Ontario nurses groups concerned over regulatory body’s plan to expand RPN duties

Dr. Angelo Zizzo was a longtime family physician in Hamilton. AP Photo/ Khalil Hamra

TORONTO — Two groups representing Ontario nurses are raising concerns about their regulatory body’s decision to expand the scope of practice for registered practical nurses in the province.

The Registered Nurses Association of Ontario and the Ontario Nurses Association are now calling on the provincial government to delay the change until after the COVID-19 pandemic ends and the Health Professions Regulatory Advisory Council conducts consultations.

“The College of Nurses of Ontario (CNO) made a shocking and stunning decision approving a regulation change for the Registered Practical Nurse (RPN) scope of practice … that will seriously jeopardize the safety of the public,” the two groups said in a statement.

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The change, the groups said, disregards the difference in educational requirements for the two different types of nursing practices and allows registered practical nurses to carry out duties currently reserved for registered nurses.

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The groups have launched a petition asking the provincial government to halt the move for now.

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A spokesperson for the Ministry of Health said in an email that it’s reviewing the proposal and has yet to make a decision, but that it remains committed to providing Ontarians with “high-quality care.”

The College of Nurses did not immediately respond to request for comment.

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Meanwhile, the Registered Practical Nurses Association of Ontario said it believes its members, if they have the appropriate knowledge, should be allowed to work within the expanded scope of practice.

It said registered practical nurses already perform procedures such as wound care and starting an IV when given an order, and should be allowed to initiate them as well — just as registered nurses can.

“We are very pleased that the College of Nurses have moved ahead with it,” said Registered Practical Nurses Association of Ontario CEO Dianne Martin.

Martin said nurses in the field say their patients were not receiving timely care because of unnecessary barriers, particularly in home care and community care, where registered practical nurses work independently.

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She added that expanding their scope of care would be an “updating of the legislation” to match knowledge the nurses already have.

Sioban Nelson, vice-provost and former dean of the University of Toronto’s faculty of nursing, said that while nurses’ scope of practice should evolve over time, this move would reduce training requirements.

“What it effectively does is it dissolves the distinction between bachelor degree-prepared nurses and two-year-prepared practical nurses,” she said.

Nelson said the development is a step backward in Canada’s efforts to move toward a degree-prepared nursing workforce.

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