Scope of Practice
Every NPP should have a written scope of practice that specifically states what the NPP may do on his or her own initiative, what requires protocol authorization, and what must be referred to the physician. It should include specific instructions for handling emergencies and urgent situations when the physician is unavailable. It should specify types of patients that the NPP should or should not accept for care. If the NPP is a licensed nurse, the scope of practice should delineate which activities are nursing and which are delegated medical care. Like protocols, this scope of practice should be agreed upon and signed by both the physician and the NPP. The scope of practice should explicitly deal with both nursing diagnoses and what constitutes unauthorized practice of medicine.