Nursing is a regulated profession. The titles of a nurse (be it RN, NP, LPN, RPN) and the acts authorized to nurses are protected and established by enabling legislation and each jurisdiction’s regulator. There is a specific legal scope of practice, as well as specific guidelines and standards associated with each title. People who are not nurses cannot call themselves a nurse, nor can they perform the acts authorized to nurses, like injections (with a few limited exceptions). Likewise, an LPN cannot call themselves an RN or perform acts authorized only to RNs. Because nursing is highly regulated, it is important for nurses to be very careful about what they do, and what they call themselves when working in both nursing and non-nursing positions. This holds true for other regulated health professions, such as doctors, physiotherapists, dietitians, midwives, etc.
Every nurse who is working in a non-nursing position or working in a nursing position but under a different designation (for example an RN working in an LPN’s role), should consider the following:
- Ensure they have a clear understanding of what capacity they will be working in, in any given situation be it volunteer or employment.
- Ensure that their employers/employees and clients understand what capacity they are working in, and the limits associated with their title. When working as an RN, for example, the nurse must restrict their activities to activities authorized to RNs. Even if an RN is also a registered midwife, when employed or working as an RN, he or she should only perform acts authorized to RNs. However, they would not be expected or even permitted to ignore their training as a midwife. For example, if their training and experience as a midwife led to an awareness of a particular problem in a pregnant woman, they would be expected to act on it.
- Verify with their regulator how they should present themselves at work and to their clients. Certain regulators will require that nurses use the professional designation that represents their status with their regulator, even if they are working in another role. For example, if you are registered as an RN, your regulator may insist you use that title even if you are working in an RPN or LPN role. This varies between jurisdictions, so it is important to check with your provincial or territorial regulator.
- Understand that even when they are performing tasks from a profession that is not regulated, they are still accountable to their designation and regulator. For example, the College of Nurses of Ontario (CNO) explains that accountability comes with registration with the CNO, and “remains an obligation whether an individual holds single or dual registration or is working as an unregulated care provider (UCP).”1
As in any employment or volunteer situation, it is important that a nurse not act beyond their legal scope (that is, what they are authorized to do pursuant to their designation) or beyond their personal scope of competence. As in any employment or volunteer situation, it is important that a nurse not act beyond their legal scope (that is, what they are authorized to do pursuant to their designation) or beyond their personal scope of competence.
CNPS beneficiaries can contact CNPS at 1-800-267-3390 to speak with a member of CNPS legal counsel. All calls are confidential.
- College of Nurses of Ontario, “Nurses Working in Different Roles” (01 July 2023), online: https://www.cno.org/en/learn-about-standards-guidelines/educational-tools/ask-practice/nurses-working-in-different-roles/
Published October 2023.
THIS PUBLICATION IS FOR INFORMATION PURPOSES ONLY. NOTHING IN THIS PUBLICATION SHOULD BE CONSTRUED AS LEGAL ADVICE FROM ANY LAWYER, CONTRIBUTOR OR THE CNPS. READERS SHOULD CONSULT LEGAL COUNSEL FOR SPECIFIC ADVICE.