The Licensed Practical Nurse in Canada

The licensed practical nurse works under a narrower nursing scope of practice than does the registered nurse. In all provinces the nursing laws define the nursing scope of practice and indicate whether supervision or direction is necessary for the LPN.

Both the registered nurse and the LPN can legally engage in nursing practice and are considered to be self regulating professionals. However, the nursing scope of practice for LPN jobs is narrower.

Some provinces have nursing laws that set limits or conditions on the nursing scope of practice for the LPN that are described by words such as:

• under supervision or direction - in British Columbia the nursing scope of practice for LPN states that the LPN can only engage in nursing practice under supervision of a registered nurse or as directed by a medical practitioner.


• assists the registered nurse - in Manitoba the practice of the LPN includes the description of the role as one that is assistive to the RN


• under direction - Prince Edward Island, Saskatchewan and New Brunswick.


• In New Brunswick the complexity of the client is defined and it is stipulated that the Registered Nursing Assistant (this is the same classification as a LPN) can assist the RN with more acutely ill patients but not take care of those patients independently.

All provinces require LPN's to work in partnership with other health care providers.

In provinces (such as Ontario) where there are no specific limits or conditions placed on the nursing scope of practice for LPN jobs there is legislation that defines "controlled" or "reserved acts". These would be actions that are potentially harmful or carry a risk to the client if performed by an unqualified person.

Regulations specify who can perform these acts and under what circumstances. In this way the limits or conditions on nursing practice are achieved through regulation of controlled or reserved acts. Alberta has a similar system in place for the licensed practical nurse.

How do limits and conditions affect nursing practice for the licensed practical nurse?

When limits and conditions of supervision, delegation, or direction are imposed on the nursing practice of the LPN it means that there must be another health care provider involved in the patient's care and the LPN works in partnership with that care provider.

In all provinces the LPN is expected to collaborate and consult with a registered nurse when the patient's care needs or health care situation increases in complexity and in some provinces under these circumstances it is required that the patient be transfered to the care of a registered nurse.

In order for true collaborative practice to take place, both the registered nurse and the LPN must understand their own scope of nursing practice and the shared roles and responsibilities between the two types of nursing.

See the Licensed Practical Nurse salary scale in Canada