Directions (I choose no and my state is Florida)

Knowing and understanding your state’s nurse practice act is key to your future role and practice. Each state’s practice act and regulations are different. Also, knowing the national board’s scope and standards of practice for your specialty is key to your future role. This assignment’s goal is to help you be aware of these regulations.

From this week’s Scope of Practice, discuss how your assigned scenario (see below) might apply differently to the state where you will practice. How would your state’s scope affect your ability to practice if you were in that scenario? Be sure to use the scope of practice from the state where you plan to be employed when responding.

If your last name begins in A through E, use the first scenario (Lydia):

Is This Within Scope of Practice?

Deciding if a Situation is Within Your Scope of Practice

When determining if a situation is within your scope of practice, keep the following things in mind:

Knowledge: Did I complete an educational program that prepared me to see this population? Have I completed supervised clinical practicum experience in this population?

Role: Am I licensed to practice in this role? Is this a specialty role that requires additional certification?

Competence & Skill: What are the skills and competence required to treat this client? Have I achieved and maintained clinical competence necessary for this situation?

Ethics: Am I prepared to accept and manage the consequences of diagnosis and treatment of this client? Is the safety of the patient at risk without my treatment?

Instructions

Read the following scenarios. Then, select whether or not you believe that the situation is within the nurse practitioner’s scope of practice. Compare your answer with the actual answer.

Scenario 1

Lydia, Adult Nurse Practitioner

Lydia is an adult nurse practitioner practicing in Michigan. She works with a physician in his private practice. After watching the MD do pelvic exams for about 6 months, he suggests that Lydia perform a pelvic exam. She was able to competently perform the exam and therefore took over performing all routine annual well woman exams for the practice. Is this within Lydia’s scope of practice?

Thoughts to Consider

• Does the ANP have the necessary knowledge to perform the well woman exam?
• Is the ANP licensed to perform in this role or is it defined as a specialty role?
• Has the ANP received adequate supervised clinical to show competence in pelvic exams?
• Are there any risks to the patient?

Is this within Lydia’s scope of practice? (Select one.)

Yes

Depends on her state of practice

No(I choose no)

Voiceover: Adult nurse practitioners are educated to provide care to adults across the spectrum, from adolescence through geriatrics. The exact age parameters may vary according to your practice state; however, it does include women of childbearing age that would be receiving pelvic exams. In reality, most programs tend to focus very little on well women exams and the practical skill of well woman and pelvic exams needs to be learned and practiced in clinical practicum. Clinical practicum experiences can vary widely based on the clinic and preceptor; therefore, each individual’s experience is different. In this case, the nurse practitioner did not have the necessary clinical experience in her educational preparation.

The adult nurse practitioner would need to review her state scope of practice to determine if she was licensed to perform pelvic exams for well woman checkups. The majority of states do incorporate this into the scope for advanced practice nurses.

In this case, it isn’t clear if the nurse practitioner received more than just the one supervised exam. This would not be evidence of clinical competence. The nurse practitioner would need to obtain more in-depth training prior to completing the skill independently.

The risk to the patient depends on the clinical competence of the provider performing the exam. However, there is not inherent risk in the client being treated by the nurse practitioner versus the physician. In this exact situation, the NP would need additional practice/supervision prior to independently performing the skill.