Every state has its own set of laws and regulations that govern the nursing profession in that state. They're typically called “Nursing Practice Acts,” though their formal names vary from state to state. In Pennsylvania, the Nursing Practice Act can be found in its Professional Nursing Law, its Practical Nurse Law, and its regulations governing the State Board of Nursing. Together, these laws and regulations cover a range of topics related to the practice of nursing in Pennsylvania, including educational requirements, licensing procedures, the composition and powers of the Board of Nursing, the types of nurses licensed, and the care they are authorized to provide nursing standards, and nurse discipline.
If you're a licensed nurse working in Pennsylvania, or if you hold a Pennsylvania nursing license and work elsewhere, it's important to have a good understanding of what the Pennsylvania Board of Nursing (BON) expects of you as a nurse as well as what you're prohibited from doing. If you have questions about any of that, or if you are facing a disciplinary investigation or proceeding from the Pennsylvania BON, you need the help of one of the experienced attorneys from the LLF Law Firm's Professional License Defense Team. Call us today at 888.535.3686 or use our contact form to arrange a confidential consultation.
What is the Nursing Practice Act?
Pennsylvania's Nursing Practice Act (NPA) – while not formally known by that name – consists of two sets of laws and one set of regulations. One set of laws is for registered nurses of all types and is known as The Professional Nursing Law. A second set of laws applies to licensed practical nurses and is called the Practical Nurse Law. Pennsylvania's nursing regulations apply to both registered and practical nurses. The Pennsylvania Board of Nursing is responsible for nurse licensing, certification of nurse education programs and continuing education programs, implementation of policies related to the practice of nursing, and nurse disciplinary investigations and proceedings, among other things.
There are hundreds of individual sections of the law and regulations that make up Pennsylvania's NPA. In addition, the Pennsylvania BON webpage provides links to a number of different informational resources for nurses as well as the general public. As useful as all of this information is, the fact that there is so much of it can sometimes make it challenging to find what you need when you have a question or have been accused of misconduct. The LLF Law Firm's Professional License Defense Team has a detailed understanding of the various aspects of Pennsylvania's NPA and is ready to help guide you when you have questions and defend you if you've been accused of misconduct.
What Does Pennsylvania's Nursing Practice Act Authorize Nurses to Do?
The Pennsylvania NPA recognizes a number of different types of nursing licenses under two categories. Registered nurses are one category, which also covers clinical nurse specialists, certified registered nurse anesthetists, and certified registered nurse practitioners. Practical nurses are a second category.
Registered nurses of all types are expected to be able to do the following:
- Collect “complete and ongoing data” about a patient and use it to determine the patient's nursing care needs.
- Analyze the health status of patients, comparing that information with “the norm” to determine the care that the patient requires.
- Identify “goals and plans” for patient nursing care.
- Carry out “nursing care actions” designed to “promote, maintain, and restore the well-being” of patients.
- Involve both patients and their families in promoting, maintaining, and restoring the patient's health.
- Evaluate the effectiveness of the nursing care provided to a patient.
- Follow applicable standards of practice and codes of behavior established by nursing associations of which the nurse may be a member.
- Administer a drug that has been ordered for a patient “in the dosage and manner described.”
- Perform immunizations and skin testing pursuant to a physician's order, following policies and procedures established by their employer.
- Only perform venipunctures and administration of intravenous fluids when ordered to do so in writing by a licensed physician, and only if the nurse has the appropriate education and experience to do so.
- Only perform external cardiac resuscitation and mouth-to-mouth artificial respiration when the patient's pulse or breathing stops unexpectedly, and only if the nurse has the appropriate education and training to do so.
- Only operate monitoring, defibrillating, or resuscitating equipment if permitted to do so by their employer, according to criteria and techniques established by physicians and nurses, and only if the nurse has received appropriate training.
In addition, registered nurses of all types, as well as practical nurses, are expected to follow certain standards of nursing conduct. These include:
- Undertaking a “specific practice” only if the nurse has the “knowledge, preparation, experience, and competency” to do so.
- Respecting and considering the patient's right to “freedom from psychological and physical abuse.”
- Safeguarding patients from “incompetent, abusive or illegal” practice.
- Safeguarding the dignity of their patient.
- Respecting the patient's right to privacy and confidentiality with respect to their health care information.
- Documenting patient care accurately
All nurses must notify the BON if they are charged with any crime, within 30 days of when they are charged. They must also notify the BON of any criminal conviction, guilty plea, “no contest” plea, or admission into a probation program within 30 days of when that occurs. If they are disciplined by another state, territory, or country, they must notify the BON within 90 days of when they receive notice of the discipline.
Certified Registered Nurse Practitioners
A certified registered nurse practitioner (CRNP) is a registered nurse who operates in an “expanded role as a professional nurse” and is authorized to diagnose patients and prescribe “medical therapeutic or corrective measures” in collaboration with a physician. Certified registered nurse practitioners are able to do the following:
- Perform “comprehensive assessments” of patients and make medical diagnoses.
- “Order, perform, and supervise diagnostic tests” for patients that are consistent with the CRNP's specialty and, if consistent with the CRNP's collaborative agreement, interpret the results.
- Refer patients to other licensed healthcare providers and consult with other healthcare providers at their request.
- “Develop and implement” patient treatment plans.
- Where the CRNP is authorized, treatment plans that include pharmaceutical treatments are developed and implemented.
- Prepare patient “admission and discharge summaries.”
- Place orders for “blood and blood components for patients.”
- Make orders for patient dietary plans.
- Make orders for a patient's “home health and hospice care.”
- Place orders for “durable medical equipment.”
- Refer patients to physical therapists and dietitians.
- Refer patients for respiratory and occupational therapy.
- Perform certain types of disability assessments.
- Certify a patient for homebound schooling.
- Make and sign an initial assessment evaluation for methadone treatment.
- Issue certain oral orders as permitted by their health care facility.
- Where the CRNP has the authority to prescribe and dispense certain types of drugs for a patient.
- Where the CRNP has the authority to request and receive professional drug samples and dispense them to patients.
The LLF Law Firm has helped CRNPs all across Pennsylvania in cases where they face misconduct investigations and allegations brought against them by the Board of Nursing.
Certified Registered Nurse Anesthetists
Certified registered nurse anesthetists are permitted to administer anesthesia under certain conditions set by the BON. In addition to the requirements that apply to all registered nurses, certified registered nurse anesthetists can:
- Administer anesthesia to patients “in cooperation with” a dentist or a surgeon.
- Provide “brief periods of care” to a patient in the absence of a dentist or surgeon in the event of an emergency.
The LLF Law Firm understands the standards that CRNAs are expected to meet in Pennsylvania and can defend you if you're a CRNA who has been accused of misconduct by the Pennsylvania BON.
Practical Nurses
Practical nurses have separate requirements from registered nurses when it comes to the care they can provide. They are expected to be able to perform the following functions:
- Seek guidance from a registered nurse and the patient's health care team under the following circumstances:
- The care needs of the patient are beyond the scope of what the practical nurse is authorized to provide.
- The care needs of the patient go beyond the practical nurse's “knowledge, skill or ability.”
- The patient's condition worsens or significantly changes; the patient fails to respond to therapy; the patient becomes unstable; or the patient needs immediate help.
- Obtain instruction and supervision when “implementing new or unfamiliar nursing practices or procedures.”
- Follow their employer's written care policies and procedures to the extent those policies and procedures are consistent with Pennsylvania's Practical Nurse Law.
- Administer medication and carry out therapeutic treatment according to appropriate written orders from a licensed health care practitioner or, under certain circumstances, according to an appropriate oral order.
- Question any order that the practical nurse believes to be unsafe or contraindicated for a particular patient and raise the matter with the physician or registered nurse who gave the order.
- Only accept oral orders to provide the type of care that is within the scope of their license.
- Record all oral orders in the appropriate patient's medical records.
- Collaborate with other health care professionals in developing, implementing, and revising policies and procedures to ensure the “comfort and safety of patients.”
- Administer immunizations and perform skin tests provided the practical nurse has the appropriate required training and the nurse has been ordered to do so by a licensed physician.
- Provide only certain types of intravenous therapy consistent with the practical nurse's education and ability and the BON regulations, following appropriate protocols, and only under appropriate supervision by a registered nurse or physician who is authorized to order the IV therapy.
If you are a practical nurse in Pennsylvania and have been notified that you're under investigation by the BON for alleged misconduct, the LLF Law Firm's Professional License Defense Team can help defend you during the investigation and any disciplinary proceeding that may follow.
Pennsylvania BON Continuing Education Requirements
Registered and practical nurses are required to meet continuing education requirements set by the Pennsylvania BON. The nurse must affirm that they have met the requirements that apply to their particular type of license when they renew it, which happens every two years. The BON performs random audits of nurses to check that they have actually completed the continuing education required for their license renewal. Nurses who misrepresent their continuing education credits will face discipline by the BON.
What Does Pennsylvania's Nursing Practice Act Prohibit Nurses From Doing?
Pennsylvania's NPA prohibits all types of nurses from engaging in the following types of misconduct:
- Discriminating against a patient based on “age, marital status, sex, sexual preference, race, religion, diagnosis, socioeconomic status or disability.”
- Helping another person violate a law or a BON regulation.
- Stealing from an employer or a patient.
- Asking for or borrowing money from a patient or their family.
- Leaving a nursing assignment before reporting to or notifying the appropriate supervisor.
- Abandoning a patient who is in need of care.
- Falsifying patient care records.
- Having sexual contact – consensual or otherwise – with a patient.
- Allowing another person to use the nurse's license or to misidentify themselves as the licensed nurse.
In addition, of course, any violation of NPA laws or rules that relate to the nurse's practice may result in a disciplinary investigation and proceeding against the nurse. If you've been notified that a misconduct complaint has been filed against you with the Pennsylvania BON, you need to take it seriously because your license and livelihood may be at risk. The LLF Law Firm's Professional License Defense Team can help you understand the allegations made against you, determine what the potential consequences are, and make sure you respond promptly and effectively to the BON's request for information. Our experienced attorneys will also vigorously represent and defend you through the entire proceeding.
How the LLF Law Firm's Professional License Defense Team Can Help
If you're facing allegations that you've violated Pennsylvania's Nurse Practice Act or any Board of Nursing rule, you need to take them very seriously. By working with one of the experienced attorneys from the LLF Law Firm's Professional License Defense Team, you avoid much of the day-to-day stress of being involved in a BON disciplinary investigation and proceeding.
We will make sure you meet all BON deadlines. We will help gather evidence that may be able to help you and can present that evidence to the BON on your behalf. We'll communicate on your behalf with the BON, saving you from having to do so, and can negotiate with the BON at appropriate times to resolve your case without a hearing. If a hearing is required, you can be sure that we will vigorously defend you and will protect your rights.
The LLF Law Firm's Professional License Defense Team has helped nurses from all across Pennsylvania and the U.S. defend their licenses, their livelihoods, and their reputations when confronted with board of nursing disciplinary investigations and proceedings. We can help you, too, but only if you call us at 888.535.3686 or use our contact form to schedule a confidential consultation. You've spent years earning your nursing license; let the LLF Law Firm help you keep it!
