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​Nursing scope of practice is shaped by more than just what's legally allowed. It is defined by four controls on prac​tice: legislation, BCCNM bylaws and standards, employer policies, and the nurse's individual competence. ​

While nursing regulations may authorize certain activities, nurses can only perform them if permitted by all four controls on practice. Each control may narrow what a nurse is allowed to do, but none can expand beyond what is allowed by the level below.​


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​​​Level 1: Legislation and nursing regulations

This level sets the legal foundation for nursing practice in B.C., through the Health Professions Act (HPA) and the Health Professions and Occupations Act (HPOA) and nursing regulations. These laws ensure that all nurses provide safe, ethical, and competent care. The legislated scope applies to all nurses, regardless of setting (e.g., hospital, community, long-term care, or self-employment).

Example: A nurse in an ER and a school nurse follow the same legislated scope, though they apply it differently based on their roles.​​

Level 2: BCCNM bylaws​​, standards, limits, and conditions

BCCNM sets practice standards and may place limits or c​​onditions on certain activities authorized in the regulation. Bylaws may also set additional requirements for practice.

Example: BCCNM may require additional education before you are authorized to perform specific activities, like venipuncture. 

Level 3: Organizational policies​​

Employers may create workplace policies that lim​​it or specify how certain activities are performed. Sometimes, employer policies are more restrictive than legislation or BCCNM standards.

Employer's job descriptions should clearly outline ​​​a nurse's expected responsibilities within a specific role. Employers may require additional education or certification for nurses to perform certain activities.

If you are self-employed, you are considered the ​employer. It is therefore your responsibility to develop appropriate policies and procedures to inform your practice and that of your employees. 

Examples:​​

  • ​A hospital may allow nurses to insert IVs but require additional training before perf​orming advanced IV therapy.
  • ​A nurse wo​​rking in an intensive care unit (ICU) may be authorized to assist with ventilator management, whereas a nurse in a long-term care facility may not be.
  • A nurse may be legally allowed to perfo​rm a certain activity, but their employer may prohibit it due to safety concerns, resource limitations, or organizational policies.

​​Level 4: Individual nurse competence

While legislation/regulations, BCCNM​​ standards, and employer policies define what nurses are allowed to do, a nurse's individual competence determines whether the nurse can safely perform an activity.

Competencies are unique to each nurse and expand w​ith additional education and experience. Example: A nurse who has been practicing for 20 years will have a greater scope of practice based on their competencies than a newly graduated nurse. 

The controls on practice help ensure that every nursing activity you perform is safe, appropriate, and within your legal scope of practice. By walking through each level—legislation and regulation, BCCNM standards, employer policies, and your own competence—you can determine whether you are authorized and safe to proceed. The final consideration before performing any activity is whether it is in the best interests of the client. Remember, just because you can doesn't mean you should.​

​​​Need help or support?​

For further guidance on understanding and applying the standards of practice, contact our team by completing the Standards Support intake form.​

900 – 200 Granville St
Vancouver, BC  V6C 1S4
Canada

info@bccnm​.ca
604.742.6200​
​Toll-free 1.866.880.7101 (within Canada only) ​


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, Inuit​ and Métis 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.​