Skip to main content

A: The Nurses (Registered) and Nurse Practitioners Regulation


The Nurses (Registered) and Nurse Practitioners Regulation (the Regulation) sets out, among other things:

  • Reserved titles for nurses1
  • A scope of practice statement
  • Restricted activities for registered nurses and nurse practitioners

Scope of Practice

Scope of practice refers to the activities that nurse practitioners are educated and authorized to perform. These activities are established through the legislated definition of nursing practice and are complemented by the standards, limits and conditions set by BCCNM.

The Regulation states that registrants of BCCNM may practise nursing. Nursing is defined in the Regulation as “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, implementing and evaluating interventions, and

 

iii.

coordinating health services;

c)

Medical assistance in dying.”

Duty to Provide Care

As set out in the Duty to Provide Care Practice Standard, nurse practitioners provide care only within their authorized scope of practice, except:

  • In situations involving imminent risk of death or serious harm that arise unexpectedly and require urgent action. In emergencies, nurse practitioners are ethically obliged to provide the best care they can, given the circumstances and their level of competence.2
  • In situations where a restricted activity has been formally delegated. To date, no activities for nurse practitioners have been approved for delegation. Delegation under the Health Professions Act requires an agreement between the College of Physicians and Surgeons of British Columbia (CPSBC) and BCCNM.

Restricted Activities

Restricted activities are clinical activities that present a significant risk of harm to the public and are therefore reserved for specified health professions only.3 The Regulation assigns specific restricted activities to registered nurses and nurse practitioners.

  • Section 9 of the Regulation describes the restricted activities that can be carried out by nurse practitioners. Examples of these activities are diagnosing a disease or disorder, prescribing drugs, and ordering forms of energy such as diagnostic imaging services, ultrasound and laser.
  • Sections 6 and 7 of the Regulation list the restricted activities that registered nurses may carry out as part of general practice.4 Section 7 of the Regulation describes the restricted activities for which registered nurses require an order. As the scope of nurse practitioner practice builds on the scope of registered nurse practice, nurse practitioners are authorized to independently carry out Section 6 and 7 activities. They are also one of the listed health professionals who can issue orders to registered nurses for Section 7 activities.

Many activities that registered nurses and nurse practitioners carry out are not restricted. The Regulation includes these activities in the broad definition of nursing. They are fundamental to registered nurse and nurse practitioner practice, and many are complex. They include activities such as counselling, health promotion and the prevention of some illnesses and injuries.

Footnotes

1

See the Appropriate Use of Titles Practice Standard and the BCCNM Bylaws for more information.

2

Employers and nurses should not rely on the emergency exemption when an activity is considered an expectation of practice in a particular setting.

3

Nursing diagnosis is a clinical judgment of an individual's mental or physical condition to determine whether the condition can be ameliorated or resolved by appropriate interventions of the nurse to achieve outcomes for which the nurse is accountable.

4

For more on registered nurse scope of practice, refer to BCCNM’s Scope of Practice for Registered Nurses: Standards, Limits and Conditions.


 

» Next: The Role of BCCNP: Standards, Limits and Conditions

« Previous: Introduction