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UDPDATE AUG. 20, 2021: PHO orders regarding mandatory vaccinations

BCCNM reminds nurses and midwives they must follow PHO orders including meeting mandatory vaccination status for working at certain sites​. Nurses must also follow organizational policies and guidelines.

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Administering the COVID-19 vaccine is within the scope of practice of all practising nurses who have the appropriate knowledge, skill and judgment. Nurses ensure they have the required competencies to safely administer vaccines and not carry out the procedure if they are not competent to do so.

BCCNM does not train, educate or provide education materials for nurses related to giving COVID-19 vaccines; BCCNM sets the standards nurses must meet when giving immunizations. Nurses and organizations/employers work together to ensure nurses giving the COVID-19 vaccine have the required education. Please visit the BCCD​C website for required competencies and training information.

Remember, a nurse role models and follows public health directives that safeguard the health of the public. This includes knowing the evidence to dispel myths and misinformation when talking to clients.

For personal reasons, I don’t want to/can’t have a COVID-19 vaccine. Will I lose my licence if I refus​e?

All nurses must follow the Provincial Health Officer’s orders, including meeting mandatory vaccination status for working at certain sites. While you’re not required to have a COVID-19 vaccine to be registered with BCCNM, as a registrant of the college, you are responsible for protecting your clients from the risk of infection. Nurses and midwives have a professional, ethical and legal duty to provide clients with safe care. Review provincial and federal and your employer’s/organization’s policies about immunizations and disease control.

The Communicable Diseases: Preventing Nurse-to-Client Transmission practice standard provides more information about your responsibilities to provide safe care to clients.


I’m new to immunization administration (have not given immunizations autonomously), what additional education do I need in order to give the COVID-19 vaccine?

For nurses new to immunization administration who will be administering only the COVID-19 vaccine, the BC Centre for Disease Control (BCCDC) is providing a condensed immunization competency education process. Please visit the BCCDC website for details. As well, check with your employer to see if there is any organizational specific education you need.

I’m not new to immunization administration (have autonomously given immunizations before), do I need to have additional education to provide the COVID-19 vaccine?

Likely yes, as the handling and storage of the COVID-19 vaccine is different than other vaccines.  Check with your employer to see what is needed at your organization.

When do I need to get a client specific order to administer the COVID-19 vaccine?

Nurses must get a client-specific order to administer an immunization if they do not meet the standards, limits and conditions set out in their Scope of Practice standards. 

Who can give a client-specific order for immunizations?

Health care professionals who are authorized to give a client-specific order is laid out in your nursing regulation. Not all nursing designations have the same list of authorized prescribers. Review your nursing regulation to see who is authorized to give client-specific orders.

Only RNs/RPNs who meet the requirements in the Giving a Client-specific Order standard can autonomously give client-specific orders for immunizations. If the nurse cannot fully meet the standard, they must get a client-specific order from another authorized health professional.

For example, a public health nurse (RN) with the immunization competencies can give a client-specific order to another RN, an LPN, or an RPN to administer the COVID-19 vaccine to a client they have assessed. The nurse who is administering the vaccine must follow the Medication practice standard and be competent to give an injection. Nurses who are acting on a client-specific order (pp. 20-24) to immunize do not need to meet all of  the competencies established by BCCDC providing they were acting on an order and meet BCCNM standards .

Nurses (RNs, RPNs) giving client specific orders for the COVID-19 vaccine must follow:

  • Scope of practice standard Giving Client-specific Orders
  • Consent practice standard
  • Medication practice standard
  • Documentation practice standard
  • Employer/organizational policies
Another health care professional has prepared the COVID-19 vaccine and I am tasked to give it. Does this meet BCCNM standards?
BCCNM has neither approved this practice nor stated that it cannot be done. However, the BCCDC may determine this is the best approach for handling and administering the vaccines given B.C.’s current public health emergency and mass immunization plan. We leave this decision to the Public Health experts. Nurses should follow their standards of practice, BCCDC guidelines and decision support tools for COVID-19 vaccines, and their organization/employer policies. ​

 Duty to provide care

Due to the COVID-19 pandemic, my employer has asked me to work in an unfamiliar area. Can I refuse to work in that area?

Nurses work in the best interests of their clients to set priorities, use critical thinking skills and apply professional judgement in these circumstances. Nurses seek out credible sources of information and follow best practice guidelines to provide nursing services and minimize the risk of disease transmission to themselves, their clients and others.

If you have concerns about your personal safety or your competence to work in a particular area, collaborate with your employer to ensure you’re providing safe care and meeting all relevant standards of practice. The Duty to Provide Care Practice Standard provides further guidance and information to support your decision-making. You can also refer to this April 7, 2020, letter from the provincial nursing leads that references working in unfamiliar areas.

Self-employed nurses may need to consider their options in meeting client care needs. Proactive communication and a collaborative approach with clients and their families can help ensure client care needs are met.

The following BCCNM resources will assist you in your decision-making.

​​I am concerned that my employer is running out of the necessary personal protective equipment (PPE) for me to do my job. Can I refuse to care for those patients without having the right PPE?

Nurses seek out credible sources of information and follow best practice guidelines to provide nursing services and minimize the risk of disease transmission to themselves, their clients and others. We acknowledge this is an unprecedented time in health care and we recognize your efforts.

Nurses use their clinical judgement, follow employer policies and procedures in assessing the appropriate need for PPE, as not every client care situation may require specific equipment.

The BC Centre for Disease Control provides specific guidelines on PPE use for Covid-19 via the BCCDC Personal Protective Equipment (PPE) Guidelines.

If you have concerns about your personal safety this is an important time for you to be proactive, to collaborate, and communicate your concerns to your employer. The Duty to Provide Care Practice Standard provides further guidance and information to support your decision-making in order to provide the safest possible care as well as addressing your own safety and personal circumstances.

It is important for you to remember that the COVID-19 pandemic is rapidly evolving. During these unprecedented times nurses must prepare to adapt quickly to a rapidly changing practice environment. You can also refer to recent Ministry of Health guidelines on use of masks in health care facilities.

Related resources

You can also contact BCCNP Regulatory Practice Consultation

 Scope of practice

Can LPNs collect nasopharyngeal and throat swabs for COVID-19 in any setting?

Yes, LPNs can collect nasopharyngeal or throat swabs for COVID-19 testing. LPNs must:

  • Follow the  PH​​O's Licensed Practical Nurse SARS-cov-2 Swabbing Order (i.e., as part of a screening program designated by the Medical Health Officer for their geographic area)

  • Have the individ​​ual competence to perform the activity safely

  • Follow workplace policies a​​nd procedures

When not following​ the public health order for COVID-19 screening, LPNs still require a client-specific order from a health professional before performing a nasopharyngeal or throat swab.

​As of June 2022, BCCNM permanently removed the Scope of Practice requirement for LPNs to have additional education to perform nasopharyngeal or throat swabs.

 Student nurses

I’m a nursing student and I want to know how I can help during the pandemic?

As a nursing student, you may participate in formal learning experiences that your school has organized for you as a part of your nursing education program. However, outside of your formal nursing program you can only help as a volunteer. You are not able to help in a nursing capacity unless you hold Employed Student Nurse (ESN) or Employed Student Psychiatric Nurse (ESPN) registration. Visit BC211 to register as a volunteer.

 Nurses who are self-employed or in private practice

I'm a nurse who is self-employed or in private practice. When and how can I resume in-person care?

The Provincial Health Officer has indicated that registrants can deliver in-person care in a way that promotes safe care to clients and continues to prevent the spread of the virus. Read the detailed direction and recommendations for providing in-person community care.

We encourage nurses to review the expectations from the Provincial Health Officer and the BCCNM practice standard Duty to Provide Care to determine how to proceed in their decision-making.

BCCNM resources


If you have questions after reviewing the above documents, you can contact Regulatory Practice Consultation

 Privacy & confidentiality

I’m seeing a lot of social media posts from nurses on COVID-19 including sharing positive patient test results and concerns around social distancing. What should nurses consider before posting anything, including about COVID-19, to social media?

While there are many benefits to social media both for personal and professional use, nurses must be aware of the many risks, such as breach of privacy and confidentiality as well as providing false or inaccurate information. Nurses must use social media responsibly at all times.

Nurses need to consider the following when interacting via social media:

  • Nurses are expected to uphold the BCCNM Standards of Practice at all times and in all settings, including on social media platforms.
  • Before posting or commenting – first and foremost, nurses should reflect on why they are sharing information via social media. They should use their professional judgement and keep their obligations to clients, colleagues and employers at forefront.
  • Registrants who identify themselves as a nurse on social media have a professional responsibility to maintain professional conduct even if posts are made while off duty.  Social media posts have the potential to negatively impact both the public's perception of nurses and trust in the nursing profession as a whole and could be considered "unprofessional conduct" under the Health Professions Act.
  • Nurses maintain the privacy and confidentiality of their clients or any other clients at all times.
  • Nurses do not share any information about clients on social media, such as posting information about a colleague who has tested positive for COVID-19.
  • Nurses must be aware of and follow their employer policies on privacy and confidentiality including those guiding the use of social media.
  • Nurses work  collaboratively when  addressing their concerns about COVID-19.

The following BCCNM Resources may be helpful to nurses during this challenging time.


Regulatory practice consultation is available by