Licensed Practical Nurse - Nursing Scope of Practice Variations in the Canadian Health Care System

Prestige and Practice - The Hunter College School of Nursing

The Hunter College School of Nursing is one of the highly esteemed units (with the Hunter- Bellevue School of Health Sciences) of the Hunter College' Schools of the Health Professions. Formerly, the nursing school was called Hunter College School of Nursing until the name changed into Hunter- Bellevue School of Nursing.

The Hunter College School of Nursing started in the year 1943 as the Hunter College, New York added a nursing program in their course offerings. It then evolved into a 4-year collegiate program giving it the name Hunter College Program in Nursing. The nursing program however closed in 1969, until it became re-absorbed as the new Hunter- Bellevue School of Nursing based at the Brookdale Campus. The Hunter- (Bellevue) College School of Nursing has then been offering both undergraduate and graduate nursing programs.

The Undergraduate Programs of the Hunter- (Bellevue) College School of Nursing comprise of the generic nursing course as well as the registered nursing prep programs. After the student's completion of the Lower Division Nursing courses and the Hunter College Distribution Requirements, he then advances to a junior admission. The Hunter- (Bellevue) College School of Nursing awards the Bachelor of Science in Nursing only after the student has undergone all requirements of the undergrad course which is a rich combination of the sciences and the arts. After which, he becomes qualified for the Hunter- (Bellevue) College School of Nursing MS and MPH degree Graduate Programs.

The Hunter- (Bellevue) College School of Nursing Graduate Programs are the advanced education curriculum following the Baccalaureate BS Nursing course. It molds the individual's ultimate excellence in the nursing profession both academically and practically. Offering 9 specializations, as well as a subspecialty in nursing HIV/AIDS patients, the Hunter- Bellevue Graduate School of Nursing places its focus both on theory-based practice and research utilization.

As the Hunter- (Bellevue) College School of Nursing MS and MPH have been prepared to assume leadership positions and trained to make significant contributions to the quality of health care and the advancement of nursing as advanced-practice in primary care, clinical specialty, or administration, the graduates immediately assume significant positions in hospitals, community agencies, health care organizations, and faculty schools of nursing, while some also serve as editors, consultants and community political health activists.

Being a proud Alpha Phi Chapter of the sigma Theta Tau Honor Society of Nurisng and CCNE accredited, the Hunter- (Bellevue) College School of Nursing is a prestigious school making major contributions to the health care profession in the United States and serving professional nursing throughout the world.

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The Nurse Practice Act - A Closer Look

The Nurse Practice Act is a set of state laws that govern specific aspects of the nursing profession. The statutes are generally grouped with a chapter of state laws, referred to in its entirety as the Nurse Practice Act "the Act". The Act aims to protect the public from an unsafe nurse by ensuring minimum levels of performance.

Individual state legislatures' determine the Acts content, so "the Act" may differ a bit from state-to-state. Nonetheless, many acts address common issues such as establishing the composition and scope of authority for the board of nursing; defining the practice of professional, practical or vocational nursing and advanced practice nursing; setting the requirements to obtain a nursing license; limiting use of the title, "nurse" and listing the grounds for discipline against a nurse's license.

And to encourage consistency across state lines, the National Council of State Boards of Nursing developed a Model Nursing Practice Act, available at http://www.ncsbn.org.

Individual State Boards of Nursing can exercise a great deal influence over the Act, although they don't author "the Act" because they are the administrative agency charged with implementing and interpreting "the Act" within the scope of authority granted to them by the legislature.

A nurse needs to be knowledgeable about their legal obligations associated with "the Act". In addition, "the Act" may allow a licensed nurse to seek the boards' written opinion regarding "the Acts" interpretation, which the nurse may consider when evaluating legal options.

On the other hand, not all laws governing the practice of nursing are found in "the Act" or its' regulations. Legal obligations common to various licensed healthcare professionals will apply to nurses, such as confidentiality requirements or mandatory reporting of suspected child abuse but these obligations are generally found outside "the Act".

Most public libraries should have a copy of the state statute books which should have a copy each individual states act. However, be sure to get a copy of the most current version and check for the latest amendments that may not be included in the format you're using. It also wouldn't hurt every licensed nurse to have a personal up-to-date copy of "the Act" available for easy reference.

Regulations are generally published in a compilation known as the administrative code. They should also be available from the same sources. Some of the board's written opinions may be public record, so you may want to give the boards' office a call to determine if these documents exist and how to obtain them.

Being Licensed in Multiple States

Most states require that a nurse obtains a license to practice nursing by the state in which they are practicing, with an obligation to abide by that state's laws and regulations, as the condition of accepting a license in the state.

As a result, in most situations, the travel nurse is bound by the Act of the state in which the deed under review occurred. Nevertheless, if one state should discipline a nurse for an act that occurred in its borders, the discipline itself (regardless of the grounds) may serve as the basis for additional discipline in each of the other states where the nurse is licensed. Consequently, a nurse may be disciplined in multiple states stemming from one incident.

Some states have entered into a Nurse Licensure Compact, which permits a licensed nurse to practice nursing in other states without obtaining a separate license. Visit the National Council of State Boards of Nursing at the domain listed earlier for more information.

The nurse must abide by the laws of the state where he or she is practicing, so complaints about the travel nurse would be processed by the state where the alleged violation occurred, but would also be reported to the travel nurse's home state.

Licensed nurses should be familiar with the Nurse Practice Act of whatever state or states they hold a license. The maxim "Ignorance of the law is no excuse" clearly applies in this arena. Remember, nurses can be held accountable for compliance with all laws governing their performance.

All nurses are strongly encouraged to obtain and review a copy of the current act(s) governing their practice and to become knowledgeable about the boards overseeing those acts.

This article may be reproduced only in its entirety.

Kevin Erickson is an entrepreneur and writer. For more articles he's written visit: Travel Nursing | Medical Transcription | Paralegal Degree

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.