The Registered Nurse - One of the Three Types of Nursing in Canada

There are three types of nursing if you are considering nursing as a career in Canada:

Licensed Practical Nurse, LPN
Registered Nurse, RN
Registered Psychiatric Nurse, RPN 

In Canada all nursing professions are regulated in the public interest and you must pass a licensing exam to become registered in order to practice nursing as a career.

Nursing education for each of these types of nursing has common curricular components and some specialty components. However, the length of nursing education varies and each category has a defined scope of practice.

Licensed Practical Nurse

The Licensed Practical Nurse has 1-2 years of education in a community college or private post-secondary training institute.  They have a limited nursing scope of practice that is completely contained within the scope of practice of a registered nurse and cannot work with clients who are complex or require multiple interventions.

In Ontario and some other provinces they are called a Registered Practical Nurse and this is abbreviated as RPN. This can be confusing because a registered psychiatric nurse is also abbreviated as RPN in the western provinces. In many provinces LPN's were not fully utilized for many years and the numbers of nurses practicing as a licensed practical nurse declined dramatically. Because of the pressures exerted by fiscal restraint and by the nursing shortage which is quite acute, the licensed practical nurse is now in demand again in provinces where they can legally practice.

Registered Psychiatric Nursing

Schools that prepare nurses to enter psychiatric nursing are limited to the four western provinces of British Columbia, Alberta, Saskatchewan, and Manitoba. There are over 5,000 Registered Psychiatric Nurses registered with the 4 regulatory authorities in these provinces.

Registered Psychiatric Nursing is not recognized as a separate type of nursing in the eastern provinces so that might be why they call practical nurses RPN's (Registered Practical Nurses). This term cannot be used in the western provinces because it already used for psychiatric nurses.

The association of Registered Psychiatric Nurses of Canada recommends that the minimum requirement for initial registrants for entry to practice into the profession of psychiatric nursing should be a baccalaureate degree by the year 2012.

On the Registered Psychiatric Nurses Association of Canada website there are 7 education programs listed for psychiatric nursing in all of Canada. There is no legally recognized classification of Psychiatric Technician in Canada. You may see this as a one of the different types of nursing in other countries such as the United States but it is not a recognized type of nursing in Canada.

Registered Nursing

Of the three types of nursing, registered nursing (the RN) is the most common type.  It is typically the registered nurse that people think of when they think of the nursing profession. Registered nursing has the broadest nursing scope of practice.  

There are no hospital based schools of nursing in Canada.   A university education is required. Some colleges have partnered with universities and students can enter a nursing program where the first two years are offered in the college setting and then complete the nursing degree at the university. 

Most provinces have registered nurse education programs that are 4 years in length ( 8-9 semesters) but some provinces are now implementing a three year program (9 semesters) as an accelerated program in order to bring more nurses into the Canadian health care system more quickly.

One province in Canada (British Columbia) is responding to increased pressures on the Canadian health care system by broadening the scope of practice of the registered nurse to include some tasks that were previously out of scope.

When these new regulations are put in place, under certain circumstances the registered nurse will be able to provide a broader range of services than that provided by the current regulations including:

ordering ultrasound or X-ray  diagnostics (in triage situations)
conducting tuberculosis screening
managing labor in hospital  when the primary  care provider is absent

These changes recognize the current education and skills of the registered nurse.  However, the changes are specific to British Columbia as the nursing profession in Canada  is regulated provincially.  It is quite possible and quite likely however, that other provinces will follow suit.

Beverly Hansen OMalley is a health promotion specialist and likes to write about health related topics that help people in their daily lives. She is the the owner of http://www.registered-nurse-canada.com where she explores the uniqueness of the nursing profession in Canada including comparison of the nursing entrance tests for the US and Canada, comparison of registered nurse salaries across the country and what it means to have a nursing license.

The Nursing Shortage Creates an Abundance of Nursing Jobs in Canada

There has been a nursing shortage in the Canadian health care system for over 30 years.  All indications are that this shortage will worsen and become more acute over the next 10 years.

The Canadian Nurses Association is predicting a shortage of 78,000 nurses in the year 2011.  By 2016 the expectation is that there will be 113,000 unfilled nursing jobs in Canada. 

There are many factors that contribute to the increasing demand for nurses including the needs of the Canadian population, the aging of the workforce already in nursing jobs, and the values and beliefs held by the Canadian public regarding their universal health care system.

Population Health Needs in Canada

It is accepted in Canada that every single person will need professional nursing services at some time in their life and this demand will increase as the Canadian population ages.

There is a well established correlation between aging and the demand for health care services. The population over 85 is the largest growing population segment in Canada.  People are living longer and living with more morbidity and chronic illness that ever before.  As the Canadian population ages there will be increasing demand on the Canadian health care system for services, and a large part of that demand will be for professional nursing services.  

Nursing Workforce

The nursing  workforce reflects the baby boomer demographics of the Canadian public. The average age of a working nurse across all provinces is in the late forties, so a large segment of the workforce already in nursing jobs in the Canadian health care system will be retiring over the next twenty years.  This mass exodus will create more and more unfilled nursing jobs.  Canada has never been able to produce enough nurses to meet the demand so the nursing shortage will increase over the next twenty years.

Values and Beliefs of the Canadian Society

The Canadian culture places a high value on equity, fairness and public accountability.  When the services of the health care system are needed Canadians expect that the needed services can be accessed regardless of age, gender, income, occupation, race, or sexual orientation.  At the same time because of the high regard for individual expression and freedom in Canada those services are expected to be individualized to accommodate the needs and preferences of each person and their family.   Providing individualized care requires optimized nurse patient ratios. 

Nurse patient ratios have been decreasing over the last twenty years in order to optimize the time that nurses have to plan with patients and their families for patient centered care. 

While the evidence shows that having nurses involved with patients and their families in planning hospital care and discharge back home reduces complications and readmission rates, lower nurse patient ratios also increases the demand  for nurses and contributes to the ever increasing nursing shortage.

Nursing as a Career

Canada has never been able to produce enough nurses to meet the demand.  Nurse education programs across the country have wait lists.  Increasing the number of seats in education programs is not an option as the nursing shortage also extends to the professional and academic areas.  Masters educated faculty are in short supply and there are already ongoing vacancies in university faculty positions in nursing programs. 

Nursing as a career is full of opportunity and diversity.  While the bedside nurse is what most people think of when they envision nursing as a career, the truth is that many nurses do not work at the beside.  Nurses work in communities, in research, in outpatient clinics, and a variety of other nursing jobs in the Canadian health care system. 

Because Canada has a universal health care system, governments are constantly re-examining how health care can be delivered in the most efficient and cost effective way without sacrificing quality.  As a result new regulations in some provinces will see nurses performing some functions that were previously out of their professional scope of practice.  These actions are all in a attempt to provide good quality services in a timely way for the Canadian public.

There is an ongoing nursing shortage in Canada and yet the future holds more opportunities and increasing demand for nursing services.  More and more nursing jobs in Canada will become vacant in the next twenty years and all Canadians will need professional nursing services. 

The nursing shortage results from a simple equation of increasing demand and reduction in supply. Now is a good time to consider nursing as a career in Canada.  You will never be without work and the challenge and opportunity for growth will be ongoing.

Beverly Hansen OMalley is a health promotion specialist and likes to write about health related topics that help people in their daily lives. She is the the owner of http://www.registered-nurse-canada.com where she explores the uniqueness of the nursing profession in Canada including comparison of the nursing entrance tests for the US and Canada, comparison of registered nurse salaries across the country and what it means to have a nursing license.

The Nursing Profession in Canada - Understanding the Role of the Regulatory Nursing Organizations

The nursing profession in Canada is regulated in the public interest. There is a regulatory nursing organization in every province established specifically to regulate the nursing profession.

A regulatory authority does not find you a job or even help you with establishing your nursing career. The regulatory nursing organizations in Canada work in the public interest to ensure that Canadians who require nursing services will have a knowledgeable, competent, and ethical practitioner to provide it.

What is the concept of public protection?

Regulation of the nursing profession means that certain standards and rules are in place under specific legislation that governs the profession. Regulation exists to protect the public who are especially vulnerable when they are sick and unable to independently meet their own needs. Laws are passed to protect the public if they happen to be in this state of vulnerability.

In order to start a nursing career and continue to practice as a nurse you must meet the requirements set by the government and enforced by the regulatory nursing body. Regulating the nursing profession improves the probability that the public will receive competent, knowledgeable, and ethical care from all the nurses.

You cannot start your nursing career in Canada unless you are registered with a regulatory authority so you must understand what they do and how and why they exist.

The regulatory nursing organizations act in the public interest and depending on the legislation this regulatory body may be a called a college ( for example the College of Registered Nurses of British Columbia ) or an association.

The mandate of public protection is fulfilled by the nursing regulatory body when they:


sett professional standards
regulate entrance to the nursing profession
regulate nursing programs
provide professional practice support for members
discipline practicing members

Setting Professional Standards

Nursing practice standards are in place in all provinces in Canada. They are established by the regulatory nursing organization as the minimum standard of practice and nurses must practice accordingly. Professional nursing standards form the basis for disciplinary investigations.

Regulating Entrance Into the Nursing Profession

You must pass the nursing entrance test for Canada in order to become a member of the nursing profession. Eligibility for the test is determined by the provincial nursing regulatory body and depends on:


graduation from an approved school of nursing in Canada
clear criminal records check
successful completion of the Canadian nursing entrance test

If you completed your nursing education outside of Canada your nursing degree will be reviewed to determine equivalency to Canadian education programs and you must meet requirements for English competency if your native language is not English.

Success on the nursing entrance exam opens the door to your nursing career in Canada as it is usually the last step to obtaining a nursing license. Once licensing is achieved, you can start your nursing career. You can renew your registration annually if you pay the fee and prove that you have met the requirements for continuing competency.

Regulating Nursing Education Programs

The delivery of post secondary education in Canada is also regulated in the public interest. Nursing schools must meet all these criteria plus the standards put in place by the regulatory nursing organizations. All nursing programs in Canada prepare candidates to write the same nursing entrance test as it is a national nursing exam. This reduces the amount of variation in nursing education programs between provinces.

Providing Professional Practice Support for Members

One of the best ways to ensure public protection is to provide support to the members of the nursing profession. Providing support to practicing members prevents poor practice and promotes good practice. All regulatory nursing organizations will have a professional practice division that is responsible for helping members with their current practice. Consultants work on issues that are in the news and affect nursing practice. They advise members who call in with specific questions and they write policy and professional practice statements.

In addition most regulatory nursing organizations have a library available for members that includes electronic databases and perhaps even a monthly publication on issues affecting the nursing profession in that province and across the country.

Disciplining Practicing Members

Anybody can make a complaint about a nurse simply by contacting the regulatory authority. All complaints are investigated and disciplinary action by the regulatory body must be undertaken if it is determined that the member failed to practice according to the professional standards.

When you enter the nursing profession and begin your nursing career in Canada you practice as a regulated professional. You cannot practice nursing or even use the title nurse if you do not have a nursing license. Safe, ethical, and autonomous practice as a nurse means that you must understand the concept of public protection and how the nursing regulatory bodies fulfill their legislated mandate.

Beverly Hansen OMalley is a nursing educator with a lifelong passion for the nursing profession. She is the the owner of http://www.registered-nurse-canada.com where she explores the uniqueness of the nursing profession in Canada including comparison of the nursing entrance tests for the US and Canada, comparison of registered nurse salaries across the country, and what it means to have a nursing license.

How to Become a Nurse in Canada

Most people ask the question "how to become a nurse" when they  start planning their career path in high school.

You may not be aware that there are three different  types of nursing in Canada and each one has different education requirement ranging from college diploma to university degree.   So when you try to explore how to become a nurse you must know the type of nurse you want to be.

 1. First decide what kind of nurse you want to be. 

registered nursing.  A registered nurse can practice with clients of all age groups and with all types of health challenges of varying degrees of complexities.  A registered nurse can practice in a variety of settings including the community, mental health settings and residential settings.  Of the three types of nursing in Canada the registered nurse has the broadest scope of practice.

registered psychiatric nursing.  A registered psychiatric nurse has a narrower scope of practice than a registered nurse and is restricted to practicing psychiatric nursing. That is they provide mental health nursing care to a wide variety of clients and in a wide variety of settings. Psychiatric nursing is not a recognized type of nursing in all of Canada.  It is only recognized in the western provinces (Manitoba, Saskatchewan, Alberta and British Columbia)

licensed practical nursing.  The licensed practical nurse has the narrowest scope of practice of the three types of nursing.  In some provinces a licensed practical nurse must work under the supervision of a registered nurse and in other provinces the scope of practice is restricted to working as an assistant to the registered nurse, and is some other provinces the licensed practical nurse is fully autonomous and does not require supervision although the scope of practice is narrower that for either of the registered nursing professions.

While the scope of practice and types of clients will vary for each of these types of nursing they are all legally defined as part of the nursing profession.  Which one of these descriptions appeals to you? Your choice may depend on your preference for future career paths as well as your preference for autonomous practice.  More career options are provided by the registered nurse or registered psychiatric nurse designation.

2. Make sure you have the correct high school prerequisites.

 Registered Nurse Education 

A university degree is required to practice as a registered nurse in Canada in all provinces.  You will need to meet the university entrance requirements as well as the specific requirement for the nursing program.

Registered nurse education programs in Canada require basic preparation in:

math usually at the Grade 11 level

sciences - both a chemistry and a biological science will be required.  Usually the chemistry course is a preparatory course such as a grade 11 level and the biological science must be at a higher level such as a grade 12 level

English - admission to a nursing program will require completion of English at a grade 12 level.

Registered psychiatric nursing

Both degree and diploma nurse education programs are available in Canada if you want to enroll in a psychiatric nursing program.  There are three psychiatric nursing programs in Canada that lead to a baccalaureate degree.  All other psychiatric nursing programs lead to a college diploma.  Even though there is no requirement for a university degree you can expect the entrance requirements to be the same as for a registered nurse education program.

Licensed Practical Nurse Education

Licensed practical nurse education programs may not have the same entrance criteria as registered nursing since they are not university degree programs.

Education programs range from one year in length in British Columbia to two years in Alberta and Ontario.  Because of the national variation in the role of the LPN and the length of the education required there may be significant variations in entrance requirements, however, you can expect entrance requirements to reflect a mastery of basic math and English.  Some programs will also require biology as a prerequisite.

3. Select your University or College nursing program

All nurse education programs in Canada take place in post secondary education institutions. There are no hospital based programs in existence so you must attend at a university or college.  Some colleges have partnered with universities making it easier to take the courses for the first first two years of a nursing program at a college and then complete the nursing degree at a university.  Many nursing programs have wait lists so be sure to submit your application as early as you can.

4. Complete the Canadian nursing entrance test.

All types of nursing are regulated in Canada and once you graduate from your nursing education program you will be required to pass a national exam before you can obtain your nursing license.  All nurses in Canada write the same national exam so once you have your license in one province it is easy to move between provinces without having to retake the exam.

So here is the summary of how to become a nurse in Canada:

decide on what type of nurse you want to be
complete the necessary high school credits
find a nursing education program in a college or university.
complete the Canadian national nursing entrance test to obtain your nursing license.

 So now that you know how to become a nurse in Canada isn't it time you got started?  There is an acute nursing shortage in the country and you will never be without work!

Beverly Hansen OMalley is a nurse with over 35 years of experience in nursing education. She has written nursing curriculum for both registered nursing and licensed practical nursing programs and currently works with internationally educated nurses who want to become a nurse in Canada. You are invited to visit http://www.registered-nurse-canada.com where Bev explores the uniqueness of the nursing profession in Canada including comparison of the nursing entrance tests for the US and Canada, comparison of registered nurse salaries across the country and what it means to have a nursing license.

Become a Nurse in Canada - Are You a Registered Nurse in Another Country?

Do you want to become a nurse in Canada?  Did you graduate and work as a registered nurse in another country?   The Canadian immigration doors are open to professionals particularly nurses who want to work in Canada.

Why would you want to become a nurse in Canada?

You can expect to earn an hourly wage between $25 and $35 depending on your level of experience and the province you work in.  The Canadian health care system is publicly funded which means that all hospitals are publicly administered.  You will receive the same salary no matter what hospital you work in because nurses are represented by  provincial labor unions.  There may be some variation in pay between provinces but there is a great deal of parity across the country in registered nurse salaries because of the labor unions.
Besides the reasonable wages there are also employer paid benefits  that have been negotiated by the labor unions including vacation time, sick time, education leave, health insurance, and pension plans.
Canadian immigration has a program for skilled workers that includes nurses.  If you have one year of experience as a registered nurse in your own country you can enter through this program.  If you do not have any experience in nursing you may have to enter Canada through the regular immigration process or through the provincial nominee program.
You will never be short of work.  There are over 250,000 registered nurses in Canada and yet there is still an ongoing nursing shortage.  Presently that shortage is estimated at 78,000 registered nurses and is predicted to rise to over 110,000 by the year 2010. 

Providing that the Canadian immigration rules, policies, and working visa requirements are met you must follow the correct procedure to become a nurse in Canada.  With the exception of providing proof of language proficiency this procedure is the same for all applicants even those educated in Canada.

Apply for your registration.

contact the provincial licensing body for registered nurses ( or licensed practical nurses ).  Be prepared to pay a fee for your application.
submit all the documentation that supports your education, experience, and immigrant status.
provide proof of English language fluency. This includes both reading, writing, and speaking.  Many provincial licensing bodies are now using the Canadian English Language Benchmark Assessment  for Nurses.  Some provinces will require this condition to be met before they accept your application for registration.
submit proof of a clear criminal records check.  You can expect to pay another fee for this. The police run a background check through a database to make sure that you do not have a criminal record.

Write and Pass the Canadian Registered Nurse Exam

Once all your documentation is reviewed and accepted as "equivalent" you will be given permission to write the Canadian Registered Nurse Exam or the Canadian Registered Practical Nurse Exam.  Which exam you write will depend on what type of nursing license you are seeking and what you qualify for.  All provinces have separate nursing regulatory bodies for registered nursing and licensed practical nursing except in Ontario where all nurses are under the same regulatory association.

Substantially Equivalent Competency Assessment

The number of internationally educated nurses who want to become a nurse in Canada is increasing every year and there have been some instances where nurses were entering the system unprepared for the real job of a registered nurse in Canada.  Because of the variations in Education for nurses around the globe  reviewing educational preparation and documentation turned out to not be a good predictor of success in the workplace in all cases.  As a result a new evaluation has emerged called the Substantially Equivalent Competency assessment or SEC.  This is an evaluation that uses both a written test and an observation of your applied clinical skills using simulated nursing situations for the Canadian health care system. 

The SEC evaluations are being done mostly in the western provinces. You may be required to undergo an SEC if your paperwork is not sufficient to support an equivalent education or experience as would be required of a registered nurse in Canada.  This often happens when a nurse graduated in another country some time ago and has many years of experience but cannot produce the complete educational documentation to support the application.

When your application to write the Canadian Registered Nurse Exam is complete there may be a waiting period because the exam is only offered every four months.  However, you may be allowed to work during that time under a temporary nursing license provided all other requirements have been met.  You must however, have an employer willing to hire you under a temporary permit and if you do not pass the Canadian Registered Nurse Exam your temporary permit will be revoked.

Many internationally educated nurses are successful in obtaining their nursing license in Canada and the number of internationally educated nurses working in the Canadian health care system has gone up dramatically since the 1990's.  Between 2000 and 2007 approximately 20% of the candidates who wrote the Canadian Registered Nurse Exam were not educated in Canada.

Your journey to become a nurse in Canada might be lengthy so don't give up!  Being a registered nurse in the Canada health care system means having a secure well paid job that can provide you with challenge and meaning in your life, so it might just be worth it!

Beverly Hansen OMalley is nurse educator with over 6 years experience working with Internationally Educated Nurses who are seeking to become a nurse in Canada. She is the the owner of http://www.registered-nurse-canada.com where she explores the uniqueness of the nursing profession in Canada including comparison of the nursing entrance tests for the US and Canada, comparison of registered nurse salaries across the country and what it means to have a nursing license.

Nursing Careers - Three Types of Nursing Jobs in Canada For Advanced Nursing Practice

Nursing careers offer many opportunities for employment in nursing. Nursing careers are some of the most challenging and rewarding careers in health care.  Typically when one thinks of nursing as a career there is a mental image of working at the bedside of a hospitalized patient.  However, advanced practice nursing provides interesting and challenging work for nurses who want to add to their basic education. Such nursing practice does not necessarily occur at the bedside.

Three different types of nursing that are considered advanced practice nursing jobs in Canada are the clinical nurse specialist, the nurse practitioner and the occupational health nurse.  Each of these career specialities could occur in a variety of settings such as a hospital, a community, or even in industry.

Clinical Nurse Specialist

The role of the clinical nurse specialist can vary greatly depending on the needs of the community and the employer.  The clinical nurse specialist may be directly involved with patients and families and often provides leadership to the nursing staff in a hospital or a community setting.

 A clinical nurse specialist is a registered nurse with a master's degree who is specialized in a particular aspect of nursing  with a specialized client group such as pediatrics or gerontology.  The clinical nurse specialist may also be specialized within a particular clinical area such as oncology,cardiology, or critical care. 

The role of a clinical nurse specialist falls within the legally defined scope of nursing practice for a registered nurse.

Occupational Health Nurse

The occupational health nurse (OHN) works in settings not typically associated with the nursing profession. Uniforms, nursing caps. and shoes have been traded for overalls, steel toe boots, and a hard hat.  Patients are not in hospital beds but are able bodied workers in factories, paper mills, and chemical plants.

According to the Canadian Association of Occupational HealthNurses the scope of nursing practice for an Occupational Health Nurse includes:

"...managing and administering an occupational health service within legal and professional parameters; conducting health examinations; assessing the work environment; providing primary, secondary, and tertiary prevention strategies; providing health education programs; providing health promotion programs; providing counseling interventions and programs; managing the information system; conducting health surveillance programs; monitoring injury/illness trends; as well as program planning, policy development, and cost-containment strategies."

The main focus of the occupational health nurse is promoting and maintaining the health of workers in their work environment.  Nursing practice in this specialty requires a strong knowledge base of :

case management
counselling and crisis intervention
health promotion and risk reduction
legal and regulatory requirements for worker safety
occupational hazard detection and reduction including ergonomic risks

 The occupational health nurse works within the same nursing scope of practice as the bedside nurse or the clinical nurse specialist and is responsible for maintaining the same practice standards as any other nurse registered with the regulatory nursing organization.

 Nurse Practitioner

The nurse practitioner has been a legally defined part of nursing practice in the United states for many years but it is one of the newer  types of nursing jobs in Canada.  The nurse practitioner is still not a legally defined type of nursing in all provinces.   British Columbia is one of the provinces that most recently made the move to include the category of nurse practitioner as one of the types of nursing regulated by the College of Registered Nurses of British Columbia.

Because a nurse practitioner practices in an advanced role as a registered nurse, an advanced education is necessary.  Typically this requires a university degree plus two additional years of nurse practitioner education resulting in a educational qualification equivalent to a master's degree.

Specific competencies for the nurse practitioner must be in place.  Within a legally defined scope of practice a nurse practitioner can engage in activities that may be outside the legal scope of practice of a registered nurse or even a clinical nurse specialist. Such activities include prescribing certain medications and treatments for specified medical problems and ordering diagnostic tests.

The clinical nurse specialist, nurse practitioner, and occupational health nurse are three different types of nursing careers in Canada.  The clinical nurse specialist and the occupational health nurse practice within  the same nursing scope of practice but the nurse practitioner practices outside of this scope of practice and therefore legislation must be in place that defines and regulates this type of nursing practice.  Not all provinces have this in place so the nurse practitioner is not a legally defined type of nursing career in all provinces in Canada.

All nursing jobs in Canada provide for challenge, but these three types of nursing careers have diversity and challenge that goes beyond that typically associated with the bedside nurse in a hospital setting.  However, all these three types of nursing careers are regulated in the public interest and nursing practice in each specialty must adhere to the nursing practice standards set by the regulatory organizations.

Beverly Hansen OMalley is a registered nurse who is passionate about the nursing profession in Canada. http://www.registered-nurse-canada.com explores the uniqueness of the nursing profession in Canada including comparison of the nursing entrance tests for the US and Canada, comparison of registered nurse salaries across the country and how to become a nurse in Canada.