| Course | NUR-6320 Nursing Administration Standards and Structures |
|---|---|
| Module | Module 2 |
| Paper type | Regulatory analysis |
| Length | About 1,003 words, 6 pages |
| Format | APA 7 student paper |
| School | Thomas Edison State University |
| Program | M.S., Nursing Administration Concentration |
| Updated | October 2026 |
Free sample paper for NUR 6320 Module 2
Must, Should or May? Sorting Federal Rules, State Board Regulations and Professional Guidance for Floating Nurses in a Critical Access Hospital
Student Name
M.S., Nursing Administration Concentration, Thomas Edison State University
NUR-6320: Nursing Administration: Standards and Structures
Mentor Name
Month Day, Year
Must, Should or May? Sorting Federal Rules, State Board Regulations and Professional Guidance for Floating Nurses in a Critical Access Hospital
The director of nursing at our 25-bed critical access hospital approves a practice every week that touches law, regulation and professional guidance at once: floating registered nurses and licensed practical nurses between the emergency department, the inpatient and swing beds, and the infusion clinic. When the practice is questioned, by a surveyor, a staff nurse or the board, the director must be able to say which requirements are binding and which are recommendations. This paper sorts the sources that govern the practice into federal conditions of participation, state law and board regulations, and professional guidance, explains how each applies, and sets out the policy decisions that remain the director's to make.
Federal Conditions of Participation
Medicare pays a critical access hospital only while it meets a set of federal conditions of participation. These are binding on the hospital as an organization. The staffing condition requires that a registered nurse, clinical nurse specialist or licensed practical nurse be on duty whenever the hospital has one or more inpatients (42 C.F.R. § 485.631). The provision of services condition requires that nursing services meet the needs of patients; that a registered nurse provide, or assign to other personnel, the nursing care of each patient, including swing-bed patients receiving skilled nursing care; that care be provided according to the patient's needs and the qualifications and competence of the staff available; that an RN oversee and evaluate each patient's nursing care; and that every inpatient have an up-to-date nursing care plan (42 C.F.R. § 485.635).
Two points follow for floating. First, the federal minimum is low: an LPN alone may satisfy the on-duty requirement on some nights, but the supervision requirement means a registered nurse must still supervise and evaluate the care, which in practice requires an RN available to the inpatient unit. Second, the phrase about qualifications and competence makes competency for each assignment a federal matter, not only a local preference.
State Law and Board Regulations
The Pennsylvania Professional Nursing Law defines the practice of professional nursing and gives the State Board of Nursing authority to license nurses and adopt regulations. Unlike the federal conditions, state law binds individual nurses through their licenses. The board's standards of nursing conduct require a registered nurse to undertake a specific practice only if the nurse has the necessary knowledge, preparation, experience and competency to perform it properly, to act to safeguard patients from incompetent practice by any individual, and to document and maintain accurate records (49 Pa. Code § 21.18).
This standard places an obligation on the floating nurse personally. A medical-surgical nurse assigned to the emergency department who has never managed a patient receiving rapid sequence intubation medications must say so, and a nurse who accepts an assignment beyond the nurse's competence risks discipline even if the hospital made the assignment. The director must therefore build a system in which nurses are not placed in that position and can raise concerns without penalty. Licensed practical nurses work under a separate practical nursing law and regulations, which limit the scope of their practice and require direction by a registered nurse or other authorized professional; their floating assignments must respect those limits.
Professional Guidance
Professional organizations publish guidance that is not law unless a statute, regulation or policy adopts it. National guidelines for nursing delegation, written jointly with the American Nurses Association, divide duties among three parties, the organization, the nurse who delegates and the assistant who accepts the task, and frame each delegation decision around five checks: a suitable task, suitable circumstances, a capable person, clear directions and planned supervision (National Council of State Boards of Nursing, 2016). Some state boards have adopted or referenced the guidelines; where they have not, the guidelines remain best practice rather than a legal requirement.
The guidelines are nonetheless important for floating. They place responsibility on the employer to identify which tasks may be delegated, to ensure staff are competent and to provide policies, and they describe the licensed nurse's duty to assess before delegating. A surveyor evaluating whether care was provided according to staff competence may look to such guidance as evidence of accepted practice, and a plaintiff's attorney certainly would.
What Is Left to the Director
Within these boundaries, many decisions belong to the organization. Federal and state rules do not specify which units a nurse may float to, how much orientation is required, whether floating is mandatory or voluntary, or how competency is validated. The director proposed a policy with four elements. First, each nurse has a documented competency profile listing the units and patient populations for which the nurse is validated, reviewed annually. Second, nurses float only to areas on their profile, except in emergencies, when they take a limited assignment under the direct supervision of a validated nurse. Third, LPN assignments are set by the charge RN within the practical nursing scope, with an RN available to each inpatient at all times. Fourth, any nurse may decline an assignment beyond the nurse's competence by notifying the charge nurse, who must document and resolve the concern.
The policy turns the regulatory sorting into practice. It meets the federal requirement that care match staff competence, supports nurses in meeting their personal licensure obligation and follows professional delegation guidance.
Conclusion
Floating nurses in a small hospital is necessary, but the sources that govern it bind different parties in different ways. Federal conditions bind the hospital, state law binds the individual nurse, and professional guidance shapes what both should do. A director who keeps those distinctions clear can defend the hospital's practice and protect the staff who make it work.
The director also plans to explain the policy to staff in plain terms, including the reason for each element. Nurses who understand that the competency profile protects their licenses as well as patients are more likely to keep it current and to use the right to decline when they need it.
References
42 C.F.R. § 485.635 (2024). Condition of participation: Provision of services. https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-485/subpart-F/section-485.635
42 C.F.R. § 485.631 (2024). Condition of participation: Staffing and staff responsibilities. https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-485/subpart-F/section-485.631
National Council of State Boards of Nursing. (2016). National guidelines for nursing delegation. Journal of Nursing Regulation, 7(1), 5-14. https://doi.org/10.1016/S2155-8256(16)31035-3
49 Pa. Code § 21.18 (2024). Standards of nursing conduct. https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/049/chapter21/s21.18.html
What the NUR 6320 Module 2 instructions ask for
The second module of NUR-6320 typically addresses the legal and regulatory environment of nursing administration. Directions may have you work out how federal regulations, state nurse practice acts and board rules, accreditation standards and professional guidelines apply to a practice or problem in your organization, and to distinguish what is required from what is recommended. Some sections ask for a policy proposal. Check the TESU classroom for whether your own state's law must be used, how legal sources should be cited in APA format and whether a specific practice is assigned. Quote or paraphrase regulations accurately and cite the section. When a case is assigned, apply the rules of the state named in it, which may differ from where you practice.
How the NUR 6320 Module 2 example is put together
The paper opens with a weekly practice the director must defend and states the sorting task. The federal section quotes and attributes the staffing and nursing services conditions and draws two consequences for floating. The state section explains how the nursing law and board standards bind individual nurses, with a concrete example, and notes the separate practical nursing rules. The guidance section explains the delegation guidelines and when guidance becomes binding. A section on what is left to the director proposes a four-part policy, and the conclusion restates who each source binds. A short note explains how the policy will be communicated so that staff understand why each element exists.
Where the marks sit in the NUR 6320 Module 2 rubric
Regulatory analyses are generally scored on accurate identification of applicable laws and regulations, correct citation, a clear distinction between binding requirements and professional recommendations, application to a specific practice, sound policy recommendations, and scholarly writing. Mentors check whether the student understands who is bound by each source, such as the organization or the licensee. Precise attributions to sections earn more than general references to the nurse practice act. Papers that identify the decisions left to the organization and propose a workable policy show the administrative perspective the course aims to develop. APA legal citation format is often assessed. A policy recommendation that staff could actually follow on a short-staffed night usually earns credit for feasibility.
NUR 6320 Module 2 help from the desk
A frequent weakness in this module's papers is treating every source as law, describing professional guidelines as if they were binding regulations. Label each source. Another is citing the nurse practice act in general without the specific section or rule. Students also overlook that federal conditions bind the hospital while licensure rules bind the nurse, which changes how a policy should be written. Use your own state's law if the directions require it. Keep regulatory language accurate. The desk can prepare a regulatory analysis of a practice in your state and organization from your directions. Check whether your state has adopted the delegation guidelines before describing them as binding.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Thomas Edison State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
More NUR 6320 and M.S., Nursing Administration Concentration sample papers
- NUR 6320 Module 1: Scope and Standards Paper
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- NUR 6320 Module 4: Decision Rights Analysis
- NUR 6320 Module 5: Leadership and Accountability
- NUR 6320 Module 6: Nursing Services Plan
NUR 6320 Module 2 questions, answered
Where can I find a free NUR 6320 Module 2 sample paper?
A regulatory analysis of floating nurses in a critical access hospital is above, annotated on each sheet. Use its sorting of federal, state and professional sources for the practice your directions name.
What is a condition of participation?
A federal rule that a hospital has to satisfy for Medicare to keep paying it. Conditions bind the organization and are enforced through surveys by state agencies or accrediting bodies with deeming authority.
Are the NCSBN delegation guidelines law?
Not by themselves. They are national guidance developed with the ANA. They become binding only where a state board adopts or incorporates them, though surveyors and courts may treat them as accepted practice.
Who is responsible if a nurse floats to a unit beyond their competence?
Both the organization and the nurse. Federal rules require care to match staff competence, and state board standards require nurses to accept only practice they are competent to perform.
What does a critical access hospital need on duty at night?
Federal rules require a registered nurse, clinical nurse specialist or licensed practical nurse on duty whenever there is an inpatient, and a registered nurse must supervise and evaluate each patient's nursing care.