The New Hampshire Board of Nursing (or simply “the Board” going forward) is the state licensing agency responsible for overseeing nurses in the Granite State—and for disciplining them when they engage in certain types of misconduct and violations. The New Hampshire Nurse Practice Act (NPA) is the law granting the Board this power.
The NPA establishes the scope of practice for different types of nurses in the state. Operating outside one's scope of practice or engaging in other types of violations can result in disciplinary action that may limit a nurse's ability to practice.
This overview of the NPA will touch on the powers it grants the Board, the duties and responsibilities it establishes for different types of nurses in New Hampshire, and the reasons the Board may consider disciplinary action under the NPA. If you ever face such disciplinary action, the Lento Law Firm Professional License Defense Team offers New Hampshire nurse license defense services to help you protect the career you've worked hard for. Learn more about what we can do for you when the Board considers disciplinary action by submitting your information via our online contact form or calling our offices today at 888-535-3686.
Powers the New Hampshire Nurse Practice Act Grants the New Hampshire Board of Nursing
The New Hampshire NPA specifically grants the Board the following powers, authorities, and duties:
- Establishing standards for nursing practice in the state that are “reasonable and uniform” and are based on criteria that the National Council of State Boards of Nursing (NCSBN) has deemed relevant
- Establishing criteria regarding eligibility to obtain or renew a nursing license
- Determining whether a nurse has engaged in misconduct and taking disciplinary action when necessary
- Establishing criteria so the Board can determine whether to deny or withdraw its approval of a nursing educational program
- Limiting a registered nurse or licensed nurse's multistate licensure privilege in accordance with state due process laws
- Establishing subcommittees that may be necessary to assist the Board in fulfilling its duties
Sometimes, the Board's duties involve protecting the public by limiting or even revoking the licenses of nurses who engage in misconduct. That's not to say the Board is always perfect in its judgment when investigating and disciplining nurses.
If the Board is investigating you, our Professional License Defense Team at the Lento Law Firm is prepared to represent you throughout an investigation. We'll present your side of the story, speak up when the Board appears to be violating your rights, and take other steps necessary to ensure you receive fair treatment (and a fair outcome).
The Scope of Practice for Different Types of Nurses Under the New Hampshire NPA
The New Hampshire NPA establishes what the following types of nurses can and can't do when practicing nursing in the state:
- Registered Nurses (RNs)
- Advanced Practice Registered Nurses (APRNs)
- Licensed Practical Nurses (LPNs)
- Licensed Nursing Assistants (LNAs)
- Certified Assisted Living Medication Aides (CALMAs)
It doesn't matter what specific type of nursing license you hold: If you have any of the above licenses and you're facing potential Board disciplinary action in New Hampshire, the Lento Law Firm Professional License Defense Team is on hand to serve your needs now.
New Hampshire NPA and the Scope of Practice for RNs
The scope of practice for a RN in New Hampshire is limited to:
- Providing comprehensive nursing assessments
- Working with other members of a healthcare team to develop and implement a plan of health for a client
- Developing a general plan of nursing strategies that should integrate with the specific health plans of specific clients
- Delegating nursing interventions for the purposes of implementing a plan of care
- Providing for maintenance of safe and effective nursing care
- Promoting an environment that's safe and therapeutic for patients
- Providing education/teaching and counseling on health topics for the benefit of patients, their families, etc.
- Advocating for clients, their families, communities, etc.
- Evaluating the effectiveness of care, interventions, etc.
- Communicating and collaborating with other professionals in the healthcare environment
- Leveraging new knowledge and technologies to assist with and improve nursing efforts
- Managing/evaluating/supervising the overall practice of nursing
- Teaching nursing's theory and practice
- Helping develop policies, procedures, etc., that may benefit patients
- Providing other nursing services that may require additional training as the Board sees fit
APRNs' Scope of Practice in New Hampshire
The scope of practice for an APRN in New Hampshire involves combining the education and skills a nurse received, cultivated, and developed during their basic nursing education. The scope of practice specifically consists of:
- Performing, at an advanced level, acts related to or involving “assessment, diagnosing, prescribing, selecting, administering, and providing therapeutic measures and treatment regimes”
- Obtaining consultation or planning services as required by a patient's needs, or transferring a patient's care to another professional as required by their needs
- Providing other services and functions that an APRN has the experience and/or skills necessary to provide, as long as one does so in accordance with the standards of an appropriate body
The Scope of Practice for a LPN in New Hampshire
In New Hampshire, the NPA establishes the scope of practice for a LPN as the following:
- Collecting patient data
- Conducting focused assessments of patient health
- Planning the nursing care of patients whose conditions are stable
- Helping develop and implement a comprehensive plan of care that's applicable to all types of patients
- While accounting for one's scope of practice, implementing elements or aspects of a plan of care as one is qualified to do so
- Assisting with the management of nursing care by assigning tasks, delegating roles, etc., as one is permitted to do under the NPA
- Whether rendering nursing care directly or indirectly, maintaining safe and effective care
- Ensuring the treatment environment is safe and therapeutic
- Participating in teaching and counseling as necessary to ensure patients receive optimal care and achieve optimal health outcomes
- Communicating and collaborating with other personnel as an advocate for a patient
- Helping evaluate patient responses to health interventions
- In general, communicating and collaborating with other professionals in the health field
- Offering input to help develop relevant policies and procedures
- Providing other nursing services that may require additional training, as the Board deems fit or necessary
New Hampshire NPA and the Scope of Practice for LNAs
The New Hampshire NPA defines the scope of practice for a LNA as well. It states that, upon completing an approved educational/training course, a LNA may:
- Be able to establish a relationship with individuals and groups that allows them to interact and communicate effectively in the performance of their duties
- Demonstrate, by performing or assisting with nursing-related activities, that they comprehend the various health needs (including emotional and social health needs) of patients
- Help individuals achieve functional independence (and maintain it)
- Generally exhibit behaviors that support the rights of patients receiving care
- Demonstrate skills indicating they are able to observe and properly report information pertaining to patient health
- Generally provide safe nursing-related activities and services while under another's supervision
That last point is important. The NPA states that a LNA in New Hampshire may only work under the supervision of a RN, APRN, or LPN.
It also states that a LNA may be able to administer medication if either of the following apply:
- They have a certificate of medication administration that's valid and current
- Another licensed nurse has delegated the task of medication administration to an LPN in a “home care, hospice, residential care, public school, or adult day care setting”
The Scope of Practice for CALMAs Under the New Hampshire NPA
Under the New Hampshire NPA, a CALMA should be able to do the following after completing an educational program:
- Applying knowledge and techniques they've acquired in their education when administering medication
- Effectively communicate with an administrator and other relevant professionals regarding the topic of medication administration
- Maintain methods of medication administration that are geared towards effectiveness and patient safety
- Maintain records per the directions of a facility's administrator
The scope of practice of a CALMA requires them to work under the supervision of a licensed facility's administrator. The NPA only authorizes a CALMA to administer non-injectable medication, and they may only do so if the following BOTH apply:
- They have completed a Board-approved CALMA educational program and hold a valid and current certificate of completion accordingly.
- They are serving patients or clients in a residential setting.
Reasons the New Hampshire Board of Nursing Can Take Disciplinary Action Under the New Hampshire Nurse Practice Act
The NPA also establishes the circumstances in which the Board is justified in considering disciplinary action against a nurse's license in New Hampshire. Per the NPA, the Board can discipline a nurse or applicant for the following reasons:
- Not demonstrating the proper qualifications or otherwise failing to satisfy the requirements necessary to practice nursing in the state
- Engaging in any conduct that violates the security of the exam nurses must complete to receive their licenses in New Hampshire
- Any conviction (whether through a trial/court or plea) of any crime in any jurisdiction, if that crime reasonably relates to the practice of nursing or otherwise indicates an individual may be unable to practice nursing safely
- Fraud or deceit in obtaining or attempting to obtain a nursing license, filing reports, or other such areas of a nurse's practice
- Engaging in various forms of unethical conduct, particularly conduct that has a relatively significant chance of defrauding or otherwise harming the public
- Having a nursing license that has been subject to discipline in another state
- Being unable to perform nursing tasks with “reasonable skill and safety”
- Unprofessional conduct
- When one is a chief administrative nurse not adhering to “recognized standards and guidelines” when overseeing nurses under one's supervision and management
- When the Board grants a modified license, failing to operate within the modified scope of practice
- Engaging in any nursing practice that could theoretically endanger a patient's safety, regardless of whether that patient sustained an actual injury
- Having an illness, injury, or other such condition that prevents a nurse from being able to practice nursing safely
- Falsifying reports, not maintaining proper boundaries with patients, engaging in sexual misconduct, engaging in violent acts, not complying with a Board investigation, and other forms of behavior inconsistent with the standards for nurses in New Hampshire
- Diverting drugs or controlled substances, or attempting to do so
- Not complying with the terms of an alternative program agreement (which is sometimes an alternative to disciplinary action when a nurse struggles with a substance abuse issue)
- Engaging in various forms of other drug-or-alcohol-related misconduct not already covered by previous points
- Assisting others in practicing unlicensed nursing
- Violating a Board rule or order
- Failing to report violations of the NPA
- Practicing beyond the scope of one's practice as the NPA defines it
The Board is authorized to take several different forms of disciplinary action against a nurse when misconduct occurs. In some cases, the Board may essentially let a nurse off with a formal warning. While this might not limit their privileges as a nurse, the public could nevertheless learn of it. The damage this does to a nurse's reputation might affect their employability.
Other forms of disciplinary action the Board may consider are more significant. The Board has the power to do everything from limiting a nurse's license so they may only perform certain nursing tasks, to revoking a nurse's license entirely.
These points highlight the importance of having a proper defense when under Board investigation. At the Lento Law Firm, attorneys with our Professional License Defense Team understand the New Hampshire NPA and how it applies to cases like yours. We'll leverage that understanding to help you fight for your career.
Get Help With a New Hampshire Nurse Practice Act Case
If you've been accused of violating any of the rules of the New Hampshire NPA (or other applicable Board rules), at the Lento Law Firm Professional License Defense Team, you'll find attorneys who specifically work with clients like you and handle cases like yours. Find out more about how we can assist with your case by submitting your information online or calling us at 888-535-3686.
