November 08, 2017

Big changes ahead: Our governance revolution

A bold vision for the College's future. 

Our ability to protect the public starts at the top. This is why Council decided four years ago to undertake a top-to-bottom review of its governance operations and structure. Council did this to make sure it was keeping pace with the public’s changing needs.

What’s Council?

Council is the College’s governing body and sets the strategic direction for regulating nursing in the public interest. Both elected nurses and government-appointed members of the public sit on Council.

In addition to Council, the College has a number of committees that make decisions related to our public protection mandate. These include committees that focus on: complaints from the public, discipline, fitness to practise, quality assurance and registration, and provide advice about financial matters.

Taking a bold step forward

What the public needs and expects from its regulators is always evolving. Therefore, our governing body must also continually evolve to best serve the public.

In 2014, Council took a bold step forward and invited an external task force to review all aspects of its governance — from the basics of how Council is formed, to how it operates. Council wanted a proactive, objective, expert and evidence-informed review that was completely centred on public trust.

The task force reviewed global governance trends, best practices and expert advice. It also shared how to apply these to the College’s governance. We published the findings and recommendations in a report called Final Report: A vision for the future. At its December 2016 meeting, the College’s Council approved this vision for governance for 2020.

What will change?

You can read the vision in full at www.cno.org/governance2020. Here are a few summarized highlights of just a few elements:

Council's size and shape
Currently, Council has 37 members, including 21 nurses and 16 members of the public. The future board (which will no longer be called Council) will have 12 members, and there will be an equal number of nurses and public members.
Why? Members of the public have an important part to play on our board. We also need nursing expertise to succeed. The new model will provide that balance and reflect the board’s commitment to the public.   

Multiple pieces of evidence say the same thing: smaller boards are more effective in making decisions. Large boards are generally more bureaucratic and less flexible. It’s easier for members to share ideas in a smaller board.

Board appointments
Board members who are nurses will no longer be volunteers who are elected by their peers. Instead, they will be appointed based on specific attributes and competencies — their experience, knowledge, and skill.
Why? The decision to move from elections to appointments was a serious one. Ultimately, it was based on two things. First, elections create the potential for misunderstanding, because nurses elected to the governing body do not serve those that elected them — they serve the public. Second, appointments based on competencies ensure that the board is comprised of a diverse group of people with a wide range of expertise, skills, extensive knowledge and different perspectives.

Advisory groups
Under the new model, the board will create advisory groups as needed to help promote decision-making from a diverse range of perspectives.
Why? Advisory groups will bring yet another layer of expertise and knowledge to the board. They may be comprised of members of the public, various industry experts and nurses with expertise in specific areas such as mental health or remote nursing.

Evaluation
Every three years, an external expert will evaluate the board and its governance processes. The findings will be public.
Why? Our board wants to be a world leader in governance excellence. To do this, it needs to evaluate itself regularly so it can continuously improve. Evaluation also holds the governing body accountable to the public.

What’s happening now?

In September 2017, Council approved the milestones for implementing the vision. We’re going to pilot-test a new process for appointing 2019 statutory committee members. This involves defining what our committees will require and developing new educational resources about the College’s governance.

Later this year, nurses who are interested in applying to a committee can use the new competencies and resources.

Our promise: Keep you informed

Over the next two years, we will be providing regular updates about the progress. We encourage you to monitor developments, especially if you’ve ever been interested in serving on Council or a committee. Look for updates at www.cno.org/governance2020 and in The Standard.

About CNO

The College of Nurses of Ontario (CNO) is the regulator of the nursing profession in Ontario. It is not a school or a nursing association. CNO acts in the public interest by:

  • assessing qualifications and registering individuals who want to practice nursing in Ontario.
  • setting the practice standards of the profession that nurses in Ontario are expected to meet.
  • promoting nurses' continuing competence through a quality assurance program.
  • holding nurses accountable to those standards by addressing complaints or reports about nursing care.

The College was founded in 1963. By establishing the College, the Ontario government was acknowledging that the nursing profession had the ability to govern itself and put the public's well-being ahead of professional interests.

For the latest information, please see our Nursing Statistics page.

Anyone who wants to use a nursing-related title — Registered Nurse (RN), Registered Practical Nurse (RPN) or Nurse Practitioner (NP) must become a member of CNO.

Frequently Asked Questions

Go to the public Register, Find a Nurse, to conduct a search for the nurse. Contact us if you can't find the person you are looking for.

All public information available about nurses is posted in the public Register, Find a Nurse, which contains profiles of every nurse in Ontario. Publicly available information about nurses include their registration history, business address, and information related to pending disciplinary hearings or past findings.

Unregistered practitioners are people who are seeking employment in nursing or holding themselves out as being able to practice nursing in Ontario, but who are not qualified to do so. They are not registered members of CNO. Only people registered with CNO can use nursing-related titles or perform certain procedures that could cause harm if carried out by a non-registered health professional. CNO takes the issue of unregistered practitioners seriously. See Unregistered Practitioners for more information.

To ensure procedural fairness for both the patient (or client) and the nurse, the Regulated Health Professions Act requires that information gathered during an investigation remain confidential until the matter is referred to the Discipline Committee or Fitness to Practise Committee. CNO will not disclose any information that could identify patients (or clients) or compromise an investigation. See Investigations: A Process Guide for more information.

Information obtained during an investigation will become public if the matter is referred to a disciplinary hearing. If a complaint is not referred to a hearing, no information will be available publicly.

See CNO's hearings schedule, which is updated as hearing dates are confirmed. Hearings at CNO are open to the public and the media. For details on how to attend a hearing, contact the Hearings Administration Team.

A summary of allegations and the disciplinary panel outcomes can be found on the public Register, Find a Nurse. Full decisions and reasons are also available.

Where a disciplinary panel makes a finding of professional misconduct, they have the authority to reprimand a nurse, and suspend or revoke a nurse's registration. Terms, conditions and limitations can also be imposed on a nurse's registration, which restricts their practice for a set period. Nurses can also be required to complete remedial activities, such as reviewing CNO documents and meeting with an expert, before returning to practice.

For detailed information see the Sexual Abuse Prevention section.

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