Practical Nurse Scope of Practice

Authorization to perform a controlled act depends on the presence of an order, directive, delegation, or another recognized mechanism that permits the act for the specific client and setting. It is important to understand that an assignment from another nurse or a prescriber does not expand the legal scope of practice, nor can a nurse’s previous experience substitute for a required authorizing mechanism. Controlled acts may be authorized either through the regulatory framework itself or via an appropriate authorizing mechanism, which varies depending on the province and practice setting. While an order is one possible mechanism, the presence or absence of a client-specific order does not carry the same implications in every jurisdiction. For example, Ontario RPNs may initiate certain controlled acts, such as medication administration and catheter insertion, without a client-specific order, provided they possess the required competence, have an appropriate authorizing mechanism, and are working in a setting that permits such practice. Additionally, any written or verbal authorizing mechanism must be properly documented. When care is delegated, it is essential to confirm that both the authorizing mechanism and...