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Is it permissible for nurses to interpret radiology chest X-rays for PICC line placement and are they covered for liability?

Friday December 7, 2012
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Dear Nancy,

Our state nurse practice act does not specifically address whether or not it is permissible for nurses to interpret radiology chest X-rays for peripherally inserted central catheter line placement. Our employer has informed us that we are covered by our policy. We have concerns about this is, because it has not been addressed. It is very difficult to petition the state board and people are concerned they will lose their jobs if they do so.


Nancy Brent replies:

Dear Pearl,

Your best bet is try and obtain an opinion from the state board of nursing on the issue of whether this practice is permissible. You mentioned that your state board is difficult to petition. Although it is not known what that process entails, this issue is an important one in terms of your scope of practice and probably affects other nurses as well as you and your colleagues.

One option that might be available to you with the board is to attend one of its open meetings and raise your concerns under "new business" or ask to be placed on the agenda to deal with the issue. Even if you do not get a decision at the meeting (and it may take the board some time to evaluate the practice), at least you have raised it for review.

Another statute you might want to look at is your state's radiology practice statute. Some states do allow nurses to obtain a limited license in radiology with limited practice requirements. When this is possible, the statute usually requires a course to be completed and a certificate issued before the limited license is issued.

If you work in a state facility, you might want to ask the state attorney general to issue an opinion on this matter, since state facilities are one of the state attorney general's client(s. This opinion, if given, would protect you if you were in compliance with the bounds of the opinion.

You might seek guidance from your professional nursing specialty association. In other words, if you work in the intensive care unit, the American Association of Critical-Care Nurses might be of some help. Although such an association cannot change one's state scope of practice, it can inform you about standards of practice of critical care nurses and provide a national perspective on this issue.

Also, you can consult with a nurse attorney or attorney in your state who works in the area of regulatory law to get direction. Do remember that one's legal scope of practice is defined by one's nurse practice act and not by one's employer.


Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.