Jesse has been a paramedic for the past eight years and continued to work part time while he finished his BScN program and prepared to write the National Council Licensure Examination (NCLEX). He recently passed his exam and applied for his registered nurse permit. This week, he was offered a part-time position as an RN with the same employer that he currently works for as a paramedic.
Jesse would like to continue working both as a paramedic and an RN but has some questions about how he would do this.
Jesse wonders what he needs to take into account when working in two roles and registered with two different regulatory colleges.
- Contact each regulatory college to verify their requirements for registration.
- Contact his employer’s human resources department as well as the managers he will report to, to discuss the factors to consider when working in two different roles for the same employer.
- Obtain the job description for each position so that he can familiarize himself with the responsibilities for each role and the expectations of the employer for that role.
- Be mindful of the role he is practicing in and how the appropriate scope of practice fits within the particular role in the specific setting.
- Remember that location of practice does not determine his professional accountability, but rather, it is the role he is practising in during that shift and the care that he provides. When practicing as an RN, he must practise within the RN scope of practice and when he is practising as a paramedic, he must practise within that scope of practice.
- Ensure he is reporting only practice hours worked in an RN role to CARNA. He cannot count the same hours for both professions.
- Use the appropriate authorized title for the specific role. In other words he cannot call himself an RN when he is practicing in the role as a paramedic or vice versa.
- Consider practising in a different practice setting for each role to decrease the potential of confusion when coworkers and patients see Jesse practicing as both an RN and paramedic in the same emergency department.
- Understand that the standards of both regulatory colleges apply in situations where a client’s condition deteriorates and he will be held accountable to the highest professional standards for acting or failing to act while a client is in distress. If he failed to meet the standards of the regulatory college(s) and a complaint is received by either or both regulatory colleges this may result in an investigation into allegations of unprofessional conduct.
- Remember that under the (HPA) he is required to maintain competency and practice hours. Each regulatory college may have different approaches to the requirements, time frame and reporting format. Jesse must keep up-to-date on knowledge related to each profession.
- Familiarize himself with the RN scope of practice and restricted activities documents that are available on the CARNA website. Scope of practice includes nursing interventions that regulated members are authorized, educated and competent to perform.
The RN Practice Statement as described in the Health Professions Act states:
In their practice, registered nurses do one or more of the following:
- based on an ethic of caring and the goals and circumstances of those receiving nursing services, registered nurses apply nursing knowledge, skill and judgment to
- assist individuals, families, groups and communities to achieve their optimal physical, emotional, mental and spiritual health and well-being,
- assess, diagnose and provide treatment and interventions and make referrals,
- prevent or treat injury and illness,
- teach, counsel and advocate to enhance health and well-being,
- coordinate, supervise, monitor and evaluate the provision of health services,
- teach nursing theory and practice,
- manage, administer and allocate resources related to health services, and
- engage in research related to health and the practice of nursing, and
- provide restricted activities authorized by the regulation
How will liability coverage work?
Jesse should determine the details of the liability protection available through his employer as well as any liability coverage available through his regulatory colleges.
After some research Jesse determines that as a practising CARNA member, he has liability coverage through his employer and through the Canadian Nurses Protective Society (CNPS). CNPS also offers additional liability coverage for members who require more coverage.
- Jesse needs to ensure he has the appropriate liability protection for each profession he holds a practice permit with.
- Since Jesse is contemplating working two different roles for the same employer it would be appropriate for him to discuss liability coverage with his employer’s human resources department.
To gather the information he needs, Jesse decides to contact the regulatory colleges and associations, CNPS and his employer.
Disclaimer: Our case studies are fictional educational resources. While we strive to make the scenarios as realistic as possible, any resemblance to actual people or events is coincidental.