Maryland

The Maryland Board of Nursing often receives inquiries from nurses regarding scope of practice such as “Is it within my scope of practice?” or “Am I covered by the Nurse Practice Act?” The Board recognizes that the practice of nursing is continuously evolving and there will be times when nurses at all levels have to deal with scope of practices dilemmas. However, it is outside the role of the BON to make scope of practice judgments or recommendations for licensees. All nurses have a common responsibility and accountability to provide safe care but the scope of practice varies.

The Maryland Nurse Practice Act (NPA), provides the individual scope of practice for each APRN, RN, and LPN which is determined by the individual’s education, training, experience, and certification. It is incumbent on nurses to familiarize themselves with the NPA as it defines the basic parameters of legal practice for nurses. However, it does not provide a list of specific duties or acts that licensed nurses are or are not permitted to perform. Advanced practice registered nurses, registered nurses, and licensed practical nurses can find the regulations related to scope and standards of practice in the Code of Maryland Regulations (COMAR) Title 10 (http://www.dsd.state.md.us/COMAR/ComarHome.html.)

The determination of scope of practice is the responsibility of the individual nurse. Tools such as The Decision Making Model for Scope of Nursing Practice Decisions can assist nurses when making individual decisions related to scope of practice. The tool, developed by the National Council of State Boards of Nursing, provides a degree of specificity associated with activities, interventions, or roles permitted under the nurse’s level of education, licensure, and competence while meeting the standards established by the Maryland Nurse Practice Act (NCSBN, 2016). The nurse must also consider professional standards, current evidence, and institutional policies regarding the act in question. Nurses should consider using this or a similar decision-making model as a guide when making scope of practice determinations. Author, Dr. Sabita Persaud is the President of the Maryland Board of Nursing and contact information is spersaud@ndm.edu or call at 410- 532-5517.