This page provides COVID-19 practice information. In addition to the information below, CNO’s Practice Support staff can help with your nursing practice-related inquires. Please review our statement on the standard of care in the Standards & Guidelines section of this website.

Applicable Legislation

Reopening Ontario (A Flexible Response to COVID-19) Act

Vaccination Information

Please visit our vaccination information page for details on the administration of COVID-19 vaccine in Ontario.

Mental Health Support for Nurses

During these challenging times, nurses are being asked to do more than ever before. It is important to remember to keep your own health and well-being a priority too. The following resources offer mental health support:

• Canadian Mental Health Association: Information, resources and tips for health care workers dealing with COVID-19
• Government of Ontario: Support for health care workers
• CAMH: Mental health and COVID-19 resources for health care workers
• CNO: Supporting nurses in self-care and self-care fact sheet
• Your employer’s Employee Assistance Program (if applicable).

COVID-19 Point-Of-Care Testing

Who can perform a COVID-19 point-of-care test?

The Ministry of Health has created an exemption in the Laboratory and Specimen Collection Centre Licensing Act, 1990 to allow any person to perform a COVID-19 point-of-care test. Anyone performing a test must follow the product label instructions and/or receive training to make sure they administer the test correctly.

Point-of-care tests involving controlled acts:

Nurse Practitioners (NPs) are authorized to perform and order point-of-care tests involving controlled act, such as nasopharyngeal swabs.

Registered Nurses (RNs) and Registered Practical Nurses (RPNs) need an order or directive from an authorized provider (i.e., physician or NP).

An unregulated care provider will require delegation from an authorized health care provider, e.g., RN or RPN.

Relevant links:

• COVID-19 Provincial Testing Guidance
• Scope of Practice

Information For Nurse Practitioners

NPs reporting deaths from COVID-19

When completing medical certificates of death, it is very important to distinguish clearly between deaths that are directly caused by COVID-19 and deaths where the person may have tested positive for COVID-19 but the death resulted from another primary cause.

NPs who sign medical certificates of death caused by any disease of public health significance, or for which the disease of public health significance was a contributing cause of death, have a legal obligation to report these deaths to their local Medical Officer of Health.

• Ministry of Health Memo: COVID-19 Reporting of Deaths

• Medical Certificate of Death - Form 16

NPs issuing medical exemptions for COVID-19 vaccine

NPs need to be aware of the Ministry of Health's direction that there are very few acceptable reasons to issue a medical exemption for the COVID-19 vaccine, for example:

• the patient has a confirmed severe allergy or an adverse (anaphylactic) reaction to a previous COVID-19 vaccine or to any of its components that cannot be mitigated

• the patient has a diagnosed episode of myocarditis/pericarditis after receipt of an mRNA vaccine

To comply with the Ministry's direction, NPs must clearly document any medical exemption including the reason the patient cannot be vaccinated and the effective time period for the medical reason (unlimited or time-limited).

You can find additional information in the Ministry of Health’s Medical Exemptions to COVID-19 guidance document.