New and revised nursing standards: HPOA

The BCCNM board on Jan. 26 and Feb. 26, 2026, approved revisions to all BCCNM nursing standards to align with the upcoming Nurses and Midwives Regulation (NMR) and Regulated Health Practitioners Regulation (RHPR) under the Health Professions and Occupations Act (HPOA).

These updates support a consistent, clear, and modern regulatory framework and will take effect on April 1, 2026, when the new regulations come into force. The revised standards can all be accessed via the table at the end of this announcement.

• Read more about HPOA-related standard revisions
  

What are the changes?

For some standards, we made non‑substantive administrative updates, such as:

• Revising titles and headings for consistency
  
• improving formatting and readability,
• aligning terminology with the HPOA and new regulations,
• standardizing introductions and glossaries, and
• removing explanatory content better suited to learning resources.

For others, a detailed comparison of existing nursing practice standards with the NMR, RHPR, and HPOA identified areas where updates were needed to:

• align language and structure with the new regulations;
• clarify expectations related to scope of practice and restricted activities;
• reduce ambiguity and improve consistency across nursing designations; and
• enhance usability for nurses in practice.

While most regulatory changes for LPNs, RNs, and RPNs are modest, corresponding updates were required to ensure practice standards accurately reflect the new regulatory framework.

Key highlights of the updated standards

The revised practice standards:

• align descriptions of restricted activities with how they are defined in the RHPR;
• update terminology to reflect the NMR (for example, “acting under an order");
• reorganize limits and conditions to mirror the structure of the RHPR;
• clarify scope of practice expectations, including updates related to advising on physical and mental health, venipuncture for LPNs, and recognized sources of orders; and
• update language related to certification and use of title to reflect BCCNM bylaws.
• New glossaries have also been added to support understanding of key terms and to clarify distinctions such as the difference between a nursing diagnosis and the diagnosis of a disease or disorder.

Certification programs

In response to feedback from certified nurses, practice standards related to certified RN and RPN practice have been reorganized so that each certification program—Reproductive Health, Remote Practice, RN First Call, and Opioid Use Disorder—has its own dedicated practice standard. This approach improves clarity and aligns with similar changes being made for midwifery certification.

• Read more
  

Moving forward

The revisions approved at this stage focus primarily on scope‑related alignment with the NMR, RHPR, and HPOA. Following adoption as bylaws, BCCNM will continue to review and update practice standards as required under the HPOA, including engagement with Indigenous Peoples and system partners.

All of these standards will come into effect April 1, 2026, and be accessible via the practice standard pages. We recommend you bookmark these pages for quick access:

• LPN
  
• NP​
  
• RN 
  
• RPN
  

Questions?

• Connect with our Standards Support team.
• Visit the HPOA resource centre​

Table of standards

Standard	Revised Title	Designation(s)	Standard Type (Practice or Ethics)	Summary of Changes
Employed Student Registrants	Employed Student Licensees	ESN, ESPN	Practice	Updated nursing standards for regulatory supervision and employed student licensees​​
Licensed Practical Nurse: Acting with Client-specific Orders	Licensed Practical Nurses: Acting under Client-specific Orders	LPN	Practice	Inclusion of dietitians as regulated health professionals who may issue orders for therapeutic diets that LPNs may compound, dispense, or administer by enteral instillation.   Addition of venipuncture (restricted activities if order), which was previously interpreted to be authorized as a procedure under the dermis (phlebotomy). Removal of requirement for the medical practitioner or nurse practitioner giving an order to cast a fracture be registered in British Columbia. Alignment of language with NMR (e.g. under an order) Addition of references to relevant sections of NMR and RHPR Addition of definitions: Activity Client Client-specific order Nursing diagnosis to clearly differentiate it from a diagnosis of a disease or disorder, as the term nursing diagnosis has been replaced by diagnosis in the regulations. Restricted activity
Licensed Practical Nurse: Acting within Autonomous Scope of Practice	Licensed Practical Nurses: Acting within Autonomous Scope of Practice	LPN	Practice	Revisions to standards to reflect how LPN scope is described in the NMR (e.g. advising on physical and mental health). Alignment of language with NMR (e.g. under an order) Alignment of language with RHPR (e.g. insert replaces put) Addition of references to relevant sections of NMR and RHPR. Addition of a definitions: Activity Client Client’s Representative Client-specific order Nursing diagnosis to clearly differentiate it from a diagnosis of a disease or disorder, as the term nursing diagnosis has been replaced by diagnosis in the regulations. Restricted activity
Medical Assistance in Dying	Licensed Practical Nurses: Medical Assistance in Dying	LPN	Practice	Moved definitions from footnotes into Glossary Made minor edits to improve readability Edited language to align with HPOA and/or new HPOA Regulations Removed information more suited to a learning resource
Professional Standards for Licensed Practical Nurses	Licensed Practical Nurses: Professional Standards	LPN	Ethics	Removed information more suited to a learning resource Removed terms from Glossary that were not used in the standard Aligned definition of “standard” with definition used in other Professional Standards
Indigenous Cultural​ Safety, Cultural Humility, and Anti-racism	Nurses & Midwives: Indigenous Cultural​ Safety, Cultural Humility, and Anti-racism	All licensees LPN, NP, RN, RPN and midwives	Ethics	Edited section headings Made minor edits to improve readability Edited language to align with HPOA and/or new HPOA Regulations Removed information more suited to a learning resource Reformatted/rearranged content
Boundaries in the Nurse-Client Relationship	Nurses: Boundaries in the Nurse-Client Relationship	LPN, NP, RN, RPN	Ethics	Moved definitions from footnotes into Glossary Made minor edits to improve readability Removed information more suited to a learning resource Reformatted/rearranged content Removed clinical/ outdated content
Conflict of Interest	Nurses: Conflict of Interest	LPN, NP, RN, RPN	Ethics	Moved definitions from footnotes into Glossary Removed information more suited to a learning resource Definition of ‘client’ added
Consent	Nurses: Consent	LPN, NP, RN, RPN	Practice	Made minor edits to improve readability
Delegation to Unregulated Care Providers	Nurses: Delegation to Unregulated Care Providers	LPN, NP, RN, RPN	Practice​	New delegation practice standard for nurses​
Documentation	Nurses: Documentation	LPN, NP, RN, RPN	Practice	Made minor edits to improve readability
Duty to Provide Care	Nurses: Duty to Provide Care	LPN, NP, RN, RPN	Ethics	Moved definitions from footnotes into Glossary Made minor edits to improve readability Removed information more suited to a learning resource
Duty to Report	Nurses: Duty to Report	LPN, NP, RN, RPN	Ethics	Moved definitions from footnotes into Glossary Edited section headings Made minor edits to improve readability Edited language to align with HPOA and/or new HPOA Regulations Reformatted/rearranged content
Medication	Nurses: Medication​	LPN, NP, RN, RPN	Practice	Alignment of language with NMR RHPR (e.g. certification) Addition of definitions: Client Client’s representative Client-specific order Competence Medication Medication-related activities Nurses Nursing Diagnosis Restricted Activity
Communicable Diseases: Preventing Nurse-to-Client Transmission	Nurses: Preventing Transmission of Communicable Diseases	LPN, NP, RN, RPN	Practice	New nursing standard on preventing transmission of communicable diseases
Privacy & Confidentiality	Nurses: Privacy & Confidentiality	LPN, NP, RN, RPN	Practice	No changes needed
Regulatory Supervision of Students	Nurses: Regulatory Supervision of Students	LPN, NP, RN, RPN	Practice	​​Updated nursing standards for regulatory supervision and employed student licensees​
Use of Title	Nurses: Use of Title	LPN, NP, RN, RPN	Practice	Alignment of language with HPOA, NMR, RHPR & BCCNM General Bylaws e.g., “Licensed,” and “class of licensure” Inclusion of multijurisdictional licensing “Non-practising” removed Adds clarity on when employed student titles apply- only in employment roles Addition of definitions: Clients Nurses
Professional Standards for Registered Nurses and Nurse Practitioners	Registered Nurses & Nurse Practitioners: Professional Standards	NP, RN	Ethics	Edited section headings Made minor edits to improve readability Removed information more suited to a learning resource Reformatted/rearranged content Removed definitions that were outdated or more suitable for a learning resource
Screening and Diagnostic Tests & Imaging	Registered Nurses and Registered Psychiatric Nurses: Screening and Diagnostic Tests & Imaging	RN, RPN	Practice	References to relevant sections of NMR and RHPR Addition of definitions: Client Client-specific order Competence Decision Support Tools Nurses Nursing Diagnosis Restricted Activity
Registered Nurse: Acting by Giving Client-specific Orders	Registered Nurses: Acting by Giving Client-specific Orders	RN	Practice	References to relevant sections of NMR and RHPR Addition of definitions: Activity Client Client-specific order Nursing diagnosis to clearly differentiate it from a diagnosis of a disease or disorder, as the term nursing diagnosis has been replaced by diagnosis in the regulations. Restricted activity
Registered Nurse: Acting with Client-specific Orders	Registered Nurses: Acting under Client-specific Orders	RN	Practice	Removal of requirement for the medical practitioner or nurse practitioner giving an order to cast a fracture be registered in British Columbia. References to relevant sections of NMR and RHPR Alignment of language with NMR (e.g. under an order) Limits and conditions presented in the same sequence as the restricted activities outlined in the RHPR. Addition of definitions: Activity Client Client-specific order Nursing diagnosis to clearly differentiate it from a diagnosis of a disease or disorder, as the term nursing diagnosis has been replaced by diagnosis in the regulations. Restricted activity
Registered Nurse: Acting within Autonomous Scope of Practice	Registered Nurses: Acting within Autonomous Scope of Practice	RN	Practice	Revisions to standards to reflect how RN scope is described in the NMR (e.g. advising on physical and mental health). References to relevant sections of NMR and RHPR Alignment of language with NMR (e.g. under an order) Alignment of language with RHPR (e.g. insert replaces put) Limits and conditions presented in the same sequence as the restricted activities outlined in the RHPR. Addition definitions: Activity Client Client’s Representative Client-specific order Nursing diagnosis to clearly differentiate it from a diagnosis of a disease or disorder, as the term nursing diagnosis has been replaced by diagnosis in the regulations. Restricted activity
Medical Assistance in Dying	Registered Nurses: Medical Assistance in Dying	RN	Practice	Moved definitions from footnotes into Glossary Removed information more suited to a learning resource
Registered Psychiatric Nurse: Acting by Giving Client-specific Orders	Registered Psychiatric Nurses: Acting by Giving Client-specific Orders	RPN	Practice	References to relevant sections of NMR and RHPR Addition definitions: Activity Client Client-specific order Nursing diagnosis to clearly differentiate it from a diagnosis of a disease or disorder, as the term nursing diagnosis has been replaced by diagnosis in the regulations. Restricted activity
Registered Psychiatric Nurse: Acting with Client-specific Orders	Registered Psychiatric Nurses: Acting under Client-specific Orders	RPN	Practice	References to relevant sections of NMR and RHPR Alignment of language with NMR (e.g. under an order) Addition of definitions: Activity Client Client-specific order Nursing diagnosis to clearly differentiate it from a diagnosis of a disease or disorder, as the term nursing diagnosis has been replaced by diagnosis in the regulations. Restricted activity
Registered Psychiatric Nurse: Acting within Autonomous Scope of Practice	Registered Psychiatric Nurses: Acting within Autonomous Scope of Practice	RPN	Practice	Revisions to standards to reflect how RPN scope is described in the NMR (e.g. advising on physical and mental health). Inclusion of urinary for irrigation and insertion of catheter to provide clarity in alignment with the legacy College of Registered Psychiatric Nurses of BC’s   intent Alignment of language with NMR (e.g. under an order) Alignment of language with RHPR (e.g. insert replaces put) References to relevant sections of NMR and RHPR Limits and conditions presented in the same sequence as the restricted activities outlined in the RHPR. Addition of definitions: Activity Client Client-specific order Client’s Representative Nursing diagnosis to clearly differentiate it from a diagnosis of a disease or disorder, as the term nursing diagnosis has been replaced by diagnosis in the regulations. Restricted activity
Code of Ethics	Registered Psychiatric Nurses: Code of Ethics	RPN	Ethics	Made minor edits to improve readability Removed information more suited to a learning resource Removed clinical/ outdated content
Medical Assistance in Dying	Registered Psychiatric Nurses: Medical Assistance in Dying​	RPN	Practice	Moved definitions from footnotes into Glossary Removed information more suited to a learning resource
Professional Standards for Registered Psychiatric Nurses	Registered Psychiatric Nurses: Professional Standards​	RPN	Ethics	Made minor edits to improve readability Removed information more suited to a learning resource Removed clinical/ outdated content Replaced outdated term of “cultural competence” with “cultural humility” Removed outdated definition of “cultural safety” Removed outdated reference to “continuing competence requirements”
Certified nurses
Registered Nurse (Certified Practice): Acting within Autonomous Scope of Practice	Certified Registered Nurses: Opioid Use Disorder	RN (Certified)	Practice	Revisions to standard to make it certification program specific (opioid use disorder) References to relevant sections of NMR and RHPR Alignment of language with NMR, RHPR (e.g. certification program) Addition of definitions: Client Client’s representative Client-specific order Medication Prescribing Restricted Activity
Registered Nurse (Certified Practice): Prescribing	Certified Registered Nurses: Prescribing	RN (Certified)	Practice	Alignment of language with NMR Reference to relevant section of BCCNM General Bylaw Addition of definitions: Client Client-specific order Medications Prescribing Restricted Activity Removal of definitions not in standard
Registered Nurse (Certified Practice): Acting within Autonomous Scope of Practice	Certified Registered Nurses: Remote Practice	RN (Certified)	Practice	Revisions to standard to make it certification program specific (remote practice) References to relevant sections of NMR and RHPR Alignment of language with NMR, RHPR (e.g. certification program) Addition of definitions: Client Client’s representative Client-specific order Medication Prescribing Restricted Activity
Registered Nurse (Certified Practice): Acting within Autonomous Scope of Practice	Certified Registered Nurses: Reproductive Health	RN (Certified)	Practice	Revisions to standard to make it certification program specific (Reproductive Health (Contraceptive Management) and Reproductive Health (Sexually Transmitted Infections)) References to relevant sections of NMR and RHPR Alignment of language with NMR, RHPR (e.g. certification program) Addition of definitions: Client Client’s representative Client-specific order Medication Prescribing Restricted Activity
Registered Nurse (Certified Practice): Acting within Autonomous Scope of Practice	Certified Registered Nurses: RN First Call	RN (Certified)	Practice	Revisions to standard to make it certification program specific (RN First Call) References to relevant sections of NMR and RHPR Alignment of language with NMR, RHPR (e.g. certification program) Addition of definitions: Client Client’s representative Client-specific order Medication Prescribing Restricted Activity
Registered Psychiatric Nurse (Certified Practice): Acting within Autonomous Scope of Practice	Certified Registered Psychiatric Nurses: Opioid Use Disorder	RPN (Certified)	Practice	Revisions to standard to make it certification program specific (Opioid Use Disorder) References to relevant sections of NMR and RHPR Alignment of language with NMR, RHPR (e.g. certification program) Addition of definitions: Client Client’s representative Client-specific order Medication Prescribing Restricted Activity
Registered Psychiatric Nurse (Certified Practice): Prescribing	Certified Registered Psychiatric Nurses: Prescribing	RPN (Certified)	Practice	Alignment of language with NMR Reference to relevant section of BCCNM General Bylaw Addition of definitions: Client Client-specific order Medication Prescribing Restricted Activity Removal of definitions not in standard

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