Nurses (Registered Psychiatric) Regulation, section 6(a):
registrant in the course of practising psychiatric nursing may make a nursing
diagnosis identifying a condition as the cause of the signs or symptoms of an
Nursing diagnosis means a clinical judgment of an individual's mental or physical condition to determine whether the condition can be ameliorated or resolved by appropriate interventions of the registrant [as authorized under the Act] to achieve outcomes for which the registrant is accountable.
The Regulation sets out the type of diagnosis RPNs can make. Specifically, RPNs make a nursing diagnosis that identifies a condition – not a disease or disorder – as the cause of a client's signs or symptoms. A nursing diagnosis is a clinical judgment of a client's mental or physical condition. It is made to determine whether the condition can be improved or resolved by the RPN intervening appropriately to achieve a result for which the RPN is accountable.
RPNs diagnose and treat a variety of conditions, including those that are resolved with nursing treatment and others that require another health professional to diagnose and treat the underlying disease. Some conditions result from a known disease or treatment of that disease (e.g., disturbed sensory perception, impaired mobility related to medication, hypoglycemia). Others require stabilization until another health professional can diagnose and treat the underlying disease (e.g., severe bleeding, acute confusion). Other examples of conditions that are diagnosed and treated by RPNs include anaphylaxis, panic, constipation related to diet and some wounds.
Before treating a condition, RPNs must first collect information using their assessment and critical thinking skills to formulate a nursing diagnosis.
In some practice settings and roles, RPNs may provide diagnostic impressions (previously this may have been referred to as a provisional diagnosis) of diseases and disorders if they have the competence to do so. A diagnostic impression:
May be temporary with the intent that it will be replaced with a diagnosis from a member of a health profession whose scope of practice permits diagnosing a disease or disorder.
May be used for triage or entry into service which allows RPNs to initiate care/services until, where possible, the client can be assessed by a member of a health profession whose scope of practice permits diagnosing a disease or disorder.
some health authorities, RPNs may be required to complete a field in a fillable
electronic record that contains a term other than diagnostic impression such as
“provisional diagnosis.” The RPN may complete this form with the understanding
they are providing a diagnostic impression.
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