED NURSE
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