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Ask Practice

Ask Practice features questions and answers about a variety of practice-related issues that nurses may face over the course of their careers.

The questions come from nurses and the answers are written by the College’s Practice Support Team. Ask Practice is updated on a regular basis, so come back often to see what new questions have been added to the list. Do you have a practice-related question that isn’t addressed here? Contact the Practice Support Team at practicesupport@cnomail.org.

Accountability 

Care Transitions: Transfer of Accountability 
Code Silver 
Communicating test results  
Continuing Competence  
Delegating the communication of a diagnosis 
Immunization reporting requirements 
Initiating a packing dressing
Nurses use of Cannabis 
Nursing Assessment 
Patient-centred care 
Performing frequent client assessments 
Refusing assignments or discontinuing nursing services 
Sleeping during shift breaks 
Risking fatigue by working long hours 
Understanding your scope of practice  
What information is required on name tags?  
Witnessing abuse

Authorizing Mechanisms

Administering influenza vaccine through a directive 
Authority to initiate intravenous lines  
Difference between a directive and prescribing 
Communicating directives 
Do directives expire? 
Signing for narcotic wastage 
Signing prescriptions with “as per…”

Confidentiality and Privacy

Accessing client’s health records 
Police access to health information 
Mandatory reporting of gunshot wounds 
Occupational Health Nurses (OHNs) and confidentiality 
Discussing clients with colleagues online 
Withholding information/Lockbox provision 

Consent

Obtaining informed consent 

Controlled Acts

Performing laser therapy 
Portable bladder ultrasound scanning 
Delegation 
Applying ultrasound in nursing assessments

Decisions About Procedures

Accountabilities when using ultrasound 
Authority to use automated external defibrillators (AEDs) 
Practice settings where health services are routinely performed

Declaration of Practice

Am I practising nursing in my new role? 
Caring for a family member 
Medical leave 
PSW work as evidence of nursing practice

Documentation

Co-signing a documentation entry 
Electronic signatures 
Title use when working in different roles

Ethical Issues

Accepting gifts from clients 
Caring for a friend 
Communicating with clients online 
Culturally Sensitive Care 
Disagreeing with the Care Plan 
Protecting Patients Act, 2017 (Bill 87) 
Providing care to a sexual partner 
Professional versus social relationships 
When employer policies conflict 
When patients attempt sexual touching 

End-of-Life Care

Who can certify death 
Can an RN or RPN pronounce death when death has occurred? 
NP Students and MAID Assessments

Independent Practice

Administering Botox
Record keeping - documentation  
Record keeping - retention 
Fees 
Products and Medication

Medication

Administering Botox 
Administering methadone 
Administering naloxone in emergencies 
Can I distribute naloxone? 
Evidence-informed sources 
Medical Cannabis 
Medication samples 
Narcotic storage and disposal 
No directives for controlled substances 
Recommending OTC medications 
RPNs administering sedation  
Sliding scale insulin 
What patients should consider before getting Botox by a nurse  

Nursing Roles

Can I register as a psychiatric nurse in Ontario?
Complementary Therapies 
Leadership in nursing practice 
Psychotherapy and the controlled act component of psychotherapy 
RPNs as circulating nurses 
RPNs and initiation 
RPNs in triage 
Supporting Learners 

Unregulated Care Providers

Can a UCP or PSW call themselves a nurse? 
Delegating to a Personal Support Worker 
Documenting for Personal Support Workers 
Working with physician assistants 
Teaching a personal support worker to administer injections 
Teaching UCP to administer Naloxone 
Teaching UCP to give oral medication 

Page last reviewed October 04, 2021