What the regulation covers

​The Regulation sets out, among other things:

1. Reserved titles that BCCNM RPN registrants can use
2. A definition of psychiatric nursing
3. Restricted activities for RPNs

Reserved titles​

BCCNM RPN registrants (except employed psychiatric nursing student registrants) can use the following reserved titles, subject to registration requirements in BCCNM Bylaws:

• registered psychiatric nurse (RPN)
  
• psychiatric nurse
  
• nurse
  

Licensed practical nurses, nurse practitioners and registered nurses are also authorized to use the title of “nurse".

More information can be found in the BCCNM practice standard Use of Title. 

RPN Scope of Practice

Scope of practice refers to activities that a group of professionals are educated and authorized to perform rather than what any individual professional can do. Hence, RPN scope of practice refers to activities RPNs are educated and authorized by the Regulation and BCCNM to perform. These activities are established through the definition of psychiatric nursing in the Regulation and are complemented by RPN standards, limits and conditions set by BCCNM.

The Regulation states that BCCNM registrants may practise psychiatric nursing. Psychiatric nursing is defined as the health profession in which a person provides the following services:

• Health care for the promotion, maintenance and restoration of health, with a focus on psychosocial, mental or emotional health.

• Prevention, treatment and palliation of illness and injury, with a focus on psychosocial, mental or emotional disorders and conditions and associated or comorbid physiological conditions, primarily by assessing healt​h status, planning, implementing and evaluating interventions and coordinating health services.

The Regulation does not refer to education, administration and research in the scope of practice statement for RPNs. However, these are all considered part of the practice of RPNs.

Psychiatric nursing can be carried out in a variety of settings. While RPNs often practise in mental health and addictions settings, they also practise psychiatric nursing in other settings with mixed populations. Examples of such settings are corrections services, palliative care, occupational health, residential care, and complex care. Such practice is within RPN scope of practice. ​

Frequently used terms ​​

The following are defined terms related to RPN scope of practice that are used throughout this document. For a full description of these terms please see the RPN scope of practice standard in Part 2: Autonomous Scope of Practice and Client-specific Orders.​

Autonomous scope of practice

Autonomous scope of practice includes the restricted activities listed in section 6 of the Regulation, and the provision of other care or services that do not involve restricted activities, except for any activities, ​​care or services that are excluded from autonomous scope of practice, as described below.

Auton​​​omous scope of practice excludes any activity, care or services:​​

​​​​Li​​​​​sted under section 7 in the Regulation (to the extent the care provided is not within the activities listed in section 6).
​​ ​Proh​​​​​ibited by:
​	​​any RP​​​​​​​​​​​N standards, limits or conditions established by BCCNM, or
​	​​any applica​b​​​​​​​​​​​le organizational policy, procedures or restrictions.​

Listed health professional 

A listed health professional is a health professional,¹ who is regulated, and authorized by the Regulation to give orders for the performance of activities listed in section 7 of the Regulation. Listed health professionals for RPNs are dentists, midwives, naturopaths, physicians, podiatrists, pharmacists, certified practice registered nurses and nurse practitioners. A listed health professional must be registered to practise in British Columbia, except where the client has been transferred from Alberta, Yukon or the Northwest Territories for emergency treatment in British Columbia.​

Non-listed health professional 

A non-listed health professional is a regulated health professional that is not listed within the Regulation. Non-listed health professionals have specialized competence within their health profession's autonomous scope of practice and within their own individual competence that allows them to assess a client and to design or recommend care appropriate for the client's condition. Examples of non-listed health professionals include dietitians, wound care nurse-clinicians, RPNs, and registered nurses (who are not certified practice registered nurses or nurse practitioners).​​ 

Client-specific order 

A client-specific order is any instr​uction or authorization given by a regulated health professional to provide care for a specific client, whether or not the care or service includes any restricted activity (see Part 3 for a complete description including what is not included in a client-specific order). The client-specific order must:

• Be docum​​ented in the client's permanent record by the regulated health professional.​
  
• Include all the information needed for the ordered activity to be carried out safely (e.g., time, frequency, dosage).
• Include a unique identifier such as a written signature or an electronically generated identifier​.
  

Exceptions

RPNs must provide care only within RPN scope of practic​e. There are two exceptions to this rule:

1. In a situation involving an imminent risk of death or serious harm, arising unexpectedly and requiring urgent action: RPNs are ethically obligated to provide the best care they can, given the circumstances and their individual competence.²
   

2. ​Where a formal delegation process is in place: At this time, no activities have been approved for delegation by another regulated health professional to RPNs (see Part 6 for further information about delegation).
   

Restricted activities

Restricted activities are clinical activities that present a significant risk of harm to the public and, therefore, may be carried out only by specified health professions. The Regulation assigns specific restricted activities to registered ​​psychiatric nurses. Under the Health Professions Act the same restricted activities may also be assigned to other health professional(s). While entry-level RPNs have the education to carry out a variety of restricted activities, RPNs with additional education can carry out more restricted activities.

Part 4 of this document discusses those restricted activities that are within RPN scope of practice. ​

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Footnotes