Second

Session, 50th General Assembly

Charles III, 2024

BILL 84

AN ACT TO AMEND THE

REGISTERED NURSES ACT, 2008

Received

and Read the First Time ................................................................

Second

Reading ............................................................................................

Committee .....................................................................................................

Third

Reading ...............................................................................................

Royal

Assent .................................................................................................

HONOURABLE JOHN

HOGAN, KC

Minister of Health

and Community Services and Attorney General

Ordered to be printed by

the Honourable House of Assembly

EXPLANATORY NOTES

This

Bill would amend the Registered Nurses Act,

2008 to

amend

definitions, add new

definitions and remove a definition that is no longer required;

update

terminology used in the Act;

remove the

authority to appoint persons as honorary members of the College of Registered

Nurses of Newfoundland and Labrador;

allow the registration of

registered psychiatric nurses; and

incorporate gender-neutral

language.

A BILL

AN ACT TO AMEND THE REGISTERED NURSES ACT,

Analysis

1. S.2

Amdt .

Definitions

2. S.3

Amdt .

Corporation

3. S.6

Amdt .

Composition of the council

4. S.8

Amdt .

Council officers

5. S.10

Amdt .

By-laws

6. S.11

Amdt .

Regulations

7. S.14

Amdt .

Qualification for registration and licensing

8. S.15

Amdt .

Requirement of council to keep registers

9. S.16

R&S

Requirements to practise

10. S.17

R&S

Prohibition

11. S.18

Amdt .

Definitions

12. S.19

Amdt .

Committees

13. S.20

R&S

Duty to report

14. S.21

Amdt .

Allegation

15. S.22

Amdt .

Effect of filing allegation

16. S.23

Amdt .

Complaints authorization committee

17. S.24

Amdt .

Adjudication tribunal

18. S.25

Amdt .

Hearing

19. S.27

Amdt .

Guilty plea by respondent

20. S.28

Amdt .

Powers of adjudication tribunal

21. S.30

Amdt .

De-registration and suspension

22. S.32

Amdt .

Reinstatement and readmission

23. S.35.1

Amdt .

Quality assurance committee

24. S.35.2

R&S

Registrant shall comply

25. S.35.3

Amdt .

Conduct of review

26. S.35.4

Amdt .

Costs

27. S.35.5

Amdt .

Termination of review

28. S.36

R&S

Other care givers

29. S.39.1

Added

Conflicting legislation

S.40 Amdt .

Offence

SNL2018 cC-12.3 Amdt .

SNL2011 cG-7.1 Amdt .

SNL1995 cP-37.1 Amdt .

SNL2005 cL-12.1 Amdt .

SNL2006 cP-12.01 Amdt .

SNL2024 cP-12.3 Amdt .

SNL2009 cV-6.01 Amdt .

NLR 24/19 Amdt .

NLR 45/15 Amdt .

NLR 56/19 Amdt .

NLR 83/23 Amdt .

NLR 53/18 Amdt .

NLR 114/96 Amdt .

NLR 15/01 Amdt .

NLR 121/18 Amdt .

Commencement

Be it enacted by the Lieutenant-Governor and

House of Assembly in Legislative Session convened, as follows:

SNL2008 cR-9.1

as amended

(1) Paragraph 2(

a) of the Registered Nurses Act, 2008 is repealed.

(2) Section 2 of the Act is amended by adding

immediately after paragraph (

d) the following:

(d.1) "licence" means, unless the context indicates otherwise, a registered

nurse licence, registered psychiatric nurse licence or nurse practitioner licence;

(3) Paragraph 2(

f) of the Act is repealed and the

following substituted:

(f) "nurse practitioner" means, unless the context indicates otherwise, a registered

nurse who holds a nurse practitioner licence;

(4) Section 2 of the Act is amended by adding

immediately after paragraph (

f) the following:

(f.1) "nurse practitioner licence" means a

licence issued under subsection 14(3) to engage in the practice of nursing;

(5) Paragraph 2(

g) of the Act is repealed and the

following substituted:

(g) "practice of nursing" means the use

of nursing knowledge, theory and skill in

(

i) the promotion, maintenance and restoration of health, and

(ii) the prevention, treatment and palliation of

illness and injury primarily by

(

A) assessing health status,

(

B) planning, implementing

and evaluating interventions, and

(

C) coordinating health services;

(6) Section 2 of the Act is amended by adding

immediately after paragraph (

g) the following:

(g.1) "practice of psychiatric nursing"

means the use of psychiatric nursing knowledge, theory

and skill in

(

i) the promotion, maintenance and restoration of health with a focus on

psychosocial, mental or emotional health, and

(ii) the prevention, treatment and palliation of

illness and injury, with a focus on psychosocial, mental, or emotional

disorders and conditions or comorbid physiological conditions, primarily by

(

A) assessing health status,

(

B) planning, implementing

and evaluating interventions, and

(

C) coordinating health services;

(7) Paragraph 2(

h) of the Act is repealed and the

following substituted:

(h) "register"

means, unless the context indicates otherwise, a register referred to in

section 15;

(8) Paragraph 2(

i) of

the Act is repealed and the following substituted:

( i ) "registered

nurse" means, unless the context indicates

otherwise, a person who is registered under subsection 14(1) and holds a

registered nurse licence;

(9) Section 2 of the Act is amended by adding

immediately after paragraph (

i) the following:

(i.1) "registered nurse licence" means a

licence issued under subsection 14(2) to engage in the practice of nursing;

(i.2) "registered psychiatric nurse" means,

unless the context indicates otherwise, a

person who is registered under subsection 14(1) and holds a registered

psychiatric nurse licence;

(i.3) "registered psychiatric nurse

licence" means a licence issued under subsection 14(5) to engage in the

practice of psychiatric nursing;

(i.4) "registrant" means a registered

nurse, registered psychiatric nurse or nurse practitioner;

2. Subsection 3(3) of the Act is repealed.

3. Subsection 6(1) of the Act is amended by

deleting the words "registered nurses" wherever they appear and

substituting the word "registrants".

4. Subsection 8(4) of the Act is amended by

deleting the words "registered nurse" and substituting the word

"registrant".

5. (1) Paragraph 10(1)(

d) of the Act is repealed.

(2) Paragraph 10(1)(

j) of the Act is amended by

deleting the words "registered nurse" and substituting the word

"registrant".

(3) Paragraph 10(1)(

k) of the Act is amended by adding immediately after the word "nursing" the

words "and the practice of psychiatric nursing".

6. (1) Subsection 11(1) of

the Act is amended by deleting the words "registered nurses" wherever

they appear and substituting the word "registrants".

(2) Paragraph 11(1)(

f) of the Act is repealed.

7. (1) Subsections 14(2) and (3) of the Act are repealed

and the following substituted:

(2) A person who

(

a) is

registered under subsection (1 );

(

b) has met all requirements for the issuance or renewal of a registered nurse licence set out in this Act and the regulations;

(

c) has

paid the required fees; and

(

d) whose

registration or licence to practise

nursing in another jurisdiction is not under review, suspended or revoked in the

other jurisdiction

is entitled to a registered nurse

licence.

(3) A registered nurse who

(

a) has

successfully completed a course of study approved by the council; or

(

b) in

the opinion of the council has sufficient knowledge and skills as prescribed by

the regulations to practise as a nurse practitioner

is entitled to a nurse practitioner

licence.

(2) Section 14 of the Act is amended by adding

immediately after subsection (4) the following:

(5) A

person who

(

a) is

registered under subsection (1 );

(

b) has met all requirements for the issuance or renewal of a registered

psychiatric nurse licence set out in this Act and the

regulations;

(

c) has

paid the required fees; and

(

d) whose

registration or licence to practise

psychiatric nursing in another jurisdiction is not under review, suspended or

revoked in the other jurisdiction

is entitled to a registered

psychiatric nurse licence .

8. Subsection 15(1) of the Act is repealed and the

following substituted:

Requirement of council to keep registers

15 .

(1) The council shall keep

(

a) a

historical register in which shall be entered the names of persons who have

been registered under subsection 14(1) together with other information that the

council may require; and

(

b) an

annual register in which shall be entered the names of all persons who hold a licence .

Section 16 of the Act is repealed and the

following substituted:

Requirements to

practise

16 . Except as provided in this Act, a person shall

not practise as a registered nurse, registered

psychiatric nurse or nurse practitioner, or represent to be a registered nurse, registered psychiatric nurse or nurse

practitioner unless that person is registered and holds a licence .

Section 17 of the Act is repealed and the

following substituted:

Prohibition

17 .

(1) A person who is not a registrant shall

not take or use the titles "Registered Nurse", "Registered

Psychiatric Nurse" or "Nurse Practitioner" or the initials

"RN", "RPN" or "NP", either alone or in

combination with other words, letters or description implying that the person

(

a) registered

and licensed under this Act;

(

b) entitled

to be registered and licensed under this Act; or

(

c) recognized

by law as a registered nurse, registered psychiatric nurse or nurse

practitioner.

(2) A person who contravenes this

section is guilty of an offence and liable on

summary

conviction to a fine not exceeding $3,000 for each offence and in default of

payment to imprisonment for a period not exceeding one month.

(1) Subparagraph 18(c)(iii) of the Act is

amended by deleting the words "registered nurse" and substituting the

word "registrant".

(2) Subparagraph

18(c)(iv) of the Act is amended by adding immediately after the word

"nursing" the words "or the practice of psychiatric

nursing".

(3) Paragraph 18(

g) of the Act is repealed and the

following substituted:

(g) "respondent" means a registrant or a

former registrant against whom an allegation is made.

12. (1) Subsection 19(5) of the Act is amended by deleting the words "registered nurses" wherever

they appear and substituting the word "registrants".

(2) Subsection 19(7) of the Act is repealed and

the following substituted:

(7) Where

the term of office of a member of the disciplinary panel expires, the member

continues to be a member of the disciplinary panel until reappointed or

replaced.

Section 20 of the Act is repealed and the

following substituted:

Duty to report

20 .

(1) A registrant who has knowledge, from direct

observation or objective evidence, of conduct deserving of sanction of another registrant

shall report the known facts to the Director of Professional Conduct Review.

(2) A

person or a corporation, partnership or association that terminates or imposes

restrictions on the employment of a registrant based on direct knowledge of the

registrant's conduct deserving of sanction shall report the known facts to the

Director of Professional Conduct Review.

(3) An

action shall not be brought against a registrant, person, corporation,

partnership or association or its directors or officers for the sole reason

that the registrant, person, corporation, partnership

or association complied with this section.

14. (1) Subsection 21(1) of the Act is amended by

deleting the words "his or her" and substituting the words "the

complainant's".

(2) Subsection 21(2)

of the Act is amended by deleting the words "his or her" and

substituting the words "the Director of Professional Conduct

Review's".

(3) Subsection 21(3) of the Act is amended by

(

a) deleting the words "registered

nurse" wherever they appear and substituting the word

"registrant"; and

(

b) deleting the words "registered

nurses" and substituting the word "registrants".

15. Subsection 22(2) of the Act is amended by

deleting the words "he or she" and substituting the words "the

Director of Professional Conduct Review".

(1) Subparagraph 23(4)(a)(

i) of the Act is amended by deleting the words "he or she" and

substituting the words "that the person".

(2) Subsection 23(5) of the Act is repealed and

the following substituted:

(5) An

action for damages does not lie against a registrant, or another person to whom

a request is made, solely because the registrant or other person provides

information requested under subsection (4).

Section 24 of the Act is amended by deleting

the words "registered nurses" wherever they appear and substituting

the word " registrants".

18. Subsection 25(2) of the Act is amended by

deleting the words "his or her".

19. Subsection 27(2) of the Act is amended by deleting

the words "his or her" wherever they appear and substituting the

words "the respondent's".

20. Subsection 28(3) of the Act is amended by

deleting the words "his or her" wherever they appear and substituting

the words "the respondent's".

Section 30 of the Act is amended by

(

a) deleting the words "his or her"

wherever they appear and substituting the words "the respondent's";

and

(

b) deleting the words "registered nurse to practise nursing " wherever they appear and

substituting the word "registrant".

22. Paragraph 32(1)(

b) of the Act is amended by

deleting the words "his or her" and substituting the words "the

respondent's".

(1) Subsection 35.1(1) of the Act is amended by

deleting the words "registered nurses" and substituting the word

"registrants".

(2) Subsection 35.1(2) of the Act is repealed and

the following substituted:

(2) The

committee may appoint registrants or persons registered as registered nurses, registered

psychiatric nurses or nurse practitioners in another province or territory of Canada,

to act as assessors or to assist the committee to perform its duties and

exercise its powers under this Act.

Section 35.2 of the Act is repealed and the

following substituted:

Registrant shall comply

35.2 A registrant

shall comply with a request or a directive of the committee, or a person

appointed to act on behalf of the committee, in connection with the conduct of

a quality assurance review with respect to the registrant or the registrant's

practice by the committee.

(1) Subsection 35.3(1)

of the Act is amended by deleting the words "registered nurse or his or

her" and substituting the word "registrant or the registrant's".

(2) Subsection 35.3(2)

of the Act is repealed and the following substituted:

(2) In connection with a quality assurance review, the quality

assurance committee may

(

a) require a registrant, or another person who has information

pertaining to or possession of records that relate to the registrant's practice, to provide information, including patient

records, for inspection or review and to permit them to be copied by the

committee or a person appointed by the committee for the purpose;

(

b) order a registrant to undergo an examination, evaluation,

assessment or review of the registrant's

professional practices or capacity or fitness to practise, to the extent and

under the circumstances required by the committee;

(

c) engage in periodic or random reviews or audits of a registrant's

performance including the consequential review of patient records; and

(

d) order a registrant to

(

i) obtain counselling, including substance abuse counselling, until the registrant

can demonstrate to the committee, or another body or a person designated by the

committee, that a condition related to the counselling has been overcome,

(ii) obtain medical treatment and authorize a person

participating in the provision of that treatment to report on it to the

committee,

(iii) complete a course of studies or an educational

or training program,

(iv) restrict the registrant's practice,

(

v) obtain supervised clinical experience as

directed by the committee and to the satisfaction of the committee,

(vi) continue the registrant's practice under

conditions the committee may specify, or

(vii) report on the registrant's compliance with an

order of the committee and authorize a person to report to the committee on

whether the registrant is complying with an order.

(3) Subsection

35.3(3) of the Act is amended by deleting the words "registered

nurse" wherever they appear and substituting the word

"registrant".

(4) Subsection

35.3(4) of the

Act is amended by deleting the words "registered nurse" and

substituting the word "registrant".

(5) Subsection

35.3(5) of the Act is repealed and the following substituted:

(5) An action for damages does not lie against a registrant, or

another person to whom a request is made, solely because the registrant or

other person provides information requested under paragraph (2)(a).

(6) Subsection

35.3(6) of the Act is amended by deleting the words "registered nurse" and substituting the

word "registrant".

Section

35.4 of the Act is amended by deleting the words "registered nurse"

wherever they appear and substituting the word "registrant".

27. Subsection

35.5(1) of the Act is amended by deleting the words "registered nurse"

wherever they appear and substituting the word "registrant".

Section 36 of the Act is repealed and the

following substituted:

Other care givers

36 . Notwithstanding any other provision of this Act, a legally qualified registered nurse, registered psychiatric

nurse or nurse practitioner from another jurisdiction, who is engaged to

provide education or consultative services in the province or to accompany and provide

care for a person who is temporarily in the province, is permitted to provide

those services during the period of the engagement where

(

a) the

period of the engagement does not exceed 28 days; and

(

b) the registered nurse, registered psychiatric nurse or nurse

practitioner does not represent to be a registrant.

29. The Act is amended by adding immediately after

section 39 the following:

Conflicting

legislation

39 .1 Nothing in this Act affects or applies to the practice of nursing

or the practice of psychiatric nursing permitted to be carried out by a person

under another statute of the province.

Section 40 of the Act is amended by deleting

the words "an annual".

SNL2018 cC-12.3 Amdt .

31. Paragraph 2( 1)( bb) of

the Children, Youth and

Families Act is amended by

deleting the word "nurse" and substituting the words "registered

nurse, registered psychiatric nurse".

SNL2011 cG-7.1 Amdt .

32. Subparagraph 2(b)(ii) of the Gunshot and Stab Wound Reporting Act is amended by deleting the words

"registered nurse" and substituting the words "registered nurse

or nurse practitioner".

SNL1995 cP-37.1 Amdt .

33. Paragraph 2(

g) of the Health and Community Services Act is repealed and the following substituted:

(g) "nurse" means

a licensed practical nurse as defined in the Licensed Practical Nurses Act,

2005 or a registered nurse, registered psychiatric nurse or nurse practitioner as

defined in the Registered Nurses Act, 2008 " .

SNL2005 cL-12.1 Amdt .

(1) Section 2 of

the Licensed Practical Nurses Act, 2005 is

amended by adding immediately after paragraph (

d) the following:

(d.1) "nurse

practitioner" means a nurse practitioner as defined in the Registered

Nurses Act, 2008 ;

(2) Paragraph 2(

f) of the Act is

repealed and the following substituted:

(f) "registered

nurse" means a registered nurse as defined in the Registered

Nurses Act, 2008 ;

(3) Section 2 of the Act is amended by deleting

the word "and" at the end of paragraph (

f) and adding immediately

after paragraph (

f) the following:

(f.1) "registered

psychiatric nurse" means a registered psychiatric nurse as defined in the Registered

Nurses Act, 2008 ; and

(4) Paragraph 29.1(2)(

b) of the Act is amended by

deleting the words " registered nurse or as a nurse practitioner "

and substituting the words " registered nurse,

registered psychiatric nurse or nurse practitioner".

(5) Paragraph 35(

c) of the Act is amended by

deleting the words "registered nurse" and substituting the words

"registered nurse, registered psychiatric nurse, nurse practitioner".

(6) Paragraph 35(

d) of the Act is amended by

deleting the words "registered nurse" and substituting the words

"registered nurse, registered psychiatric nurse or nurse

practitioner".

SNL2006 cP-12.01 Amdt .

35. Paragraph 2(

p) of the Pharmaceutical Services Act is amended by deleting the word

"and" at the end of subparagraph (vii), deleting the semi-colon at

the end of subparagraph (viii) and substituting a comma and by adding

immediately after subparagraph (viii) the following:

(ix) a registered psychiatric nurse licensed under

the Registered Nurses Act, 2008 ; and

SNL2024 cP-12.3 Amdt .

36. (1) Subsection 3(1) of the Pharmacy Act,

2024 is amended by deleting the word "and" at the end of

paragraph (f), deleting the period at the end of paragraph (

g) and substituting

a semi-colon and the word "and" and by adding immediately after

paragraph (

g) the following:

(

h) a registered

psychiatric nurse licensed and acting under the Registered Nurses Act, 2008 whose

licence includes the authority to prescribe under the Registered Nurses

Regulations.

(2) Subsection 3(2) of the Act is amended by

deleting the words "registered nurses" and substituting the words

"registered nurses, registered psychiatric nurses".

SNL2009 cV-6.01 Amdt .

37. (1) Subsection 2(1) of the Vital Statistics

Act, 2009 is amended by adding immediately after paragraph (q.1) the

following:

(q.2) "registered psychiatric nurse" means

a registered psychiatric nurse as defined in the Registered

Nurses Act, 2008 ;

(2) Paragraph 26.1(2)(

b) of the Act is amended by

adding immediately after subparagraph (ii) the following:

(ii.1) a registered psychiatric nurse,

NLR 24/19 Amdt .

38. Paragraph 2(

h) of the Accessible Parking Regulations under the Highway Traffic Act is repealed

and the following substituted:

(h) "registered nurse" means a registered nurse or nurse practitioner as defined in the Registered

Nurses Act, 2008 .

NLR 45/15 Amdt .

39. Paragraph 2(

b) of the Access to Information and Protection of Privacy

Regulations under the Access

to Information and Protection of Privacy Act, 2015 is amended by deleting

the words "registered nurse" and substituting the words

"registered nurse, registered psychiatric nurse".

NLR 56/19 Amdt .

Section 5 of the Automobile Insurance Regulations, 2019 under the Automobile Insurance Act is

amended by deleting the word "and" at the end of paragraph (m),

deleting the period at the end of paragraph (

n) and substituting a semi-colon

and the word "and" and by adding immediately after paragraph (

n) the

following:

(

o) a

registered psychiatric nurse as defined in the Registered Nurses Act, 2008 .

NLR 83/23 Amdt .

41. Paragraph 6(

e) of the Interpersonal Violence Disclosure Protocol

Regulations under the Interpersonal

Violence Disclosure Protocol Act is amended by deleting the words

"registered nurse" and substituting the words "registered nurse,

registered psychiatric nurse or nurse practitioner".

NLR 53/18 Amdt .

(1) Section 2 of the Monitored Drugs Regulations under the Prescription Monitoring Act

is amended by adding immediately after paragraph (

b) the following:

(b.1) "dispensing nurse practitioner"

means a nurse practitioner licensed

under the Registered Nurses Act, 2008 who dispenses monitored drugs in

the course of the nurse practitioner's practice;

(2) Section 2 of the regulations is amended by adding immediately after

paragraph (

d) the following:

(d.1) "dispensing registered psychiatric

nurse" means a registered psychiatric

nurse licensed under the Registered Nurses Act, 2008 who

dispenses monitored drugs in the course of the registered psychiatric nurse's

employment with the Provincial Health Authority;

(3) Subsection 4(2) of the regulations is amended

by deleting the words " physician

or a dispensing registered nurse" and substituting the words "physician,

dispensing registered nurse, dispensing registered psychiatric nurse or a

dispensing nurse practitioner".

NLR 114/96 Amdt .

43. Subsection 18.1(6) of the Pension Benefits Act Regulations under the Pension Benefits Act, 1997 is

amended by deleting the word "and" at the end of paragraph (m),

deleting the period at the end of paragraph (

n) and substituting a semi-colon

and the word "and" and by adding immediately after paragraph (

n) the

following:

(

o) a

registered psychiatric nurse as defined in the Registered Nurses Act, 2008 .

NLR 15/01 Amdt .

44. Subsection 13(1) of the Personal Care Home

Regulations under the Health and Community Services Act is amended

by deleting the words "registered nurse" and substituting the words

"registered nurse, nurse practitioner".

NLR 121/18 Amdt .

45. Paragraph 2(

b) of the Residential Tenancies Regulations under the Residential Tenancies Act, 2018 is

repealed and the following substituted:

(

b) a

registered nurse, registered psychiatric nurse or nurse practitioner registered

and licensed under the Registered Nurses Act, 2008 ;

Commencement

46. This Act comes into force on January 1, 2025.

King's Printer