Practice Standards set out requirements for specific aspects of nurses' practice. They link with other standards, policies and bylaws of the College of Registered Nurses of British Columbia and relevant legislation.
Education programs and employers are responsible for providing the organizational supports and resources necessary for nurses to provide regulatory supervision of nursing student activities safely and according to CRNBC standards.
Nurses1 have a professional responsibility to provide regulatory supervision of nursing student activities that may affect clients. Nursing students do not have the authority to perform these activities independently, but may do them if they are authorized by a nurse.
Regulatory supervision is the process nurses follow in authorizing these activities. The purpose of the process is to ensure public protection when students are doing activities as part of:
Nurses providing regulatory supervision follow the process outlined in this practice standard, and use their professional judgment to make decisions about activities a nursing student may do with clients. Regulatory supervision is conceptually different from other types of supervision, such as employment or education supervision that might be carried out by a unit manager or an educator.
The process of regulatory supervision consists of four components, each of which needs to be in place to meet this standard.
Know the nursing student's competence
The nurse must be reasonably satisfied that the nursing student has the competence to do an activity. Students achieve competence through their education program, e.g., theory, lab work and successful demonstration. Nurses learn about a student's competence from a variety of sources, such as the student, employer, education program, observation, etc.
When deciding to authorize activities, the nurse considers (at minimum):
Set the conditions
The nurse sets conditions for the student to perform the activities, considering such things as:
Manage risks to the client
The nurse anticipates and manages potential and actual risks that originate from the nursing student activities. This includes reviewing and revising regulatory supervision decisions.
The following principles set out the legal and ethical requirements for practice.
Nurses provide regulatory supervision for those activities that may have an impact on clients, are within registered nurses' scope of practice and fall within the nurse's individual competence.
Nurses consent to taking on the responsibility for regulatory supervision of nursing student activities.
Nurses must be reasonably satisfied that the nursing student has achieved sufficient competence through their nursing education program before authorizing the activity.
Nurses do not authorize activities that would require employed student nurses2 to acquire new clinical skills to be learned outside their education program.
Nurses consider the client's opinion about the nursing student's involvement in his or her care before authorizing activities.
Nurses clearly communicate to the nursing student which activities they have authorized and the conditions they have set.
Nurses meet this practice standard regardless of job title or where they are employed (e.g., faculty member, staff nurse, manager, etc.).
Nurses have an obligation to comply with the regulatory supervision process regardless of employer, educational or other considerations.
Nurses collaborate to establish roles and accountabilities for the components of the regulatory supervision process when more than one nurse is involved (e.g., faculty member and placement agency staff).
Nurses are accountable and responsible for decisions associated with the regulatory supervision process.
Nurses use professional judgment to guide their decisions throughout the regulatory supervision process.
Nurses initiate, monitor and terminate the regulatory supervision process as appropriate.
Involving others in the process
You may involve others when setting conditions for a nursing student's activities. As an RN, you might authorize an activity on the condition that a specific non-CRNBC registrant (e.g., LPN, RPN) staff person is present in the practice setting. However, you are still responsible for the regulatory supervision process.
If you provide regulatory supervision with other RNs, you must collaborate on each part of the process. Each nurse is accountable and responsible for their decisions and the process. See principles 6, 9, 10, 11.
Deciding which nurse is best to provide regulatory supervision
CRNBC does not specify the role or job title of the nurse providing regulatory supervision. Who fills the role will be based on the circumstances and the setting. The best nurse may be a front line nurse, a manager, a faculty member, etc. See principles 1, 7.
Meeting professional obligations
The Professional Standards set the expectation that you provide appropriate regulatory supervision of nursing student activities. If you have concerns about your competence or workload, consider what you can safely agree to. CRNBC resources can help you arrive at a solution with your manager. See principles 1, 2, 10, 11, 12.
Public protection comes first
There are times when nurses may be responsible for regulatory supervision as well as employment or educational supervision. You may experience this if you are a nurse manager or a nursing instructor/faculty member. The purposes of these types of supervision can overlap and you can often meet the responsibilities of both. Occasionally these purposes may be at odds. When this happens, regulatory supervision must come first to ensure public protection. For example, there might be an opportunity for an ESN to try a new skill. If they don't have the competencies from their nursing education program, the activity cannot be authorized. See links to principles 4, 7, 8, 10.
Collaboration: A joint communication and decision-making process with the expressed goal of working together toward identified outcomes while respecting the unique qualities and abilities of each member of the group or team.
Individual Competence: The particular subset of registered nurse scope of practice activities the nurse has acquired the knowledge, skills, attitude and judgment to perform.
Nursing Student: An individual enrolled in a CRNBC-recognized entry-level or re-entry-level registered nurse education program (or equivalent) or course, (regardless of whether or not the student is registered with CRNBC, either as an employed student registrant or a grandparented student registrant).
Registered Nurse: Refers to the following CRNBC registrants: registered nurses, nurse practitioners, licensed graduate nurses.
Regulatory Supervision: The process by which a nurse may authorize an activity to be performed by another person who does not otherwise have authority to perform the activity.
Scope of Practice: The activities that registered nurses are educated and authorized to perform set out in the Nurses (Registered) and Nurse Practitioners Regulation under the Health Professions Act and complemented by standards, limits and conditions set by CRNBC.
CRNBC's Standards of Practice (Professional Standards, Practice Standards, and Scope of Practice Standards) set out requirements for practice that nurses must meet.
For more information on this or any other practice issue, contact CRNBC's Practice Support Services by email at firstname.lastname@example.org or call 604.736.7331 ext. 332 or toll-free 1.800.565.6505.
Nurse: Refers to the following CRNBC registrants: registered nurses, nurse practitioners, licensed graduate nurses. NB In the case of employed student nurse (ESN) employment activities, the nurse could, for example, be a unit manager or clinical nurse educator. In the case of a nursing student in education program activities, the nurse could, for example, be a clinical instructor or a unit manager. The nurse could hold one of many roles; it may not always be a bedside nurse on the unit.
Employed student nurses include both employed student registrants and grandparented student registrants authorized to work as employed student nurses under section 4.121(5) of the CRNBC Bylaws.
Working With Students web module
For further information on the Standards of Practice or professional practice matters, contact us: