Running Head: SCOPES AND STANDARDS OF PRACTICE

American Nurses Association Scopes and Standards of Practice

Andrew Smith
Ferris State University

SCOPES AND STANDARDS OF PRACTICE

Abstract
This paper, based off the American Nurses Associations (ANA) Scopes and Standards
of Practice (2010) and Code of Ethics with Interpretive Statements (2015), is a self-assessment
of my personal competencies reflected off both of these works. A critical thinking analysis will
applied to all competencies within each standard and professional development plans will be
developed when needed to gain competency and remain competent following graduation and
licensure.
Keywords: nursing, nursing process, competency

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ANA Scopes and Standards of Practice and Ethics

Nursing Scopes and Standards of Practice
The Nursing Scopes and Standards of Practice (ANA, 2010) is one of three resources and
frameworks created by the American Nurses Association (ANA) that help shape a registered
nurses thinking and decision-making and guides their practice (ANA, 2010, p. 7). The first set
of six standards, or standards of practice, describe a competent level of nursing care as
demonstrated by the critical thinking model known as nursing process (ANA, 2010, p. 17). The
second set, or standards of professional performance, describe a competent level of behavior in
the professional role, including activities related to ethics, education, evidence-based practice
and research, quality of practice, communication, leadership, collaboration, professional practice
evaluation, resource utilization, and environmental health (ANA, 2010, p. 18). This paper will
evaluate my experiences in both the clinical and classroom setting as it relates to my future as a
professional registered nurse.
Standards of Practice
Assessment
This first standard states that the registered nurse collects comprehensive data pertinent
to the healthcare consumers health and/or the situation (ANA, 2010, p. 17). I have met the
requirements for this standard when I go to clinical every week at Gerber Memorial Hospital. I
collect vital signs and perform necessary assessments on every single patient following report
and throughout the day. A pertinent example of this would be performing pulse checks and
assessing grip/pull strength on a patient with a deep-vein thrombosis risk or a post-surgical knee
patient.

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Diagnosis
The standard of diagnosis states that the registered nurse analyzes the assessment data to
determine the diagnoses or the issues (ANA, 2010, p. 41). For this standard I have met the
requirements set forth. In both the clinical setting and the classroom setting I make nursing
diagnoses based off of the assessment data that I collect on an ongoing basis. I then use these
diagnoses to set up expected outcomes and then a plan that use for implementation. An example
of this would be making a nursing diagnosis of impaired gas exchange r/t ventilation-perfusion
inequality on a patient with chronic-obstructive pulmonary disease (COPD) that I am caring for
in the clinical setting.
Identification of Outcomes
The standard of identification of outcomes states that The registered nurse identifies
expected outcomes for a plan individualized to the healthcare consumer or the situation. (ANA,
2010, p. 42). I have met the required competencies of this standard in both the clinical and
classroom setting. The outcomes established from the nursing diagnosis I set up for that COPD
patient had to based off a time estimate for completion and they had to be measurable. An
example of these would be for me to ensure my patient maintains clear airways and lung fields
by administering medication when needed, such as inhalers and nebulizers like Symbicort or
Albuterol.
Planning
This standard states that the registered nurse develops a plan that prescribes strategies
and alternatives to attain expected outcomes (ANA, 2010, p. 43). I have also met the
competencies set forth with this standard in the clinical setting. When working with the COPD

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patient I ensure to incorporate family and others as necessary in partnership when coming up
with the individualized plan of care. Also a major portion of planning involved with the patient
with COPD is considering the economic impact that medication, oxygen, and other equipment
could have on their finances.
Implementation
The implementation standard states that The registered nurse implements the identified
plan (ANA, 2010, p. 45). I meet the numerous competencies of this standard which include
partnering with family and utilizing technology when implementing the plan using nursing
process. Documentation and collection of data occurs digitally via the Cerner application in the
clinical setting and with the COPD patient the family members are involved in order to provide a
safe, realistic, and timely implementation and results to the patient.
Evaluation
The final standard of practice states that the the registered nurse evaluates progress
toward attainment of outcomes (ANA, 2010, p. 52). I meet the competencies required for this
standard by revising plans of care when needed based off assessment data and disseminating the
results to the patient and family based of facility standards and federal law such as HIPAA. Also
a final portion of this standard includes documenting results from the evaluation and I would
complete this electronically within the Cerner application. All of this is an ongoing process that
occurs before and after the discharge of the patient and ensuring that the plan of care was met for
the COPD patient and that results were satisfactory.
Standards of Professional Performance
Evidence-Based Practice

SCOPES AND STANDARDS OF PRACTICE

The backbone of the nursing profession is the use of evidence and research that are
incorporated into our practices. Only current evidence-based knowledge is used within practice
and is often used to replace old standards and policies when needed to bring upon improvements
in areas such as patient safety. The knowledge that I am currently learning is school is based off
of evidenced-based practice and while it may be applicable now, it may not be in 10 years for
example and I will have to change my practice in order to stay current and relevant with policies
and standards.
Quality of Practice
As a student nurse and as a future registered nurse I will contribute to quality nursing
practice (ANA, 2010, p. 59). This occurs in both the clinical and classroom setting by
incorporating creativity and innovation based of evidence-based practice in the care that I
provide. As nurses we always achieve to improve our quality of practice and this occurs through
collecting and analyzing data to identify areas of practice that need improving in quality and
effectiveness. I do this at Gerber Memorial Hospital and at home by practicing, watching
education videos, and reading literature to make sure I am remaining effective at performing
skills such as medication injections and immunizations.
Education
I am currently meeting this standard by attaining knowledge and competence that
reflects current nursing practice (ANA, 2010, p. 56) with attending Ferris State University for
my BSN and will continue to gain knowledge into the future when working in my chosen
nursing field. I learn new knowledge and skills every day in both the clinical and classroom
settings such as Gerber Memorial Hospital and the Sim-Lab within the VFS building at Ferris.

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The learning process occurs with fellow classmates and peers in both formal and informal
settings that are conducive to our education.
Professional Practice Evaluation
For this standard the The registered nurse evaluates her or his own nursing practice in
relation to professional practice standards and guidelines, relevant statutes, rules, and
regulations (ANA, 2010, p. 66). A couple examples of this standard occurred in various clinical
settings including the Devos Childrens Hospital and Pine Rest Christian Mental Health
Services. In both of those settings I provided care that was age and developmentally appropriate
and after each of those clinical experiences I self-evaluated myself with a checklist based off of
various competencies.
Collaboration
I meet the competencies of this standard every time Im at Gerber Memorial Hospital by
collaborating with the healthcare consumer, family and others in the conduct of nursing
practice (ANA, 2010, p. 64). Partnering with the patient, family and others can benefit their
plan of care and produce positive outcomes through effective communication and trust. At
Gerber Memorial Hospital this can include including the family in medication reconciliation and
other basic patient care needs like ambulating, etc. Collaboration is based off a system of trust
and cooperation to aid in teamwork and team-building.
Ethics
The registered nurse and myself need to practice ethically and is guided with the Code of
Ethics for Nurses with interpretive statements (ANA, 2015). I ensure to deliver patient care that
preserves and protects the patients rights, beliefs, privacy, and values. I maintain appropriate

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professional role-boundaries within the therapeutic and professional patient-nurse relationship.

Ethical standards are applied in every setting including classroom, clinical, and informal ones. A
further look into the Code of Ethics will be discussed later in this paper.
Resource Utilization
For this standard the registered nurse utilizes appropriate resources to plan and provide
nursing services that are safe, effective, and financially responsible (ANA, 2010, p. 67). In the
clinical setting I advocate for the use of technology to aid students with learning skills and
knowledge outside of textbooks. Various cellphone applications, or apps, can provide valuable
learning opportunities from medication resources, study cards, and trivia to test knowledge and
skills. With the use of technology in the clinical setting monitoring would have to be
occasionally used to make sure the student is actually using it for scholarly opportunities and not
for entertainment.
Leadership
The final standard of leadership states that The registered nurse demonstrates leadership
in the professional practice setting and the profession (ANA, 2010, p. 62). I meet some
competencies of this standard including treating colleagues and classmates with respect, trust,
and dignity in every interaction. I abide by the vision and goals of the healthcare settings I work
and learn in including Gerber Memorial Hospital and Ferris State University. I can still work at
this standard more in the future by participating in professional organizations and seeking
leadership and management opportunities.
Nursing Code of Ethics
Standard One

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The first provision of the Code of Ethics states that, The nurse practices with
compassion and respect for the inherent dignity, worth, and unique attributes of every person
(ANA, 2015, p. 1). I believe I have the met the goals of this provision by ensuring that I respect
the dignity of patients and the unique attributes associated with any them such as their lifestyle,
gender, religious beliefs, and culture. Respecting these attributes ensures that an atmosphere of
trust is gained with the care I provide and that the right of self-determination is always applied so
a patient has the final say in the care that they receive or refuse to receive.
Standard Two
Provision two of the Code of Ethics states that, The nurses primary commitment is to
the patient, whether an individual, family, group, community, or population (ANA, 2015, p. 5).
I have met the competence required for this provision and will continue to meet the goals
required into the future. I ensure that professional boundaries are established immediately in
clinical settings and seek help whenever I may be faced with a difficult situation. I collaborate on
a daily basis with other nursing students, RNs, doctors, teachers, and other healthcare
professionals to ensure that patient-centered care always remains a priority. As a future nurse I
advocate for my patients wishes and rights and make sure my patients interests remain my
primary commitment.
Standard Three
Provision three of the Code of Ethics states that, The nurse promotes, advocates for, and
protects the rights, health, and safety of the patient (ANA, 2015, p. 9). I believe I remain
competent with this provision as should every other nursing student and RN. This provision is
grounded in the rules and regulations governed by the Health Insurance Portability and

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Accountability Act of 1996 (HIPAA). I know and ensure that patient rights and privacy are the
primary factors that govern my practice and their confidentiality is of upmost importance. As I
graduate and gain licensure I will continue to gain competency in this provision by participating
with the development and implementation of policies, in whatever facility I work in, which are
garnered toward patient safety, health, and rights.
Standard Four
Provision four of the Code of Ethics states that, The nurse has authority, accountability,
and responsibility for nursing practice; makes decisions; and takes action consistent with the
obligation to promote health and provide optimal care (ANA, 2015, p. 15). For this provision I
believe I remain competent with it and will continue to as I develop as a student and upon
graduation and licensure. As a nursing student I dont really delegate tasks but I do ask for help
when needed for various tasks. But as a student I still have responsibilities with passing
medications, performing technical tasks, and other patient care needs with safety in mind. I
follow various codes of conduct from concepts of loyalty and beneficence and maintaining the
safety and dignity of patients. For a future goal with this provision I want to be less reliant on
technology such as Nursing Central and instead use it as an adjunct to my own accountable skills
and knowledge.
Standard Five
Provision five of the Code of Ethics states that, The nurse owes the same duties to self
as to others, including the responsibility to promote health and safety, preserve wholeness of
character and integrity, maintain competence, and continue personal and professional growth
(ANA, 2015, p. 19). I believe I met the standards required for this provision because I care for

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myself and my own personal health just as much as I care for the patients that I care for. If were
supposed to maintain and promote a healthy lifestyle to the patients we care for then we need to
lead by example and also live healthy lifestyles. I will continue to promote and lead healthy
lifestyles and reduce the stressors in my life that may impede my practice now and into the
future.
Standard Six
Provision six of the Code of Ethics states that, The nurse, through individual and
collective effort, establishes, maintains, and improves the ethical environment of the work setting
and conditions of employment that are conductive to safe, quality health care (ANA, 2015, p.
23). I havent met the first portion of this provision because its basically a portion of the ethic
that will develop with time as an RN as I contribute to a morally good environment wherever I
end up working and growing. But I do remain competent in the remaining portions of this
provision in ensuring safe, quality patient care by maintaining septic technique, washing hands
after any interactions, and disposing of materials and waste in their respective containers.
Standard Seven
Provision seven of the Code of Ethics states that, The nurse participates in the
advancement of the profession through contributions to practice, education, administration, and
knowledge development (ANA, 2015, p. 27). I havent met the requirements needed to be
competent with this standard because I currently am not an educator, executive, or researcher
involved with advancing the profession of nursing. As a goal for my future to gain competency
with this specific standard would be to become an educator to future nursing students. I wouldnt

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put this as an immediate goal but more of a goal in the upcoming decades as I age and before
retirement.
Standard Eight
Provision eight of the Code of Ethics states that, The nurse collaborates with other
health professionals and the public in promoting community, national, and international efforts to
meet health needs (ANA, 2015, p. 31). I believe I have met the competency required for this
provision with past endeavors and will continue to meet it in the future upon graduation. As a
student attending Northern Michigan University I acted as our dormitories vice-president and
organized our participation in the annual Relay for Life event. Relay for Life is a fundraising
organization by the American Cancer Society and relies on the use of 24 hour walking event and
other ceremonies to raise funds for cancer research and improve the quality of life for cancer
patients and their families.
In the future I could continue to gain competency with this provision and contribute
towards the efforts of organizations such as Doctors Without Borders to promote the idea that
health is a universal right and improve the access to it around the globe wherever needed. The
contribution I could give could either be financial through donations or even possibly working in
the field as an RN.
Standard Nine
Provision nine of the Code of Ethics states that, The profession of nursing, as
represented by associations and their members, is responsible for articulating nursing values, for
maintaining the integrity of the profession and its practice, and for shaping social policy (ANA,
2015, p. 35). In regards to this specific provision I believe I do not currently meet the

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expectations required because I am currently not a member of a nursing association because Im

not an RN yet. Im not yet able to meet the responsibilities involved with articulating nursing
values, and shaping social policies. For a future goal, upon graduation and licensure I will join a
relevant nursing association where I can interact with other professionals and be the voices of
nurses around the globe to impact politics and global health. Being part of an association will
allow me and others to unite and voice our shared values on a local, national, and global scale.
Conclusion
In conclusion, as I finish up nursing school and look forward to graduation and ponder
the future, my goal remains to remain competent with the standards of practice and the ethics set
forth by the ANA. This in turn will shape my critical thinking skills now and into the future in
the clinical setting and allow me to make decisions in a therapeutic manner that ensures patient
safety, privacy, and values remain a priority in their plan of care.

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References
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements.
Silver Spring, MD.
American Nurses Association. (2010). Scopes and standards of practice: second edition. Silver
Spring, MD.