While a nurse’s scope of practice is legally based on educational qualifications and specific experiences,professional and organizational expectations determine the degree to which autonomous practice occurs.Strategies for enchancing autonomous and providing support for increasing the knowledge and expertise of nurse. Licensure is very important and mandatory for nurses to provide for public safety and consumer protection. Licensure provides the minimum standards for practice in the state and also sets legal recourse for individuals who have been harmed by those who not provided services or have misrepresented their credentials services that meet the standards imposed by licensing bodies. Certification is voluntary and it indicates that the individual has met certain pre-determined standards established by the entity which offering certification. Certifications may be earned from a professional society and must be renewed periodically, generally through completed continuing education units.If working in Nephrology department ,the entry-level preparation for practice in this specialty includes theoretical and clinical components for six months.