CRNE OCTOBER 2012 - page 7

by kheemooy 69,536 Views | 267 Comments

Hi everyone! I am an IEN from the Philippines batch 2009 I moved here in Brampton last November 2010. I took the May 2012 CPNRE (first time) and still waiting for the results which will come out on June. Apparently, I just... Read More


  1. 0
    which branch of brampton library?
  2. 0
    Hi everyone

    For the CRNE June passers, can I ask, how did you study for maternity? I never bought the book and my program covered 12 weeks of maternity, not sure if this information alone is enough to pass.
  3. 0
    I would appreciate if anyone can help me to understand the 'delegation' part (highlighted in bold) in the Scope of Nursing from the RHPA practice guideline.

    "Delegation is a formal process by which a regulated health professional, who is authorized and competent to perform a procedure under one of the controlled acts, delegates the performance of that procedure to someone, regulated or unregulated, who is not authorized by legislation to perform it.

    There are controlled acts not authorized to nursing by the legislation, but which may be performed by a nurse when the procedure has been delegated by a person who is authorized by legislation to perform it."

    My questions are
    1. "Can a regulated health professional delegate a job to someone who is not authorized by legislation? What it actually means?"
    2. If I delegate a job to someone (regulated or non regulated or non authorized by legislation to perform it), and that person thinks that he/she is not competent to do it, can that someone refuse to do it if they think that they are not competent to do it?"

    Hope my questions are not confusing (I am more confused ).

    Thanks in advance.
  4. 0
    Quote from missysg
    I would appreciate if anyone can help me to understand the 'delegation' part (highlighted in bold) in the Scope of Nursing from the RHPA practice guideline.

    "Delegation is a formal process by which a regulated health professional, who is authorized and competent to perform a procedure under one of the controlled acts, delegates the performance of that procedure to someone, regulated or unregulated, who is not authorized by legislation to perform it.

    There are controlled acts not authorized to nursing by the legislation, but which may be performed by a nurse when the procedure has been delegated by a person who is authorized by legislation to perform it."

    My questions are
    1. "Can a regulated health professional delegate a job to someone who is not authorized by legislation? What it actually means?"
    2. If I delegate a job to someone (regulated or non regulated or non authorized by legislation to perform it), and that person thinks that he/she is not competent to do it, can that someone refuse to do it if they think that they are not competent to do it?"

    Hope my questions are not confusing (I am more confused ).

    Thanks in advance.
    Hello missysg, I will try my best to answer your question.

    1. "Can a regulated health professional delegate a job to someone who is not authorized by legislation? What it actually means?"
    --- Delegation is giving a task to someone or letting someone perform a certain procedure. In delegation, an RN, for example determines the person's scope of practice, competence and patient condition when giving a task to an RPN or UCP (unregulated care provider)

    For example, vital signs can be done by an RN, RPN and a UCP as well. But in certain, situations vital signs of an unstable patient (eg. comatose or patient experiencing shock) cannot be taken by a UCP.

    Another example is the assessment, any assessment for example, assessment of wound, cannot be delegated to a UCP, it can only be done by a regulated and trained health care provider like RN and RPN.

    Care of Gastrostomy tubes, declogging nasogastric tubes, starting an IV or blood transfusions can only be done by RN, and are not part of RPN's scope of practice.

    The rule here is that whoever provided a certain care or procedure, he or she is the one responsible for it. An RN would not be responsible for an RPN or UCP's error. A nursing student, as well, is responsible for his or her actions and not the clinical instructor.

    2. If I delegate a job to someone (regulated or non regulated or non authorized by legislation to perform it), and that person thinks that he/she is not competent to do it, can that someone refuse to do it if they think that they are not competent to do it?"

    Yes, the person can refuse to do it if the person feels that he is not competent, but, he should take measures in order to gain knowledge and experience of that particular procedure being expected from him. For example, an newly grad RN's first time to actually handle a patient with tracheostomy and hasn't performed an actual tracheostomy care, he should inform the charge nurse, senior nurse or nursing supervisor that he needs assistance because it is his first time to do it. He can also ask for an in-service so he gains the knowledge and experience he needs.


    You can check the compendium for nurses, it is available at the CNO website. They explained the scope of practice of RN, RPN and UCP's. The Fundamental of Nursing by Potter and Perry also has some notes regarding delegation in every procedure. You can check that out as well.

    I hope I answered your question.
  5. 0
    60. Which of the following poses the greatest risk for electrolyte imbalance?
    1. Inadequate dietary intake
    2. Dehydration
    3. Diuretic therap
    4. Anticoagulant
    hi everyone, lets try to answer this question for crne october....) thanks.
  6. 0
    Quote from PanToronto
    60. Which of the following poses the greatest risk for electrolyte imbalance?
    [*]Inadequate dietary intake[*]Dehydration[*]Diuretic therap[*]Anticoagulant
    hi everyone, lets try to answer this question for crne october....) thanks.
    My answer is Diuretic therapy especially loop diuretics because it directly affects potassium, it promotes potassium excretion that's why when clients are taking loop diuretics (eg. furosemide) usually patients are prescribed with potassium supplement or advised to increase potassium in diet.
  7. 0
    For some those who (especially IENs) are confused about the scope of practice of RN and RPN you can check this pdf file by CNO ---> http://www.cno.org/Global/docs/prac/41062.pdf

  8. 0
    @ k..Y... I also think the same rational and answer....but it really stresses out withe the DEHYDRATION, which kindda make the confusion.
    if burn pt--> hyperkalemia, hyponatremia, fluid loss,
    if dehydration--> hyperkalemia, hypernatremia??
    if pt with AKF--> hyperkalemia, hypernatremia????
    I kindda confused about this things, please feel free to clarify???? help please! thanks
  9. 0
    Quote from kheemooy
    Hello missysg, I will try my best to answer your question.

    Yes, the person can refuse to do it if the person feels that he is not competent, but, he should take measures in order to gain knowledge and experience of that particular procedure being expected from him. For example, an newly grad RN's first time to actually handle a patient with tracheostomy and hasn't performed an actual tracheostomy care, he should inform the charge nurse, senior nurse or nursing supervisor that he needs assistance because it is his first time to do it. He can also ask for an in-service so he gains the knowledge and experience he needs.


    You can check the compendium for nurses, it is available at the CNO website. They explained the scope of practice of RN, RPN and UCP's. The Fundamental of Nursing by Potter and Perry also has some notes regarding delegation in every procedure. You can check that out as well.

    I hope I answered your question.
    Hi kheemooy...

    Thanks for the reply.
    I guess the words 'not authorized by legislation' confused me. In my mind I was asking 'how can a health professional delegate a job to someone who is not authorized by legislation to do some professional task'. Well now I understand.
  10. 0
    Quote from PanToronto
    @ k..Y... I also think the same rational and answer....but it really stresses out withe the DEHYDRATION, which kindda make the confusion.
    if burn pt--> hyperkalemia, hyponatremia, fluid loss,
    if dehydration--> hyperkalemia, hypernatremia??
    if pt with AKF--> hyperkalemia, hypernatremia????
    I kindda confused about this things, please feel free to clarify???? help please! thanks
    Hi PanToronto,
    You mean 'Dehydration' is the right answer mentioned in the book?


Top