What is a Registered Psychiatric Nurse? 

A Registered Psychiatric Nurse (RPN) is a regulated health professional that provides health care for the promotion, maintenance, and restoration of health, with a focus on psychosocial, mental, or emotional health. In psychiatric nursing there is a focus on mental health, addictions, and neurodevelopmental disorders. This includes: 

• Assisting clients, families, groups, communities, and populations to achieve, maintain and restore their optimal physical, mental, emotional, social, and spiritual health 
• Assessing, planning, providing, and evaluating treatment and interventions 
• Providing education to clients and advocating with or on their behalf to enhance their health and well-being 
• Providing counselling to clients 
• Coordinating, monitoring, delivering, and evaluating health care and psychosocial services 
• Managing, administering, and developing systems related to registered psychiatric nursing and the provision of health care and psychosocial services 
• Teaching nursing theory and the practice of registered psychiatric nursing 
• Engaging in research related to health and the practice of registered psychiatric nursing 

What guides the practice of psychiatric nursing? 

The practice of registered psychiatric nursing is guided by: 

• Regulated Health Professions Act (RHPA) 
• Registered Nurses and Registered Psychiatric Nurses Regulations 
• Standards of Nursing Practice for Registered Psychiatric Nurses 
• Code of Ethics 
• PEICNM policies, bylaws, practice directives, and other documents 
• Employer policies, guidelines, and procedures 
• Other provincial and federal legislation 

Where do RPNs work? 

RPNs work in a variety of areas, although most commonly they work in mental health and addictions settings. They also work in settings including corrections, palliative care, occupational health, schools, residential care, and complex care. 

Reserved Activities 

A reserved activity is a clinical activity that can only be performed by specific regulated health professionals as there is a significant risk of harm to the public. The RHPA decides which professional can perform each reserved activity, which means that other regulated health professionals may also be assigned the same reserved activities. This means that collaborative practice is imperative. 

The Code of Ethics and Standards of Nursing Practice also underpin the practice and the performance of reserved activities. As well, practice directives expand on concepts in the regulations and outline specific practice expectations for the performance of reserved activities. 

Reserved Activities for RPNs 

An RPN may only perform a reserved activity if: 

• the reserved activity is listed in the Registered Nurses and Registered Psychiatric Nurses regulations, which are discussed below. 
• they meet the conditions outlined in Section 23.9(2) of the regulations. 
• the reserved activity is within the individual RPN’s scope of competence. An individual RPN’s scope cannot exceed the RPN profession’s legislated scope of practice. Each individual RPN must be qualified and competent with their own scope of practice. 
• they follow employer’s policies. Employer policies provide further direction on an RPN’s practice. An employer may place limits on RPNs and their practice. An employer’s policies must be consistent with the RHPA, regulations, bylaws, standards, code of ethical conduct and practice directives. 

The following are reserved activities for RPNs: 

1. Performing a procedure on tissue below the dermis, or below the surface of a mucous membrane. 
2. Administering a substance by injection, transfusion, inhalation, mechanical ventilation, irrigation or enteral or parenteral instillation. 
3. Administering a drug or vaccine by any means. 
4. Putting an instrument, hand or finger
   • beyond the external ear canal, 
   • beyond the point in the nasal passages where they normally narrow, 
   • beyond the pharynx or larynx, 
   • beyond the opening of the urethra, 
   • beyond the labia majora, 
   • beyond the anal verge, or 
   • into an artificial opening into the body 
5. Applying sound energy or electrical energy, other than ionizing radiation. 
6. Performing a psycho-social intervention with an expectation of modifying a substantial disorder of thought, mood, perception, orientation or memory that grossly impairs judgment, behaviour, the capacity to recognize reality or the ability to meet the ordinary demands of life. 

Activities that are not reserved 

A profession’s scope of practice is not solely encompassed by reserved activities. The full extent of a nurse’s scope of practice cannot be described by reserved activities alone. The Standards of Practice would include examples of nursing practice that do not fall under a reserved activity. Some examples are: 

• Assessing the health status of a client 
• Planning and evaluating client care 
• Critical thinking 
• Supporting activities of daily living 
• Communicating with clients and families 
• Collaborating with the health care team 
• Developing professional and therapeutic relationships 
• Documenting 
• Maintaining client safety 
• Mentoring students and new graduates 
• Ensuring infection control