Introduction
According to the Kentucky Nursing Laws Chapter KRS 314, every nurse is accountable and responsible for each decision or action was taken in the course of duty. This chapter further defines the individual roles of the registered nurse (RN), Licensed Practical Nurses (LPN), and the Advanced Registered Nurses (ARN). This statute that governs the nursing practices is interpreted by the Kentucky Board of Nursing as the guideline to provide safe nursing practices. However, there are instances whereby some nursing actions are not covered in the Kentucky Nursing Laws, and in such instances; the nurse is expected to employ professional judgment to determine whether an action is acceptable by the standards of practice which the nurse is allowed to undertake. To provide a better solution to such a scenario, the Kentucky Board of Nursing established a decision tree-chart to guide nurses when making decisions on a selected action so as it may fall within the scope of safe nursing.
Scenario 1
Licensed Practical Nursing practice is defined by KRS 314.011 (10) as “taking action that requires skills and knowledge which is either acquired or taught in schools that are approved to offer practical nursing”. Such actions are, for instance, offering care for the ill or the injured as directed by a registered nurse (RN) or a physician who is registered. In addition, licensed practical nurses can counsel and apply procedures that are meant to save a patient’s life or improve a patient’s health. Another role of licensed practical nurses is to administer treatment or medication as may be directed by a physician or an advanced registered nurse or according to the requirements of the nursing board (Potts & Lynch, 2006).
For the scenario of Mrs. Brown, she exercised her duties as required by the law that governs the nursing practice, KRS 314 011 (10). Mrs. Brown was a licensed practical nurse whose responsibility as stipulated by the act was to take care of a patient and administer medication as directed by a physician. Mrs. Brown opted to apply oxygen at 2 L/min to Mr. Smith to keep him healthy until 7 am when the physician would be available to attend to this patient.
Scenario 2
This scenario was about registered nursing practice. According to KRS 314.011 (6), this is the taking of actions that require a lot of knowledge which is specialized. According to Potts & Lynch (2006) “registered nursing practice require judgment and nursing skill based on the principles of psychological, biological physical and social science in the application of the nursing practice”. The knowledge and skills are applied in the counsel, health teaching, and care of the ill or the injured. In addition to these roles, registered nurses are required to administer medication or provide treatment by following the prescription provided by a physician or an advanced registered nurse. The roles of a registered nurse (RN) in administering medication include: giving medication to a patient as per the prescribed dosage, frequency, or route, noting the effects of a medication, responding to the cases of emergency care from the effects of drugs, and also to provide instructions about medication.
Alex as a registered nurse performed his duty according to the required standards when he was admitting the patient in the ICU. Alex respected the orders of the physician who had performed the surgery on a patient by abandoning what he was doing to attend to the more serious patient. Administering fresh frozen platelets to the open-heart surgery patient was an emergency action that required Alex’s attention to stop the patient from bleeding. Therefore, by delegating the other task to Donna who was also an RN, Alex made a wise decision as required by the nursing ethics.
Reference
Potts, J & Lynch, B. (2006). The American Heart Association CPR Anytime Program: the potential impact of highly accessible training in cardiopulmonary resuscitation. Journal of Cardiopulmonary Rehabilitation. 26(6):346-54.