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 Last modified September 8, 2004  

Practising Nursing

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Q

I am an RN and a case manager for a community agency. Because my colleagues in the same position are not nurses, I am unsure if I am practising nursing in this role. If I am practising, my understanding is that I have to participate in Reflective Practice. How do I determine if I am practising nursing?

A

In today’s health care environment nurses work in a wide variety of practice settings. However, the vast majority of nurses do fall into one of four dimensions of practice — direct practitioner, administrator, educator, or researcher — and are expected to participate in Reflective Practice.

It is important to note that you can “practise nursing” without being employed as a nurse. Even though your position as a case manager may not require you to be a nurse, you may still be practising nursing and, as such, would be accountable to the practice standards.

To determine if you are practising nursing ask yourself:

  • Do I apply my nursing knowledge, skill and judgement?
  • Do my actions have a direct or indirect effect on the clients?
  • Am I using the nursing process to make decisions about client care?
  • Am I assessing the client's heath care needs, health care resources and delivery of nursing care?
  • When planning, do I analyze the findings of the health assessment and decide on an appropriate service, care provider or equipment?
  • Do I intervene to provide services, teach colleagues about health, communicate with clients or their families, give professional advice, collaborate with and influence other health care providers, or directly or indirectly manage these providers?
  • Within my role as a case manager, do I interpret client records, have access to confidential information, collect data through a therapeutic nurse-client relationship or am I involved in health-related products or process?

As a case manager, your answers of "yes" would indicate you are practising nursing. For example, assessment skills are key to the co-ordination of in-home care needs and the actions have a direct effect on clients' ability to meet their health care needs at home.

The setting where you carry out the role of case manager may also indicate that you are practising nursing.

If you determine that you are practising nursing, you are required to participate fully in Reflective Practice every year. This five-step, self-directed program includes doing a self-assessment, obtaining peer feedback and developing a learning plan, followed by implementing and evaluating the learning. As a practising nurse, you may also be randomly selected to participate in Practice Review, another element of the Quality Assurance Program that includes a written assessment.

Non-practising nurses are expected to participate partially in Reflective Practice by staying up-to-date on changes in nursing in Ontario. One way of doing this is to read The Standard. Nurses in the Retired Class do not have to participate in Reflective Practice.

 

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