Nursing Practice Updates

The Canadian Council for Registered Nurse Regulators (CCRNR) is updating the entry-level competencies (ELCs) for Registered Nurses across Canada and is inviting your feedback through a short survey to help validate the draft updates.

Your insights will help the steering committee determine whether the draft set of ELCs accurately capture the full scope of contemporary nursing practice and identify anything that may have been overlooked or needs refinement.

You can access the survey here.

The survey is confidential, takes approximately 25-30 minutes to complete, and includes a save and continue later option. The deadline to provide feedback is April 17, 2026, at 3:00 pm.

If you have any questions, please contact the survey administrator, Sense & Nous, at survey@sensenous.ca. 

The CRNS is revising the current Professional Boundary Considerations for Nurse Client Relationships resource. 

As part of the external consultation process, the CRNS is seeking feedback from registrants and external partners. The consultation period is March 19 to April 9. The deadline to provide feedback is April 9, 2026, at 4:00 pm. The online survey can be accessed here.

Questions or comments are welcome and can be directed to Nursing Practice Advice at practiceadvice@crns.ca.   

Given the nature of the work/services provided by Registered Nurses (RN) and Nurse Practitioners (NP) in independent practice, there is potential for increased risk to the public. Effective March 9, 2026, registrants who operate in an independent practice must register the practice with the CRNS. 

RNs and NPs in independent practice are self-employed and provide professional nursing services in a variety of ways:

• as an individual;
• in association with other self-employed health professionals; and/or, 
• as an employer of other health professionals. 

These nursing services are provided independent of an employer or health care agency. As they do not operate under the direct control of another health professional, employer or health care institution, RNs and NPs are legally accountable for the professional services they provide as well as the business matters related to the independent practice. 

RNs and NPs may also be subject to various laws and regulations regarding the organization of the services provided (i.e., the business) in addition to those that regulate the practice of nursing (CNPS, 2021). Examples of independent practice may include but are not limited to health promotion services (smoking cessation, prenatal classes); or curative/restorative/palliative care (foot care, home care, aesthetics). 

Registering an independent practice is a separate process from Confirming Nursing Practice. The confirmation process may also be required. 

To register your independent practice:

• Sign into your CRNS profile.
• On the left side of the screen, click “Add independ. practice” to complete a two-step registration process.
• There is no associated fee.

A separate register will be housed on our website at CRNS.ca  where the public can look up a registrant and their independent practice.

CRNS Registration Nursing Advisors are available to answer your questions by email at regulation@crns.ca.

The CRNS recently updated three documents now available on the CRNS website.

• Prescribing Medication Guideline
  Updated on the CRNS five-year review cycle to include references to applicable bylaws, current practice standards and entry-level competencies, headings for increased readability and RN(AAP) prescribing.
• Recommending and Administering Non-Prescription Drugs Guideline
  Updated on the CRNS five-year review cycle to include references to applicable bylaws, current practice standards and entry-level competencies, and RN authority to administer seasonal vaccines, epinephrine and naloxone.
• Prescribing Controlled Drugs and Substances for Nurse Practitioners Resource
  Updated to include education and practice recommendations for NPs prescribing methadone for pain management.

CRNS Practice and Education Nursing Advisors are available to answer your questions by phone at 1.800.667.9945 or 306.359.4227 or by email at practiceadvice@crns.ca.

On December 19, 2025, the Ministry of Health approved changes to CRNS Bylaws that removed the Nurse Practitioner (NP) Specialty Categories.

As we move into the implementation phase for the general NP model, CRNS will be implementing a series of regulatory changes to reflect the transition. The removal of the NP Specialty Categories is a step in the transition.

The removal of the Specialty Categories does not impact NPs currently practicing in Saskatchewan but will support increased interprovincial mobility and contribute to improved access to health care services across Canada.

For background information:

• The NPR-FIPP Project summary is available here.
• The NPR-FIPP FAQs are available here.
• For more information and project news archives, visit the CCRNR Website. 

If you have questions, please contact register@crns.ca.

On December 19, 2025, the Ministry of Health approved changes to CRNS Bylaws that removed the requirement for Nurse Practitioners (NPs) to obtain Registrar approval to prescribe methadone for the management of pain. 

This change is reflected in CRNS Council Policy 2.7. As of February 17, 2026, NPs are not required to obtain approval from the Registrar to prescribe methadone or buprenorphine solely for the purpose of pain management and specializations for this practice area will no longer be captured on the Nurse License Check.

Key practice considerations for NPs prescribing methadone for pain management:

• Methadone can be used for the treatment of severe pain associated with chronic conditions or cancer.
• NPs must only prescribe and/or administer a drug they have the knowledge, skill and judgement to do so safely and effectively.
• CRNS highly recommends that NPs who plan to prescribe methadone for pain management complete Methadone for Pain Management education such as methadone4pain.ca and reach out to a provider experienced in prescribing methadone for pain for further education and consultation when required.
• Methadone:
  • is listed in the Panel of Monitored Drugs (CPSS Regulatory Bylaw 18.1);
  • must be prescribed cautiously and in accordance with prescribing requirements for controlled drugs and substances; and,
  • dosing must be tailored to each patient.
• Prescribers are strongly encouraged to provide the indication for prescribing (e.g., chronic pain) on methadone prescriptions to enhance communication with the pharmacist and assist the pharmacist with accurate transmission to the Pharmaceutical Information Program.
• Saskatchewan Coroners Service concludes accidental or intentional methadone related deaths are commonly associated with unauthorized use. As with all controlled drugs, NPs should be cognizant of diversion potential and be mindful of potentially fraudulent requests for this drug.

NPs who require the authority to prescribe methadone or buprenorphine for the treatment of addiction continue to require Registrar approval per CRNS Regulatory Bylaw XII, Section 3(d)i.1. 

For more information, on the prescribing requirements for the treatment of opioid use disorder, please visit the CRNS website or contact the Opioid Agonist Therapy Program at OUD@crns.ca.

On December 19, 2025, the Ministry of Health approved changes to CRNS Bylaws that replace the Canadian Nurses Association (CNA) Code of Ethics for Registered Nurses with the CRNS Code of Conduct.

The CRNS Code of Conduct (the Code) is a set of six principles that describes the accountabilities RNs have to clients, employers, colleagues and the public. The Code explains what the public can expect from RNs, and what RNs do to maintain professionalism, competence and ethical behavior to deliver safe client care. 

The Code is effective February 17, 2026. 

Although the words may be different, the practice expectations of RNs and NPs have not changed. Getting to know the Code is a great focus for your 2026 Continuing Competence Program learning plan. A couple of resources to help familiarize yourself with the Code are:

• CRNS Code of Conduct 
• CRNS Code of Conduct FAQ
• Key differences between the Code of Conduct and Code of Ethics

CRNS Practice and Education Nursing Advisors are available to answer your questions by phone at 1.800.667.9945 or 306.359.4227 or by email at practiceadvice@crns.ca.

The second phase of the Saskatchewan Biosimilars Initiative launches on February 1, 2026. Under the Biosimilars Initiative, patients receive Saskatchewan Drug Plan coverage for a biosimilar when one is available and listed on the Saskatchewan Formulary. Biosimilars offer safe, effective treatment options and support significant cost savings and long term health system sustainability. Expanding the initiative helps maintain patient access to publicly funded drug coverage.

The second phase of the Biosimilars Initiative includes four drugs listed on the Saskatchewan Formulary:

• denosumab (Prolia®);
• omalizumab (Xolair®);
• tocilizumab (Actemra®); and,
• ustekinumab (Stelara®).

For more information, visit:

• Nursing Practice Update November 27, 2025
• Formulary Bulletin #261
• Saskatchewan Biosimilars Initiative website
• Letter to Health Care Providers January 26, 2026

Health Canada has contacted the College of Physicians and Surgeons and the CRNS (the “Colleges”) and expressed concern that some Saskatchewan physicians, NPs and RNs are contravening the Food and Drugs Act. It has advised the Colleges that in order to comply with the Food and Drugs Act, a physician or NP must provide a patient specific order (prescription) for each patient to whom an RN will provide an injection of Botox or other bioactive agent.

Click here for the full joint statement.

The CRNS acknowledges this may result in a change in practice. To support RNs and NPs in understanding practice expectations a Q&A session will be held on Wednesday, December 10, 2025 from 7 to 8 pm. The meeting link and password was sent to CRNS registrants by email on December 4, 2025 and can additionally be obtained by emailing info@crns.ca or calling (306) 359-4200.

CRNS Practice and Education Nursing Advisors are available to answer your questions by phone at 1.800.667.9945 or 306.359.4227 or by email at practiceadvice@crns.ca.

The Ministry of Health will be launching the second phase of the Saskatchewan Biosimilars Initiative in February 2026. This phase builds on the progress of the first phase of the Biosimilars Initiative, which was successfully completed in April 2024, and will continue to promote the use of biosimilar medications.

Under the Biosimilars Initiative, patients receive Saskatchewan Drug Plan coverage for a biosimilar version of their biologic medication where one is available and listed on the Saskatchewan Formulary. Biosimilars present a significant opportunity for cost savings and long-term health system sustainability while providing safe and effective medication options. Continued expansion of the Biosimilars Initiative supports patient access to public drug plan coverage.

For more information, visit:

The College of Registered Nurses of Saskatchewan (CRNS) is revising the Prescribing Medication Guideline and the RNs Recommending & Administering Non-prescription Drugs Guideline.

As part of the external consultation process, the CRNS is seeking feedback on both guidelines from registrants and external partners, including the public. Please complete the following surveys by Wednesday, December 4, 2025 at 4 pm.

Prescribing Medication Guideline Survey

RNs Recommending & Administering Non-Prescription Drugs Guideline Survey

Questions or comments are welcome and can be directed to Catharine Wirth at cwirth@crns.ca

Effective October 1, 2025, family physicians/general practitioners with additional qualifications may be eligible to bill a new fee code (14B) for consulting patients referred by a nurse practitioner (NP).

The Saskatchewan Medical Association (SMA) and the Ministry of Health have worked collaboratively to establish a solution within current legislative boundaries of the Saskatchewan Medical Care Insurance Payment Regulations, that enables family physicians with additional training to bill a new service code (14B) comparable to a consultation when seeing patients referred to them by NPs.

Relevant details regarding this service code are available on the SMA website.

CRNS Practice and Education Nursing Advisors are available to answer your questions by phone at 1.800.667.9945 or 306.359.4227 or by email at practiceadvice@crns.ca.

The Helicobacter pylori (H. pylori) Clinical Decision Tool (CDT) for RNs with Additional Authorized Practice [RN(AAP)s] has been revised to reflect current evidence-informed practice. The previous H. pylori CDT is no longer in effect. All RN(AAP)s are highly encouraged to review the updated CDT.

The CRNS CDTs are specific evidence-informed documents that guide RN(AAP)s in the assessment, diagnosis, and treatment of limited common medical disorders encountered in primary care settings in Saskatchewan. 

CRNS Practice and Education Nursing Advisors are available to answer your questions by phone at 1.800.667.9945 or 306.359.4227 or by email at practiceadvice@crns.ca.

The Graduate Nurse (GN) Practice Guideline has been reviewed on the five year cycle incorporating both internal and external recommendations, to provide updated direction to employers and registrants in the following areas:

• Bylaw references.
• Language referencing professional conduct.
• Clarification on when a complaint regarding GN practice can be made.
• Content focused on supporting GNs to deliver safe care. 

CRNS Practice and Education Nursing Advisors are available to answer your questions by phone at 1.800.667.9945 or 306.359.4227 or by email at practiceadvice@crns.ca.

The Registered Nurse Specialty Practice (RNSP) Guideline has been revised to provide further clarity in the following areas:

• Roles and responsibilities for employer, authorizer and registrants engaged in self-employed practice; 
• Graphic depicting the RNSP model;
• Enhanced description of the four essential components: client at the centre, supporting evidence, authorizing mechanism and RN competency requirements; and,
• An updated RN Clinical Protocol Checklist that can be utilized during the development, implementation and evaluation of the RNSP. 

CRNS Practice and Education Nursing Advisors are available to answer your questions by phone at 1.800.667.9945 or 306.359.4227 or by email at practiceadvice@crns.ca.

The CRNS has confirmed the Health Canada Subsection 56(1) Class Exemption for Nurse Practitioners to Prescribe Anabolic Steroids for Therapeutic Use applies to Saskatchewan Nurse Practitioners (NP) who have the knowledge, skill and judgment to care for clients experiencing the common medical disorder applicable to the exemption. 

NPs who incorporate this exemption into their practice are encouraged to monitor for updates from Health Canada as the exemption could be revoked or replaced by another exemption at any time. The CRNS Prescribing Controlled Drugs and Substances for NPs resource has been updated to reflect the applicability of the exemption in Saskatchewan.

CRNS Practice and Education Nursing Advisors are available to answer your questions by phone at 1.800.667.9945 or 306.359.4227 or by email at 

PRP@crns.ca.

Nurse Practitioners (NP) interested in prescribing for Opioid Use Disorder (OUD) or Methadone for Pain Management are required to complete a CRNS application to be approved as a prescriber. While the requirement remains the same, we are pleased to inform registrants that the application process is now available online in Alinity. 

We encourage NPs interested in becoming a prescriber to submit their application prior to completing the practicum requirement. For more information and instructions, please visit Nursing Practice > Prescribing.  

CRNS Practice and Education Nursing Advisors are available to answer your questions by phone at 1.800.667.9945 or 306.359.4227 or by email at OUD@crns.ca.

The Saskatchewan Cancer Agency (SCA) has requested that Myeloma resources be shared with NPs. Attached is the Think Myeloma card, a quick reference guide to help primary care providers recognize key Myeloma signs and symptoms, order essential tests and access the Monoclonal Gammopathies (MG) Clinic Referral Form and Pathway. The card can be printed for quick reference on a wall or desk or used digitally.

Also attached is a note from the project lead, Dr. Julie Stakiw (Hematologist at SCA). It includes a letter with links to Myeloma resources, including the Think Myeloma card, the MG Clinic Referral Form and Pathway, as well as other relevant materials.

This revised process focuses on evolving and innovative RN and NP roles and settings, relying on the nurse as expert, and incorporating principles of right touch regulation.

Confirming Nursing Practice (CNP) is a regulatory process whereby the registrant confirms the activity or service they provide meets all the legislative requirements and definition of RN or NP practice. 

To complete the CNP Process:

• review the CRNS Legislated Scope of Practice Self-Assessment Tool;
• watch the CNP educational video; and,
• log into your Alinity account to submit the CNP form on your dashboard.

CNP is meant for registrants who are or who will be working in non-traditional roles or settings, who are self-employed, engaged in independent practice, or who are in a role that does not specifically require the knowledge and competency of an RN or NP.

Visit the CRNS Confirming Nursing Practice (CNP) webpage for up-to-date information and to access instructions.

Contact a CRNS Practice and Education Nursing Advisor by email at practiceadvice@crns.ca or by phone at 1.800.667.9945.

In light of ongoing and persistent drug shortages, Health Canada has issued clarification regarding pharmacist dispensing authority under the Controlled Drugs and Substances Act and its regulations. Please access the communication provided from the Saskatchewan College of Pharmacy Professionals here.

CRNS Practice and Education Nursing Advisors are available to answer your questions by phone at 1.800.667.9945 or 306.359.4227 or by email at practiceadvice@crns.ca.