Flashcard: Scope of Practice
How to find your lane and stay in it
Scope of practice is a term of art in medicine that signifies the specific skills that a medical professional is allowed to do.
Think of it as a skills band, with higher complexity items on the top and lower complexity items at the bottom. The more education, training, and practice a person has, the higher the complexity at the top of their skills band or scope of practice.
Legal and regulatory guidelines also specify who is allowed to perform certain procedures, to make sure the practitioners have the right training and skill set. Paramedics can intubate, EMTs cannot. RNs can start an IV in a peripheral line, but they can’t put in an arterial line.
I use the concept of a scope of practice with my coaching clients because it’s a good analogy to double check that they are working where they are most effective. A surgeon certainly has the capacity and knowledge to change the dressing on a wound, but is that the most effective use of her time? And whose job would she be infringing on if she was changing the dressing? Perhaps a nurse who is better at changing dressings because he does it more often and therefor more skillfully.
Imagine a list of all your tasks, duties, and responsibilities at work. Rearrange the list so that the first items are the things that are at the top of your scope of practice: your tasks, or tasks that only you can/should do or the ones that you are most qualified to do.
Let’s imagine you have three sections in your scope of practice band. Your tasks are at the top. If you’re a CMO then the top of your scope of practice might be planning strategy, choosing the right marketing partners, and working with the CTO on investments for marketing technology. The middle of your band includes tasks that you are capable of doing but which aren’t the most effective use of your time, like deciding the percentage of your social media spend that should go to one channel over the other. Yes, you can do that, but so can your Director or Marketing Manager. At the bottom of your scope of practice are things you really shouldn’t be doing except in case of emergency. For our CMO friend, if you’re fixing a navigation button on your website, or checking signage proofs, you’re at the bottom of your scope of practice.
What percentage of time do you spend at the top of your scope of practice? What percentage in the middle or at the bottom?
I love to swim, and before the pandemic I would swim all the time at the lap pool at my gym. So, I often use the hackneyed analogy of staying in your lane to explain the challenge with leaders not staying at the top of their scope of practice. Because, to me, swimming analogies are not a cliché. I have had people swim right into me. I’ve suffered the wide swimmers, who lash their arms out, flail their legs, and create aquatic havoc. I’ve had people who are technically in their lane catch me with an errant leg beneath the lane dividers and leave a bruise.
Swim lane violations are as uncomfortable in the real life of a lap pool as they are at the workplace.
Think of the people whose scope of practice is below yours. What is at your midlevel will be at the top of their scope of practice. If you let them do what they are qualified to do and what is theirs to do, they will be happier and develop competency and additional skills. In some cases, they’ll be better at those skills than you are, because they use them more frequently.
If you’re wide swimming into their lane, the turbulence could be destabilizing and distracting.
Of course, circumstances may come up where it’s useful to move below the top of your scope of practice. When I was early in my career, I would be all over my scope of practice, swimming in every lane of the pool, so I could learn new skills and prove my worth to the organization by being willing to pick up the slack and answer phones or record a voice over or help someone out with their workload.
As I moved ahead in my career, and managed people, I was more aware of staying in my lane, but in a crunch, I would roll up my sleeves and proofread a presentation deck because it was good for the team. (And I’m wicked good at proofreading decks.) In lean organizations or start ups, executives who can’t or won’t roll up their sleeves and help out with the actual work when needed are going to lose social capital.
Understand what your scope of practice should be to maximize the time and energy you spend on the things that you do best and where you are the best one to be doing them.
Limit straying into the middle or bottom of your scope of practice so you don’t crowd out someone else.
One last point. I’m intentionally using visual images like a band or list of skills and tasks, because I think this should be something that is used within an organization. I’m always pleased when I find a company that has these kinds of bands written down. They don’t call them a scope of practice, that’s my term, but that’s what they are. A list of skills and capabilities for every level in the department. The list builds, so that the most senior person can do all the things on the list of the most junior, but they, hopefully, are not.
If you don’t have a list like this for the people on your team, if you have a team, build one. And if your boss or company doesn’t have one, ask for it. It will be a critical way for you to understand what skills you need to be developing.