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​I'm an NP and want to work as an RN. Can I d​o this?

Yes. Practising NP registration allows an NP to also practise as an RN. When working as RNs, NPs work within the RN role and scope of practice. They use the title RN, not NP, when working in the RN role.​

Things to consider

  • Employer policies may not allow NPs to work as RNs.
  • To work as a certified practice RN (RN(C)), you need to apply to BCCNM to be certified.
  • RN and RN(C) hours do not count as NP practice hours for the purpose of renewing your NP registration.
  • NP privileges granted by a health authority do not apply when working in RN roles.
  • There m​ay be legal implications for an NP working as an RN. Contact CNPS to understand the legal implications for your situation.

Keep in mind that if you are working in an RN role, you are still an NP registrant under BCCNM bylaws. This means you have a duty to provide care in some emergency situations (e.g., situations involving imminent risk of death or serious harm that arise unexpectedly and require urgent action) within your competence and to the standard of an NP.

​Questions to ask yourself if you are an NP considering work as an RN

  • How will I manage potential role confusion/conflict with clients, families, and the health care team?
  • How will I manage expectations and role boundaries when working in both an RN and NP role?
  • How will I protect clients' privacy and maintain confidentiality?
  • What do I need to consider related to documentation and access to client records?
  • How will I maintain my fitness to practice when working in two roles?
  • If I'm a new NP, ​how will I ensure I have a good transition to the NP role and consolidate my NP practice? 

Consider these scenarios

You work as an independent contractor NP in a primary care network (PCN). You don’t have hospital privileges as an NP. You pick up shifts as an RN on the surgical unit at the hospital on weekends (read more).

You come on your first shift and see that one of your PCN clients is about to be discharged from the unit and you want to review their records. What do you do?

  • Act proactively to avoid role conflict. Advise the manager of the potential conflict and ask not to be assigned to your PCN client.

  • If you are not assigned/providing care to the client, you are not authorized to access their medical records. Doing so would breach the Privacy and Confidentiality standard and, likely, the hospital policy.

  • If you are assigned and/or your PCN client attempts to engage with you as an NP, clearly communicate that your role on the unit is as an RN, not as their primary care NP.​

You pick up a shift working as an RN in the Emergency Department (ED). A client from your NP practice is sitting in the waiting room and sees you (read more).

The client approaches and asks you to renew a duplicate prescription for the medication that you prescribed in your NP role. What do you do?

  • Nurses only carry out medication-related activities for clients under their care. As the person is not your client when you are working your shift as an RN, you cannot write a prescription. Also, in the RN role, RNs are not authorized to write prescriptions for Schedule IA medications. Clearly explain to the client your role and why you cannot write the prescription.

You are working a shift as an RN in a remote community nursing station. A client asks for a prescription for birth control. What do you do? (read more)

The RN scope of practice does not authorized RNs to write prescriptions for Schedule I medications (note that certified practice nurses are authorized to prescribe a limited number of Schedule I medications). Because you are working in the RN role, you are not authorized to write this prescription. In situations like this, you would need to refer the client to someone who is authorized to prescribe.

You work casually as an RN in a specialty clinic in a health authority. You also just started working part time in the clinic as an NP. During one of your RN shifts, the unit’s other NP goes home sick around noon (read more).

The manager asks you to cover the unit’s NP role for the rest of your shift. What do you do?

  • In situations like this, you need to determine with the manager which role you will be working in. If you are taking over the NP’s role, then arrangements will need to be made to cover your RN assignment. The change in your role should be clearly communicated to all staff on shift. Make sure that when you sign into a client’s medical record, your unique identifier reflects the role/title you are working in.


Resources

Use of Title practice standard

Privacy and Confidentiality practice standard

Duty to Provide Care practice standard​​​​