What Is The Nurse Practice Act?

Nursing is a protected profession defined by the nurse practice act (NPA). The guidelines and rules in this act define the scope of practice, while the right to practice the profession is granted by each state only to those nurses who satisfy all requirements in this document (also see code of ethics for nurses).  

If you want to become a nurse, the first thing to understand is that the NPA is a dynamic and continuously evolving document. Guidelines might change as the scope of practice expands.

That’s why all registered nurses have the duty to understand the nurse practice act in their state and stay up to date with its changes.  

What Is The Evolution of The Nurse Practice Act?

Nursing is one of the oldest professions. Apparently, it dates back to 300 AD, but nurse practice acts didn’t exist back then.

Indeed, prior to the Industrial Revolution, there was no need for a profession to be regulated by a professional body. Back then, everyone knew everyone, and people turned to other people’s services based on their reputation.

As knowledge and technology advanced, though, more and more people started to call themselves nurses. Thus, it became impossible to assess one’s reputation and service quality anymore.

Because the U.S. Constitution doesn’t include provisions to regulate this practice, it fell into the responsibility of the various states to come up with their own policies to legitimize the profession in the eyes of the public.

The first law calling for nurses registration was enacted in 1903 in North Carolina. It did exactly what it does now. It protects the title of nurse and is aimed to improve the practice of nursing.

Under the new regulations, the state began to develop nursing exams and issue licenses.

From North Carolina, the practice expanded to all other states by 1970, and today, all states require nurses to pass a licensure examination before being able to call themselves registered nurses.

Besides the registered nurse registration, advanced practice registered nurses (APRN) must pass further examinations as part of the evolution of their formal scope of practice.  

What Does The Nurse Practice Act Comprise?

Because the United States doesn’t have a federal nurse practice act, it is up to each state to pass their own NPAs based on their legislature.

To create the act, the rules and regulations within it must undergo a process of public review before enacted; once enacted, the rules and regulations in the nurse practice act have the full effect of the law.

Although the specific rules in the NPA may vary from state to state, all nurse practice acts include:

  • Definitions: Because NPAs are enacted laws, states must ensure that the citizens are fully aware of what they mean. A nurse practice act doesn’t define the terms that are commonly understood, but it defines all other terms that might be ambiguous.
  • Authority, power, and composition of the board of nursing (BON): The board of nursing has the authority to develop regulations and administrative rules to clarify or make laws more specific. The nurse practice act defines the authority, power, and composition of these boards.
  • Educational program standards: All pre-licensure nursing education programs and clinical learning experience must be defined by the board of nursing and meet the standards of the nurse practice act.  The act often includes specific curriculum requirements.
  • Standards and scope of nursing practice: This section serves as a guideline for the professionals, as all the standards and scope of practice in the NPAs are aligned with the nursing process. Standards include everything from the definition of primary care and how it should be provided to personal skills, such as critical thinking and decision making.
  • Types of titles and licenses: Because the use of the title nurse by unlicensed individuals can be dangerous, the nurse practice act also includes a statement regarding the protected titles and who can use them. Currently, the nurse practice act protects the titles of a registered nurse (RN), licensed practical nurses (LPN), and licensed vocational nurses (LVN).  
  • Protection of title: The nurse license act protects the nursing titles; if anyone who doesn’t have a license uses those titles, they must respond in front of the law.
  • Requirements for licensure: The NPA also states what are the requirements for licensure. These statements include everything from formal educational training to personal skills and individual core values. It also establishes how the licensure may be obtained and what the examination implies.
  • Grounds for disciplinary action, violations, and possible remedies: Lastly, the nurse practice act includes statements regarding all disciplinary actions that may be taken against those nurses who no longer respect the standards or rules within the act; it also establishes what measures can be taken against those who violate the protected titles. Nurses must also read this act to find out what represents a violation against its rules. Ultimately, the act also includes statements regarding the possible remedies.

Wrapping It All Up

The nurse practice act is nursing law. It protects a nurse’s title and defines the nursing laws and standards.

To be successful in your career, you should become familiar with the nurse practice act in your state and make sure you meet all requirements to obtain and maintain your license.

If you want to work as a travel nurse or plan to practice your profession in various states, you should also know that the nurse practice act varies from state to state and you must obtain a license in each state where you want to practice.

With this in mind, just search the NPA in your state and familiarize yourself with the document. Undoubtedly, this is the first step towards your dream job.

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