Registed Nurses' Association of Ontario

Proposed changes to scope of practice for Nurse Practitioners insufficient to increase timely access to health services: Nurses say

Proposed changes to scope of practice for Nurse Practitioners insufficient to increase timely access to health services: Nurses say


Toronto, May 11, 2009 – Regulations aimed at changing the way nurse practitioners (NPs) practice represent a step in the right direction but the top professional nursing organization in Ontario says the government has missed an opportunity to lift the regulatory handcuffs that limit the role of NPs to increase timely access to health services and reduce wait times.

The proposed changes are set out in legislation unveiled today by Premier Dalton McGuinty and Ontario’s Minister of Health and Long-Term Care David Caplan.

The Registered Nurses’ Association of Ontario (RNAO) and the Nurse Practitioners’ Association of Ontario (NPAO) say they are pleased that under the proposed legislation, NPs will now be able to carry out a variety of acts and treatment procedures previously not authorized to them such as setting or casting bone fractures, dispensing certain drugs, ordering bone density tests, as well as MRIs. “These changes are welcome and will alleviate a great deal of frustration among NPs who have felt their education, skills and experience are not fully utilized in Ontario,” says Wendy Fucile, president of RNAO.

But RNAO and NPAO say the government will fail the public if they refuse to act in two key areas: broader prescribing authority to enable timely access to pharmaceutical treatment, and authority to admit and discharge patients in hospitals.

Fucile says the government ignored a key recommendation that the College of Nurses of Ontario (the nurses’ regulatory body that is accountable to protect the public) had called for in the area of prescribing medications. The College, with full support from RNAO and NPAO, called for open prescribing for NPs, which already exists in most jurisdictions in Canada and the United States. “NPs in Ontario have been able to prescribe a limited number of medications for the past 11 years, but the model government has chosen to continue using is outdated and significantly hinders timely pharmacological treatment,” Fucile says, adding that “the McGuinty government must do what is right for the public by following the rest of Canada.”

RNAO and NPAO argue the province also failed to recognize that NPs represent a critical resource when it comes to reducing wait times by improving access to enter and exit the hospital system. “We asked government to remove legislative barriers and allow NPs to admit and discharge patients in hospitals and other institutional settings,” says Tina Hurlock-Chorostecki, President of NPAO, an expert group of RNAO, which represents all NPs in the province. “As a nurse practitioner working in a hospital setting, I know first-hand that NPs can positively impact patient care and reduce wait lists,” adds Hurlock-Chorostecki.

Doris Grinspun, RNAO’s executive director states that “nurses and nurse practitioners look forward to working with government and others on amending the proposed legislation to ensure that NPs’ expertise, knowledge and skills are fully available to serve the public.” Grinspun says “NPs have the competencies and experience to ensure patients are moving through the system effectively and efficiently while getting the timely and quality care they need and deserve.”

RNAO and NPAO will pursue all the necessary amendments to the legislation so that the public can take full advantage of NPs. “Ontario was the first jurisdiction in Canada to regulate the NP role 11 years ago but has fallen significantly behind the rest of the country in fully engaging the role to improve access to timely, safe and effective care,” says Grinspun. She adds, “Premier McGuinty must live up to his words that NPs are an untapped resource that government must take full advantage of. If the premier is serious about improving access to patient care and reducing wait times, then he must make all necessary amendments to the legislation.”

The Registered Nurses Association of Ontario (RNAO) is the professional association representing registered nurses wherever they practise in Ontario. Since 1925, RNAO has lobbied for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health-care system, and influence decisions that affect nurses and the public they serve.

The Nurse Practitioners’ Association of Ontario (NPAO) is the professional association representing nurse practitioners in Ontario since 1973. NPAO is an expert group of RNAO for issues related to nurse practitioner practice. NPAO’s mission is to achieve full integration of Nurse Practitioners to ensure accessible, high quality health care for Ontarians.


Please contact:
Marion Zych, Director of Communications, RNAO
Cell: 647-406-5605 / Office: 416-408-5605
Toll free: 1-800-268-7199 ext. 209