Responding to Professional Practice Issues (PPIs)

I am an RN who recently came from another province to become a nursing unit manager. At the first unit meeting, I was made aware of an ongoing professional practice issue the staff want to be resolved as soon as possible. They informed me that they are following the steps in the resolution process outlined by the CRNS. Please help me understand the process and my ethical and professional obligations as an RN in this situation.

Nursing practice environments are complex and challenging places to work. The acuity of clients is high, their care needs are complex, shortages of both human and material resources occur, and the workplace is constantly in a state of change. Given this complex environment, RNs, NPs and employers have an obligation to advocate for conditions that support safe, ethical nursing practice, including quality practice environments for the benefit of persons receiving care. A professional practice issue (PPI) impacts both clients and others in the workplace.

A Professional Practice Issue (PPI) is:

• any situation that puts clients at risk; and,
• interferes with RNs ability to comply with the professional standards of practice, Code of Conduct, employer policies and/or other best practice clinical standards.

A PPI typically requires collaborative resolution within the workplace.

This scenario involves a PPI and the utilization of the CRNS’s Resolving Professional Practice Issues: A Toolkit for Registered Nurses and Nurse Practitioners, which provides tools and a five-step framework to support the resolution of the PPI in your context of practice. It provides guidance to RNs who believe they may have identified a professional practice concern in the workplace that needs to be addressed. This document is utilized with the Registered Nurse Practice Standards, 2024 and the Code of Conduct, 2026. Links to CRNS resources are included below.

Some managers are RNs themselves, and their responsibilities and accountabilities are the same as the RNs working on the unit/facility. Some managers are not RNs and may have their own professional responsibilities and accountabilities as part of a regulated profession. All managers of RNs are required to understand the professional responsibilities and accountabilities of the RNs they manage and to support the RN in complying with the standards of RN practice. The responsibilities and accountabilities of RN practice that apply to this situation are:

• RNs are accountable and accept responsibility for their own actions and decisions (1).
• RNs demonstrate effective collaborative practice, including communication, problem-solving strategies, decision-making and conflict resolution (2).
• RNs challenge and take action on unclear or questionable orders, decisions or actions made by other health care team members (3).
• RNs utilize knowledge of the health care system to improve health care services (4).
• RNs practice in accordance with the current Code of Conduct (5).
• RNs take action to create a safe work environment that contributes to healthy teams and optimal client outcomes (6).
• RNs participate and contribute to health care team development by [...] contributing registered nursing perspectives on issues being addressed by the health care team (7).
• RNs practice in accordance with The Registered Nurses Act, 1988, other current relevant legislation, bylaws, scope of practice, practice standards, entry-level competencies, guidelines and employer policies (8).
• RNs collaborate with the employer and other organizations as needed to resolve professional practice issues (9).
• RNs promote dignity and respect for the nursing profession by demonstrating professionalism and showing leadership. To achieve this, RNs are expected to not engage in any acts of professional incompetence and/or misconduct and report any concerns related to these and/or fitness to practice and to comply with the duty to report as outlined within The Registered Nurses Act, 1988 (10).
• RNs work within the scope of practice, education, experience, knowledge, skill and judgement. RNs are expected to seek and use the best available evidence to inform their practice (11).
• RNs are accountable to one another and are expected to build and maintain respectful relationships with the health care team. RNs demonstrate professionalism and treat all health care team members with respect in all contexts, including on social media (12).

CRNS Resources

Code of Conduct (2026)

The Registered Nurses Act, 1988

Registered Nurse Practice Standards (2026)

Registered Nurse Entry-Level Competencies (2026)

Resolving Professional Practice Issues: A Toolkit for Registered Nurses and Nurse Practitioners (2026)