This standard applies to NPs, RNs, and RPNs.
Practice Standards set out requirements related to specific aspects of nurses’ practice. They link with other standards, policies and bylaws of the BC College of Nurses and Midwives and all legislation relevant to nursing practice.
This practice standard applies to employed student nurses and employed student psychiatric nurses, as well as the nurse practitioners, registered nurses, or registered psychiatric nurses who supervise their practice. Licensed practical nurses are not authorized to supervise employed student registrants, per BCCNM Bylaws.
**This standard should be read alongside the practice standard Regulatory Supervision of Students**
Being an employed student nurse (ESN) or employed student psychiatric nurse (ESPN) is a role in which a
nursing1 or
psychiatric nursing2 student is employed in a health care setting during or between terms of their education program, in accordance with the BCCNM Bylaws. Working as an ESN or ESPN is not required for graduation from a
BCCNM-recognized3 nursing or psychiatric
nursing education program4, nor is it required for eventual registration as a registered nurse (RN) or registered psychiatric nurse (RPN). Being an ESN or ESPN offers students the opportunity to consolidate skills learned during their education program. All students who are enrolled in an entry-level nursing or psychiatric nursing education program recognized by BCCNM and who are seeking employment as an ESN or ESPN register with BCCNM as an ESN or ESPN, as appropriate.
Practice Activities
ESNs and ESPNs do not have a "scope of practice" in regulation, in the same way RN or RPNs do. Specifically, an ESN or ESPN does not have authority to autonomously perform any
restricted activities5 (either those that do or do not require an order). They may only perform restricted activities when:
they are authorized by a practising NP, RN, or RPN who has accepted the responsibility for regulatory supervision of that employed student registrant activity in accordance with the practice standard
Regulatory Supervision of Students6, and
have gained competence for that activity in an entry-level nursing or psychiatric nursing education program recognized by BCCNM (this competence is usually achieved by learning the theory, practising in the lab, and being observed performing the activity to the satisfaction of the education program faculty).
They must also comply with any limitations set by their employer.
Subject to Regulatory Oversight
The legal authority for an employed student nurse or employed student psychiatric nurse to perform any activity that may affect a client exists only through regulatory supervision by a BCCNM-registered NP, RN, or RPN.
Subject to Inquiry and Discipline
BCCNM will consider any complaint made against an ESN or ESPN within the inquiry and discipline processes established under the Health Professions Act. There may be significant consequences to being subject to inquiry and discipline processes, including that:
the ESN or ESPN may have limits or conditions placed on their practice,
the ESN or ESPN may be unable to fulfill the requirements needed to graduate from their education program,
the ESN or ESPN may be delayed in becoming, or may not be eligible to become, an RN or RPN.
Principles
1. | Employed student nurses and employed student psychiatric nurses act under the
regulatory supervision7 of a practising nurse practitioner (NP), practising registered nurse (RN), or practising registered psychiatric nurse (RPN). |
2. | Licensed practical nurses are not authorized to supervise
employed student registrants8. LPNs may supervise practical nursing, nursing, and psychiatric nursing students during the course of the education program and should review the practice standard Regulatory Supervision of Students. |
3. | Employed student registrants are responsible and accountable for the care and actions they perform, as authorized by a practising NP, RN, or RPN. |
4. | Nurses supervise employed student registrants within their (the nurse’s) own scope of practice and individual competence. |
5. | As BCCNM registrants, employed student registrants are held to all applicable BCCNM Standards of Practice that set out requirements for RNs or RPNs. |
6. | Employed student registrants use the following titles when identifying themselves to clients, team members, and others: |
| a. | Employed Student Nurses:
“employed student nurse”
“ESN” |
| b. | Employed Student Psychiatric Nurses:
“employed student psychiatric nurse”
“ESPN” |
7. | Employed student registrants communicate to clients, team members, and others that they are employed student nurses or employed student psychiatric nurses and that they are practising under the regulatory supervision of an NP, RN, or RPN. |
8. | Employed student registrants know which practising NP, RN, or RPN is responsible for the regulatory supervision of their practice. |
9. | Employed student registrants only undertake those activities: |
| a. | for which they have gained competence through their BCCNM-recognized education program, and |
| b. | which are authorized by the NP, RN, or RPN providing regulatory supervision.
|
10.
| ESNs and ESPNs are permitted to perform only those clinical skills learned through their education program and for which they have attained competence. |
11. | Practising NPs, RNs, and RPNs who provide regulatory supervision of employed student registrants: |
| a. | ensure the student knows how to access support if the nurse is not able to provide support personally, |
| b. | know the level of competence of the employed student registrant, and |
| c. | ensure the employed student registrant does not practise beyond their competence. |
12. | Employed student registrants work alongside other staff, contractors, volunteers, and students, and do not oversee or direct others. |
13. | Employed student registrants do not accept client-specific orders from a health professional (including nurses) and only act on orders as permitted by the nurse providing regulatory supervision of their work. |
14. | Employed student nurses and employed student psychiatric nurses provide information on their own competence to the nurse providing regulatory supervision, and know their roles and accountabilities as outlined in the practice standard Regulatory Supervision of Students. |
15. | Employed student registrants provide care to clients only when there is a practising NP, RN, or RPN (as appropriate) physically present at the work location to provide regulatory supervision. |
16. | The employed student registrant promptly notifies BCCNM: |
| a. | when they change employment status or location, even if it is with the same employer, and |
| b. | when they change education programs, and |
| c. | when they are no longer enrolled in a nursing or psychiatric nursing education program.
|
Footnotes
1
| "Nursing" is the profession defined in the Nurses (Registered) and Nurse Practitioners Regulation [B.C. Reg. 284/2008]. In this standard "nursing" does not include "practical nursing" as defined by the Nurses (Licensed Practical) Regulation [B.C. Reg. 224/2015] or "psychiatric nursing" as defined by the Nurses (Registered Psychiatric) Regulation [B.C. Reg. 227/2015]. |
2
| "Psychiatric nursing" is the profession defined in the Nurses (Registered Psychiatric) Regulation [B.C. Reg. 227/2015]. "Psychiatric nursing" does not include "practical nursing" as defined by the Nurses (Licensed Practical) Regulation [B.C. Reg. 224/2015] or "nursing" as defined in the Nurses (Registered) and Nurse Practitioners Regulation [B.C. Reg. 284/2008]. |
3
| The education program must be recognized by BCCNM or by another regulator of nursing or psychiatric nursing within Canada. |
4
| In this standard, "nursing program" refers only to programs that prepare students for registered nursing practice and "psychiatric nursing program" refers only to programs that prepare students for registered psychiatric nursing practice. Licensed practical nurses and practical nursing students are not included in this standard. |
5
| "Restricted activities" refers to those activities listed in section 6 and section 7 of the Nurses (Registered) and Nurse Practitioners Regulation [B.C. Reg. 284/2008] or Nurses (Registered Psychiatric) Regulation [B.C. Reg. 227/2015]. |
6
| Regulatory supervision is different from other types of supervision, such as employment or education supervision that might be carried out by a unit manager or an educator. |
7
| In this standard, "NP", "RN", and "RPN" refer to registrants of BCCNM who hold a practicing registration within that designation. Provisional, temporary, and non-practising registrants are not permitted to supervise employed student registrants. This nurse is the person directly working with the employed student registrant. |
8
| For the purposes of this standard, "employed student registrant" refers to employed student nurses and employed student psychiatric nurses, unless otherwise specified. |
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