1. 1. 660 S.W.2d 683 (Mo. banc 1983) [hereinafter referred to as Sermchief].
2. 8. Id. at 130.
3. 9. While the authority to practice nursing comes exclusively from state statutes and regulations, the authority to act does not. A physician may delegate to a nurse a responsibility which the nurse would otherwise be unauthorized to perform. The principle is codified in many states. See, e.g., Delegation of Medical Services, Mass. Admin. Code tit. 243, §2.06(4) (1980). “A full licensee may permit a skilled professional or nonprofessional assistant to perform services in a manner consistent with accepted medical standards and appropriate to the assistant's skill.”The delegation does not change existing law; that is, it does not transform a non-nursing act to conform to the legal definition of nursing. The act must be one which is appropriate for delegation, and the delegator must select an appropriate delegatee; beyond these guidelines, custom and usage permit physicians to delegate a wide variety of medical acts. Thus, it could be argued that it is irrelevant whether nurses acting pursuant to established protocols and standing orders are practicing nursing, since the nurses are lawfully carrying out delegated medical acts. This argument is not presented here as a serious solution to the question of the need for expanded role legislation, because such an argument would be professionally and politically disadvantageous for nursing. However, the argument may have merit as a legal defense for an individual nurse whose conduct is challenged as unauthorized.
4. 7. Id. at 105.