21 NCAC 36 .0221             LICENSE REQUIRED

(a)  No cap, pin, uniform, insignia or title shall be used to represent to the public, that an unlicensed person is a registered nurse or a licensed practical nurse as defined in G.S. 90-171.43.

(b)  The repetitive performance of a common task or procedure which does not require the professional judgment of a registered nurse or licensed practical nurse shall not be considered the practice of nursing for which a license is required. Tasks that may be delegated to the Nurse Aide I and Nurse Aide II shall be established by the Board of Nursing pursuant to 21 NCAC 36 .0403. Tasks may be delegated to an unlicensed person which:

(1)           frequently recur in the daily care of a client or group of clients;

(2)           are performed according to an established sequence of steps;

(3)           involve little or no modification from one client-care situation to another;

(4)           may be performed with a predictable outcome; and

(5)           do not inherently involve ongoing assessment, interpretation, or decision-making which cannot be logically separated from the procedure(s) itself.

Client-care services which do not meet all of these criteria shall be performed by a licensed nurse

(c)  The registered nurse or licensed practical nurse shall not delegate the professional judgment required to implement any treatment or pharmaceutical regimen which is likely to produce side effects, toxic effects, allergic reactions, or other unusual effects; or which may rapidly endanger a client's life or well-being and which is prescribed by a person authorized by state law to prescribe such a regimen.  The nurse who assumes responsibility for implementing a treatment or pharmaceutical regimen shall be accountable for:

(1)           recognizing side effects;

(2)           recognizing toxic effects;

(3)           recognizing allergic reactions;

(4)           recognizing immediate desired effects;

(5)           recognizing unusual and unexpected effects;

(6)           recognizing changes in client's condition that contraindicates continued administration of the pharmaceutical or treatment regimen;

(7)           anticipating those effects which may rapidly endanger a client's life or well-being; and

(8)           making judgments and decisions concerning actions to take in the event such effects occur.

(d)  When health care needs of an individual are incidental to the personal care needs of the individual, nurses shall not be accountable for care performed by clients themselves, their families or significant others, or by caretakers who provide personal care to the individual.

(e)  Pharmacists may administer drugs in accordance with 21 NCAC 46 .2507.


History Note:        Authority G.S. 90-85.3; 90-171.23(b); 90-171.43; 90-171.83;

Eff. May 1, 1982;

Amended Eff. July 1, 2004; April 1, 2002; December 1, 2000; July 1, 2000; January 1, 1996; February 1, 1994; April 1, 1989; January 1, 1984;

Emergency Amendment Eff. September 10, 2004;

Amended Eff. April 1, 2008; December 1, 2004.