New Mexico uses the Nurse Practice Act (NPA) to establish the rules and regulations related to effective, legal, and safe nursing care for the state's recipients. The NPA outlines the scope of practice and professional standards for nursing of every caliber, including those serving as trainees. While it is designed to protect patients and ensure the delivery of competent care, its complexity can create challenges for nursing professionals who may find themselves facing allegations of misconduct, practice disputes, or issues with licensure compliance.
Unfortunately, even a single violation or false allegation can upend a nurse's career, no matter how seemingly minor it may be, such as:
- Ignoring a patient's change in condition
- Penning illegible medical records
- Administering medication without delegation or supervision
- Making independent decisions without appropriate licensing
Nurses invest years of their lives in fulfilling education and licensing requirements to earn authority in the medical field, and any allegation must be taken seriously. Trials exist around every corner, educating patients, administering medications, and performing medical interventions, but when New Mexico nurses run into trouble with state authorities or medical facilities, they can call on the assistance of the Lento Law Firm.
The Lento Law Firm Professional License Defense Team understands the risk placed on New Mexico nurses to provide life-affirming and life-saving care on a daily basis. We will ensure that you can mount a robust defense against alleged NPA violations to mitigate sanctions and corrective actions. Get in touch with a dedicated ally of the nursing community and call the Lento Law Firm Professional License Defense Team at 888-535-3686 or submit your details now.
Scope of Practice for Different Types of Nurses
The NPA is a nationwide series of regulations standardizing ethical and legal medical care. New Mexico's Board of Nursing (NMBON) uses NPA guidelines to codify requirements for licensure, professional conduct, practice authorizations, and personnel limitations.
In New Mexico, the practice of nursing is defined as assisting others in maintaining or attaining optimal health, initiating comfort measures, providing medical guidance and intervention, and remaining accountable for safe and effective nursing. Those who are permitted to engage in professional registered nursing include assessing and establishing diagnoses, developing patient care places, evaluating interventions, and managing or supervising others involved in the practice of nursing.
In creating distinct boundaries on who may render nursing care, those authorized to practice in New Mexico are those with the following credentials:
- Certified Medication Aides (CMAs)
- Certified Hemodialysis Technicians (CHTs)
- Registered Nurses (RNs)
- Licensed Practical Nurses (LPNs)
- Advanced Practice Register Nurses (APRNs)
Nurses are closely monitored by the NMBON for compliance to ensure top patient care standards in facilities and home settings throughout the state. Each division has clear distinctions, which sets them apart in terms of education and duties.
Certified Medication Aides and Certified Hemodialysis Technicians
Certified by the state nursing agency, CMAs, and CHTs provide care under the supervision of licensed healthcare professionals. The NPA details that CMAs primarily assist with basic nursing care and daily living activities, like patient observation, medical documentation, and the administering of some medications. Typically, CMAs may only give patients general medicines prescribed by physicians or supervising nurses, such as topical, oral, eye, ear, and some inhaled drugs.
Also managed through the NPA, CHTs use their practice to focus on patients with kidney diseases or complications. They help improve patients' quality of life and contribute to the overall success of care plans under the supervision and direction of an RN or LPN.
CMAs and CHTs alike lack the authority to make independent decisions about medication or administering intravenous drugs or scheduled narcotics without training and approval from NMBON. Additionally, they cannot assess patients to make an official diagnosis or perform complex medical procedures and most tasks beyond first aid.
Licensed Practical Nurses
LPNs provide basic nursing care for the sick, injured, convalescent, or disabled under the direction of RNs or physicians. After obtaining licensure from the NMBON. The scope of practice for LPNs includes:
- Patient Care Assistance: Implementing segments of care plans developed by an RN, physician, or other higher-level provider.
- Care Delivery: Keeping patients comfortable, administering medications, and wound dressing.
- Monitoring Patients: Overseeing patient conditions and recording changes but not interpreting them to make independent decisions.
While LPNs may assume some duties and perform specific procedures beyond their educational preparation, LPNs are responsible for obtaining the appropriate knowledge, skills, and supervision to ensure competent patient care. LPNs are authorized to perform intravenous therapies, including fluids and medications; however, administration of drugs for moderate, deep, or palliative sedation, including anesthetics, is not within an LPN's scope of practice.
Registered Nurses
RNs have a broader scope of practice and are responsible for delivering more complex patient care and have varying specialist and managerial levels. For instance, an RN Level I conducts routine nursing care, whereas an RN Level III may support and deliver public health programs related to cancer screenings or immunizations. Those in supervisory roles assume primary responsibilities related to educating residents and staff along with facilitating interdepartmental collaborations.
Under the New Mexico NPA, essential duties and responsibilities of RNs with the maximum level of supervisory authority include:
- Managing compliance actions within a given facility.
- Ensuring resident and patient safety and well-being.
- Evaluating nursing personnel and guiding staff procedures and objectives.
- Creating and updating medical policies to promote optimal care.
- Maintaining occupancy of facilities through marketing and outreach techniques.
- Maximize reimbursements for facility or provider services.
- Participate in strategic planning initiatives for procedure development and performance improvement.
Among those reserved for RN specialists include:
- Serving as lead on clinical policy review
- Tracking ongoing infectious diseases
- Provide highly specialized nursing care to patients
- Provide clinical supervision of unlicensed personnel and junior staff
- Render services in surgery, anesthesia, emergency care, nuclear medicine, rehabilitation, and others.
RNs are not authorized to perform medical diagnoses independently and must have authorization and supervision from a physician or an APRN. Moreover, while RNs may administer medication and monitor patient reactions, they may not initiate, alter, or stop them.
Advanced Practice Registered Nurses
APRNs are the highest level of nurses and are licensed and authorized to make independent decisions about specialist nursing needs. They are directly accountable and responsible to the patient or care recipient and are often divided into two classifications: Certified Nurse Practitioners (CNPs) and Certified Nurse Specialists (CNSs). Each must possess full prescriptive authority and must be eligible for registration with the federal Drug Enforcement Administration.
The New Mexico NPA authorizes CNPs and CNSs to assess, diagnose, and manage medical conditions within their scope of practice. Duties include the following:
- Ordering and interpreting laboratory tests and diagnostic imaging
- Ensuring compliance with medical policies, practices, and protocols
- Conducting daily onsite evaluation
- Providing clinical supervision over residents and staff
- Recommending and developing practice standards
Record-keeping is an essential duty of New Mexico APRNs, and the NPA mandates that they provide complete copies of medical records to a patient or to another practitioner promptly when legally requested. Medical records may not be withheld because an account is overdue or a bill is owed.
When closing or departing from practice, the destruction of medical records must be such that confidentiality is maintained. Moreover, a log of all charts destroyed, including patient names and dates of services, must be retained.
Supervision and Delegation Rules
One of the most significant principles in providing effective patient care is how duties are delegated to nurses of varying certification and licensure. As such, the NPA establishes guidelines to ensure patient safety. Other than physicians, RNs and APRNs have the authority to assign nursing tasks to other licensed personnel. LPNs, however, may only assign basic tasks—bathing, dressing, nutrition monitoring—to CMAs.
Before delegating tasks, individuals must consider the delegatee's level of competency and educational background, as well as the complexity of the care required by the patient. Delegators are accountable for the care provided to patients under their supervision. Therefore, nurses may face facility backlash and eventual sanctions from complaints if their delegation fails to provide adequate care.
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.
- Support nurses and other personnel with clear directions to develop the skills necessary for competent nursing practice.
- Evaluate the quality and effectiveness of care delivered by those under their supervision.
When tasks are delegated repeatedly or involve administering medications, written protocols are necessary. Procedures 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
New Mexico requires nurses to complete continuing education (CE) contact hours 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.
At the time of license renewal, LPNs, RNs, and APRNs must complete 30 contact hours of approved CE. CMAs and CHTs must complete 16 contact hours. Under NPA provisions, nurses must ensure CE is recorded as follows:
- Certificates or a transcript clearly designating successfully completed hours
- Log of completion dates
- Names of the course and accrediting organization
All nurses must maintain documentation to verify CE contact hours for at least four years. In the case of an NMBON audit, failure to prove completion can result in misconduct charges.
Unprofessional Conduct and Discipline
The New Mexico NPA outlines the scope of practice and authorized acts among various levels of nursing. Yet, all nurses, no matter what type of license, are subject to the NPA's guidelines for professional behavior and conduct.
While there are many issues that may warrant disciplinary action, the following are also frequent reasons for disciplinary investigations:
- Practicing beyond the scope of a license or outside of delegated tasks
- Failure to maintain professional medical records
- Impaired practice because of physical or emotional conditions
- Failing to safeguard patients' or public safety or abandonment of care
- Inappropriately delegating tasks or failure to adequately supervise delegatees
- Violating patient boundaries or confidentiality
- Disciplinary action on a license in another jurisdiction or criminal convictions
- Misappropriation of medication, medical supplies, or equipment
Misconduct allegations related to NPA violations may arise from patient complaints, staff members, supervisors, and even anonymously through the state's complaint portal. The NPA directs the NMBON to investigate all allegations and gives the state agency the authority to levy disciplinary action against nurses who fail to report rule breaches immediately.
While nurses have the opportunity to defend themselves in a formal hearing before the NMBON and may appeal corrective action, oftentimes, nurses come away with restrictions and limitations on their practice. Furthermore, punishment doesn't end at the state's borders.
New Mexico joins over 40 states in the Nurse Licensure Compact (NLC), which enables nurses and other healthcare professionals to work across state lines through reciprocity. Unfortunately, for those receiving discipline, any restriction or limitations—probation, suspension, revocation—affect the ability to practice in other NLC-compliant states. Therefore, New Mexico nurses will be unable to practice in the same capacity (or at all) until the sanction period is over.
Contact the Lento Law Firm for New Mexico NPA Defense
When New Mexico nurses face allegations of NPA violations, they need a dedicated ally of healthcare professionals nationwide. No matter what situation CMAs, CHTs, LPNs, RNs, or APRNs encounter, the Lento Law Firm Professional License Defense Team stands ready to begin their defense.
Our team understands that even the most minor violation can end a nurse's career, such as:
- Forgetting to record medication taken by a patient
- Losing records related to CE contact hours
- Making illegible marks on a patient's medical record
- Working outside of delegated or supervised care duties
While some may think a short departure from official responsibilities deserves a second chance, the NMBON is strict with its application of the NPA. Nurses need an experienced team that knows how to negotiate with state authorities, and the Lento Law Firm will provide valuable assurance in protecting a license to practice. Call us at 888-535-3686 today or fill out our consultation form.
