GUIDELINES FOR REGISTERED PSYCHIATRIC NURSES IN INDEPENDENT PRACTICE
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The College of Registered Psychiatric Nurses of Alberta recognizes that independent practice, also known as self-employed practice, is a legitimate practice option for Registered Psychiatric Nurses (RPN). However, there are unique policies, practice and liability issues that arise for Registered Psychiatric Nurses in independent practice. Consistent with their mandates to ensure public protection, the bodies that regulate the psychiatric nursing profession in Canada, are responsible to ensure safe, competent and ethical practice. With the growing number of Registered Psychiatric Nurses choosing to enter independent practice, it is critical to ensure that Registered Psychiatric Nurses in independent practice understand the full extent of their professional responsibility.
Registered Psychiatric Nurses and provincial psychiatric nursing regulatory bodies believe that the development of an independent practice document is important to provide guidance to Registered Psychiatric Nurses in independent practice while ensuring the ongoing protection of the public.
The professional responsibility falls upon the Registered Psychiatric Nurse in independent practice to ensure that the professional practice, liability and risk management issues have been addressed. This document provides guidelines for Registered Psychiatric Nurses in independent practice for that purpose.
RPNs in self-employed practice are responsible to ensure that all aspects of professional practice, liability, and risk management are properly addressed.
This document provides guidelines for Registered Psychiatric Nurses in independent practice for that purpose.
Independent practice is the application of psychiatric nursing knowledge and principles in an unsupervised, self-employment setting in psychiatric nursing practice and/or psychiatric nursing services. Registered Psychiatric Nurses in independent practice must conform to their provincial Standards of Psychiatric Nursing Practice and the professional Code of Ethics and all other provincial legislation that is relevant to those in independent practice.
The Registered Psychiatric Nurse in independent practice:
· is a graduate from an approved psychiatric nursing program, with additional education and/or experience in their area of practice.
· must have an active certificate of practice and be registered in good standing in the province(s) where they practice; and,
· is legally responsible for their practice.
Is this Practice Considered Independent Practice?
Determining whether you are self-employed as a Registered Psychiatric Nurse (RPN) involves evaluating several key aspects of your professional life, including control over your work, financial responsibilities, business operations, and legal obligations. Unlike traditional employment where an employer dictates your schedule, duties, and compensation, self-employment as an RPN offers autonomy but also requires you to manage various administrative, financial, and regulatory tasks independently. Review the checklist below to help you assess whether you are functioning as a self-employed RPN by reflecting on your control over practice decisions, client management, business structure, and personal accountability. By answering the following questions, you can gain a clearer understanding of your employment status and whether your practice aligns with the characteristics of self-employment.
¨ Do I have control over my hours of work?
¨ Do I have control over the services I provide?
¨ Do I make decisions about my business policies and procedures?
¨ Am I responsible for the financial aspect of my business (handling my own billing, taxes, business expenses).
¨ Do I receive income based on the services I provide?
¨ Have I established my own business identity or registered as a business?
¨ Do I manage my own client base?
¨ Do I handle my own marketing?
¨ Do I work independently without supervision or oversight of an employer?
¨ Am I the custodian of the health record as defined in the Health Information Act?
If you answer yes to most or all these questions it is likely you are self-employed and in independent practice, meaning you are an independent contractor or a business owner responsible for managing your practice, clients, financial matters and legal obligations.
Operating a self-employed practice has the potential to include activities that extend beyond the traditional roles and responsibilities of an RPN, which may increase the risk of practicing outside your professional and personal scope. To ensure your practice aligns with recognized RPN practice hours and remains within scope, consult the resource Is My Practice Considered Psychiatric Nursing Practice?
Enforceability
The Health Professions Act includes a detailed definition of professional misconduct including contravention of the Act, the Code of Ethics and Standards of Psychiatric Nursing Practice. Any Registered Psychiatric Nurse identified as non-compliant or in contravention is subject to the investigations and complaints process as set out in Part 4 of the Health Professions Act.
The public expects the RPN in independent practice has the requisite knowledge, experience, skills and competencies and that the RPN has the requisite additional education and continued competence in their area(s) of practice. Although this is not unlike the expectations for any RPN in any practice area, the self-employed nature of this practice puts a greater responsibility on the Registered Psychiatric Nurse.
The identified area(s) of practice, or clinical focus of independent practice, is where the RPN has their primary area(s) of competence and is the basis of their practice.
It is recommended that RPNs have a minimum of 5 years of experience before assuming full independent RPN practice roles to support safe, competent, and effective practice.
The RPN in independent practice is required to identify their own area(s) of practice or primary clinical focus of practice based on the education and experience the RPN has in a particular domain of practice or with a specific population, practice setting or range of services they can provide. The RPN is required to remain current and knowledgeable about new trends, practice issues, and education in their field of independent practice by engaging in continuous professional development, attending relevant workshops and conferences, and reviewing current evidence-based guidelines and research.
Independent psychiatric nursing practice may occur in the domains of:
- clinical practice
- education
- research
- administration
If an RPN is preparing for an independent practice that could include providing services virtually or through telehealth to more than the public of Alberta, the RPN must be aware of the legislative requirements of each jurisdiction in which services may be provided. Please note: The RPN may require an active practice permit in each of these jurisdictions.
Some examples of identified areas of psychiatric nursing practice may include, but are not limited to:
- Counselling Services (e.g., specializing in CBT, DBT, MBSR, EMDR, trauma-informed care)
- Virtual and Telehealth Services
- Health Education and Coaching (e.g., chronic disease management, lifestyle modification)
- Occupational and Community Health Services
- Consulting, Education, Research
- Medical Aesthetics (e.g., neuromodulator injections, dermal fillers, microneedling, laser treatments)
Registered Psychiatric Nursing practice involves complex responsibilities that require sound clinical judgment, emotional intelligence, and the ability to make autonomous decisions in dynamic mental health environments. Research indicates that it takes approximately 2 to 3 years of clinical practice for nurses to consolidate theoretical knowledge into competent, real-world decision-making (Benner, 1984; Missen et al., 2016; Kaihlanen et al., 2020). During this period, new graduates transition from novice to competent practitioners through direct experience, mentorship, and critical reflection.
Self-employed practice requires more than foundational competence; it demands a high level of professional autonomy, the ability to apply one’s expertise independently and confidently in complex situations. An additional 1-2 years beyond the consolidation of knowledge phase allows RPNs to deepen their reflective practice, critically evaluate interventions, exposure to varied psychiatric conditions and apply evidenced based frameworks with more nuance to promote safe, effective and ethical care. Autonomy in nursing is a multidimensional concept that extends beyond routine care to include independent decision-making, role clarity, and professional accountability (Pursio et al., 2021). As Pursio et al. note, professional autonomy is realized not only in collaboration with other disciplines but also in the nurse’s ability to manage their own clinical responsibilities and apply judgment rooted in experience.
An additional 1-2 years beyond the consolidation of knowledge phase allows RPNs to deepen their reflective practice, critically evaluate interventions, exposure to varied psychiatric conditions and apply evidenced based frameworks with more nuance to promote safe, effective and ethical care.
It is recommended that the RPN has been actively practicing for a minimum of five (5) years of full-time equivalence in their identified area of practice prior to establishing an independent practice to support safe, competent, and effective practice. In addition to having 5 years’ experience in the relevant area which you wish to practice independently, an RPN in independent practice must also have a combination of experience and formal and informal education which includes:
• successful completion of an approved psychiatric nursing education program;
• additional education and training relevant to the independent practice area which meets industry standards, is evidence-informed, and demonstrates best practices;
• provisions for continued education and continuing competence;
• professional assistance, support, or referral for clinical, ethical, and other issues where gaps and limitations in knowledge base are evident or when a client’s needs exceed the competencies of the RPN.
1. The RPN must hold an active registration and a valid unincumbered practice permit to use the protected title of Registered Psychiatric Nurse or RPN in their course of business; and
2. The RPN must obtain and maintain professional liability and malpractice insurance protection in the amount of no less than two million dollars ($2,000,000) per occurrence. You are required to have specific PLI coverage for self-employment and submit verification to CRPNA annually as this is a requirement for entering into independent or self-employed practice.
3. The RPN must only offer services for which they are competent, or for which they have obtained additional education or supervision when extending their area(s) of competence; and
4. The RPN must practice within the boundaries of legislative, regulatory, business, ethical and professional standards.
There are two distinct components to independent psychiatric nursing practices: service delivery and business management. Service delivery includes such aspects as law, ethics, and risk management. Business management includes the organization and operation of a business and the financial structures which support the delivery of the psychiatric nursing services. It is recommended that RPNs in self-employed practice consult a business lawyer and/or accountant regarding business and financial structures.
The RPN in independent practice is responsible and advised to develop a Service Delivery Plan. The Service Delivery Plan may include:
• an outline of the clinical focus and the scope of services or self-employed practice
• the purpose, goals and expected outcomes of the services or practice
• location of the business, telephone number and hours of operation
• fees and payment schedules
• qualifications of the self-employed RPN - education, experience and specialization
• expectations of the nurse/client relationship
• developing referral sources
• accountability for service including scheduling of clients
• purchasing equipment and supplies
• paying bills and taxes
• writing reports
• informed consent
• confidentiality
• conflict of interest
• ensuring that the minimum requirement for professional liability protection is sufficient for self-employed practice
• documentation and records, including electronic files
• continuous quality improvement
• continuing competency
• contractual agreements with established agencies for third party reimbursement
• termination of practice
RPNs in independent practice are encouraged to keep a copy of all their documentation, in case of audit.
Self-employed RPNs in Alberta may choose to operate as a Professional Corporation, provided they meet the requirements set out in Part 5 of the Health Professions Act (the “Act”), the Business Corporations Act, and the College of Registered Psychiatric Nurses of Alberta Profession Regulation.
There are several critical considerations for RPNs in self-employed practice. RPNs are strongly encouraged to explore the following considerations and to develop a plan to address them. It is also recommended to keep a record of this plan.
Accountability
The RPN in independent practice demonstrates accountability to the client, the public and the CRPNA by:
• recognizing personal and professional boundaries and limitations
• making appropriate referrals
• seeking out appropriate personal and professional resources
• assuming responsibility for continually maintaining and upgrading skills and education in areas of focus
• applying the concepts of accountability, responsibility and continuing competence
• knowing professional issues in psychiatric nursing practice
• knowing and applying the Standards of Psychiatric Nursing Practice and Code of Ethics
• identifying and incorporating best practices
Informed Consent
The RPN in independent practice demonstrates knowledge and understanding that the issues of competency, capacity and consent arise in numerous contexts including, but not limited to:
• consent and competency/capacity to consent to admission/entry to a hospital/facility, agency/service or psychiatric nursing care, treatment, psychiatric nursing interventions, tests and procedures, research and release of information
The RPN in independent practice demonstrates an understanding that the legal principles governing competence/capacity to consent vary depending on the context:
• age of consent identified under Alberta legislation
• client’s ability to understand the nature of the treatment or procedure, the benefits and risks
• client’s intellectual capacity to understand what is proposed
• client’s cognitive capacity to understand and comprehend what is being proposed
• client’s mental status
The RPN in self-employed practice demonstrates knowledge of and effective application of the principles of consent as it applies to psychiatric nursing practice including, but not limited to:
• implicit or explicit consent
• consent is considered valid only when given “voluntarily” (client’s decision is the product of the conscious mind) and not coerced in any way
• consent is considered to be valid only if the client is competent
• consent of next-of-kin is only relevant if the client is not capable of consenting and if the next-of-kin is duly appointed as the substitute decision-maker
• consent is to be obtained in advance of the initiation of any test, procedure or psychiatric nursing intervention
• consent must relate to specific treatment or psychiatric nursing intervention(s) undertaken
• record keeping, reporting and other disclosures of information
• full and frank disclosure of the nature of the intervention(s), the risks and alternatives
• the scope of consent
• withdrawal of consent
• emergency treatment under Alberta or federal law, risk of serious harm to the health or safety of the individual the information is about or another individual, or of the public health or public safety
Informed consent must be obtained at the beginning and is an ongoing process in the professional relationship. If the conditions that the client imposes would render the intervention(s) futile or harmful, the RPN should withdraw from the relationship.
The RPN must clearly identify processes to be followed to address issues of consent in their practice.
Confidentiality
Professionally acquired information must be treated as confidential communication. The obligation of confidentiality begins in any situation in which there is a reasonable expectation of privacy.
The RPN in self-employed practice demonstrates knowledge and application of confidentiality principles in the therapeutic relationship and manages and stores all information about clients in ways that maintain and safeguard confidentiality.
The RPN in independent practice remains up to date all relevant legislation regarding health information and privacy, including but not limited to: The Health Information Act (HIA), The Protection of Privacy Act (POPA), and Personal Information Protection Act (PIPA), and ethical guidelines concerning confidentiality. Additional information on Alberta’s legislation can be found here.
The RPN demonstrates knowledge and ability to define those circumstances where confidentiality can be breached.
These could include:
• a risk of harm to the health and safety of a minor, or
• risk of serious harm to the health or safety of the individual the information is about or another individual, or to the public health or public safety:
• court subpoena or when required by law
• where the RPN is a defendant in a civil, criminal or disciplinary action arising from the professional relationship
Every disclosure must be limited to the minimum amount of information necessary to accomplish the purpose for which the information is disclosed.
Conflict of Interest
The RPN in independent practice adheres to and abides to the Standards of Psychiatric Nursing Practice and Code of Ethics. Conflict of interest issues include, but are not limited to:
• directly or indirectly recruiting clients from one’s employer or former employer
• providing services to a client personally known to the RPN on a social basis
• a dual relationship of any form
• recognition of conflict-of-interest situations
Being self-employed creates an increased risk for a conflict of interest. The need to establish a business base as a way of creating an income can influence behavior that might be considered a conflict of interest.
If you are unsure if a situation is a conflict of interest, ask yourself the following self-reflective questions:
¨ Do I ensure my referrals are made based on the client’s best interest, not personal or financial gain?
¨ Do I market my services in a way that is truthful, and does not mislead potential clients?
¨ Do I provide clients with full information to make informed decisions without pressure or conflict of interest?
¨ Do I regularly review and assess my practice to identify and address any potential conflicts of interest?
¨ Do I seek guidance from peers, mentors or professional organizations on managing conflicts of interest?
¨ Do I follow CRPNAs documents and regulations to avoid conflicts of interest and maintain professional integrity?
Any “no” responses to the above self-reflective questions may indicate a potential conflict of interest or highlight areas of your practice that could benefit from self-reflection and clinical support and/or consultation to ensure that client care is being prioritized over competing business interests. It is essential to implement proactive plans that prioritize client care and uphold professional integrity.
It is advised to seek professional assistance and/or consultation with a CRPNA Policy and Practice Consultant if it is unclear whether a specific situation constitutes a conflict of interest.
Professional Liability Protection
The Health Professions Act (HPA) requires that a member who holds a valid practice permit must obtain and maintain professional liability insurance (PLI). Being self-employed introduces additional liability protection needs. It is recommended that RPNs consult their current insurance provider to review their current professional liability protection and determine any additional requirements based on their specific practice area and business needs.
Documentation and Records
RPNs in independent practice must be familiar with The Health Information Act (HIA) and the implications of being a custodian or trustee of a health record.
Records refer to documentation kept about clients, whether on paper, on computer, or by any other means and include appropriate storage, retention and authorized release of client information.
It is recommended that the health record documentation includes, but is not limited to:
• a general client information form
• a voluntary consent form signed and dated by the client or by a duly appointed substitute decision-maker
• documentation of services provided, and any organizational/operational policies used in practice
• times and dates of contacts with clients
• referral forms for consultation with other professionals in situations requiring additional expertise
• a signed release of information in the event of referral to other health care professionals or agencies
At all times the client files (electronic or hard copy) and pertinent documentation must be properly secured and maintained to ensure confidentiality. The files and documentation must be maintained in accordance with privacy legislation in Alberta. For further support, it is recommended that self-employed RPNs contact the Alberta Ombudsman to ensure understanding and compliance with The Health Information Act (HIA), The Protection of Privacy Act (POPA), and Personal Information Protection Act (PIPA) Self-employed RPNs will be held accountable for the proper handling, protection, use and disclosure of personal and personal health information.
The RPN in independent practice is required to keep accurate and adequate records. Failure to do so could be considered to be professional misconduct.
Continuing Competence
The RPN in independent practice ensures mechanisms to evaluate psychiatric nursing practice and services. Working as a self-employed RPN may increase practice isolation. It is the responsibility of the RPN to ensure they have processes and policies in place for enhancing patient care and maintaining high standards of professional practice. This includes but is not limited to:
• integrating the latest research and clinical guidance into daily practice to ensure care is evidenced based
• establish and set measurable and clear goals to improve client outcomes
• ongoing professional development and adherence with the Continuing Competency Program
• community of practice for ongoing professional development, clinical accountability, reflective practice and ethical decision making
Advertising, Marketing, and Practice Promotion
When advertising to the public the RPN is responsible for:
• Including a description of your services to the public to help clients make informed decisions
• Include your name and protected title, practice permit, and additional certificates and credentials for your specialty area of practice
• Include only accurate, factual and verifiable information
The RPN is prohibited from including testimonials. This restriction is designed to maintain the integrity of psychiatric nursing practice, protect the public from misleading information, and ensure that all claims about psychiatric nursing services are evidence-based. This requires the public to be provided with accurate information that will not exaggerate the benefits of the services provided, mislead the public, or detract from the public image of the psychiatric nursing profession.
Financial incentives or discounts for services are not permitted and may contribute to the appearance of impropriety, potentially undermining trust in the therapeutic relationship. Endorsements are not appropriate for advertising material. Private for-profit services are to be structured to reflect the true costs of providing care, ensuring that all clients receive equitable services.
Materials, information and presentations designed to reflect or promote the RPNs practice to both current and potential patients must be:
• truthful and factual in all respects;
• professional in description, content and presentation;
• clearly identifiable as being provided by a Registered Psychiatric Nurse with specialty training in the area of independent practice;
• inclusive of only matters within the training and scope of practice of the RPN;
• of a nature that does not inappropriately evoke concern or fear;
• exclusive of any claims of guaranteed results, or clinically predictive or specific outcomes;
• compliant with patient confidentiality requirements;
• compliant with all CRPNA Standards, policies and practice directions;
• reflective of broadly accepted evidence-based research and information;
• respectful of widely accepted public health doctrine;
• exclusive of any claims or allusion to professional superiority.
Registered Psychiatric Nurses are also required to comply with the CRPNA Social Media and e-Professionalism Guidelines. Social media use that undermines the public’s confidence in the profession may be subject to review. Use of the CRPNA logo is prohibited, as are any communications that imply speaking on behalf of, or as representing the CRPNA.
Risk Management
Working in independent practice presents a unique set of challenges that can create a higher risk environment compared to traditional healthcare settings. Unlike working within a hospital or clinic, self-employed RPNs are highly autonomous, without the immediate support of a larger team or supervision. This isolation can lead to increased responsibility for clinical decision-making, client safety, and business operations. Additionally, self-employed RPNs are tasked with managing both the clinical and administrative aspects of their practice, including financial management, legal compliance, and marketing.
The absence of built-in support systems, such as other RPNs to transfer client care, peer consultation, and readily available resources, heightens the risks of burnout, legal liability, environmental and operational disruptions. A robust risk management plan is essential.
Being engaged in independent practice brings certain opportunities and inherent risks. It is important to:
Identify areas of risk
• Client safety
• Uninformed practice (currency of education, evidence-based research and best practice)
• Crisis management
• Boundary violations
• Environmental risk (uncontrolled settings, working alone)
• Confidentiality breaches
• Scope of practice violations
• Workplace safety
• Infection prevention and control
• Medication storage and procurement
• Business continuity
• Financial management
• Legal compliance
• Public perception
• Lack of support
• Burnout
Analyze risk
• What is the likelihood of something going wrong?
• What harm could be caused if something does go wrong?
• How often can something go wrong?
Mitigate risk
• What changes can be made to prevent this?
• How can consequences be mitigated from the outset?
• What will help reduce the effects or consequences?
These factors make it essential for self-employed RPNs to have a robust risk management plan in place to ensure they can mitigate potential hazards while maintaining a high standard of care for their clients.
Termination of Practice
Independent practice RPNs must have a plan for the termination of practice as it relates to:
• Clients of the service
• Referral sources
• Professional colleagues
• Transfer of clients
• Transfer of client files when appropriate written permission has been obtained from the client
• Maintaining or destroying client files in a secure, confidential manner in accordance with the Health Information Act and other provincial legislation
• Arrange for a transfer of client files to a trustee under provincial legislation
• Closure of business accounts and payment of fees
• Catastrophic events such as death or unforeseen circumstance
Independent practice as a Registered Psychiatric Nurse demands advanced clinical competence but also requires a strong commitment to the Standards and Code of Ethics, professional practice, accountability and risk management. The increased autonomy and reduced oversight inherent in self-employed practice increases the potential for risk to clients and the RPN.
It is recommended that RPNs review this document regularly. It is also essential that RPNs stay up to date on changes to legislation, trends and evidenced based practice and self-employment legal liability. As new information becomes available from the CRPNA, it is the responsibility of the RPN to stay informed and up to date.
The final section of this document (Appendix A) includes an Independent Practice Checklist to help RPNs assess their readiness to engage in self-employed practice. This checklist is not exhaustive and is intended as a guiding tool.
Independent Practice Checklist
1. Practice Guidelines and Scope of Practice
¨ Have you reviewed the Practice Guidelines for Registered Psychiatric Nurses in Independent Practice?
¨ Is your independent practice business within the scope of registered psychiatric nursing?
¨ Does the service you provide fall within the defined scope of registered psychiatric nursing practice?
¨ Is the service evidence-based and aligned with current best practices?
¨ Are the services you provide effective and beneficial for your clients?
¨ Who is the target client for your services (individuals, families, groups, communities, populations)?
¨ Do you utilize the steps of the nursing process (assessment, diagnosis, planning, implementation, and evaluation) as an integral part of your practice?
¨ Do the services you offer require the specialized knowledge, skills, and judgment of a Registered Psychiatric Nurse?
2. Competence in Your Chosen Practice Area
¨ Are you competent in the specific area of practice you've chosen for self-employed practice?
¨ Do you have the necessary knowledge, skills, judgment, and experience to meet the standards of psychiatric nursing practice?
¨ Are you capable of performing any restricted activities within the psychiatric nursing scope that require additional education or training?
¨ Do you have a process in place for referral and peer support when your clients need services beyond your own competence or capacity?
¨ Do you have mechanisms in place to evaluate and improve your practice regularly?
¨ Can you meet the expectations for responsibility and accountability as outlined in the Standards of Practice, Code of Ethics, Practice Directions and Guidelines, Entry-level Competencies, and relevant legislation?
3. Addressing Limitations
¨ Are there any practice expectations or requirements that cannot be met in the services you are providing? If so, how will you address these limitations?
4. Policies, Procedures, and Professional Standards
¨ Do you have policies and procedures in place to support your practice and maintain professional standards?
¨ Is there a plan in place for regularly reviewing and updating these policies and procedures?
Key concepts to establish in independent practice:
¨ Client Assessment: Ensuring proper assessment processes are followed.
¨ Reporting Adverse Effects: Mechanisms for tracking and reporting any negative outcomes or side effects related to your interventions.
¨ Consent Forms: Ensuring you have valid, informed consent from all clients before providing services.
¨ Infection and Prevention Control: Protocols to prevent infection and ensure client safety.
¨ Documentation: Maintaining proper and accurate documentation for all client interactions and services provided.
¨ Health Information Act (HIA): Adhering to privacy regulations for managing clients' health information.
¨ Client Record Management/Storage: Proper systems for storing and managing client records securely.
¨ Conflict of Interest: Clear policies to identify and manage any potential conflicts of interest.
¨ Client Relationships: Clear processes for accepting, refusing, or terminating client relationships.
¨ Notice of Required Payment: Clear communication regarding fees, payment schedules, and any financial policies.
¨ Request by Client to View Health Information: Procedures for providing clients with access to their health information upon request.
¨ Advertising: Ensuring advertising practices are ethical and compliant with relevant regulations.
Schedule 25 Health Professions Act RSA 2000 Chapter H-7
Practice
3(1) In their practice, psychiatric nurses apply nursing knowledge and skills and judgment and do one or more of the following:
(a) work with individuals of all ages, families, groups and communities,
(b) assess and help address physical, mental, emotional and spiritual health needs,
(c) develop diagnoses and plan, implement and evaluate nursing care and make referrals,
(c.1) teach, counsel and advocate to enhance health and well-being,
(c.2) co-ordinate, supervise, monitor and evaluate the provision of health services,
(c.3) teach nursing theory and practice,
(c.4) manage, administer and allocate resources related to health services,
(c.5) engage in research related to health and the practice of nursing, and
(d) provide restricted activities authorized by the regulations.
(2) Repealed 2016 c9 s22. RSA 2000 cH-7 Sched. 25 s3;2003 c39 s13;2016 c9 s2
Is my Practice Considered Psychiatric Nursing Practice?
In determining if a role or position could be considered registered psychiatric nursing practice, work through the guiding principles set out below. We encourage RPNs to contact the College to discuss the guiding principles and how they may apply to your practice or your potential practice setting. If you answer 'no’ to any of these questions, then it is important to consider whether your role fits within the profession of psychiatric nursing and to apply it to the standards and code of ethics for RPNs:
1) I introduce myself as an RPN in my role.
2) I sign my credentials as an RPN (e.g. client chart, business cards, etc.)
3) My employer or business requires me to maintain licensure with the CRPNA.
4) I would direct clients/public to the College’s website to validate my licensure.
5) I use nursing/psychiatric nursing theoretical perspectives to guide my practice, and I apply psychiatric nursing knowledge and competencies in my role.
6) I consistently apply my psychiatric nursing knowledge, competencies, and judgement in the provision of my services (e.g., an RPN in a non-traditional role such as aesthetic nursing services).
7) I attend professional development opportunities (e.g., conferences, education sessions, etc.) that specifically add to my psychiatric nursing knowledge to maintain my continuing competency in my role.
8) I have policies and procedures to guide/accomplish my role as RPN (e.g., evidence-based guidelines or best practice, collaborative teams, etc.).
9) I reflect on and use the full nursing/psychiatric nursing process as the focus of my employment/practice and I use psychiatric nursing knowledge, competencies, and judgement if using interventions from another discipline based upon my nursing assessment and as part of my treatment plan (e.g., I am practicing as an RPN and using acupuncture as an intervention/modality/treatment option).
10) My practice as an RPN has a direct or indirect impact on clients; health care systems or the health of the public (e.g., an RPN in an executive position in a health organization. will have an indirect impact through their contribution to health system management).
11) The healthcare services I provide require critical thinking, problem solving, professional judgement, and accurate interpretation of information from a variety of sources.
12) I apply competencies in one of the other domains of nursing practice (e.g., administration, policy, research, education) in which I practice as an RPN.
13) Clients, team members and members of the public benefit from my training and education as an RPN.
If you answered “no” to any of the above questions, your practice might be outside the scope of psychiatric nursing practice.
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