The Scope of Nursing Practice defines what, why, how, who, where, and when RNs practice. Answering these questions paints a complete picture of nursing’s current and evolving role in healthcare and beyond.
The depth and breadth with which RNs engage in their scope of nursing practice are dependent on the context, including but not limited to, education, role, experience, certification, setting, population, and lawful authority.
Nursing is a person-centered, evidence-informed profession that integrates the art and science of caring, critical thinking and judgment, promotion of health and wellness, disease and injury prevention, and alleviation of suffering to support healing through compassionate presence across the lifespan.
RNs respond to the evolving needs of individuals, populations, and society to achieve positive health outcomes. Nursing practice is grounded in a social contract that calls for RNs to care for people’s health and advocate for quality, safety, and well-being for all populations
The nursing process, a systematic, evidence-informed framework, guides RNs in delivering safe, effective, and person-centered care. The process consists of six interrelated steps: assessment, diagnosis/problem identification, goals/outcomes identification, planning, implementation, and evaluation. This dynamic and iterative process integrates evidence, critical thinking, and judgment across all nursing roles and settings.
Education
Students prepare for entry into nursing by completing one of several educational pathways, including diploma, associate, baccalaureate, or direct-entry graduate programs. Each path provides education in the art and science of nursing and qualifies graduates to sit for the licensure examination to become a registered nurse.
Graduate education in nursing builds on entry-level nursing preparation, often follows practice experience, and prepares RNs for advanced roles such as those in clinical care, research, education, public health, and leadership.
Licensure
RNs are licensed professionals authorized to practice nursing in a U.S. state, commonwealth, or territory. Through licensure, RNs are held to standards that reflect their responsibility to deliver ethical, evidence-informed care and uphold public trust across all settings. Licensure requirements may differ by jurisdiction (e.g., minimum age, background checks, state-specific training, criteria for taking the NCLEX); however, all nursing licensure candidates must pass the NCLEX to become licensed and to use the RN designation.
APRNs apply for an additional license to recognize their APRN role, but this title varies across jurisdictions.
RNs practice nursing in diverse settings wherever care, information, or advocacy are needed. Wherever nursing happens, the approach is person-centered, evidence-informed, and applies the nursing process to promote health and wellness. Practice settings vary from hospitals, ambulatory care, long-term care, and skilled nursing facilities, to educational institutions, government, military, faith-based and community organizations, correctional, public health, virtual environments, and countless other settings. Nurses engage in care, leadership, education, advocacy, consultative, and many other roles.
APRNs are initially licensed as RNs. Their advanced practice role builds upon the foundational knowledge, competencies, and professional standards established in RN practice. Graduate education and supervised clinical training prepare APRNs in one of four recognized roles: certified nurse-midwife (CNM), clinical nurse specialist (CNS), certified nurse practitioner (CNP), and certified registered nurse anesthetist/anesthesiologist (CRNA).
The 5th Edition of the American Nurses Association (ANA) Nursing: Scope and Standards of Practice revision was guided by the findings of a research study titled “Diffusion and adoption of the ANA Nursing: Scope and Standards of Practice Document: A National Survey” (Culver et al., 2025; Sitzer et al., 2023). The study explored how registered nurses (RNs) across diverse roles and settings engage with the foundational document, revealing critical insights into its accessibility, relevance, and usability in everyday practice.
The Specialty Scope and Standards of Practice describe the responsibilities, professional boundaries, and expected competencies of nurses practicing within a recognized specialty. Together, the scope and standards define the who, what, where, when, why, and how of specialty nursing practice and serve as an authoritative resource for nurses, employers, educators, regulators, and the public.
The scope of practice articulates the characteristics and parameters of a nursing specialty, including the population served, practice settings, and core functions. The standards of practice describe a competent level of specialty nursing practice, while the standards of professional performance outline expectations for professional behavior, ethical practice, education, collaboration, and quality improvement.
ANA is pleased to assist specialty nursing organizations as they explore their interest in recognition of a nursing specialty, complete their assessment of readiness to be formally recognized by ANA as a specialty practice, or pursue approval of a scope of practice statement and acknowledgment of specialty practice standards.
To assist us in planning, resource allocation, and workflow management, we ask that all organizations interested in pursuing specialty recognition, developing a new Scope and Standards, revising an existing publication, or exploring future opportunities complete the survey below.
Please complete the survey here:
https://surveys.nursingworld.org/s3/Specialty-Scope-Standards-Interest-Form
Following review of your submission, a member of the Nursing Practice team will follow up with any next steps or additional information.
