Communicating a diagnosis

I’m an RN working in a day treatment program that specializes in addictions. I perform substance abuse and substance dependency assessments on clients before they are seen by the physician.

A colleague recently told me that I’m not allowed to communicate a diagnosis to the client, even when the assessment results indicate substance abuse or dependency. Is this true?

Yes. Communicating a diagnosis to a client or their representative is a controlled act that is not authorized to RNs or RPNs. Only Nurse Practitioners (NPs) have the authority to communicate a diagnosis to clients.

The Regulated Health Professions Act, 1991 defines the controlled act of communicating a diagnosis as “identifying a disease or disorder as the cause of symptoms of the individual in circumstances in which it is reasonably foreseeable that the individual or his or her personal representative will rely on the diagnosis.”

This means that RNs and RPNs cannot provide a client with a definitive diagnosis based on the client’s symptoms. However, they can discuss a client’s diagnosis with him or her, after the client has received the diagnosis from practitioners who are authorized to communicate them.

All nurses – RNs, RPNs and NPs – can communicate test results, as well as health conditions (such as pregnancy), which are neither diseases nor disorders. As well, all nurses can communicate findings from an assessment to clients. For example, you can discuss the results of the substance abuse assessment with your client, but you cannot communicate a diagnosis of substance abuse or substance dependency. Nurses should ensure they are not communicating a diagnosis to clients when discussing test results or assessment findings.

You can recommend, when appropriate, that clients follow up with practitioners who are authorized to provide definitive diagnoses to clients, such as physicians or NPs. 

Page last reviewed March 26, 2015