Nurse Practice Act, Rules & Regulations

Nurse Practice Acts Guide and Govern Nursing Practice

Why are there laws regulating nursing?

The practice of nursing requires specialized knowledge, skill, and independent decision making. Nursing careers take widely divergent paths - practice focus varies by setting, by type of client, by different disease, therapeutic approach or level of rehabilitation. Moreover, nurses are mobile and sophisticated and work in a society that is changing and asymmetrical for consumers. The result is that the risk of harm is inherent in the provision of nursing care.

Because nursing care poses a risk of harm to the public if practiced by professionals who are unprepared or incompetent, the state, through its police powers, is required to protect its citizens from harm. That protection is in the form of reasonable laws to regulate nursing. State legislatures delegate many enforcement activities to state administrative agencies. In the case of the nursing profession that delegation is to boards of nursing. The charge from the state to the board of nursing is to protect the public.

What are the laws related to nursing?

All states and territories have enacted a nurse practice act (NPA). Each state’s NPA is enacted by the state’s legislature. The NPA itself is insufficient to provide the necessary guidance for the nursing profession, therefore, each NPA establishes a board of nursing (BON) that has the authority to develop administrative rules or regulations to clarify or make the law more specific. Rules and regulations must be consistent with the NPA and cannot go beyond it. These rules and regulations undergo a process of public review before enactment. Once enacted, rules and regulations have the full force and effect of law.

Although the specificity of NPAs varies among states, all NPAs include:

  • Authority, power and composition of a board of nursing 
  • Education program standards 
  • Standards and scope of nursing practice 
  • Types of titles and licenses 
  • Requirements for licensure 
  • Grounds for disciplinary action, other violations and possible remedies

Statute of Limitation

Statutes of limitation are designed for use in civil and criminal litigation to prevent unreasonable delay and the prosecution of stale claims for the purpose of preserving the expectation of private legal rights. However, in the absence of a specific statute to the contrary, statutes of limitation are inapplicable to administrative board of nursing license revocation and disciplinary proceedings. Boards of Nursing take disciplinary action in order to protect the public by insuring that only properly qualified and ethical individuals practice nursing. This public safety objective is not time-limited.

Reciprocal Actions

A state board of nursing has the authority to take action against a licensee on the basis of another state’s licensure disciplinary action that implicates the individual’s ongoing ability and likelihood to practice professionally and safely. This retained jurisdictional authority, allowed by administrative law principles and case law, seeks to prevent the nurse from evading disciplinary action merely by fleeing the state.

Why does a nurse need to know about the NPA?

The practice of nursing is a right granted by a state to protect those who need nursing care. The guidelines of the NPA and its rules provide safe parameters within which to work, as well as protect patients from unprofessional and unsafe nursing practice. The act is a dynamic document that evolves and is updated or amended as changes in scope of practice occur.

The laws of the nursing profession can only function properly if nurses know the current laws governing practice in their state. Ignorance of the law is never an excuse! 

Use the Nurse Practice Act Toolkit to:

  • Learn about the law and regulations that guide and govern nursing practice 
  • Locate your state nurse practice act and regulations 
  • Access nurse practice act educational resources