New emergency regulation regarding scope of practice
The Ontario government issued on April 21 an emergency order addressing regulated health professions in hospitals (here). The College of Nurses (CNO) has provided a message here and and update here. Under this new government order, health professionals from Ontario or other Canadian jurisdictions – including nurses – are authorized to engage outside of their regular scope of practice provided that doing so is necessary in order for the health care professional to respond to, prevent, or alleviate the effects of the COVID-19 outbreak. This new order applies only to health professionals working in hospitals.
The changes enacted by the nurses’ regulatory body (CNO) means that an RPN, RN, NP or other health professional in a hospital can be asked to perform tasks outside their scope of practice. While RNAO understands the direness of the situation, we are concerned about the safety of patients and the impact it will have on the nursing profession. RNAO is cautioning that this emergency order should not be used to push forward permanent changes to scope of practice after the pandemic crisis passes. Government and the CNO have tried to address the long standing crisis of care in Ontario due to its lowest RN per population in Canada by promoting deskilling of nursing work.
There is also the issue of disciplinary action against a nurse for errors while performing outside their scope of practice. The government regulation stipulates that “a member of a College continues to be subject to the jurisdiction of the College for incompetence” in that situation. The College says that “CNO always considers the context in which you must provide care when we are assessing concerns that we may receive.”