Registed Nurses' Association of Ontario

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Comparison of Key Characteristics of Hospital Based Care Providers

The purpose of this document is to compare and contrast qualifications, role, training and regulatory underpinnings of various hospital based care providers. This document will be useful to administrators who aim to enhance their human resource composition to optimize meeting patient care needs and achieving cost effectiveness.

Characteristic Nurse Practitioner Physician’s Assistant Clinical Nurse Specialist Physician
Regulated health profession Yes, RN(EC) No Yes, RN (general class) Yes
Specialty Practice

Yes
(Primary Care;
Adult;
Pediatric; or Anesthesia)

No defined specialty Yes, a wide range of clinical specialty applications within RN (general class) role. Yes
Education

Baccalaureate degree in nursing +

minimum of two years nursing experience +

completion of NP university certificate and/or Master’s/Doctorate program

Minimum two years of university study in any field +

baccalaureate physician assistant degree.

No health-care experience necessary.
Master’s or Doctorate prepared, along with significant clinical experience and additional specialty education.

Baccalaureate degree (typically in sciences) +
Doctor of Medicine degree +

residency
Autonomous scope of practice (health assessment, diagnosis, prescription, order diagnostic tests, cast) Yes

No, physician extenders

(Work under the direction of a physician to provide patient care)

Yes, within RN (general class) scope.

No if within expanded scope

(work via authorizing mechanisms)
Yes
Accountability for practice Yes Shared

Yes

Shared with nurse practitioner or physician if using authorizing mechanisms
Yes
Provides leadership in QI initiatives Yes No Yes Yes
Provides mentorship to  Nursing staff and the Interprofessional team Yes No, supports physicians Yes No
Provides health assessment Yes Yes Yes Yes
Orders diagnostics Yes Under direction/authorization of physician May initiate medical directive for some diagnostics under specific situations Yes
Orders therapeutics Yes, with few limitations Under direction/authorization of physician May initiate medical directive for some diagnostics under specific situations Yes
Health promotion Yes Not specifically Yes Yes
Compensation Salary from global budget, Ministry funded Salary from global budget, Ministry funded Salary from global budget, Ministry funded OHIP billing, global budget stipend for leadership roles
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