Scope Creep

Abstract

The finite boundaries of the scope of nursing practice are constantly changing. One could expect that with new technology and advances in science, the interventions and assessments nurses perform will change over time. The practice of nursing is governed by nursing, however, it is often challenged by our partners in medicine, and frequently driven by time constraints or reimbursement issues. This article reviews a case example in which nurses were asked to expand their practice to assume responsibility for duties that were once traditionally performed by physicians. An evaluation of a practice problem using an evidence-based approach applying the PICO (population, intervention, comparison, outcome) method is explored. Proposed steps to minimize risk and staff moral distress are also described.

Pediatric Sedation: Using Secondary Data to Describe Registered Nurse Practice in Radiology

“…Few boards of nursing and professional standards address deep sedation by RNs or have incorporated standards from organizations such as the ASA that restrict RNs from administering propofol and other anesthetic medications into their position statements. However, this study found that 13.69% of RNs in the sample provided deep sedation (see Table 5), demonstrating that RNs are already providing care that conflicts with recommendations by the ASA and exceeds the scope of practice set by some state boards of nursing (Davidson, Bloomberg, & Burnell, 2007). …”