The RN you hire will come with Entry-Level Competencies (ELC) on which they can build, or they may already have advanced skills they have developed through the course of their career. Either way, it is important to discuss this with the RN to better understand what skills they have, what skills they might need and want to develop, and what experience they have in the context and setting you plan to optimize their scope.
It is the responsibility of each RN to understand their legislated scope of practice and to practice within it (1), to be aware of their individual competence (experience, knowledge and skills) and ensure policies and procedures are in place to support their practice. Managers can help ensure a successful practice environment for all by understanding legislated scope of practice, exploring and supporting individual competence, and aligning policies and procedures.
A first and important step when considering optimizing RN practice is to explore and work through the Legislated Scope of Practice Assessment Tool. This online tool helps walk you through several required considerations, such as legislation, individual competence and employer and practice setting supports. It is also a great place to access resources and links all in one spot.
There are several ways to optimize RN practice:
- Using current guidelines, resources and developed employer policy to work within their current scope.
- An example of this could be RNs recommending over-the-counter drugs and using the CRNS Guideline for RNs Recommending & Administering Non-prescription Drugs.
- Applying the Registered Nurse Specialty Practice (RNSP) framework to enable and authorize RNs to perform beyond entry-level competencies.
- Examples of this could be RNs providing seasonal influenza immunizations, engaging in emergency care, or employee hearing screening.
- Adding RNs who have Additional Authorized Practice, otherwise known as an RN(AAP) to care models, or supporting the RN you hire to take the additional training to obtain this additional authorization. RN(AAP) have additional knowledge, skills, competencies and authority to treat limited common medical disorders according to specific Clinical Decision Tools(CDT).
- An example of this could be the RN assessing, prescribing, and treating acute bronchitis while working in an urban community health clinic, or assessing and prescribing for a child who has an ear infection in a rural & remote area.
- Including a Nurse Practitioner (NP) in the interprofessional team or supporting an RN to obtain a graduate (master’s) degree from a Nurse Practitioner program and licensing as a Nurse Practitioner.
- An NP is a Registered Nurse (RN) with additional graduate-level nursing education, providing in-depth knowledge and clinical expertise.
- Within their legislated scope of practice, the NP autonomously diagnoses common medical disorders, orders and interprets diagnostic tests, prescribes pharmacological and non-pharmacological interventions, dispenses pharmaceuticals and performs procedures (2).
- Visit crns.ca to learn more about NP practice and optimization.
Every setting and context is different and will require unique considerations when it comes to optimizing the RNs you have. When assessing if a particular activity or practice is within the legislated scope, it is paramount to ensure it is in the best interest of the client within their surrounding environment (3). If you have questions about optimizing RN scope or would like to discuss the resources and your unique practice setting, please reach out to practiceadvice@crns.ca.
CRNS Resources
Registered Nurse Practice Standards (2026)
Registered Nurse Entry-Level Competencies (2026)
Legislated Scope of Practice Assessment Tool
Registered Nurse Specialty Practice Guideline (2026)
RN with Additional Authorised Practice [RN(AAP)] Practice Standards (2026)
| Resource Key | ||
| Number | Resource | Reference |
| 1 | Registered Nurse Practice Standards (2026) | Standard 1: Indicator 3, page 4 |
| 2 | Nurse Practitioner Practice Standards (2026) | Page 2 |
| 3 | Registered Nurse Practice Standards (2026) | Standard 1, page 4 |