Ky.gov

Kentucky Board of Nursing

Practice

Registered Nurse FAQ

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​​​​​This page provides information on frequently asked questions (FAQ) the KBN receives related RN nursing scope of practice.  You may review all the nursing scope of practice FAQs through the list below or search by key words.

 Please note: additional FAQs are added routinely.​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​

​Notes: *Qualified healthcare providers are physicians, physician assistants, dentists, or advanced practice registered nurses.  See, KRS 314.011(6).​



​What do I need to know about the recent measles outbreak?

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The KBN sent an informative email to all nurses in the Commonwealth regarding the recent measles outbreak, as several cases have been identified in Kentucky. Due to the risk of additional potential measles cases and the possibility of exposure, you may find the following resources valuable.​​


Is it acceptable for an RN or LPN to compound GLP-1 medications such as Semaglutide or administer such medications instead of the commercially available drug? 

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The Kentucky Board of Pharmacy has provided guidance related to this matter. 

Considering this information, it would not be permissible for the RN or LPN to administer the compounded version of a commercially available drug except in narrow circumstances. ​

Specifically, the Federal Drug & Cosmetic Act does not allow compounding of “drug products that are essentially copies of a commercially available drug product” except in narrow circumstances. Additionally, the Kentucky Board of Pharmacy provided guidance from 201 KAR 2:076, which prohibits the compounding of essential copies of a commercially available drug product except in narrow circumstances as authorized by 21 U.S.C. 353(a).

For additional information, see:

​​What is Patient Abandonment?​

While the terms “abandonment” and “patient abandonment” are not used in the Kentucky Nursing Laws (Kentucky Revised Statutes Chapter 314), the Board has the authority to take disciplinary action in specific cases based on its interpretation of what constitutes professional misconduct.

In Kentucky, a nurse whose behaviors are inconsistent with the safe practice of nursing may be charged with being in violation of KRS 314.091(1)(d) “…negligently or willfully acting in a manner inconsistent with the practice of nursing….” All complaints received by the Board alleging patient abandonment are evaluated on a case-by-case basis. The Kentucky Board of Nursing (KBN) has investigated and disciplined nurses for issues surrounding the concept of abandonment as it relates to the nurse’s duty to a patient.​

The position of KBN applies to the licensed practical nurse (LPN), registered nurse (RN), and advanced registered nurse practitioner (APRN).

While it is difficult to specifically state when abandonment occurs, abandonment does not occur when a nurse who cannot practice with reasonable skill and safety leaves an assignment after fulfilling the two obligations stated above. There are employment issues that do not rise to the level of patient abandonment, and thus, are not within the jurisdiction of the Board to address. Examples of employer issues include an employee “no call, no show” situation, an employee refusal to work “mandatory overtime” beyond the regularly scheduled number of hours, and employer resignation policies.

As a guide to nurses and employers, the Board advises that, in general, a nurse who has accepted responsibility for a patient assignment may leave the patient assignment only after: ​

  1. ​Communicating the need to do so with the nurse’s supervisor; and ​
  2. Exhausting all reasonable and prudent efforts to place the care of the patients in another nurse’s care.

Nurses have a professional and ethical obligation to provide for patient safety, avoid patient abandonment, and to withdraw only when assured that, nursing care is available to the patient (American Nurses Association - ANA, 2015).​

​For more information related to patient abandonment, see: 

​How can I Determine if a Particular Task is within My Scope of Practice?

In the practice of nursing, professional issues and practice questions arise that require the nurse to apply education, experience, and professional judgment and to be legally responsible and accountable for the outcome(s). The role of a Board of Nursing is to establish minimum standards for education, licensure, and practice, and to provide information to practicing nurses, to ultimately promote public protection. Scope of practice is the range of roles, functions, responsibilities, and activities that a nurse is educated, competent, and authorized to perform. Scope of practice can evolve and change through experience, clinical competency, evidence-based practice, research, technology, legislation, and changes in the healthcare system.

When the performance of a specific act is not definitively addressed in the Kentucky Nursing Laws or an advisory opinion of the Board, the nurse must exercise professional judgment in determining whether the performance of the act is within the scope of practice for which the individual nurse is licensed. The KBN has developed a decision-making model that provides guidelines to nurses in determining whether a selected act is within an individual nurse’s scope of practice. ​

For more information regarding scope of practice determination guidelines see:​

​Can an RN own a Medspa?

Statutes and regulations do not prohibit a nurse from owning a practice. However, RNs can only administer medication and treatment as prescribed by a qualified healthcare provider*. An RN may use standing orders or protocols that have been established by a qualified healthcare provider.

For more information regarding Medspas see:

Does a client need to be seen by a healthcare provider prior to aesthetic treatments?

Prior to determining and ordering a course of treatment, the qualified healthcare provider* must establish a practitioner-patient relationship, See, KRS 218A.010 (41), and assess the patient by conducting a good-faith prior examination, See, KRS 218A.010 (18). A Registered Nurse (RN) may conduct ongoing assessments related to the qualified healthcare provider’s course of treatment, using a standardized nursing assessment tool as noted within protocols or standing orders that have been created by the facility/agency/office providing aesthetic services. Standing orders/protocols can only be approved by a qualified healthcare provider.*

For more information regarding Medspas see:

​What dermatology and cosmetic Procedures can an RN perform?

Provided below are some important takeaways from AOS #35 Roles of Nurses in Cosmetic and Dermatological Procedures. It is recommended to review the AOS in its entirety if practicing in this setting.

  • Aesthetic, cosmetic, and dermatological procedures may be performed by a nurse as a part of a medically prescribed plan of care for treatment of various dermatological conditions.​
    • ​​If the procedure is not a part of the medically prescribed plan of care, it may require licensure by another regulatory Board.
  • ​The RN may follow standing orders/protocol after the qualified healthcare provider* has established a treatment plan.
  • ​RNs can implement interventions, administer medications, and treatments as prescribed and supervised by a qualified healthcare provider*.
  • It is not within the scope of practice for an RN to independently practice, order products, prescribe treatments, or perform medical aesthetic procedures such as Botox© or Dermal fillers.

The nurse should use the AOS #41 RN/LPN/APRN Scope or Practice Determination Guidelines to determine if a specific activity is within the nurse's legal and individual scope of practice.

For more information regarding Aesthetics:

Can an RN administer Botox® or inject medications for sclerotherapy or dermal fillers?

The nursing laws and rules allow a competent and appropriately trained registered nurse to administer neuromodulators (such as Botox®, Dysport®, or Xeomin®). These procedures require a prescription by a qualified healthcare provider*.

For more information regarding Aesthetics:​
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What is the RN’s role in an IV Hydration Clinic?

IV Hydration clinics, mobile or freestanding are not regulated in Kentucky. IV fluid administration is considered a treatment and requires and order, regardless of whether medications may or may not be added. Nurses are held responsible and accountable for their decisions regarding the receipt and implementation of patient care orders based upon the individuals' educational preparation and clinical competence in nursing. The nurse’s practice should be consistent with the Kentucky Nursing Laws, established standards of practice, and be evidence-based. See, KRS 314.011. 

The performance of a documented initial assessment and development of a treatment plan by a qualified healthcare provider* is a prerequisite for the implantation of any treatment or therapy. After the patient has been assessed by a qualified healthcare provider*, and the orders are specific to the patient noting whether it is a one-time-only administration or is a series with a specific time frame for the administration of such fluids, a nurse may administer the IV medication. It is not within the scope of practice for the nurse to independently practice, assess, diagnose, order products, or prescribe treatments. Following the performance of a documented initial assessment and the development of a treatment plan by a qualified healthcare provider*, treatment or therapies may be performed. The nurse may apply standing orders and protocols that have been prescribed. ​

No more than three (3) medications may be added to a bag of IV fluids. Adding more than three (3) medications is considered compounding and is outside the scope of practice of the nurse.

For more information related to IV Hydration Clinics see:


Does a client need to be seen by a healthcare provider prior to IV Hydration treatments?

Prior to determining and ordering a course of treatment, the qualified healthcare provider* must establish a practitioner-patient relationship, See, KRS 218A.010 (41), and assess the patient by conducting a good-faith prior examination, See, KRS 218A.010 (18). A Registered Nurse (RN) may conduct ongoing assessments related to the qualified healthcare provider’s course of treatment, using a standardized nursing assessment tool as noted within protocols or standing orders that have been created by the facility/agency/office providing aesthetic services.. Standing orders/protocols can only be approved by a qualified healthcare provider.*​

For more information related to IV Hydration Clinics see:​


​Are there any medications that the RN is not allowed to administer? ​

The nursing laws and rules do not prohibit a competent and appropriately trained registered nurse from administering any medication – legend or controlled substance (Schedule II-IV) or over-the-counter medications. The RN may administer medications by any route. The RN must be competent and follow the standards for medication administration.

Please note: While it is within the scope of practice for an RN to administer medications for procedural sedation and analgesia, it is not within the RNs scope of practice to administer medications for the purpose of anesthesia.

For more information regarding medication administration:

Can the RN be delegated to enter medication prescriptions into an electronic health system or call in an order to a pharmacy?

Receiving telephone and verbal prescription orders, transcribing, and transmitting prescription orders are activities often performed by nurses and appropriately included by many organizations in the responsibilities of the registered nurse. The RN has the skill and knowledge to receive a prescription order and transcribe it accurately for other nurses to implement or transmit the order to a pharmacist to dispense. The laws and rules do not prohibit the RN from calling in medication orders except for those restrictions in the Controlled Substances Act. The RN may enter medication prescriptions into an electronic health system under the direction of a qualified healthcare provider*. These directions may come through standing orders or verbal orders.

For more information regarding medication prescriptions:


Can the RN renew a prescription?

It is not within the scope of practice for the RN to independently renew an existing medication without a new prescription from a qualified healthcare provider*. ​

For more information regarding medication prescriptions:


Can the registered nurse compound medications?

No, adding more than three (3) sterile products is considered compounding and is outside the scope of practice of the registered nurse.

For more information regarding compounding see:​


Is it within the scope of practice for an RN to insert Testosterone Pellets?

No, it is not within the RNs scope of practice to administer sub-q testosterone pellets.

For more information regarding women’s health see:




​What task can be delegated by the RN?

When considering if a task should be delegated the nurse must consider the following:​

  • Right task: The activity falls within the delegatee’s job description or is included as part of the established written policies and procedures for the nursing practice setting….
  • Right circumstance: The health condition of the patient must be stable. If the patient’s condition changes, the delegatee must communicate this to the licensed nurse, and the licensed nurse must reassess the situation and the appropriateness of the delegation. 
  • Right person: The licensed nurse along with the employer and the delegatee is responsible for ensuring that the delegatee possesses the appropriate skills and knowledge to perform the activity. 
  • Right directions and communication: Each delegation situation should be specific to the patient, the licensed nurse and the delegatee. The licensed nurse is expected to communicate specific instructions for the delegated activity to the delegatee; the delegatee, as part of the two-way communication, should ask any clarifying questions…. The delegatee must understand the terms of the delegation and must agree to accept the delegated activity. The licensed nurse should ensure that the delegatee understands that she or he cannot make any decisions or modifications in carrying out the activity without first consulting the licensed nurse.
  • Right supervision and evaluation: The licensed nurse is responsible for monitoring the delegated activity, following up with the delegatee at the completion of the activity, and evaluating patient outcomes. The delegatee is responsible for communicating patient information to the licensed nurse during the delegated situation.
For more information regarding delegation of nursing tasks see:


Is a school nurse from another state required to have a Kentucky nursing license to accompany students to Kentucky for a field trip?

  • ​​For Nurses Outside of Kentucky Without a Multistate/Compact License If the school nurse has a single state license, and the state is not a member of the Nurse Licensure Compact, and the nurse is in the state on a non-routine basis not to exceed seven (7) days; the nurse may practice while in the state.
  • A nurse with a multistate license from another NLC state has the privilege to practice in KY.​
  • A nurse travelling to Kentucky would be e​xpected to understand Kentucky laws related to nursing practice in the state.

For more information related to school nursing see:


Is it okay for the School Nurse to monitor a student’s continuous glucose monitoring (CGM) on a personal device?

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​School nurses who provide nursing care for monitoring and maintaining continuous glucose monitoring (CGM) for students during the school day or during school activities should do so only if they are educationally prepared and clinically competent to perform such tasks. The school nurse should never use a personal device for CGM, data collection, or communication between themselves, students, guardians, or healthcare providers due to the risk of confidential student data being compromised. 

Further, schools should develop internal policies and procedures related to:

  1. The storage of CGM monitoring devices on school property; and
  2. Appropriate training guidelines for all staff responsible for using or storing CGM devices.

For more information related to school nursing see:

If a student’s continuous glucose monitor falls off in the school setting, should the school nurse replace it?

School nurses who care for students who have had a CGM sensor that has become dislodged should follow national guidance as outlined by the American Diabetes Association (ADA) regarding sensor replacement. ​

The ADA recommends:
  • Placing all sensor pieces into a sealable plastic bag to be sent home with the student 
  • DO NOT discard of any CGM sensor parts
  • If the student has been approved to self-manage then allow the student or family member to replace the CGM sensor at school ​
  • Perform finger sticks for blood glucose monitoring for a student with a dislodged CGM sensor while in the school setting ​
​Further, schools should develop internal policies and procedures related to: 1) The dislodgement of CGM sensors on school property and 2) Appropriate training guidelines for all staff responsible for CGM devices.

For more information related to school nursing see:


Can a School Nurse administer over-the-counter (OTC) medications to a student in the school setting without an order from a qualified healthcare provider?

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A school nurse should only administer medication to a student in the school setting with a valid order from a qualified healthcare provider as well as written parental/guardian consent. 

For more information related to school nursing see: 


​What is the RN’s responsibility specific to patient abandonment? 

The KBN, as outlined in KRS 314.021(2), holds nurses individually responsible and accountable for rendering safe, effective nursing care to patients and for judgments exercised and actions taken while providing care.​

The nurse must fulfill a patient care assignment or transfer responsibility to another qualified person once the assignment has been accepted. ​

As a guide to nurses and employers, the Board advises that, in general, a nurse who has accepted responsibility for a patient assignment may leave the patient assignment only after: ​

  1. ​Communicating the need to do so with the nurse’s supervisor; and
  2. Exhausting all reasonable and prudent efforts to place the care of the patients in another nurse’s care.​

For more information related to patient abandonment see:


What if my employer requires me to work overtime or take an assignment that I believe unsafe due to staffing ratios? Does this fall under patient abandonment?

There are employment issues that do not rise to the level of patient abandonment, and thus, are not within the jurisdiction of the Board to address. Examples of employer issues include an employee “no call, no show” situation, an employee refusal to work “mandatory overtime” beyond the regularly scheduled number of hours, and employer resignation policies. Please note: The KBN has no jurisdiction over facility-based policies regarding hours worked or overtime hours.​


Does the Kentucky Board of Nursing Require a Specific Nurse to Patient Ratio?

No, the Kentucky Board of Nursing does not establish a ratio for the given number of patients for which a nurse may be assigned. Pursuant to the KRS Chapter 216B, the Cabinet for Health and Family Services promulgate administrative regulations requiring that health care facilities employ enough qualified personnel to meet the needs of the patients [902 KAR 20:016; 048; 051]. A patient/nurse ratio should be minimally based upon the qualifications of each nursing staff member, nursing care needs of the patient, and the patient's prescribed medical and nursing care requirements set forth in a plan of care. When patients do not receive necessary care because of understaffing, then the specific facts of the given situations should be documented and reported to the nurse's chain of command as well to the Cabinet for Health and Family Services, Office of the Inspector General, Division of Health Care Facilities and Services, (502-564-7963), and to the Joint Commission on Accreditation of Healthcare Organizations.

For more information see:

​What does Telehealth consist of? ​

Telehealth includes the use of interactive audio, video, or other electronic media to deliver health care. It includes the use of electronic media for diagnosis, consultation, treatment, transfer of health or medical data, and continuing education. The term does not include audio-only telephone calls, email messages, or facsimile transactions​.

For more information regarding Telehealth see:


​What is the RN’s role when utilizing telehealth services?

Nurses must be licensed to practice in each state in which the patients they provide care to reside. Currently, licensing in 42 states may be accomplished by holding a Nursing Compact License. Telehealth may be practiced by nurses as defined by their licensed scope of practice in KRS 314.011​. Each nurse must practice within his/her licensed scope of practice. Telehealth/telenursing may include all elements of the nursing process. Nurses utilizing telehealth to provide patient care must follow all requirements listed in KRS 314.155​ and 201 KAR 20:520 and, as relevant 907 KAR 3:170.


​Can an RN sign a death certificate?

In Kentucky, 314.181 Determination of death by registered nurses -- Notification. A registered nurse who is employed by a health facility as defined in KRS 216B.015 may determine whether a patient is dead in accordance with the requirements of KRS 446.400. The nurse shall notify the patient's attending physician or other appropriate practitioner of the death in accordance with the facility's policy. The registered nurse is authorized to sign the provisional report of death as furnished by the state registrar of vital statistics.​

For more information regarding Death Certificates, see:


​Is it within the scope of practice for an RN to perform Ultrasound/Ultrasonography?

A nurse who is educationally prepared and clinically competent to perform ultrasound/ultrasonography may perform the act within the legal scope of registered nursing practice. The formulation of a medical diagnosis is not within the scope of registered nursing practice.

​For more information regarding women’s health see:

Is it within the scope of practice for an RN to insert Testosterone Pellets?

No, it is not within the RNs scope of practice to administer sub-q testosterone pellets.​

​For more information regarding women’s health see:


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