Nursing Interventions
Scope Has Four Gates
An NP may be highly experienced yet still be unable to perform a particular act in a particular setting.
An NP may be highly experienced yet still be unable to perform a particular act in a particular setting. Scope of practice is the legal boundary. Competence is the knowledge, skill, judgment, and current experience needed to perform the act safely. Credentialing and privileging determine what an employer or facility permits that individual to do. Local policy determines how the activity must be carried out and what resources must be available. These are separate gates: | Gate | Question it answers | What happens if the answer is no? | |---|---|---| | Law and regulation | Is this activity authorized for this licence in this jurisdiction? | Do not perform it unless a lawful mechanism applies. | | Competence | Can I perform it safely for this patient and population? | Obtain training, consultation, or referral. | | Credentialing and privileging | Has this employer or facility authorized me to perform it here? | Follow the credentialing pathway before proceeding. | | Policy and resources | Can it be done with the required equipment, monitoring, follow-up, and emergency support? |...