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Foundations for Practice and Action: Scope and Standards for Practice

Last month’s short history about the development of today’s Code of Ethics for Nurses with Interpretive Statements and Nursing’s Social Policy Statement, Second Edition, reminded us of the legacy the American Nurses Association (ANA) provides to all nurses. Now, let’s explore the next important ANA contribution to nursing practice, Nursing: Scope and Standards of Practice. This work constitutes the “nuts and bolts” of nursing practice and highlights our contributions to our patients, healthcare consumers, and the healthcare delivery system.

The Standards document will help you appreciate the new definition of nursing, the complexity of our contemporary and evolving scope of practice, the definition of the standards of practice and professional performance for all registered nurses, and the history that includes previous published versions of the scope of practice and standards. I recommend you scan the listing of the standards of practice inside the front cover and the standards of professional performance inside the back cover.

The Preface and Introduction set the stage and alert you to the new standards of nursing practice and the definition of nursing:Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.

This language focuses on the opportunities for positive outcomes associated with positive actions of protection, promotion, optimization, prevention, alleviation, and advocacy. I find this a very powerful statement. It describes the practice of every registered nurse in every role and every setting. My campaign message focused on my commitment to ACTION, and I challenge you to act: Ask five nurses to define nursing. Because you are gathering evidence as you conduct this research (Standard 13 Research, one of the defined standards of professional performance for all registered nurses), ask your colleague for the source of the definition. Compile your findings and share them with another nurse who has done a similar assessment (Standard 1 Assessment, one of the standards of practice). What do you predict you will discover?

Perhaps your analysis will match my observations during recent meetings and visits to practice environments. Some nurses are incorporating the standards of practice and professional performance in their everyday practice. Others learned about the scope and standards of practice in their academic programs but don’t have the opportunity to implement the standards in their workplace. Others have no clue what I mean when we discuss the scope and standards of practice.

Again, I call you to action, using one as the metric. Read the entire scope of practice statement and the standards of nursing practice one time. Then talk with one nurse about one concept, thought, or sentence in the scope of practice statement. What does it mean to each of you? How can you use it to make a difference in your practice? Should the language be revised to better describe nursing today or the future we envision?

On one other occasion, select one standard of nursing practice and the accompanying measurement criteria. Describe to one nurse how that one standard is reflected in your practice. Does your practice environment support, hamper, or prevent compliance with the selected standard and each measurement criterion? What one action could help ensure that your practice environment would allow you to demonstrate compliance?

You might be asking: “So what? Why should I do just one thing? Who cares?” Well, you never know how your one action, one comment, or one question about nursing’s scope and standards of practice might positively affect one other person to do the same, and in turn prompt another person to do the same, and so on. And please remember that I care, as do your fellow nurses, the students who see you as a role model, and those receiving your nursing care. We must be the best we can be through ACTION! Just Do It!

Rebecca M. Patton, MSN, RN, CNOR

American Nurses Association

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