Safety to Practice
Guidance regarding the interpretation and application of the Nurse Practices Act (NPA) may be adopted by the ND Board of Nursing (Board) as a means of providing direction to licensees and stakeholders who seek to ensure safe nursing practice and to address issues of concern relevant to public protection. (North Dakota Century Code (NDCC) 43-12.1-08(2)(p)).
Board approved practice guidance does not carry the force and effect of the law/rules. Each licensed nurse (nurse) is “responsible and accountable to practice according to the standards of practice prescribed by the board and the profession”; and must “accept responsibility for judgments, individual nursing actions, competence, decisions, and behavior in the course of nursing practice.” (Standards of Practice, North Dakota Administrative Code (NDAC) 54-05-01-07 and 54-05-02-04). “Competence": means the application and integration of knowledge, skills, ability, and judgment necessary to meet standards. (NDAC 54-01-03-01(16)).
The competence and reliability with which a nurse can practice at any given time is called functional ability. It is an essential element of safe nursing practice.
The Board of Nursing is aware that nurses sometimes experience short or long term situations that may compromise the individual’s ability to safely practice nursing. Situations may include personal or job-related stress, sleep deprivation, normal effects of aging, episodic or persistent health conditions and any other unique circumstances affecting the person. These situations may require the use of prescription and/or non-prescription medications.
Role of the Nurse
Whether a nurse should continue practicing nursing when they or their practice may be compromised depends upon the nurse’s functional ability to practice safely and effectively. The assessment of functional ability requires active consideration of all relevant factors, such as diagnosis, prescribed treatment and situational events, as well as an evaluation of the impact of those factors on the individual being assessed.
Each individual nurse is responsible to constantly evaluate their ability to safely and competently practice nursing. Licensed nurses are accountable for assuring that their actions and behaviors meet all applicable standards for safe and competent practice at all times. This requires constant awareness of the demands of the job and a continual process of evaluation and assessment. The nurse must be sure they are fit to practice and competent to safely perform functions that fall within the defined scope of nursing practice for which the nurse has accepted responsibility.
In some instances, it may be necessary for the employer and/or the Board of Nursing to require assessment and evaluation, using reliable methods administered by qualified licensed professionals. Practicing outside of the standards of practice may subject the licensee to disciplinary action by the Board of Nursing.
*Adapted from Idaho Board of Nursing.
Developed by Nurse Practice Committee 2006 with consultation and input from the staff of the following organizations: NDBME, NDBOP, NDDH, NDMA, NDHA, and NDLTCA.
Adopted: May 2006