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Nursing Act, 1991
Loi de 1991 sur les infirmières et infirmiers

ONTARIO REGULATION 275/94

GENERAL

Consolidation Period: From January 1, 2014 to the e-Laws currency date.

Last amendment: O. Reg. 268/13.

This Regulation is made in English only.

CONTENTS

   

Sections

PART I

INTERPRETATION

0.1-0.2

PART II

REGISTRATION

 
 

Certificates of Registration

1-1.2

 

Application for Certificate of Registration

1.3

 

Requirements for Issuance of Certificate of Registration, Any Class

1.4

 

Terms, etc., of Every Certificate

1.5

 

General Certificates of Registration — Registered Nurse

2

 

Mobility Within Canada

2.1

 

Titles — Registered Nurse

2.2

 

General Certificates Of Registration — Registered Practical Nurse

3

 

Mobility Within Canada

3.1

 

Titles — Registered Practical Nurses

3.2

 

Extended Certificates of Registration

4

 

Mobility Within Canada

4.1

 

Titles

4.2

 

Temporary Certificates of Registration

5-5.1

 

Mobility Within Canada

5.2

 

Special Assignment Certificates of Registration

6

 

Labour Mobility — Special Assignment Class

6.1-6.2

 

Emergency Assignment Certificates of Registration

7

 

Non-Practising Certificates of Registration

8

 

Examinations — General Class

9

 

Examinations — Extended Class

9.1

 

Resignation

10

 

Suspension for Failure to Provide Information

10.1

 

Suspension for Failure to Provide Evidence of Professional Liability Protection

10.2

 

Lifting of Certain Suspensions

10.3

 

Revocation

10.4

 

Reinstatement, on Application

10.5

 

Reinstatement, Non-Practising

10.6

 

Reinstatement, Extended Class

10.7

 

Reinstatement, Pursuant to Order

10.8

 

Terms, etc.

10.9

 

Declaration

11

 

Transition

12-12.2

PART III

CONTROLLED ACTS

 
 

Interpretation

13.2

 

Procedures

14-15.1

 

Prescribing, Dispensing, Selling and Compounding a Drug

16

 

Prescribing

17

 

Dispensing

18

 

Compounding

19

 

Selling

19.1

 

Administration of a Substance by Injection or Inhalation

20

PART IV

QUALITY ASSURANCE

 
 

General

21-23

 

Member Assessment

24-26

 

Practice Assessment and Remediation

27-31

PART V

DELEGATION

32-42

Schedule 1

 
     

PART I
INTERPRETATION

0.1 In this Regulation,

“registered nurse in the extended class” means a member who holds an extended certificate of registration as a registered nurse;

“registered nurse in the General class” means a member who holds a General certificate of registration as a registered nurse;

“registered practical nurse in the General class” means a member who holds a General certificate of registration as a registered practical nurse. O. Reg. 175/12, s. 1.

0.2 Where the provisions of this Regulation are inconsistent with the provisions of the Emergency Management and Civil Protection Act, the provisions of that Act shall prevail and the provisions of this Regulation, to the extent that they are inconsistent with that Act, shall not apply. O. Reg. 175/12, s. 1.

PART II
REGISTRATION

Certificates of Registration

1. (1) The following are prescribed as classes of certificates of registration for registered nurses:

1. General.

2. Extended.

3. Temporary.

4. Special Assignment.

5. Emergency Assignment.

6. Non-Practising. O. Reg. 175/12, s. 1.

(2) A registered nurse may not hold more than one class of certificate of registration as a registered nurse at one time. O. Reg. 175/12, s. 1.

1.1 (1) The following are prescribed as classes of certificates of registration for registered practical nurses:

1. General.

2. Temporary.

3. Special Assignment.

4. Emergency Assignment.

5. Non-Practising. O. Reg. 175/12, s. 1.

(2) A registered practical nurse may not hold more than one class of certificate of registration as a registered practical nurse at one time. O. Reg. 175/12, s. 1.

1.2 (1) The following are defined as specialties for certificates for a member who is a registered nurse in the extended class:

1. Primary Health Care.

2. Paediatrics.

3. Adult.

4. Anaesthesia. O. Reg. 175/12, s. 1.

(2) A registered nurse in the extended class shall hold a certificate in a specialty mentioned in subsection (1). O. Reg. 175/12, s. 1.

(3) A registered nurse in the extended class who is issued a certificate in a specialty mentioned in subsection (1) may be issued additional specialty certificates if he or she meets all the requirements in this Regulation relating to those specialty certificates. O. Reg. 175/12, s. 1.

(4) For greater clarity, a specialty certificate defined under subsection (1) is not a class of certificate of registration. O. Reg. 175/12, s. 1.

Application for Certificate of Registration

1.3 (1) A person may apply for a certificate of registration in any class by completing an application in the form provided by the Executive Director and submitting it along with any supporting documentation requested by the Executive Director and the applicable fees. O. Reg. 175/12, s. 1.

(2) If a person applies for an extended class certificate of registration, he or she must apply for a specialty certificate in at least one of the specialties of the extended class. O. Reg. 175/12, s. 1.

(3) A person who files an application for a certificate of registration may not make another application for the same class of certificate until the outstanding application has been finally disposed of. O. Reg. 175/12, s. 1.

Requirements for Issuance of Certificate of Registration, Any Class

1.4 (1) The following are registration requirements for the issuance of a certificate of registration for any class:

1. The applicant must provide details to the Executive Director of any of the following that relate to the applicant at the time that the applicant submits the application, and of any of the following that come to relate to the applicant after the application is submitted and before a certificate of registration is issued:

i. A finding of guilt for any criminal offence, any offence relating to the use, possession or sale of drugs, any offence under the Controlled Drugs and Substances Act (Canada), or any other offence in relation to the practice of nursing or another profession in any jurisdiction.

ii. A finding of professional misconduct, incompetence, incapacity, professional negligence, malpractice or any similar finding against the applicant in relation to the practice of nursing or another profession in any jurisdiction.

iii. A current investigation, inquiry or proceeding for professional misconduct, incompetence or incapacity or any similar investigation or proceeding in relation to the practice of nursing or another profession in any jurisdiction.

iv. A current proceeding in respect of any offence in any jurisdiction.

v. A refusal to register the applicant to practise as a nurse or in another profession in any jurisdiction.

2. The applicant’s past and present conduct, in the opinion of the Executive Director or a panel of the Registration Committee, must afford reasonable grounds for the belief that the applicant,

i. does not suffer from any physical or mental condition or disorder that could affect his or her ability to practise nursing in a safe manner,

ii. will practise nursing with decency, honesty and integrity and in accordance with the law,

iii. has sufficient knowledge, skill and judgment to competently engage in the practice of nursing authorized by the certificate of registration, and

iv. will display an appropriately professional attitude.

3. The applicant must have paid any fees required under the by-laws for the issuance of the certificate of registration. O. Reg. 175/12, s. 1.

(2) It is a registration requirement for the issuance of a certificate of registration for any class, other than the Emergency Assignment and Non-Practising classes, that the applicant must be a Canadian citizen or permanent resident of Canada or must hold the appropriate authorization under the Immigration and Refugee Protection Act (Canada) to permit the applicant to engage in the practice of nursing in Ontario. O. Reg. 175/12, s. 1.

(3) The requirements under subsection (1) are non-exemptible. O. Reg. 175/12, s. 1.

(4) An applicant must meet all of the requirements for registration within two years from the day that he or she filed his or her application, but this does not prevent an applicant from filing a new application. O. Reg. 175/12, s. 1.

(5) An applicant shall be deemed not to have satisfied the requirements for the issuance of a certificate of registration of any class if the applicant makes a false or misleading statement or representation in his or her application or supporting documentation. O. Reg. 175/12, s. 1.

Terms, etc., of Every Certificate

1.5 (1) Every certificate of registration is subject to the following terms, conditions and limitations:

1. The member shall provide to the Executive Director the details of any of the following that relate to the member and occur or arise on or after the day that the member was issued a certificate of registration:

i. A finding of guilt arising in any jurisdiction relating to any offence.

ii. A charge arising in any jurisdiction relating to any offence.

iii. A finding of professional misconduct, incompetence or incapacity or any similar finding, in relation to the practice of nursing or another profession in any jurisdiction.

iv. A current investigation, inquiry or proceeding for professional misconduct, incompetence or incapacity or any similar investigation or proceeding in relation to the practice of nursing or another profession in any jurisdiction.

2. The member shall, at the request of the Executive Director, provide information that is required pursuant to the Act, the Regulated Health Professions Act, 1991, regulations under those Acts or the by-laws in the form and manner requested by the Executive Director. O. Reg. 175/12, s. 1.

(2) Every certificate of registration, other than an Emergency Assignment or Non-Practising certificate of registration, is subject to the following terms, conditions and limitations:

1. The member shall not engage in the practice of nursing unless the member is a Canadian citizen or permanent resident of Canada or has authorization under the Immigration and Refugee Protection Act (Canada) permitting the member to engage in the practice of nursing in Ontario.

2. The member shall immediately advise the Executive Director in writing in the event that the member ceases to be a Canadian citizen or permanent resident of Canada or to have authorization under the Immigration and Refugee Protection Act (Canada) permitting the member to engage in the practice of nursing in Ontario.

3. If a member to whom paragraph 2 applies subsequently obtains Canadian citizenship, becomes a permanent resident of Canada or attains authorization under the Immigration and Refugee Protection Act (Canada) permitting the member to engage in the practice of nursing in Ontario, he or she shall immediately advise the Executive Director in writing of that fact.

4. The member shall maintain professional liability protection in accordance with the requirements, if any, set out in the by-laws.

5. The member shall, at the request of the Executive Director, provide evidence satisfactory to the Executive Director that the member meets the condition required in paragraph 4, in the form and manner requested by the Executive Director. O. Reg. 175/12, s. 1.

(3) Every Emergency Assignment certificate of registration is subject, in addition to the terms, conditions and limitations set out in subsection (1), to the following terms, conditions and limitations:

1. The member shall maintain professional liability protection in accordance with the requirements, if any, set out in the by-laws.

2. The member shall, at the request of the Executive Director, provide evidence satisfactory to the Executive Director that the member meets the condition required in paragraph 1, in the form and manner requested by the Executive Director. O. Reg. 175/12, s. 1.

General Certificates of Registration — Registered Nurse

2. (1) The following are additional requirements for the issuance of a certificate of registration as a registered nurse in the General class:

1. The applicant,

i. must have a minimum of a baccalaureate degree in nursing evidencing the successful completion of a program specifically designed to educate and train persons to be practising registered nurses,

A. awarded by a university in Canada as a result of successful completion of a program that was approved by Council or that was accredited or approved by a body approved by Council for that purpose, or

B. awarded by a university as a result of successful completion of a program that was approved by Council or that was accredited or approved by a body approved by Council for that purpose,

ii. must have a minimum of a baccalaureate degree in nursing evidencing the successful completion of a program specifically designed to educate and train persons to be practising registered nurses other than a program mentioned in subparagraph i, which program was approved by the Registration Committee as one whose graduates should possess knowledge, skill and judgment at least equivalent to those of current graduates of a program mentioned in sub-subparagraph i A, or

iii. must have successfully completed a program in nursing specifically designed to educate and train persons to be practising registered nurses, other than a program mentioned in subparagraph i or ii, and,

A. must have successfully completed a program that, at the time the applicant commenced it, was approved by Council as one whose graduates should possess knowledge, skill and judgment at least equivalent to those of current graduates of a program mentioned in sub-subparagraph i A, or

B. must have paid any fees required under the by-laws, undergone an evaluation approved by Council and satisfied the Executive Director or a panel of the Registration Committee that he or she has successfully completed further education or training or combination of education and training approved by the Registration Committee that was identified in the evaluation as being necessary to evidence that the applicant possesses knowledge, skill and judgment at least equivalent to those of current graduates of a program mentioned in sub-subparagraph i A.

2. The applicant must have successfully completed the examination for registration as a registered nurse at the time when the examination was approved by Council or have successfully completed another examination approved by Council for that purpose, at a time when he or she was eligible to take the examination.

3. The applicant,

i. must have been awarded the degree mentioned in subparagraph 1 i or ii no more than three years before the day that the applicant met all other requirements for the issuance of the certificate of registration,

ii. must have successfully completed all requirements of one of sub-subparagraph 1 iii A or B no more than three years before the day that the applicant met all other requirements for the issuance of the certificate of registration,

iii. must demonstrate evidence of practice as a registered nurse no more than three years before the day on which the applicant met all other requirements for the issuance of the certificate of registration, or

iv. must have paid any fees required under the by-laws, undergone an evaluation approved by the Registration Committee at a time when the evaluation was approved by the Registration Committee and met requirements regarding additional training, experience, examinations or assessments specified by a panel of the Registration Committee within the period of time specified by the panel.

4. The applicant must, within five years before the day that the applicant is issued the certificate of registration, have successfully completed the examination in nursing jurisprudence that is approved by Council for applicants for the issuance of a certificate of registration as a registered nurse.

5. The applicant must have demonstrated language proficiency and the ability to communicate and comprehend effectively, both orally and in writing, in either English or French at a date no more than two years before the day that he or she is issued the certificate of registration, or such longer period of time as specified by a panel of the Registration Committee, unless,

i. the applicant, on the day he or she submits the application, holds a certificate of registration as a registered nurse, other than a certificate in the Emergency Assignment or Non-Practising class, or

ii. the applicant previously held a certificate of registration as a registered nurse, other than a certificate in the Emergency Assignment, retired or Non-Practising class and since the date that the applicant last held that certificate no more than two years or such longer period of time as specified by a panel of the Registration Committee has elapsed. O. Reg. 175/12, s. 1.

(2) The requirements in subparagraph 1 ii or iii of subsection (1) shall be deemed not to have been met if the nursing program which the applicant relies on to meet that requirement was not recognized or approved in the jurisdiction in which the program was taken as qualifying the applicant to practise as a registered nurse in that jurisdiction. O. Reg. 175/12, s. 1.

(3) The requirements in paragraphs 1 and 2 of subsection (1) do not apply to an applicant who previously held a certificate as a registered nurse in the General or extended class. O. Reg. 175/12, s. 1.

(4) An applicant is exempt from the requirements in paragraphs 1, 2 and 5 of subsection (1) if the applicant holds a certificate of registration in the extended class at the time that he or she applies for the issuance of a certificate of registration as a registered nurse in the General class. O. Reg. 175/12, s. 1.

(5) Subject to subsections (3) and (4) and section 2.1, the requirements in subsection (1) are non-exemptible. O. Reg. 175/12, s. 1.

Mobility Within Canada

2.1 (1) Where section 22.18 of the Health Professions Procedural Code applies to an applicant for a certificate of registration as a registered nurse in the General class, the requirements of paragraphs 1, 2 and 3 of subsection 2 (1) of this Regulation are deemed to be met by the applicant. O. Reg. 175/12, s. 1.

(2) Despite subsection (1), it is a non-exemptible requirement that an applicant referred to in subsection (1) provide, for each jurisdiction where the applicant holds an out-of-province certificate, a certificate, letter or other evidence satisfactory to the Executive Director or a panel of the Registration Committee confirming that the applicant is in good standing as a nurse in that jurisdiction. O. Reg. 175/12, s. 1.

(3) Without in any way limiting the generality of subsection (1), “good standing” shall include the fact that,

(a) the applicant is not the subject of any discipline or fitness to practise order or of any proceeding or ongoing investigation or of any interim order or agreement as a result of a complaint, investigation or proceeding; and

(b) the applicant is in compliance with the continuing competency and quality assurance requirements of the regulatory authority that issued the applicant the out-of-province certificate as a registered nurse. O. Reg. 175/12, s. 1.

(4) An applicant referred to in subsection (1) is deemed to have met the requirements of paragraph 5 of subsection 2 (1) where the requirements for the issuance of the applicant’s out-of-province certificate of registration included language proficiency requirements equivalent to those required by that paragraph. O. Reg. 175/12, s. 1.

(5) Despite subsection (1), a requirement set out in paragraph 1, 2 or 3 of subsection 2 (1) will continue to apply to an applicant where that requirement is a requirement described in subsection 22.18 (3) of the Health Professions Procedural Code. O. Reg. 175/12, s. 1.

(6) If an applicant to whom subsection (1) applies is unable to satisfy the Executive Director or a panel of the Registration Committee that the applicant practised the profession of nursing to the extent that would be permitted by a General certificate of registration as a registered nurse at any time in the three years immediately before the date of that applicant’s application, the applicant must meet any further requirement to undertake, obtain or undergo material additional training, experience, examinations or assessments that may be specified by a panel of the Registration Committee. O. Reg. 175/12, s. 1.

Titles — Registered Nurse

2.2 (1) Subject to subsection (2), a registered nurse in the General class shall only use the title “Registered Nurse” or the abbreviation “RN” when practising as a nurse. O. Reg. 175/12, s. 1.

(2) If a member is a registered nurse in the General class and a registered practical nurse in the General class, he or she shall only use the title “Registered Practical Nurse” or the abbreviation “RPN” when practising the profession as a registered practical nurse. O. Reg. 175/12, s. 1.

General Certificates Of Registration — Registered Practical Nurse

3. (1) The following are additional requirements for the issuance of a certificate of registration as a registered practical nurse in the General class:

1. The applicant,

i. must have a diploma in practical nursing evidencing the successful completion of a program specifically designed to educate and train persons to be practising registered practical nurses,

A. awarded by a College of Applied Arts and Technology in Ontario whose program was approved by Council or by a body approved by Council for that purpose, or

B. awarded as a result of successful completion of a program that was approved by Council or by a body approved by Council for that purpose,

ii. must have a diploma in practical nursing evidencing the successful completion of a program specifically designed to educate and train persons to be practising registered practical nurses, other than a program mentioned in subparagraph i, which program was approved by the Registration Committee as one whose graduates should possess knowledge, skill and judgment at least equivalent to those of current graduates of a program mentioned in sub-subparagraph i A,

iii. must have successfully completed a program in practical nursing specifically designed to educate and train persons to be practising registered practical nurses, other than a program mentioned in subparagraph i or ii, and,

A. must have successfully completed a program that, at the time the applicant commenced it, was approved by Council as one whose graduates should possess knowledge, skill and judgment at least equivalent to those of current graduates of a program mentioned in sub-subparagraph i A, or

B. must have paid any fees required under the by-laws, undergone an evaluation approved by Council and satisfied the Executive Director or a panel of the Registration Committee that he or she has successfully completed further education or training or combination of education and training approved by the Registration Committee that was identified in the evaluation as necessary to evidence that the applicant possesses knowledge, skill and judgment at least equivalent to those of current graduates of a program mentioned in sub-subparagraph i A.

iv. must have satisfied the requirements of paragraph 1 of subsection 2 (1), or

v. must, if the applicant has not satisfied the requirements of paragraph 1 of subsection 2 (1), have successfully completed a program in nursing, specifically designed to educate and train persons to be practising registered nurses, must have paid any fees required under the by-laws, undergone an evaluation approved by Council and satisfied the Executive Director or a panel of the Registration Committee that he or she has successfully completed further education or training or combination of education and training approved by the Registration Committee that was identified in the evaluation as necessary to evidence that the applicant possesses knowledge, skill and judgment at least equivalent to those of current graduates of a program mentioned in sub-subparagraph i A.

2. The applicant must have successfully completed the examination for registration as a registered practical nurse at a time when the examination was approved by Council or have successfully completed another examination approved by Council for that purpose at a time when he or she was eligible to undertake it.

3. The applicant,

i. must have been awarded the diploma mentioned in subparagraph 1 i or ii no more than three years before the day that the applicant met all other requirements for the issuance of the certificate of registration,

ii. must have successfully completed all the requirements of subparagraph 1 iii, iv or v no more than three years before the day that the applicant met all other requirements for the issuance of the certificate of registration,

iii. must demonstrate evidence of practice as a registered practical nurse no more than three years before the day on which the applicant met all other requirements for the issuance of the certificate of registration, or

iv. must have paid any fees required under the by-laws, undergone an evaluation approved by the Registration Committee at a time when the evaluation was approved by the Registration Committee and met requirements regarding additional training, experience, examinations or assessments specified by a panel of the Registration Committee within the period of time specified by the panel.

4. The applicant must, within five years before the day that the applicant is issued a certificate as a registered practical nurse, have successfully completed the examination in nursing jurisprudence that is approved by Council for applicants for the issuance of a certificate as a registered practical nurse.

5. The applicant must have demonstrated language proficiency and the ability to communicate and comprehend effectively, both orally and in writing, in either English or French at a date no more than two years before the day that he or she is issued a certificate in the General class, or such longer period of time as specified by a panel of the Registration Committee, unless,

i. the applicant, on the day he or she submits the application, holds a certificate of registration as a registered practical nurse, other than a certificate in the Emergency Assignment or Non-Practising class, or

ii. the applicant previously held a certificate of registration as a registered practical nurse, other than a certificate in the Emergency Assignment, retired or Non-Practising class and since the last date that the applicant held that certificate no more than two years or such longer period of time as specified by a panel of the Registration Committee has elapsed. O. Reg. 175/12, s. 1.

(2) The requirements of subparagraph 1 ii, iii or v of subsection (1) shall be deemed not to have been met where the nursing program which the applicant relies on to meet that requirement was not recognized or approved in the jurisdiction in which the program was taken as qualifying the applicant to practise as a registered practical nurse in that jurisdiction. O. Reg. 175/12, s. 1.

(3) The requirements in paragraphs 1 and 2 of subsection (1) do not apply to an applicant who previously held a certificate as a registered practical nurse in the General class. O. Reg. 175/12, s. 1.

(4) Subject to subsections (2) and (3) and section 3.1, the requirements in subsection (1) are non-exemptible. O. Reg. 175/12, s. 1.

Mobility Within Canada

3.1 (1) Where section 22.18 of the Health Professions Procedural Code applies to an applicant for a certificate of registration as a registered practical nurse in the General class, the requirements of paragraphs 1, 2 and 3 of subsection 3 (1) of this Regulation are deemed to be met by the applicant. O. Reg. 175/12, s. 1.

(2) Despite subsection (1), it is a non-exemptible requirement that an applicant referred to in subsection (1) provide, for each jurisdiction where the applicant holds an out-of-province certificate, a certificate, letter or other evidence satisfactory to the Executive Director or a panel of the Registration Committee confirming that the applicant is in good standing as a nurse in that jurisdiction. O. Reg. 175/12, s. 1.

(3) Without in any way limiting the generality of subsection (1), “good standing” shall include the fact that,

(a) the applicant is not the subject of any discipline or fitness to practise order or of any proceeding or ongoing investigation or of any interim order or agreement as a result of a complaint, investigation or proceeding; and

(b) the applicant is in compliance with the continuing competency and quality assurance requirements of the regulatory authority that issued the applicant the out-of-province certificate as a registered practical nurse. O. Reg. 175/12, s. 1.

(4) An applicant referred to in subsection (1) is deemed to have met the requirements of paragraph 5 of subsection 3 (1) where the requirements for the issuance of the applicant’s out-of-province certificate of registration included language proficiency requirements equivalent to those required by that paragraph. O. Reg. 175/12, s. 1.

(5) Despite subsection (1), a requirement set out in paragraph 1, 2 or 3 of subsection 3 (1) will apply to an applicant if that requirement is a requirement described in subsection 22.18 (3) of the Health Professions Procedural Code. O. Reg. 175/12, s. 1.

(6) If an applicant to whom subsection (1) applies is unable to satisfy the Executive Director or a panel of the Registration Committee that the applicant practised the profession of nursing to the extent that would be permitted by a General certificate of registration as a registered practical nurse at any time in the three years immediately before the date of that applicant’s application, the applicant must meet any further requirement to undertake, obtain or undergo material additional training, experience, examinations or assessments that may be specified by a panel of the Registration Committee. O. Reg. 175/12, s. 1.

Titles — Registered Practical Nurses

3.2 (1) Subject to subsections (2) and (3), a registered practical nurse in the General class shall use only the title “Registered Practical Nurse” or the abbreviation “RPN” when practising as a nurse. O. Reg. 175/12, s. 1.

(2) If a member is a registered practical nurse in the General class and a registered nurse in the General class, he or she shall use only the title “Registered Nurse” or the abbreviation “RN” when practising the profession as a registered nurse. O. Reg. 175/12, s. 1.

(3) If a member is a registered practical nurse in the General class and a registered nurse in the extended class, he or she shall use only the title “Registered Nurse Extended Class” or “Nurse Practitioner” and the abbreviation “RN(EC)” or “NP” when practising the profession as a registered nurse in the extended class. O. Reg. 175/12, s. 1.

Extended Certificates of Registration

4. (1) The following are additional requirements for the issuance of a certificate of registration as a registered nurse in the extended class:

1. The applicant,

i. must be or have been registered as a registered nurse in the General class by the College,

ii. must meet the registration requirements as a registered nurse in the General class set out in paragraphs 1 and 2 of subsection 2 (1), or

iii. must be or have been registered as a registered nurse by the health regulatory authority in a province or territory of Canada, in one of the states of the United States of America or in another jurisdiction approved by Council.

2. The applicant,

i. must have graduated from an Ontario university nursing program specifically designed to educate and train a registered nurse to practise in the specialty for which he or she applied in the extended class and which program was approved by Council or a body approved by Council for that purpose,

ii. must have graduated from a university nursing program specifically designed to educate and train a registered nurse to practise in the specialty for which he or she applied in the extended class and which program was approved by Council or a body approved by Council for that purpose,

iii. must have graduated from a university nursing program specifically designed to educate and train a registered nurse to practise in the specialty for which he or she applied in the extended class, other than a program mentioned in subparagraph i or ii, which program was approved by the Registration Committee as one whose graduates should possess knowledge, skill and judgment at least equivalent to those of current graduates of a program mentioned in subparagraph i, or

iv. must have graduated from a program in nursing specifically designed to educate and train a registered nurse to practise in the specialty for which he or she applied in the extended class other than a program mentioned in subparagraph i, ii or iii, and,

A. must have successfully completed a program approved by Council as one whose graduates should possess knowledge, skill and judgment at least equivalent to current graduates of a program mentioned in subparagraph i, or

B. must have paid any fees required under the by-laws, have undergone an evaluation approved by Council and satisfied the Executive Director or a panel of the Registration Committee that he or she has successfully completed any further education or training or combination of education and training approved by the Registration Committee that was identified by the evaluation as being necessary to evidence that the applicant possesses knowledge, skill and judgment at least equivalent to those of current graduates of a program mentioned in subparagraph i.

3. The applicant,

i. must be eligible to take the examination in the speciality for which he or she applied in the extended class at the time he or she undertakes it, and

ii. must have successfully completed the examination in that specialty in the extended class for which he or she applied at a time when the examination was approved by Council or must have successfully completed another examination approved by Council for that purpose.

4. The applicant,

i. must have graduated from a university nursing program referred to in subparagraph 2 i, ii or iii no more than three years before the day that he or she met all other requirements for the issuance of a certificate as a registered nurse in the extended class,

ii. must have successfully completed all the requirements of one of sub-subparagraph 2 iv A or B no more than three years before the day that he or she met all other requirements for the issuance of a certificate as a registered nurse in the extended class,

iii. must demonstrate evidence of practice as a registered nurse no more than three years before the day on which the applicant met all other requirements for the issuance of a certificate as a registered nurse in the extended class, and in such a case the practice must include,

A. clinical practice within each specialty in the extended class for which the applicant applied, and

B. a nursing role within that specialty that required him or her to use, in the treatment of patients, advanced knowledge and decision-making skill in assessment, diagnosis and therapeutics, or

iv. must have paid any fees required under the by-laws, undergone an evaluation approved by the Registration Committee at a time when that evaluation was approved by the Registration Committee and met requirements regarding additional training, experience, examinations or assessments specified by a panel of the Registration Committee within the period of time specified by the panel.

5. The applicant must, within five years before the day that the applicant is issued a certificate as a registered nurse in the extended class, have successfully completed the examination in nursing jurisprudence that is approved by Council for applicants for the issuance of a certificate as a registered nurse in the extended class.

6. The applicant must have demonstrated language proficiency and the ability to communicate and comprehend effectively, both orally and in writing, in either English or French at a date no more than two years before the day that he or she is issued a certificate in the extended class, or such longer period of time as specified by a panel of the Registration Committee, unless,

i. the applicant, on the day that he or she submits the application, holds a certificate of registration issued by the College, other than an Emergency Assignment or Non-Practising class, or

ii. the applicant previously held a certificate of registration, other than an Emergency Assignment, retired or Non-Practising class, and no more than two years has elapsed since the date that the applicant last held that certificate or such longer period of time as specified by a panel of the Registration Committee. O. Reg. 175/12, s. 1.

(2) The requirements of subparagraph 2 iii or iv of subsection (1) shall be deemed not to have been met where the nursing program which the applicant relies on to meet that requirement was not recognized or approved in the jurisdiction in which the program was taken as qualifying the applicant to practise as a registered nurse or a registered nurse in the extended class in that jurisdiction. O. Reg. 175/12, s. 1.

(3) An applicant is deemed to have met the requirements of subparagraph 2 i of subsection (1) if he or she,

(a) was enrolled before December 31, 2011, in an Ontario university program designed to educate and train registered nurses to practise the speciality for which the applicant applied in the extended class that was approved by the Council of Ontario University Programs in Nursing and the Senate or Governing Council of the Ontario university that offered the program; and

(b) graduated after December 31, 2011 from the program referred to in clause (a). O. Reg. 175/12, s. 1.

(4) The requirements in paragraphs 1, 2 and 3 of subsection (1) do not apply with respect to an applicant who previously held an extended class certificate of registration as a registered nurse. O. Reg. 175/12, s. 1.

(5) Subject to subsections (3) and (4) and section 4.1, the requirements of subsection (1) are non-exemptible. O. Reg. 175/12, s. 1.

Mobility Within Canada

4.1 (1) Where section 22.18 of the Health Professions Procedural Code applies to an applicant for a certificate of registration as a registered nurse in the extended class, the requirements of paragraphs 1, 2, 3 and 4 of subsection 4 (1) of this Regulation are deemed to be met by the applicant. O. Reg. 175/12, s. 1.

(2) Despite subsection (1), it is a non-exemptible requirement that an applicant referred to in subsection (1) provide, for each jurisdiction where the applicant holds an out-of-province certificate, a certificate, letter or other evidence satisfactory to the Executive Director or a panel of the Registration Committee confirming that the applicant is in good standing as a nurse in that jurisdiction. O. Reg. 175/12, s. 1.

(3) Without in any way limiting the generality of subsection (1), “good standing” shall include the fact that,

(a) the applicant is not the subject of any discipline or fitness to practise order or of any proceeding or ongoing investigation or of any interim order or agreement as a result of a complaint, investigation or proceeding; and

(b) the applicant is in compliance with the continuing competency and quality assurance requirements of the regulatory authority that issued the applicant the out-of-province certificate as a registered nurse in the extended class. O. Reg. 175/12, s. 1.

(4) An applicant referred to in subsection (1) is deemed to have met the requirement of paragraph 6 of subsection 4 (1) where the requirements for the issuance of the applicant’s out-of-province certificate of registration included language proficiency requirements equivalent to those required by that paragraph. O. Reg. 175/12, s. 1.

(5) Despite subsection (1), a requirement set out in paragraph 1, 2, 3 or 4 of subsection 4 (1) will continue to apply to an applicant where that requirement is a requirement described in subsection 22.18 (3) of the Health Professions Procedural Code. O. Reg. 175/12, s. 1.

(6) If an applicant to whom subsection (1) applies is unable to satisfy the Executive Director or a panel of the Registration Committee that the applicant practised the profession of nursing to the extent that would be permitted by an extended class certificate of registration at any time in the three years immediately before the date of that applicant’s application, the applicant must meet any further requirement to undertake, obtain or undergo material additional training, experience, examinations or assessments that may be specified by a panel of the Registration Committee. O. Reg. 175/12, s. 1.

Titles

4.2 (1) Subject to subsections (2), (3), (4) and (5) and 3.2 (3), a registered nurse in the extended class shall use the title “Nurse Practitioner” or the abbreviation “NP” or the title “Registered Nurse Extended Class” or the abbreviation “RN(EC)” when practising as a nurse. O. Reg. 175/12, s. 1.

(2) A member holding a primary health care specialty certificate may use the title “Nurse Practitioner — Primary Health Care” or the abbreviation “NP — PHC” when practising in that role. O. Reg. 175/12, s. 1.

(3) A member holding a paediatrics specialty certificate may use the title “Nurse Practitioner — Paediatrics” or the abbreviation “NP — Paediatrics” when practising in that role. O. Reg. 175/12, s. 1.

(4) A member holding an adult specialty certificate may use the title “Nurse Practitioner — Adult” or the abbreviation “NP — Adult” when practising in that role. O. Reg. 175/12, s. 1.

(5) A member holding an anaesthesia specialty certificate may use the title “Nurse Practitioner — Anaesthesia” or the abbreviation “NP — Anaesthesia” when practising in that role. O. Reg. 175/12, s. 1.

(6) Except as permitted by the Act or this Regulation, no other title, designation, variation, abbreviation or an equivalent in another language shall be used by a registered nurse in the extended class. O. Reg. 175/12, s. 1.

(7) No member shall use the title “Nurse Practitioner” or any variation or abbreviation thereof, or the designation “Registered Nurse Extended Class” or any variation or abbreviation thereof, unless the member holds an extended class certificate of registration. O. Reg. 175/12, s. 1.

(8) No member shall refer to himself or herself as a specialist in any specialty of the extended class unless the member holds a specialty certificate in that specialty. O. Reg. 175/12, s. 1.

Temporary Certificates of Registration

5. (1) The following are additional requirements for the issuance of a certificate of registration in the Temporary class:

1. The applicant must not have previously held,

i. a Temporary certificate of registration as a registered nurse, in the case of a registered nurse applicant, or

ii. a Temporary certificate of registration as a registered practical nurse, in the case of a registered practical nurse applicant.

2. The applicant must meet the educational requirements for a General certificate of registration which are set out in,

i. paragraph 1 of subsection 2 (1), in the case of a registered nurse applicant, or

ii. paragraph 1 of subsection 3 (1), in the case of a registered practical nurse applicant.

3. Since meeting the requirements mentioned in paragraph 2, the applicant must not have failed,

i. an examination mentioned in paragraph 2 of subsection 2 (1), in the case of a registered nurse applicant, or

ii. an examination mentioned in paragraph 2 of subsection 3 (1), in the case of a registered practical nurse applicant.

4. The applicant must have a written offer of employment with an Ontario facility described in Schedule 1, or approved by a panel of the Registration Committee,

i. as a registered nurse, in the case of a registered nurse applicant, or

ii. as a registered practical nurse, in the case of a registered practical nurse applicant.

5. The applicant, within five years before the day that he or she is issued a Temporary certificate, must have successfully completed the examination in nursing jurisprudence approved by Council for,

i. a registered nurse, in the case of a registered nurse applicant, or

ii. a registered practical nurse, in the case of a registered practical nurse applicant.

6. The applicant must have demonstrated language proficiency and the ability to communicate and comprehend effectively, both orally and in writing, in either English or French within two years before the issuance of the certificate or such longer period of time as approved by a panel of the Registration Committee.

7. The applicant must have successfully completed a nursing program that was, at the time the applicant completed the program, recognized or approved in the jurisdiction in which the program was taken as qualifying the applicant,

i. to practise as a registered nurse in that jurisdiction, in the case of an applicant for a Temporary certificate of registration as a registered nurse, or

ii. to practise as a registered practical nurse in that jurisdiction, in the case of an applicant for a Temporary certificate of registration as a registered practical nurse. O. Reg. 175/12, s. 1.

(2) The requirement of subparagraph 2 i of subsection (1) shall be deemed not to have been met unless,

(a) the requirement was met within one year before the day on which the applicant met all other requirements for the issuance of a Temporary certificate as a registered nurse;

(b) the applicant demonstrates evidence of practice as a registered nurse no more than three years before the day on which the applicant met all other requirements for the issuance of a Temporary certificate as a registered nurse; or

(c) the applicant pays any fees required under the by-laws, undergoes an evaluation approved by the Registration Committee, at a time when that evaluation was approved by the Registration Committee, and meets requirements regarding additional training, experience, examinations or assessments specified by a panel of the Registration Committee within three years before the day on which the applicant met all other requirements for the issuance of a temporary certificate as a registered nurse. O. Reg. 175/12, s. 1.

(3) The requirement of subparagraph 2 ii of subsection (1) shall be deemed not to have been met unless,

(a) the requirement was met within one year before the day on which the applicant met all other requirements for the issuance of a Temporary certificate as a registered practical nurse;

(b) the applicant demonstrates evidence of practice as a registered practical nurse no more than three years before the day on which the applicant met all other requirements for the issuance of a Temporary certificate as a registered practical nurse; or

(c) the applicant pays any fees required under the by-laws, undergoes an evaluation approved by the Registration Committee, at a time when that evaluation was approved by the Registration Committee, and meets requirements regarding additional training, experience, examinations or assessments specified by a panel of the Registration Committee within three years before the day on which the applicant met all other requirements for the issuance of a temporary certificate as a registered practical nurse. O. Reg. 175/12, s. 1.

(4) Subject to section 5.2, the requirements of subsection (1) are non-exemptible. O. Reg. 175/12, s. 1.

5.1 (1) The following are terms, conditions and limitations of a Temporary certificate of registration:

1. The member shall practise the profession only within the facility mentioned in paragraph 4 of subsection 5 (1) and only within the scope of his or her employment with that facility.

2. The member’s practice must be monitored and directed by a member of the College holding a General or extended class certificate of registration.

3. The member shall not perform a controlled or authorized act, unless the act is ordered,

i. pursuant to clause 5 (1) (b) of the Act, or

ii. by a registered nurse in the General class.

4. The member shall not supervise, monitor or direct the performance of a controlled or authorized act or the practice of another member in any class.

5. The member shall not accept the delegation of a controlled or authorized act from another member or any other person.

6. The member shall not delegate to another member or any other person the authority to perform a controlled or authorized act.

7. The member shall at all times when providing nursing services identify himself or herself as a Temporary member.

8. The member shall be restricted to the use of the following title:

i. in the case of the holder of a Temporary certificate of registration as a registered nurse, “Registered Nurse (Temporary)” or “RN (Temp)”, or

ii. in the case of the holder of a Temporary certificate of registration as a registered practical nurse, “Registered Practical Nurse (Temporary)” or “RPN (Temp)”. O. Reg. 175/12, s. 1.

(2) A member’s Temporary certificate of registration is automatically revoked on the occurrence of one of the following events, whichever occurs first:

1. The expiry of six months from the date the certificate was issued.

2. The issuance of a General class certificate of registration,

i. as a registered nurse, in the case of a member holding a Temporary certificate of registration as a registered nurse, or

ii. as a registered practical nurse, in the case of a member holding a Temporary certificate of registration as a registered practical nurse.

3. Receipt of notification of the failure of the examination referred to in,

i. paragraph 2 of subsection 2 (1), in the case of a member holding a Temporary certificate of registration as a registered nurse, or

ii. paragraph 2 of subsection 3 (1), in the case of a member holding a Temporary certificate of registration as a registered practical nurse. O. Reg. 175/12, s. 1.

(3) Where a member holding a Temporary certificate of registration obtains alternate or additional employment as a nurse in the same class for which the Temporary certificate of registration was issued, the member may only practise the profession under that employment if,

(a) the employment is with an Ontario facility that is described in Schedule 1 or approved by a panel of the Registration Committee; and

(b) the member has first filed with the College a written offer of employment from that facility. O. Reg. 175/12, s. 1.

Mobility Within Canada

5.2 (1) Where section 22.18 of the Health Professions Procedural Code applies to an applicant for a certificate of registration in the Temporary class, the requirements of paragraphs 2 and 7 of subsection 5 (1) of this Regulation are deemed to be met by the applicant. O. Reg. 175/12, s. 1.

(2) Despite subsection (1), it is a non-exemptible requirement that an applicant referred to in subsection (1) provide, for each jurisdiction where the applicant holds an out-of-province certificate, a certificate, letter or other evidence satisfactory to the Executive Director or a panel of the Registration Committee confirming that the applicant is in good standing as a nurse in every jurisdiction where the applicant holds an out-of-province certificate. O. Reg. 175/12, s. 1.

(3) Without in any way limiting the generality of subsection (2), “good standing” shall include the fact that,

(a) the applicant is not the subject of any discipline or fitness to practise order or any proceeding or ongoing investigation or any interim order or agreement as a result of a complaint, investigation or proceeding; and

(b) the applicant is in compliance with the continuing competency and quality assurance requirements of the regulatory authority that issued the applicant the out-of-province certificate as a registered nurse in the case of an application for a Temporary certificate as a registered nurse, or as a registered practical nurse in the case of an application for a Temporary certificate as a registered practical nurse. O. Reg. 175/12, s. 1.

(4) An applicant referred to in subsection (1) is deemed to have met the requirements of paragraph 6 of subsection 5 (1) where the requirements for the issuance of the applicant’s out-of-province certificate included language proficiency requirements equivalent to those required by that paragraph. O. Reg. 175/12, s. 1.

(5) Despite subsection (1), a requirement set out in paragraph 2 or 7 of subsection 5 (1) will continue to apply to an applicant where that requirement is a requirement described in subsection 22.18 (3) of the Health Professions Procedural Code. O. Reg. 175/12, s. 1.

(6) If an applicant to whom subsection (1) applies is unable to satisfy the Executive Director or a panel of the Registration Committee that the applicant practised the profession of nursing to the extent that would be permitted by a Temporary certificate of registration at any time in the 12 months immediately before the date of that applicant’s application, the applicant must meet any further requirement to undertake, obtain or undergo material additional training, experience, examinations or assessments that may be specified by a panel of the Registration Committee. O. Reg. 175/12, s. 1.

Special Assignment Certificates of Registration

6. (1) The following are additional requirements for the issuance of a certificate of registration as a registered nurse in the Special Assignment class:

1. The applicant must have successfully completed the examination in nursing jurisprudence approved by Council for applicants for a General class certificate of registration as a registered nurse within five years before the day that he or she is issued a certificate as a registered nurse in the Special Assignment class.

2. The applicant must have demonstrated language proficiency and the ability to communicate and comprehend effectively, both orally and in writing, in either English or French within two years before the issuance of the certificate or such longer time as may be specified by a panel of the Registration Committee.

3. The applicant must have successfully completed a nursing program that was, at the time the applicant completed the program, recognized or approved in the jurisdiction in which the program was taken as qualifying the applicant to practise as a registered nurse in that jurisdiction.

4. The applicant,

i. must have met the program requirement mentioned in paragraph 3 within three years before the day on which the applicant met all other requirements for the issuance of a Special Assignment class certificate as a registered nurse,

ii. must demonstrate evidence of practice as a registered nurse no more than three years before the day on which the applicant met all other requirements for the issuance of a Special Assignment class certificate of registration as a registered nurse, or

iii. must have paid any fees required under the by-laws, undergone an evaluation approved by the Registration Committee when that evaluation was approved by the Registration Committee and met requirements regarding additional training, experience, examinations or assessments specified by a panel of the Registration Committee within three years before the day on which the applicant met all other requirements for the issuance of a Special Assignment class of certificate of registration as a registered nurse.

5. The applicant must not have been previously registered with the College as a registered nurse except as the holder of a Special Assignment or Emergency Assignment class certificate.

6. The applicant must have an appointment or special assignment as a registered nurse with an Ontario facility described in Schedule 1 or another assignment approved by a panel of the Registration Committee.

7. The applicant must not have previously held a Special Assignment certificate for the same assignment or appointment. O. Reg. 175/12, s. 1.

(2) Subject to section 6.1, the requirements of subsection (1) are non-exemptible. O. Reg. 175/12, s. 1.

(3) The following are additional registration requirements for the issuance of a certificate as a registered practical nurse in the Special Assignment class:

1. The applicant must have successfully completed the examination in nursing jurisprudence approved by Council for applicants for a General class certificate of registration as a registered practical nurse within five years before the day that he or she is issued a certificate as a registered practical nurse in the Special Assignment class.

2. The applicant must have demonstrated language proficiency and the ability to communicate and comprehend effectively, both orally and in writing, in either English or French at a date no more than two years before the day that he or she is issued the certificate or such longer time as may be specified by a panel of the Registration Committee.

3. The applicant must have successfully completed a nursing program that was, at the time the applicant completed the program, recognized or approved in the jurisdiction in which the program was taken as qualifying the applicant to practise as a registered practical nurse in that jurisdiction.

4. The applicant,

i. must have met the program requirement mentioned in paragraph 3 within three years before the day on which the applicant met all other requirements for the issuance of a certificate as a registered practical nurse in the Special Assignment class,

ii. must demonstrate evidence of practice as a registered practical nurse no more than three years before the day on which the applicant met all other requirements for the issuance of a certificate as a registered practical nurse in the Special Assignment class, or

iii. must have paid any fees required under the by-laws, undergone an evaluation approved by the Registration Committee at a time when that evaluation was approved by the Registration Committee and met requirements regarding additional training, experience, examinations or assessments specified by a panel of the Registration Committee within three years before the day on which the applicant met all other requirements for the issuance of the certificate of registration.

5. The applicant must not have been previously registered with the College as a registered practical nurse except as the holder of a Special Assignment or Emergency Assignment class certificate.

6. The applicant must have an appointment or special assignment as a registered practical nurse with an Ontario facility described in Schedule 1 or another assignment approved by a panel of the Registration Committee.

7. The applicant must not have previously held a Special Assignment certificate for the same assignment or appointment. O. Reg. 175/12, s. 1.

(4) Subject to section 6.2, the requirements of subsection (3) are non-exemptible. O. Reg. 175/12, s. 1.

(5) The following are terms, conditions and limitations of a Special Assignment certificate of registration:

1. The member shall practise the profession only within the scope of his or her appointment or special assignment and only within the facility named in the certificate.

2. The member’s practice must be monitored and directed by a member of the College holding a General or extended class certificate of registration.

3. The member shall not perform a controlled or authorized act, including one which is delegated to him or her, unless the act is ordered,

i. pursuant to clause 5 (1) (b) of the Act, or

ii. by a registered nurse in the General class.

4. The member shall not supervise, monitor or direct the performance of a controlled or authorized act or the practice of another member in any class.

5. The member shall not delegate to another member or any other person the authority to perform a controlled or authorized act.

6. The member shall at all times when providing nursing services identify himself or herself as a Special Assignment member.

7. The member shall be restricted to the use of the following title:

i. in the case of the holder of a Special Assignment certificate of registration as a registered nurse, “Registered Nurse (Special Assignment)” or “RN (Spec. Assign.)”, or

ii. in the case of a holder of a Special Assignment certificate of registration as a registered practical nurse, “Registered Practical Nurse (Special Assignment)” or “RPN (Spec. Assign.)”. O. Reg. 175/12, s. 1.

(6) A Special Assignment certificate of registration is automatically revoked on the occurrence of one of the following events, whichever occurs first:

1. The date specified in the certificate or, if no date is specified, the day that is one year from the date the member was issued the certificate.

2. The last day of the appointment or Special Assignment. O. Reg. 175/12, s. 1.

(7) If a member who holds a Special Assignment certificate of registration does not receive a certificate of another class before the revocation of the Special Assignment certificate, he or she shall be deemed to have resigned as a member at the end of the last day the Special Assignment certificate is valid. O. Reg. 175/12, s. 1.

Labour Mobility — Special Assignment Class

6.1 (1) Where section 22.18 of the Health Professions Procedural Code applies to an applicant for a Special Assignment certificate of registration as a registered nurse, the requirements of paragraphs 3 and 4 of subsection 6 (1) of this Regulation are deemed to be met by the applicant. O. Reg. 175/12, s. 1.

(2) Despite subsection (1), it is a non-exemptible requirement that an applicant referred to in subsection (1) provide, for each jurisdiction where the applicant holds an out-of-province certificate, a certificate, letter or other evidence satisfactory to the Executive Director or a panel of the Registration Committee confirming that the applicant is in good standing as a nurse in that jurisdiction. O. Reg. 175/12, s. 1.

(3) Without in any way limiting the generality of subsection (2), “good standing” shall include the fact that,

(a) the applicant is not the subject of any discipline or fitness to practise order or of any proceeding or ongoing investigation or of any interim order or agreement as a result of a complaint, investigation or proceeding; and

(b) the applicant has complied with continuing competency and quality assurance requirements of the regulatory authority that issued the applicant the out-of-province Special Assignment certificate as a registered nurse. O. Reg. 175/12, s. 1.

(4) An applicant referred to in subsection (1) is deemed to have met the requirement of paragraph 2 of subsection 6 (1) where the requirements for the issuance of the applicant’s out-of-province certificate of registration included language proficiency requirements equivalent to those required by that paragraph. O. Reg. 175/12, s. 1.

(5) Despite subsection (1), a requirement set out in paragraphs 3 and 4 of subsection 6 (1) will apply to an applicant if that requirement is a requirement described in subsection 22.18 (3) of the Health Professions Procedural Code. O. Reg. 175/12, s. 1.

(6) If an applicant to whom subsection (1) applies is unable to satisfy the Executive Director or a panel of the Registration Committee that the applicant practised the profession of nursing to the extent that would be permitted by a Special Assignment certificate of registration as a registered nurse at any time in the three years immediately before the date of that applicant’s application, the applicant must meet any further requirement to undertake, obtain or undergo material additional training, experience, examinations or assessments that may be specified by a panel of the Registration Committee. O. Reg. 175/12, s. 1.

6.2 (1) Where section 22.18 of the Health Professions Procedural Code applies to an applicant for a Special Assignment certificate of registration as a registered practical nurse, the requirements of paragraphs 3 and 4 of subsection 6 (3) of this Regulation are deemed to be met by the applicant. O. Reg. 175/12, s. 1.

(2) Despite subsection (1), it is a non-exemptible requirement that an applicant referred to in subsection (1) provide, for each jurisdiction where the applicant holds an out-of-province certificate, a certificate, letter or other evidence satisfactory to the Executive Director or a panel of the Registration Committee confirming that the applicant is in good standing as a nurse in that jurisdiction. O. Reg. 175/12, s. 1.

(3) Without in any way limiting the generality of subsection (2), “good standing” shall include the fact that,

(a) the applicant is not the subject of any discipline or fitness to practise order or of any proceeding or ongoing investigation or of any interim order or agreement as a result of a complaint, investigation or proceeding; and

(b) the applicant is in compliance with the continuing competency and quality assurance requirements of the regulatory authority that issued the applicant the out-of-province Special Assignment certificate as a registered practical nurse. O. Reg. 175/12, s. 1.

(4) An applicant referred to in subsection (1) is deemed to have met the requirement of paragraph 2 of subsection 6 (3) where the requirements for the issuance of the applicant’s out-of-province certificate of registration included language proficiency requirements equivalent to those required by that paragraph. O. Reg. 175/12, s. 1.

(5) Despite subsection (1), a requirement set out in paragraphs 3 and 4 of subsection 6 (3) will apply to an applicant if that requirement is a requirement described in subsection 22.18 (3) of the Health Professions Procedural Code. O. Reg. 175/12, s. 1.

(6) If an applicant to whom subsection (1) applies is unable to satisfy the Executive Director or a panel of the Registration Committee that the applicant practised the profession of nursing to the extent that would be permitted by a Special Assignment certificate of registration as a registered practical nurse at any time in the three years immediately before the date of that applicant’s application, the applicant must meet any further requirement to undertake, obtain or undergo material additional training, experience, examinations or assessments that may be specified by a panel of the Registration Committee. O. Reg. 175/12, s. 1.

Emergency Assignment Certificates of Registration

7. (1) The following are additional requirements for the issuance of a certificate as a registered nurse in the Emergency Assignment class:

1. The Government of Ontario has requested that the College assist it by issuing Emergency Assignment certificates of registration to qualified applicants.

2. The applicant must satisfy the Executive Director that he or she has language proficiency, in either English or French, to be able to communicate and comprehend effectively, both orally and in writing.

3. The applicant must have successfully completed a nursing program that was, at the time the applicant completed the program, recognized or approved in the jurisdiction in which the program was taken as qualifying the applicant to practise as a registered nurse in that jurisdiction.

4. The applicant must satisfy the Executive Director that he or she practised as a registered nurse within three years before the day on which the applicant met all other requirements for the issuance of the certificate of registration. O. Reg. 175/12, s. 1.

(2) The requirements of subsection (1) are non-exemptible. O. Reg. 175/12, s. 1.

(3) The following are additional requirements for the issuance of a certificate of registration as a registered practical nurse in the Emergency Assignment class:

1. The Government of Ontario has requested that the College assist it by issuing Emergency Assignment class certificates of registration to qualified applicants.

2. The applicant must satisfy the Executive Director that he or she has language proficiency, in either English or French, to be able to communicate and comprehend effectively, both orally and in writing.

3. The applicant must have successfully completed a nursing program that was, at the time the applicant completed the program, recognized or approved in the jurisdiction in which the program was taken as qualifying the applicant to practise as a registered practical nurse in that jurisdiction.

4. The applicant must satisfy the Executive Director that he or she practised as a registered practical nurse within three years before the day on which the applicant met all other requirements for the issuance of the certificate of registration. O. Reg. 175/12, s. 1.

(4) The requirements of subsection (3) are non-exemptible. O. Reg. 175/12, s. 1.

(5) Every certificate of registration in the Emergency Assignment class is subject to the following terms, conditions and limitations:

1. The member shall practise the profession only within the scope of his or her Emergency Assignment certificate.

2. The member shall at all times when providing nursing services identify himself or herself as an Emergency Assignment member.

3. The member shall be restricted to the use of the following title:

i. in the case of a member holding an Emergency Assignment certificate of registration as a registered nurse, “Registered Nurse (Emergency Assignment)” or “RN (Emerg. Assign.)”, or

ii. in the case of a member holding an Emergency Assignment certificate of registration as a registered practical nurse, “Registered Practical Nurse (Emergency Assignment)” or “RPN (Emerg. Assign.)”. O. Reg. 175/12, s. 1.

(6) An Emergency Assignment certificate of registration is automatically revoked on the occurrence of one of the following events:

1. The expiry of 60 days from the date the certificate was issued, unless the Executive Director extends the certificate for one or more extensions under subsection (7).

2. The date the Executive Director extended the certificate under subsection (7).

3. The issuance of a General, extended or Special Assignment class certificate of registration as a registered nurse or a General or Special Assignment certificate of registration as a registered practical nurse.

4. The date that the Executive Director revokes the certificate. O. Reg. 175/12, s. 1.

(7) The Executive Director may extend an Emergency Assignment certificate of registration for one or more periods, each of which is not to exceed 60 days, if, in the opinion of the Executive Director, it is advisable or necessary to do so. O. Reg. 175/12, s. 1.

Non-Practising Certificates of Registration

8. (1) The following are additional requirements for the issuance of a certificate of registration as a registered nurse in the Non-Practising class:

1. The applicant must be a member of the College holding a General or extended class certificate of registration as a registered nurse or have previously been a member of the College holding a General or extended class certificate of registration as a registered nurse.

2. The applicant must not be in default of payment of fees, penalties or any other amount owing to the College on the date of the issuance of the certificate. O. Reg. 175/12, s. 1.

(2) The requirements of subsection (1) are non-exemptible. O. Reg. 175/12, s. 1.

(3) The following are additional requirements for the issuance of a certificate of registration as a registered practical nurse in the Non-Practising class:

1. The applicant must be a member of the College holding a General class certificate of registration as a registered practical nurse or have previously been a member of the College holding a General class certificate of registration as a registered practical nurse.

2. The applicant must not be in default of payment fees, penalties or any other amount owing to the College on the date of the issuance of the certificate. O. Reg. 175/12, s. 1.

(4) The requirements of subsection (3) are non-exemptible. O. Reg. 175/12, s. 1.

(5) Subject to subsection (6), every Non-Practising class certificate of registration is subject to the following terms, conditions and limitations:

1. The member shall not engage in the practice of nursing in Ontario.

2. The member shall not hold himself or herself out as a person qualified to practise in Ontario as a nurse, nurse practitioner, registered nurse, practical nurse, registered practical nurse, or in any speciality of nursing.

3. The member shall be restricted to the use of the following title:

i. in the case of a holder of a Non-Practising class certificate of registration as a registered nurse, “Registered Nurse, Non-Practising”, or “RN Non-Practising”, or

ii. in the case of a holder of a Non-Practising class certificate of registration as a registered practical nurse, “Registered Practical Nurse, Non-Practising” or “RPN Non-Practising”. O. Reg. 175/12, s. 1.

(6) A member holding a Non-Practising class certificate of registration shall not be considered to be in breach of paragraph 1 of subsection (5) if,

(a) the member is engaged in continuing education or remediation directed by a committee or a panel of a committee of the College, approved by the Executive Director or as required to obtain the reinstatement of a General or extended class certificate of registration which he or she formerly held; and

(b) the member maintains professional liability protection in accordance with the requirements, if any, set out in the by-laws for a member holding the class of certificate for which he or she is seeking reinstatement. O. Reg. 175/12, s. 1.

(7) All certificates of registration held by the member shall be revoked automatically at the time that the member is issued a certificate of registration as a registered nurse or registered practical nurse in the Non-Practising class. O. Reg. 175/12, s. 1.

Examinations — General Class

9. (1) The College shall ensure that an examination that is a requirement for a General class certificate of registration for a registered nurse in the General class or a registered practical nurse in the General class is held at least once every six months. O. Reg. 175/12, s. 1.

(2) An applicant who meets the following requirements is eligible to attempt the examination referred to in paragraph 2 of subsection 2 (1) for a General certificate of registration as a registered nurse:

1. The person must file a completed examination application form.

2. The person must pay the required examination fee.

3. The person must meet the requirement of paragraph 1 of subsection 2 (1).

4. The person must not have failed, on three previous occasions, an examination which would, if successfully completed, have met the examination requirement for the issuance of a certificate for a registered nurse in the General class. O. Reg. 175/12, s. 1.

(3) An applicant who meets the following requirements is eligible to attempt the examination referred to in paragraph 2 of subsection 3 (1) for a General certificate of registration as a registered practical nurse:

1. The person must file a completed examination application form.

2. The person must pay the required examination fee.

3. The person must meet the requirement of paragraph 1 of subsection 3 (1).

4. The person must not have failed on three previous occasions an examination which would, if successfully completed, have met the examination requirement for the issuance of a certificate for a registered practical nurse in the General class. O. Reg. 175/12, s. 1.

(4) An applicant who is ineligible to take the examination because he or she failed to meet the requirement in paragraph 4 of subsection (2) may only take the examination if the applicant obtains a new degree that meets the requirement of subparagraph 1 i or ii of subsection 2 (1). O. Reg. 175/12, s. 1.

(5) An applicant who is ineligible to take the examination because he or she failed to meet the requirement in paragraph 4 of subsection (3) may only take the examination if the applicant obtains a new diploma that meets the requirement of subparagraph 1 i or ii of subsection 3 (1) or a new degree that meets the requirement of subparagraph 1 i or ii of subsection 2 (1). O. Reg. 175/12, s. 1.

(6) An applicant who obtains a new degree in accordance with subsection (4) is ineligible to attempt the examination referred to in paragraph 2 of subsection 2 (1) if he or she failed, on three occasions after obtaining the new degree, an examination which would, if successfully completed, have met the examination requirement for the issuance of a certificate for a registered nurse in the General class. O. Reg. 175/12, s. 1.

(7) An applicant who obtains a new diploma or degree in accordance with subsection (5) is ineligible to attempt the examination referred to in paragraph 2 of subsection 3 (1) if he or she failed, on three occasions after obtaining the new diploma or degree, an examination which would, if successfully completed, have met the examination requirement for the issuance of a certificate for a registered practical nurse in the General class. O. Reg. 175/12, s. 1.

Examinations — Extended Class

9.1 (1) The College shall ensure that an examination in each of the specialties that is a requirement for an extended class certificate of registration, other than anaesthesia, is available at least once every year. O. Reg. 175/12, s. 1.

(2) An applicant who meets the following requirements is eligible to attempt the examination referred to in paragraph 3 of subsection 4 (1) for an extended certificate of registration as a registered nurse:

1. The person must file a completed examination application form.

2. The person must pay the required examination fee.

3. The person must meet the requirements of paragraph 1 of subsection 4 (1).

4. The person must meet the requirements of paragraph 2 of subsection 4 (1) for that specialty to which the examination relates.

5. The person must not have failed on three previous occasions an examination for a specialty which would, if successfully completed, have met the examination requirement for registration in the extended class. O. Reg. 175/12, s. 1.

(3) An applicant who is ineligible to take the examination because he or she failed to meet the requirement in paragraph 5 of subsection (2) may only take the examination again if the applicant successfully completes a new program that meets the requirements set out within subparagraph 2 i, ii or iii of subsection 4 (1). O. Reg. 175/12, s. 1.

(4) An applicant who successfully completes a new program in accordance with subsection (3) is ineligible to attempt the examination referred to in paragraph 3 of subsection 4 (1) if he or she failed, on three occasions after completing the new program, an examination for a specialty which would, if successfully completed, have met the examination requirement for registration in the extended class. O. Reg. 175/12, s. 1.

Resignation

10. (1) A member may resign as a member of the College by giving written notice to the College. O. Reg. 175/12, s. 1.

(2) A resignation under this section is effective on the date set out in the resignation or on the date it is received by the College, whichever is later. O. Reg. 175/12, s. 1.

(3) A resignation under subsection (1) automatically revokes the certificate or certificates of registration and any specialty certificates to which it applies at the time the resignation becomes effective. O. Reg. 175/12, s. 1.

Suspension for Failure to Provide Information

10.1 (1) If a member fails to provide to the College information about the member in the manner and form required under the by-laws, the Executive Director shall give the member notice of intention to suspend the member and may suspend one or more of the member’s certificates of registration for failure to provide the information where at least 30 days have passed after notice is given. O. Reg. 175/12, s. 1.

(2) Where the Executive Director suspends a member’s certificate of registration under subsection (1), the Executive Director shall lift the suspension upon being satisfied that the required information has been filed with the College and that any fees required under the by-laws for the lifting of that suspension have been paid. O. Reg. 175/12, s. 1.

Suspension for Failure to Provide Evidence of Professional Liability Protection

10.2 (1) If the Executive Director requests evidence that the member holds professional liability protection in accordance with the requirements, if any, set out in the by-laws and the member fails to provide that evidence within 14 days of having been requested to do so or such longer period as is specified by the Executive Director, the Executive Director shall give the member notice of intention to suspend the member and may suspend the member’s certificate of registration for failure to provide the evidence where at least 30 days have passed after notice is given. O. Reg. 175/12, s. 1.

(2) If a member holds more than one certificate of registration, a suspension mentioned in subsection (1) applies only to the certificate or certificates in respect of which notice was given. O. Reg. 175/12, s. 1.

(3) Where the Executive Director suspends the member’s certificate of registration under subsection (1), the Executive Director shall lift that suspension upon being satisfied that the member holds professional liability protection in accordance with the requirements, if any, set out in the by-laws and that any fees required under the by-laws for the lifting of that suspension have been paid. O. Reg. 175/12, s. 1.

Lifting of Certain Suspensions

10.3 Where the Executive Director suspended a certificate of registration pursuant to section 24 of the Health Professions Procedural Code, the Executive Director shall lift the suspension upon being satisfied that,

(a) all amounts owing to the College at the time of the suspension have been paid; and

(b) any fees required under the by-laws for the lifting of the suspension have been paid. O. Reg. 175/12, s. 1.

Revocation

10.4 (1) The Executive Director shall revoke the certificate of registration of a member where,

(a) his or her certificate of registration was suspended pursuant to section 24 of the Health Professions Procedural Code and that suspension continued for at least 30 days; or

(b) his or her certificate of registration was suspended pursuant to subsection 10.1 (1) or 10.2 (1) of this Regulation and the suspension continued for at least 30 days. O. Reg. 175/12, s. 1.

(2) The Executive Director may revoke a certificate of registration of a member if the member has more than one certificate of registration and gives written notice to the College asking that one of his or her certificates of registration be revoked. O. Reg. 175/12, s. 1.

(3) All specialty certificates are revoked at the time that a member’s extended class certificate of registration is revoked. O. Reg. 175/12, s. 1.

(4) The Executive Director shall revoke a specialty certificate of a registered nurse in the extended class if he or she gives written notice to the College asking that his or her specialty certificate be revoked. O. Reg. 175/12, s. 1.

Reinstatement, on Application

10.5 (1) A former member who held a General certificate of registration as a registered nurse or registered practical nurse or an extended certificate of registration as a registered nurse, and who resigned pursuant to section 10 or whose certificate was revoked pursuant to section 10.4 or a predecessor to one of those provisions may apply for the reinstatement of his or her certificate of registration by submitting a completed application to the Executive Director in the form provided by the Executive Director. O. Reg. 175/12, s. 1.

(2) A former member who applies for reinstatement of a certificate of registration as a registered nurse in the extended class under subsection (1) shall also apply for reinstatement of one or more specialty certificates that he or she previously held. O. Reg. 175/12, s. 1.

(3) Subject to subsection (4), the Executive Director may reinstate the former member’s certificate of registration if,

(a) the Executive Director is satisfied that the former member has corrected the deficiency or deficiencies that provided the grounds for the revocation of the former member’s certificate pursuant to section 10.4, if applicable;

(b) the application for reinstatement was submitted to the Executive Director within three years of the date on which the former member’s certificate of registration was revoked;

(c) the former member has paid,

(i) the reinstatement fees required under the by-laws,

(ii) any other applicable fees required under the by-laws,

(iii) any other money otherwise owed by the former member to the College at the date the application for reinstatement is submitted, including, without limitation, any costs or expenses ordered to be paid under section 53.1 of the Health Professions Procedural Code, any costs awarded to the College by a court and any amount owing to the College under a by-law or former regulation made under the Act; and

(d) the former member,

(i) satisfies the Executive Director that he or she completed all education, experience and training requirements for the issuance of the certificate of registration that is the subject of the application for reinstatement within the three years immediately preceding the date on which the applicant satisfied all other requirements for reinstatement, or

(ii) demonstrates evidence of practice within the three years immediately preceding the date on which the applicant satisfied all other requirements for reinstatement,

(A) as a registered nurse, if he or she is applying for reinstatement of a General certificate of registration as a registered nurse,

(B) as a registered practical nurse, if he or she is applying for reinstatement of a General certificate of registration as a registered practical nurse, or

(C) as a registered nurse in the extended class, if he or she is applying for reinstatement of an extended certificate of registration as a registered nurse and in such a case the practice must include,

(1) clinical practice within each specialty in the extended class for which the former member is seeking reinstatement, and

(2) a nursing role within that specialty that required him or her to use, in the treatment of patients, advanced knowledge and decision-making skill in assessment, diagnosis and therapeutics. O. Reg. 175/12, s. 1.

(4) A former member is ineligible for reinstatement under subsection (3) if he or she,

(a) was, after he or she ceased to be a member, found guilty of any criminal offence in any jurisdiction or of any offence involving the use, possession or sale of drugs in any jurisdiction;

(b) was, after he or she ceased to be a member, found guilty of any offence in any jurisdiction relating to the practice of nursing or any other profession;

(c) has been the subject of an inquiry or investigation by the Executive Director that was not completed on its merits prior to the time that the applicant ceased being a member or that resulted in the member’s resignation;

(d) was, at the time he or she ceased to be a member, the subject of an outstanding order of a Committee or of a panel of a Committee or a Board of Inquiry of the College;

(e) was, at the time he or she ceased to be a member, in breach of an order of a Committee or of a panel of a Committee or a Board of Inquiry of the College;

(f) was, prior to the time he or she ceased to be a member, selected or directed to undergo an assessment or reassessment under the College’s Quality Assurance Program unless the assessment or reassessment was completed and any continuing education or remedial program required by a panel of the Quality Assurance Committee was completed before the time he or she ceased to be a member;

(g) was, at the time he or she ceased to be a member, in breach of any written agreement with or undertaking provided to the College;

(h) was, after he or she ceased to be a member, refused registration in any jurisdiction either in nursing or any other profession; or

(i) was, after he or she ceased to be a member, the subject of a finding of professional negligence or malpractice in any jurisdiction in relation to nursing or any other profession. O. Reg. 175/12, s. 1.

Reinstatement, Non-Practising

10.6 (1) A member holding a Non-Practising certificate of registration may apply for reinstatement of the General certificate of registration as a registered nurse or registered practical nurse or the extended certificate of registration as a registered nurse that he or she previously held by submitting a completed application to the Executive Director in the form provided by the Executive Director. O. Reg. 175/12, s. 1.

(2) A member who applies for reinstatement of a certificate of registration as a registered nurse in the extended class under subsection (1) shall also apply for reinstatement of one or more specialty certificates that he or she previously held. O. Reg. 175/12, s. 1.

(3) Subject to subsection (4), the Executive Director may reinstate the member’s certificate of registration if,

(a) the member has paid,

(i) the reinstatement fees required under the by-laws, and

(ii) any other applicable fees required under the by-laws;

(b) the member demonstrates evidence of practice within the three years immediately preceding the date on which the applicant satisfies all other requirements for reinstatement,

(i) as a registered nurse, if he or she is applying for reinstatement of a General certificate of registration as a registered nurse,

(ii) as a registered practical nurse, if he or she is applying for reinstatement of a General certificate of registration as a registered practical nurse, or

(iii) as a registered nurse in the extended class if he or she is applying for reinstatement of an extended certificate of registration as a registered nurse, and in such a case the practice must have included,

(A) clinical practice within each specialty in the extended class for which the member is seeking reinstatement, and

(B) a nursing role within that specialty that required him or her to use, in the treatment of patients, advanced knowledge and decision-making skill in assessment, diagnosis and therapeutics;

(c) the member demonstrates language proficiency and the ability to communicate and comprehend effectively, both orally and in writing, in either English or French, unless the member held a certificate of registration, other than an Emergency Assignment, retired or Non-Practising certificate of registration, less than two years before applying for reinstatement or within such longer period as specified by the Executive Director; and

(d) the member successfully completed the examination in nursing jurisprudence approved by Council for applicants for the issuance of the class of certificate for which he or she is seeking reinstatement within five years before the date on which the member met all of the other requirements for reinstatement, unless the member held a certificate of registration, other than an Emergency Assignment, retired or Non-Practising certificate of registration, less than five years before applying for reinstatement. O. Reg. 175/12, s. 1.

(4) A member is ineligible for reinstatement under subsection (3) if any of the provisions set out in clauses 10.5 (4) (a) to (i), with necessary modifications, apply to the member. O. Reg. 175/12, s. 1.

Reinstatement, Extended Class

10.7 (1) A member who holds a General certificate of registration as a registered nurse and who formerly held an extended certificate of registration as a registered nurse may apply for the reinstatement of his or her extended certificate of registration by submitting a completed application to the Executive Director in the form provided by the Executive Director. O. Reg. 175/12, s. 1.

(2) A member who applies for reinstatement of a certificate of registration as a registered nurse in the extended class under subsection (1) shall also apply for reinstatement of one or more specialty certificates that he or she previously held. O. Reg. 175/12, s. 1.

(3) The Executive Director may reinstate the member’s extended certificate of registration and one or more speciality certificates previously held by the member if,

(a) the member has paid,

(i) the reinstatement fees required under the by-laws, and

(ii) any other applicable fees required under the by-laws;

(b) the member demonstrates evidence of practice as a registered nurse in the extended class within the three years immediately preceding the date on which the applicant satisfied all other requirements for reinstatement, and in such a case the practice must have included,

(i) clinical practice within each specialty in the extended class for which the member is seeking reinstatement, and

(ii) a nursing role within that specialty that required him or her to use, in the treatment of patients, advanced knowledge and decision-making skill in assessment, diagnosis and therapeutics; and

(c) the member successfully completed the examination in nursing jurisprudence approved by Council for applicants for the issuance of an extended certificate of registration within five years before the date on which the member met all of the other requirements for reinstatement, unless the member held an extended class certificate of registration as a registered nurse less than five years before applying for reinstatement. O. Reg. 175/12, s. 1.

Reinstatement, Pursuant to Order

10.8 (1) If a former member’s certificate of registration is ordered to be reinstated by a panel of the Discipline Committee or of the Fitness to Practise Committee, the Executive Director shall reinstate the certificate of registration upon payment of,

(a) the reinstatement fee required under the by-laws; and

(b) any other applicable fees required under the by-laws. O. Reg. 175/12, s. 1.

(2) If a former member’s extended class certificate of registration is reinstated under subsection (1), any speciality certificate that he or she held shall be reinstated unless otherwise ordered. O. Reg. 175/12, s. 1.

Terms, etc.

10.9 (1) The Executive Director may impose on a member’s certificate of registration that is reinstated under this Regulation any terms, conditions or limitations that were imposed on the member’s previously held certificate of registration. O. Reg. 175/12, s. 1.

(2) Nothing in sections 10.5, 10.6 or 10.7 prevents a member or former member from making an application for a new certificate of registration. O. Reg. 175/12, s. 1.

(3) An applicant for reinstatement under sections 10.5, 10.6 or 10.7 must meet all the requirements for reinstatement within two years of the date of filing his or her completed application to the Executive Director, but this does not prevent the member or former member from filing a new application for reinstatement. O. Reg. 175/12, s. 1.

(4) An applicant for reinstatement under sections 10.5, 10.6 or 10.7 shall be deemed not to have satisfied the requirements for reinstatement if he or she makes a false or misleading statement or representation in the application or supporting documents. O. Reg. 175/12, s. 1.

Declaration

11. (1) Every member holding a General or extended certificate of registration shall make a declaration, at the request of the Executive Director or at the time he or she pays the annual membership fee required under the by-laws, about whether the member has engaged in the practice of nursing in Ontario during the previous three years,

(a) as a registered nurse in the General class, if he or she holds that certificate;

(b) as a registered practical nurse in the General class, if he or she holds that certificate; or

(c) as a registered nurse in the extended class, if he or she holds that certificate, and such a member must also declare whether that practice included,

(i) clinical practice within each specialty in the extended class for which the member holds a specialty certificate, and

(ii) a nursing role within that specialty that required him or her to use, in the treatment of patients, advanced knowledge and decision-making skill in assessment, diagnosis and therapeutics. O. Reg. 175/12, s. 1.

(2) If a member mentioned in clause (1) (a), (b) or (c) declares that he or she has not engaged in the practice of nursing in Ontario during the previous three years, all of the member’s certificates of registration shall be revoked. O. Reg. 175/12, s. 1.

(3) If a member mentioned in clause (1) (c) declares that he or she has engaged in the practice of nursing in Ontario during the previous three years but has not practised in any specialty for which the member holds a specialty certificate,

(a) the member is deemed to have met all the requirements for the issuance of a certificate of registration as a registered nurse in the General class and the Executive Director shall issue that certificate to the member; and

(b) the extended class certificate of registration that the member previously held, along with all of the specialty certificates that the member held, shall be revoked. O. Reg. 175/12, s. 1.

(4) If a member who is a registered nurse in the General class and a registered practical nurse in the General class declares that he or she has not practised as a registered nurse in Ontario during the previous three years, but has practised as a registered practical nurse, the member’s General certificate of registration as a registered nurse shall be revoked. O. Reg. 175/12, s. 1.

(5) If a member who is a registered nurse in the General class and a registered practical nurse in the General class declares that he or she has not practised as a registered practical nurse in Ontario during the previous three years, the member’s General certificate of registration as a registered practical nurse shall be revoked. O. Reg. 175/12, s. 1.

(6) If a member who is a registered nurse in the extended class and a registered practical nurse in the General class declares that he or she has not practised as a registered practical nurse in Ontario during the previous three years, the member’s General certificate of registration as a registered practical nurse shall be revoked. O. Reg. 175/12, s. 1.

(7) If a member who is a registered nurse in the extended class and a registered practical nurse in the General class declares that he or she has not practised in any of the specialties related to his or her extended certificate during the previous three years in Ontario, the member’s extended certificate of registration, along with all the specialty certificates, shall be revoked. O. Reg. 175/12, s. 1.

(8) If a member who is a registered nurse in the extended class declares that he or she practised as a nurse in Ontario during the previous three years in one or more of the specialties related to his or her extended certificate, but did not practise in one or more of the other specialties related to his or her extended certificate, the one or more specialty certificates in which the member did not practise during the previous three years shall be revoked. O. Reg. 175/12, s. 1.

(9) At the request of the Executive Director, a member who makes a declaration under subsection (1) shall provide evidence that, in the opinion of the Executive Director, is satisfactory to support the declaration, within 14 days, or such longer period as approved by the Executive Director. O. Reg. 175/12, s. 1.

Transition

12. (1) A member holding a retired certificate of registration as a registered nurse immediately before January 1, 2013 shall be deemed to be the holder of a Non-Practising certificate of registration as a registered nurse. O. Reg. 175/12, s. 1.

(2) A member holding a retired certificate of registration as a registered practical nurse immediately before January 1, 2013 shall be deemed to be the holder of a Non-Practising certificate of registration as a registered practical nurse. O. Reg. 175/12, s. 1.

12.1 Subject to section 12, every certificate of registration that was in existence immediately before January 1, 2013 is continued as the equivalent certificate of registration under this Regulation and is subject to any terms, conditions and limitations imposed on the certificate of registration. O. Reg. 175/12, s. 1.

12.2 If a certificate of registration of a former member was suspended for failure to pay a fee required under the by-laws or any previous legislation before January 1, 2013 and that suspension was in effect immediately before January 1, 2013, that certificate shall be deemed to be revoked 30 days after January 1, 2013. O. Reg. 175/12, s. 1.

PART III
CONTROLLED ACTS

Interpretation

13.2 In this Part,

“controlled substance” means a controlled substance within the meaning of the Controlled Drugs and Substances Act (Canada);

“electronic signature” means electronic information that a person creates or adopts in order to sign a document and that is in, attached to or associated with the document;

“signature” includes an electronic signature. O. Reg. 387/11, s. 1.

Procedures

14. All procedures on tissue below the dermis or below the surface of a mucous membrane are prescribed for the purposes of paragraph 1 of section 4 of the Act. O. Reg. 387/11, s. 1.

15. (1) For the purposes of clause 5 (1) (a) of the Act, a registered nurse in the general class may perform a procedure set out in subsection (4) if he or she meets all of the conditions set out in subsection (5). O. Reg. 387/11, s. 1.

(2) For the purposes of clause 5 (1) (a) of the Act, any member may perform a procedure set out in subsection (4) if the procedure is ordered by a registered nurse in the general class. O. Reg. 387/11, s. 1.

(3) No registered nurse in the general class shall order a procedure set out in subsection (4) unless he or she meets all of the conditions set out in subsection (5). O. Reg. 387/11, s. 1.

(4) The following are the procedures referred to in subsections (1), (2) and (3):

1. With respect to the care of a wound below the dermis or below a mucous membrane, any of the following procedures:

i. cleansing,

ii. soaking,

iii. irrigating,

iv. probing,

v. debriding,

vi. packing,

vii. dressing.

2. Venipuncture to establish peripheral intravenous access and maintain patency, using a solution of normal saline (0.9 per cent), in circumstances in which,

i. the individual requires medical attention, and

ii. delaying venipuncture is likely to be harmful to the individual.

3. A procedure that, for the purpose of assisting an individual with health management activities, requires putting an instrument,

i. beyond the point in the individual’s nasal passages where they normally narrow,

ii. beyond the individual’s larynx, or

iii. beyond the opening of the individual’s urethra.

4. A procedure that, for the purpose of assessing an individual or assisting an individual with health management activities, requires putting an instrument or finger,

i. beyond the individual’s anal verge, or

ii. into an artificial opening into the individual’s body.

5. A procedure that, for the purpose of assessing an individual or assisting an individual with health management activities, requires putting an instrument, hand or finger beyond the individual’s labia majora. O. Reg. 387/11, s. 1.

(5) The following are the conditions referred to in subsections (1) and (3):

1. The registered nurse has the knowledge, skill and judgment to perform the procedure safely, effectively and ethically.

2. The registered nurse has the knowledge, skill and judgment to determine whether the individual’s condition warrants performance of the procedure.

3. The registered nurse determines that the individual’s condition warrants performance of the procedure, having considered,

i. the known risks and benefits to the individual of performing the procedure,

ii. the predictability of the outcome of performing the procedure,

iii. the safeguards and resources available in the circumstances to safely manage the outcome of performing the procedure, and

iv. other relevant factors specific to the situation.

4. The registered nurse accepts accountability for determining that the individual’s condition warrants performance of the procedure. O. Reg. 387/11, s. 1.

15.1 (1) For the purposes of clause 5 (1) (a) of the Act, a registered practical nurse in the general class may perform a procedure set out in subsection (2) if he or she meets all of the conditions set out in subsection (3). O. Reg. 387/11, s. 1.

(2) The following are the procedures referred to in subsection (1):

1. With respect to the care of a wound below the dermis or below a mucous membrane, any of the following procedures:

i. cleansing,

ii. soaking,

iii. dressing.

2. A procedure that, for the purpose of assisting an individual with health management activities, requires putting an instrument,

i. beyond the point in the individual’s nasal passages where they normally narrow,

ii. beyond the individual’s larynx, or

iii. beyond the opening of the individual’s urethra.

3. A procedure that, for the purpose of assisting an individual with health management activities, requires putting a hand or finger beyond the individual’s labia majora.

4. A procedure that, for the purpose of assessing an individual or assisting an individual with health management activities, requires putting an instrument or finger beyond the individual’s anal verge. O. Reg. 387/11, s. 1.

(3) The following are the conditions referred to in subsection (1):

1. The registered practical nurse has the knowledge, skill and judgment to perform the procedure safely, effectively and ethically.

2. The registered practical nurse has the knowledge, skill and judgment to determine whether the individual’s condition warrants performance of the procedure.

3. The registered practical nurse determines that the individual’s condition warrants performance of the procedure, having considered,

i. the known risks and benefits to the individual of performing the procedure,

ii. the predictability of the outcome of performing the procedure,

iii. the safeguards and resources available in the circumstances to safely manage the outcome of performing the procedure, and

iv. other relevant factors specific to the situation.

4. The registered practical nurse accepts accountability for determining that the individual’s condition warrants performance of the procedure. O. Reg. 387/11, s. 1.

Prescribing, Dispensing, Selling and Compounding a Drug

16. (1) A member shall not engage in conduct that results, directly or indirectly, in a personal or financial benefit that conflicts with his or her professional or ethical duty to a patient as a result of prescribing, dispensing, selling or compounding a drug. O. Reg. 387/11, s. 1.

(2) A member who prescribes, dispenses, sells or compounds a drug shall comply with all applicable federal and provincial law related to prescribing, dispensing, selling or compounding a drug. O. Reg. 387/11, s. 1.

(3) A member who is authorized to prescribe, dispense, sell or compound a drug shall not delegate the performance of prescribing, dispensing, selling or compounding a drug to any other person. O. Reg. 387/11, s. 1.

(4) A member who is authorized to prescribe, sell or compound a drug shall not prescribe, sell or compound a controlled substance. O. Reg. 387/11, s. 1.

Prescribing

17. For the purposes of paragraph 8 of subsection 5.1 (1) of the Act, a member may only prescribe a drug if all of the following conditions are met:

1. The member must have a nurse-patient relationship with the patient for whom the drug is prescribed.

2. The member must prescribe the drug for therapeutic purposes only.

3. The member must ensure that the following information is recorded on the prescription:

i. the name and address of the person for whom the drug is prescribed,

ii. the name, strength (where applicable) and quantity of the drug that is prescribed,

iii. the directions for use,

iv. the member’s name, address, telephone number, title and registration number issued by the College,

v. the member’s signature,

vi. the date on which the drug is prescribed, and

vii. the number of refills, if applicable.

4. The member must retain a copy of the information recorded on the prescription required under paragraph 3 as part of the patient’s health record. O. Reg. 387/11, s. 1.

Dispensing

18. (1) For the purposes of paragraph 8 of subsection 5.1 (1) of the Act, a member may only dispense a drug if all of the following conditions are met:

1. The member must have a nurse-patient relationship with the patient for whom the drug is dispensed.

2. The member must not dispense a drug pursuant to a prescription issued by any other person.

3. The member must provide the drug directly to the patient or the patient’s representative.

4. The member must dispense the drug for therapeutic purposes only.

5. The member must have made reasonable inquiries and be satisfied that,

i. the patient does not have reasonable or timely access to a pharmacy,

ii. the patient would not otherwise receive the drug,

iii. the patient does not have the financial resources to obtain the drug if it is not dispensed by the member,

iv. the drug is being dispensed for a patient in conjunction with a health promotion initiative, or

v. dispensing the drug is necessary to test the patient’s response to the drug.

6. The member must dispense a reasonable quantity of the drug having regard to the information provided by the patient in response to the inquiries under paragraph 5.

7. The member must have reasonable grounds to believe that the drug has been obtained and stored in accordance with any applicable legislation.

8. The member must be satisfied that the drug has not expired and will not expire before the date on which the patient is expected to take the last of the drug.

9. The member must ensure that the container in which the drug is dispensed is marked with,

i. an identification number, if applicable,

ii. the member’s name and title,

iii. the name, address and telephone number of the place from which the drug is dispensed,

iv. the identification of the drug as to its name, its strength (where applicable) and, if available, its manufacturer,

v. the quantity of the drug dispensed,

vi. the date the drug is dispensed,

vii. the expiry date of the drug, if applicable,

viii. the name of the patient for whom the drug is dispensed, and

ix. the directions for use.

10. The member must retain a copy of the information set out under paragraph 9 on the container in which the drug was dispensed in the patient’s health record, along with the information provided by the patient in response to the inquiries under paragraph 5. O. Reg. 387/11, s. 1.

(2) A registered nurse in the extended class shall not describe himself or herself orally or in writing as a person who is authorized to dispense a drug unless he or she sets out in writing or orally the inquiries that must be made by the member before dispensing a drug to a patient under paragraph 5 of subsection (1). O. Reg. 387/11, s. 1.

Compounding

19. For the purposes of paragraph 8 of subsection 5.1 (1) of the Act, a member may only compound a drug if all of the following conditions are met:

1. The member must only compound two or more non-sterile creams or ointments to produce a compounded cream or ointment.

2. The member must ensure that the compounded cream or ointment is for topical use only and for therapeutic purposes.

3. The member must have a nurse-patient relationship with the patient for whom the cream or ointment is compounded.

4. The member must dispense the compounded cream or ointment to the patient or his or her representative or apply it directly to the patient.

5. The member must have made reasonable inquiries and be satisfied that,

i. the patient does not have reasonable or timely access to a pharmacy,

ii. the patient would not otherwise receive the compounded cream or ointment, or

iii. the patient does not have the financial resources to obtain the compounded cream or ointment if it is not compounded by the member.

6. The member must have reasonable grounds to believe that the creams or ointments used in the compounding have been obtained and stored in accordance with any applicable legislation.

7. The member must be satisfied that the creams or ointments used in the compounding have not expired and will not expire before the date on which the patient is expected to apply the last of the compounded cream or ointment.

8. The member must ensure that the container holding the compounded cream or ointment is marked with,

i. an identification number, if applicable,

ii. the name and title of the member,

iii. the name, address and telephone number of the place in which the compounded cream or ointment was compounded,

iv. the identification of the substances used in the compounded cream and ointment, their names, strength and manufacturer,

v. the percentage of each of the creams or ointments used to make the compounded cream or ointment and the quantity placed in the container,

vi. the date the compounded cream or ointment was compounded and the date the compounded cream or ointment was dispensed, if different from the former date,

vii. the expiry date of the compounded cream or ointment,

viii. the name of the patient for whom the cream or ointment was compounded, and

ix. the directions for use.

9. The member must retain a copy of the information set out under paragraph 8 in the patient’s health record, along with the information provided by the patient in response to the inquiries under paragraph 5. O. Reg. 387/11, s. 1.

Selling

19.1 (1) For the purposes of paragraph 8 of subsection 5.1 (1) of the Act, a member may only sell a drug if all of the following conditions are met:

1. The member must have a nurse-patient relationship with the patient to whom the drug is sold.

2. The member must sell the drug for therapeutic purposes only and only if he or she dispenses the drug directly to the patient or the patient’s representative or the drug is administered to the patient.

3. The member must have made reasonable inquiries and be satisfied that,

i. the patient does not have reasonable or timely access to a pharmacy,

ii. the patient would not otherwise buy the drug,

iii. the patient does not have the financial resources to obtain the drug if it is not sold by the member, or

iv. the drug is sold in conjunction with a health promotion initiative.

4. The member must have reasonable grounds to believe that the drug has been obtained and stored in accordance with any applicable federal or provincial legislation.

5. The member must be satisfied that the drug has not expired and will not expire before the date on which the patient is expected to take the last of the drug.

6. The member must not sell a drug if the selling provides a profit to him or her or a direct or indirect personal or financial benefit, other than the actual cost of the drug.

7. The member must retain in the patient’s health record a record that the drug was sold to the patient, the price charged and the information provided by the patient in response to the inquiries under paragraph 3. O. Reg. 387/11, s. 1.

(2) A registered nurse in the extended class shall not describe himself or herself orally or in writing as a person who is authorized to sell a drug unless he or she sets out in writing or orally the inquiries that must be made by the member before selling a drug to a patient under paragraph 3 of subsection (1). O. Reg. 387/11, s. 1.

Administration of a Substance by Injection or Inhalation

20. For the purposes of paragraph 6 of subsection 5.1 (1) of the Act, a member may only administer a substance by injection or inhalation if,

(a) he or she has a nurse-patient relationship with the patient for whom the administration of a substance by injection or inhalation is performed; and

(b) the procedure is performed only for therapeutic purposes. O. Reg. 387/11, s. 1.

PART IV
QUALITY ASSURANCE

General

21. (1) In this Part,

“assessor” means an assessor appointed under section 81 of the Health Professions Procedural Code;

“Committee” means the Quality Assurance Committee of the College. O. Reg. 311/10, s. 1.

(2) Unless otherwise specified, this Part only applies to members holding a general or extended class certificate of registration. O. Reg. 311/10, s. 1; O. Reg. 174/12, s. 11.

22. (1) The Committee shall administer the quality assurance program of the College. O. Reg. 311/10, s. 1.

(2) Any of the powers of the Committee under this Part may be exercised by a panel of the Committee appointed under this section. O. Reg. 311/10, s. 1.

(3) The chair of the Committee may select a panel of at least three members from the members of the Committee. O. Reg. 311/10, s. 1.

(4) A panel shall include,

(a) at least one member who is both a member of the Council and a member of the College; and

(b) at least one person who is a member of the Council appointed to the Council by the Lieutenant Governor in Council. O. Reg. 311/10, s. 1.

(5) Three members of a panel shall constitute a quorum. O. Reg. 311/10, s. 1.

23. The quality assurance program shall include the following components:

1. Member assessment.

2. Practice assessment.

3. Remediation. O. Reg. 311/10, s. 1.

Member Assessment

24. (1) The purpose of the member assessment shall be to assist each member to promote continuing competence and continuing quality improvement of the member’s practice by assisting the member in,

(a) identifying the extent to which his or her practice meets current standards of practice of the profession;

(b) identifying changes in entry to practice competencies, practice environments and technology and the relevance of those changes to the member’s practice; and

(c) identifying actions which the member should take to maintain continuing competence and to continue quality improvement of the member’s practice. O. Reg. 311/10, s. 1.

(2) Each member to whom this Part applies shall participate in a member assessment in accordance with a program approved by Council. O. Reg. 311/10, s. 1.

(3) A member assessment shall include,

(a) a self assessment;

(b) a written learning plan; and

(c) if requested by the Committee or an assessor, the completion of,

(i) one or more written questionnaires, and

(ii) any other materials that, in the opinion of the Committee or an assessor, are relevant to the assessment. O. Reg. 311/10, s. 1.

(4) In order to promote continuing competence and continuing quality improvement of the member’s practice, each member shall prepare and update his or her learning plan at least once every 12 months and shall include in the learning plan a record of,

(a) the specific programs or activities that the member plans to undertake; and

(b) the specific programs or activities in which the member has participated. O. Reg. 311/10, s. 1.

25. (1) The member shall retain the learning plan as well as any written materials required to be completed as part of the member assessment for at least two years. O. Reg. 311/10, s. 1.

(2) The member shall, upon written request of the Committee, submit the learning plan and any written materials required to be completed as part of the member assessment within 30 days of receipt of that request. O. Reg. 311/10, s. 1.

(3) Each member shall at the time of payment of his or her annual fee, if requested, confirm whether or not he or she has completed the member assessment and prepared a learning plan in accordance with this Part in the previous 12 months. O. Reg. 311/10, s. 1.

26. (1) The Committee may require a member who fails to comply with subsection 24 (2), (3) or (4) or section 25, to undergo a practice assessment within the time specified by the Committee. O. Reg. 311/10, s. 1.

(2) The Committee shall give notice to the member described in subsection (1) that he or she may be required to participate in a practice assessment. O. Reg. 311/10, s. 1.

(3) If the Committee determines that the member should undergo a practice assessment, it will give notice of its determination to the member and the member shall be allowed at least 14 days to make submissions to the Committee. O. Reg. 311/10, s. 1.

(4) The Committee shall consider all information that is relevant, including the member’s submissions, and determine whether or not the member shall be required to undergo a practice assessment. O. Reg. 311/10, s. 1.

Practice Assessment and Remediation

27. The purpose of the practice assessment is to assess the knowledge, skill and judgment of the member and shall include peer assessment. O. Reg. 311/10, s. 1.

28. (1) The practice assessment shall include one or more of the following activities:

1. Requiring the member to complete one or more questionnaires.

2. Assessing the records required to be maintained by the member relating to the member assessment.

3. Requiring the member to answer questions relating to the standards of practice of the profession.

4. Requiring the member to demonstrate the application of standards of practice in clinical simulations.

5. Inspecting the member’s records, including without limitation, records relating to the care of patients.

6. Inspecting the member’s clinical practice in accordance with section 82 of the Health Professions Procedural Code.

7. Inspecting the premises where the member practises.

8. Requiring the member to participate in any other reasonable activity approved by the Committee to assess whether the member has satisfactory knowledge, skill and judgment. O. Reg. 311/10, s. 1.

(2) The Committee may require a member to undertake the same or different practice assessment activities as another member holding the same class of certificate of registration. O. Reg. 311/10, s. 1.

(3) The Committee may require a member to undertake one or more additional practice assessment activities if, in the opinion of the Committee, additional information is required to determine whether the member’s knowledge, skill and judgment are satisfactory. O. Reg. 311/10, s. 1.

29. (1) A member shall undergo a practice assessment,

(a) if required to do so by the Committee under section 26; or

(b) if the member’s name is selected in accordance with a process approved by Council. O. Reg. 311/10, s. 1.

(2) The Council may approve different processes for selection under clause (1) (b) for members holding different classes of certificate of registration. O. Reg. 311/10, s. 1.

30. (1) A member who is required to undergo a practice assessment shall co-operate fully with the Committee and any assessor. O. Reg. 311/10, s. 1.

(2) Subject to subsection (3), after a member who is required to undergo a practice assessment has completed it, an assessor shall submit a written report to the Committee respecting the assessment which shall state whether, in the assessor’s opinion, the member’s knowledge, skill and judgment are satisfactory. O. Reg. 311/10, s. 1.

(3) If, after a practice assessment the assessor believes that he or she has insufficient information to form an opinion about whether the member’s knowledge, skill and judgment are satisfactory, the assessor shall submit a written report to the Committee with recommendations about how to obtain sufficient information to enable the assessor to form his or her opinion. O. Reg. 311/10, s. 1.

(4) If, after a practice assessment has been completed, it is the opinion of the assessor that the member’s knowledge, skill and judgment are unsatisfactory, the assessor shall submit a written report to the Committee which shall include the basis for that opinion and recommendations about appropriate specified continuing education programs or remedial measures that may assist in enhancing the member’s knowledge, skill and judgment. O. Reg. 311/10, s. 1.

(5) The Committee shall provide to the member,

(a) a copy of any report made under subsection (2), (3) or (4) along with any other material received by the Committee that is relevant to the member’s assessment; and

(b) where the report was made under subsection (3) or (4), notice of the member’s right to give the Committee a written submission with respect to the assessor’s report within at least 14 days of receipt of a copy of the assessor’s report. O. Reg. 311/10, s. 1.

(6) After receiving an assessor’s report under subsection (3), the Committee shall decide what steps are needed to obtain sufficient information to complete the member’s practice assessment, including one or more of the following:

1. Appointing a new assessor.

2. Requiring the member to engage in the same or different practice assessment activities to complete the practice assessment.

3. Such steps that, in the Committee’s opinion, are appropriate to complete the member’s practice assessment. O. Reg. 311/10, s. 1.

(7) After considering all reports made by an assessor relating to the practice assessment and any other materials received by the Committee relevant to the assessment, including any written submissions made by the member, the Committee shall decide whether the member’s knowledge, skill and judgment are satisfactory. O. Reg. 311/10, s. 1.

(8) Where the Committee requires a member to participate in specified continuing education or remediation programs under section 80.2 of the Health Professions Procedural Code, it shall also specify the time period within which the requirement must be met. O. Reg. 311/10, s. 1.

(9) Where the Committee requires a member to participate in specified continuing education or remediation programs under section 80.2 of the Health Professions Procedural Code, it may also require the member to do one or both of the following:

1. Provide evidence satisfactory to the Committee that the member has complied with the requirement.

2. Undergo a practice reassessment. O. Reg. 311/10, s. 1.

(10) The Committee may appoint an assessor to assess or reassess a member, even if the assessor has conducted a previous assessment or reassessment respecting that member. O. Reg. 311/10, s. 1.

(11) An assessor who conducts a practice reassessment may review any and all assessment reports previously made respecting the member as well as any other material that is relevant to the assessment or reassessment of the member. O. Reg. 311/10, s. 1.

31. The provisions of sections 28 and 30 apply with necessary modifications to a practice reassessment provided that the Committee shall not require the member to undergo more than two practice reassessments without the member’s written consent. O. Reg. 311/10, s. 1.

PART V
DELEGATION

32. In this Part,

“controlled act” means a controlled act set out in subsection 27 (2) of the Regulated Health Professions Act, 1991;

“delegatee” means a person to whom a controlled act is delegated;

“delegator” means a person who delegates a controlled act. O. Reg. 268/13, s. 1.

33. A member shall not, except in accordance with this Regulation, delegate a controlled act or perform a controlled act that was delegated to him or her. O. Reg. 268/13, s. 1.

34. (1) A member who delegates a controlled act is responsible for the decision to delegate the controlled act. O. Reg. 268/13, s. 1.

(2) A member who performs a controlled act that is delegated to him or her is responsible for the decision to carry out the controlled act and for its performance. O. Reg. 268/13, s. 1.

35. (1) Subject to this Part, and to the terms, conditions and limitations placed on his or her certificate of registration, a registered nurse in the General or Emergency Assignment class or registered practical nurse in the General or Emergency Assignment class who is authorized to perform a controlled act set out in section 4 of the Act may delegate that controlled act. O. Reg. 268/13, s. 1.

Note: On the day section 16 of Schedule R to the Health System Improvements Act, 2007 comes into force, section 35 is amended by adding the following subsection: (See: O. Reg. 268/13, ss. 2 (1), 4 (2))

(2) Despite subsection (1), a member mentioned in that subsection may not delegate the controlled act of treating, by means of psychotherapy technique delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual’s judgment, insight, behaviour, communication or social functioning. O. Reg. 268/13, s. 2 (1).

(3) Despite subsection (1), a member mentioned in that subsection may not delegate the controlled act of dispensing a drug. O. Reg. 268/13, s. 2 (2).

36. (1) Subject to this Part, and to the terms, conditions and limitations placed on his or her certificate of registration, a registered nurse in the extended class who is authorized to perform a controlled act set out in section 5.1 of the Act may delegate that controlled act. O. Reg. 268/13, s. 1.

(2) Despite subsection (1), a member mentioned in that subsection may not delegate the controlled acts of prescribing, dispensing, compounding or selling a drug. O. Reg. 268/13, s. 1.

(3) Despite subsection (1), a member mentioned in that subsection may not delegate the controlled act of ordering the application of a form of energy prescribed by the regulations under the Regulated Health Professions Act, 1991. O. Reg. 268/13, s. 1.

(4) Despite subsection (1), a member mentioned in that subsection may not delegate the controlled act of setting a fracture of a bone or dislocation of a joint. O. Reg. 268/13, s. 1.

Note: On the day subsection 18 (4) of the Regulated Health Professions Statute Law Amendment Act, 2009 comes into force, section 36 is amended by adding the following subsection: (See: O. Reg. 268/13, ss. 3, 4 (4))

(5) Despite subsection (1), a member mentioned in that subsection may not delegate the controlled act of treating, by means of psychotherapy technique delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception or memory that may seriously impair the individual’s judgment, insight, behaviour, communication or social functioning. O. Reg. 268/13, s. 3.

37. (1) A member shall ensure, before delegating any controlled act, that he or she,

(a) has the authority under the Act and its regulations to perform the controlled act himself or herself;

(b) has the knowledge, skill and judgment to perform the controlled act safely and ethically;

(c) has a nurse-patient relationship with the patient for whom the controlled act will be performed;

(d) has considered whether delegation of the controlled act is appropriate, bearing in mind the best interests and needs of the patient;

(e) after taking reasonable steps, is satisfied that sufficient safeguards and resources are available to the delegatee so that the controlled act may be performed safely and ethically;

(f) has considered whether delegation of the controlled act should be subject to any conditions to ensure that it is performed safely and ethically and has made the delegation subject to conditions, if applicable;

(g) after taking reasonable steps, is satisfied that the delegatee is a person who is permitted to accept the delegation;

(h) after taking reasonable steps, is satisfied that the delegatee is,

(i) a member of the College who has a nurse-patient relationship with the patient,

(ii) a health care provider who has a professional relationship with the patient,

(iii) a person in the patient’s household, or

(iv) a person who routinely provides assistance or treatment for the patient; and

(i) after taking reasonable steps, is satisfied,

(i) that the delegatee has the knowledge, skill and judgment to perform the controlled act safely and ethically, where the delegatee is a member of the College or member of a health profession other than the profession of nursing, or

(ii) that the delegation is appropriate for the patient and that the delegatee has the knowledge, skill and judgment to perform the controlled act safely and ethically, where the delegatee is not a member of the College or a member of another health profession. O. Reg. 268/13, s. 1.

(2) A member shall not delegate a controlled act that was delegated to him or her to perform. O. Reg. 268/13, s. 1.

(3) A member who delegated a controlled act but has reasonable grounds to believe that the delegatee no longer has the ability to perform the controlled act safely and ethically shall immediately cease to delegate the controlled act to that delegatee. O. Reg. 268/13, s. 1.

38. The delegation of a controlled act may be made orally or in writing. O. Reg. 268/13, s. 1.

39. A member who delegates a controlled act shall,

(a) ensure that a written record of the particulars of the delegation is available in the place where the controlled act is to be performed before it is performed;

(b) ensure that a written record of the particulars of the delegation, or a copy of the record, is placed in the patient record at the time the delegation takes place or within a reasonable period of time afterwards; or

(c) record particulars of the delegation in the patient record either at the time the delegation takes place or within a reasonable period of time afterwards. O. Reg. 268/13, s. 1.

40. Subject to this Part, and to the terms, conditions and limitations placed on their certificate of registration, the following members may, in the course of engaging in the practice of nursing, perform controlled acts that are delegated to them:

1. A registered nurse in the General class or registered practical nurse in the General class.

2. A registered nurse in the extended class.

3. A registered nurse in the Emergency Assignment or Special Assignment class or registered practical nurse in the Emergency Assignment or Special Assignment class. O. Reg. 268/13, s. 1.

41. (1) A member shall not accept the delegation of a controlled act unless the person delegating the controlled act was, at the time of the delegation, a member of the College or a member of another College authorized to perform that controlled act by a health profession Act governing his or her profession. O. Reg. 268/13, s. 1.

(2) A member shall not perform a controlled act that was delegated to him or her by a person to whom the controlled act was delegated. O. Reg. 268/13, s. 1.

(3) A member shall only perform a controlled act delegated to him or her if, before performing the controlled act, the member ensures that he or she,

(a) has the knowledge, skill and judgment to perform the controlled act safely and ethically;

(b) has a nurse-patient relationship with the patient for whom the controlled act is to be performed;

(c) has considered whether performing the controlled act is appropriate, bearing in mind the best interests and needs of the patient;

(d) after taking reasonable steps, is satisfied that there are sufficient safeguards and resources available to ensure that the controlled act can be performed safely and ethically;

(e) has no reason to believe that the delegator is not permitted to delegate that controlled act; and

(f) if the delegation is subject to any conditions, has ensured that any conditions have been met. O. Reg. 268/13, s. 1.

(4) A member who performs a controlled act that was delegated to him or her shall record particulars of the delegation in the patient record, unless,

(a) a written record of the particulars of the delegation is available in the place where the controlled act is to be performed;

(b) a written record of the particulars of the delegation, or a copy of the record, is present in the patient record; or

(c) the particulars of the delegation have already been recorded in the patient record. O. Reg. 268/13, s. 1.

42. Any record of the particulars of a delegation must include,

(a) the date of the delegation;

(b) the delegator’s name, if the controlled act was delegated to the member;

(c) the delegatee’s name, if the controlled act was delegated by the member; and

(d) the conditions, if any, applicable to the delegation. O. Reg. 268/13, s. 1.

SCHEDULE 1

Boards under the Education Act

Boards of Health under the Health Protection and Promotion Act

Independent Health Facilities under the Independent Health Facilities Act

Long-Term Care Homes under the Long-Term Care Homes Act, 2007

Psychiatric Facilities under the Mental Health Act

Hospitals under the Public Hospitals Act

Agencies, Boards and Commissions as defined by the Government of Ontario

Institutions funded by the Minister of Health and Long-Term Care as Community Health Centres (CHCs), Nurse Practitioner-Led Clinics (NPLCs) or Family Health Teams, and physicians funded by Ministry of Health and Long-Term Care primary care alternate payment plan agreements

Post Secondary Educational Institutions

O. Reg. 175/12, s. 2.

SCHEDULES 2, 3 Revoked: O. Reg. 387/11, s. 2.