Registered nurses frequently contact the College of Registered Nurses of Manitoba (CRNM) with questions related to self-employment. Although self-employed registered nurses face some unique challenges, they are bound by all nursing legislation and standards.
The following resources have been compiled to provide information to assist registered nurses in understanding self-employment. CRNM does not recommend self-employed practice by new graduates or registered nurses with limited or no recent registered nursing practice.
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- Legislation
The Registered Nurses Act and Regulations is the legislation that sets out the College’s legal authority to regulate registered nurses (RN), registered nurses (extended practice) (RN(EP)), and graduate nurses (GN). Registered Nurses in self-employed practice must ensure that they practice in accordance with:
- Nursing Practice Expectations
Nursing Practice Expectations are achievable levels of performance of which all practicing members of the College of Registered Nurses of Manitoba are expected to comply. These expectations are approved by the CRNM Board of Directors.
Standards of Practice
Competencies
Other
Code of Ethics
The Canadian Nurses Association’s
Code of Ethics for Registered Nurses is a statement of the ethical values of nurses and of nurses’ commitments to persons with health-care needs and persons receiving care. It is intended for nurses in all contexts and domains of nursing practice and at all levels of decision-making. It is developed by nurses for nurses and can assist nurses in practising ethically and working through ethical challenges that arise in their practice with individuals, families, communities and public health systems. In June 2008, the CRNM Board of Directors adopted the Code of Ethics for Registered Nurses (2008), part 1 for use by registered nurses in Manitoba.
- Scope of Practice
Accrual of registered nursing practice hours is a requirement for registration renewal (see section E: Registration Renewal).
It is therefore critical that the service being provided by self-employed registered nurses meets the definition of registered nursing practice in
The Registered Nurses Act (2001) section 2(1).
The scope of RN practice is very broad and encompasses all areas of practice and roles for registered nursing. The RN must have current competence (knowledge, skill and judgment) in their area of practice. Just because an RN is providing a service does not mean that it is RN practice.
These resources may help you to determine if the service you wish to provide can be considered registered nursing practice:
- Use of Title
Registered Nurse, Graduate Nurse, Registered Nurse (Extended Practice) and Nurse practitioner are regulated professional designations in Manitoba. This legal restriction assures the public that a person using one of the protected titles is entitled to practice nursing in Manitoba within the scope of practice determined by CRNM.
- Registration Renewal
To be eligible for registration renewal:
- RNs must accrue 1125 total registered nurse practice hours over the previous 5 years or 450 hours in the previous 2 years
- NPs must accrue 1800 total registered nurse (extended practice)/nurse practitioner practice hours over the previous 3 years or 600 hours in the previous year
Continuing Competence
RNs and NPs in self-employed practice are required to complete the College’s Continuing Competence Program on an annual basis. Competence is continually maintained and acquired through reflective practice, lifelong learning and integration of learning into nursing practice. All continuing competence documentation must be kept for
five years for auditing purposes.
- Information Management/Documentation
The management of information is an important consideration for self-employed practice. Documentation is a practice expectation and one of the Standards of Practice for Registered Nurses (Standard IV).
The following publications should be reviewed when considering the management of information:
Self-employed RNs have a legal and ethical responsibility to obtain informed consent from clients for any registered nursing services.
- Legal Information
If you are considering self-employed registered nursing practice you should consult with business professionals such as lawyers and accountants.
For information regarding liability protection, contact the Canadian Nurses Protective Society (CNPS) at 1-800-267-3390 or
visit their website. To access the following documents on the secure member-only section of the CNPS website, use the log-in information on the back of your CRNM certificate of practice. If you cannot find the information contact the College at
- Business Considerations
Marketing/Advertising
Marketing strategies such as business cards, brochures and media advertising may be used provided that the service is represented clearly. It is recommended that legal and financial advice be sought regarding registering the name of the business, licensing requirements, etc.
Fees
Governments do not reimburse registered nurses through provincial health insurance plans, therefore most self-employed RNs are paid directly by their clients or their private insurance. Seeking the advice of an accountant or other financial consultant(s) is recommended.
- Summary and Miscellaneous Resources
Self-employed registered nurses must:
- Be registered on the CRNM practicing register
- Meet the CRNM Continuing Competence program requirements
- Be able to verify practice hours. This may include providing to CRNM client billing information, receipts or contracts upon request
- Have and maintain competencies in the area in which registered nursing services are being provided
- Demonstrate the use of the nursing process to assess, make diagnoses, plan, implement and evaluate all care in a holistic manner
Additional Documents
For more information please contact:
Geraldine Selkirk RN, Nursing Practice Consultant
Telephone: (204) 784-6467
Toll free (Manitoba only): (800) 665-2027 ext. 467
Fax: (204) 775-6052
Email:
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