celebrating the evolution of nursing regulation in british columbia 100 Years of Nursing Regulation 1912 - 2012

NURSING STANDARDS

The concern that all registered nurses in British Columbia meet established professional and practice standards was, without doubt, on the minds of those who sought nurse regulation in 1912. But what they could not have imagined was the growing complexity and specialization of the profession over the past 100 years.

The need for established standards came into focus in 1973, beginning with a resolution that RNABC was “on record as supporting the principle that all practising members are required to provide evidence of keeping up-to-date in order to retain their professional standing.”

That same year, a priority for the Association was “the development of standards of nursing care.” Six task committees were established to address practice standards for extended care, intensive and coronary care nursing, obstetric, pediatric and psychiatric nursing, and emergency care.

It was almost 10 years before the Standards for Nursing Practice in British Columbia was published and distributed to all RNABC members. This document defined what the profession expected of its members. The Standards were considered “the criteria against which all registered nurses are measured by consumers, employers, colleagues and themselves.”

Following a two-year trial, the Workplace Representative Program was established in 1989 as a provincial network of RNABC representatives who volunteered to be resources for their nursing colleagues and particularly in relation to the Standards for Nursing Practice. The program continued to expand to an increasing number of sites, and in 1998 a Student Representative Program was also developed. The Workplace and Student Representative Programs became part of CRNBC when it was established in 2005 and, five years later, the Workplace Representative Program was renamed the Professional Support Program.

Although standards for nursing care had been established, they remained guidelines and expectations. In the early 1990s, RNABC’s legal requirement to “establish, monitor and enforce” standards of practice and standards of education was added as statutory objects under the Nurses (Registered) Act. Today, the Health Professions Act requires regulatory colleges to establish not only standards, but also limits and conditions for registrant’s practice as well as standards for academic achievement and registration. In other words, the legislation gives CRNBC the authority to establish standards that are not subject to government approval. CRNBC’s Bylaws require registrants to “conduct themselves in accordance with the standards of practice and the standards of professional ethics.”

In 2001, RNABC began working in partnership with the provincial government to implement the nurse practitioner role in British Columbia. The first nurse practitioners graduated in 2005.

Today, CRNBC’s Standards of Practice assist nurses to provide competent and ethical care by setting the requirements for practice. There are three categories of nursing standards:

  • Professional Standards guide and direct nurses’ practice by setting out levels of performance that CRNBC registrants are required to achieve in their practice. They reflect the values of the nursing profession and clarify what the profession expects from nurses.
  • Scope of Practice Standards set standards, limits and conditions related to the scope of practice of registered nurses and nurse practitioners under the Nurses (Registered) and Nurse Practitioners Regulation.
  • Practice Standards set out requirements related to specific aspects of nurses’ practice. They link with other standards, policies and bylaws of CRNBC and all legislation relevant to nursing practice.