December 19, 2022

Government reviews regulations to expand RPN scope of practice

The Ontario government is reviewing proposed changes under the Nursing Act, 1991 to expand the scope of practice for RPNs. You can see the changes on the Regulatory Registry, a government website that shares information on new, amended or approved regulations.

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The Ontario government is reviewing proposed changes under the Nursing Act, 1991 to expand the scope of practice for RPNs. You can see the changes on the Regulatory Registry, a government website that shares information on new, amended or approved regulations.

If government approves the regulation, RPNs who have the relevant competence will be able to independently initiate specific controlled acts without an order in certain practice settings. These changes are intended to increase patient access to timely health care services and reduce barriers to patient care.

“Using the training and expertise of RPNs more efficiently makes health care more accessible to patients and may help lessen some of the pressures in the health care system,” says Anne Marie Shin, Director of Professional Practice.

In 2017, CNO started work to expand RPN scope of practice at the Minister of Health's request. CNO led policy work and a robust public consultation, and reviewed stakeholder feedback to inform the regulation changes. CNO’s Council (or board) approved the proposed regulation, which we submitted to government for review in September 2020.  

Supporting safe practice

If government approves the regulation, CNO will begin developing resources to support RPN’s to implement this scope of practice change.   

“Nurses in Ontario are world-class. Recognizing that RPNs have the knowledge, skill and judgment to further address needs in the health care system will hopefully expand access to safe care for Ontarians,” says Carol Timmings, Deputy Registrar and Chief Quality Officer.  

While the changes may give RPNs access to initiate controlled acts, they will not apply to certain practice settings because of other legislation or facility policies. For example, RPNs who practice in hospitals will always need an order. This is a requirement under the Public Hospitals Act.

If the regulation is approved, we will also engage with nurses and other partners in the health care system to support implementation. We will keep you informed with updates on www.cno.org and social media, 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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