Practice Expectation Spotlight: What’s Changed With the Updated Practice Expectations for RNs 

Practice expectations set out accountabilities and responsibilities that we are all expected to meet when practising registered nursing.  In December 2022, Council approved the updated Practice Direction: Practice Expectations for RNs.  These expectations apply in all domains of practice whether an RN is providing direct care, education, administration, or research.  These expectations also serve as a legal reference to describe reasonable and prudent nursing practice.  In addition, RNs, RN(AP)s, and RN(NP)s are expected to meet these expectations, as well as the additional practice expectations specific to them.

The following is a summation of Practice Expectations for RNs.  You will want to be sure you review the complete document as well as the highlights below.

Competent practice
RNs are accountable and responsible to demonstrate competence in registered nursing practice. 

• Competent practice, previously a responsibility of professional practice, is now its own practice expectation.  Your responsibilities include: 

• • Applying, at a minimum, the entry-level competencies for RNs 
  • Continuing to develop your nursing competence 
  • Using current evidence, critical thinking, and critical inquiry 
  • Employing judgement about the risks and benefits of the various technologies available before and during client care 

Cultural safety, cultural humility, and anti-racism
RNs reflect, learn, act, and work collaboratively to create an environment to promote cultural safety and anti-racism.

• There is an increasing awareness of the need to specifically include expectations for care of Indigenous peoples or anyone vulnerable to experiencing discrimination or health inequity. 
• Responsibilities include: 

• • Reflecting upon and developing awareness of unconscious bias and your personal privileges   
  • Taking active steps to identify, address, prevent, and eliminate any form of racism including Indigenous-specific racism 
  • Improving our understanding of trauma-informed care as well as ways to support a culturally safe environment 
  • Attention to the strength and resilience that all clients bring to their own health care

Professional communication
RNs effectively communicate, integrating the nursing perspective into professional communication. 

• Responsibilities for communication are updated with the following: 

• • Introduce yourself with your full name and title.  Feedback from the public indicates the need for your willingness to use your name and answer their questions.  When you do not do this, it sends a signal that you may not be trustworthy. The need to use your full name and title also remains part of the standard for client-centered care. 
  • Therapeutic relationship development also includes ending relationships appropriately 
  • In ever-increasing complex and changing health care situations, continue to communicate effectively  to promote care continuity and delivery of safe, competent, and ethical care.  This includes a willingness to answer clients’ questions about their health care. 

Professional practice
RNs demonstrate professional behaviours, attributes and values to uphold trust.   

• Responsibilities for professional practice are reorganized to add clarity in this expectation
• We continue to have the responsibility to: 

• • Understand legislation governing RN nursing practice 
  • Promote a practice environment for responsibility, accountability, professional development, and respect 
  • Act as a mentor 
  • Take responsibility for your professional conduct and fitness to practice 
  • Identify and participate to resolve professional practice issues  
  • Follow your duty to report and/or self-disclose 
  • Encourage, facilitate and/or participate in relevant research 

Ethical Practice
RNs recognize, promote, and uphold the ethical standards of the nursing profession . 

• Providing compassionate care, honouring dignity, and non-discrimination continue as vital elements of our need to practice in accordance with values in the Code of Ethics. 

Standards 

• All standards from the CRNM general regulations continue as part of these practice expectations: 

• • Client-centered practice 
  • Collaborative care 
  • Follow-up to diagnostic test results 
  • Practice environment 
  • Client records 

Purpose statement, definitions, and references 

• The purpose statement is updated to more clearly outline the reason for these practice expectations
• New references were added and existing references updated 
• The definitions were updated to now also include: 

• • cultural safety 
  • cultural humility 
  • anti-racism 
  • indigenous 
  • indigenous specific racism 
  • intergenerational trauma 
  • racism 

Updating our practice expectations supports us, as registered nurses in all registration classifications, to continue to serve and protect the public interest.  Standards and practice expectations set the minimum expectations for competent practice.  They provide RNs, RN(AP)s, and RN(NP)s with the parameters to which we are held accountable.  Practice expectations state what the public can expect at a minimum in registered nursing practice. 

RNs who work at the College are reflecting and updating how we will continue to meet our practice expectations.  We acknowledge the need to practice according to the values in the Code of Ethics which has always included the need to promote justice, respect dignity, and provide non-judgmental care.  Increasing awareness of the impact of colonization and oppression of Indigenous peoples highlights the need for practice expectations to incorporate cultural safety, cultural humility, and anti-racism in our practice.  We are always working to improve our continuing competence in everyday practice.  We look forward to sharing Practice Spotlights throughout this year to demonstrate how all RNs, RN(AP)s, and RN(NP)s can and do demonstrate excellence in practice.

References and Resources 

Entry-level Competencies for the Practice of Registered Nurses

Practice Expectations for RNs

Practice Expectation Spotlight: Entry-level Competencies for RN(NP)s