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?
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Can Nurses Order Lab Tests?
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.
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.
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?
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