Consultation Overview
Under the Nursing Act, the currency of practice requirements from the legacy colleges continue to remain in effect until new by-laws are created by NSCN. As part of NSCN’s continued growth and development, the College is introducing by-laws respecting currency of practice requirements to implement a consistent NSCN-based approach. Stakeholders are invited to provide feedback during a 30-day period in accordance with section 9(2) of the Nursing Act.
Background on the Initiative
One of the requirements for registration and licensure with NSCN is that the applicant provides satisfactory proof that they meet our currency of practice requirements. Currency of practice requirements are used to promote continuing nursing competence. These requirements generally relate to a nurse’s time actively engaged in practice or the length of time since they completed their education. These requirements are founded on the premise that competence diminishes as the time that a nurse is away from practice increases, which may place the public at risk when the nurse returns to practice.
There are presently three different sets of currency of practice requirements at NSCN - one for each of our three nursing designations. Those requirements can be found here.
The legacy colleges (the College of Licensed Practical Nurses of Nova Scotia and the College of Registered Nurses of Nova Scotia), each had regulations setting out currency of practice requirements that an applicant had to meet in order to register and be licenced. During the creation of NSCN, these requirements were continued under the Nursing Act until NSCN creates new by-laws.
The use of the legacy colleges’ currency of practice requirements was not meant to be permanent, but rather temporarily remained as we transitioned to NSCN. We are now in a position to introduce new currency of practice by-laws to replace the legacy requirements. These will be the first NSCN by-laws with respect to currency of practice.
The creation of NSCN’s currency of practice by-laws also provided an opportunity to review the various currency requirements and consider their continued relevance in meeting our mandate of public protection.
As a result, we are seeking feedback on draft by-laws and updated currency of practice requirements. This is another constructive step in building new, modernized regulatory systems. The proposed requirements promote consistency between designations and reflect our right-touch regulatory philosophy.
Proposed By-Laws
NSCN proposes the following new By-Laws respecting currency of practice requirements:
30.1 Pursuant to subsection 20(1)(b)(iv) of the Nursing Act, an applicant for licensure as an LPN, RN or NP must provide proof satisfactory to the Chief Executive Officer that the applicant meets one or more of the following currency of practice requirements:
- 30.1.1 licensure as a nurse in another jurisdiction in or outside of Canada as approved by the Chief Executive Officer;
- 30.1.2 nursing practice that meets the criteria established by Board resolution;
- 30.1.3 satisfaction of all requirements subsection 18(1)(c)(i) of the Nursing Act within a period of time established by Board resolution;
- 30.1.4 Successful completion of one of the following within a period of time established by Board by resolution:
- 30.1.4.1 a re-entry program ;
- 30.1.4.2 bridging education; or
- 30.1.4.3 such other education as determined to be appropriate by the Chief Executive Officer;
- 30.1.5 Successful completion of a competence assessment within a period of time established by Board resolution;
- 30.1.6 Such other requirement consistent with the objects of the Act as established by Board resolution.
Updated Currency of Practice Requirements
Requirements for licensure should undergo regular review to determine their continued relevance in meeting our mandate of public protection. LPNs have had the same currency of practice requirement since at least 2002, and RN requirements were established as early as 1987. These proposed changes will result in LPNs and RNs having consistent currency of practice requirements for licensure. NPs will have comparable currency requirements, taking into account the risks posed by competence drift in their broader scope of practice.
We recognize that currency of practice requirements should not be the only way to promote continuing competence. We also recognize that those who meet the currency of practice requirements sometimes have competence issues. Given the range of factors that can impact continuing competence, our proposed approach to currency of practice is more agile and balances the need for regulatory intervention with individual self-regulation and employer oversight. In particular, all Nova Scotia nurses are accountable through their Standards of Practice to self-assess and maintain their competence to practice safely, and to participate in continuing development. Additionally, the Nursing Act requires employers and nursing co-workers to report concerns of incompetence to NSCN. This safeguard allows us to investigate competence concerns and take appropriate action to protect the public, including requiring remediation and temporarily removing a nurse from practice where necessary.
It is proposed that an applicant could meet the currency of practice requirements in one of the following ways:
New options available to LPNs, RNs or NPs:
a) Proof of nursing practice in the last 3 years - This option does not include a minimum number of practice hours. CNO successfully implemented a similar requirement several years ago without an identified increase in concerns related to public safety.
b) Successful completion of required registration examination(s) (such as the CPNRE, NCLEX-RN or CNPE) in the last 3 years. – This recognizes the role of registration examinations in assessing an applicant’s competence. These examinations test whether an applicant meets Canadian entry-to-practice competencies (ELCs), which are foundational knowledge, skills and judgment that an individual must demonstrate for safe and ethical practice.
c) Proof of current licensure with a nursing regulator in a jurisdiction approved by the CEO. This new option is part of our comprehensive review of all registration and licensing processes to ensure they are relevant, flexible and positively contribute to the supply of nurses while simultaneously meeting NSCN’s legislated mandate to protect the public. Currently, it is proposed that the approved jurisdictions for LPNs and NPs would be other Canadian provinces and territories. The jurisdictions for RNs would also include the countries approved for the expedited registration and licensing process (more information here).
Options only available to LPNs or RNs:
d) Proof that, in the last 5 years, the applicant either completed remedial education (such as bridging education a re-entry program), or practised for a minimum of 320 hours. – These are updated versions of legacy currency of practice requirements. The practice hours are consistent with a re-entry program’s typical clinical requirements.
e) Proof of nursing practice in the last 3-10 years, and consent to several licensing conditions and restrictions determined to be appropriate by the CEO, such as a preceptored period, development of an orientation plan with the employer, and implementation of a learning plan. – Since the 2021 licensing year, we have granted conditional licensure to eligible registrants who did not fully meet our currency of practice requirements. There has not been an identified increase in competence complaints or reports as a result of this pilot and we consider it appropriate to implement this option as a currency of practice requirement.
f) Successful completion of a competence assessment in the last 5 years. - This is a continuation of currency of practice requirements that have been in place through both legacy colleges for many years. If there are competence gaps identified through the competence assessment, the applicant would be required to complete remedial education.
The options outlined in (d) to (f) are not currently proposed as ways for NP applicants to meet currency of practice requirements. However, the proposed By-laws are enabling and would permit the extension of these options to NPs in the future. Additionally, NPs can already re-establish currency of practice in similar ways with approval from the Registration and Licensing Committee. The Registration and Licensing Committee process will continue to be available to NPs after the new currency of practice requirements are implemented.
Join the Conversation
If you have feedback regarding the proposed new By-laws, please email Heather Totton at Heather.Totton@nscn.ca by April 23, 2023. Please identify whether you are a member of the public or a nurse and whether you are responding as an individual or on behalf of an organization.
In providing your feedback, we invite you to consider:
- Are the proposed currency of practice requirements and draft By-laws in the public interest?
- Will there be benefits from the proposed changes?
- Will there be risks from the proposed changes?
- Do you support the proposed currency of practice requirements and draft By-laws?
Consultation Next Steps
NSCN will share the feedback with the NSCN Board for their consideration prior to their vote on whether to approve the by-laws and currency of practice requirements. If these new by-laws are approved, an updated by-laws document will be posted on the website.
