COVID-19: SRNA Update

The SRNA is closely monitoring the ongoing outbreak to provide support to Registered Nurses (RNs), Registered Nurses with Additional Authorized Practice [RN(AAP)s], Nurse Practitioners (NPs), employers and provincial leadership. The SRNA is working closely with industry partners to monitor developments relating to COVID-19 and taking direction from provincial, federal and global health authorities. We will update this page daily with new information for the public and our members.

For the Public

The COVID-19 situation is stressful, and it is normal to be anxious and worried. 211 Saskatchewan is a free, confidential, 24/7 service that connects individuals with supports via phone, text or web chat. Read More

In response to the COVID-19 pandemic, Choosing Wisely Canada has developed a list of recommendations for the public about the need to use limited health care resources wisely. Read More

Our system will continue to accept complaints as protection of the public remains our priority; however, given the current situation with Covid-19—although investigations will continue—delays will occur. Read More

For Members

As of September 18, 2020, The CNPE will be offered through secure online proctoring for the October 14, 2020 writing. Read More

As of June 3, 2020, the curve of COVID-19 in Saskatchewan is flattening and the health care system is managing with the current number of cases; therefore, the SRNA will no longer be requesting applications or processing applications for Emergency Practicing Licenses. Read More

Effective May 20, 2020, the Ministry of Health is removing the quantity limits and returning to the Drug Plan and Extended Benefits Branch (DPEBB) standard rule of three (3) prescription fills in a 45-day period. Read More

As of May 4, 2020, the Pearson Vue NCLEX testing sites in Regina and Saskatoon are open. Read More


Daily Updates:

As of September 18, 2020

  • The Canadian Nurse Practitioner Exam (CNPE): The CNPE will be offered through secure online proctoring for the October 14, 2020 writing. Due to current and potential future test center closures related to the COVID-19 pandemic, SRNA in partnership with Yardstick Assessment Strategies is pleased to announce that the CNPE will be administered using secure online proctoring.
    Read More

As of June 17, 2020

As of June 3, 2020

  • SRNA No Longer Processing Emergency Practicing Licenses: As of June 3, 2020, the curve of COVID-19 in Saskatchewan is flattening and the health care system is managing with the current number of cases; therefore, the SRNA will no longer be requesting applications or processing applications for Emergency Practicing Licenses. Current Emergency Practicing Licenses will remain valid for the 90-day period.

As of May 20, 2020

  • Removing Quantity Limits on Prescription Fills: In March 2020, Saskatchewan and many other provinces and territories, implemented prescription quantity limits to ensure the continued supply, and to prevent the stockpiling of prescription medications. Effective May 20, 2020, the Ministry of Health is removing the quantity and returning to the Drug Plan and Extended Benefits Branch (DPEBB) standard rule of three (3) prescription fills in a 45-day period. Read More

As of May 4, 2020

  • SHA Seeking to Pro-Actively Hire to Assist Northern Communities: Based on recent outbreak events in northern Saskatchewan, The SHA would like to immediately start hiring those who are either retired or otherwise eligible for licensure who are not already employed by the SHA. Read More
  • NCLEX Testing Sites Reopening: The National Council of State Boards of Nursing (NCSBN) has been working with Pearson VUE to facilitate the resumption of NCLEX testing. Effective today, May 4, 2020, testing sites in Regina and Saskatoon have reopened. Read More

As of April 20, 2020

  • Saskatoon Police Service – Criminal Record Checks and Vulnerable Sector Checks: Be advised that the Saskatoon Police Service has opened their online application process for Basic Criminal Record Checks and Vulnerable Record Checks. Read More

As of April 15, 2020

  • Prescription Quantity Restrictions: Updated List of Exceptions: To ensure the continued supply of prescription medications during the COVID-19 pandemic, the Ministry of Health requires that Saskatchewan pharmacists limit the quantity and frequency of prescription drugs dispensed. Review the full Prescription Quantity Restrictions and review the Drug Plan and Extended Benefits’ updated list of exceptions. Read More

As of April 14, 2020

  • Pexip Applications Open for NPs: The Government of Saskatchewan has expanded virtual care options for physicians, NPs and health care providers to facilitate patient clinics virtually. Read More
  • Interim Measures Related to Exception Drug Status (EDS) for NP Prescribers: Effective immediately, the Drug Plan and Extended Benefits Branch is temporarily increasing access to the direct oral anticoagulant (DOAC) medications for patients with atrial fibrillation, deep vein thrombosis or pulmonary embolism. Read More

As of April 6, 2020

  • 211 Saskatchewan: 211 Saskatchewan is a free, confidential, 24/7 service that connects individuals to human services in the province by telephone, text, or web chat, plus a searchable website with over 5,000 listings of social, community, non-clinical health, and government services across the province. Read More
  • Graduate Nurses Applying for Emergency Practicing Licenses: If you are a recent graduate from a Saskatchewan nursing education program, you must first open an account with the SRNA and apply to write the NCLEX-RN. Once your NCLEX application shows the status of “Approved”, you can apply for a GN license or for the Emergency Practicing License as a GN. Read More

As of April 3, 2020

  • Choosing Wisely Canada COVID-19 Recommendations: The COVID-19 pandemic presents an unprecedented challenge to the capacity of health care systems and providers around the world. Choosing Wisely Canada has developed a list of recommendations for the public and clinicians about the need to use limited health care resources wisely. Read More

As of March 30, 2020

  • Change to Exception Drug Status (EDS) for Hydroxychloroquine and Chloroquine: The Saskatchewan Ministry of Health has identified existing patients who have been using Hydroxychloroquine and Chloroquine long term. The Ministry of Health has applied Exception Drug Status (EDS) to their records so that they will continue to receive the medications as a benefit under the Drug Plan. Read More

As of March 26, 2020

  • CNPE Administration Affected by Covid-19 Pandemic: On March 24, 2020, the SRNA received a notice from Yardstick Assessment Strategies (YAS) that the administration of the Canadian Nurse Practitioner Examination (CNPE) writing scheduled for May 6, 2020 has been affected by COVID-19. Read More
  • A Joint Message to Saskatchewan’s Doctors, Registered Nurses/Nurse Practitioners and Pharmacists: Use of Hydroxychloroquine (Plaquenil®) and Azithromycin for COVID-19. Read More

As of March 25, 2020

  • Nursing Use of ICT Practice Update: RNs and NPs are working with organizations to provide continued safe, competent and ethical care to the people of Saskatchewan during the COVID-19 pandemic. Using virtual means, such as telehealth, to connect with patients and families is a necessity in today’s environment. When utilizing any other form of information and communication technologies (ICT) for telepractice, RNs and NPs must ensure they continue to uphold their standards, competencies and code of ethics. Read More
  • NCLEX Testing Opening: The National Council of State Boards of Nursing (NCSBN) has been working with Pearson VUE to facilitate the resumption of NCLEX testing March 25, 2020, in more than 70 Pearson VUE professional testing centers across the United States and Canada. At this time, Pearson Vue will not be opening a testing site in Saskatchewan. Read More
  • CELBAN Testing: Touchstone Institute has cancelled all upcoming CELBAN tests through July 31, 2020. Read More

As of March 20, 2020

  • In preparation for when our health care system needs us, the SRNA is compiling a bank of Emergency Practicing licensed RNs ready for when they are needed. We will be posting all approved and active Emergency Practicing RNs here.  If you, or anyone you know, may be interested in applying for Emergency Practicing licensure to help in this difficult time, refer to the criteria here. Current RNs, RN(AAP)s and NPs interested in being reassigned or those wishing to volunteer with the SHA, can contact HR-covid19@saskhealthauthority.ca.

As of March 19, 2020

  • CALLING ALL ELIGIBLE NURSES: We are implementing our plan to mobilize and support the province by putting a call out to all eligible Retired RNs and Grad Nurses to come forward and apply for Emergency Practicing licensure to assist our health care system in providing care during this unprecedented time. Read More
  • Nurse Practitioners Limiting Prescriptions: To ensure the continued supply, and to prevent the stockpiling of a prescription medication, the Saskatchewan Ministry of Health will require that Saskatchewan pharmacists limit the number and quantity of prescription drug dispenses. Read More

As of March 18, 2020

  • Office Closure: Effective Wednesday, March 18, 2020, the SRNA office will be closed to the public until further notice. The SRNA will continue to be accountable for public protection by ensuring members are competent, especially during these unprecedented times. All SRNA services will be provided online, but all employees are working from home when possible. We expect these measures to continue for the foreseeable future, but they will be re-evaluated as the pandemic situation develops. If you have questions, contact us:
  • CELBAN Testing: Touchstone Institute has decided to cancel upcoming Canadian English Language Benchmark Assessment for Nurses (CELBAN) tests. More information here.
  • NCLEX Testing: The National Council of State Boards of Nursing (NCSBN) will be suspending all test deliveries at the U.S.-and-Canada based Pearson VUE test centers, the NCLEX test administrator, until further notice. NCSBN has published this FAQ for NCLEX candidates, educators and regulators.

As of March 11, 2020

  • Current State: On March 11, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic. The SRNA is responding and planning accordingly.

For the Public

June 3, 2020: SRNA No Longer Processing Emergency Practicing Licenses

As of June 3, 2020, the curve of COVID-19 in Saskatchewan is flattening and the health care system is managing with the current number of cases; therefore, the SRNA will no longer be requesting applications or processing applications for Emergency Practicing Licenses. Current Emergency Practicing Licenses will remain valid for the 90-day period.

211 Saskatchewan

The effort to address COVID-19 can pose a range of challenges on individuals and families as they respond to the demands of the situation. The situation is stressful, and it is normal to be anxious and worried. 211 Saskatchewan is a free, confidential, 24/7 service that connects individuals to human services in the province by telephone, text, or web chat, plus a searchable website with over 5,000 listings of social, community, non-clinical health, and government services across the province.

This access to community, health and government services is available 24 hours a day, 7 days a week, 365 days a year. Over 175 languages, including 17 Indigenous languages, are available over the phone.

Choosing Wisely Canada COVID-19 Recommendations

The COVID-19 pandemic presents an unprecedented challenge to the capacity of health care systems and providers around the world. Choosing Wisely Canada has developed a list of recommendations for the public and clinicians about the need to use limited health care resources wisely. Now, more than ever, stewardship of limited resources is critical.

The nine recommendations can be found here: https://choosingwiselycanada.org/covid-19/ Recommendations for the Public (#1-4); Recommendations for Clinicians (#5-9).

The list of recommendations was compiled with input from clinicians representing different specialties, patient advisors, and leaders of the Choosing Wisely international community. This list will be updated on a frequent and ongoing basis as evidence emerges in response to the COVID-19 pandemic. This list was developed as an information resource and should not be used as a substitute for medical advice or treatment. Please consult with your health care provider or local public health authority before making any health care decisions related to COVID-19.

SRNA Complaints and Investigations

Our system will continue to accept complaints as protection of the public remains our priority; however, given the current situation with Covid-19—although investigations will continue—delays will occur.

March 20, 2020: Emergency Practicing Licenses

Emergency Practicing licenses are being manually processed by the Regulatory team, but you can still perform a Nurse License Check on our website. View the list of SRNA RNs, RN(AAP)s and NPs with current active Emergency Practicing licenses here. Note that this list will change as new members are licensed.

Important measures individuals can take to prevent respiratory illnesses, including COVID-19, are:

  • Cleaning your hands regularly
  • Avoiding touching your face
  • Coughing or sneezing into your elbow sleeve
  • Disposing of tissues appropriately
  • Practicing social distancing by staying home and away from others, if you are sick

For Members

September 18, 2020: The Canadian Nurse Practitioner Exam (CNPE)

The CNPE will be offered through secure online proctoring for the October 14, 2020 writing. 

Due to current and potential future test center closures related to the COVID-19 pandemic, SRNA in partnership with Yardstick Assessment Strategies is pleased to announce that the CNPE will be administered using secure online proctoring. 

Moving the CNPE to an online proctoring environment will help ensure that NP candidates have access to their exam despite test centre closures and physical distancing guidelines. Given the rapid evolution of online proctoring technologies and methodologies, we are satisfied that this administration modality presents a secure and reliable administration option for the CNPE

We have worked in close partnership with Yardstick for several years to develop and deliver the CNPE and look forward to implementing this solution during these challenging times. You can read more about Yardstick Assessment Strategies on their website. You can read more about Online Proctoring on their FAQ page.

Please contact register@srna.org if you have any questions.

June 17, 2020: Update of medSask Postings for NP Prescribers

medSask recently posted documents for amoxicillin suspension and dipyridamole/ASA. This update follows postings in April 2020 for fluticasone and salbutamol inhalers.

Drug shortages are a serious and growing concern for the Canadian (and global) health care system. medSask has always endeavoured to support practitioners as much as possible with respect to drug shortages by developing information of alternative treatments in a timely manner. Review medSask’s COVID-19 FAQ page to answer any questions.

June 3, 2020: SRNA No Longer Processing Emergency Practicing Licenses

As of June 3, 2020, the curve of COVID-19 in Saskatchewan is flattening and the health care system is managing with the current number of cases; therefore, the SRNA will no longer be requesting applications or processing applications for Emergency Practicing Licenses. Current Emergency Practicing Licenses will remain valid for the 90-day period.

May 20, 2020: Removing Quantity Limits on Prescription Fills

On March 18, 2020, in response to drug supply concerns, Saskatchewan and many other provinces and territories, implemented prescription quantity limits to ensure the continued supply, and to prevent the stockpiling of prescription medications.

Effective May 20, 2020, the Ministry of Health is removing the quantity limits (subject to pharmacists’ judgement regarding evolving shortages) and returning to the Drug Plan and Extended Benefits Branch (DPEBB) standard rule of three prescription fills in a 45-day period. This change should not affect most prescriptions. In 2019-2020, 87 per cent of prescriptions submitted to the province’s Drug Plan were for a 34-day supply of medication or less.

The drug supply is being actively monitored to inform timely responses as the COVID-19 pandemic evolves. Quantity limits may be reinstated if the drug supply is once again in jeopardy. Read the Letter to Pharmacists Here

May 4, 2020: SHA Seeking to Pro-Actively Hire to Assist Northern Communities

Based on recent outbreak events in northern Saskatchewan, the Saskatchewan Health Authority has decided to pro-actively hire as many individuals who are eligible for licensure as possible, including RNs and NPs.

The SHA would like to immediately start hiring those who are either retired or otherwise eligible for licensure who are not already employed by the SHA. Please complete this External Pre-Screening Form to help expedite the process and assist our northern communities.

May 4, 2020: NCLEX Testing Sites Reopening

The National Council of State Boards of Nursing (NCSBN) has been working with Pearson VUE to facilitate the resumption of NCLEX testing. Effective today, May 4, 2020, testing sites in Regina and Saskatoon have reopened.

For additional information, please visit: https://home.pearsonvue.com/coronavirus-update

April 20, 2020: Saskatoon Police Service – Criminal Record Checks and Vulnerable Sector Checks

Be advised that the Saskatoon Police Service has opened their online application process for Basic Criminal Record Checks and Vulnerable Record Checks. The cost is $75 with an additional $9.95 processing fee to verify applicant ID. The Saskatoon Record Check Office is closed to walk-in service.

Ensure you indicate that your application is regarding health care/nursing so that your check is given priority status. You will not require notarized ID for this process. If you fail to authenticate by incorrectly answering credit questions, are under the age of 21 or have not established a credit history (i.e. no credit card, mortgage etc.), the Saskatoon Police Service will contact you to arrange an appointment.

Review application instructions and apply online here.

April 15, 2020: Prescription Quantity Restrictions: Updated List of Exceptions

To ensure the continued supply of prescription medications during the COVID-19 pandemic, the Ministry of Health requires that Saskatchewan pharmacists limit the quantity and frequency of prescription drugs dispensed.

Effective March 18, 2020, for drugs not included on the Maintenance Drug Schedule, only one prescription claim will adjudicate in a 28-day period. A prescription claim in the case of these drugs will be a one-month supply to a maximum of a 35-day supply. Pharmacies will receive an HC/HD error code for claims that exceed one in 28 days. If the prescription allows, consider using professional judgement to dispense an adequate one-month quantity to avoid generating an HC/HD error. Review the full Prescription Quantity Restrictions and review the Drug Plan and Extended Benefits’ updated list of exceptions in the Formulary Bulletin #728 here.

April 14, 2020: Pexip Applications Open for NPs

In response to the global pandemic, the province has expanded virtual care options for physicians, NPs and health care providers to facilitate patient clinics virtually. Pexip is the Saskachewan Health Authority’s (SHA) approved videoconferencing software solution for face-to-face collaboration with patients using a PC, laptop, tablet or mobile device. The province is approving request access by NPs to create and use a Pexip account.

NPs wanting to apply for access to Pexip can review the requirements and apply on the Government of Saskatchewan website here.

April 14, 2020: Interim Measures Related to Exception Drug Status (EDS) During COVID-19 Pandemic

The Saskatchewan Ministry of Health has released interim measures related to Exception Drug Status (EDS) during the COVID-19 pandemic. Effective immediately, the Drug Plan and Extended Benefits Branch is temporarily increasing access to the direct oral anticoagulant (DOAC) medications for patients with atrial fibrillation, deep vein thrombosis or pulmonary embolism. In addition, requests that have been received by the Drug Plan and Extended Benefits Branch for EDS coverage of DOACs for these conditions will be approved and backdated to March 11, 2020. These temporary changes will help ensure appropriate use of these medications while recognizing the need for social distancing as a result of the current COVID-19 pandemic. NP prescribers are encouraged to carefully review their patients to determine who would be considered appropriate for treatment with a DOAC rather than warfarin.

To review an in-depth breakdown of which medications will be transitioning to a temporary full Formulary status during the COVID-19 pandemic, review the Saskatchewan Formulary Bulletin here.

April 8, 2020: Writing the Canadian Nurse Practitioner Examination (CNPE)

As a result of the impact of the COVID-19 global pandemic, the May 6, 2020, writing of the Canadian Nurse Practitioner Examination (CNPE) has been cancelled. At this time, we expect that the October 14th date will continue as planned. Anticipating an increase in the number of candidates writing the October 14th CNPE, Canadian nursing regulatory bodies are working with the examination provider to be prepared.

Candidates who applied for the May 6 examination will receive communication from their regulatory body on the process to write on October 14, 2020.

We thank all nurses for their professional dedication during this challenging time.

April 6, 2020: Graduate Nurses Applying for Emergency Practicing Licenses

If you are a recent graduate from a Saskatchewan nursing education program, you must first open an account with the SRNA and apply to write the NCLEX-RN. Once your NCLEX application shows the status of “Approved”, you can apply for a GN license or for the Emergency Practicing License as a GN.

Please note that the Emergency Practicing License is solely for the purpose of providing assistance in Saskatchewan during the pandemic; it is DOES NOT guarantee a position or job offer.

If you have been offered work as a graduate nurse, you must complete the Graduate Nurse License application. If you wish to apply for a position, you should complete the Graduate Nurse License application.

March 30, 2020: Change to Exception Drug Status (EDS) for Hydroxychloroquine and Chloroquine

The Drug Plan and Extended Benefits Branch is aligning access to certain medications with input from the Saskatchewan Health Authority (SHA) and the infectious disease clinicians to avoid inappropriate use of these medications as a result of the current COVID-19 pandemic.

The Saskatchewan Ministry of Health has identified existing patients who have been using Hydroxychloroquine and Chloroquine long term. The Ministry of Health has applied Exception Drug Status (EDS) to their records so that they will continue to receive the medications as a benefit under the Drug Plan. Their prescribers do not need to contact the Saskatchewan Ministry of Health to apply for EDS.

In addition, for new patients requiring these therapies, the Drug Plan has worked with adult and pediatric rheumatologists and infectious disease specialists to identify a list of those prescribers. We have created a process so that when a new prescription is filled at a pharmacy from one of these identified prescribers, the EDS will be automatically approved by the Drug Plan claims system for that patient. Again, no application is needed for EDS.

Currently, there are no antiviral agents that have been demonstrated to have clinical activity against COVID-19, and the foundation of treatment for all patients with COVID-19 remains supportive care, commensurate with degree of illness.

Review the Formulary Bulletin from the Ministry of Health here: Interim Measures Related to Exception Drug Status (EDS) During COVID-19 Pandemic

March 26, 2020: CNPE Administration Affected by Covid-19 Pandemic

On March 24, 2020, the SRNA received a notice from Yardstick Assessment Strategies (YAS) that the administration of the Canadian Nurse Practitioner Examination (CNPE) writing scheduled for May 6, 2020 has been affected by COVID-19.

The Canadian RN regulators are working together with YAS to determine options and possible next steps.

Information about next steps will be posted here as the information becomes available.

March 26, 2020: A Joint Message to Saskatchewan’s Doctors, Registered Nurses/Nurse Practitioners and Pharmacists: Use of Hydroxychloroquine (Plaquenil®) and Azithromycin for COVID-19

During this time of unprecedented challenge and fast-moving information, we understand how difficult it is to keep up with all available evidence related to treatment of COVID-19.  With the recent barrage of social media on the use of these two drugs for COVID-19 treatment, we want to be sure you are clear on the current evidence and related risks. Read the full statement here

March 25, 2020: Nursing Use of ICT Practice Update

RNs and NPs are working with organizations to provide continued safe, competent and ethical care to the people of Saskatchewan during the COVID-19 pandemic. Using virtual means, such as telehealth, to connect with patients and families is a necessity in today’s environment. When utilizing any other form of information and communication technologies (ICT) for telepractice, RNs and NPs must ensure they continue to uphold their standards, competencies and code of ethics.

The importance of clinical knowledge, nursing judgment, communication and documentation skills is paramount when establishing and maintaining a nurse client relationship through telehealth. More information for nursing telehealth activities can be found in this nursing practice update.

March 25, 2020: NCSBN Resuming NCLEX Testing

The National Council of State Boards of Nursing (NCSBN) has been working with Pearson VUE to facilitate the resumption of NCLEX testing March 25, 2020, in more than 70 Pearson VUE professional testing centers across the United States and Canada. NCSBN indicated this is the initial phase of test openings, which was focused on large metropolitan areas where the immediate need for nurses was expected to be the greatest due to the patterns of rapid spread of COVID-19 experienced during this global pandemic.

NCSBN will continue to work with jurisdictions to determine if it is feasible to open testing centers in other areas. The ability to open a testing center is dependent upon several factors including whether there is a viable supply line of materials needed to disinfect the centers thoroughly for the duration of the crisis. Another is governmental rules or legislations that would prevent the opening of the testing center (i.e., essential business restrictions, building lockouts, etc.).

The SRNA will continue to provide updates as new information becomes available.

For additional information, please visit: https://home.pearsonvue.com/nclex/essential-services

March 19, 2020: Information for NP Prescribers

In response to the evolving COVID-19 outbreak, Health Canada has advised that they have issued exemptions for prescribing controlled substances under the Controlled Drugs and Substances Act (CDSA) and its Regulations. The exemptions include:

  • Permit pharmacists to extend prescriptions;
  • Permit pharmacists to transfer prescriptions to other pharmacists; and
  • Permit prescribers to issue verbal orders (i.e. over the phone) to extend or refill a prescription.

In response to the pandemic situation, the SRNA is amending Bylaw VI Subsection 4(5), to facilitate flexibility in the method Nurse Practitioners (NP) prescribe treatment should they determine that it is warranted and in the best interest of the patient.

Other SRNA documents that the NP must reference include the Registered Nurse (Nurse Practitioner) Practice Standards, SRNA 2017Guideline for NP Prescribing Controlled Drugs and Substances, SRNA 2019 and the CNA Code of Ethics for Registered Nurses, 2017.

For more information, please email Susan Furman-Pelzer, Nursing Advisor, PRP at sfurman-pelzer@srna.org

March 19, 2020: Nurse Practitioners (NP) Limiting Prescriptions

To ensure the continued supply, and to prevent the stockpiling of a prescription medication, the Saskatchewan Ministry of Health will require that Saskatchewan pharmacists limit the number and quantity of prescription drug dispenses as follows:

  • Saskatchewan pharmacists may only provide a ONE MONTH supply (to a maximum of a 35-day supply) in a 28-day period for ALL DRUGS NOT ON THE MAINTENANCE DRUG SCHEDULE (i.e., the 100 Day List and the Two Month Drug List).
  • Saskatchewan pharmacists may only provide a TWO MONTH supply in a 55-day period for drugs on the TWO MONTH DRUG LIST.
  • Saskatchewan pharmacists may only provide a 100 DAY supply in a 95-day period for drugs on the 100 DAY LIST.
  • This restriction applies to all prescriptions regardless of whether the patient pays or has a private or public Drug Plan that pays for the prescription.

The Maintenance Drug Schedule can be found on the Saskatchewan Online Formulary: Maintenance Drug Schedule

The letter from the Ministry of Health can be found in full here.

March 11, 2020: Adhering to the SRNA Registered Nurse Practice Standards and the Canadian Nurses Association’s Code of Ethics for Registered Nurses. 

RNs, RN(AAP)s and NPs should continue to follow their employer’s standard infection control precautions. They must also adhere to the SRNA Registered Nurse Practice Standards and the Canadian Nurses Association’s Code of Ethics for Registered Nurses

March 11, 2020: Standards and Competencies

While there are many Registered Nurses Entry-Level Competencies and Registered Nurse Practice Standards that may apply, the following are a couple of salient statements: 

RNs as coordinators, use knowledge about global health care issues and participate in emergency preparedness and disaster management to optimize client health outcomes at the local level (Registered Nurses Entry-Level Competencies, 5.9 and 9.6). 

RNs demonstrate leadership by advocating for and participating in emergency preparedness planning and working collaboratively with others to develop and implement plans to facilitate the protection of the public (Registered Nurse Practice Standards 47). 

March 11, 2020: Code of Ethics 

RNs practice in accordance with the current Canadian Nurses Association’s Code of Ethics for Registered Nurses. The section, “Ethical Considerations for Nurses in a Natural or Human-Made Disaster, Communicable Disease Outbreak or Pandemic” specifically applies ethical principles to a pandemic scenario (CNA, 2017, p.38-40).  

Historically and currently, nurses provide care to those in need, even when providing care puts their own health and life at risk (for example, when they work in war-torn areas, places of poverty, places with poor sanitation, etc.). Nurses also encounter personal risk when providing care for those with a known or unknown communicable or infectious disease. However, disasters and communicable disease outbreaks call for extraordinary effort from all health care personnel, including nurses.  

The Code of Ethics for Registered Nurses states:  

During a natural or human-made disaster, including a communicable disease outbreak, nurses provide care using appropriate safety precautions in accordance with legislation, regulations and guidelines provided by government, regulatory bodies, employers, unions and professional associations. (A9)  

duty to provide care refers to a nurse’s professional obligation to provide persons receiving care with safe, competent, compassionate and ethical care. However, there may be some circumstances in which it is acceptable for a nurse to withdraw from providing care or to refuse to provide care (CRNBC, 2017b; CRNNS, 2014). Unreasonable burden is a concept raised in relation to the duty to provide care and withdrawing from or refusing to provide care. An unreasonable burden may exist when a nurse’s ability to provide safe care and meet professional standards of practice is compromised by unreasonable expectations, lack of resources or ongoing threats to personal and family well-being (CRNBC, 2017b). 

The following criteria could be useful for nurses to consider when contemplating providing care in a disaster or communicable disease outbreak:  

  • The significance of the risk to the person in care if the nurse does not assist;  
  • Whether the nurse’s intervention is directly relevant to preventing harm;  
  • Whether the nurse’s care will probably prevent harm; and  
  • Whether the benefit of the nurse’s intervention outweighs harms the nurse might incur and does not present more than an acceptable risk to the nurse (ANA, 2006).  

When demands on the health care system are excessive, material resources may be in short supply and nurses and other health care providers may be at risk. Nurses have a right to receive truthful and complete information so they can fulfil their duty to provide care. They have a clear understanding about the obligations and expectations around their role. They must also be supported in meeting their own health needs. Nurses’ employers have a reciprocal duty to protect and support them as well as to provide necessary and sufficient protective equipment and supplies that will “maximally minimize risk” to nurses and other health care providers. At the same time, nurses use their professional judgment to select and use the appropriate prevention measures; select, in collaboration with the health care team, the appropriate agency, manufacturer and government guidelines concerning use and fit of personal protective equipment; and advocate for a change when agency, manufacturer or government guidelines do not meet the infection control requirements regarding appropriate use and fit of personal protective equipment (CNO, 2009b).  

Nurses carefully consider their professional role, their duty to provide care and other competing obligations to their own health, to family and to friends. In doing so, they understand the steps they might take both in advance of and during an emergency or pandemic situation so that they are prepared for making ethical decisions (CNA, 2008; Thompson, Faith, Gibson, & Upshur, 2006). Value and responsibility statements in the Code support nurses’ reflection and actions.  

A. In anticipation of the need for nursing care in a disaster or disease outbreak, nurses:  

  • work together with nurse colleagues, unions and joint occupational health and safety committees, and others in positions of leadership to develop emergency response practice guidelines using available resources and guidelines from governments, professional associations and regulatory bodies;  
  • learn about and provide input into the guidelines the region, province or country has established regarding which persons are to receive priority in care (e.g., priority based on greatest need, priority based on the probability of a good outcome, etc.);  
  • learn how support will be provided for those providing care and carrying the physical and moral burden of care;  
  • request and receive regular updates about appropriate safety measures nurses might take to protect and prevent themselves from becoming the victim of a disaster or disease;  
  • assist in developing a fair way to settle conflicts or disputes regarding work exemptions or exemptions from the prophylaxis or vaccination of health care providers; and  
  • help develop ways in which appeals or complaints can be handled within the occupational health and safety framework. 

B. When in the midst of a disaster or disease outbreak, nurses:  

  • refer to regulations and guidelines provided by government, regulatory bodies, employers and professional associations;  
  • help make the fairest decisions possible about the allocation of resources;  
  • help set priorities in as transparent a manner as possible;  
  • provide safe, compassionate, competent and ethical care (in disasters, as much as circumstances permit);  
  • help determine if, when and how nurses may have to decline or withdraw from care; and  
  • advocate for the least restrictive measures possible when a person’s individual rights must be restricted. 

RNs are also encouraged to contact SRNA Practice Consultation with questions or concerns. Consultation is available by: 

Email: practiceadvice@srna.org  

Phone: 1-800-667-9945 


Other Important Information

March 11, 2020: The Government of Canada has released the following recommendations to public health care professionals: 

Useful resources:  

Government of Saskatchewan (Provincial) 

Public Health Agency of Canada (Federal) 

World Health Organization (WHO) (Global)  

 

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