Tennessee Code Annotated
Tenn. Code Ann. § 63-7-103 (2026)
"Practice of professional nursing" and "professional nursing" defined
✓ current as of May 2026
- (a)
- (1) "Practice of professional nursing" means the performance for compensation of any act requiring substantial specialized judgment and skill based on knowledge of the natural, behavioral and nursing sciences and the humanities as the basis for application of the nursing process in wellness and illness care.
- (2) "Professional nursing" includes:
- (A) Responsible supervision of a patient requiring skill and observation of symptoms and reactions and accurate recording of the facts;
- (B) Promotion, restoration and maintenance of health or prevention of illness of others;
- (C) Counseling, managing, supervising and teaching of others;
- (D) Administration of medications and treatments as prescribed by a licensed physician, dentist, podiatrist, or nurse authorized to prescribe pursuant to § 63-7-123, or selected, ordered, or administered by an advanced practice registered nurse specializing as a certified registered nurse anesthetist (CRNA) during services ordered by a physician, dentist, or podiatrist and provided by a CRNA in collaboration with the ordering physician, dentist, or podiatrist that are within the scope of practice of the CRNA and authorized by clinical privileges granted by the medical staff of the facility. A CRNA shall collaborate in a cooperative working relationship with the ordering physician, dentist, or podiatrist in the provision of patient care, which includes consultation regarding patient treatment and cooperation in the management and delivery of health care;
- (E) Application of such nursing procedures as involve understanding of cause and effect; and
- (F) Nursing management of illness, injury or infirmity including identification of patient problems.
- (b) Notwithstanding subsection (a), the practice of professional nursing does not include acts of medical diagnosis or the development of a medical plan of care and therapeutics for a patient, except to the extent such acts may be authorized by §§ 63-1-132, 63-7-123 and 63-7-207.
- (c)
- (1) This section does not preclude a qualified registered nurse from determining whether a patient presenting to a hospital has an emergency medical condition if the determination is pursuant to:
- (A) A cooperative working relationship with a physician; and
- (B) Protocols jointly developed by the hospital's medical and nursing leadership and adopted by the hospital's medical staff and governing body.
- (2) The protocols described in subdivision (c)(1) must include a requirement that the qualified registered nurse obtain the concurrence of a physician when making a determination authorized under subdivision (c)(1).
- (3) As used in this subsection (c):
- (A) "Emergency medical condition" means:
- (i) A medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in:
- (a) Placing the health of the individual or, with respect to a pregnant woman, the health of the woman or the woman's unborn child, in serious jeopardy;
- (b) Serious impairment to bodily functions; or
- (c) Serious dysfunction of any bodily organ or part; and
- (ii) With respect to a pregnant woman who is having contractions:
- (a) That there is inadequate time to effect a safe transfer to another hospital before delivery; or
- (b) That transfer may pose a threat to the health or safety of the woman or the woman's unborn child; and
- (i) A medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in:
- (B) "Qualified registered nurse" means a registered nurse who has been approved by the hospital governing body, based on the recommendation of hospital nursing leadership, as possessing the skills and competency to make a determination of the existence of a specified emergency medical condition of a patient presenting to a hospital.
- (A) "Emergency medical condition" means:
- (1) This section does not preclude a qualified registered nurse from determining whether a patient presenting to a hospital has an emergency medical condition if the determination is pursuant to:
Amended by 2019 Tenn. Acts, ch. 12, s 1, eff. 3/20/2019.
Amended by 2016 Tenn. Acts, ch. 980, s 11, eff. 7/1/2016.
Amended by 2015 Tenn. Acts, ch. 513, s 2, eff. 5/20/2015.
Acts 1967, ch. 78, § 12; 1972, ch. 523, § 1; T.C.A., § 63-740; Acts 1990, ch. 651, § 2.
Notes of Decisions
Cited in 14
cases, 1998–2017 · leading case: Richberger v. West Clinic, P.C., 152 S.W.3d 505 (Tenn. Ct. App. 2004).
Richberger v. West Clinic, P.C., 152 S.W.3d 505 (Tenn. Ct. App. 2004). “The court’s ruling was based on its conclusion that a “registered nurse is prohibited from making a medical diagnosis [pursuant to T.C.A. § 63-7-103(b),] and is therefore not competent to offer opinions on medical causation in a medical malpractice action.”
State v. Bonds, 502 S.W.3d 118 (Tenn. Crim. App. 2015). “” To support the argument that Nurse Greene testified beyond her expertise, Defendant Bonds cites Tennessee Code Annotated section 63-7-103(b) which provides: Notwithstanding the provisions of subsection (a), the practice of professional nursing does not include acts of medical…”
Clifford Swearengen v. DMC-Memphis, Inc., 488 S.W.3d 774 (Tenn. Ct. App. 2015). “A¿ § 68-6-204 and do not involve the practice of professional nursing as defined in T.C.A. § 63-7-103, [DMC] is prohibited by law to practice medicine, it does not and did not attempt to diagnose, develop a medical plan of care, perform surgery or otherwise practice medicine…”
Sandi D. Jackson v. Tennessee Bd. of Nursing (Tenn. Ct. App. 2012). “13(u) “Practicing professional nursing in a manner inconsistent with T.C.A. § 63-7-103”; (3) Tenn. Comp. R. & Regs.”
Anita Adkins v. Assocs. of the Mem'l/Mission Outpatient Surgery Ctr., LLC. (Tenn. Ct. App. 2015). “Citing Tennessee Code Annotated section 63-7-103(a)(1), Defendant claimed that the practice of professional nursing is defined as the performance for compensation of any act requiring substantial specialized judgment and skill based on knowledge of the natural, behavioral and…”
State of Tennessee v. Devonte Bonds (Tenn. Crim. App. 2016). “‖ To support the argument that Nurse Greene testified beyond her expertise, Defendant Bonds cites Tennessee Code Annotated section 63-7-103(b) which provides: Notwithstanding the provisions of subsection (a), the practice of professional nursing does not include acts of medical…”
Myrna Wheelock v. Jesse Thomas Doers, M.D. (Tenn. Ct. App. 2010). “We also note that because a nurse is prohibited under Tenn. Code Ann. § 63-7-103 (b) from making a medical diagnosis, a nurse is likewise prohibited from testifying as to medical causation.”
Myrna Wheelock v. Jesse Thomas Doers, M.D. (Tenn. Ct. App. 2010). “We also note that because a nurse is prohibited under Tenn. Code Ann. § 63-7-103 (b) from making a medical diagnosis, a nurse is likewise prohibited from testifying as to medical causation.”
Nancy Luna v. Roger Deversa, M.D. & Hamilton Cnty. Hosp. Auth. (Tenn. Ct. App. 2010). “Registered nurses are not authorized under their state practice act (T.C.A. §63-7-103(b)) to order discharges.”
Barsha Bates Land v. Larry W. Barnes (Tenn. Ct. App. 2008). “, a nurse is prohibited by Tenn. Code Ann. § 63-7-103 (b) from making a medical diagnosis and, therefore, he or she lacks the expertise to testify as to causation.”
Maggie Lee Banks v. Jack C. Sanford, M.D. (Tenn. Ct. App. 2007). “May 4, 1990)); see also Tenn. Code Ann. § 63-7-103 (b) (Supp. 2006) (providing that “the practice of professional nursing does not include acts of medical diagnosis”).”
Est. of Evelyn Sample v. Life Care Centers Of Am., Inc. (2017). “§ 29-26-115 (a)(3) because a registered nurse is prohibited from making a medical diagnosis pursuant to Tenn. Code Ann. § 63-7-103 (b). Richberger v.”
— Tenn. Code Ann. § 63-7-103(2)(D) — 1 case
Sandi D. Jackson v. Tennessee Bd. of Nursing (Tenn. Ct. App. 2012). “13(u) “Practicing professional nursing in a manner inconsistent with T.C.A. § 63-7-103”; (3) Tenn. Comp. R. & Regs.”
— Tenn. Code Ann. § 63-7-103(a)(1) — 2 cases
Anita Adkins v. Assocs. of the Mem'l/Mission Outpatient Surgery Ctr., LLC. (Tenn. Ct. App. 2015). “Citing Tennessee Code Annotated section 63-7-103(a)(1), Defendant claimed that the practice of professional nursing is defined as the performance for compensation of any act requiring substantial specialized judgment and skill based on knowledge of the natural, behavioral and…”
Susan Todd/State v. Weakley Co. (Tenn. Ct. App. 1998).
— Tenn. Code Ann. § 63-7-103(b) — 4 cases
Richberger v. West Clinic, P.C., 152 S.W.3d 505 (Tenn. Ct. App. 2004). “The court’s ruling was based on its conclusion that a “registered nurse is prohibited from making a medical diagnosis [pursuant to T.C.A. § 63-7-103(b),] and is therefore not competent to offer opinions on medical causation in a medical malpractice action.”
State v. Bonds, 502 S.W.3d 118 (Tenn. Crim. App. 2015). “” To support the argument that Nurse Greene testified beyond her expertise, Defendant Bonds cites Tennessee Code Annotated section 63-7-103(b) which provides: Notwithstanding the provisions of subsection (a), the practice of professional nursing does not include acts of medical…”
State of Tennessee v. Devonte Bonds (Tenn. Crim. App. 2016). “‖ To support the argument that Nurse Greene testified beyond her expertise, Defendant Bonds cites Tennessee Code Annotated section 63-7-103(b) which provides: Notwithstanding the provisions of subsection (a), the practice of professional nursing does not include acts of medical…”
Nancy Luna v. Roger Deversa, M.D. & Hamilton Cnty. Hosp. Auth. (Tenn. Ct. App. 2010). “Registered nurses are not authorized under their state practice act (T.C.A. §63-7-103(b)) to order discharges.”
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