Quality Practice - A resource for nurses and nurse leaders

  June 2019 | Volume 18, issue 3
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Remind new employees to update the public Register

Nurses have an accountability to update their employment information on the public Register whenever there is a change in their employment info. If you’ve recently hired any new employees, please remind them of this accountability.

Nurses can log on to Maintain Your Membership to update their info. This should be done within 30 days of the change. We require this so that the public Register, Find a Nurse, is always up to date. It’s important for the public and employers to have accurate information about nurses. It increases transparency, promotes trust and allows people to make informed decisions about who is providing their care.

  • Job or business address. The address and contact info of their current employer or employers. This includes any volunteer or unpaid positions in which a nurse is providing nursing care.
  • Contact info. So that we can reach nurses with important information, they should make sure their home address, telephone number and email are current. This information will not appear on Find a Nurse.
  • Other registrations and licences. Nurses must report any other professional licences or registrations in any province, territory or country. This includes additional nursing licences from other provinces or territories or outside of Canada, as well as non-nursing licences and registrations.

For NPs

  • Hospital or health facility privileges. NPs should make sure we have a current and complete list of each hospital or health facility where they hold privileges. They must also let us know if their privileges are revoked, suspended or restricted. 

If nurses do not update this info within 30 days of a change, they might be fined $100. They can check their info to make sure it’s current and update their information quickly and easily at any time on Maintain Your Membership.

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We’re getting ready for committee recruitment this fall

At CNO, committees are critical to our mandate to protect the public. For the nurses who join, it is an opportunity to contribute to patient safety, learn about regulation and hone their skills in decision-making, communication and teamwork. They bring that knowledge back to where they work.

Each year, we appoint RPNs, RNs and NPs to committees such as Discipline; Fitness to Practise; Inquiries, Complaints and Reports; Quality Assurance; and Registration.

This year, we needed to fill 10 positions on four committees. The response was great overall. We received 48 applications and filled our vacancies with qualified candidates but we received relatively few applications from RPNs. We know there are qualified RPNs out there. We have several RPNs serving on CNO committees now, including in leadership roles (such as our panel chair). As we plan for 2020 recruitment, we want to get the word out early that we need more RPNs to apply!

To serve on a committee, we need nurses who understand practice standards and how a nurse’s practice, behaviour and health impacts patient safety. We want nurses who demonstrate a commitment to acting in their patients’ best interest.

Do you know RPNs who are strongly committed to patient care and you think would be an asset on a committee? Is that someone you would like to see grow in new ways? Encourage them to learn more about CNO’s statutory committees by visiting www.cno.org/committee-application.

Our next application process will open in early fall 2019.


A new way to assess risk

Addressing concerns about a nurse’s behaviour is one of the ways CNO protects the public. When an employer, patient, or another health professional tells us that they have a concern about the conduct or competence of a nurse, we begin by assessing the alleged conduct to determine how risky the nurse’s behaviour is to patients. 

Assessing risk is a complex process and we must consider a wide range of factors. To support this work, we developed a tool that will make it easier for us to complete our assessment. You can view the new Risk Analysis Tool at www.cno.org/reports. Creating this tool is part of our ongoing effort to enhance our professional conduct procedures.

When we created the tool, we also added a few new factors based on recent research. For example, we added factors to help identify nurses who intentionally cause serious harm. This addition came from research we conducted to improve our processes and support the Long-Term Care Homes Public Inquiry.

When using the new tool, the investigator will:

  • consider the nurse’s conduct, including the nurse’s intent, behaviour and response, and professional conduct history
  • identify the level of risk and whether the nurse’s behaviour was deliberate, reckless, put patients at risk, or was a result of human or system error
  • balance evidence-informed risk factors against mitigating factors
  • consider the public’s interest, including the risk of the nurse repeating the action and causing patient harm

Using the results, the investigator can more accurately determine the level of risk a nurse has to public safety and make a recommendation to CNO’s Executive Director. These recommendations vary depending on the seriousness of the conduct. A nurse with low-risk behaviour may receive a letter of notice and direction from CNO asking them to review specific practice standards and guidelines. High-risk behaviour can lead to a formal hearing to determine if the nurse’s conduct breached practice standards. 

If you would like to know more about this process, read “What does the College do when it receives a report?” in our Mandatory Reporting: A process guide for employers, facility operators and nurses.

You can learn more about our investigation process and the factors we consider when deciding how to address information we receive about nurses at www.cno.org/reports.
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Should a nurse ever accept a patient’s friend request on social media?

Social media use has moved far beyond being just a way to communicate with friends. It’s now used regularly in most professional settings, including health care. As a result, nurses are facing increased requests from patients to connect on not only professional social media accounts, but on their personal ones as well. So, while trying to balance privacy and boundary requirements, how do you know what social media activity is acceptable and what’s not?

The answer is actually straightforward.

A nurse should never accept a patient’s friend request on their personal social media accounts.

A nurse should not enter into a friendship or other personal relationship with a patient, their family members or their substitute decision-makers. They should always keep their personal and professional lives separate.

By connecting on or corresponding over a personal social media account, a nurse is crossing the boundary where the professional therapeutic nurse-client relationship changes to unprofessional and personal. If you or nurses at your facility would like to learn more, read our article in the April issue of The Standard.

More information
The Code of Conduct states that nurses are accountable for maintaining professional boundaries with patients and that nurses should not share personal patient information on social media.

In addition, the International Nurse Regulator Collaborative, a group of seven nursing regulators that includes CNO, has released a position statement on the use of social media by nurses. Nurses can read these recommendations to learn about respecting boundaries, acting professionally and maintaining patient privacy (as well as their own) while blogging, sharing photos or posting on social media.

Our social media webcast, Social Media: Reflect Before You Post, shows how to use CNO practice standards and reflective questions to assess situations before engaging in any social media activity.

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