Communicating a diagnosis
Can RNs or RPNs communicate a diagnosis to a client?
RNs and RPNs are not authorized to perform the controlled act of communicating a diagnosis. Only RNs with prescribing authority are authorized to communicate a diagnosis that they have made for the purposes of prescribing medication. RNs with prescribing authority cannot delegate this authority to another RN or RPN. See the Registered Nurse (RN) Prescribing practice standard for more information.
Can RNs or RPNs communicate a diagnosis to a patient if the controlled act is delegated to them?
Yes, RNs or RPNs can communicate a diagnosis if the controlled act is delegated to them The nurse (delegate) and physician/NP (delegator) must meet the requirements outlined in CNO’s Scope of Practice standard. RNs with prescribing authority are not permitted to delegate communicating a diagnosis.
Communicating a diagnosis to a client has potential risks. In addition to the appropriate authority, it is important that the nurse has the appropriate knowledge, skill and judgment to:
- understand the decision-making process leading to the diagnosis including analysis and interpretation of findings from a variety of sources
- ensure appropriate follow up plans are in place for the client
- respond to questions the client may have regarding the diagnosis and its meaning for them. The client will rely on this information to help them determine next steps.
- support the client through emotional responses depending on what the diagnosis is
If a physician or NP determines that delegating the controlled act of communicating a diagnosis to a client or a client’s representative is appropriate, they can use their professional judgment to delegate the activity to an RN or RPN. Before accepting this delegation, the RN or RPN should consider:
- their organization’s policies that support this delegation
- the plan for client follow-up
- a communication strategy to inform the delegator of any important information
What does it mean to delegate a controlled act?
Delegation has a specific meaning in the Nursing Act, 1991. Delegation is a formal process through which a regulated health professional (delegator) who has the authority and competence to perform an activity under one of the controlled acts, delegates the performance of that activity to another individual (delegatee). Delegation can be oral or written, and appropriate documentation of the particulars of the delegation must be maintained by one of the practitioners involved. To delegate or accept a delegation of any controlled act, both the delegator and delegatee must meet the requirements outlined in CNO’s Scope of Practice standard.
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