ANA Updates Nursing Scope and Standards of Practice

ANA has updated Nursing Scope and Standards of Practice

By Debra Wood, RN, contributor

American Nurses Association (ANA) has revised the definition of nursing, added an advocacy standard, and updated the Nursing: Scope and Standards of Practice resource to emphasize diversity and inclusion and an examination of ethics in nursing. 

“The purpose in updating the Scope and Standards of Practice every five years is to reflect changes and new insights into our practice,” said Patty Bartzak, DNP, RN, CMSRN, TCRN, a staff nurse in infectious disease at Lahey Hospital and Medical Center in Massachusetts and co-chair of the 2019-2020 Nursing Scope and Standards Revision Workgroup. 

“The standards do not describe the super nurse but rather a competent level of behavior in the professional role,” Bartzak said. “There is a list of competencies for all nurses.”

ANA introduced the new fourth edition of its Nursing: Scope and Standards of Practice during a Nurses Month webinar on May 19, 2021, “Redefining Nursing – Reaffirming Our Practice.” The release coincided with the Professional Development theme that is the focus of the third week of National Nurses Month.

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Changing the definition of nursing

The ANA updated the definition of nursing, which now reads: 

“Nursing integrates the art and science of caring and focuses on the protection, promotion and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence. Nursing is the diagnosis and treatment of human responses, and advocacy in the care of individuals, families, groups, communities, and in recognition of the connection of all humanity.”

The word “caring” was not part of prior Scope and Standards versions. However, it is a core concept of nursing, Bartzak said. The second change was adding the concept of compassionate presence and the third was including “recognition of the connection of all humanity.” 

New introductions to the Scope and Standards

ANA created a new nurse advocacy standard. “Advocacy begins with the acknowledgement that passive acceptance must be addressed, and it’s incumbent on the nurse to voice a challenge and actively work toward the highest and best care to achieve wholeness and optimal outcomes,” Bartzak said. 

The ANA also introduced a nursing practice model in the Scope and Standards. 

“We saw a need to describe who nurses are and what nursing work is,” Bartzak said. “The nursing practice model is an articulation of what we do.”

The updated Scope and Standards also includes a look at the regulatory model, with five components and nine regulatory influencers, and how it affects nurses’ practice. Regulations are in place to protect the healthcare consumer, said Kahlil Demonbreun, DNP, RNC-OB, WHNP-BC, ANP-BC, FAANP, FAAN, in Columbia, South Carolina, and co-chair of the 2019-2020 Nursing Scope and Standards Revision Workgroup.

The new Scope and Standards discuss the ethical challenges faced by the profession and how to apply the Code of Ethics for Nurses with Interpretive Statements to everyday practice. 

“Ethical practice is essential to nursing care,” Bartzak said. 

Highlighting diversity, inclusion and social justice

The ANA added “Respect, Equity, Inclusion and Social Justice” to the standards. The book describes respect as “treating someone how they and you want to be treated.”

Katie Boston-Leary, PhD, MBA, MHA, NEA-BC, director of nursing programs at the American Nurses Association, overseeing the Nursing Practice and Work Environment Division and Healthy Nurse, Healthy Nation, reported that diversity, inclusion and justice have different meanings and outcomes. 

“Equality is treating everybody the same way and that does not go far enough,” Boston-Leary said. “Equity, on the other hand, requires meeting people where they are and puts everyone on the same plane, which is fairness.”

Justice refers to all members feeling an equilibrium and equal access. The concepts are looped together, she added. 

The updated standards recommend a departure from the tradition of cultural competency training, but rather a need for lifelong learning to continuously reshape the world. 

“Nursing’s history is deeply rooted in social justice,” Boston-Leary said. “Nurses must become leaders of social change.” 

The updated Nursing Scope and Standards of Practice can serve as a guide to professional practice. 

“I hope you find the ANA Scope and Standards, Fourth Edition, to be an excellent resource in your daily practice,” Demonbreun said. 

Learn more about the updated Nursing: Scope and Standards of Practice, 4th Edition, by watching the free ANA webinar.  


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