What will I learn?
- What scope of practice is and how it is established.
- Key concepts related to scope of practice.
Standards
- Scope of practice standards
Scope of practice overview
Scope of practice is the activities listed in the
Nurses (Licensed Practical) Regulation that LPNs are educated and authorized to perform. The provincial government writes and approves the Regulation. BCCNM then determines:
Activities fall into three categories:
LPNs provide care to clients by:
- Acting within autonomous scope of practice (performing not restricted activities and Section 6 restricted activities).
|
- Acting with a client-specific order from
|
|
- a listed health professional for a Section 7 restricted activity.
|
|
- a non-listed health professional for an activity that is within the LPN scope of practice and the individual nurse's competence.
|
Scope of Practice standards
The Scope of Practice Standards set the standards, limits, and conditions for the activities nurses are educated and authorized to carry out. These scope of practice standards link to other BCCNM standards and bylaws, and all legislation relevant to nursing practice.
The LPN scope of practice standards include:
- Acting within autonomous scope of practice – when carrying out not restricted and section 6 restricted activities unless the activity is excluded by BCCNM.
Scope of standards comparison by designation
Aspects of nursing scope of practice
Nursing scope of practice has two aspects:
All nurses work within the nursing profession's scope of practice as outlined in the
Regulation. This is also called the profession's
legislated scope of practice as it is based on legislation.
Scope of practice activities link to:
BCCNM documents
- Entry Level Competencies
- Standards, limits, and conditions
-
BCCNM bylaws
- Controls on practice
Individual nurse's scope of practice
The individual scope of practice is an individual nurse's unique scope of practice, which is often narrower than the legislated scope of practice. Each nurse's individual practice will look different.
Nurses determine their individual scope of practice within their practice settings by reflecting on:
- Their education (including additional education) and experience.
- Authority to perform activities.
- Individual competence – their ability to integrate and apply knowledge, skills, and judgment for safe and appropriate performance in practice.
- Workplace policies that may restrict practice.
Key Concepts
Many of the terms and concepts used throughout the scope of practice standards have specific legislative meaning, which can differ from the words in everyday use.
- Restricted activities
-
Restricted activities are clinical activities that pose a risk of harm to the public. These include restricted activities that “do not require an order" (section 6) and restricted activities that “require an order" (section 7).
- Autonomous scope of practice
-
Autonomous scope of practice refers to the activities and responsibilities that a nurse is educated, competent and authorized to perform independently, without direct supervision or direction from a physician or other health-care provider. Acting within autonomous scope of practice means nurses assume accountability and responsibility for::
- Making decisions about client care, and
-
Performing activities that are within their autonomous scope of practice (includes activities that are not restricted and Section 6 restricted activities).
Autonomous scope of practice does not include any activities, care, or services excluded under BCCNM standards, limits, and conditions, and controls on practice. Read more about
acting within autonomous scope of practice.
- Client-specific order
-
Client-specific order, often just called an 'order', is when a regulated health professional authorizes/instructs a nurse to perform an activity for a specific client. A client-specific order can include non-restricted or restricted activities.
A client-specific order is:
- Documented in the client's health record, and
- Includes all information to carry out the activity safely (such as time, frequency, dosage, route), and
- Includes the health professional's unique identifier (written signature or electronic identifier).
Read more about
acting with client-specific orders.
- Nursing diagnosis
-
Nursing diagnosis is a clinical judgment about a client's mental or physical condition. General practice nurses make nursing diagnoses that identify conditions, not diseases or disorders, as the cause of a client's signs or symptoms. A nursing diagnosis is used to determine if nursing interventions can improve or resolve the client's condition. Certified practice nurses are authorized to diagnose a limited number of diseases and disorders.
Read more about
diagnosing and treating conditions.
- Prescribe
-
Prescribe is to issue a prescription (written or electronic) for a pharmacist to dispense a specified medication to a specific client. Prescriptions can also be issued for medical devices. BCCNM only authorized certified practice nurses and nurse practitioners to prescribe. Read more about
certified practice nurse prescribing.
- Regulated health professional
-
Regulated health professional is a health professional registered with a profession's regulatory body. They meet specific requirements to be registered and abide by the bylaws and standards set by their regulatory body. Not all health professions are regulated – for example, homeopaths, clinical counsellors, and health care aides are unregulated.
Case studies
- Case study series: Diagnosing and treating conditions
|
|
|
| |
|
| |
|
| |
|
|
|
FAQs
- Can a nurse pronounce death?
-
Yes, a nurse can pronounce death. In B.C. there are no laws governing who can pronounce death; however, BCCNM has limits and conditions on pronouncing death, and your workplace may have policies and procedures related to this.
NPs can pronounce death related to Medical Assistance in Dying (MAiD) however, LPNs, RNs, and RPNs are not authorized to pronounce death related to MAiD.
Resources
BCCNM resources
External resources
Related BCCNM public notices
Review the following consent agreements to see how not meeting BCCNM Standards of Practice can affect your nursing practice.
- (Title of notice to be hyperlinked)