The 4 types of New York nursing professions are:
*In New York, midwifery is not considered a nursing profession. Midwifery is a separately licensed profession.
A nurse may provide nursing services allowed by New York law only if the nurse is personally competent to deliver the services. You are not legally allowed to provide nursing services that you are not personally competent to perform, even if New York law generally allows a nurse to provide the service. As a licensed professional, it is your responsibility to provide care competently, and as authorized by New York law. If you don’t, you could be charged with professional misconduct.
No. New York law restricts the use of the title “nurse” to persons who are licensed by the New York State Education Department as an RN, LPN, CNS or NP. Graduates of certain RN or LPN education programs may also use the title of “graduate nurse” or graduate practical nurse” if they have applied for a New York State RN or LPN license and a limited permit.
Yes. You must be licensed and registered by SED as a LPN in order to practice as an LPN. You must be licensed and registered by SED as a RN in order to practice as an RN. In order to practice as a nurse practitioner, you must be licensed and registered by SED as a RN and certified and registered by SED as a nurse practitioner. In order to practice as a clinical nurse specialist, you must be licensed and registered by SED as a RN and certified and registered by SED as a clinical nurse specialist.
Yes. You are legally required to wear an identification badge indicating your name and your professional title if you are practicing at a hospital, clinic, group practice or other establishment offering health services to the public.
No. In New York, it is illegal for business ventures that are not specifically authorized by New York Law to provide medical or nursing care (i.e., salons or nutritional supplement stores) may not legally hire licensed nurses to provide nursing services in New York State.
All licensed healthcare practitioners with private practices must retain patient records for at least six years. Some records must be retained for even longer periods of time. Obstetrical records and records of minor patients must be retained for at least six years, and until one year after the minor patient reaches the age of 21 years. It is unprofessional conduct to fail to maintain a record for each patient, which accurately reflects the evaluation and treatment of the patient. See, 8 NYCRR §29.2(3).
No. In New York, a licensed professional such as a physician, may not delegate tasks that fall exclusively within that practitioner's scope of practice to another licensed professional, such as an RN, LPN or CNS, who does not have that task within her/his licensed scope of practice.
Several options are available. You can share your concerns with your clinical supervisor or report your observations to the New York State Department of Health’s Bureau of Controlled Substances at 866-811-7957. If your co-worker is a nurse, you may also assist the nurse to contact; (1) the New York State Nurses Association's Statewide Peer Assistance for Nurses (SPAN) program by phone 518-782-9400 ext. 304, or electronically through their Web site at https://www.nysna.org/nursing-practice/statewide-peer-assistance-nurses; or, (2) the New York State Education Department's Professional Assistance Program (PAP) at 518-485-9353.
Insurance companies, managed care organizations and other health care payors do not define the legal scope of practice of nurses. However, they may determine which nursing services they will pay for and how much they will pay. The State Board for Nursing does not have the authority to resolve fee disputes between nurses and managed care organizations, insurance companies or other payors.
Please review the practice guidance information available on this website. You may also use the “Find Answers” button at the top of this webpage. If the information that you seek is not on this website, you may seek guidance from the Nursing Board office by EMAIL at: email@example.com, or by telephone at 518-474-3817 ext. 120. You may also send a letter with your question to: New York State Education Department, 89 Washington Avenue-Education Building, State Board for Nursing, Second Floor, West Wing, Albany, New York, 12234.
According to New York State Education Law §6902, LPNs perform tasks and responsibilities within the framework of case finding, health teaching, health counseling and provide supportive and restorative care under the direction of a registered professional nurse (RN), clinical nurse specialist, physician, nurse practitioner, licensed midwife, physician assistant, specialist assistant, dentist or podiatrist. An LPN typically provides the following types services under the direction of an RN or other qualified practitioner (assuming that the LPN is personally competent to do so):
New York law does not allow LPNs to determine nursing diagnoses, develop or change nursing care plans, perform triage, or perform any service that the LPN is not personally competent to perform. There are many services not listed here that LPNs may or may not be allowed to perform. There are many New York laws and regulations that impact the practice of LPNs. To view some of these laws and regulations, click on "Laws, Rules & Regulations" in the left navigation menu.
According to New York State Education Law §6902, RNs diagnose and treat human responses to actual or potential health problems through such services as case finding, health teaching, health counseling and providing care supportive to or restorative of life and well-being. RNs also execute medical regimens prescribed by a licensed physician, dentist, nurse practitioner, physician assistant, specialist assistant, midwife or podiatrist in accordance with New York State Education Department regulations. A nursing regimen must be consistent with any existing medical regimen. RNs may practice independently, in collaboration with other health care practitioners, or under the supervision of a physician, nurse practitioner, midwife, dentist, podiatrist, clinical nurse specialist or another RN. An RN typically provides the following types of services (assuming that the RN is personally competent to do so):
RNs make nursing assessments and nursing diagnoses, and also plan, implement and evaluate nursing care. RNs do not make medical diagnoses or prescribe medical treatments or drugs. There are many New York laws and regulations that impact the practice of RNs. To view some of these laws and regulations, click on "Laws, Rules & Regulations" in the left navigation menu.
In some cases, yes. The New York State Education Department (SED) issues limited permits RN or LPN license applicants who have met all legal requirements to be licensed and registered to practice nursing except for taking the National Council Licensure Examinations (NCLEX–RN or NCLEX–PN). An LPN license applicant with a limited permit is a graduate practical nurse (GPN). An RN license applicant with a limited permit is graduate nurse (GN). This title must be displayed on the GPN’s or GN’s identification badge and must also be used when signing patient records.
GPNs and GNs must practice at all times under the supervision of a registered professional nurse (RN) in a hospital or residential healthcare facility (nursing home). The supervising RN must be on the patient care unit at all times when professional services are being rendered by the GPN or GN. The supervising RN must provide an appropriate degree of supervision, which is determined by the care needs of the patients and the skill and experience of the GPN or GN and other relevant factors.
Yes. A licensed nurse may work in a position that he/she has the training to do and that is within his/her scope of practice. RNs have the training to perform LPN, Certified Nurses Aid and Home Care Aid functions and therefore could accept a work identified for these levels. An LPN has the training to perform Certified Nurses Aid and Home Care Aid functions, and could accept work identified for either of these positions. However, the nurse that does so would still be required to act prudently based on his/her educational preparation and would be held to that standard. In addition, the nurse cannot refer to themselves as an "LPN" or "Certified Nurse Aid" unless it is, in fact, true.
Only a licensed physician, nurse practitioner, midwife, podiatrist, dentist, clinical nurse specialist or an RN may supervise the nursing practice of an RN. All other licensed professionals (including licensed practical nurses) are not legally allowed to supervise the professional nursing practice of an RN. They could, however, supervise non-clinical matters such as attendance, dress code, etc.
Only a licensed physician, nurse practitioner, midwife, podiatrist, dentist, physician assistant, specialist assistant, clinical nurse specialist or registered professional nurse may direct the nursing practice of an LPN. Although no other licensed professionals or individuals are legally authorized to supervise the professional nursing practice of an LPN, they could supervise non-clinical matters such as attendance, dress code, use of paid and unpaid leave.
No. New York State Education Law § 6902 requires LPNs to practice under the direction of a registered professional nurse, clinical nurse specialist, nurse practitioner, physician, dentist, physician assistant, specialist assistant, podiatrist, or midwife (“directing practitioner”). The directing practitioner must provide an appropriate degree of direction to the LPN, which is determined by the care needs of the patients and the skill and ability of the LPN. In most cases, the directing practitioner must be on premises when LPNs provide nursing care. The directing practitioner does not necessarily have to be on premises to direct an LPN where: (1) the LPN has demonstrated competence to meet the nursing care needs of the LPN’s patients; (2) the LPN’s patients are highly unlikely to require personal intervention by the directing practitioner; and (3) the directing practitioner is available to direct the LPN by telephone and can personally intervene within 15 minutes to ensure timely and appropriate care. The directing practitioner remains ultimately responsible for providing appropriate direction by phone or in person to ensure patient or client safety. LPNs must practice under the direction of a directing practitioner even if the LPN has been issued an "Independent Medicaid Provider Number" by the New York State Department of Health. The "Independent Medicaid Provider Number" merely allows the LPN to be paid for Medicaid services provided by the LPN; it doesn’t authorize the LPN to practice independently.
An LPN may supervise another LPN if: (1) the services delegated are within both LPN’s legal scope of practice and personal competency; and (2) both LPNs practice under the continuous direction of a registered professional nurse (RN), clinical nurse specialist, nurse practitioner or physician. An LPN cannot legally “direct” the practice of other LPNs in lieu of an RN or other qualified practitioner. LPNs are not legally allowed to supervise RNs or other licensed health care professionals. New York law does not authorize LPNs to determine nursing diagnoses, or develop nursing care plans. To the extent that charge nurse or supervisor responsibilities are inconsistent with the above mentioned legal restrictions, LPNs accepting such positions could have a disciplinary charge against their license for working beyond their lawful scope of practice.
Not usually. Nurses are legally required to administer medications and tests pursuant to patient-specific orders, except for certain immunizations, anaphylaxis treatments, purified protein derivative (PPD) tests, Hepatitis C tests and Human Immunodeficiency Virus (HIV) tests, which may be provided pursuant to non-patient specific orders issued by a nurse practitioner or physician. For more information concerning New York Laws that govern non-patient specific orders and protocols, see Education Law §6909 and 8 NYCRR §64.7.
In New York State, a clinical nurse specialist is a registered professional nurse who has completed advanced education (usually a master’s or doctorate degree) in a nursing clinical practice specialty and is certified by the New York State Education Department (SED) as a "Clinical Nurse Specialist" or "CNS".
Clinical nurse specialists provide expert, highly skilled nursing services to benefit patients with complex health care needs. In addition to providing, coordinating and supervising care, CNSs evaluate the quality and effectiveness of patient care. They provide clinical consultation to other health care personnel. CNSs may be involved in health care management, health systems improvement, clinical research and health care policy development.
Clinical nurse specialists do not determine medical diagnoses and do not prescribe or order medical treatments or diagnostic tests. For example, a clinical nurse specialist does not prescribe medications or order CT scans. There are many laws that govern clinical nurse specialist practice. To view some of these laws and regulations, click on "Laws, Rules & Regulations" in the left navigation menu.
SED issues clinical nurse specialist certifications in the following specialty areas: Adult Health; Pediatrics; Psychiatric/Mental Health; and, Oncology.
In New York State, a nurse practitioner is a registered professional nurse who has completed advanced nursing education (usually a master's or doctorate degree) in a nurse practitioner specialty area and is certified by the New York State Education Department ("SED") as a "Nurse Practitioner" or "NP". SED certifies nurse practitioners to practice in the following specialty practice areas: Acute Care; Adult Health; Community Health; College Health; Family Health; Gerontology; Holistic Care; Neonatology; Obstetrics; Oncology; Palliative Care; Pediatrics; Perinatology; Psychiatry; School Health; and Women's Health. . Nurse Practitioners manage the medical and nursing care of their patients. According to New York State Education Law §6902, a nurse practitioner diagnoses illnesses and physical conditions and performs therapeutic and corrective measures within a specialty area of practice in which the nurse practitioner is certified by SED.
SED issues nurse practitioner certificates in the following specialty practice areas:
Nurse Practitioner (Acute Care): diagnoses, treats and manages the care of acutely ill patients in a variety of hospital and ambulatory care settings.
Nurse Practitioner (Adult Health): diagnoses, treats and manages the care of adults (young adults from about age 18 to the very elderly). Adult nurse practitioners may provide primary care or acute care; they may address acute or chronic health problems or provide preventive or supportive care.
Nurse Practitioner (College Health): addresses the physical and mental health needs of adolescent and adult populations in college settings.
Nurse Practitioner (Community Health): provides primary care services in community settings, and engages in population based health planning for communities.
Nurse Practitioner (Family Health): diagnoses, treats and manages the care of families and individuals across the life span. Family nurse practitioners usually provide primary care but they may also provide acute care, address acute or chronic health problems, and provide preventive and supportive care. Family Nurse Practitioners practice in a variety of settings, including schools, homes, work places, hospitals, clinics and primary care health practices.
Nurse Practitioner (Gerontology): diagnoses, treats and manages the care of older adults. This includes primary care and acute care, adressing acute or chronic health problems and providing preventive or supportive care.
Nurse Practitioner (Holistic Care): provides care that encompasses the body, emotion, mind and spirit, focusing on personal development and self-healing.
Nurse Practitioner (Neonatology): diagnoses, treats and manages the care of newborns and infants up to 1 year of age and provides support services to new parents.
Nurse Practitioner (Obstetrics and Gynecology): provides reproductive health care to women and female adolescents. Obstetrics and Gynecology nurse practitioners may provide primary care or acute care; they may address acute or chronic health problems and provide preventive or supportive care. Some Obstetrics and Gynecology nurse practitioners sub-specialize in fields such as Labor & Delivery.
Nurse Practitioner (Oncology): diagnoses and treats and manages oncology related care for patients with cancer, and counsels, educates and provides support to their families.
Nurse Practitioner (Palliative Care): provides care to improve the quality of life of individuals with chronic, debilitating and life limiting illnesses and their families. Palliative care nurse practitioners typically treat pain and other distressing symptoms as well as address other physical, psychosocial and spiritual needs of patients and families.
Nurse Practitioner (Pediatrics): diagnoses, treats and manages the care of infant, children, adolescents and young adults (infants, children and adolescents up to about age 21). Pediatric nurse practitioners provide primary care and acute care; they address acute or chronic health problems and provide preventive and supportive care.
Nurse Practitioner (Perinatology): promotes quality care across the spectrum of birth experiences, ranging from a physiologic approach to birth that minimizes unnecessary intervention to coordinating treatment plans for conditions typically associated with high-risk pregnancies. They also work with new parents with breast feeding and parenting.
Nurse Practitioner (Psychiatry): diagnoses and treats psychiatric disorders and manages other acute and chronic mental health problems of adults and children. They may provide primary mental health care services or acute mental health services (i.e., triage, crisis intervention services).
Nurse Practitioner (School Health): addresses the health care needs of students in school settings. School health nurse practitioners may develop care plans to be implemented in school settings, train school staff to help students with health issues, and provide counseling and health education to students and their families.
Nurse Practitioner (Women’s Health): diagnoses, treats and manages the care of women and female adolescents, with a focus on primary care and gynecological care. They diagnose and treat sexually transmitted diseases in adults and adolescents, regardless of sex or gender identity.