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Newfoundland and Labrador
Regulation 2013


NEWFOUNDLAND AND LABRADOR REGULATION 66/13

NEWFOUNDLAND AND LABRADOR
REGULATION 66/13

Registered Nurses Regulations
under the
Registered Nurses Act, 2008

(Filed June 12, 2013)

Under the authority of sections 11 and 38 of the Registered Nurses Act, 2008, the Council of the Association of Registered Nurses of Newfoundland and Labrador, with the approval of the Minister of Health and Community Services, makes the following regulations.

Dated at St. John’s, June 12, 2013.

Catherine Stratton
President
Council of the Association of Registered Nurses
 of Newfoundland and Labrador

Susan Sullivan
Minister of Health and Community Services

REGULATIONS

Analysis


        1.   Short title

        2.   Definitions

              PART I
REGISTRATION

        3.   Registration

        4.   Provisional
registration

              PART II
LICENSURE

        5.   Registered nurse licence

        6.   Interim licence

        7.   Exam failure -
registered nurse

        8.   Nurse practitioner
licensure

        9.   Interim nurse
practitioner
licensure

      10.   Exam failure -
nurse practitioner

      11.   Licence conditions

      12.   Renewal of
registered nurse licence

      13.   Renewal of nurse practitioner
licensure

              PART III
NURSE PRACTITIONER AUTHORITY AND PROTOCOLS

      14.   Authority of nurse practitioner

      15.   Practice protocol

              PART IV
GENERAL

      16.   Alternative dispute resolution

      17.   Continuing
competency
program

      18.   Approved education programs

      19.   Conditions or restrictions

      20.   Repeal


Short title

        1. These regulations may be cited as the Registered Nurses Regulations.

Definitions

        2. In these regulations

             (a)  "Act" means the Registered Nurses Act, 2008;

             (b)  "letter of good standing" means a letter from a regulatory body in another jurisdiction certifying that a person meets the professional and practice requirements of a registered nurse in that jurisdiction; and

             (c)  "standards committee" means the nurse practitioner standards committee established by the association under section 37 of the Act.

PART I
REGISTRATION

Registration

        3. (1) A person applying to be registered as a registered nurse shall

             (a)  complete an application in the prescribed form;

             (b)  submit satisfactory proof of the successful completion of

                      (i)  a baccalaureate nursing education program approved by the council where the person completed his or her nursing education on or after January 1, 2000, or

                     (ii)  a nursing program approved by the council, where the person completed his or her nursing education prior to January 1, 2000;

             (c)  submit satisfactory proof of the successful completion of a registered nurse examination approved by the council;

             (d)  submit identification documents, including photo identification, satisfactory to the council;

             (e)  demonstrate to the council in accordance with the standards approved by the council proficiency in the English language sufficient to enable the applicant to practise as a registered nurse in the province;

              (f)  submit a current Certificate of Conduct satisfactory to the council from the Royal Newfoundland Constabulary, Royal Canadian Mounted Police or other appropriate policing agency;

             (g)  submit a declaration stating that he or she

                      (i)  has capacity and is fit to engage in the practice of nursing,

                     (ii)  has not been denied registration in another jurisdiction within the 5 year period prior to the date of application or the details regarding the denial of registration in another jurisdiction, and

                    (iii)  has never been convicted of an offence under the Criminal Code (Canada), the Controlled Drugs and Substances Act (Canada) or a similar penal statute of another country or the details of his or her conviction;

             (h)  submit evidence satisfactory to the council that he or she is of good character;

              (i)  provide written consent to allow the council to obtain confirmation or verification of the documentation and information submitted as part of the application; and

              (j)  provide other documentation requested by the council.

             (2)  A person applying to be registered as a registered nurse who obtained his or her education in another jurisdiction in Canada shall, in addition to the requirements in subsection (1), provide a letter of good standing from each jurisdiction where he or she is registered or licensed.

             (3)  A person applying to be registered as a registered nurse who obtained his or her nursing education outside Canada shall, in addition to the requirements in subsection (1),

             (a)  submit a transcript from the educational institution where he or she completed his or her nursing education;

             (b)  provide written confirmation of the contents of the nursing education program he or she completed, including hours spent in each area of the program and other information required by the council;                                          

             (c)  submit a letter of good standing from each jurisdiction where he or she is currently, or was previously, registered or licensed; and

             (d)  submit a professional reference satisfactory to the council.

             (4)  The documentation required in paragraphs 3(a) and (b) shall be submitted to the council directly from the educational institution where the person completed his or her nursing education.

             (5)  Notwithstanding subsection (3), a person applying to be registered to practice nursing, who

             (a)  obtained his or her nursing education outside Canada;

             (b)  at the time of application is not practicing in Canada; and

             (c)  cannot provide evidence satisfactory to the council of his or her nursing education or his or her registration from each jurisdiction where he or she is currently, or was previously, registered or licensed

may be registered in accordance with subsection  (6).

             (6)  A person referred to in subsection (5) may be registered where he or she

             (a)  satisfies all other registration requirements;

             (b)  successfully completes an assessment of his or her nursing education and competencies; and

             (c)  where required by the council, successfully completes a program of nursing education prescribed by the council.

             (7)  The letter of good standing required in subsections (2) and (3) shall include

             (a)  confirmation that the person's registration or licence is not under review and has not been suspended or revoked; or

             (b)  details of

                      (i)  the conditions or restrictions on the registration or licence, or

                     (ii)  the review, suspension or revocation of the registration or licence.

Provisional
registration

        4. (1) Where a person applying to be registered as a registered nurse is unable to

             (a)  submit satisfactory proof of the successful completion of the registered nurse examination approved by the council; or

             (b)  provide a professional reference, where required

he or she may be registered in the provisional register.

             (2)  A person may be registered in the provisional register until the date specified in the certificate of provisional registration unless suspended or revoked earlier.

             (3)  Registration in the provisional register may be renewed but a person's name shall be removed from the provisional register where 2 years have elapsed from the date the person was entered in the provisional register.

             (4)  Where a person provides the documentation in subsection (1) and continues to meet the registration requirements of the Act and regulations his or her name shall be removed from the provisional register and entered in the registered nurse's register.              

PART II
LICENSURE

Registered nurse licence

        5. (1) A person may be granted a registered nurse licence where he or she

             (a)  submits an application in the prescribed form;

             (b)  meets the requirements in subsection 14(2) of the Act; and

             (c)  provides proof that he or she

                      (i)  graduated from an approved baccalaureate nursing education program within the 60 month period immediately preceding the application for a licence,

                     (ii)  practised as a registered nurse for at least 1125 hours within the preceding 60 month period or 450 hours within the preceding 24 month period,

                    (iii)  completed an approved nursing re-entry program within the preceding 60 month period, or

                    (iv)  is enrolled and participating in a baccalaureate nursing education program or graduate or doctoral program in nursing or in a health-related discipline recognized by the council and at the date of admission to the program was eligible for a practicing licence.

             (2)  A licence issued under subsection (1) is valid until the date specified in the licence, unless suspended or revoked earlier, and may be renewed annually.

Interim licence

        6. (1) A person who is registered on the provisional register may be granted an interim licence to practise nursing.

             (2)  Where a person who has not written the registered nurse examination is granted an interim licence he or she shall write the exam at the first available sitting or another time approved by the council.

             (3)  An interim licence is valid from the date of issuance until the date specified in the licence unless suspended or revoked earlier.

             (4)  An interim licence may, with the approval of the council, be renewed for a maximum of 2 years from the date of issuance.

Exam failure -
registered nurse

        7. (1) Where a person fails the approved registered nurse examination his or her interim licence shall be revoked but he or she may remain registered on the provisional register.

             (2)  A person shall complete a remedial nursing education program prior to writing the examination a third time.

             (3)  Where a person fails the approved registered nurse examination 3 times he or she shall be removed from the provisional register.

             (4)  Notwithstanding subsection (3), the council may, in extenuating circumstances, allow a person who has failed the approved registered nurse examination 3 times to write the examination a fourth time.

             (5)  A person who, with the approval of the council, writes the approved registered nurse examination a fourth time may remain registered on the provisional register but shall be removed from the provisional register if he or she fails the examination a fourth time.

             (6)  Where a person is removed from the provisional register under subsection (3) or (5), he or she shall not be eligible to apply for registration.

Nurse practitioner
licensure

        8. (1) A licence issued to a registered nurse under section 5 may include licensure to practise as a nurse practitioner where the registered nurse provides the following:

             (a)  satisfactory proof of the successful completion of a nurse practitioner examination approved by the council; and

             (b)  proof that within the 36 month period immediately preceding the application for a licence he or she

                      (i)  graduated from an approved nurse practitioner education program,

                     (ii)  practised as a nurse practitioner for at least 900 hours, or

                    (iii)  successfully completed a nurse practitioner competency validation process or a nurse practitioner re-entry program approved by the council;

             (2)  Notwithstanding paragraph (1)(a), a registered nurse who cannot provide satisfactory proof of the successful completion of a nurse practitioner examination approved by the council may be licensed as a nurse practitioner where he or she

             (a)  meets the requirement in paragraph (1)(b); and

             (b)  provides satisfactory proof of the issuance of a practice protocol.

             (3)  In addition to the requirements in this section, where the registered nurse is not an employee of a regional health authority he or she shall submit a declaration stating

             (a)  that he or she has an arrangement with a physician for the purpose of consultation with respect to the care of a patient; 

             (b)  the name and address of the physician;

             (c)  the date he or she entered into the arrangement with the physician; and

             (d)  that the care of a patient may be transferred to the physician.

             (4)  A registered nurse shall immediately notify the council where there is a change in the information provided in subsection (3).

Interim nurse
practitioner
licensure

        9. (1) A registered nurse may be granted interim licensure to practice as a nurse practitioner where he or she meets the requirements in paragraph 8(1)(b) but does not meet the requirements in

             (a)  paragraph 8(1)(a) because he or she has not written the approved registered nurse practitioner examination or is awaiting the results of the approved nurse practitioner examination; or

             (b)  paragraph 8(2)(b) because he or she is awaiting final approval of a practice protocol.

             (2)  Where a person who has not written the nurse practitioner examination is granted an interim licence he or she shall write the exam at the first available sitting or at another time approved by the council.

             (3)  An interim licence is valid from the date of issuance until the date specified in the licence unless suspended or revoked earlier.

             (4)  An interim licence to practice as a nurse practitioner may, with the approval of the council, be renewed for a maximum of 2 years from the date of issuance.

Exam failure -
nurse practitioner

      10. (1) Where a registered nurse fails the approved nurse practitioner examination his or her interim licensure to practise as a nurse practitioner shall be revoked.

             (2)  A registered nurse shall complete a remedial nurse education program prior to writing the approved nurse practitioner examination a third time.

             (3)  A registered nurse who fails the approved nurse practitioner examination 3 times shall not be eligible to apply for licensure as a nurse practitioner.

             (4)  Notwithstanding subsection (3), the council may, in extenuating circumstances, allow a person who has failed the approved nurse practitioner examination 3 times to write the examination a fourth time and be eligible to apply for licensure as a nurse practitioner.

             (5)  A person who writes and fails the approved nurse practitioner examination a fourth time is not eligible to apply for licensure as a nurse practitioner.

Licence conditions

      11. (1) It is a condition of a licence issued under the Act and regulations that a registered nurse shall

             (a)  maintain professional liability protection as approved by the council;

             (b)  notify the council of a change in his or her name, address, employer or other information as required by the council;

             (c)  notify the council of disciplinary proceedings or pending disciplinary proceedings in another jurisdiction; and

             (d)  immediately notify the council of a criminal conviction.

             (2)  Notification under paragraphs (1)(b) and (c) shall be provided as soon as practicable and no later than 30 days after the effective date of the change or notice of the disciplinary action.

             (3)  Notification under subsection (1) shall include all information necessary to explain the conviction or disciplinary action.

Renewal of
registered nurse licence

      12. (1) A person applying for a renewal of a licence to practise nursing shall submit

             (a)  a renewal application in the prescribed form;

             (b)  a declaration stating

                      (i)  that he or she has never been convicted of an offence under the Criminal Code (Canada), the Controlled Drugs and Substances Act (Canada) or a similar penal statute, or

                     (ii)  the details of his or her convictions under the Criminal Code (Canada), the Controlled Drugs and Substances Act (Canada) or a similar penal statute;

             (c)  proof satisfactory to the council that he or she has successfully completed the program of continuing competency required by the council;

             (d)  a letter of good standing from each jurisdiction where he or she was registered or licensed in the 12 month period preceding the submission of his or her renewal application; and

             (e)  proof that he or she

                      (i)  graduated from a nursing education program within the 60 month period immediately preceding the application for a licence,

                     (ii)  practised as a registered nurse for at least 1125 hours within the preceding 60 month period or 450 hours within the preceding 24 month period,

                    (iii)  completed an approved nursing re-entry program within the preceding 60 month period, or

                    (iv)  is enrolled and participating in a baccalaureate nursing education program or graduate or doctoral program in nursing or in a health-related discipline recognized by the council and at the date of admission to the program was eligible for a practicing licence.

             (2)  Notwithstanding subparagraph (1)(d)(iv), a person shall not be granted a renewal of his or her licence where he or she

             (a)  is enrolled in a baccalaureate nursing education program or a graduate or doctoral program in nursing or in a health related discipline for more than 5 years; and

             (b)  has had his or her licence renewed each year for the preceding 5 year period.

             (3)  Notwithstanding paragraph (1)(c), a person who has not completed the continuing competency program may be granted a renewal of his or her licence subject to the conditions prescribed by the council.

Renewal of nurse practitioner
licensure

      13. A person applying for renewal of licensure as a nurse practitioner shall submit the documentation required in paragraph 8(1)(b) or subsection 8(2), subsection 8(3) where applicable and paragraphs 12(1)(a) to (e).

PART III
NURSE PRACTITIONER AUTHORITY AND PROTOCOLS

Authority of nurse practitioner

      14. (1) A nurse practitioner may

             (a)  order the application of a form of energy permitted by the standards established by the standards committee or which he or she is authorized to order under a practice protocol issued to him or her;

             (b)  order laboratory or other tests permitted by the standards established by the standards committee or which he or she is permitted to order under a practice protocol; and

             (c)  prescribe a drug permitted by the standards established by the standards committee or which he or she is authorized to prescribe under a practice protocol.

             (2)  The council may prescribe categories of nurse practitioners and the standards and scope of practice for each category.

Practice protocol

      15. (1) A registered nurse who wishes to practice as a nurse practitioner and who does not meet the requirements in paragraph 8(1)(a) may, before December 31, 2013, apply to the standards committee for approval of a practice protocol.

             (2)  A nurse practitioner that has been issued a practice protocol shall comply with the parameters of practice contained in his or her practice protocol.

             (3)  A practice protocol is not transferable.

             (4)  A practice protocol shall contain the information required by the standards committee.

             (5)  The standards committee on the application of a nurse practitioner and subject to the approval of his or her employer, may approve an amendment of the practice protocol applicable to the nurse practitioner.

PART IV
GENERAL

Alternative dispute resolution

      16. (1) Where the complaints authorization committee refers an allegation to the Director of Professional Conduct Review for alternative dispute resolution, the alternative dispute resolution shall be conducted in accordance with the policy established by the council.

             (2)  Alternative dispute resolution shall not be conducted unless the complainant and respondent consent to it in writing.

             (3)  The Director of Professional Conduct Review may appoint those other persons he or she considers necessary to assist in the alternative dispute resolution process.

             (4)  Where the allegation is not resolved through alternative dispute resolution or where, in the opinion of the Director of Professional Conduct Review, the allegation is unsuitable for alternative dispute resolution, the Director of Professional Conduct Review shall refer the allegation back to the complaints authorization committee.

Continuing
competency
program

      17. (1) All members shall complete a continuing competency program as required by the council.

             (2)  The council shall conduct regular audits of the members' participation in the continuing competency program.

             (3)  Members shall provide all information requested in the conduct of the audit.

Approved education programs

      18. (1) The council shall approve a program of education for registered nurses where the program meets the standards and criteria established by the council including provision of clinical, laboratory and theoretical experience necessary to meet standards of practice for registered nurses and achieve the council’s required competencies of a registered nurse.

             (2)  The council shall approve a program of education for nurse practitioners where the program meets the standards and criteria established by the council including provision of clinical, laboratory and theoretical experience necessary to meet standards of practice for nurse practitioners and achieve the council’s required competencies of a nurse practitioner.

Conditions or restrictions

      19. (1) The council may attach those conditions or restrictions to a registration or licence that the council considers appropriate, including

             (a)  placing limits on the activities the members may perform; and

             (b)  setting requirements for supervision of the member which may include specifics on the form or duration of the supervision.

             (2)  A member shall comply with all conditions and restrictions that are attached to his or her registration or licence by the council.

Repeal

      20. The Nurse Practitioner Regulations, 2009, Newfoundland and Labrador Regulation 68/09, are repealed.