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Which Department of Labor regulations affecting nursing scope of practice changed during the Trump administration?
Executive summary
The Department of Labor (DOL) itself did not publish sweeping new federal “scope‑of‑practice” rules for nurses during the Trump administration in the materials provided; instead, Trump‑era federal actions that affected nursing practice came mainly from other federal agencies (Centers for Medicare & Medicaid Services and executive orders) that encouraged loosening supervision and billing rules and temporarily waived some qualifications during the COVID‑19 emergency (CMS waivers) and an October 2019 executive order that directed review of supervision/reimbursement barriers for Advanced Practice Registered Nurses (APRN) [1] [2]. Separately, the Department of Education under the Trump administration revised its definition of “professional degree,” excluding nursing from that list and thereby changing loan eligibility that influences advanced‑practice training pathways [3] [4].
1. Executive orders and federal guidance nudged states and payers on APRN scope
The Trump administration issued an executive order directing federal officials to examine policies that could let APRNs and physician assistants practice to the “full extent of their education and training,” including investigating reimbursement tied to time with patients rather than provider role—language intended to reduce supervision barriers and encourage states and payers to expand APRN roles [2] [5]. The American Association of Nurse Practitioners publicly commended those recommendations as supportive of removing “needless barriers” to APRN practice [6].
2. CMS pandemic-era waivers temporarily broadened what nurses could do in facilities
During the COVID‑19 emergency, CMS temporarily suspended multiple rules to let hospitals and rural facilities increase frontline staffing: CMS waived certain federal minimum personnel qualifications for clinical nurse specialists, nurse practitioners, and physician assistants so they could work at rural hospitals (provided they met state licensure), and otherwise reduced supervision/certification hurdles to let clinicians “operate to the fullest extent of their licensure” [1]. Those were emergency waivers, not permanent DOL rule changes, and they applied as part of CMS’s public‑health emergency response [1].
3. Department of Education’s “professional degree” redefinition affected advanced‑practice pipelines
Although not a direct scope‑of‑practice rule, the Department of Education’s decision to exclude nursing from the list of programs labeled “professional degree” changed student loan eligibility and aggregate borrowing caps—an indirect but significant lever on the workforce because it affects access to graduate training (MSN, DNP) that expands nurses’ scope in practice [3] [4]. Nursing organizations warned this change would make advanced education harder to afford and might reduce the supply of advanced practice nurses [7] [8].
4. Distinction: DOL vs. other federal actors — DOL materials in reporting focus on workplace standards, not scope restructuring
The Department of Labor’s materials included OSHA workplace standards and health‑care labor topics (safe patient handling, breaks, recordkeeping), but the reporting and sources supplied do not show the DOL itself promulgating new nationwide scope‑of‑practice definitions for nurses during the Trump years; scope remains primarily defined by state Nursing Practice Acts and boards, while federal agencies (CMS, HHS) and executive directions influenced reimbursement and supervision practices [9] [10] [11] [12].
5. What the nursing profession and advocates said — competing viewpoints
Nursing organizations praised moves to remove “excessive supervision requirements” and to let APRNs practice fully, framing them as access‑improving reforms [6] [13]. Conversely, nursing groups also criticized the Department of Education loan‑eligibility change as harmful to workforce development, arguing it would constrain graduate education and thus long‑term scope expansion [3] [8]. The sources show both the administration’s deregulatory intent on practice supervision/reimbursement and professional alarm when other policy changes threatened training pipelines [2] [7].
6. Limits of available reporting and what’s not found here
Available sources do not mention any single, codified Department of Labor regulation during the Trump administration that redefined nursing scope nationwide; instead, changes came from CMS emergency waivers and executive directives plus Education Department rulemaking affecting education financing [1] [2] [3]. If you are looking for specific DOL rule text or a statute formally altering state scope laws, those are not present in the provided documents (not found in current reporting).
7. Practical takeaway for nurses and policymakers
Policy levers that changed practice under Trump were primarily reimbursement, supervision guidance, and emergency waivers (CMS, executive order) that enabled nurses to practice more independently in some settings, while Department of Education rule changes reduced some advanced‑education funding—an example of how interagency moves (not just one federal department) combine to shape who can practice what, and where [1] [2] [3]. For definitive, up‑to‑date scope status in any state or facility, consult that state’s Nursing Practice Act and CMS rule updates because federal waivers can be temporary and state law remains central [12] [11].