Recognition of Practice

What is Recognition of Practice

The College of Registered Nurses of Saskatchewan (CRNS) recognizes that Registered Nurses (RN) and Nurse Practitioners (NP) are engaged in a multitude of services and activities. The Recognition of Practice process assists registrants in determining if the service or activity they are planning to provide falls within the definition of registered nursing practice in accordance with The Registered Nurses Act, 1988.

The Registered Nurses Act, 1988, section 2, states that the “practice of registered nursing” means the performance or co-ordination of health care services including but not limited to:

(i) observing and assessing the health status of clients and planning, implementing and evaluating nursing care; and

(ii) the counselling, teaching, supervision, administration and research that is required to implement or complement health care services; for the purpose of promoting, maintaining or restoring health, preventing illness and alleviating suffering... (p. 3).

Process for Recognizing Nursing Practice

RNs and NPs seeking to incorporate new and innovative services or activities into their practice must consult with the CRNS before engaging in them to ensure they fall within the definition of registered nursing practice. Through the Recognition of Practice process, the registrant will submit information to the CRNS regarding the services or activities they are asking to be approved. Each request for recognition of registered nursing practice is reviewed individually. If the CRNS approves the request, the registrant may use the title RN or NP and count the hours engaged in the service or activity towards their annual license renewal.

RNs and NPs must comply with the current practice standards and Code of Ethics for Registered Nurses as a foundation for their practice. The RN or NP must be licensed and in good standing for the review to be considered.

Although the activities that an RN or NP may perform through the Recognition of Practice framework may be in new and innovative settings, they must have the appropriate support to practice safely and competently.

There are several questions to explore when deciding to perform registered nursing activities that may be new or innovative. The RNSP guidelines provide further information on these areas.

• Nursing Practice: How is this considered registered nursing practice? Does it require registered nursing knowledge, skill and judgement while using the registered nursing process to provide the service or activity?
• Client: Is it in the client's best interest in their particular environment? Are there sufficient physical and human resources to ensure safe patient care and to be able to manage any unintended consequences?
• Evidence: Does current best practice evidence support the registered nursing practice? Have you explored if other RNs or NPs are engaged in the registered nursing activity anywhere else in the province or country?
• Authorizing Mechanism: Where will the authority come from? Are the services or activities authorized under federal and/or provincial legislation?
• Competency: What competencies are required to perform the registered nursing activity? How can the competencies be acquired?

RN Recognition of Practice

When working with other health care professionals in the provision of care in any setting, the RN must clearly understand their relationship, role, and responsibilities with the other health care provider(s) and seek clarification if the relationship is unclear. This is best achieved with good communication and clear lines of authority. Notably, with shared activities, there are shared accountabilities for the safe performance of the activity, e.g., the RN carries out an activity based on an authorized health provider’s order. Still, the decision to order the treatment or function resides with the authorized care provider. RNs must use their knowledge, skill and judgement and question client care orders when further clarity is required.

To further support professional practice, the CRNS has created several resources to review:

Reflect on Your Practice: Cosmetic Injectables

Aesthetics Nursing Resource

Medication Management Guideline

Registered Nurse Specialty Practices Guideline

Nurse Practitioner (NP) Recognition of Practice

The scope of practice of the NP encompasses the registered nursing activities within common medical disorders for which they are competent to perform and is influenced by the setting in which they practice and the client's needs. NPs work within a collaborative team of physicians, RNs and other health care providers to implement the registered nursing process, including assessment, care planning, implementation and evaluation.

Review and Decision Process

The CRNS has provided a checklist for RNs and NPs who are seeking a Recognition of Practice to ensure the service or activity falls within the definition of registered nursing practice contained in The Registered Nurses Act, 1988. The checklist provides recommendations for RNs and NPs currently employed, contracted or pursuing self-employment to review when practicing in innovative settings. Once completed, please sign and date the checklist and send it back to practiceadvice@crns.ca.

Recognition of Practice Checklist

Once your checklist has been submitted, it will be reviewed by CRNS staff. As part of the review process, you may:

• be required to submit additional documentation; and/or,
• be contacted by email or phone to discuss your application further.

During the review process and until a decision is made by the CRNS, you may not:

• include your RN or NP practice hours worked in the role towards licensure until approved; nor,
• use the title Registered Nurse, Reg. N, RN, Nurse Practitioner or NP until approved.

You will receive a confirmation by email from the CRNS with the decision to approve or deny your request for Recognition of Practice.

Regulations and entry requirements are subject to bylaws and policy changes.

If you have any questions, contact practiceadvice@crns.ca.