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 that 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 a Nurse Aide I and a Nurse Aide II shall be established by the Board pursuant to 21 NCAC 36 .0403. Tasks may be delegated to an unlicensed person that:

(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 that cannot be logically separated from the tasks themselves.

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

(c)  A registered nurse or licensed practical nurse shall not delegate the professional judgment required to implement a treatment or pharmaceutical regimen that is likely to produce side effects, toxic effects, allergic reactions, or other unusual effects or that may rapidly endanger a client's life or well-being and that is prescribed by an individual authorized by State law to prescribe such a regimen. A nurse who assumes responsibility directly or through delegation 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 a client's condition that contraindicates continued administration of the pharmaceutical or treatment regimen;

(7)           anticipating those effects that 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)  If health care needs of a client are incidental to the personal care needs of the client, a nurse 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 and .2514.

History Note:        Authority G.S. 90-85.3; 90-85.15B; 90-171.23(b); 90-171.43; 90-171.95B

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;

Readopted Eff. January 1, 2019;

Amended Eff. July 1, 2023.