It is common for nurses to work in different roles. For example, an RN may work as an unregulated care provider (UCP) or as an RPN. And NPs may work in an RN role. It is up to employers to determine whether it is acceptable for an RN or RPN to work in a UCP role or an NP to work in an RN role. As the nurse regulator, CNO does not restrict this.

Nurses are encouraged to clarify the scope of their roles and responsibilities with their employer or potential employers as there may be policies regarding employees working in different roles. This webpage describes the accountabilities of nurses when working in different roles, including in emergency situations.

Registration

Nurses registered with CNO are accountable for their own conduct and practice regardless of whether they hold a single or dual registration or are working as a UCP.

Dual registration refers to nurses who hold registration in more than one category. For example, a nurse may be registered as an RPN and as an RN. Dual registration permits a nurse to use both titles.

Nurses cannot be registered in the General Class (RN or RPN) and in the Extended Class (NP) simultaneously.

Once an RN registers with CNO as an NP, their RN certificate is no longer active.

CNO does not require nurses to have dual registration to work in specific positions. For example, an RN is not required to be registered as an RPN to accept a role for an RPN.

Similarly, an NP can work in an RN role even though they are not registered as an RN in the General Class.

When a nurse accepts a position as a UCP

When a nurse accepts a position as a UCP, the nurse is expected to fulfil only the requirements of the position’s job description.

A nurse working in a UCP role is accountable for:

  • knowing and performing within the limits of the UCP role; and
  • recognizing when the client’s condition deviates from the norm.

For unexpected or emergency situations beyond the role of a UCP, a nurse working as a UCP is accountable for:

  • Communicating critical information to the most appropriate health care provider
  • Stepping out of the UCP role to identify and assess the situation using their nursing competence
  • Responding to the emergency (if needed) to ensure the client receives the appropriate care using nursing knowledge, skill and judgement until another provider is available

When an NP accepts a position as an RN

When an NP accepts a position as an RN, the nurse is expected to fulfil only the requirements of the position’s job description.

A nurse’s primary accountability is to the client, not to the employer. For example, an NP remains accountable as an NP even when employed as an RN. This means that an NP who is employed as an RN must balance knowledge of the role with an assessment of when their NP skills must be employed in the interest of client safety.

For unexpected or emergency situations that are beyond the role of an RN or RPN, the NP is accountable for:

  • Communicating critical information to the most appropriate health care provider
  • Stepping into the NP role
  • Identifying and assessing the situation.
  • Responding to the emergency (if needed) to ensure the client receives appropriate care
  • Using nursing knowledge, skill and judgement until another provider is available.

RNs working in RPN roles or NPs working in RN roles are required to document and identify themselves to clients in a manner that reflects their registration status with CNO regardless of the role they are working in.

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