Recipients of Mississippi healthcare depend on empathetic nurses dedicated to their practice to render life-affirming and life-saving care on a daily basis. In earning their competency and authority in the medical field, nurses expend years of their lives and a small fortune from schooling and licensing to on-the-job training and continuing education. Challenges exist around every corner with educating patients, administering medications, and performing medical interventions. Still, the only thing that stands between a nurse and their ability to practice could be a single violation of the Nurse Practice Act (NPA).
The NPA is a nationwide series of rules and regulations standardizing ethical and legal medical care. Mississippi uses the NPA to create the framework for nursing care to promote and protect public health, welfare, and safety. Since Mississippi nurses are closely monitored for compliance, even unfounded allegations can threaten one's career. When licensees at any level violate the NPA guidelines, it commonly has effects like:
- Payment of fines that can induce financial stress.
- Mandatory practice restrictions that harm one's professional reputation.
- Suspension or revocation of credentials forces nurses to find employment elsewhere.
While Mississippi nurses may run into trouble with state authorities or medical facilities over alleged NPA breaches, they can call on the assistance of the Lento Law Firm. We will direct anyone on how NPA changes may affect them and their practice and defend them against sanctions and corrective actions related to violations. Call the Lento Law Firm Professional License Defense Team at 888-535-3686 now or submit your details online, and we will contact you.
Scope of Practice for Different Types of Nurses
Mississippi's NPA defines the scope of practice and professional expectations for nurses within the state. It provides distinct boundaries on what nurses are authorized to do in a medical setting and what is prohibited. Among those listed to practice nursing care in the state include:
- Certified Nurse Aides (CNAs)
- Licensed Practical Nurses (LPNs)
- Registered Nurses (RNs)
- Advanced Practice Registered Nurses (APRNs)
Nurses must obtain licensure through the Mississippi State Board of Nursing (MSBN), which employs the NPA to create levels of credentials consistent with education and medical training. Below is how the NPA divides duties among licensees:
Certified Nurse Aide
CNAs provide care under the supervision of licensed healthcare professionals, such as RNs and LPNs. After completion of a state-approved training program, competency exams, and licensing by the Mississippi State Department of Health, they primarily assist with basic nursing care and daily living activities, like the following:
- Patient Assistance: Helping with hygienic activities, supporting patient mobility, and assisting with comfort measures.
- Nutrition Support: Monitoring dietary intake and assisting patients with eating and drinking.
- Basic Reporting: Recording vital signs, documenting changes in patient conditions, and caloric intake and outtake.
Mississippi CNAs are restricted from performing tasks requiring clinical judgment or invasive action like sterilizing wounds or using intravenous lines. Moreover, they cannot administer medications, including over-the-counter drugs, unless they have additional certification and are delegated that task by a supervisor.
Registered Nurses
RNs have a broader scope of practice and are responsible for delivering more complex patient care. Individuals must have a diploma from a medical-based program (two-year or four-year), a passing score on exams, and fulfillment of all requirements to become licensed in Mississippi. An RN's scope of practice under the NPA includes:
- Assessment and Care Planning: Identifying patient care needs and implementing plans to oversee medical progress.
- Medication Administration: Administering all forms of medication, including intravenous drugs and controlled substances, with corresponding certification.
- Supervision and Delegation: Overseeing CNAs and LPNs to ensure safe and effective care for patients and healthcare recipients.
RNs are not authorized to perform medical diagnoses (even simple ones) or prescribe treatments without further certification. They also cannot order diagnostic tests without an APRN or physician's authorization.
Licensed Practical Nurses
LPNs provide basic nursing care while working with a supervisor—usually a physician or RN. They must graduate from an accredited program, pass mandatory exams, and obtain licensure from the MSBN. The scope of practice for LPNs under the NPA includes:
- Patient Care Assistance: Executing portions of patient care plans developed by an RN, physician, or other higher-level licensee.
- Care Delivery: Administering basic medications, wound triage, and responding to patient needs.
- Data Collection: Monitoring patient conditions and recording changes but not interpreting them to make independent decisions.
LPNs cannot administer certain intravenous drug therapies, such as chemotherapy, without certification, delegation, and, in some cases, supervision. However, if RN supervision is always available, LPNs may assume "charge nurse" responsibilities, but only administrative, not supervisory.
Advanced Practice Registered Nurses
APRNs have the most education and training and, thus, an expansive scope of practice among nursing professionals. With licensing from the MSBN, the NPA authorizes them to have the following responsibilities:
- Autonomous Practice: Assess, diagnose, and manage medical conditions within their scope of practice.
- Prescriptive Authority: Prescribe medications, including controlled substances, and provide methods and care standards that comply with state and federal requirements.
- Specialized Procedures: Perform advanced interventions specific to their certifications.
APRNs must practice within the bounds of their specialization and training. Yet, to enhance patient safety and improve consistency in care, the MSBN encourages APRNs to take advantage of a "special privilege" to complete the state's Decision-Making Model. The provision allows further autonomy in procedures, skills, roles, or interventions germane to the nurse's practice.
Supervision and Delegation Rules
One of the most significant tenets of providing effective patient care is how care duties are delegated to various nurse licensees. Yet, delegated tasks, in many cases, require some amount of supervision. Therefore, the Mississippi NPA also provides guidelines to mitigate improper delegation or supervision to ensure patient safety.
Other than physicians, RNs and APRNs have the authority to assign nursing tasks to other personnel. Before doing so, they must evaluate several factors, including:
- The level of guidance and oversight the delegatee will need from the delegator.
- The complexity of the nursing care required by the patient.
- The educational background and demonstrated competence of the delegatee.
Ultimately, delegators are accountable for the care provided to patients under their supervision. As a result, RNs and APRNs may face disciplinary actions stemming from complaints related to delegation.
In terms of supervision, nurses with authority over others must adhere to specific responsibilities outlined in the NPA. Supervisors are required to:
- Prioritize patient needs above the scope of delegated or supervised duties.
- Offer clear directions to ensure patient care objectives are met.
- Support nurses and other personnel in developing the skills necessary for competent nursing practice.
- Assess the quality and effectiveness of care delivered by those under their supervision.
When tasks are delegated repeatedly or involve administering medications, written protocols are often necessary. These protocols should clearly outline procedures for identifying the types of patients to be treated, the intended medical treatments, and the process for addressing any issues related to prescribed medications.
Continuing Education and Competence
Mississippi 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.
LPNs or RNs must complete 20 hours of CE per period and are permitted to submit a maximum of 10 carryover hours from the prior renewed licensing period to satisfy the requirement. APRNs have more extensive requirements for renewal. They must complete a minimum of 40 hours of CE, of which 10 must be dedicated to controlled substances. APRNs can allocate 20 hours CE from the previous renewal period to fulfill the 40-hour requirement, but they cannot be used to satisfy controlled substances CE hours.
As part of the renewal process, nurses must provide attestation of compliance, including but not limited to:
- The number of required CE hours
- The designated earning period
- The content and acceptability of CE program activities (without repeating)
- Any other requirements for renewal established through MSBN action
Regardless of what level of medical license, all individuals must maintain documentation, including but not limited to certificates, transcripts, or other citations of attendance, to substantiate earned CE hours for at least four years. In the case of an MSBN audit, failure to prove completion of CE requirements can result in adverse actions. At a minimum, it may invoke additional conditions for renewal and could lead to revocation of credentials.
Unprofessional Conduct and Discipline
The Mississippi NPA also outlines professional standards for nurses. While each level of licensure has its own authorized acts in the medical field, all licensees, regardless of caliber, are subject to its guidelines.
While there are many issues that may warrant disciplinary action, the following are also frequent reasons for disciplinary investigations:
- Practicing nursing beyond the authorized scope of a license.
- Failure to maintain medical records professionally, such as making unintelligible entries, falsifying, or altering them.
- Practicing while an individual's ability is impaired by a physical or emotional condition.
- Inappropriately delegating tasks or failure to adequately supervise, manage, or train delegatees.
- Violating patient confidentiality or professional boundaries, including sexual, emotional, or financial exploitation.
- Having a license denied, conditionally issued, reprimanded, placed on probation, suspended, revoked, or voluntarily surrendered in another jurisdiction.
- Failure to protect a patient's rights and dignity, including abandonment.
- Practicing while under the influence of alcohol or other mood-altering substances.
- Misappropriation or forgery related to controlled substances, medical supplies, or facility equipment.
Not only will a nurse garner disciplinary action for violating the NPA, but those who fail to immediately report allegations may land themselves in trouble, too. However, the requirement excludes reporting chemically dependent nurses who have sought and complied with treatment, provided that no other Mississippi NPA has been violated.
In the event that allegations of misconduct or NPA violation arise from recipient complaints or coworkers and supervisors, the grievance process presents a significant threat to nurses. Whether individuals approach informal or formal disciplinary measures, sanctions can include the following:
- Fines and restitution
- Practice limitations or restrictions
- Mandatory CE hours or courses
- License suspension for up to five years
- License revocation with or without the ability to reapply
Just because a nurse receives discipline in Mississippi doesn't mean the effects remain within the state's borders. Nearly three dozen states are part of the Nurse Licensure Compact (NLC), and while the NLC enables nurses to work in other states through reciprocity, any disciplinary action taken on an individual's license in Mississippi will affect the status in other NLC-compliant states until their license is reinstated or limitations and restrictions are removed.
Non-NLC states rely on the Nursys database from the National Council of State Boards of Nursing as a source of licensing information. Therefore, Mississippi nurses face the next-to-impossible challenge of looking for work as licensed healthcare professionals elsewhere.
Contact the Lento Law Firm for Mississippi NPA Defense
The Lento Law Firm Professional License Defense Team understands that even the most minor NPA violation can spell the end of a nurse's career. Nurses can become implicated for something as seemingly harmless as recording a patient's change in condition in a matter illegible to another. While some may think a short departure from official responsibility deserves a second chance, that isn't how the NPA directs the MSBN to manage rule violations.
Mississippi nurses need an experienced team that knows how to negotiate with state authorities and understands the administrative proceedings used to adjudicate and levy sanctions. We provide a delicate approach toward protecting a license to practice, such as negotiating with the MSBN to promote a beneficial resolution without enduring formal grievance procedures. Don't wait until complaints or investigations begin; call the Lento Law Firm Professional License Defense Team at 888-535-3686 today or fill out our consultation form.