The Tennessee Nurse Practice Act (NPA) is a collection of laws pertaining to nursing in the state. The Tennessee NPA contains many of the rules and regulations explaining what licensed nursing professionals can and can't do.
It also grants the Tennessee Board of Nursing (the Board) the authority to take disciplinary action against nurses who violate the NPA or other applicable rules. Because the Board has the authority to suspend or revoke a nurse's license when doing so appears necessary, it's important to familiarize yourself with the law if you're any type of nurse in Tennessee. Tennessee nurse license defense attorneys can provide valuable assistance if you face disciplinary action because of an alleged violation.
At the Lento Law Firm, our Professional License Defense Team will help you protect the career you've worked hard for if you're ever under investigation by the Board. Learn more by submitting your information through our online contact form or calling us at 888-535-3686.
General Rules and Regulations of the Tennessee Nurse Practice Act
Tennessee law establishes certain rules and regulations that specifically apply to the practice of nursing. Violations of these rules and regulations may trigger Board disciplinary proceedings.
The law indicates a nurse in Tennessee may face disciplinary action for engaging in unprofessional conduct or demonstrating unfitness or incompetence resulting from negligence, habits, or other relevant causes. According to the statute, such unprofessional conduct may involve:
- Harming or attempting to physically or mentally harm a patient, whether intentionally or out of negligence
- Not maintaining proper patient records with information regarding their condition and the specific nursing problems a nurse addressed
- Not maintaining proper records indicating which nurses provided a patient with care
- Abandoning/neglecting a patient in need of a nurse's care
- Making false or materially incorrect entries in records related to patient care or other such records
- Making inconsistent or unintelligible entries in records related to patient care and other such records
- Using or removing drugs, supplies, equipment, or narcotics from a health care facility or other such workplace/health care environment without proper authorization
- Using intoxicating beverages or illegally using narcotics or dangerous drugs while working or while on call
- Being intoxicated or under the influence of drugs or alcohol while on duty or on call
- Attempting to impersonate another nurse or licensed medical professional
- Allowing someone else to use one's nursing license for the purposes of providing nursing care/services and receiving compensation
- Any disciplinary action against a nurse's license or multistate privilege in another state/territory due to acts or conduct that would warrant disciplinary action in Tennessee
- Practicing nursing in Tennessee with a lapsed license
- Assigning unqualified individuals tasks that should be performed by someone with the proper license and qualifications
- Delegating responsibilities in a manner that violates the Nurse Practice Act in Tennessee or otherwise jeopardizes patient safety
- Not properly supervising those to whom one delegates nursing tasks or responsibilities
- Aiding, abetting, hiring, or otherwise assisting anyone in a manner that helps them violate or circumvent any law/rule regulating nursing or the medical professions in general
- Attempting to use one's influence over a patient for personal gain, such as promoting unnecessary products or services
- Violating a patient's confidentiality except when a court of law requires one to provide confidential patient information
- Not taking action to protect a patient from unsafe healthcare practices
- Not properly reporting one's concerns to the Board when one has reason to believe a healthcare provider has engaged in incompetent, unethical, or illegal practices
- Over-prescribing, or not prescribing in a manner consistent with the applicable laws or accepted standards of care
- Practicing nursing in any manner that doesn't align with the applicable laws or accepted standards of care
- Performing nursing techniques or methods for which one lacks the necessary training, knowledge, expertise, etc.
- Engaging in dishonest acts that relate to the practice of nursing
- Getting a positive drug screen and not having a valid prescription
- Providing someone else with a code, key, or other such means of accessing a drug dispensing system
- Not coordinating with a reliable collaborating physician when prescribing, diagnosing, or dispensing
- Having to surrender a DEA registration certificate or having said certificate revoked
- Engaging in deceit in connection with an investigation for violations of rules pertaining to nurse licensing
- Violating professional boundaries
- Engaging in sexual conduct with a patient
- Carelessly and/or repeatedly failing to practice in a manner consistent with accepted standards for the nursing profession in a given healthcare setting
- Prescribing controlled substances for oneself, one's immediate family members, or one's friends, except in emergency situations where doing so is necessary for health and safety reasons
These are rules that apply to anyone working in the nursing profession. Further down, this guide will cover rules and regulations that apply to specific types of licenses for nursing professionals in Tennessee.
The Importance of Sharing Information About Past Criminal Convictions or Disciplinary Actions with the Board
Anyone applying for a nursing license of any kind in Tennessee may be asked to provide the Board with information regarding any prior criminal convictions. Similarly, an application will typically require them to provide information about any past disciplinary action taken against their license in another state.
Providing accurate and honest information is crucial. The Board can deny an applicant a license if it's discovered they lied about or concealed their criminal past or the fact that they were previously subject to disciplinary action elsewhere. If the Board discovers a licensed nurse successfully deceived the Board when applying for a license, disciplinary action is likely to follow.
Special Rules for Licensed Practical Nurses in Tennessee
The Tennessee NPA establishes a critical difference between Registered Nurses (RNs) and Licensed Practical Nurses (LPNs). The law describes a LPN as someone who has “knowledge and preparation in nursing, but not to the extent of Registered Nurses.” Thus, a LPN may only perform duties covered by the relevant practical nurse curriculum.
Noteworthy rules and requirements that apply to LPNs in Tennessee include:
- A LPN may participate in various nursing tasks as their experience and education allow while supervised by a nurse or other such medical professional with the necessary credentials.
- A LPN can assist in collecting and reporting patient data and participating in making and implementing plans for patient care.
- A LPN may delegate responsibilities, tasks, and activities, but only if they are within a LPN's scope of care. They must also only delegate tasks to individuals who are qualified to handle them safely.
- A LPN may administer an “intravenous push medication” when an appropriate medical professional has prescribed these medications and an appropriate medical professional is supervising the LPN.
There are instances when a LPN may not be permitted to administer intravenous push medications, even when they meet the other criteria mentioned above. For example, the law prohibits a LPN from administering intravenous push medications to anyone who isn't an adult weighing more than 80 pounds.
The law also prohibits LPNs from administering the following in the context of intravenous therapy:
- Chemotherapy
- Serums
- Oxytocics
- Tocolytics
- Thrombolytics
- Blood or blood products
- Titrated medications and similar calculated doses
- Moderate sedation
- Anesthetics
- Paralytics
- Experimental drugs
- Investigative drugs
That's just a general overview. Remember that the overall rules pertaining to the practice of nursing apply to LPNs as well in Tennessee.
Also, remember that being accused of a violation can significantly jeopardize your career. If you're a LPN in Tennessee who has been accused of violating the Nurse Practice Act in any way, be proactive about securing your future by enlisting the help of our Professional License Defense Team at the Lento Law Firm.
Rules and Regulations for Registered Nurses in Tennessee
A RN has more training and education in the nursing profession than a LPN. The Tennessee NPA contains a statute describing the scope of practice for a RN in the state. A RN may:
- Conduct a comprehensive nursing assessment
- Document a comprehensive nursing assessment
- Apply nursing knowledge based on various factors of a patient's condition
- Identify patient information that's inaccurate, missing, or otherwise faulty
- Plan nursing care and interventions that align with a patient's overall health/treatment plan
- Make independent nursing decisions and diagnoses based on one's reasonable critical thinking, judgment, etc.
- Ask for clarification of orders when necessary
- Provide treatment and therapy
- Obtain the necessary instruction when using new tools, technology, and equipment, or when in an otherwise unfamiliar care situation
- Attentively monitor patients
- Identify patient health status changes and understand what those changes may signify in regard to patient wellness
- Evaluate the way patients respond to nursing care and other therapies
- Communicate and consult with other members of a patient's health team
- Properly document nursing care
- Revise a care plan when necessary
- Take necessary preventive measures to optimize the safety of patients, oneself, and others
- Provide nursing and health education
Other general points the law makes regarding the duties and permitted activities of RNs in Tennessee are:
- Although the Tennessee code doesn't prohibit RNs from expanding their roles, if a RN does expand their role, they assume personal responsibility for their acts.
- A RN must generally serve as a patient advocate. This involves, among other duties, respecting a patient, attending to their needs, speaking up for their needs, promoting their choices, and working to ensure a safe environment for patients.
- A RN has certain management and organizational authority that allows them to delegate tasks relevant to a patient's care.
- When necessary, an RN has the authority to make a pronouncement of death.
The full text of the law elaborates on the above points. Its complexity highlights an important fact: There can be seemingly gray areas in regard to a nurse's rights and responsibilities.
It's possible to face disciplinary action for a debatable violation if a nurse performs a task that may or may not be outside their scope of practice. If this is happening to you, or if you're facing disciplinary action for any other alleged violation of the Tennessee Nurse Practice Act, the Lento Law Firm Professional License Defense Team is on hand to help.
Rules and Regulations for Advanced Practice Regular Nurses in Tennessee
The Tennessee NPA also contains a section describing the duties and scope of practice of advanced practice regular nurses (APRNs). Highlights from this section of the law regarding the responsibilities of APRNs include:
- Along with complying with the standards that apply to RNs, APRNs must comply with the standards of the national certifying bodies for their areas of specialty. If there are conflicts between the accepted standards for an APRN's specialty and the accepted standards for RNs, the standards for the APRN's area of specialty take precedence.
- APRNs may be involved in treating patient pain. The law provides detailed explanations regarding how an APRN may treat patient pain using controlled substances and other such methods in a manner that's consistent with their scope of practice. An APRN involved in managing patient pain should review the law to determine which specific details apply to them. For example, an APRN may need to document that they prescribed or administered a controlled substance to address patient pain for a legitimate medical purpose supported by scientific knowledge.
- APRNs have a duty to create and maintain medical records for all patients they treat. These records are separate from the hospital records a healthcare facility generates, even if a nurse is an employee of said facility.
As one's responsibilities increase as a licensed nurse, so do the chances of accidentally engaging in violations of the NPA due to misunderstandings of the rules. Be sure you have proper representation if you're ever accused of such a violation.
Get Help from the Lento Law Firm for an Alleged Violation of the Tennessee Nurse Practice Act
We at the Lento Law Firm's Professional License Defense Team have substantial experience representing clients facing disciplinary action due to supposed violations that could put their licenses at risk. Although this overview of the Tennessee NPA hopefully provided valuable information, there's no substitute for having attorneys on your side during disciplinary proceedings. Find out more about how we can help by submitting your information via our online contact form or calling our offices at 888-535-3686.
