• This Discussion Thread has 32 replies, 31 voices, and was last updated 1 day, 9 hours ago by Sheryl.
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    • #6036
      Sharon
      Member

      You have a new patient that needs an immediate medical response. You know that you have the knowledge, skill and judgement to perform the needed controlled act. Can you initiate this action? Y/N and why?

    • #8612
      Courtney
      Member

      Yes a RPN can initiate a procedure that is deemed necessary as long as they have the knowledgeable, skill and judgement to do so. They must also though consider any other policies or legislation that may require them from refraining to do so. The procedure must be within the nurses scope of practice and they must ensure that is safe and appropriate by: assess, identifying a problem, considering all other options, looking at the risks and benefits, making a plan of action, considering all outcomes and then accepting full responsibility. Difference between an RPN and RN in this situation is that an RN can write the order.

      • #11788
        Adetutu
        Member

        If it is emergency and it within my scope of practice,I will do the care.

    • #8783
      Tara
      Member

      Yes, an RPN can initiate a procedure in an emergent situation providing they have the skill set and knowledge to safely do so. They must consider if within their scope and is appropriate.

    • #9892
      Emma-Leigh
      Member

      After verifying the knowledge, skill, judgement and appropriate scope, yes the RPN can initiate a procedure in an emergency situation.

    • #10499
      Antoinette
      Member

      Knowledge, skill and judgment are essential when completing any nursing act. A nurse must have all three prior to initiating or performing an act independently. In addition they have to ensure that act is within their scope of practice at the organization they are practicing at. Ie. if there is training that needs to be signed off before completing an act for example IV insertion.

    • #10715
      Patrice
      Member

      In accordance with the CNO (2023), RPN Scope of Practice, a nurse can perform a needed controlled act in certain situations providing that they have the knowledge, skill, and judgment to do so. However, in certain practice settings, there might be restrictions based on legislation or policies of such facilities.

    • #11348
      Brittany
      Member

      An RPN in an emergent situation, may perform a controlled act if they have the knowledge, skill and judgment to do so. Some facilities may have different legislation that also needs to be taken into consideration but as we are governed by the CNO we cannot go above.

    • #11392
      Ayotunde
      Member

      Yes, an RPN can initiate the practice if it is within their scope of practice. Of course, the most important is the knowledge, skill, and judgement while ensuring to follow company or agency policy.

    • #11408
      Omono
      Member

      Yes, as long as you have the knowledge, skill and judgement to carry out the control act. Also want to consider the policy of your agency if it’s within the stipulated scope of practice.

    • #11633
      Amber
      Member

      Yes the RPN can carry out the controlled act if they have the knowledge, skill, and judgment to do so but they also need to consider the scope of practice and policies and procedures at their facility.

    • #11857
      Judith
      Member

      As an RPN, I will do it if I have the knowledge, skill and judgement. suppose it is within my scope of practice and the company policy.

    • #12138
      Adeola
      Member

      After reviewing the facility’s policy and my competencies regarding the controlled act to be performed, If it is within my scope of practice and I have the knowledge and skills to perform the act, I will complete it as RPN may perform some controlled act in an emergency.

    • #12208
      Christiana
      Member

      It depends on the practice setting. Yes, RPNs with the knowledge, skill, and judgement can initiate a controlled act as long as it is allowed in that practice setting.

    • #12251
      Coleen
      Member

      As an RPN (Registered Practical Nurse), if I have the knowledge, skills, and judgment to perform a needed controlled act for a new patient requiring immediate medical response, I can initiate the action within the scope of my practice. Controlled acts are specific procedures or actions defined by legislation that require a regulated healthcare professional to perform due to their potential risks. RPNs are authorized to perform certain controlled acts within their scope of practice as defined by the regulations and guidelines provided by the regulatory body governing nursing practice in their jurisdiction. However, it’s essential to ensure that the action is within my scope of practice, aligns with organizational policies and procedures, and is in the best interest of the patient’s health and safety.

    • #12267
      Shannon
      Member

      Yes, as long as i have the knowledge, skill and judgement to complete the task at hand. Also need to ensure that its not only within the standards of the CNO but your agency as well

    • #12455
      Paige
      Member

      Yes, because you have the knowledge, skill and judgement to do so.

    • #12576
      Adriana
      Member

      That is an absolutely yes while prioritizing client’s safety, and following the guidelines of the CNO as well the organizations in which this event is happening.

    • #12608
      Brianne
      Member

      Yes, as you have the knowledge, skill, and judgement to control the outcome of the controlled act. But if you feel uncomfortable and need additional assistance, you are always better off asking for help over trying to do it yourself, especially the first time.

    • #12613
      Julian
      Member

      Yes, I would first check if its permitted in the policies of the facility and than if I have the knowledge and skill to perform the procedure; also if its in my scope of practice. After that I would complete the procedure.

    • #12666
      Kerisha
      Member

      Yes, the patient needs an immediate response and I as their nurse have the skills, knowledge and judgement to provide care that is within my scope to help that patient.

    • #12748
      Nicole
      Member

      It is important to utilize tools such as the three-factor framework because it may help better understand whether the nurse can initiate the medical intervention required. Things that must be considered are scope, competency, legislation, and policy. While the nurse may have the knowledge, skill, and judgment to perform the controlled act, there needs to be accountability in the workplace.

    • #13169
      Ngan
      Member

      The initiation of immediate medical response is dependent on many factors. The three factor risk assessment is a tool that can be utilize in determining if the nurse should preform the needed control act. As the nurse who is competent, possessing the knowledge, skill and judgement the initiation of action leans towards, yes.
      However, the risk factor of “the patient” and “the environment” still has to be taken into account before a definitive answer can be achieved. With the environment factor RPN’s and RN’s have the ability to decided the need of a procedure in absence of a directive or policy but this authority is limited by other legislation and policy. In the case that the organization does not allow or support the nurse to preform such acts then the performance of the controlled act cannot be completed.
      With concern to the patient’s risk factors the nurse needs to asses that in that moment they are the most appropriate person to preform the controlled act. If there are other safe guards in place to protect the patient and minimize risk. Another person who is available, more competent and able to preform the controlled act then the nurse should perform the act to prevent potential harm and minimize risk.

    • #14790
      Yanique
      Member

      Yes, I can initiate the action if the controlled act is within my scope of practice and legally permitted by my regulatory body to perform.
      However, it’s important to note that while I may have the knowledge, skill, and judgment to perform the controlled act, the decision depends on my professional regulations and practice context.

    • #14801
      Janecia
      Member

      Yes, if its within my scope of practice and also if the situation is an emergency where immediate action is required to prevent serious harm, I would use my professional judgment to intervene appropriately while ensuring that I document and report my actions to the appropriate healthcare provider.

    • #14843
      Gagandeep
      Member

      Yes, if it’s within my scope and I meet the CNO’s criteria for initiation. If I have the knowledge, skill, and judgment to perform the controlled act safely and it’s necessary for the patient’s well-being, I can proceed. But if an order is required, I’d need to get it first since patient safety always comes first!

    • #15001
      Nancy
      Member

      Registered Nurses (RNs) are permitted to perform controlled acts if they have the necessary authorization or in emergency situations. They can carry out these acts only when they receive an order from a physician, nurse practitioner, or another healthcare provider who is authorized to delegate these tasks. RNs may also act under a medical directive, which is a pre-approved order that allows them to perform specific controlled acts in defined circumstances.

      In emergencies, the Regulated Health Professions Act (RHPA) grants RNs the ability to take action without a prior order when it is essential to prevent serious harm. If a situation is life-threatening and demands immediate intervention, RNs can proceed under the doctrine of necessity. However, they must document and justify their actions afterward, ensuring they possess the appropriate knowledge, skills, and judgment to carry out the controlled act safely.

      • #15037
        Rose
        Member

        Hi,
        You’re absolutely right, Nancy! RNs can perform controlled acts if they have the necessary authorization, in emergency situations, or under a medical directive. In emergencies, RNs can act without a prior order if it’s necessary to prevent serious harm, as long as they have the required knowledge, skills, and judgment. It’s crucial that they document and justify their actions afterward to ensure patient safety and accountability. Thanks for sharing!
        Rose

    • #15036
      Rose
      Member

      Yes, if I know that I have the knowledge, skill, and judgment to perform the needed controlled act of RNs, I will perform it. In an emergency or urgent situation, patient safety is the priority, and if I am confident in my ability to carry out the act competently, I will take action to ensure the patient’s immediate needs are addressed. It is essential to act within my scope of practice and follow the guidelines set out by my professional regulatory body, but in situations where my competence and the circumstances allow, performing the controlled act is necessary to prevent harm and provide the best care.
      Thanks !
      Rose

    • #15070
      Wafaa
      Member

      Yes, I can initiate this action as Registered Nurses (RN) are authorized to initiate controlled acts if have the necessary knowledge, skill, and judgment to do so safely. The CNO recognizes that emergencies can require urgent action, and in these situations, RNs are expected to act in the best interest of the patient, based on their professional training.

    • #15510
      Audrey
      Member

      Yes and once it is within the scope of practice of the RPN.

    • #15588
      Sheryl
      Member

      First of all i need to identify what is the immediate responce and what kind of procedure . If I have the skills then Yes , because I have the knowledge and judgement and I am confident to perform the procedure in a safely manner. I also accepts the accountability but since I am only a new nursing graduate what I can do for now is to advocate and support the client since i dont have much experience but it depends on the situation

    • #15589
      Sheryl
      Member

      yes, if i have the right knowledge, skills and judgement doing it safely and ethically.

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