What's New in Nursing's Scope and Standards of Practice: Innovation and AI - LIVE at ANCC Magnet & Pathway 2026

[00:00:10] Hello and welcome to the Nurse Rosa's INsights coming to you live from Magnet in Chicago, Illinois. And today I'm joined by two of the experts who were just talking to us on the stage about the brand new Scope and Standards of Practice that the ANA has put out. We have Bradley Gaitle, the CNO of the whole ANA or A&E.

[00:00:34] And then Sarah Gray, this is my first time meeting you. So thank you so much for joining us today. And tell us what is new about the Scope and Standards of Practice? Did you rewrite it from the bottom up or did you just kind of tweak some things? We certainly look at the entire thing. So rewriting it from the ground up? No, not necessarily because there's a lot of things that are foundational to nursing that haven't changed.

[00:01:01] We do rewrite the document every five years. It takes us about 48 months in order to do that process though. So it's kind of a continuous iteration. So we're adding two things that are new to this document are the innovation piece, as well as the AI information that's incorporated into there.

[00:01:19] We look at everything, review everything with a lot of rigor that goes into the process. And I was just speaking about that rigorous process that we have, which separates us from having a conversation and a club of individuals that just want to decide things versus the fact that we have a profession and we go through a rigorous process to actually make this document come to life.

[00:01:49] And Bradley, we've seen so much talk this year about whether or not nursing is even a profession. So was this a key part of that discussion in getting nursing recognized as a profession? Well, this is the fifth edition of the Scopes and Standards. And this is the foundational document that really describes the who, what, when, where, and why about our profession.

[00:02:11] So it's not like I said, or like Sarah saying, it's not necessarily a new document or a new conversation. I think it underscores the fact that we are a profession, that we're based in science, that we use the evidence to guide our practice. And the document definitely underscores that.

[00:02:28] You know, our work to talk about, you know, how we're recognized as a profession and that advanced practice nursing is recognized as an advanced practice degree was really happening in tandem with the new document review. But that's a whole nother issue that really was a major policy point for the association this last year.

[00:02:50] Exactly. And we're talking about, you know, nurses and nurse practitioners. Does that include the scope and standards of practice for like an LPN versus an RN versus an APRN or what all does it cover?

[00:03:02] So this document is foundational to what a registered nurse does. It does not necessarily include LPNs, LPNs. However, with the addition of LPNs and LPNs being included and the membership of ANA, that decision just being made at our membership assembly in 2026, we are certainly looking at that for the future. But this document is specific. For the next 48-month process.

[00:03:26] Yes. So there's going to be a lag at time, right? It'll be a little time before we get that document produced. But we certainly are talking and looking at that. But for advanced practice nurses and clinical nurse specialists and all of those types of things, yes, they have advanced degrees, but foundationally, they're still an RN. So this document is the foundational RN document. There are additional scope and standards for, you know, specialties and nursing and things like that.

[00:03:56] But this applies to every nurse, regardless of where you work, regardless of what your specialty is, and regardless of what role you would have advanced to within the profession. I think what's cool about the document also, and this is really from the Code of Ethics, is nurses are defining nursing practice. Nobody else. And that's what's foundational to this document as well, is it's written by nurses, made for nurses, and describes nursing practice.

[00:04:23] Nobody else should take control over defining what we do as a profession. So it's self-governing. That's right. Yeah. And you mentioned two new areas being innovation and AI. So what is covered as far as innovation? I see there's entire tracks around innovation, specifically at this conference. That's right. I mean, nurses are natural innovators. That's just built into who we are. You mean it's not just limited to work around?

[00:04:52] Right. It's not just duct tape and, you know, trying to put some tubes together to try to make something work. But I mean, we always find a way and we're natural innovators. And now we're really highlighting that in the scopes and standards because it is an essential part of our practice. It's really how we critically think and solve problems. Yeah. So the innovation section that has been added to this book is really the process of innovation.

[00:05:19] So it is less about the duct tape and more about the process of how you think through an innovative process. There is also components related to artificial intelligence in here. It is fairly brief because we're doing a lot more with AI as it evolves. But it talks about some of those foundational things that at the end of the day, nurses are still in charge of their clinical judgment and their practice and making sure that we're providing safe care.

[00:05:46] And we need to make sure that we the buck still stops with nurses. It does not stop with the artificial intelligence recommendation. Right. So we still have to have that clinical judgment piece. And so that's what's incorporated into here is that nurses are in charge of clinical judgment and making sure that nurses are equipped with the knowledge of AI. And that's what it recommends.

[00:06:11] I would just add there is it's so hard to keep up right now with everything that's changing with artificial intelligence. But we did just open up public comment for the ethical principles around AI. And that should be closing next week, I believe, if not this week. So we're trying to keep up with making sure that we can really give guiding principles to nurses around AI. But it's so hard to keep it up. A book will be published today and we'll have, you know, new guiding principles tomorrow. 48 months ago. I know.

[00:06:42] What was the conversation around AI? Nothing like it is. Exactly. And since you mentioned we want the buck to stop with nurses, I don't know if the decision is made by the AI, should the nurse be then liable and responsible and have their license on the line for a decision they don't have the authority or input on? Yeah.

[00:07:04] Personally, I think that when the nurse confirms or agrees, then they have accountability, right? Because they've been a part of that process. I don't believe that if an artificial intelligence or technology makes a decision for a nurse that a nurse has never been a part of, that they should hold that accountability. But being that we are the ones actually taking care of that patient and advocating for that patient, if something's not right, it's a see something, say something moment. And, you know, don't push forward.

[00:07:34] And there's a lot of experience that nurses bring to the table. And it's I'm not sure that we can trust all the technology just yet to make every clinical judgment for us. It definitely can help reduce cognitive burden. It can definitely help identify trends over time that maybe our brain is not fast enough to be able to see. And it can be, you know, enlightening and help capture important things. But we still have to use our personal judgment. And that's the human part of nursing.

[00:08:03] I want to read just a quick couple of sentences directly from this book so that you can really get a sense of what this says about AI and that decision making process. So under safe integration of artificial intelligence and nursing practice, that subsection, and I'm reading from page 81 in case anybody's following along here.

[00:08:23] AI enabled information is one input into professional decision making and must be integrated into a holistic nursing assessment, evidence informed practice and clinical expertise. Treating AI as supportive information, not final authority. So, yes, there is also some information on the next page that talks about support and governance to ensure safety for nursing licensure. So that piece is incorporated in here as well.

[00:08:53] But we're going to continue to look at that as, you know, the American Nurses Association and how we support nurses in that governance piece. So that is a key piece that we are looking at in the coming months. Not necessarily something we may put in a document that has a five-year shelf life, but certainly something that we will continue to evolve to provide information and guidance on for the profession.

[00:09:15] It's like this guidance would be most helpful in those governance conversations where the nurses are part of the decision on what the policies are going to be in the hospital when they are created. Right. So it sounds like that's where the key is, because this is not going to be serving as some kind of protective legal document.

[00:09:34] If a nurse is brought into a court case about, you know, whether or not they are liable for something like this might be supportive, but it sounds like it's more helpful in the prevention side of the conversation. Would you say that's right? It really helps guide our practice. The other documents and work that we're doing may provide a little bit more clarity around some of those questions. Or, you know, we're still trying to figure out how best to navigate those challenging conversations ourselves.

[00:10:03] But we did pull together an AI think tank earlier in the year. And so we had industry leaders, nursing experts, AI experts, technology experts, folks from across different generations, across different geographies to really help us decide what are the tools and resources that we need to put out. Not only for nurses, but for leaders and for policymakers and to make sure that we're protecting nurses.

[00:10:33] And I'll just add, because we do have that policy advocacy and lobbying piece and arm to the association. No, we will continue to advocate and look at how that is incorporated into that side of our profession and how we can support nurses in that way, too. It's evolving, obviously, very quickly. But we will continue to do that work on behalf of the profession with all of the input from the profession.

[00:10:59] And I think it's really important to have, like, this core support coming from a national level, because if, like, from the federal level, they're not going to regulate AI and the states are going to have to take it upon themselves to implement regulations on AI usage and things like that.

[00:11:17] It'll be up to the state nurses to use the guidelines to have these conversations with their legislatures on a state-by-state basis and not hang their hat on the ANA to do everything for them, right? But you're at least helping to lay the foundations for those conversations and those talking points? Absolutely. And our government affairs team has a state government affairs arm, and we work directly with the CSNAs in every single state to help advance policy conversation.

[00:11:46] Sorry, the constituent and state nursing associations. So we help advance policy really across the country in partnership with the states as well. Nothing bad. Oh, okay. Go ahead. That's right. Yeah, it's just important to define our acronyms because there's so many. There are. That could be anything, right? Yeah. But thank you so much for sharing this with us today and giving us maybe some cliff notes and things like that. Now, are people able to read this online?

[00:12:15] Like they can read the Code of Ethics online or did they have to order a paper book in order to see what it says? It's available both ways. So you can get a paper book. And I just do want to point out it's much smaller than it was in the past as well. So you can order a paper book as well as an e-copy if you would like to do it that way. And a final thought that I would just throw out there as well is that this is like 100 and what did I say? 125 pages or something. No, it's not an expectation that nurses have this memorized cover to cover.

[00:12:44] It's just like a drug book reference, right? We have it. We know where the information is when we need it. We know what the basis for it is. But this is foundational documentation that most of it is what you've already been infused with throughout your nursing programs, you know, your undergraduate type program and have probably built on through professional development.

[00:13:08] So there's lots to build on, right, with the innovation and the AI pieces you should be familiar with. And it's important for leaders to also know what's in here so that they can help support their staff and reference them to the right resource when they have questions and when they need it as well. So thank you so much. Thanks for having us. Appreciate you. Of course. Thanks for being at the conference. Of course. Can't miss it. Thank you.