We held a series of interviews with stakeholders to talk about nursing regulation. The purpose of these discussions was to ensure our work is current and relevant to nurses and the public. Read the full report Underlying Philosophies and Trend Affecting Professional Regulation (PDF).
Registered nursing is a self-regulated profession. It means the public — and the government that represents them — give RNs and NPs the authority to oversee the professional services provided by their peers. The professional self-regulation framework must justify patients’ trust and make sure health professionals work effectively together and provide safe, appropriate and effective care.
At the core of our framework, we set standards, support nurses to meet standards, and act when standards are not met. No matter how we work as a regulator, these responsibilities do not change.
The College Board and staff agree that a focus on prevention and risk reduction is the best approach to public safety. We believe this proactive approach reflects the following concepts:
As an organization that subscribes to just culture, we accept that mistakes will occur. But we won’t wait for them to happen before making needed changes. In order to maintain a just culture, as a regulator, we must create opportunities for conversations and maintain an open and on-going relationship with nurses, their employers, and their union so that we remain aware of issues and changes within professional and work environments. As a regulator we will develop and deliver programs to help registered nurses make safe choices and learn when mistakes occur.
Right-touch regulation is the minimum regulatory force required to achieve a desired result. When regulation is appropriate, it should be simple, regularly reviewed for effectiveness and impact, and used only when necessary. As with just culture, right-touch regulation demands the regulator be aware of the environment in which it is operating, to anticipate changes before they occur, to foresee risks and to take timely action to prevent and lessen those risks.
Just as we believe there is room for improvements to achieve greater collaborative, team approaches when delivering health care to clients, we also believe there can be greater oversight by regulatory bodies to reduce duplication, promote meaningful dialogue, plan, and act as partners across professional boundaries. Collaborative self-regulation does not diminish self-regulation; instead, it enhances the individual professions and develops an expectation for partnership and shared accountability while respecting, accommodating, and strengthening the contribution each profession makes to the inter-professional team.
Health care is complex and changing rapidly. Detailed, rules-based systems can create a false sense of security. In a principle-based approach, the professional needs to know how capable they are to manage the risk involved in what they are doing. As a regulator, we need to ask if the professional applied the right priority and judgment to the situation. If the professional thinks that harm could be an outcome, then they should make changes to their practice before waiting for rules and regulations to come in force. A shift from rules-based processes to principle-based dynamics requires us to move from ways to evaluate performance to systems that can demonstrate measurement and accountability for excellent practice. This shift supports excellence both at the point of practice and at the level of the individual nurse.
Practice, continuous learning and professional development are inseparable and essential. As a regulator we must demonstrate responsibility for promoting the enhancement of professional practice to benefit both the public and the nurse. In addition to continued professional development of broad knowledge, skills and attitudes, nurses as professionals must understand their role and function as a part of a system, as well as with their relationship with clients.
Nurses (Registered) and Nurse Practitioners Regulation(opens in a new window)