Scope of Nursing and Midwifery Practice Framework: definition of scope of nursing practice

A registered nurse is a person who:

• Has successfully completed a recognised and approved nursing education programme in the country where the qualification was achieved;
• Has acquired the necessary requirements to be registered to practise nursing in this jurisdiction and use the title ‘registered nurse’;
• Demonstrates and maintains competency in the practice of nursing.

This definition provides the basis for the following definition of the scope of nursing practice.

The scope of nursing practice is the range of roles, functions, responsibilities and activities which a registered nurse is educated, competent and has authority to perform.

Nursing practice is underpinned by values that guide the way in which nursing care is provided. The Nursing and Midwifery Board of Ireland considers that the following values should underpin nursing practice and provide the basis for the formulation of a philosophy of nursing:

1. In making decisions about their individual scope of practice; nurses should keep to the fore the rights, needs and overall benefit to the patient and the importance of promoting and maintaining the highest standards of quality in the health services.
2. Nurses respect all people equally without discriminating on the grounds of age, gender, race, ethnicity, religion, civil status, family status, sexual orientation, disability (physical, mental or intellectual), or membership of the Traveller community.
3. Fundamental to nursing practice is the therapeutic relationship between the nurse and the patient that is based on open communication, trust, understanding, compassion and kindness, and serves to empower the patient to make life choices.
4. Nursing practice involves advocacy for the rights of the individual patient and for their family. It also involves advocacy on behalf of nursing practice in organisational and management structures within nursing.
5. Nurses recognise their role in delegating care appropriately and providing supervision to junior colleagues and other health care workers, where required.
6. Nursing care combines art and science. Nursing care is holistic in nature, grounded in an understanding of the social, emotional, cultural, spiritual, psychological and physical experiences of patients, and is based upon the best available research and experiential evidence.
7. Nursing practice must always be based on the principles of professional conduct stated in the latest edition of the Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives.

An individual nurse’s scope of practice is dynamic – that is, it will change and grow as they progress in their career.

The scope of practice of the individual nurse is influenced by a number of factors, including:

• The nurse's educational preparation, professional practice and competence
• Local, national and international guidelines, policies and evidence
• The practice setting
• Collaborative practice
• Other factors, such as patient safety, patient needs and care outcomes