Scope of Practice Decision Making Model LPNs in a ... - Montana DLI

In a rapidly
changing
healthcare
environment,
it is important
that nurses
have the
tools to make
sound clinical
judgments
and decisions
about nursing
practice.
4
FROM THE EXECUTIVE DIRECTOR
Thank you to all of the nurses out there
in Montana who are working hard to make a
difference in peoples’ lives! We all understand
that nursing in a frontier state may
pose unusual challenges, so it is not surprising
that when I am out in the field visiting
with staff nurses, nursing leaders, and administrators,
those challenges come to light.
Nursing practice is regulated by the
Board of Nursing, but nurses are also working
in environments regulated by federal
and state agencies. At times, nurses find
the role expectations to be inconsistent
with what they may have been told is okay
or not okay – or at best, unclear. That is
one of the reasons that this newsletter includes
information about the board’s Scope
of Practice Decision Making Model. This is
one tool that may be used when you are not
sure what to do.
STATE TRAVELS
Over the previous years in which I
served as Executive Director to the Board
of Nursing, as well as during the past year, I
have traveled around the state to provide
education about the board, including its
structure, processes and functions, to
nurses, nursing leaders, and administrators
of health care facilities. I have gone to all
corners of the state, such as Kalispell,
Phillipsburg, Butte, Fort Peck/Poplar/Wolf
Point, Billings, Bozeman, Helena, Great
Falls, and others to meet with people involved
in nursing. All of this travel has provided
great opportunities for dialogue about
nursing issues and board policies.
A topic of great interest at this time is
the Scope of Practice Decision Making
Model provided in this issue (also available
on our website www.nurse.mt.gov). This
tool helps nurses make informed decisions
about whether or not to perform a particular
function and what level of licensure may
be needed to do so. What is okay for one
nurse to do is not necessarily okay for all
nurses to do. Of course, we are always willing
to help you work through this process
via email, letter or phone communications.
I am glad to provide these educational
opportunities and, upon request, will schedule
a visit to your area or facility. This is an
important role for the BON Executive Di-
rector and I am more than happy to provide
this service so that individuals can
gain a better understanding of board functions
and how the laws and rules pertaining
to nursing are applied to nursing practice.
In a rapidly changing healthcare environment,
it is important that nurses have the
tools to make sound clinical judgments and
decisions about nursing practice.
Always remember that an employer can
limit a nurse’s scope and responsibilities
through policies and procedures, but nobody
can expand the role and scope of a licensed
nurse other than the Board of
Nursing and Montana Legislature.
BON WINS LAWSUIT
We have many areas in our state that are
primarily served by APRNs, particularly
CRNAs and Nurse Practitioners. We are
pleased to provide a regulatory environment
that allows independent practice,
which is not the case in many other US
board jurisdictions.
In November 2007, the Montana
Supreme Court ruled unanimously for the
Board of Nursing in its interpretation of
CRNA practice as independent and collaborative.
The suit was brought by The Montana
Society of Anesthesiologists and Dr.
Michael Sterbis in December 2002. I would
like to thank our attorney, Lorraine Schneider,
who provided counsel on behalf of the
Board in this lengthy process.
We also sincerely thank our friends in
this effort, MHA – An Association of Montana
Healthcare Providers and the Montana
Association for Nurse Anesthetists,
for their support and participation in the
case. This case has been of significant interest
to CRNAs around the country and,
fortunately, served to validate what the
Board has always maintained – that
APRNs can and do function independently
and collaboratively.
I look forward to meeting more of you in
the coming months as I continue to travel
around the state. Please feel free to call me
if you wish to schedule a presentation!
Barbara Swehla, MN RN
Executive Director