Position Statement





The Missouri State Board of Nursing believes that the provisions of the State of Missouri Nursing Practice Act (1993) and its rules and regulations reflect the public policy of this state that its licensed nurses have a duty to faithfully serve the best interests of their patients.

As an essential component of safeguarding patient health and safety, nurses must seek appropriate consultation and collaboration, as indicated, and ultimately exercise informed judgments about their own or other providers' education, knowledge, competency, and extent of clinical experience in

    1. accepting nursing responsibilities, or
    2. assigning or delegating nursing care activities to others.

The Missouri State Board of Nursing believes that, within an environment of conflicting requirements, nurses have a responsibility to take initiative in facilitating and participating in the development of creative strategies that will preserve and promote the health and welfare of patients and their families.

The Missouri State Board of Nursing further believes that nurses have a responsibility to engage in ongoing education and training in order to exercise a fuller range of competencies within the environments they choose to work. When nurses are expected to work in new settings outside their usual area of practice, adequate orientation, education, training and supervision are prerequisites to the development of competence.


  1. American Nurses Association. (1985). Code for nurses with interpretive statements. Washington, DC: Author.
  2. American Nurses Association. (1991). Standards of clinical nursing practice. Kansas City, MO: Author.
  3. American Organization of Nurse Executives. (1993). Cross-utilization of nursing staff. Nursing Management, 24, 38-39.
  4. Kansas State Nurses Association Council on Practice. (1992). Guidelines for the registered nurse in accepting or rejecting a work assignment. Topeka: Kansas State Nurses Association.
  5. Kirk v. Mercy Hospital Tri-County, 851 S.W.2d 617 (Mo.App. S.D. 1993).
  6. State of Missouri. (1993). Nursing practice act. Missouri Statutes, Chapter 335 Nurses. Jefferson City: Missouri State Board of Nursing.