Scope of practice

The first thing that you write about and the first recommendation that you guys have in this report is about recruiting, right? It's the recruitment of psychologists into public health organizations.

And you suggest that these organizations enable autonomous decision-making within the full scope of practice of psychologists, that these organizations engage psychologists as leaders in interdisciplinary teams.

And I'm wondering, I, I guess I sort of thought that that was already the case.

I guess I thought that that was why you would have a psychologist in a public health setting.

In fact, the majority of graduating psychologists do choose to go into the private sector where they're hard to access with all of that training than the public sector.

But then once you're in hospitals, I think a challenge we face with psychologists is the degree of variability.

I think it-- I think the models for deploying physicians in hospitals, for example, are much more standardized in terms of leadership roles in clinical teams, decision-making, scope of practice, all of those kind of elements.

I mean, there's variability there too, but I think it's, it's a lot better defined.

This is episode 221, Working Within Your Scope of Practice.

My name is Stephanie Laines.

I'm the owner of the Stephanie Laines Institute Online Esthetician School and the owner of the Online Esthetician School Podcast.

We try to lobby.

We try to petition.

But we really never figure out actually how we got to that point where a state's going to remove a modality, right? So when I spoke about working within your scope of practice, there's a lot of estheticians that are doing really two big things that are definitely blaring in our industry.

One, they're showing off the fact that they're not working in scope of practice and they're doing this on social media.

And two, there's a lot of uninsured estheticians that are not insured and some of them go to the extent where they're causing damage and then there has to be some kind of insurance involved or suing involved or going to the state and getting them involved when it comes to someone seeking damages right or they are licensed and there is an incident and now they are going to the insurance to seek damages right so I come in and I have these types of conversations a lot of times with estheticians to kind of really remind them whether I'm coming in in a coaching situation or I'm teaching a class or I have an esthetician that stopped by our esthetician store and we're having a conversation.

And we need to tread very carefully so that your health isn't impacted, so that whatever advice you are given is not at your detriment.

Because there is no regulation within the coaching industry, it is very, very easy for people to then work outside of their scope of practice.

And by doing so, they tend not to understand the risks.

They tend to be completely ignoring their own limitations.

The person with the most experience should be leading the team, and geography should not change the quality of health care that any Oklahoman receives.

OSMA supported physician-led care even when Scope of Practice passed a couple of years ago.

We were disappointed in the legislature's decisions despite our caution.

However, we did create one of the most rigorous paths to independent practice there is.

and, of course, other health systems across the state.

But what actions will OSMA take to help mitigate those layoffs, specifically the impact that those layoffs have on patient care and, of course, on physician workload through advocacy for payment reforms, support for affected clinicians, and, of course, collaboration with hospital systems, specifically when it comes to workforce planning?

Well, our efforts at the legislative level are important as far as improving funding for Medicaid, for prior authorization reform, for reducing scope uh, expansion scope of practice expansion, um, which helps, um, bolster physicians, the independent physicians, as well as hospital based physicians, um, layoffs for doctors by large hospital settings is very dis alarming.

And, um, it, um, um, it has a chilling effect on new physician recruitment morale.

[upbeat music] I'm Hayley Ryan, the Director of Wound Rescue, and this podcast is produced in partnership with Learn on the Move.

Today, we're stepping slightly outside wound care to talk about something that affects every nurse listening, our scope of practice, our professional responsibilities, our accountability, and perhaps most importantly, what happens when something goes wrong? Today, I'm joined by Dr.

Michelle Gunn, Head of Nursing Practice and Regulations at the International Council of Nurses.

Michelle brings a fairly unique perspective to this conversation because she's both a registered nurse and a lawyer.

She's a former chief nursing officer, holds a PhD in health law and ethics, and was the lead consultant for the International Council of Nurses landmark definition of nursing project.

So today, I'm going to ask Michelle some of the big questions about nursing now and where the profession needs to go next.

What is the International Council of Nurses and why should it work-- why should we work, and why should it matter to nurses everywhere? What do the new definitions of nursing and a nurse mean for the profession, and what actually determines our scope of practice? So we have a lot to unpack, and so I wanna get stuck in.

So let's unwrap it.

We are focusing on obtaining a complete health history and performing medication reconciliation for the NHA CCMA exam.

This is a critical area of patient intake, and the exam will test your ability to be thorough and to understand your scope of practice.

Let's start with the health history.

It's broken down into several key parts.

The patient tells you their endocrinologist increased the dose to 1,000 milligrams daily last week.

What is your next action? The wrong answer and the trap is to independently update the dose in the patient's chart.

As a CCMA, your scope of practice does not allow you to make changes to the medication list.

Your job is to identify the discrepancy, document it accurately, and report it to the licensed provider for them to reconcile and officially update the record.

And I think that's pretty easy to understand for most health coaches and practitioners out there.

What What is our scope of practice as an unlicensed professional when somebody is asking if they should go on a GLP-1 or if they should come off?

Not our scope at all.

We cannot be making that decision.

It's that serious, yes.

In the midst of all this interaction, there is a very important caution note in the source material regarding the scope of practice.

This is a massive legal, ethical, and operational boundary that every single student needs to understand deeply.

The scope of practice is a hugely high risk area for miscommunication.

A radiologic technologist's scope of practice strictly defines the legal boundaries of their authorized clinical duties.

It outlines exactly what you are trained, certified, and legally permitted to do.

And diagnosing pathology is absolutely outside that scope.

And how prepping the room like a chef's kitchen prevents motion artifacts.