Glossary

• A
• B
• C
• D
• E
• F
• G
• H
• I
• L
• M
• N
• O
• P
• R
• S
• U

A

Additional education

Additional education is structured education, e.g., workshop, course, program of study, designed so that registered nurses can attain the competencies required to carry out a specific activity as part of registered nursing practice. Additional education builds on the entry-level competencies of registered nurses; identifies the competencies expected of learners on completion of the education; includes both theory and application to practice, and includes an objective, external evaluation of learners’ competencies on completion of the education. The term does not refer to a course or program approved by BCCNM for BCCNM-certified practice.

B

BCCNM certification

Satisfactory completion of a process that leads to a registered nurse’s name being entered on the BCCNM certified practices register. The process involves the successful completion of a program established or approved by BCCNM. BCCNM certification is not the same as employer certification or specialty certification (e.g., through the Canadian Nurses Association).

BCCNM-certified practices

See certified practices.

C

Cardiac stress testing

A medical test that indirectly reflects arterial blood flow to the heart during physical exercise. It is performed to detect, diagnose or evaluate disease or disease processes and determine a course of treatment.

Certified practices

Restricted activities that are subject to regulatory provisions under Section 8 of the Nurses (Registered) and Nurse Practitioners Regulation. These provisions require registered nurses to successfully complete a certification program approved by BCCNM before carrying out the restricted activities designated as certified practices. Certified practices are also referred to as BCCNM-certified practices to distinguish them from activities that employers or other organizations certify.

Cervical cancer screening

A screening test for cervical squamous dysplasia and early invasive squamous carcinoma of the cervix. The current method used to obtain cytology specimens is the Papanicoulaou smear (Pap smear). [Adapted from B.C. Cancer Agency. (2013). Screening for Cancer of the Cervix: An Office Manual for Health Professionals.]

Client

An individual, family, group, population or entire community who requires nursing expertise. In some clinical settings, the client may be referred to as a patient or a resident. In research, the client may be referred to as a participant.

Collaboration

Joint communication and decision-making with the expressed goal of working together toward identified health outcomes while respecting the unique qualities and abilities of each member of the group or team.

Competence

The integration and application of knowledge, skills and judgment required for safe and appropriate performance in an individual's practice.

Competencies

Statements about the knowledge, skills, attitudes and judgments required to perform safely and ethically within an individual’s nursing practice or in a designated role or setting.

Complementary and alternative health care

Modalities or interventions utilized to address client's health needs across the continuum of health care, but which are not considered at this time to be a part of mainstream health care practices in B.C. “Complementary” practices are practices that are used alongside the mainstream health care system, while “alternative” practices are used in place of mainstream health care practices.

Compound

To mix a drug with one or more other ingredients for the purposes of dispensing or administering the drug, or to mix two or more ingredients of a therapeutic diet for the purpose of dispensing or administering the therapeutic diet.

Compression therapy

Application of elastic or inelastic wraps or garments that exert sustained external pressure over the lower extremities to relieve venous congestion, reduce edema and promote the return of venous blood to the heart.

Condition

The type of nursing diagnosis a registered nurse is authorized to make through the Nurses (Registered) and Nurse Practitioners Regulation. A condition is different from a disease or disorder. A condition can be improved or resolved by a registered nurse’s interventions and achieves outcomes for which the registered nurse is accountable (e.g., post-operative urinary retention).

Conflict of interest

In the context of registered nursing practice, a conflict of interest occurs when a nurse's personal or private interests interfere with a client’s best interests or the nurse’s own professional responsibilities. The conflict can be actual, perceived or potential.

Consent

The voluntary agreement to some act or purpose made by a capable individual. The conditions for consent include the following: The client or substitute decision-maker being adequately informed; the client or substitute decision-maker being capable of giving or refusing consent; there being no coercion, fraud or misrepresentation.

Conservative sharp wound debridement

The removal of nonviable tissue (e.g., slough, callus) to the level of viable tissue using instruments (e.g., scalpel, scissors, curette) to create a clean wound bed.

Critical thinking

A purposeful, disciplined and systematic process of continual questioning, logical reasoning and reflecting through the use of interpretation, inference, analysis, synthesis and evaluation to achieve a desired outcome.

D

Decision support tools

Evidence-based documents used by registered nurses to guide the assessment, diagnosis and treatment of client-specific clinical problems.

Delegation

Sharing authority with other health care providers to provide a particular aspect of care. Delegation among regulated care providers occurs when a restricted activity is within the scope of the delegating profession and outside the scope of the other profession.

E

Employed student nurse

The employment role in which a nursing student is employed in a health care setting during or between terms of their education program, in accordance with BCCNM bylaws. Also, the title an employed student registrant is permitted to use as set out in the practice standard Appropriate Use of Titles.

Endotracheal intubation

Procedure in which a tube is inserted through the mouth into the trachea. Before surgery, this is often done under deep sedation. In emergency situations, the patient is often unconscious at the time of this procedure. [Adapted from Schiffman, G. Endotracheal Intubation. Retrieved January 19, 2016. from www.medicinenet.com ]

Entry level registered nurse

The registered nurse at the point of initial registration is a generalist and a graduate from a recognized nursing education program or equivalent.

Evidence

Data derived from various sources including research, national guidelines, policies, consensus statements, expert opinion and quality improvement.

Evidence-based

Describing something (e.g., practice, decision support tool) that is based on successful strategies that improve client outcomes and are derived from a combination of various sources of evidence, including research, national guidelines, policies, consensus statements, expert opinion, quality improvement data and client perspectives.

F

Fitness to practice

All the qualities and capabilities of an individual relevant to his or her capacity to practise as a nurse, including, but not limited to, any cognitive, physical, psychological or emotional condition, or a dependence on alcohol or drugs, that impairs his or her ability to practise nursing.

G

General anesthesia

The induction of a state of unconsciousness, accompanied by the paralysis of skeletal muscle and the absence of pain sensation. It is induced through the administration of anesthetic drugs and is used during major surgery and other invasive surgical procedures.

H

Health care team

Clients, health care professionals, unregulated care providers, students and others who may be involved in providing care.

I

Insulin dose adjustment (IDA)

Determining the dose and timing of insulin to achieve glycemic control and advising the client/patient. Changing the type of insulin is not included in IDA. IDA occurs only in clients/patients who are on insulin therapy; that is to say, diabetes has already been diagnosed and insulin ordered. IDA considers many factors including but not limited to diet, exercise and blood glucose and/or sensor glucose levels.

L

Limits and conditions

As related to scope of practice, what registered nurses are not permitted to do (limits) and the circumstances under which registered nurses may carry out an activity (conditions).

M

Maggot debridement therapy

The therapeutic use of live medical-grade maggots (fly larvae) to debride a wound.

Managing labour

Taking professional responsibility and accountability for the assessment of maternal and fetal well-being in labour, the assessment of progress in labour, and clinical decisions and clinical actions based on the above assessments. Managing labour includes providing care, advice and support to a woman in labour, guided by current standards and evidence for optimum maternity care. It includes collaborating with other care providers, as appropriate to each regulated health professional’s scope of practice, and is carried out in the context of informed consent, respecting the woman’s values and her role in decision-making. [College of Midwives of B.C., College of Physicians of B.C., College of Registered Nurses of B.C. (2008). Joint Statement: Managing Labour.]

Marketing

(a) an advertisement, (b) any publication or communication in any medium with any patient, prospective patient or the public generally in the nature of an advertisement, promotional activity or material, a listing in a directory, a public appearance, or any other means by which professional services are promoted, and (c) contact with a prospective client initiated by or under the direction of a registrant.

N

Negative pressure wound therapy

A wound management modality that delivers a controlled, localized, negative (sub-atmospheric) pressure to a wound to promote healing or to manage a heavily exudative wound.

Non-practising registration

A class of registration in which the registrant cannot practice as a nurse or nurse practitioner. Non-practicing registrants must have qualified for practicing registration upon initially being granted registration.

Nursing

The health profession in which a person provides the following services: (a) health care for the promotion, maintenance and restoration of health; (b) prevention, treatment and palliation of illness and injury, primarily by (i) assessing health status, (ii) planning and implementing interventions, and (iii) coordinating health services.

Nursing diagnosis

A clinical judgment about an individual’s mental or physical condition to determine whether the condition can be improved or resolved by appropriate interventions of the registered nurse to achieve outcomes for which the registered nurse is accountable.

Nursing science

Knowledge (e.g., concepts, constructs, principles, theories) of nursing derived from systematic observation, study and research.

O

Order

An "order" is any instruction or authorization given by a regulated health professional to provide care for a specific client, whether or not the care or service includes any restricted activity. Orders can include instructions that set out the usual care for a particular client group or client problem and are made client-specific by the ordering regulated health professional. The order must be documented in the client’s permanent record by the regulated health professional; include all the information needed for the ordered activity to be carried out safely (e.g. time, frequency, dosage, etc.); and include a unique identifier such as a written signature or an electronically generated identifier. Once given, orders may be transcribed in other documents such as a client care plan.

P

Pelvic exams

Examinations with three components: an external genital exam; a speculum exam; and a bimanual exam. The speculum exam and the bimanual exam are included in the restricted activity of putting an instrument, device, hand or finger beyond the labia majora. [Adapted from Provincial Health Services Authority (2012). Decision Support Tool: Pelvic Exam.]

Practising registration

Licensed practical nurses, registered nurses, nurse practitioners, licensed graduate nurses, registered psychiatric nurses, employed student registrants and grandparented student registrants in British Columbia, whether employed or in a voluntary capacity, can hold practising registration with BCCNM. Registrants with practising registration have the right to practise nursing and to use titles appropriate to their class of registration as identified in the BCCNM Appropriate Use of Titles Practice Standard. Also see Classes of Registrants in the BCCNM bylaws.

Primary care provider

Primary care providers are health professionals who take primary responsibility for an established group of patients for whom they provide: longitudinal person-focused care; comprehensive care for most health needs; first contact assessment for new health care needs; and referral and coordination of care when it must be sought elsewhere. A primary care provider is ideally chosen by an individual to serve as his or her health care professional to address a wide variety of health issues including health promotion, illness and injury prevention, and the diagnosis and treatment of illness and injury.

Primary health care

Essential health care (promotive, preventive, curative, rehabilitative, and supportive) that focuses on preventing illness and promoting health with optimal individual and community involvement. It is both a philosophy and an approach that provides a framework for health care delivery systems. The five principles of primary health care are accessibility, public participation, health promotion, appropriate technology and intersectoral collaboration.

Privacy

The right of individuals to determine how, when, to whom and for what purposes any personal information will be divulged.

R

Registrant

A person who is granted registration with a regulatory college, e.g., BCCNM, in accordance with the Health Professions Act.

Regulatory supervision

The process by which a nurse may authorize an activity to be performed by another person who does not otherwise have authority to perform the activity.

Remote Nursing Practice

Nursing practice that occurs in communities where there is no resident physician or nurse practitioner, but where physicians or nurse practitioners visit the community periodically and are available to provide consultation to the registered nurse. (See RN First Call).

Requisite skills and abilities

Certain basic skills and abilities that are required for a student to attain the entry level competencies required for initial registration.

Reserved title

A professional title, protected by legislation or regulation, that can only be used by registered members of a profession in accordance with any other applicable legal requirements.

Restricted activities

Higher risk clinical activities that must not be performed by any person in the course of providing health services, except members of a regulated profession that has been granted specific legislative authority to do so, based on their education and competencies.

RN First Assist Program

A formal course or program of study that prepares registered nurses to act in a registered nurse first assist (RNFA) role. An RNFA is an experienced perioperative nurse who has acquired additional knowledge and judgment, along with advanced technical skills to function as an assistant to the surgeon throughout the client’s surgical experience. Examples of these advanced technical skills include closing the surgical site by suturing, doing electrocautery and harvesting veins.

RN First Call

Nursing practice that occurs in small acute care hospitals, diagnostic and treatment centres and other settings where there is physician service available in the community. See Remote Nursing Practice.

S

Scope of practice

The activities RNs are educated and authorized to perform as set out in the Nurses (Registered) and Nurse Practitioners Regulation under the Health Professions Act and complemented by standards, limits and conditions established by BCCNM.

Sexual misconduct

Professional misconduct involving sexual intercourse or other forms of physical sexual relations between a registrant and a patient, touching, of a sexual nature, of a patient by a registrant, or behaviour or remarks of a sexual nature by a registrant towards a patient; but does not include touching, behaviour and remarks by a registrant towards a patient that are of a clinical nature appropriate to the service being provided.

Standard

An expected and achievable level of performance against which actual performance can be compared. It is the minimum level of acceptable performance.

U

Uncomplicated lacerations

A laceration that has no complications such as fracture, foreign body, etc. Uncomplicated lacerations do not include lacerations that are caused by a human or animal bite; are associated with a fractured bone or located over a joint; are grossly contaminated; are more than 12 hours old; involve tendons, nerves or large blood vessels; or have severe surrounding soft tissue damage and maceration.

Unregulated care provider

Paid providers who are neither registered nor licensed by a regulatory body. They have no legally defined scope of practice. Unregulated care providers do not have mandatory education or practice standards. Unregulated care providers include, but are not limited to, resident care attendants, home support workers, mental health workers, teaching assistants and community health representatives