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Letter to the Editor

  • As the general public slowly recognizes the nurse practitioner as a primary care provider, society has a right to question whether or not the profession is in keeping with their own unique code of ethics.

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State Boards of Nursing (BONs) - Kentucky

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May 1, 1996

Jill Berger RN
Pain Management Coordinator
Baptist East Hospital
4000 Kresge Way
Louisville Ky 40207


Dear Ms. Berger:

During the regular meeting held April 18 and 19, 1996, the Kentucky Board of Nursing considered your letter dated August 8, 1995. In you letter, you requested an opinion as to whether the performance of Healing Touch, Therapeutic Touch and/or Reiki are within the scope of registered nursing practice.

KRS 314.011(6) defines "registered nursing practice" as:

… The performance of acts requiring substantial specialized knowledge, judgment and nursing skill based upon the principles of psychological biological, physical and social sciences in the application of the nursing process in:

a) The care, counsel, and health teaching of the ill, injured or infirm.

b) The maintenance of health or prevention of illness of others.

c) The administration of medication and treatment as prescribed by a physician or dentist and as further authorized or limited by the board, and which are consistent either with American Nurses' Association Standards of Practice or with Standards of Practice established by nationally accepted organizations of registered nurses. Components of medication administration include, but are not limited to:

  1. Preparing and giving medication in the prescribed dosage, route, and frequency;
  2. observing, recording, and reporting desired effects, untoward reactions, and side effects of drug therapy;
  3. Intervening when emergency care is required as a result of drug therapy;
  4. Recognizing accepted prescribing limits and reporting deviations to the prescribing individual;
  5. Recognizing drug incompatibilities and reporting interactions or potential interactions to the prescribing individual; and Instructing an individual regarding medications.

d) The supervision, teaching of, and delegation to other personnel in the performance of activities relating to nursing care.

e) The performance of other nursing acts which are authorized or limited by the board, and which are consistent either with American Nurses' Association Standards of Practice or with Standards of Practice established by nationally accepted organizations of registered nurses.

KRS 314.021(2) holds all nurses responsible and accountable for making decisions that are based upon the individuals' educational preparation and experience in nursing, and requires licensees to practice nursing with reasonable skill and safety.

Following discussion of the statutes governing registered nursing practice, and the questions posed in your letter, it was the advisory opinion of the Board that the performance of Healing Touch, Therapeutic Touch and/or Reiki by registered nurses would not be prohibited by KRS Chapter 314, The Kentucky Nursing Laws. Pursuant to KRS 314.021 (2), nurses who perform Healing Touch, Therapeutic Touch, and/or Reiki should be able to document their educational and experiential qualifications to perform these practices with reasonable skill and safety. The registered nurse who performs Healing Touch, Therapeutic Touch or Reiki is responsible and accountable for assuring that the client or legal guardian is provided with sufficient information about the proposed modalities in order to give informed consent prior to the performance of the procedures.

It should be assured that scientifically valid data exists which supports the validity and efficacy of these practices as therapeutic treatment modalities. Further, you should be aware that KRS Chapter 367, The Kentucky Consumer Protection Act, prohibits the making of commercial claims which are fraudulent or deceptive.

The "American Nurses' Association Code for Nurses With Interpretive Statements" includes the following:

... 10. The nurse participates in the profession's effort to protect the public from misinformation and misrepresentation and to maintain the integrity of nursing. ... the nurse does not give or imply endorsement to advertising, promotion, or sale of commercial products or services in manner that may be interpreted as reflecting the opinion or judgment of the profession as a whole. The nurse may use knowledge of specific services or products in advising an individual client, since this may contribute to the client's health and well-being. In the course of providing information or education to clients or other practitioners about commercial products or services, however, a variety of similar products or services should be offered or described so the client or practitioner can make an informed choice.

The Kentucky Board of Nursing issues advisory opinions as to what constitutes safe nursing practice. As such, an opinion is not a regulation of the Board and does not have the force and effect of law. It is issued as a guidepost to licensees who wish to engage in safe nursing practice, and to facilitate the delivery of safe, effective nursing care to the public.

Should you have any other questions or if we may be of further assistance to you, please contact Paula S. Stone, MPH, RN, Assistant Executive Director, at the Board office (502) 329-7000, extension 236.

Sincerely,
MELDA S. LOGAN, MSN, RN
PRESIDENT

By: Sharon M. Weisenbeck, MS, RN
Executive Director

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