The Registered Nurses’ Association of Ontario (RNAO) is the professional organization for registered nurses who practice in all roles and sectors across Ontario. Our mandate is to advocate for healthy public policy and for nursing. It is in the context of this mandate that RNAO is pleased to respond to the Health Professions Regulatory Advisory Council’s (HPRAC) request for feedback on the following issues:
Registered nurses are the single largest group of health-care professionals in the province. The legislative environment in which we work has an impact on our practice, our working environment, and our relationships with other health-care professionals. RNAO and its members are very supportive of the RHPA and the fundamental concepts that underlie the legislation – protection of the public and self-regulation. This legislative context has accommodated many advances in nursing over the last 14 years. While the structure of the legislation with overlapping scope of practice, self-regulation and protection of the public remains current, the legislation does require some changes to keep up with the changing practice environment.
Summary of Recommendations
RNAO recommends access to the following additional controlled acts for the profession of nursing:
a. Communicating to the individual or his or her personal representative a diagnosis identifying a disease or disorder as the cause of symptoms of the individual in circumstances in which it is reasonably foreseeable that the individual or his or her personal representative will rely on the diagnosis.
b. Setting or casting a fracture of a bone or a dislocation of a joint;
c. Applying a form of energy prescribed by the regulations under this Act (i.e. RHPA); and,
d. Dispensing a drug as defined in subsection 117 (1) of the Drug and Pharmacies Regulation Act.
The current list-based approval process for Registered Nurse (Extended Class) prescriptive and diagnostic authority be moved to a broader, less restricted model, using options such as Drug Schedules or Formularies and open authority to diagnostic tests.
The title of Nurse Practitioner be protected.
Improve the effectiveness and efficiency of the current regulatory approval process.
Implement a systemic review of the legislative framework and regulation of the delegation process.
RNAO recommends that the performance of psychotherapy be regulated utilizing the most appropriate legislative strategy and that RNs with the required qualifications have the regulatory authority to practice it.
Appropriate liability coverage should be mandatory for registrants.
If in the course of an investigation, regulatory colleges discover unsafe practice settings, they should be required to report them to the Minister of Health for investigation. There should be provisions to protect a regulated health professional who reports an unsafe practice setting.