All BCCNM registrants are required to practice according to the college's Standards of Practice. This guide is to help you identify your responsibilities as a self-employed nurse (LPN, RN, RPN, NP) so that you practise according to related legislation, regulations, bylaws and standards.
While BCCNM Standards of Practice, bylaws, policies and guidelines apply to nurses in all practice settings, there are some aspects of these that have particular importance for those who practise in a self-employed role.
Each BCCNM registrant is accountable for the practice they provide to the public. BCCNM has developed resources to assist nurses to provide safe and ethical care. These resources are intended to support, not replace, your professional judgement.
It is strongly recommended that persons interested in self-employed practice contact their liability insurance provider as well as consult a lawyer, accountant and/ or business consultant regarding contracts and business processes.
BCCNM’s Standards of Practice set out practice requirements for all nurses and must be met by those in independent practice.
Practice Standards set out the requirements related to specific aspects of nursing practice. Practice Standards of particular significance to self-employed practice include: Consent, Documentation, Duty to Provide Care, Privacy and Confidentiality, Boundaries in the Nurse-Client Relationship, Conflict of Interest, and Appropriate Use of Titles by Nurses.
Scope of Practice Standards set out the standards, limits and conditions for nurses. Scope of Practice Standards for NPs is further specified for family, adult and pediatric NP practice. The BCCNM standards for Acting within Autonomous Scope and Acting with Client-specific Orders in the Scope of Practice Standards provide direction for independent practice and decision making.
Quality Assurance requirements are set out for nurses for their annual renewal of practising registration. These include:
Nurse practitioners must meet additional quality assurance requirements stemming from the legislated scope of nurse practitioner practice. These include an on-site peer review and chart audit for quality assurance purposes.
A communicable disease is caused by an infectious agent that is spread from person to person, either directly or indirectly. Review BCCNM's applicable Communicable Diseases: Preventing Nurse-to-Client Transmission practice standard to understand your responsibility on preventing, detecting, and controlling the spread of infectious agents from nurse to client.
Before becoming self-employed, ensure you have the competencies required for the services you will be providing. When self-employed, you assume the responsibility of an employer both for yourself, and any others that you employ. This may involve setting policies, adopting decision support tools (DSTs), and following relevant legislation. You must also consider the controls on nursing practice, which are defined in your scope of practice standard.
Nurses, like other health care professionals, can be sued by clients, former clients, their families, or their legal representative(s). If a claim is made against a nurse, it can be helpful for the nurse to have access to the client health record.
Record retention practices are affected by the time within which a legal claim can be made against a nurse. The Limitation Act sets out the time periods within which a lawsuit can be commenced in the civil justice system.
We recommend that nurses who are storing health records consult a lawyer for advice regarding the retention of records.
No, it is not appropriate to refer clients from your employment to your private business. Your personal interests could interfere with your professional judgment or your clients’ best interests. For example, your clients may think by hiring you as a foot care nurse, they will receive better home care services.
Refer to the
Conflict of Interest and
Boundaries in the Nurse-Client Relationship practice standards for more information.
No, you may not use the BCCNM logo in connection with your business.
In addition, you may not make any other representation implying your self-employed practice is connected to or endorsed by the college, or that you are speaking on behalf of or in any way representing BCCNM.
Yes, you must inform BCCNM as soon as you become self-employed.
Every time you renew your registration or request a change in status you will be asked on the relevant form whether you are self-employed. If you are self-employed you must answer “yes” to this question and provide the additional information requested (your practice area and evidence of your insurance), even if you have previously informed BCCNM of your self-employment.