Medical patients, healthcare recipients, and Idaho's citizens depend on the compassion and competency of the state's nursing professionals for routine treatments and life-saving interventions. In becoming a trusted member of Idaho's healthcare community, nurses of every caliber expend years of their lives to complete education and training requirements, including licensing with governing organizations. To ensure proper and legal care standards, Idaho has strict nursing guidelines provided through the Nurse Practice Act (NPA).
The NPA is a nationwide legislative compact giving state agencies the authority to establish frameworks for nursing practices and provisions, with the aim of protecting public health, welfare, and safety. While Idaho nurses are instructed on NPA guidelines throughout their time in schools, residency, and progressing through their practice, the risk for discipline continues throughout their careers. A single violation or false allegation can upend a nurse's career, no matter how minor it may be, such as:
- Forgetting to record a patient's change in condition
- Making scribbled medical records
- Administering medication without delegation or supervision
- Making independent decisions on patient conditions
When Idaho nurses are threatened with adverse action from medical facilities or state authorities, they can call on the support of the Lento Law Firm. We direct healthcare professional on how NPA changes affect them and their practice and stand prepared to defend them against disciplinary measures. Call the Lento Law Firm Professional License Defense Team at 888-535-3686 now or fill out our confidential consultation form.
Scope of Practice for Different Types of Nurses
Idaho's NPA is a set of laws and regulations that define the scope of practice and professional expectations for nurses within the state. It provides guidelines on what exactly nurses are authorized to do in a given placement or facility and those that are prohibited or require additional certification. Among those listed to practice nursing care in the state include:
- Certified Medication Assistants (MA-Cs)
- Licensed Practical Nurses (LPNs)
- Licensed Registered Nurses (RNs)
- Advanced Practice Registered Nurses (APRNs)
Licensees may hold only one active renewable license to practice nursing at any time. However, APRNs must also be licensed to practice as RNs.
In the healthcare workplace, there are others referred to as unlicensed assistive personnel (UAPs) who perform nursing care under the direction and supervision of licensed nurses. UAPs are prohibited from performing any licensed nurse functions, such as:
- Decision-making related to patient conditions
- Implementation of nursing plans
- Emergency interventions
- Medication administration
- Delegation of duties
While UAPs need not be licensed, they must be eligible for placement on the state's Nurse Aide Registry. Otherwise, those who render nursing care must obtain licensure through the Idaho Board of Nursing (IBN).
The IBN utilizes the NPA to create credentials that are consistent with education and medical training. Therefore, the scope of practice for nursing professionals in Idaho depends on the level of licensure, with each containing specifics of authorized and prohibited acts and official responsibilities.
Certified Medication Assistants
MA-Cs act as a link between UAPs and licensed nursing professionals. The Idaho NPA requires MA-Cs to train in administering medications and work under the supervision of a licensed nurse, as well as completing a board-approved course and corresponding exam. Their scope of practice typically includes basic medical tasks that do not require specialized or skilled nursing knowledge or judgment. MA-Cs will record patient interventions accurately for official records and give patients general medication prescribed by physicians or supervising nurses.
The Idaho NPA forbids MA-Cs from working autonomously and cannot make independent decisions about patient care or perform surgical procedures. Although they have the opportunity to administer intravenous drugs or scheduled narcotics, MA-Cs must obtain the necessary training, education, and IBN approval.
Licensed Practical Nurses
LPNs provide basic nursing care, all the while working with a supervisor, providing nursing care at the delegation of an RN licensed physician or licensed dentist. The stability of a patient, their environment, and the predictability of the outcome determine the degree of direction and supervision that must be provided to LPNs by higher-level nurses.
Care delivery, medication administration, and responding to patients encompass an LPN's primary duties. Yet, they will also perform the following functions:
- Collecting and reporting patient medical data
- Participate in developing and modifying care plans
- Implement partial aspects of care plans
- Partake in the evaluation of responses to patient interventions
- Fulfill charge nurse responsibilities as permitted
- Delegate tasks responsibly
- Accepts delegated assignments only as allowed
LPNs are not permitted to make comprehensive patient assessments—such as diagnoses—or modify nursing care plans independently. Furthermore, they may not prescribe medications, only administer them.
Licensed Registered Nurses
RNs have a broader scope of practice and are responsible for delivering more complex patient care. In addition to providing hands-on nursing care, RNs serve in capacities including, but not limited to, administration, case management, delegation, and teaching. They are licensed by the IBN and expected to exercise competency in judgment, decision-making, and implementation of nursing practices.
Some of the functions of Idaho RNs include:
- Assessing individual and group health statuses
- Using data to identify and document nursing diagnoses
- Developing medical intervention plans
- Collaborating with the patients and healthcare workers
- Implementing orders for medications and treatments from authorized prescribers
- Monitoring care plan outcomes and coordinating responses
RNs are not authorized to perform medical diagnoses or prescribe treatments. They also cannot order diagnostic tests, such as CT scans, X-rays, or MRIs, without authorization from an APRN, physician, or dentist. Yet, they may administer intravenous drugs and start therapies based on established facility protocols if the patient has been assessed and determined to be in peril.
Advanced Practice Registered Nurses
APRNs have the most education and training and, therefore, have the most expansive scope of practice among nursing professionals. Acting as the first line of assistance to physicians, they also provide the first point of contact with patients on a daily basis. They assume primary responsibility for patient care and incorporate professional judgment to focus on an area of specialization in one of four disciplines:
- Certified Nurse Practitioner
- Certified Registered Nurse Anesthetist
- Certified Nurse Mid-Wife
- Clinical Nurse Specialist
APRNs normally engage in autonomous practice and may assess, diagnose, and manage patients within their competence and education. They also have the ability to prescribe medications, including controlled substances, provide care standards that comply with state and federal requirements, and have the proper certifications. However, they may not prescribe or dispense drugs except in the course of their professional practice and when they have assumed responsibility for the patient's care under the appropriate conditions.
Supervision and Delegation Rules
The Idaho NPA also provides guidelines for on-the-job delegation and nursing care supervision. Improper delegation or failure to supervise effectively can result in disciplinary action for the supervising nurse and the delegatee.
UAPs are prohibited from accepting any delegated task that may require the knowledge and skill of a licensed nurse. Also, licensees are prohibited from delegating tasks outside the delegatee's scope or their own.
The decision-making model is the process by which licensed nurses evaluate whether a particular act is within the legal scope of that nurse's practice and determine whether to delegate it in a given setting. A licensed nurse shall determine whether the task is:
- Limited to the scope of practice of an APRN or RN
- Taught in a nurse's educational curriculum
- Consistent with contemporary standards of practice
- Accepted as reasonable and prudent nursing care
When delegating, nurses retain accountability for the delegated acts and the consequences of delegation. Nurses must provide appropriate instruction for performance, and in some cases, nurses must establish written guidelines if delegated tasks are engaged multiple times. Guidelines must include procedures for identifying the type of patient to be served, intended medical treatment, and resolving any questions related to prescribed medications.
Furthermore, licensees must determine the degree of supervision required and evaluate whether the activity is completed in a manner that meets acceptable outcomes. Supervision is based on the patient's stability and status and the complexity of the care, given the delegatee's competence.
Continuing Education and Competence
Idaho requires nurses to complete continuing education (CE) to maintain their licenses to ensure they remain current with medical knowledge and practice standards. Renewal dates run on a two-year cycle, and all hours of CE must be completed within that timeframe.
To renew credentials, LPNs, and RNs must complete two of the following learning activities:
- Current nursing certification or 100 hours of simulation practice
- 15 contact hours of CE, wherein one contact hour equals 50 minutes of instruction
- One semester credit hour of post-licensure nursing education
- Completion of a board-recognized refresher course
- Participation in a board-recognized workshop seminar or conference
- Contribution to related professional activities like volunteer work or teaching
APRNs must complete 30 contact hours of CE, which must include ten contact hours in pharmacology. They must also complete eight hours related to managing patients with opioid and other substance abuse disorders.
In case of an audit, all individuals must maintain documentation of completed CE activities for at least the prior two-year renewal cycle. Failure to complete CE requirements can result in license suspension or additional conditions for renewal.
Unprofessional Conduct and Discipline
Another significant tenet of the Idaho NPA is to outline professional standards for nurses. While each level of licensure has its own authorized acts in the medical field, all licensees, no matter what caliber, must follow the state's code of conduct.
The IBN has the authority to reprimand, restrict, or revoke a nursing license as it deems proper upon determination by the board. Grounds for disciplinary action include the following:
- Making false, fraudulent, or forged statements to procure a license to practice
- Practicing under a false or assumed name
- Entering into a guilty plea in some criminal charges
- Grossly negligent or reckless performance of nursing functions
- Habitual use of drugs or alcohol
- Practicing while physically or mentally unfit
- Deceiving, defrauding, or endangering patients or the public
- Receiving discipline from a nursing regulatory authority in any jurisdiction
- Engaging in sexual, sexually exploitative, or sexually demeaning conduct
- Failure to comply with abortion complications reporting
If allegations of misconduct or NPA violation arise from patient complaints or those of coworkers and supervisors, the grievance process presents a significant threat to nurses at any license level. Whether individuals approach informal or formal disciplinary measures, sanctions can derail a career. Even on a first-time offense, the IBN may levy license revocation—with or without the ability to reapply.
Still, just because a nurse is disciplined in Idaho doesn't mean the effects remain within the state's borders. Along with nearly 40 other states, Idaho is a part of the Nurse Licensure Compact (NLC), which allows healthcare workers, such as LPNs, RNs, and APRNs, to practice in multiple states without additional or supplementary licensing. However, reciprocity also encompasses disciplinary action, meaning Idaho nurses cannot practice until their license is permitted to be reinstated or limitations and restrictions are removed.
Contact the Lento Law Firm for Idaho NPA Defense
The potential for violating the NPA is high for nurses in the complex and often chaotic world of nursing care. While nurses may become implicated in allegations of misconduct or patient complaints, they can rely on the support of the Lento Law Firm Professional License Defense Team.
We understand that even the most minor NPA violation can spell the end of a nurse's career, and our team has what it takes to ensure you protect your practice and career. While some may think a short departure from duties deserves a second chance, the NPA does not direct the IBN to handle it that way.
Nurses need an experienced team that is well-versed in the administrative proceedings used to adjudicate and levy sanctions. We provide a delicate approach to protecting a license to practice, such as negotiating with the IBN to promote a beneficial resolution without discipline. From monitoring changing state nursing requirements to building a defense against NPA violations, we are an ally of healthcare professionals nationwide. Call the Lento Law Firm Professional License Defense Team at 888-535-3686 today or fill out our consultation form.
