Nursing professional responsibility includes professional, legal, and ethical responsibilities and cultural safety. Nurses have a professional responsibility to demonstrate knowledge and judgment and be accountable for their actions and decisions. Nurses must also be aware of how their actions and decisions reflect on their reputation, their employer’s/organization’s reputation and the nursing profession in general.
NPs accepting clients onto their panels are responsible to ensure clients have access to a primary care provider by:
NPs decide to accept or decline new clients in good faith and not on personal judgments about the client or the client’s lifestyle. Under the BC Human Rights Code it may be considered discrimination to refuse clients for reasons of race, colour, ancestry, place of origin, religion, marital status, family status, physical or mental disability, sex, sexual orientation, gender identity or expression, or age.
NPs consistently apply and document their client selection process. If NPs choose to limit their practice based on legitimate reasons (e.g., at practice capacity, competence, work-life balance) these limitations should be clearly and publicly available (e.g., by a sign in the office, on a practice’s website), and communicated to persons seeking care.
If NPs have introductory meetings to get to know new clients and learn of their health concerns and histories, the decisions to accept or decline clients should be made on the basis of the nature and scope of their practice and composition of their panel, not on the simplicity or complexity of the clients.
NPs convey decisions to decline someone as a client honestly and respectfully, and offer assistance to find an alternative health care provider as appropriate.
Once you have given reasonable notice, you are responsible and accountable for working with the Health Authority to facilitate continuity and transfer of client care. For example, notifying clients and giving them information about how their health care needs will be met; prioritizing high-risk clients for appointments; ensuring the clinic is aware of pending diagnostic test or lab results. You may also have other obligations to the Health Authority based on your employment contract with them.
The clinic is responsible for addressing client-care needs while they recruit your replacement.
You cannot access client health records, including diagnostic test results, when you are no longer employed at the clinic. You can only remain involved in the care of these clients if you are retained by the Health Authority in some other way
(e.g., contract), to provide health services to these clients.
Thank you to the College of Nurses of Ontario for allowing us to adapt this Q & A from their NP Practice Q & A tab.
You are responsible and accountable for ending relationships in a way that considers the clients needs and ensures continuity of care. Avoid actions that could be seen as abandonment of care.
The Duty to Provide Care practice standard provides more information and guidance about your legal and professional obligations to clients.
NPs are independent contractors, not Health Authority employees when contracted to provide health services in primary care networks. You are responsible and accountable for ending relationships in a way that considers the clients’ needs, ensures continuity of care, and meets your obligations to the Health Authority based on your employment contract with them.
As a general rule, clients have a right to know who is caring for them. One way of demonstrating accountability is sharing your name and title with your clients.
All nurses have the right to be safe. Health care agencies need to balance clients' interests with staff safety. Agencies should have policies on staff identification, documentation and releasing employee names.
Yes. The college requires nurses to report criminal charges. Under the
Criminal Records Review Act, nurses charged with a relevant or specified criminal offence must promptly report it to the college.
Report as soon as a charge is laid
We require nurses to contact us as soon as a criminal charge has been laid, before the information is disclosed to us by law enforcement or other third parties. We have an obligation to deal with such information in a transparent and fair manner while pursuing our public protection mandate.
Registered nurses are also required to disclose any outstanding or recently concluded charges every year when renewing registration. Failing to do so is considered to be misconduct under the
Health Professions Act and will result in an investigation by our Professional Conduct Review department.
When we learn of a new charge or conviction for a criminal offence listed in the
Criminal Records Review Act, we (a) require you to authorize a new criminal record check, and (b) notify your employer that we are requesting a criminal record check because you have disclosed an offence listed in the Act. All nurses must consent to a criminal record check every five years.
Requirements under legislation
Criminal Records Review Act, helps protect children and vulnerable adults from physical, sexual or financial abuse. Under the Act, convictions include "conditional discharges," ""alternative measures" and "peace bonds" ordered under sections 717 and 810 of the Criminal Code.
Applicants must also disclose charges and convictions
Applicants to the college are required to disclose all outstanding charges and concluded criminal matters when applying for registration.
There are several important reasons why you cannot work as a registered nurse unless you have current practising registration with BCCNM.
If you have been practising nursing without being registered, you must stop immediately, inform your employer and contact BCCNM’s
Registration, Inquiry and Discipline Department for direction. If you have worked for more than 60 days without practising registration, you will be referred to BCCNM’s Professional Conduct Review Process.
In the meantime, your employer may determine that there is other work you can do that is not considered the practice of nursing and assign this work to you.
Situations where the need for health care is greater than the available resources require your professional judgment and ethical decision making. You are responsible for providing safe, appropriate and ethical care to the best of your ability.
The following strategies may help you:
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10 tips may provide further information and guidance for these situations. For further assistance contact
In this type of situation it is very unlikely that you would be reported to BCCNM. For BCCNM to become involved, a formal written complaint must be received, describing how a nurse’s unethical, impaired or incompetent practice puts clients’ at risk.
It’s important to remember that even in situations where you cannot provide optimal client care, you can still meet the Professional Standards. These situations are usually beyond your individual control and often require a systems approach for resolution. You are responsible for providing the best care possible under the circumstances. In these situations:
By following these steps, you are likely meeting your
Professional Standards and your obligation to provide clients with safe, competent, ethical care.
You’ll find more information and guidance in in the resource
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For further assistance contact
Your employer has a right to reassign you to another area. You were likely hired by an agency or health authority and cannot refuse to be reassigned.
Consider what care you can safely provide, while practicing within your level of competence. Clearly communicate this to the most appropriate person such as your immediate supervisor and discuss any concerns about your reassignment. Refusing a reassignment is generally justified only when the risk of harm to clients is greater if you accept than if you refuse. If you don’t have the competence to work in the assigned area, collaborate with others to determine the best option and follow up in writing.
Working in an unfamiliar practice area can be challenging and anxiety provoking. Using these strategies may help:
Working with limited resources may provide further information and guidance for these situations. For further assistance contact