Nursing Roles In Ontario

In Ontario, nursing is one profession with two categories of care providers - Registered Nurses (RNs) and Registered Practical Nurses (RPNs). While there are areas of overlap between the two categories, the roles differ in terms of educational preparation - depth and breadth of knowledge - and the degree of autonomy in practice. Nurses in both categories are important and valued members of our health force.

RNs graduate with a four-year baccalaureate degree in nursing.  RPNs graduate with a two-year practical nursing diploma. RNs practice more autonomously when making decisions and carrying out nursing responsibilities regardless of the complexity of care needs and in all practice environments. An RPNs autonomy increases when caring for people with less complex conditions. The RPN practices in consultation and collaboration with an RN when care needs or situations increase in complexity.

Classes of Registration

General Class:  This is the most common class of registration. It is held for a member's lifetime, and an annual fee is required to maintain a current Certificate of Registration.

Temporary Class:  People who have met all of the registration requirements, except passing the Canadian Registered Nurse Examination (CRNE) or the Canadian Practical Nurse Registration Examination (CPNRE), can still practice as a registered member. If you’re eligible to write the exam, or are waiting for the exam results, have evidence of recent practice one year from the date of your application and have a written offer of employment, you may apply for temporary registration.

Special Assignment Class:  This is a short-term, non-renewable registration for individuals, usually from outside Ontario, who have an appointment or assignment as an RN or RPN with an approved facility, and who do not plan to stay in Ontario for more than one year. People in this class of registration can only practice within the scope of her or his appointment and under defined terms, limits and conditions.

Extended Class Registration: The RN, Extended Class (EC) was designed to accommodate the role of the nurse practitioner. Nurse practitioners are RNs who have received further education in the provision of primary health care and are able to perform some of the diagnostic and treatment functions that were previously within the domain of physicians. The Extended Class gives nurses access to controlled acts beyond those of an RN, based on their advanced knowledge and decision-making skills.  RN(EC)s offer comprehensive health services encompassing health promotion, prevention of disease and injury, cure, rehabilitation and support services. They have an extended scope in the areas of assessment, diagnosis, prescription of drugs and treatments, and health promotion. Accordingly, they often work in primary health care centres, community health centres, remote nursing stations, emergency departments and outpatient settings in acute care facilities.  Only primary health care nurse practitioners are presently eligible for registration in this class, but work is underway to include acute care nurse practitioners.

Retired Class:  This is an option for Ontario nurses aged 65 or older who have permanently retired from nursing practice.

Transitional Class:  The Transitional Class will allow members of other Canadian nursing regulatory bodies who have graduated after January 1, 2005, and who do not meet the new education requirements, to register and work in Ontario for a limited time while pursuing further nursing studies to meet the entry-to-practice education requirement. RNs have four years and RPNs have two years to complete the further studies to meet the requirement.

Nurses care for people at all stages of the life cycle and in all states of health, from normal functioning to crisis. Increasingly, nurses are employed in community and workplace settings as well as traditional health care settings such as hospitals.

Commonly advertised positions include:

• Registered Nurse
• Registered Practical Nurse
• Public Health Nurse
• Nurse Manager
• Nursing Director
• Nurse Educator
• Clinical Nurse Specialist
• Primary Health Care Nurse Practitioner
• Acute Care Nurse Practitioner
• Chief Nurse Executive/Chief Nursing Officer

Copyright in this career map is held jointly by the Queen’s Printer for Ontario and the College of Nurses of Ontario, ©, 2005

New Roles in Nursing

One of the key components of the HealthForceOntario strategy involves establishing innovative new health care professional roles in areas of high need. Two of the four new roles already announced are open to registered nurses:

Nurse Endoscopist:  A registered nurse with extended specialized education in anatomy, physiology and pathophysiology who works with a physician to perform flexible sigmoidoscopies (i.e. diagnostic procedure used to screen for abnormalities in the lower third of the colon). These individuals can support Ontario’s colon cancer screening initiative.

Surgical First Assist:  Works with the surgeon and the rest of the operating room team to ensure the safe outcome for a surgical patient before, during and after surgery. A registered nurse can perform this role with an additional certification in surgical first assistance.

Click here for more new roles for other health professionals.