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Standards for delegating to registered nurses

Part 6: Delegation

Standards for delegating to registered nurses

  1. Delegation is required for restricted activities that fall outside the scope of practice of registered nurses.
  2. Only certain restricted activities may be delegated to registered nurses. BCCNM and the regulatory body of the delegating professional must both agree that the restricted activity is appropriate for delegation to registered nurses.
  3. Even when the two regulatory bodies agree that a restricted activity may be delegated, the decision to delegate remains with the delegating health professional.
  4. Before a restricted activity can be delegated, the individual registered nurse to whom it can be delegated must be willing to accept the delegation.
  5. The restricted activity must be within the scope of practice of the delegating health professional.
  6. A delegating health professional with relevant expertise must ensure that the required knowledge and skill are appropriately taught, and confirm that the registered nurse performing the restricted activity has the competence to perform the restricted activity.
  7. It is not appropriate for registered nurses to teach a delegated restricted activity to other registered nurses. Any exceptions must be approved by BCCNM.
  8. Written instructions for the delegation must be provided.
  9. The delegating health professional and the registered nurse are jointly responsible for ensuring that ongoing competence is maintained through mechanisms such as continuing education, experience, re-evaluation and retraining.
  10. The registered nurse’s employer must have a process in place to authorize and support registered nurses carrying out the delegated restricted activity.
  11. Responsibility is shared when an aspect of client care is delegated. The delegating health professional continues to have a responsibility to the client and is responsible for ensuring that the registered nurse carrying out the restricted activity is competent to do so. The registered nurse has a responsibility to carry out the restricted activity safely and ethically.

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We acknowledge the rights and title of the First Nations on whose collective unceded territories encompass the land base colonially known as British Columbia. We give specific thanks to the hən̓q̓əmin̓əm̓ speaking peoples the xʷməθkʷəy̓əm (Musqueam) and sel̓íl̓witulh (Tsleil-Waututh) Nations and the Sḵwx̱wú7mesh-ulh Sníchim speaking Peoples the Sḵwx̱wú7mesh Úxwumixw (Squamish Nation), on whose unceded territories BCCNM’s office is located. We also give thanks for the medicines of these territories and recognize that laws, governance, and health systems tied to these lands and waters have existed here for over 9000 years.

We also acknowledge the unique and distinct rights, including rights to health and wellness, of First Nations, Métis, and Inuit peoples from elsewhere in Canada who now live in British Columbia. As leaders in the settler health system, we acknowledge our responsibilities to these rights under international, national, and provincial law.​