It’s All About Synergies: Understanding the Role of the Registered Practical Nurse in Ontario’s Health Care System

Background Since the early 2000s, there have been significant changes to the Registered Practical Nurse (RPN) and Registered Nurse (RN) roles in Ontario. In 2005, changes to the basic entry-to-practice educational requirements for both RPNs and RNs came into effect with a 2-year diploma required for RPNs and a baccalaureate degree in nursing required for RNs. Additionally in 2005, changes to the Nursing Act (1991) allowed for a broader role for RPNs (e.g., initiation of controlled acts).

Changes to educational preparation and scope of practice, coupled with variations in nursing care delivery models, have resulted in varying degrees of role ambiguity and, in some instances, role conflict. In order to better understand the factors that contribute to role clarity or role confusion, the Registered Practical Nurses Association (RPNAO) launched a provincial project titled It’s All About Synergies: Understanding the Role of the Registered Practical Nurse in Ontario’s Health Care System.

Purpose The purpose of this project was to invite nurses (RPNs and RNs), nurse leaders, nursing faculty, and other health care experts from around Ontario to share their knowledge and insights regarding the critical factors that support or hinder the appropriate utilization of RPNs and their ability to work to their full scope of practice as members of intra- and interprofessional health care teams.

Goal The goal of this project was to develop an increased understanding of the factors that contribute to confusion regarding the RPN role and overlapping scope of practice of the RPN and RN roles. The knowledge gained would be used to generate strategies that may assist in decreasing the degree of ambiguity associated with the RPN role and role functioning in order to optimize the contribution of RPNs in the provision of high-quality patient care within and across the health care system.

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