Delegating the communication of a diagnosis

Can RNs or RPNs communicate a diagnosis to a patient if the controlled act is delegated to them?

Yes, an RN or RPN 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 Authorizing Mechanisms practice guideline.

Communicating a diagnosis to a patient has potential risks. In addition to the appropriate authority, it is important that the nurse has the appropriate knowledge, skill and judgement 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 patient
  • Answer questions the patient may have regarding the diagnosis and its meaning for them. The patient will rely on this information to help them determine next steps.
  • Depending on what the diagnosis is, you may need to support the patient through emotional responses.

If a physician or NP feels that delegating the controlled act of communicating a diagnosis to a patient or a patient’s representative is appropriate, they can use their professional judgement 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 patient 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 a procedure under one of the controlled acts, delegates the performance of that procedure 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 Authorizing Mechanisms practice guideline.  

Page last reviewed June 07, 2022