This page provides COVID-19 practice and vaccination information for nurses. In addition to the information on this page, CNO’s Practice Support staff can help with your nursing practice-related inquires. Please review our statement on the standard of care in the Standards & Guidelines section of this website.
COVID-19 point-of-care testing
Who can perform a COVID-19 point-of-care test?
The Ministry of Health created an exemption in the Laboratory and Specimen Collection Centre Licensing Act, 1990 to allow any person to perform a COVID-19 point-of-care test. Anyone performing a test must follow the product label instructions or receive training to make sure they administer the test correctly.
Point-of-care tests involving controlled acts
Nurse Practitioners (NPs) are authorized to perform and order point-of-care tests involving controlled acts, such as nasopharyngeal swabs.
Registered Nurses (RNs) and Registered Practical Nurses (RPNs) need an order or directive from an authorized provider (a physician or NP) to perform a test involving a controlled act.
An unregulated care provider will require delegation from an authorized health care provider, such as an RN or RPN to perform a test involving a controlled act.
Relevant links:
Information For Nurse Practitioners
NPs reporting deaths from COVID-19
When completing medical certificates of death, it is very important to distinguish clearly between deaths that are directly caused by COVID-19 and deaths where the person may have tested positive for COVID-19 but the death resulted from another primary cause.
NPs who sign medical certificates of death caused by any disease of public health significance, or for which the disease of public health significance was a contributing cause of death, have a legal obligation to report these deaths to their local Medical Officer of Health.
Vaccination Information
COVID-19 public health vaccination information
- Nurses are responsible to ensure they have the appropriate knowledge, skill and judgment to safely administer vaccines and to refrain from performing the procedure if they are not competent to do so.
- Public health measures work best when used in combination (for example, vaccination, masking, physical distancing and hand washing).
- Health Canada sets high standards for drug review, approvals and monitoring processes.
- Nurses are accountable to act as role models and follow public health directives that keep patients safe, including knowing the evidence to dispel myths and misinformation so that they can have a conversation with patients in a helpful way.
Resources
Ministry of Health COVID-19 vaccine-relevant information and planning resources
NPs issuing medical exemptions for COVID-19 vaccine
The Ministry of Health's direction provides very few acceptable reasons to issue a medical exemption for the COVID-19 vaccine. For example:
- the patient has a confirmed a severe allergy or an adverse (anaphylactic) reaction to a previous COVID-19 vaccine, or to any of its components, that cannot be mitigated
- the patient has a diagnosed episode of myocarditis/pericarditis after receipt of an mRNA vaccine
To comply with the Ministry's direction, NPs must clearly document any medical exemption, including the reason the patient cannot be vaccinated and the effective time period for the medical reason (unlimited or time-limited).
Talking To Patients About COVID-19 Vaccinations
When you talk to patients about any treatment, ensure you include patients as partners in their care decisions and set aside adequate time to listen to patients, address their concerns and correct misconceptions.
Vaccines are one of the ways we fight COVID-19. Like any other drug/vaccine/treatment, there are benefits and risks. Nurses should discuss the benefits and risks of vaccines versus the risks of diseases.
Nurses can employ the following strategies during difficult discussions with patients:
- continually seek to understand the patient’s health care needs and perspectives
- ask open-ended questions
- acknowledge the patient’s concerns about the health care system and their experiences as a patient
For more information, please see the Conflict Prevention and Management guideline
Resources
Toronto Public Health: Immunization & Vaccine Information for Health Professionals
CNO recommends that nurses get vaccinated
Vaccinations are an evidence-based public health intervention and CNO strongly recommends that nurses get vaccinated. Vaccines produce protection against diseases as a result of the body developing an immune response. This immunity helps people fight the virus if they are exposed.
We also encourage nurses to refer to their employer policies about vaccination requirements.
By getting the COVID-19 vaccine, you are not only protecting yourself, but you are also protecting those you care for, and the health care system’s capacity to deliver needed services during a pandemic.
Vaccination Resources
Health Canada: Vaccines for COVID-19
Vaccine information from the World Health Organization