Ask Shaye
Scope of practice
Question: I am an Enrolled Nurse and I am constantly being told I must work within my scope of practice. Can you explain how this is determined and who is responsible for doing this?
Answer: Scope of practice is best defined as the boundaries that a nurse must work within. there are different aspects to determining a nurse’s scope of practice. The main requirement is that you should only be nursing to your level of training, knowledge and experience, and you should be assessed for competency in the procedure.
The Nursing and Midwifery Board of Australia has produced a very good flow chart to assist nurse managers and registered nurses in determining whether a certain procedure fits within your scope of practice. I would refer you to the AHPRA/ Nursing and Midwifery Board of Australia website, the document is titled “Nursing practice decision flowchart”.
Your employer must also reflect scope of practice for all nursing and care staff within their policy directives; it is not appropriate for nurses to be asked to carry out procedures where the policy is unclear or does not allow for them to carry out the procedure. It is the employer’s responsibility to clearly define a nurse’s scope of practice based on all aspects of the work they are required to undertake, it reflects best practice and ensures safe care for those nurses care for as well as a safe working environment for the nurse. Management are responsible to ensure that nurses are assessed for competence in the care they provide, individual nurses are responsible for ensuring they keep up to date with best practice principles, and to build on their level of knowledge and experience on a continuing basis.
Scope of practice is not static; it can change based on further training and experience. It is important to understand that working outside of your scope of practice has the potential to jeopardise your registration, which is why you should always work within it.