BCCNM has the authority, under the
Health Professions Act, to establish, monitor and enforce standards, limits and conditions for RPN practice. Standards, limits and conditions increase the public's level of protection. These concepts are defined below:
Standard
A desired and achievable level of performance against which actual performance can be compared. It provides a benchmark below which performance is unacceptable.
The RPN scope of practice standard Autonomous Scope of Practice and Client-specific Orders outlines the requirements for RPNs when providing psychiatric nursing care. The RPN scope of practice standard Autonomous Scope of Practice and Client-specific Orders consists of three standards:
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Acting within Autonomous Scope of Practice.
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Acting with Client-specific Orders.
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Giving Client-specific Orders.
The RPN scope of practice standards are discussed in
Part 2.
Limit
Specifies what RPNs are not permitted to do. For example, when acting within autonomous scope of practice, RPNs must not immunize children under the age of four.
Condition
The circumstances under which RPNs may carry out an activity. There are three types of conditions in this context: education, competencies and decision support tools.
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Education RPNs must successfully complete post-basic education before being able to carry out some psychiatric nursing activities. There are two types of post-basic education:
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Additional education: Structured education (e.g., workshop, course, program of study) designed for psychiatric nurses to attain the competencies required to carry out a specific activity as part of psychiatric nursing practice. Additional education must:
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- build on the entry-level competencies of RPNs,
- identify the competencies expected on completion of the education,
- include both theory and application to practise, and
- include an objective, independent evaluation of competencies on completion of the education.
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- Education through a named agency: Education through a provincial expert group or school of psychiatric nursing that develops a curriculum and/or delivers the required education (e.g., British Columbia Centre for Disease Control [BCCDC]). These courses provide consistency across the province.
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2.
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Competencies
RPNs must have the competencies identified by a particular agency to carry out a restricted activity (e.g., BCCDC identifies competencies related to immunizations).
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3.
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Decision support tools
When required, RPNs must follow established decision support tools (DSTs). Decision support tools are systems that provide evidence-based information to support clinical judgment. DSTs come in various forms and are created by organizations or specialists in a specific area of health care. They are not the same as practice standards provided by BCCNM.
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BCCNM strongly recommends that registrants keep a permanent record of information showing that they have met any conditions associated with an activity, such as evidence of successful completion of education.
Registrants who are unsure whether an activity is considered within RPN scope of practice should contact BCCNM. RPNs are required to follow the RPN standards, limits and conditions set out by BCCNM.
Key points
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RPNs are responsible and accountable for determining if an activity is within scope of practice for RPNs.
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All four levels of controls on practice must permit the activity: Health Professions Act and the Regulation; BCCNM RPN standards, limits and conditions; employer/organization policies; and the RPN’s own competence.
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Having the regulatory authority to carry out a psychiatric nursing activity is not necessarily reason to do so.
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