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Duty to Report

Practice Standard for nurse practitioners

​​​​This standard applies to LPNs, NPs, RNs, and RPNs​.​​​​​​​​​​​​​​​​​​

Practice Standards set out requirements related to specific aspects of nurses’ practice. They link with other standards, policies and bylaws of the BC College of Nurses and Midwives and all legislation relevant to nursing practice.

Nurses1 (in all positions and settings) have a legal and ethical obligation to report incompetent or impaired practice or unethical conduct of regulated health professionals. It is important for nurses to understand when to report, what to report and how to report, and to know what is legally and ethically required.

In B.C., the Health Professions Act establishes a legal duty for nurses to report situations in which there is a good reason to believe that a regulated health professional’s practice is impaired or incompetent and may pose a danger to the public (s. 32.2). The Health Professions Act also requires nurses to report any sexual misconduct by a regulated health professional.  If concerns about sexual misconduct are based on information from a client, nurses must first obtain the client’s (or substitute decision-maker’s) consent before making a report (s. 32.4). The Health Professions Act protects a nurse who makes a report in good faith from legal liability in circumstances where the nurse has a legal duty to report under the Act.

Under this practice standard, nurses also have an expanded duty to report situations in which they have reason to believe that a regulated health professional’s practice poses a danger to the public because of unethical behaviour or for other reasons.

Nurses may have obligations to report regulated health professionals under other legislation and regulations. The specific legislation or regulation that applies to a nurse’s practice depends on the work setting and the nature of the work.​

​​Principles​​

​1.

​Nurses are attentiv​e to signs that a colleague is unable to perform​​ their dut​ies, an​​d they are o​bligated to take the necessary steps to protect client safety.​

​2.

​​Nurses report, in writing, to the appropriate regulatory body when they ​​have reason to believe th​​​at a regulated health professional is pract​​ising when they:​

a.​

​are suffering​ fr​om a​​ mental or physical problem, an emotional disturbance, or an addiction to drugs or alcohol that impairs their ability to practise;​

​b.

​have a pattern of in​​competent practice that may pose a danger to​​ the​​ public;



​c.

​​have behaved unethically in a way that may pose a danger to the ​​p​​ublic;


d.​

​otherwise pre​​sen​​t a danger to the public.

3.​​

​Nurses report, in writing, to the appropriate regulatory body if they believe that a​​ ​​regulated health professional has engaged in sexual misconduct. ​​

​4.

​If concerns about sexual misconduct are based on information from ​​a cli​​ent, nurses must first obtain the client’s (or substitute decision-maker’s) consent before making a report.


5.

​Nurses may have additional employment obligations to report any unprofessional conduct to their supervisor/employer and should also follow applicable employment policies. If no report has been made by the supervisor or e​​mp​​loyer, the nurse must make a direct report to the regulatory body.

​6.

​Nurses working a​s employers, managers or business partners or associates ​of regulated health profe​ssionals report, in writing, to the appropriate regulatory body when they take any of the following actions against a regulated health professional based on a belief that their continued practice may pose a danger to the public because they are not competent to practise, or because their practise is impaired by a mental or physical problem, emotional disturbance, or an addiction to drugs or alcohol:2


​a.

​terminating the​​ regulated health professional’s employmen​​t;​



b.​

​revoking, suspending or imposing restrictions on the regulated h​​e​​alth professional’s privileges; or



​c.

​dis​so​​lving a partnership or association with the regulated heal​​​​th professional

7.​

​Nurses have ​a legal duty to report to BCCNM when they have been charged with or convicted of a criminal offence identified by legislation as relevant to working with children or vulnerable adults. Nurses working as employers also have a legal duty to notify the appropriate regulatory body when they become aware that an employee who is a regulated health professional has been charged with or convicted of such an offence (Crimin​al Records Review Act, ss. 12 and 17).​​​

​​Applying the principles to practice​

​​​​If you suspect incompetent or impaired practice or unethical condu​ct, con​​sider:​​​

​a.

​​​Is the regulated health professional failing to provide safe, ​competent and e​thical care?​

​b.

​Does the behaviour fail​​ to meet the standards of practice or standards for professional ethics?​

​c.

​​Has there been a ​​pattern of questionable behaviour?

​d.

​Is the regulated health professional unable, or unwilling, to recognize and correct the ​​behaviour?​

​e.

​​Have clients been har​​med by this behaviour?

​f.

​​Are clients lik​​ely to be h​armed in future?

​​Take action if you answ​​er ‘yes’ to any of the questions above. Some actions may include:​​

​a.

​Discussing your co​​ncerns directly with the regulated health professional;

​b.

​Documenting a factua​​l description of your concerns including dates, times and a description of what occurred;

​c.

​Reporting to your m​​anager or supervisor;

​d.

​Con​​sulting with the​​ appropriate regulatory body.

Whe​​n making a ​formal complaint:​​

​a.

Contact the appro​​priate regulatory body to determine what information should be included in your written complaint;

b.​

​Make your complaint factual; provide details of specific incidents includin​g​​ dates, names and a specific description of what occurred;

​c.

​Remem​​ber that, unless it is specifically part of your job (i.e., as a manager), it is th​​e regulatory body’s job, not yours, to investigate the concern.

​​​​Nurses have separate duties to rep​ort that are governed by other legislation. For more information consult the BCCNM document Legislation Relevant to Nurses’ Practice and speak with your employer or manager.​

​​​The Health Professions Act establishes requirements for consent before making a complaint about alleged sexual misconduct by a regulate​d health professional, if the complaint is based on info​​rmation provided by a client (s. 32.4(2)). Also review the BCCNM document Legislation Relevant to Nurses’ Practice for more information.​


​Gloss​ary​​

Sexual Misconduct: Sexual misconduct includes professional misconduct involving:​​

  • sexual intercour​​s​​e or other forms of physical sexual relations between a registrant and a client,

  • touching, o​f a sexual nature, of a client by a registrant, or

  • behaviour or remarks of a sexual nature by a registrant towa​​rds a client,

but does not include touching, behaviour and remarks by a registrant​​ towards a client that are of a clinical nature appropriate to the service being provided (see BCCNM Bylaws, s. 165(4)).

Regulated Health Professional: “Regulated health professional” refers to a registrant of BCCNM  or any health profession college​ under the Health Professions Act.​

Footno​tes

​​1
​“Nurse” refers to all BCCNM nursing registrants, including: licensed practical nurses, nurse practitioners, registered nurses, registered psychiatric nurses, licensed graduate nurses, employed student nurses, and employed student psychiatric nurses.
​​2
​This duty to report also applies if a nurse intends to take such action but the regulated health professional resigns, relinquishes their privileges, or dissolves their partnership or association before the nurse acts.


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​​Need help or support?​

For further guidance on understanding and applying the standards of practice, contact our team by completing the Standards Support intake form.​

900 – 200 Granville St
Vancouver, BC  V6C 1S4
Canada

info@bccnm​.ca
604.742.6200​
​Toll-free 1.866.880.7101 (within Canada only) ​


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