Exemption Review Guidelines
for Employment Verification
NDCC 43-12.1-04. PERSONS EXEMPT FROM PROVISIONS OF CHAPTER. This chapter does not apply to (6) an individual who performs nursing tasks for a family member. Nurses are excluded in the definition of a person in NDCC 43-12.1-04 (6).
Within NDCC Section 43-12.1-03 any person who provides nursing care to a resident of this state must hold a current license issued by the board. It is unlawful for a person to practice nursing, offer to practice nursing, or use any title, abbreviation, or designation to indicate that the person is practicing nursing in this state unless that person is currently licensed. Nurses caring for a family member may apply that type of nursing practice towards meeting the practice requirement for renewal of licensure provided the activities performed are those which require the judgment and skill of a licensed nurse. Any nurse submitting practice hours involving care of family must:
- Submit documentation that provides at least weekly documentation of care utilizing knowledge and skills that meet the definition of nursing. See ND Nurse Practices Act 43-12.1-02(5). DEFINITIONS.
- The documentation must include the following:
- Relationship to client
- Age of client
- Medical diagnosis
- Length of time care provided
- Approximate number of hours per day providing nursing care.
- The documentation must reflect use of the nursing process.
- ASSESSMENT OF HEALTH STATUS OF AN INDIVIDUAL
- Include an assessment of all systems and status of system, i.e. lung sounds, bowel sounds, heart sounds etc.
- Emotional status
- Psychological status
- Spiritual status
- ESTABLISHES NURSING DIAGNOSIS TO IDENTIFY NEED OF CLIENT (Actual or potential health problems)
- Client oriented. The client not the nurse is expected to meet these outcomes. For instance, “the client will walk around the room at least once very eight hours” or “by the end of the month client will routinely perform self-care activities independently without reminders.”
- PLANNING OF CARE
- What skills did you use in performing interventions?
- Intellectual, interpersonal, and technical skills. For example:
- Offer fluids every two hours
- Positioned for optimum breathing
- Taught deep-breathing exercises
- Include medications, treatments, activity, diet.
- IMPLEMENTATION OF NURSING PLAN OF CARE
- EVALUATION OF THE RESPONSES TO NURSING INTERVENTIONS
- What effect did your care provide to the family member?
- Communicating response to care to appropriate members
of the health care team.
The burden of proof that activities meet the practice requirement remains with the applicant for renewal of licensure or applicant for licensure by endorsement. The Board will review the documentation that is submitted by the individual on a case by case basis. The Board will consider the following elements and ask the following questions when evaluating applicants for licensure regarding meeting the practice requirement:
- Are the activities the nurse performs within the statutory definition of the practice of nursing?
- Do the activities require application of the knowledge and skill gained from nursing education?
- Does the nurse use the elements of the nursing process in his/her work?
- Are the activities with the scope of practice for which application for licensure is made (LPN or RN)?
- In a situation where care is provided for a family member, would the nurse, if unavailable to provide the care, have to utilize a nurse to provide the care?
- Can the nurse describe how he/she uses nursing knowledge and elements of the nursing process in his/her work?
- Can the nurse volunteer articulate what parts of the volunteer role use elements of nursing practice?
If the documentation submitted does not show sufficient evidence by which the Board may determine that the practice fits the definition of nursing the individual shall be notified by the Board that the hours submitted do not meet the criteria set forth in the law and rules.
For information on the Board’s Rules on Standards of Practice please refer to NDAC Section 54-05-02 Standards of Practice for Registered Nurses or NDAC Section 54-05-01 Standards of Practice for Licensed Practical Nurses.
Complete the Exemption Review Form.