Scope of Practice

As you progress through the nursing program, you will add many skills to your repertoire; this comprises your scope of practice. When you have been checked off to do a skill in lab, you may be able to perform it in clinical practice under the supervision of your instructor, nurse, or individually. 

N142 Scope of Practice (Academic Term 1)

• Introduction to foundational nursing skills and assessment

  • Preparing to enter a room

  • Communication techniques

  • Professional introduction

  • Professional interview

• Infection prevention and control

  • Chain of infection

  • Universal precautions

  • Hand hygiene

  • Various precautions

  • Donning and doffing PPE

• Body mechanics

  • Point of care risk assessment (PCRA)

  • Ergonomics

• Safe patient handling

  • Positioning

  • Body alignment

  • Transfers using devices: transfer belt, over-head lift, canes/crutches/walkers

  • Pre-handling safety check

  • Passive and active range of motion

• Personal care

  • Hygiene/bed bath

  • Hair and nail care

  • Hearing aide application

  • Pericare

  • Cleansing a patient with a Foley catheter

  • Urinary and fecal incontinence devices

  • Briefs

  • Toileting routines

  • Changing to a leg bag

  • Removal of an indwelling urinary catheter

  • Condom catheter application and removal

  • Basic fluid balance calculation

  • Specimen collection for urinalysis and midstream

  • Digital removal of stool

• Making occupied and unoccupied beds

• Teeth, mouth, and denture care

• Newborn bath and personal care

• Nutrition

  • Aspiration risk

  • Nutritional status

  • Diet

  • Assisting with oral intake

  • Oropharyngeal suctioning

• Introduction to vital signs

• Functional assessment

• Documentation and communication introduction

  • Introduction to SBAR

• Introduction to medication administration

  • Administration schedules

  • Standards of medication administration

  • Orders

  • Units of measurement

  • Calculation of drug dosages

N143 Scope of Practice (Academic Term 2)

• Documentation

• Assessing vital signs

• The general survey and health history taking

  • Subjective vs. objective data

• Pain assessment

• Assessing the integumentary system (including assessment of pressure injuries)

• Assessing the musculoskeletal system

  • Application of hot and cold

• Assessment of head and neck (eyes, ears, nose, throat, and regional lymphatic system)

• Assessing the neurological system (Glasgow Coma Scale)

• Assessing mental health (use of mental health assessment tools and withdrawal risk assessments: CIWA/COWS)

• Assessing sleep and rest

• Assessing the respiratory system

• Assessing the cardiovascular system

• Assessing the peripheral vascular and lymphatic systems

  • Application of compression devices: TED stockings

• Assessing the gastrointestinal system

  • Assisting with bowel diversionary systems: ostomy emptying

• Assessing nutrition and intake

• Assessing the genitourinary system

• Assessing newborns

• Integration of all assessments into a comprehensive head-to-toe and/or a bedside assessment

• Medication administration

  • Basic principles

  • Oral medications

N190 Scope of Practice (CPE 1)

• Medication administration

  • Transdermal

  • Rectal

  • Vaginal

  • Ophthalmic

  • Nasal

  • Ear

  • Inhalation

• Oxygen administration introduction

• Care of the body postmortem

• Violence awareness and prevention

N242 Scope of Practice (Academic Term 3)

• Oxygen administration and airway management

• Asepsis and specimen collection

• Parenteral medication administration

  • Subcutaneous (SubQ) & Subcutaneous Butterfly (SCBF)

  • Intramuscular (IM)

  • Intradermal (ID)

  • Insulin

• Students cannot administer high-risk cytotoxic medications

  • Students can administer low reproductive risk and low-risk drugs if they adhere to the Hazardous Drug Handling and Administration Precautions

• Introduction to peripheral venous access devices (PVADs) and infusion therapy

  • Indications and assessment

  • Calculations

  • Troubleshooting

  • Basic solutions

• IV SIGMA pumps

  • Initiating and regulating

  • Changing a solution

  • Changing an administration set

• IV care and removal

• Bedside blood glucose monitoring

• Simple sterile dressing changes (surgical wounds)

• Wound drain maintenance and removal

• Removal of sutures and staples

N243 Scope of Practice (Academic Term 4)

• Care and assessment of central venous access devices (CVADs)

  • Peripherally inserted central catheter (PICC)

    • Flushing

    • Blood sampling and culture

  • Non-Tunneled central venous catheter (NT-CVC)

    • Flushing

    • Blood sampling and culture

• Patient controlled analgesia (PCA) and epidurals

  • Maintenance

  • Monitoring

  • Treatment of complications

  • Discontinuation

• Continuous IV medication administration via the primary bag (PVAD and CVAD)

  • IV monograph interpretation

  • Preparing medications

  • Compatibility assessments

  • Monitoring and assessing complications

  • Dosing calculations

  • IV fluid balance 

• Intermittent IV medication administration (PVAD and CVAD)

  • Reconstitution

  • Piggyback infusions

  • Intermittent infusions

• Direct/push IV medication administration (PVAD and CVAD)

• IV insulin and heparin administration

• Ostomy (new or revised) care, assessment, and application of pouch

• Caring for patients receiving antineoplastic medication

• Insertion, maintenance, and removal of nasogastric (NG) tubes for decompression, feeding, and medication administration

• Gastrostomy care and maintenance

  • Feeding

  • Medication administration

• Administering enteral feeds through an NG or gastrostomy tube

N342 Scope of Practice (Academic Term 5)

• Advanced wound care

  • Cleansing and irrigating chronic wounds

  • Wound culture

  • Packing

  • Dressing

• CVAD dressing change and removal (PICC and NT-CVC)

• Peripheral IV insertion

• Administration of total parenteral nutrition (TPN)

• Urinary catheterization

• Continuous bladder irrigation

  • Maintenance

  • Assessment

  • Management of complications

• Chest tubes

  • Patient care

  • Troubleshooting/complications

  • Dressing

  • Drainage devices

  • Assisting with removal

• Administration of blood and blood products

  • Knowledge of various products

  • Blood typing and matching

  • Patient ID procedures

  • Complications

  • Administration

  • Disposal

• Tracheostomy care

  • Maintenance

  • Suctioning

  • Emergency management

Once a student has completed N342, they will have a full scope of practice required for a registered nurse.