There are numerous things registered nurses cannot do because of their training and scope of practice.
These healthcare workers perform multiple tasks every day to ensure patient safety and care.
However, registered nurses have more limitations than nurse practitioners and advanced practice registered nurses.
Medical professionals must have adequate education and expertise to perform the duties mentioned in this article.
Their responsibilities must also fall within their scope of practice/domain, facility guidelines, and state laws.
The following section covers several limitations for registered nurses.
1. Make a Medical Diagnosis
Qualified registered nurses can make a nursing diagnosis to assess a patient’s response to actual or potential health problems.
However, they cannot conduct a medical diagnosis to determine a patient’s disease or condition.
Instead, a doctor or physician must perform a medical diagnosis.
A medical diagnosis requires years of training at a medical school.
Medical doctors must also participate in a residency/fellowship and work as attending physicians to earn their licenses.
Most doctors spend 10 – 14 years developing expertise to diagnose and treat rare and complex medical conditions.
A nurse practitioner can diagnose patients with common health conditions within their scope of practice.
However, they cannot diagnose complex medical conditions that require the expertise of a physician.
A nurse practitioner’s diagnosis capabilities also vary depending on their scope of practice within their state.
2. Perform Surgery or Invasive Procedures
Numerous registered nurses perform minor procedures with appropriate training and supervision.
For instance, registered nurses cannot suture wounds but can remove stitches after a patient has healed appropriately.
In some cases, they may also perform more advanced duties with the supervision of a physician or doctor.
Regardless, registered nurses cannot perform surgery or invasive procedures.
Surgeons, obstetricians, gynecologists, ophthalmologists, and experts with adequate training perform surgical procedures.
St. George’s University provides a list of 14 Types of Surgeons to clarify who can perform surgery/invasive procedures.
With that said, there is some confusion about the duties of a surgical nurse.
Surgical nurses specialize in perioperative care, also referred to as scrub nurses.
These medical professionals assist patients before, during, and after surgery.
Surgical nurses monitor and evaluate patient vitals, prepare patients for surgery and provide perioperative instructions.
They also assist the surgeon/anesthesiologists when necessary, sterilize medical equipment, and prepare the operating room.
Post-operation nurses administer necessary medications, ensure patient vital remains stable, and help manage recovery.
With that said, surgical nurses do not perform surgical procedures.
They only perform duties that are within their scope of practice.
Finally, there are various surgical nursing specialties with unique responsibilities and training.
The list below covers multiple disciplines registered nurses can pursue in the surgical field.
Surgical Nursing Specialties:
- Cardiac cath lab nurse
- Nurse anesthetist
- Ophthalmic nurse
- Otorhinolaryngology nurse
- Perioperative nurse
- Plastic surgery nurse
- Reconstructive surgery nurse
- Transplant nurse
It’s also necessary to mention that nurse practitioners cannot perform surgery.
They can perform more advanced procedures than registered nurses but do not have surgical expertise.
3. Prescribe Medications
Registered nurses administer/dispense medications to patients based on a physician or nurse practitioner’s guidance.
However, they cannot prescribe medications due to their limited educational background and scope of practice.
Prescribing medications is restricted to medical professionals with appropriate training and expertise.
It includes physicians/doctors, nurse practitioners, and other medical professionals with advanced education.
That said, they’ve received post-graduate education and specialize in their domains.
It allows them to perform duties regular registered nurses cannot.
For instance, nurse practitioners can diagnose patient conditions.
They can also act as primary care providers and prescribe medications within their scope of practice.
Some nurse practitioners even open and operate clinics without limitation in full-practice states.
4. Share Patient & Work Information
Keeping sensitive patient information private applies to registered nurses and all medical professionals.
Nurses must maintain a strict policy for patient privacy to comply with HIPPA regulations.
Those who do not follow HIPPA compliance may receive disciplinary action, including being fired.
Maintaining patient privacy is essential for countless reasons.
It is crucial for preventing legal issues, but it’s also vital for ensuring patient confidence.
Without confidentially, patients will have less trust and are less likely to seek medical care or discuss private matters with a medical professional.
It opens up implications for medical mistakes and misinformation, impacting the patient and those involved.
Therefore, medical professionals must obtain as much information as possible to ensure everyone receives proper care.
5. Act as Primary Care Providers
Registered nurses cannot act as primary care providers for the patients they serve.
Instead, they work under the supervision of physicians, nurse practitioners, and other high-level specialists.
Some advanced practice registered nurses (APRNs) can become primary care providers.
However, it requires returning to postgraduate school to receive specialized education and acquire an MSN or DNP degree.
Advanced practice registered nurses can perform duties, tasks, and responsibilities well beyond general registered nurses.
For instance, CRNAs administer anesthesia and acute care nurse practitioners diagnose and treat certain conditions.
APRNs specialize in one of four domains.
It includes certified registered nurse anesthetists, clinical nurse specialists, midwives, and nurse practitioners.
Each specialization/role serves a necessary healthcare function for patients within specific healthcare groups.
For example, nurse practitioners specialize in a variety of patient care areas.
The following list explores different disciplines for nurse practitioners who provide care to specific patient demographics.
- Acute Care Nurse Practitioner
- Adult-Gerontology Nurse Practitioner
- Family Nurse Practitioner
- Neonatal Nurse Practitioner
- Pediatric nurse practitioner
- Psychiatric Mental Health Nurse Practitioner
- Women’s Health Nurse Practitioner
Depending on state practice laws, these specialists can diagnose and treat patient conditions within their specialization.
They may also prescribe medications and open independent offices in full-practice states to act as primary care providers.
Advanced practice registered nurses and nurse educators have the broadest scope of practice in the nursing profession.
As a result, they work in primary care, leadership/management roles, academic settings, and other high-level occupations.
A registered nurse’s obligations, responsibilities, and duties vary based on their education, specialty, and training.
Most registered nurses cannot complete the tasks mentioned above due to their limited schooling.
Prescribing medications, making a medical diagnosis, and acting as primary care providers require extensive expertise.
Instead, physicians, nurse practitioners, and qualified medical experts handle these tasks if it’s within their domain.
A nurse’s scope of practice varies depending on their state, education level, and specialty.
In addition, various levels of nursing exist, enabling healthcare professionals to pursue different careers from an academic standpoint.
It includes LPNs, RNs, APRNs, Nurse Managers, Executives, and Doctors of Nursing Practice.
Each discipline requires further education, training, certification, and passing a state exam.
In advanced specializations, nurses have more duties, a broader scope of practice, and better career advancement options.
Registered nurses who want to expand their scope of practice must return to school and earn an advanced degree.
It enables them to become nurse anesthetists, clinical nurse specialists, certified nurse midwives, or nurse practitioners.
Nevertheless, it takes an additional 2 – 4 years of education to become an APRN after obtaining a BSN.
Postgraduate education allows registered nurses to receive an MSN or DNP degree.
At that point, they can perform some of the above-mentioned tasks.