Can nurses administer laser therapy?

There are many different forms of energy that are not listed as controlled acts in the Regulated Health Professions Act, 1991 (RHPA). In instances where a specific form of energy is not listed in legislation, the RHPA does not restrict how or by whom that form of energy may be applied.

The forms of energy mentioned by name in the RHPA include electricity, electromagnetism and soundwaves. The legislation does not refer to laser therapy; therefore, the administration of laser therapy is not restricted and a nurse can administer it to clients.

It is important to remember that controlled acts are not the only procedures that could potentially cause harm, and that having the authority to perform an activity does not necessarily mean it is appropriate to do so. Nurses performing laser therapy should be aware that all practice standards would apply just as they would with any other procedure.

When performing a procedure of any kind, nurses must ensure they have the required knowledge, skill and judgment to perform the procedure safely and ethically, as well as manage outcomes. They also need to ensure they have the authority to perform the procedure by way of an authorizing mechanism (e.g., orders, initiation, directives and delegation).

What is a form of energy?

There are 14 controlled acts listed in the RHPA, including: “applying or ordering the application of a form of energy prescribed by the regulations under this Act.”

The regulation under this Act that refers to controlled acts identifies the forms of energy as such:

  1. Electricity for,
    1. aversive conditioning,
    2. cardiac pacemaker therapy,
    3. cardioversion,
    4. defibrillation,
    5. electrocoagulation,
    6. electroconvulsive shock therapy,
    7. electromyography,
    8. fulguration,
    9. nerve conduction studies, or
    10. transcutaneous cardiac pacing.
  2. Electromagnetism for magnetic resonance imaging.
  3. Soundwaves for,
    1. diagnostic ultrasound, or
    2. lithotripsy

This list is inclusive of all forms of energy that fall under the controlled act related to applying or ordering the application of a form of energy. If an intervention or test is not listed in this regulation, then it is not considered a form of energy according to the regulation, and therefore not considered a controlled act.

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