The nursing profession is one of the most trusted and critical components of the healthcare system in Louisiana. Whether working in hospitals, schools, clinics, or private homes, nurses can have a huge impact on their patient's lives and health.
The role of nurses in healthcare has significantly changed over the years. In the past, nurses primarily provided bedside care, focusing on comfort, hygiene, and basic medical assistance. But today's nurses take on advanced roles, including diagnosing illnesses, prescribing medication, and using advanced medical technologies, from electronic health records to telehealth platforms. They also play a critical role in managing and interpreting patient data. Some are even licensed to manage patient care independently.
While it's exciting to see the nursing role expand, the downside is that more nurses are encountering legal challenges, including accusations of malpractice. Such claims can jeopardize their professional reputations, put their licenses in danger, and disrupt their ability to provide care.
In Louisiana, nurses are governed by the Louisiana Nursing Practice Act (LNPA), a legal framework that establishes standards of practice, continuing education requirements, prohibited behaviors, and disciplinary procedures. This law, enforced by the Louisiana State Board of Nursing (LSBN) and supplemented by the Louisiana Administrative Code (LAC), aims to protect the public while supporting professional growth within the nursing field.
As a Louisiana nurse, you should fully acquaint yourself with the LNPA and LAC to ensure that your professional actions align with the law. Familiarizing yourself with these statutes and codes ensures you avoid unintentional violations that might result in disciplinary actions, such as fines, suspension, or even revocation of your license. Staying up-to-date and compliant with these regulations enables you to deliver safe, ethical, and effective care while protecting your professional future.
If you're a Louisiana nurse facing disciplinary action, contact the Lento Law Firm's experienced Professional License Defense Team without delay. We have helped numerous medical professionals all across the country protect their licenses, and we're ready to help you, too. Contact us today at 888.535.3686 or through our online contact form to discuss your case.
What is the Nursing Scope of Practice in Louisiana?
The scope of practice defines the responsibilities, duties, and limitations for each type of nursing license in Louisiana. By clearly distinguishing what each type of nurse can and cannot do, the LNPA helps ensure patient safety and high standards of care. Nurses who step outside their authorized roles risk disciplinary action, jeopardizing their patients' well-being.
Licensed Practical Nurses (LPNs)
LPNs are entry-level nurses who perform basic nursing care under the supervision of a Registered Nurse (RN), physician, or dentist. Their work is essential to the healthcare system, often focusing on tasks that require technical skill but not advanced medical judgment. Under Louisiana law, key responsibilities of LPNs include:
- Administering medications. LPNs can administer medications orally, topically, or via injection but are not authorized to administer them intravenously or start IV lines.
- Monitoring patient conditions. LPNs measure vital signs, document changes in patient health, and report findings to supervising RNs or physicians.
- Basic patient care: LPNs assist with hygiene, nutrition, mobility, and comfort. This can include tasks like bathing, dressing wounds, or helping with feeding.
- Preparing Equipment. LPNs can prepare equipment for treatments, including sterilizing tools.
- Documenting visits. LPNs can record each visit made to the patient and incorporate findings into the patient notes.
- Collaborative care: LPNs play a supportive role in executing care plans developed by RNs, physicians, or other healthcare providers.
While LPNs are integral to patient care, they must defer advanced assessments, care plans, and critical decision-making to RNs or APRNs. LPNs also have clearly articulated limitations. For example, they are not allowed to administer intravenous appliances "for any reason," nor may they make patient assessments. Failure to follow any of these rules can result in disciplinary action.
Registered Nurses (RNs)
RNs have a broader scope of practice than LPNs and are often leaders within the healthcare team. Their responsibilities encompass both technical skills and critical thinking. Core functions of RNs include:
- Performing comprehensive assessments. RNs analyze patient conditions holistically, identifying needs that go beyond immediate symptoms.
- Developing and implementing care plans. Based on assessments, RNs create individualized care plans to address patient needs and evaluate their effectiveness over time.
- Administering medications and treatments. RNs handle more complex drug administration, including IV medications, blood transfusions, and chemotherapy.
- Patient education. RNs teach patients and their families about managing conditions, medications, and follow-up care.
- Supervisory roles. RNs oversee LPNs and unlicensed personnel, ensuring care standards are met.
Advanced Practice Registered Nurses (APRNs)
APRNs are highly trained professionals with advanced education and certification. In Louisiana, APRNs include Nurse Anesthetists (CRNAs), Nurse Midwives (CNMs), Clinical Nurse Specialists (CNSs), and Certified Nurse Practitioners (CNPs). APRNs are expected to provide direct care with an expanded knowledge base, clinical skills, and complex interventions. Responsibilities of APRNs include:
- Operating under a Collaborative Practice Agreement (CPA). Louisiana APRNs must work within CPA with a Collaborating Physician (CP) or dentist. The CPA outlines the scope of collaborative patient care, prescribing authority, and referral processes. The agreement should also include guidelines for consultations and cover the healthcare needs of patients during any absence of the APRN or CP.
- Diagnosing and treating illnesses. APRNs are often authorized to assess patients and provide diagnoses without physician oversight.
- Prescribing medications. APRNs in Louisiana are granted prescriptive authority, which is regulated by the CPA. The guidelines within the agreement govern the types of drugs that can be prescribed and distributed, including controlled substances.
- Performing specialized procedures. APRNs, depending on their specialty, may conduct advanced procedures such as epidurals or neonatal care.
APRNs are required to recognize their limits of knowledge and clinical experience and refer or consult with other healthcare providers when situations exceed their expertise. They are accountable for the quality of care provided and are expected to practice in accordance with established standards and evidence-based practices.
What are the Permissible Delegation of Tasks?
RNs and APRNs may delegate tasks if they fall within their appropriate scope of practice, comply with administrative delegation rules, and align with workplace policies. In addition, the person to whom the task has been delegated must have been trained and deemed competent. The nurse must also be able to provide instruction, supervision, and evaluation, and the task must pose minimal risk to the client if performed improperly.
Nurses are prohibited from delegating tasks that require the nursing process, involve assessment, interpretation, or independent decision-making, fall outside the Louisiana RN or APRN scope of practice, or involve medication administration without state-approved training. Failure to adhere to this law may result in severe sanctions.
What are Continuing Nursing Education Requirements?
Continuing education (CE) ensures that nurses stay current with medical advancements, technologies, and best practices. As of this writing, LPNs in Louisiana aren't required to complete a CE course. However, RNs and APRNs have specific obligations.
RNs must complete at least one of the following requirements during a two-year licensure period: either 30 board-approved contact hours of continuing education or 900 practice hours, as verified by the employer on a form provided by the Board.
APRNs are required to fulfill 30 contact hours annually, including at least 6 hours in pharmacology for those with prescriptive authority. APRNs must also complete CE relevant to their specialty, such as neonatal care for CNMs or anesthesia techniques for CRNAs.
Each year after license renewal, the LSBN conducts a random audit requiring selected licensees to provide documentation, such as CE certificates or employment verification, to confirm compliance with CE and practice requirements. All nurses must maintain records of their CE activities for at least five years and be prepared to submit them upon request. Noncompliance can result in fines, license suspension, or other disciplinary actions.
What Kinds of Actions are Prohibited to Louisiana Nurses?
The LNPA and the LSBN explicitly outline nursing actions that will give rise to disciplinary measures. These prohibited acts are designed to protect both patients and the integrity of the nursing profession. Certain of these include:
Practicing Beyond Scope
Each nursing role has defined boundaries. Performing duties outside one's scope—such as an LPN prescribing medications or an RN conducting surgical procedures—is a violation of the NPA.
Substance Use and Impairment
Practicing while under the influence of drugs or alcohol poses a direct risk to patient safety. Nurses struggling with substance use can access programs like Louisiana's Recovering Nurse Program (RNP) for rehabilitation, but impairment on the job is a violation.
Unprofessional Conduct
This broad category includes behaviors that undermine trust in the profession, such as:
- Patient abuse or neglect. Causing physical, emotional, or financial harm to patients is grounds for immediate disciplinary action.
- Falsifying records. Altering documentation to hide errors or mislead others is a serious offense.
- Breaching confidentiality. Sharing patient information without authorization violates both the LNPA and federal HIPAA laws.
- Exceeding professional boundaries. Nurses must always behave professionally with patients, including avoiding sexual misconduct.
- Improper usage. Using drugs, medical equipment or supplies, or patient records improperly can result in sanctions.
- Failing to use good judgment. Nurses must act in accordance with the legal standards of nursing practice and use good judgment in the execution of their duties. Poor judgment may include failing to report other healthcare professionals who may be engaged in unethical, criminal, or unprofessional conduct.
Criminal Activity
Nurses may be disciplined for any crime or offense that affects the nurses' ability to practice with regard to the health and safety of clients or patients. Even non-work-related crimes can trigger Board investigations if they suggest a nurse's unfitness to practice. Such crimes mainly include crimes of moral turpitude such as fraud, assault, rape, domestic violence, robbery, murder and drug-related offenses.
What are the Types of Disciplinary Actions a Nurse May Face?
If someone alleges that a nurse has violated Louisiana's Nurse Practice Act, the Louisiana Board of Nursing will investigate the matter. If the investigation reveals that the nurse violated the scope of practice or engaged in unsafe or unethical behavior, the Board may impose various sanctions. These include:
Formal Reprimand. The Board will issue a written warning, which will be filed with the license as "Prior Board Action."
Suspension with Stay/Probation. Your license remains active, but a supervisor will closely monitor your work; noncompliance may trigger unconditional suspension.
Suspension. Your license is inactive, and you are prohibited from nursing practice during the suspension period.
Voluntary Surrender. Your license is invalidated; however, it may be reinstated after a minimum of two years if you have met specific conditions.
Summary Suspension. The Board will take emergency action to suspend a license pending a prompt disciplinary hearing.
Revocation. Your license is annulled and void. Reinstatement may be possible after five years, except if the license was revoked permanently. If the Board issues a permanent revocation, you shall never be eligible to practice registered nursing in Louisiana again.
How Professional License Defense Lawyers Can Help
Facing allegations of misconduct can be a serious threat to a nurse's career. Even misunderstandings or misinterpretations can lead to severe disciplinary actions, including suspension or permanent license revocation. If you're a nurse accused of misconduct or malpractice, the Professional License Defense Team at the Lento Law Firm is here to help.
Our experienced team can:
- Investigate Accusations: We thoroughly examine the claims against you, gathering evidence and reviewing your conduct, documentation, and relevant medical records to build a strong defense.
- Protect Your Rights: We ensure your legal rights are upheld during Board of Nursing hearings and guide you through interviews or testimony preparation.
- Negotiate Settlements: If appropriate, we work to secure favorable terms that may help you avoid harsher penalties.
With skilled and experienced lawyers by your side, you can increase your chances of a favorable outcome and potentially save your professional license. Contact the Lento Law Firm's Professional License Defense Team today at 888.535.3686 or through our online contact form. No matter in which state you practice, we're ready to help protect your nursing license–and your career.
