What is a Nursing Scope of Practice Statement?

A nursing scope of practice statement defines the boundaries of professional practice for all types of nursing. Scope of practice statements form the foundation for nursing curriculum, nursing standards of practice and nursing job descriptions.

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A scope of practice statement is not a statement of exclusivity and is not protected. Other professionals are not excluded from performing the same activities listed in a scope of practice statement.

It is title that is protected not the scope of practice. You cannot use the title "nurse, "doctor", or other specialized title unless you are licensed by the regulatory body for that profession.

Since there are three different types of nursing in Canada a scope of practice statement becomes important in differentiating the roles and responsibilities of the various types of nursing practice.

Nursing laws regulate the profession in the public interest so nursing programs must be approved or recgonized by the nursing regulatory body before graduates are eligible to write the Canadian Registered Nurse Exam or the Canadian Registered Practical Nurse Exam.

As a requirement for recognition or approval by the regulatory nursing organizations, nursing education programs must prove that their program prepares graduates to practice within the defined nursing scope of practice.

Here is an example of the scope of practice description for the three different types of nursing in the province of British Columbia. This is taken from the specific regulation for each type of nursing under the Health Professions Act in BC.

Registered Nurse	Registered Psychiatric Nurse	Licensed Practical Nurse (currently under review)
the registered nurse may practice "nursing". It defines specific "restricted activities" that the registrant may perform independently and "under an order"	the registered psychiatric nurse may practice "psychiatric nursing".	A registrant may provide such nursing services as are consistent with his or her training. The regulation also sets certain limits and conditions on nursing practice such that the LPN practices under supervision of a registered nurse or the direction of a medical practitioner.

This chart reveals that the practice of a registered psychiatric nurse in BC is limited to practicing psychiatric nursing.

A licensed practical nurse can practice nursing with certain limits and conditions (supervision or direction) and a registered nurse can practice nursing.

Scope of practice statements and regulations are highly dependent on the legal definition of nursing.

In all provinces the scope of practice of a licensed practical nurse is wholly contained within the scope of practice of a registered nurse.

In other words the LPN (or RNA - registered nursing assistant) in Canada practices nursing under the legal definition of nursing but works under a narrower scope of practice than the registered nurse.

There is nothing in the scope of practice of an LPN that is outside of the scope of the registered nurse.