Health Transition Fund Final Report - Projects Listed By Subject Area

delegated must be used in accordance with the laws of Canada and the relevant province/territory. As with
other self-regulating professions, the role of nursing associations include:
< the establishment and enforcement of standards of practice;
< control of entry into the practice of nursing; and
< a mandate to ensure that nursing practice within the relevant jurisdiction is carried out
consistently and safely.
The interface between professional groups and the health care system is multi-faceted. The
boundaries of a profession’s practice domain is defined within its “scope of practice” guidelines. Of
significance to the extended/expanded nursing role are the “scopes of practice” of physicians, registered
nurses and pharmacists. The primary care functions included within the extended/expanded nursing role
which are of interest in the current study are those functions which have been delegated through legislation
to physicians and/or pharmacists. If registered nurses are to perform functions that are within the scope
of practice of another profession, authority to do so must be secured from the relevant regulatory body or
specific legislation enacted to include them within nursing’s scope of practice.
Certain functions may also be shared by nursing with medicine and/or pharmacy. Traditionally
shared jurisdictions have been undertaken through protocol arrangements negotiated between the
regulatory bodies of nursing, medicine, pharmacy, government, and/or individual employers. Protocol
arrangements do not transfer the authority to perform shared functions to all registered nurses but rather
restricts these functions to those who have been appropriately trained to undertake them. The important
question is what are the most appropriate strategies for providing nurses with the authority and resources
to undertake the functions of the extended/expanded role. This is a relevant public policy consideration
for all governments, professional associations and the public.
1.5 Health Care Reform and the Extended/Expanded Role of the Registered Nurse
Canada’s health care system is being challenged on two fronts: 1) both the underlying fundamental
assumptions of our publically funded system and, 2) sustaining the system itself. All levels of government
have been promoting a policy direction that recognizes the broadness of the health concept and the need
The Centre for Nursing Studies in collaboration with
The Institute for the Advancement of Public Policy, Inc. 5