Can Nurses Order Lab Tests?

In this article, I’m going to answer a question about whether or not nurses can order lab and blood tests. Here’s the question.

I just recently started working as a nurse, and I see nurses all the time in the ER that I work in ordering labs without first talking to a physician or one of the providers there. I guess my question is, can nurses order lab tests? Also, can nurses read those lab results?

Keep reading for the answer. Don’t forget to search for nursing programs on my site if you’re thinking of becoming a registered nurse.

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Typically Registered Nurses cannot order lab tests without an order from a physician or another provider. The exception are scenarios where standing orders or hospital protocols dictate what a nurse can do in specific situations.

Let’s talk about that in more detail below.

What Governs a Nurses Scope of Practice

It’s important to remember that ultimately what governs your scope of practice is laws passed by your state’s legislature or governing body and finally manifesting in your state’s Nurse Practice Act.

Your State’s Nurse Practice Act combined with your employer’s rules and protocols dictates what you can or cannot do.

With that said, Nurse Practice Acts typically do not allow registered nurses or licensed practical nurses to order any blood tests (or lab tests in general).

Knowing your scope of practice based on your state’s Nurse Practice Act is important for various reasons. But beyond that, you need to understand what your facility can and cannot do.

For starters, the facility you work at can write rules and policies limiting your scope of practice. However, they CANNOT have a policy that broadens your scope of practice as dictated by the Nurse Practice Act and enforced by your state’s Board of Nursing.

In Other Words
Your facility can limit your scope of practice, but they can’t broaden it more than what was intended by the Nurse Practice Act.

Are There Exceptions to The Rule?

The slight exception is that some facilities will have standing orders or facility protocols that dictate what a nurse can order without getting orders in specific situations.

You’ll see this in specialty departments like the emergency room. This is typically done to help make things run a little smoother and more efficiently.

Please note the limitations of this because even a nurse ordering labs (or anything) based on standing orders or protocol is usually ordering it under a physician’s name.

In other words, they’re ordering it as a physician’s order and not based on their own license capabilities.

Example
When I worked in mental health, the facility had protocols for various scenarios. For example, if a patient was being admitted, we had an admission protocol with sets of labs and orders that went into place for all admitted patience.

What to Do if Something Seems Off

If something looks off based on how your facility handles orders, make sure to bring up the issue. You can do this by following it up using your facility’s chain of command.

Pro-Tip
From what I’ve seen, issues like this involving scope of practice don’t usually come from any policy written by the facility but from the staff working there who never double-checked and just assumed they can do that.

Have You Read Any of These?

If you want to learn more about nurses, make sure to check out these articles.

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Frequently Asked Questions

Nurses can put orders in, but it has to come from a physician. Ordering medications and labs are usually not within the scope of practice of a registered nurse. Only certain advanced practice nurses like nurse practitioners have prescriptive authority.

Laboratory tests are not usually over-the-counter, and therefore patients need orders to get them done. There are some exceptions to this in some states.

Nurses can NOT start an IV without orders. The exception is that many departments have standing orders, such as all admitting patients get an IV. In that case, the doctors have already agreed, and nurses go ahead and follow those standing orders.

Nurse practitioners can order lab tests. Make sure to check your state’s nurse practice act as your state could limit what labs you can or can NOT order.

Typically speaking, registered nurses (RNs) can not order lab tests. It’s against their scope of practice.

Generally speaking, nurses cannot order blood tests. It would most likely be against their nurse practice act for their state. The exception are situations where there are standing orders.

Good nurses should be able to read lab tests and be able to interpret good results from bad ones. This skill is important because a nurse’s interventions would change based on those lab results.

Check your facility policy or what’s common practice in your facility. Typically nurses defer telling patients bad results to the physicians because when they talk to the patient they can go over what the implications maybe.

For things like X-rays and ultrasound in most cases, you’re going to let the physician discuss that with the patient. Most nurses aren’t trained to read those, and even if you were you should still defer it to the physician.

Can Nurses Order Lab and Blood Tests?