RPN Practice: Communicating, Clarifying,
and Valuing Roles
Anthony Derro, RN,
Practice Consultant
Angela McNabb, RN, Outreach Consultant
Copyright © College of Nurses of Ontario, 2012
Objectives
The participant will be able to:
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Apply the revised guideline to their practice setting
Identify the importance of consultation and
collaboration
Understand how to manage conflict that may arise
among team members
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The Revision Process
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Comprehensive revision process
Feedback from membership was catalyst
Retained the Three Factor Framework
Retained decision tree
Increased clarification of accountability of the
individual nurse
Removed duplication
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Client Factors
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Nurse Factors
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One profession
Accountability
Foundational knowledge
Knowledge enhancements
Autonomous practice
Consultation
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Environment Factors
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Professional Standards, Revised 2002
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Accountability
Continuing competence
Ethics
Knowledge/Knowledge Application
Leadership
Relationships
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Scenarios
Scenario 1
You work in a department that employs both RNs and
RPNs. In this care environment, RPNs are assigned to
less complex, more predictable clients with lower risk of
negative outcomes. Today, one your clients has become
more complex over time and eventually you find that you
require RN consultation.
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Scenario 2
You are an RPN who has recently started working on a
unit that was previously all RN. You are finding that
RPNs are constantly being given unsuitable assignments
and often the RN staff will refuse to consult with the
RPNs.
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Scenario 3
You are an experienced inpatient RPN in a particular
specialty. The program has recently initiated a
community support home visiting service and is
considering using RPNs for some of the positions. The
RNs have vocalized concerns with this transition.
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The Inter-relationships that Support
Nursing Practice:
Nursing Process:
Organization Supports:
Assessment
Policies
Planning
and procedures
Decision
Implementation
support tools
Environmental
and human
resource support
Client communicates:
Evaluation
Needs
Goals
CNO Supports:
Practice
standards
Practice
guidelines
Fact
Perspective
Choice
and preference
Legislation
e.g. PHIPPA,
HCCA, MHA,
sheets
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Discussion questions:
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Can you share with us how you have been able to use
the Three Factor Framework to assist colleagues in
understanding care assignments?
What current trends are you noticing with regard to
RPN roles?
What are the challenges you are currently facing as
an RPN in Ontario?
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Outreach Program
Academic
 Acute Care – Adult
 Community/Public Health
 Complex Continuing Care/Rehabilitation
 Long-Term Care/Retirement Homes
 Mental Health/Corrections
 Nurses Newly Registered NEW!
 Paediatrics
 Palliative Care
www.cno.org/outreach
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Resources
Telephone: Practice Support Line
Toll free in Ontario 1-800-387-5526 or 416-928-0900
ext. 6397
Web site: www.cno.org
E-mail: ppd@cnomail.org
Anthony Derro: 416 928 0900 ext 7626 or
aderro@cnomail.org
Angela McNabb: 416 607 7165 or
amcnabb@cnomail.org
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