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Hazardous forms of energy




apply ultrasound for the purposes of bladder volume measurement, blood flow monitoring or fetal heart monitoring




apply electricity for the purpose of defibrillation in the course of emergency cardiac care;




apply electricity for the purpose of providing transcutaneous electrical nerve stimulation;

The Regulation permits registered nurses to use ultrasound without an order to:

  • Measure bladder volume
  • Monitor blood flow (e.g., assessing pedal pulses)
  • Monitor the fetal heart

The Regulation also states that registered nurses may apply electricity to defibrillate during the provision of emergency cardiac care. Registered nurses can use automatic external defibrillators to provide basic emergency cardiac care. Application of electricity using a manual defibrillator, however, is subject to the following limits and conditions.

BCCNM Limits and Conditions

Registered nurses who, in the course of providing emergency cardiac care, apply electricity using a manual defibrillator must possess the competencies established by Providence Health Care and follow decision support tools established by Providence Health Care.

Some forms of electricity do not present a high level of risk (i.e., they do not destroy tissue or alter central nervous system function), and BCCNM considers applying these forms of electricity to be within the scope of practice of registered nurses. Transcutaneous electrical nerve stimulation is an example of nursing practice that uses the application of such electricity.

Applying laser for the purpose of cutting or destroying tissue is considered a restricted activity. Registered nurses have not been authorized to apply laser autonomously. The Regulation only permits registered nurses to apply laser, with an order, for the purpose of destroying tissue. See Section 7: Restricted Activities that Require an Order.