[Sharon]

(from the Activities above) Pick one of the statements that you indicated was False and explain why, provide an example.

[Melanie]

Think about a current or previous patient care area where you’ve worked:

For this specific module, I chose to go back many years to a patient care area that I worked in back in 2008 while living and practising in Alberta.

1. Consider the nursing functions that both RPNs and RNs perform to deliver patient care and support inter-professional teamwork in that area.

I was working at the IVF clinic as an LPN. Our clinic was staffed with LPN’s and RN’s as well as OB/Gyns and Embryologists.

2 . Consider the roles, functions, and patient care scenarios that are outside the scope for RPNs and therefore the sole domain of RNs.

During my employment there (2008-2009) the LPN’s were in the Surgical suite during the oocyte retrievals assisting the OB/GYN. There were no RN’s in the suite during the retrievals. However, for the Embryo transfer procedure, the RN’s were in the suite assisting the OB/Gyn, LPN’s were not as this was not part of our role.

The RN’s were also able to perform the IUI (Intrauterine insemination) on patients, but LPN’s were not.

These practices may have changed over the years in Alberta seeing as it’s now 2026.

According to the CNO Scope of Practice, RPN’s in Ontario can perform the controlled act ” putting an instrument, hand or finger beyond the labia majora” as long as it’s authorized in their practice setting and the nurse’s competency.

[Marion Catherine]

1) “Fiscal realities have resulted in replacing RNs with RPNs” (activity 2) and
2) “While implementation requires practice and psychomotor skill, it also often requires less depth and breadth of knowledge” (above) are statements that I have found to be untrue.
In the first case, if RPN’s replaced missing RN’s then there wouldn’t be so many shortages. How nurses are treated generally by the industry and society could point a finger at why there are shortages.
In the second case, the reason for implementing an intervention and what the expected and adverse effects needs to be known and understood by the administering nurse. Consequently, a reasonable depth and breadth of knowledge is required so that accurate evaluation of the intervention can be meaningful.

[Alexandra]

1) The scope of practise to me means the parameters in which we follow to help the roles of the nurses RPN/RN’s determine the best care plan for patient load, responsibilities, and tasks assigned to the individual. There is no clear list of tasks in the scope of practise but more nurse knowledge/comfort level and training being a determining factor in each individual facility in which they delegate the tasks for the nurses. Keeping in mind the frailty of the patients and critical condition they may be in for understanding the correct use of the nurses and assigning the best fit for the patients being taken care of.

2) I would say that the role of a NICU nurse or ICU nurse would be more suited to the RN’s capabilities and training. The nurses would have to have the knowledge and experience in critical care of very frail individuals needing very complex observation and skill level to give them the best care possible as their health outcomes and turn from good to bad very quickly.

[Teresa]

I agree, Alexandra, to both your comments.

1 – that is a good definition of scope of practice – I like that you used patient load, responsibilities and tasks assigned – and included knowledge and training as determining factors – it give a bigger range of “things we can do”, for sure

2 – I used intensivist care in my example also of “things I cannot do” – but I agree with you NICU and ICU are critically unstable patients that may be better suited to RN work

[Teresa]

Describe what the scope of practice means to you and how you know when you have reached the boundaries of your scope.

Scope of practice means, to me, the broad area of the work activity of nurses. For every nurse, scope of practice is different based on experience, education and skill level. I know I have reached the boundaries of my scope (as an NP), if I do not have the knowledge, skill or judgement to carry out a task or procedure (or process). For instance, I do minor procedures in my practice as I have the knowledge, skill and judgement to do these procedures. I know the risks and benefits of the procedure, and can articulate that to patients. I was not educated on these procedures in my initial NP education, but I have educated myself and gained experience through the years. An example of an activity outside my scope of practice is intensivist care (care of patients in ICU). I do not have the knowledge, skill or judgement to carry out intensivist care. My scope of practice is primary care.

[Sadie]

I really liked your point about gaining knowledge, skill, and judgment through experience, even for activities that were not part of your initial NP education. It highlights that scope of practice is not simply based on what was covered in a nurse’s formal education. For example, drawing blood was not something that was covered in my nursing school education. As a new graduate, I would not have considered it within the boundaries of my scope of practice. However, after receiving training and doing it regularly, I would now consider it part of my scope of practice.

[Sadie]

To me, scope of practice is a combination of what a nurse is technically allowed to do, their level of competence, and the specific practice context.

I know I have reached the boundaries of my scope when I do not have the training or competence to safely perform something, even if another nurse with the same title could do it. For example, when I worked in public health, some nurses performed tuberculin skin tests as part of their role in the immunization program. I had not worked in that program or been trained in the specific administration technique, so I would not have considered it within my scope at that time. In that situation, it made more sense for a nurse with the right education and experience to perform the test.

[Author]

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