Consultation Overview
“Scope of practice” defines the roles, functions and accountabilities that a nurse is educated and authorized to perform in delivering nursing care in Nova Scotia. The Nursing Act defines the scope of practice for LPNs, RNs, and NPs. The scopes of practice for these designations overlap, but are different and distinct from each other.
The new Nursing Act also contains a definition of “nursing services”, which outlines the scope of practice for the entire nursing profession. This is seen as the “outer limits” of nursing scope of practise in Nova Scotia. The scopes of practice for LPNs, RNs and NPs all fall within the definition of nursing services. Practice which exceeds this outer limit is not permitted by any nurse in Nova Scotia.
Within this structure of scope of practice, NSCN has the ability to approve “expanded scopes of practice”. The concept of “expanded scope of practice’ was included in the Nursing Act to allow NSCN the ability to modify the scopes of practice of LPNs and RNs within the limits of nursing practice for the profession.
The Nursing Act defines “expanded scope of practice” to mean: “…those services not presently in the scope of practice of a particular designation, but within the scope of practice of the nursing profession, approved by the Board for practice by registrants who have completed education approved for that purpose by the Board.”
To approve an expanded scope of practice, the Board must approve by-laws “respecting the approval procedures for expanded scopes of practice and for educational prerequisites for expanded scopes of practice”.
Once approved, the by-laws will permit the Board to expand the scope of a particular nursing designation as long as it does not exceed the scope for the profession.
RN prescribing is one example of expanded scope of practice. RN prescribing enables qualified registered nurses to prescribe medications and devices (excluding controlled drugs and substances, methadone, investigational agents, or medical cannabis) and order and interpret relevant screening or diagnostic tests within their specific area of clinical expertise, prescribing competence, and practice context.
On January 1, 2022, NSCN is enabling RN prescribing practice in Nova Scotia as part of a collaborative effort between the provincial government, employers, and educators to support the public’s access to timely care. In order to approve RN prescribing as an expanded scope of practice, the Board requires new by-laws which provide approval procedures for expanded scopes of practice and required educational prerequisites.
The proposed by-laws permit the Board to approve, by resolution, an expanded scope of practice for registrants, provided it is satisfied that that certain criteria have been meet, both for the proposed expanded scope and for the proposed educational prerequisites registrants must complete in order to qualify for the expanded scope of practice.
To participate in this consultation, please review the proposed new by-laws below and email NSCN if you have any feedback.
Proposed New By-Laws
PART IX – EXPANDED SCOPES OF PRACTICE
30. Approval procedure for expanded scopes of practice
30.1 The Board may by resolution approve an expanded scope of practice for a specified nursing designation when satisfied in such manner as determined by the Board of all of the following:
30.1.1 the proposed expanded scope of practice falls within the scope of practice of the nursing profession;
30.1.2 Standards of Practice and Competencies for the proposed expanded scope of practice will be approved by the Board prior to any registrant engaging in the expanded scope of practice;
30.1.3 a consultation process approved by the Board has been completed; and
30.1.4 it is consistent with the objects of the College to approve the proposed expanded scope of practice.
31. Approval procedure for educational prerequisites for expanded scopes of practice
31.1 The Board may by resolution approve educational prerequisites for an expanded scope of practice for a specified nursing designation when satisfied in such manner as determined by the Board of all of the following:
31.1.1 the proposed education program includes the curriculum, resources and activities that collectively prepare the graduate of the program to safely, ethically and competently engage in the expanded scope of practice;
31.1.2 the proposed education program is subject to regular evaluation in such manner and at such intervals as determined by the CEO;
31.1.3 the institution offering the proposed education program has a system in place acceptable to the CEO to provide timely information respecting the status of registrants in the program;
31.1.4 the institution offering the proposed education program has a system in place acceptable to the CEO to notify and consult with the CEO respecting any proposed changes to the program;
31.1.5 the proposed education program meets such other criteria as determined by the Board to be relevant to the specific expanded scope of practice.
Overview of Feedback on the Proposed Bylaws
All of the feedback received centered around support for enabling expanded scope of practice and particular RN prescribing. No feedback on the proposed bylaws was received.
Consultation Next Steps
NSCN will share the by-law feedback with the NSCN Board for their consideration, prior to their vote on whether to approve the by-laws. If approved, an updated by-laws document will be posted on the website.
