The College of Physicians and Surgeons of Saskatchewan (CPSS), through The Medical Professions Act, 1981 and their bylaws provide the opportunity for physicians to delegate certain activities to Registered Nurses (RN). The current CPSS Bylaw 23.3 permits delegation from a physician to an RN.
RNs who are considering accepting a delegation from a physician must understand the conditions for this to occur. RNs accepting a delegation from a physician should ensure that they:
- are certain that the practice is in the best interest of the client in their surrounding environment, including assessment of the risks and all possible outcomes;
- are willing to only accept a delegation from a physician if the activity is specified in the current CPSS Bylaw 23.3 and for which they are competent;
- confirm appropriate education, supervision, support and communication avenues are in place with the delegating physician before performing a delegated medical activity;
- possess the competencies required to manage any outcomes of that activity, including intended and unintended consequences;
- do not delegate any activity delegated by a physician, to another RN or any other health care provider;
- are practicing within the legislated scope of registered nursing practice and are upholding the current standards, competencies and code of ethics;
- have a written agreement with the physician who is delegating to the RN;
- verify that employer policies and processes are in place to enable acceptance of a delegation from a physician; and,
- adhere to the employer policy and procedure for a delegated medical activity. That said, no employer policy can relieve RNs of their professional accountability and responsibility. The RN must ensure that:
- roles, responsibilities and authority, specific for the physician and RN, are clearly outlined in the policies and procedures, including clear lines of reporting and communication;
- a collaborative process with representation from appropriate professionals, guides the development of these policies and procedures, to ensure professional roles are accurate, professional accountabilities and standards can be met, and that the documents are based upon evidence-informed best practice; and that
- there is ongoing monitoring and evaluation of the physician to RN delegation process.
The information contained within this nursing practice update replaces the former CRNS document, Guidelines for Physician to RN Delegation.
If you have questions, please contact an CRNS Practice Advisor by phone at 1.800.667.9945 or 306.359.4227 or by email firstname.lastname@example.org.