Nursing Regulation

Nursing regulation is the governmental oversight provided for nursing practice in each state. Nursing is regulated because it is one of the health professions that pose risk of harm to the public if practiced by someone who is unprepared and incompetent.

It includes:

1.Nurse Practice Acts


3.Nursing Standards of Care

  1. Nurse Practice Acts

Each state has a nurse practice act, which protects the public by legally defining and describing the scope of nursing practice. Nurse practice acts also legally control nursing practice through licensing requirements. For advanced nursing practice, many states require a different license or have an additional clause that pertains to actions that may be performed only by nurses with advanced education. For example, an additional license may be required to practice as nurse midwife, nurse anesthetist, or nurse practitioner. Nurse practice acts, while similar, do differ from state to state. For example, they may differ in their scope of practice definition and in licensing and license renewal requirements. It is the nurse’s responsibility to know the nurse practice act of the state in which he or she practices nursing. A state’s nurse practice act is easily accessed at the specific state board of nursing’s website.

2.   Credentialing

Credentialing is the process of determining and maintaining competence in nursing practice. The credentialing process is one way in which the nursing profession maintains standards of practice and accountability for the educational preparations of its members.

a.   Licensure

A license is a legal permit that a government agency grants to individuals to engage in the practice of a profession and to use a particular title. Licensure is a process by which a state determines that a candidate meets certain minimum requirement to practice in the profession of his/her choice and grant a license to do so. In Nepal, nursing practice license is provided by Nepal Nursing Council. For an occupation to obtain the right to license its members, it generally must meet three criteria:

1)There is a need to protect the public’s safety or welfare.

2)The occupation is clearly delineated as a separate, distinct area of work.

3)There is a proper authority to assume the obligations of the licensing process, for example: in nursing, state boards of nursing.

Each state has a mechanism by which licenses can be revoked for just cause (example: incompetent nursing practice, professional misconduct or conviction of a crime such as using or selling drugs illegally). In each situation, a committee at a hearing reviews all the facts. Nurses are entitled to be represented by legal counsel at such a hearing. If the nurse’s license is revoked as a result of the hearing, either the nurse can appeal the decision to a court or law or in some states, an agency is designated to review the decision before any court action is initiated.

b.   Certification

Certification is the voluntary practice of validating that an individual nurse has met minimum standards of nursing competence in specialty areas as maternal-child health, pediatrics, mental health, gerontology and school nursing. Nursing certification is required in order to become licensed as an advanced practice nurse. Certification programs are conducted by specialty nursing organization. Example: Education institutions

c.   Accreditation

It is the process by which an educational program is evaluated and then recognized as having met certain predetermined standards of education. Accreditation is to ensure schools preparing nurses maintain minimum standards of education. Maintaining voluntary accreditation is a means of informing the public and prospective students that the nursing program has met certain criteria. In Nepal, accreditation of nursing is done by Nepal Nursing Council and Accrediting Universities.

3.   Nursing Standards of Care

The purpose of standards of care is to protect the consumer. Standards of care are the skills and learning commonly possessed by members of a profession. These standards are used to evaluate the quality of care nurses provide and therefore, become legal guidelines for nursing practice. Nursing standards of care can be classified into two categories: internal and external standards.

Internal standards of care include “the nurse’s job description, education and expertise as well as individual institutional policies and procedures.

External standards consist of following:

  • Nurse practice acts
  • Professional organization
  • Nursing specialty practice organization (Example: Emergency Nurse Association, Oncology Nursing Society)
  • Federal organizations and Federal guidelines

Nepali Nurse

Nepali Nurse,RN,BSN

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