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 have a professional responsibility to provide regulatory supervision of student activities that affect clients (e.g., assessments, treatments, interventions). The nurse may be in any number of roles, including an instructor supervising a clinical rotation or a nurse supervising a student’s preceptorship, and has a responsibility when they agree to supervise students.
Students2 and employed student registrants3 do not have the authority to perform any activities that affect a client unless authorized by a nurse who is a registrant of BCCNM. Regulatory supervision is the process nurses follow in authorizing students to perform activities as part of:
This practice standard is to be used when nurses provide regulatory supervision to students or employed student registrants and make decisions about what care students and employed student registrants may provide to clients.
Education programs and employers provide the organizational supports and resources necessary for nurses to safely provide regulatory supervision of students and to meet the BCCNM Standards of Practice. Employers provide supports and resources necessary for nurses to safely provide regulatory supervision of employed student registrants.
Principles
1.
| Nurses are accountable and responsible for decisions associated with the regulatory supervision process, including decisions made by the nursing student. |
2.
| Nurses providing regulatory supervision of students or employed student registrants may only authorize activities: |
| a.
| for which the student has gained competence through their BCCNM-recognized education program (or equivalent), |
| b. | within the supervising nurse’s scope of practice, and |
| c. | within the supervising nurse’s individual competence.
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Notice: January 10, 2022: Effective immediately and for the duration of the COVID-19 public health emergency under the BC Public Health Act, the requirements that employed student nurses (ESNs) and employed student psychiatric nurses (ESPNs) must only undertake those activities for which they have gained competence through their BCCNM-recognized education program and only perform clinical skills learned through their education program are temporarily suspended for the activity of specimen collection for the purpose of SARS-CoV-2 screening under the following conditions: |
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a.
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The specimen collection is performed as part of a SARS-CoV-2 screening program approved by a medical health officer and the health authority. |
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b.
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The screening program is conducted according to British Columbia Centre for Disease Control guidelines.
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c.
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The ESN/ESPN successfully completes additional education established by the health authority that includes who to test, specimen collection (including pediatric considerations if applicable) and labelling, and the use of personal protective equipment.
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d.
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The ESN/ESPN is authorized to perform this activity by the registered nurse (RN), registered psychiatric nurse (RPN), or nurse practitioner (NP) who is providing the regulatory supervision and is competent in specimen collection for the purpose of SARS-CoV-2 screening.
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e.
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All other requirements of the BCCNM Employed Student Registrants practice standard and BCCNM Regulatory Supervision of Students practice standard remain in effect.
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(NOTE: ESNs and ESPNs who are not part of such a screening program are not permitted to perform specimen collection if they have not attained competence in this activity through their BCCNM-recognized education program.) |
3. | In addition to this standard, nurse practitioners supervising nurse practitioner students follow the standard Regulatory Supervision of Nurse Practitioner Student Restricted Activities in the Scope of Practice for Nurse Practitioners: Standards, Limits, and Conditions. |
4. | Nurses obtain consent from the client, when possible, about the student’s involvement in their care before authorizing activities. |
5. | Nurses set the conditions for the student to perform activities, considering: |
| a. | the client’s health condition, preferences and needs, |
| b. | the nature and complexity of activities to be performed, |
| c. | the practice setting and work environment, |
| d. | the level of supervision the student requires, |
| e. | involvement of others in overseeing the activities, and |
| f. | how the nurse will know what activities have been done and the effects on the client. |
6. | Nurses anticipate and mitigate potential and actual risks to the client arising from nursing student activities. |
7. | Nurses collaborate to establish roles and accountabilities for the components of the regulatory supervision process when more than one nurse is involved. |
8. | Nurses review and revise supervision needs on an ongoing basis. |
Applying the principles
As a nurse, you might identify and/or authorize an activity to be performed by the student or employed student registrant, on the condition that another BCCNM registrant (LPN, NP, RN, RPN) is present in the practice setting to support regulatory supervision. In this case, responsibility for regulatory supervision is shared between the nurses involved. When you share this responsibility, be clear about how you will work together to evaluate the student.
There are times when nurses may be responsible for regulatory supervision as well as employment or educational supervision. You may experience this if you are a manager or a nursing instructor/faculty member. These types of supervision can overlap; however, regulatory supervision must come first to ensure public protection. For example, there might be an opportunity for an employed student registrant to try a new skill. If they don't have the competencies from their education program, the activity cannot be authorized.
This standard only addresses students coming from education programs within Canada. For nursing students from an international entry-level program seeking a clinical experience in B.C., contact BCCNM at practice@bccnm.ca.
Footnotes
1 | “Nurse” refers to the following BCCNM nursing registrants: licensed graduate nurses, licensed practical nurses, nurse practitioners, registered nurses, registered psychiatric nurses, except where otherwise specified. |
2
| In this practice standard, “student” refers to any student in a BCCNM-recognized entry-level or re-entry nursing, practical nursing, or psychiatric nursing education program. It also includes a student from the same type of program from an institution elsewhere in Canada, approved by that province or territory’s regulator. |
3 | “Employed student registrant” refers to students who are registered with BCCNM and practising as employed student nurses or employed student psychiatric nurses. |
4 | "Nursing education program" refers to a BCCNM-recognized entry level or re-entry nursing, practical nursing, or psychiatric nursing education program, including programs from other provinces or territories in Canada, approved by that province or territory’s regulator. |
5 | LPNs are not authorized to supervise employed student registrants per BCCNM Bylaws.
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