The Illinois legislature enacted a revised Nurse Practice Act that went into effect October 5, 2007. Several provisions of this statute are of relevance to the medical assisting profession, especially the section that acknowledges the authority of physicians to delegate tasks to professionals other than registered nurses and licensed practical nurses.

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For the last twenty years this author has written and spoken frequently about the dangers of a medical assistant referring to herself/himself as a “nurse,” even in a generic sense. The following language from the Illinois Nurse Practice Act reinforces the importance of this legal principle.

Section 50-15 (a)…No person shall practice or offer to practice advanced, professional, or practical nursing in Illinois or use any title, sign, card or device to indicate that such a person is practicing professional or practical nursing unless such person has been licensed under the provisions of this Act.

Section 50-20. Unlicensed practice; violation; civil penalty. (a) Any person who practices, offers to practice, attempts to practice, or holds oneself out to practice nursing without being licensed under this Act shall, in addition to any other penalty provided by law, pay a civil penalty to the Department [of Financial and Professional Regulation] in an amount not to exceed $10,000 for each offense as determined by the Department. The civil penalty shall be assessed by the Department after a hearing is held in accordance with the provisions set forth in this Act regarding the provision of a hearing for the discipline of a licensee.

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The law delineates what registered nurses/or registered professional nurses are permitted to delegate. Delegation of medication administration to anyone other than a registered nurse or a licensed practical nurse is forbidden.

Section 50-75. Nursing delegation…(c) A registered professional nurse shall not delegate any nursing activity requiring the specialized knowledge, judgment, and skill of a licensed nurse to an unlicensed person, including medication administration. 

A registered professional nurse may delegate nursing activities to other registered professional nurses or licensed practical nurses. A registered nurse may delegate tasks to other licensed and unlicensed persons. A licensed practical nurse who has been delegated a nursing activity shall not re-delegate the nursing activity. A registered professional nurse or advanced practice nurse retains the right to refuse to delegate or to stop or rescind a previously authorized delegation.

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The statute reflects the fact that a physician’s authority to delegate arises from the provisions of the Illinois Medical Practice Act, not from the provisions of the Illinois Nurse Practice Act.

Section 50-15 (b) This Act does not prohibit the following:

(13) Nothing in this Act shall be construed to limit the delegation of tasks or duties by a physician, dentist, or podiatrist to a licensed practical nurse, a registered professional nurse, or other persons.

Note the following language from the Illinois Medical Practice Act.

Section 54.5. Physician delegation of authority

(d) Nothing in this Act shall be construed to limit the delegation of tasks or duties by a physician licensed to practice medicine in all its branches to a licensed practical nurse, a registered professional nurse, or other persons.

Also note the following language from the Illinois Administrative Code.

Section 1285.335. Physician Delegation of Authority

(f) Nothing in this Section shall be construed to limit the delegation of tasks or duties by a physician licensed to practice medicine in all its branches to a licensed practical nurse, a registered professional nurse, or other personnel including, but not limited to, certified nursing assistants or medical assistants. (Section 54.5 of the Act)

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In conclusion, the Illinois Nurse Practice Act sets forth the consequences of a non-nurse holding herself/himself out to be a registered professional nurse or a licensed practical nurse. The statute also addresses what tasks registered nurses are permitted to delegate, and are forbidden from delegating. Quite significantly, the relevant sections of the Illinois Nurse Practice Act and the Illinois Medical Practice Act protect and establish, respectively, a supervising physician’s right to delegate tasks or duties to medical assistants working under the physician’s supervision.

Any questions about this issue may be directed to Executive Director Donald A. Balasa, JD, MBA, at dbalasa@aama-ntl.org.