NCF Group Sponsors Health Fair

This is a great question Donna. Many parish/faith community nurses, as well as other nurses assisting at health fairs, do BP, eye and diabetes screenings and it is important to know if this is within a nurse's scope of practice. Each state has their own nurse practice laws. I found a great website with links to these laws for each state. You can find it at http://kcsun3.tripod.com/id110.htm. I looked up my state and found that there was not a hard and fast answer, but instead a "decision tree" where one could answer questions about their specific issue and make a decision from that. Some of the criteria were based on the activity going against any state law, and the nurse being trained and accurately documenting their results and intervention. I have not explored other state's nurse practice laws, but I would think that screening exams would fall under our scope of practice. I think of examples such as school nurses who are not under a doctor's directive to screen students or parish nurses who function independently. There is also prudence to think of. I think it would not be good practice to screen people if you do not have some place to refer them to for further care should you have an abnormal test. So there are those types of scope of practice issues to consider. Are there any school nurses, faith community nurses or anyone else who would like to respond?

I agree with Bonnie’s response to the question about the legality of nurses performing screening tests. Most institutions such as public health departments, community health agencies, and schools do have physician-approved protocols in place that direct nurses to perform screening tests. However, it is my understanding that performing screening tests is usually considered an independent nursing function and does not require a physician’s order. As Bonnie mentioned previously, nurses must be sure that they are skilled at performing the screening tests and that they have identified referral resources for people that need follow-up based on the screening tests results. It is always inappropriate to screen people without viable resources in place. Nurses must also be skilled in teaching the people about the screening test, the results, and how to receive follow-up care. In addition, nurses must practice in accordance with the nursing practice law in their states. For example, the Texas Nurse Practice Act defines professional nursing as: (2) “Professional nursing” means the performance of an act that requires substantial specialized judgment and skill, the proper performance of which is based on knowledge and application of the principles of biological, physical, and social science as acquired by a completed course in an approved school of professional nursing. The term does not include acts of medical diagnosis or the prescription of therapeutic or corrective measures. Professional nursing involves: (A) the observation, assessment, intervention, evaluation, rehabilitation, care and counsel, or health teachings of a person who is ill, injured, infirm, or experiencing a change in normal health processes; (B) the maintenance of health or prevention of illness; Etc…… According to this definition, it is within the professional nurse’s scope of practice to perform health screenings and do health teaching, but it is not legal for a nurse to “diagnose” a health condition. When performing any screening tests, nurses need to inform the person that “screening” tests help identify people who may have a health condition or are at risk for one, and they need to refer these persons to their personal healthcare provider or to the resource that the nurses have already identified. Jane Hall