delegation, On the Job, Scope of Practice

Suicide Safety Plan Delegation

Is it appropriate for a nurse practitioner to delegate patient follow-up that will establish a suicide safety plan to a medical assistant?

My legal opinion is that nursing law of some states allows nurse practitioners to assign to knowledgeable and competent unlicensed professionals such as medical assistants the interacting by telephone with chronically suicidal patients to establish a suicide safety plan as long as both of the following conditions are met:

  1. The medical assistant adheres strictly to the information guidelines provided by the licensed therapist and approved by the nurse practitioner
  2. The medical assistant’s interaction with the patient does not require the exercise of any degree of independent clinical judgment or the making of clinical assessments or evaluations 

These principles are especially important in interacting with psychiatric patients—even more so for those who are chronically suicidal.

I would also suggest that delegating nurse practitioners check with their malpractice insurance carrier to make sure that the insurance would cover any negligence by a medical assistant in assisting a patient in establishing a suicide safety plan. The opinion from the malpractice carrier should be in writing and kept on file.

On the Job, Scope of Practice

NP Delegation in South Carolina: State Law Permits Nurse Practitioner Delegation to Medical Assistants

Conflicting information has been circulating about whether South Carolina nursing law permits licensed nurses—including advanced practice registered nurses (APRNs), such as nurse practitioners (NPs)—to delegate tasks to medical assistants.

Nevertheless, South Carolina law specifically authorizes licensed nurses, including NPs, to delegate certain nursing tasks to knowledgeable and competent unlicensed assistive personnel (UAP), such as medical assistants, who are working under appropriate nurse supervision.

Administration of medication, however, is a task licensed nurses cannot legally delegate to UAP (such as medical assistants) under South Carolina nursing law.

Review the supporting evidence in the January/February 2020 Public Affairs article, “NP Delegation in South Carolina,” on the AAMA website.