As a registered nurse, your scope of practice may be more far-reaching than that of a CNA or even an LPN.

However, it does not give you the sweeping powers that a medical doctor has.

Make sure you stay away from the following tasks to protect your license.

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What Are Registered Nurses Not Allowed to Do?

Some of the things registered nurses are not allowed to do include violating HIPAA laws, prescribing medications, or performing advanced invasive medical procedures. Many of these laws will vary from state to state.

Registered nurses in every state have a scope of practice given to them by law that they must follow.

While scope often refers to the type of care they do based on their area of expertise and their facility, it can also identify what tasks are reserved for medical doctors or other healthcare practitioners.

Related: CNA vs LPN vs RN vs BSN vs ADN

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Are There Laws That Bar Registered Nurses From Doing Certain Tasks?

Every state has a legal code that defines who a registered nurse is, what legal rights he/she has and what their practice standards are.

Surprisingly, you will find that many states have slight differences in what RNs are allowed to do and what they must leave to the doctor to do.

For example, while nearly all RNs perform basic assessments and administer a variety of medications, not all create nursing care plans or perform regular patient education.

Here are a just a few of things that you will be barred from doing as you work as a registered nurse.

1. Diagnosing Medical Conditions

Although you may think you know exactly what is wrong with your patient as soon as you walk through the door, you have to leave the official diagnoses to the physician.

As a nurse, you can make nursing diagnoses, but these are quite different from medical diagnoses.

A nursing diagnosis covers the patient’s or family’s response to a health concern or ailment and may include such problems as a risk for falls or impaired mobility.

2. Prescribing Medications

As a registered nurse, you will also not be prescribing medications but must instead follow the doctor’s orders for administering medications at the prescribed times and in the prescribed dosages.

My hospital had a set of standing orders for various problems that allowed me to institute an order set for certain simple medications, such as acetaminophen or an enema.

These orders demonstrated that the doctors trusted our nursing knowledge with these matters and ensured that we would not be calling them all night long.

However, you will have to check with your own facility to see what standing orders if any you can follow.

3. Prescribing Treatments

While you can carry out certain treatments as an RN, you’re not allowed to prescribe them except in the case of certain standing orders.

Once again, look at this as a safety precaution that helps you protect your career from unwanted lawsuits.

Your job is to follow the doctor’s orders, using your critical thinking skills to clarify orders or to notify the doctor of patient changes that could affect the outcome of a previously prescribed treatment.

4. Performing Most Invasive Procedures

You will need many exciting skills as a registered nurse, such as cleaning and bandaging wounds, inserting foley catheters, starting intravenous lines and inserting nasogastric tubes.

However, you will not be doing highly invasive procedures that require cutting the skin or connective tissues.

Even if you work as a surgical nurse, you will be assisting the surgeon or functioning as the circulating nurse or recorder.

5. Sharing HIPAA-Protected Information

Just as importantly, you will have to keep your mouth closed most of the time as a nurse.

I know just how tempting it can be to tell your friend about a particularly difficult patient you had or to share how a patient is doing with his so-called best friend over the telephone.

However, HIPAA privacy laws protect the rights of each of your patients and deny you the ability to share personally identifiable information with anyone other than those approved by the patient.

Depending on your facility, you may only be able to give patient information to family members and friends who have the patient-chosen password.

6. Making Referrals

Finally, in most states, you will not be allowed to make patient referrals to specialists.

Although you may be able to initiate minor referrals, such as to a social worker or a chaplain, you will probably not be able to refer patients to a medical specialist for follow-up care.

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Final Thoughts

While RNs are not inferior to medical doctors, they must still defer to them many times as they care for their patients.

This can reduce the incidence of errors and malpractice suits.

What does the nursing scope of practice look like in your state? Let us know by commenting below.

Frequently Asked Questions

  1. Can nurses diagnose patients?

    With the nurse practice act nurses can make nursing diagnosis but they can’t make medical diagnosis. The exception are advanced practice nurses.

  2. How many patients can a nurse have legally?

    General rule of thumb for certain areas is in the operating room one nurse for 1 patient. Intensive care unit is 1-2 patients per nurse, but this will vary depending on the speciality, the facility and the state the nurse works in.

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  1. Can a nurse touch a patient hair because she feels like she just had to touch it without the patient permission

  2. You spelled HIPAA wrong a couple of times at the start of this article. You have it as “HIPPA.”

  3. What should happen to an aide if she forgot to give a patient his meds (opiod) and left it on his bedside table?

  4. I saw an RN who diagnosed my goiter, which was the size of a golf ball, as a “fatty cyst” and told me not to worry about it. This, in spite of the fact that I told her that I suspected it was my thyroid because I had a family history of Hashimoto’s thyroiditis and I was having a lot of symptoms of hypothyroidism, i.e. feeling cold and sluggish all the time. I didn’t trust her diagnosis so I went to my mother’s endocrinologist, who immediately recognized that I had a goiter and ordered a TSH test. My TSH level was sky high. He said, “You must have been feeling worse than you thought you were. Your thyroid was really failing.” He could not believe that a nurse would tell me that I had a fatty cyst and “not to worry about it”. I know to never rely on an RN’s “diagnosis” because they aren’t qualified.

    1. Hey Mary, I’m sorry to hear that happened to you. Fortunately, you were able to get the proper diagnosis and hopefully, the appropriate treatment. I’m curious where a nurse was diagnosing you and not a provider (NP, PA, MD, etc.)?

  5. Can a nurse make a warm rag or heating pad if the patient Begs for it?
    I was fired for simply making a hot rag for her back of which she handled before she placed it on her own back and said she burnt herslef

    1. Unfortunately, no a nurse cannot do that without an order. Technically, it is a treatment and must be prescribed as there are a few situations where a hot rag could cause patient more harm, not just the burned skin, but certain disease processes inside the body. The same can be said for cold compress. Even though you are good at heart and want to help the patient, some things you just cannot do if you want what’s best for patient. There’s so many little things like that that you learn in nursing school and with experience.

  6. Are RN’s allowed to see patients in a clinic inside a hospital setting without a provider present in the clinic?

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