A newly hired RN is assigned to perform an advanced procedure outside their scope of practice. What is the expected action?

• A. Refuse to perform the procedure and notify the supervisor; request proper assignment or supervision.
• B. Proceed under supervision regardless
• C. Delegate to another new RN
• D. Document the request and consider later

Answer: (A)

Boundaries of practice and using the chain of command when asked to perform something beyond your training are being tested. If a newly hired RN is asked to perform an advanced procedure outside what they are licensed or trained to do, the safest and most appropriate action is to refuse and immediately notify the supervisor or charge nurse, requesting a proper assignment within scope or supervision by someone who is credentialed for that procedure. This protects both the nurse’s license and patient safety, ensuring that care is provided by someone with the right credentials and supervision. It also aligns with policy that requires authorization before expanding practice beyond current scope. Proceeding under supervision or delegating to another newly hired nurse doesn’t resolve the issue of the procedure lying outside the proper scope, and delaying action or documenting and considering later fails to address an immediate safety concern. If there's a real-time safety risk, escalate urgently while seeking appropriate authorization or assignment.