RNAO calls on Premier Ford and Minister Elliott to Delay Action on CNO Council Decision to Expand RPN Scope

Close to 6,000 have already signed RNAO’s Action Alert to its members and the public, issued on September 17 regarding the following:  

The College of Nurses of Ontario (CNO) made a shocking and stunning decision approving a regulation change for the Registered Practical Nurse (RPN) scope of practice at its CNO Council meeting today, September 17, 2020 that will seriously jeopardize the safety of the public and render the Registered Nurse (RN) and Registered Practical Nurse (RPN) scope of practice virtually identical.

RNAO and ONA value the significant contributions of RPNs to Ontario’s health system. Scope of practice limitations guided by entry level education are a critical component of self-regulation that exists to protect the public. This is why this entry level major regulatory change is dangerous for Ontarians. RNs, RPNs and NPs all have a critical role to fill in advancing a strengthened health system that meets the needs of all Ontarians. Within this context, we are strongly opposed to this regulation change to the RPN scope due to its potentially damaging shortfalls in relation to: 

1. Protection of patient safety
2. Knowledge and judgment required for “initiating” a procedure as different from “performing” a procedure with an order that are not part of the RPN skill set
3. Adherence to the CNO’s three factor framework of client complexity, predictability and risk of negative outcomes
4. The CNO’s mandate to regulate two major categories of nurse- RNs and RPNs- with distinct bodies of knowledge, abilities and skill sets that define and differentiate scope of practice.

RNAO and ONA call Premier Ford and Minister Elliott to delay any action on the September 17, 2020 CNO Council decision to expand RPN scope of during this time, given the pandemic has profoundly impacted the nursing profession. 

To our alarm, the approval of the expansion of RPN scope of practice allows RPNs to independently initiate four controlled acts that are currently reserved for the registered nurse (RN) scope of practice. 

Reiterating the strong opposition to this regulatory change expressed by each of our organizations individually, RNAO and ONA are jointly taking a stand against any further action by the Ontario government to move forward with the proposed RPN regulation change. The rationale for our action is clearly laid out in our respective letters to CNO. Both were included in the June 2020 Council Briefing Package, and in our joint letter. This change made without due process because of COVID-19, lack of full disclosure of ONA and RNAO’s joint position, and misinformation related to the evidence regarding patient need and patient safety is unconscionable. In summary, this decision that allows RPNs to perform the above intrusive procedures without an order from an appropriate provider: disregards the differences in educational preparation for RNs and RPNs; undervalues the four-year baccalaureate degree required of RNs to meet their standard entry-to-practice requirements; will contribute to further role blurring between RNs and RPNs; and was made in the absence of evidence regarding the safety of and the need for this scope of practice change, thus jeopardizing the safety of Ontarians receiving nursing and health care.

We urge you to sign the Action Alert below and tell Premier Ford, and Minister Christine Elliott that you want government to delay action on the CNO September 17, 2020 Council to expand the RPN scope of practice until post COVID-19.

You can sign the Action Alert here.