Rn Health requirements?

OttawaRPN · Nov 20, 2010

You mean will they discriminate against someone who has ADHD? Of course not, that would be against the law.

The only health requirements are the ones enforced by your school ie) up to date immunizations, etc. and this varies from school to school.

The CNO also doesn't mandate health requirements but your place of employment might; again, it varies from employer to employer.

FutureRNontario · Nov 20, 2010

Well there has to be some sort of regulation. It's not discrimination if it could affect patient care. Not necessisarily with ADHD, but any sort of mental disorder. Can someone who is bi-polar or schizophrenic become an RN? I would hope not. And with ADHD, do you not think patient care could be affected? My brother has it, and unless he is taking his meds, his ability to process information, and pay attention is greatly affected. What if, say a nurse was not paying attention to the proper dose of meds that was called for, and a patient was administered a life threatening dose? I'm not saying that they shouldn't be allowed to practice, I'm just curious as to what sort of governing there is for stuff like that. And is there a difference for RN an RPN health Regs b/c an RN is involved in more critical thinking decisions?

flyingchange · Nov 20, 2010

Hi Alicia,

I was a pre-nursing student not so long ago with some potentially unfair biases so I will extend a welcome to you, and share some ideas I hope you find insightful.

In nursing school you will find that there are no black and white distinctions about how a person's capabilities and potential relate to his or her diagnosis. You will be asked to reflect on and consider your own opinions a great deal. I wonder why you feel that ADHD, Bipolar, or other mental illnesses should preclude someone from even considering being a Nurse.

OttawaRPN's post is correct. The regulatory body of RNs in Alberta, which is probably very similar to Ontario as we are all ultimately united by the CNA, cites the Health Professions Act. The only portion of it that really applies to the concerns you raise is the following section:

Good character, reputation
11An applicant for registration as a regulated member must provide evidence satisfactory to the Registrar of having good character and reputation by submitting one or more of the following on the request of the Registrar:
(a)written references with respect to the applicant's nursing practice from an employer or educational institution;
(b)a statement by the applicant as to whether the applicant is currently undergoing an investigation or is subject to an unprofessional conduct process or has previously been disciplined by another regulatory body responsible for the regulation of registered nursing or another profession that provides a professional service;
©a statement as to whether the applicant has ever pleaded guilty or has been found guilty of a criminal offence in Canada or an offence of a similar nature in a jurisdiction outside Canada for which the applicant has not been pardoned;
(d)any other evidence as required.

So, to answer your question, a Registered Nurse in Alberta (and similarly around the country) is not precluded from registration on the basis of medical diagnosis, but on his or her capacity to be a Nurse of good character and reputation. If you have made it through your entire life up to the time of registration without committing a crime, and can provide a good reference from your place of work or educational institution, CARNA says you can be an RN, because it seems like you are a good person.

That is to say, if your disability prevents you from making it through nursing school - a particularly gruelling time, IMO - you wouldn't be eligible for writing the CRNE. If it prevented you from acting unsafely in clinicals, you wouldn't pass clinicals. If it prevented you from acting safely as an RN, you would be answering to the Disciplinary Tribunal.

There are many failsafes to ensure that people who can't practice safely do not become licenced or do not stay licenced. There is no "medical test" to go through that would indicate to the College whether or not you could do these things. Nurses are judged by their past actions and practice, not their potential.

Tread lightly in regards to what makes a good RN or a good RPN/LPN. We are all held to the same standards of safe practice.

Take care :nurse:

loriangel14, RN · Nov 21, 2010

I have worked with both a nurse with ADHD and one that is bipolar. They both manage their conditions and function fine on the job as far as I have seen.

OttawaRPN · Nov 21, 2010

Alicia, I think you are looking for some hard and fast rules about what medical conditions should preclude someone from becoming a nurse. Well, there aren't any. A large proportion of the population suffer from some sort of mental illness, but mental illness is treatable and manageable so to expect that no one with ADD/bipolar/schizo be allowed to become a nurse is judgmental and discriminatory. Our society just doesn't function like that. As for making life-threatening errors, that can happen to any nurse with our without a medical condition, as we are all human and as the saying goes "to err is human". But what joins us all at the hip is that we, as nurses, are all fully accountable for our actions, both good and bad, no matter the circumstance and no matter what our health history may be.

FutureRNontario · Nov 21, 2010

I agree with what all of you are saying, I just wouldn't want someone to spend 4 years and alot of money on their education and not be able to get their license to practice. The reason I asked if anyone knew the exact regulations is because Georgian College states in thier program outline for BScN that:

"Note: The College of Nurses of Ontario (CNO), the body responsible for regulating nursing in Ontario, sets entry to practice requirements that nurses and practical nurses must meet to become registered in Ontario. CNO's mission is to regulate nursing to protect the public interest. Among CNO's entry to practice requirements are provisions specifically intended to enhance public safety. These provisions require that applicants for registration in Ontario:

a) have not been found guilty of a criminal offence or an offence under the Narcotic Control Act (Canada) and the Foods and Drug Act (Canada);

b) not have been the subject of a finding of professional misconduct, incompetence or incapacity, whether in Ontario or in another jurisdiction and whether in relation to the nursing profession or another health profession;

c) not currently be the subject of proceedings for professional misconduct, incompetence or incapacity, whether in Ontario or in another jurisdiction and whether in relation to the nursing profession or another health profession;

d) not be suffering from a physical or mental condition that makes it desirable in the public interest that he or she not practice.

An applicant for registration who does not meet one or more of these requirements must inform CNO and provide details about the incident or situation. The applicant will not be necessarily refused registration because CNO's Registration Committee will review information about the incident or situation to determine if an exemption from the requirement(s) will be granted. An applicant for registration, who does not inform CNO, may have the application for registration cancelled, or any certification of registration which may have been issued revoked."

It wouldn't be fair for a student to get through school, pass the exam, and then find out it was all a waste of time. And also, I don't think that I am being judgemental or discriminating. These things should definitely be assessed to ensure proper patient care. If the person is competent than that is fine. I have had alot of first hand experience with mental illness in my family (not just my brothers ADHD), so I know how quickly things happen and situations can change if someone decides to stop taking their meds. This is what made me want to pursue a career in nursing, and be able to help people. I'm not looking to pass judgement or say that anyone is incapable, ( I wouldn't be surprised to learn that I myself have ADHD) I'm just curious to know how situations where common mental health issues are looked at.

Balder_LPN, LPN · Nov 22, 2010

Well there has to be some sort of regulation. It's not discrimination if it could affect patient care. Not necessisarily with ADHD, but any sort of mental disorder. Can someone who is bi-polar or schizophrenic become an RN? I would hope not. And with ADHD, do you not think patient care could be affected? My brother has it, and unless he is taking his meds, his ability to process information, and pay attention is greatly affected. What if, say a nurse was not paying attention to the proper dose of meds that was called for, and a patient was administered a life threatening dose? I'm not saying that they shouldn't be allowed to practice, I'm just curious as to what sort of governing there is for stuff like that. And is there a difference for RN an RPN health Regs b/c an RN is involved in more critical thinking decisions?

and not just mental disorders may effect patient care. Maybe nurses with Type 1 DM should not be allowed to practice either. I mean, if they took their insulin, missed lunch, and went into a coma, what do you think that would do to pt care?

and on that note, :idea: Why doesnt the Board of Nursing regulate nurses fitness levels too? I mean if no one was over weight, if we could all lift a certain amount, if our cardio fitness levels were up to snuff we could RUN from bed to bed to bed, to our regulated lunch (to make sure we dont get overweight and slow down). That would so IMPROVE pt care. I mean obviously all those factors contribute to good pt care, so lacking in any compromises care, right?

My point is; Every single aspect of a nurses health cannot be reasonably regulated. Report unsafe practice to managment, QA, the board, discuss it with the staff member, what ever the policy of your facility or licensing board requires, they cant have laws to cover every little nuance of medication and disease management.

Sorry, up on my soapbox here, so many ppl treat mental health issues so much like substance abuse (which is a mental health issue itself) but ADHD, or bi-polar do not have the same type of effect on pt care as a nurse who is altered by alcohol or painkillers. You cant discriminate against someone who is able to safely perform their job, whether or not they need to take a prescription to do so.

Balder_LPN, LPN · Nov 22, 2010

d) not be suffering from a physical or mental condition that makes it desirable in the public interest that he or she not practice.
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It wouldn't be fair for a student to get through school, pass the exam, and then find out it was all a waste of time. And also, I don't think that I am being judgemental or discriminating. These things should definitely be assessed to ensure proper patient care. If the person is competent than that is fine.

hmmm, I think the biggest issue, Alicia, is that you think these things constitute a "public interest that he/she not practice", when in reality you are only applying your own fears about these and projecting it to "my fears" = "the public interest". As was mentioned above, the fact that you made it thru school (and life) without killing or injuring someone, thru intention, negligence, lack of due diligence, whatever, demonstrates that you DONT have a physical/mental condition that makes it desirable in the public interest to not practice.

Also you seem to be saying that if someone has any mental health dx then they should be "assessed to ensure proper patient care". Ummm, thats what they where doing while you were in school. And how do we handle those with possible un-dx'd mental health issues, like your own possible ADHD. I mean if you THINK you may have it, and havent sought dx and tx then aren't you comitting a gross negligence, since you seem to think this can cause such a serious compromise in pt care, but arent taking the steps to mitigate the risk?

And back to my TYPE 1 DM example, the law quoted here (pretty standard language in the US and Canada, and prob most anywhere) also says PHYSICAL, so does your line of reasoning lead to the conclusion that - Anyone with any medical dx be evaluated to see what risk they may present to pt's? or just the ones that scare Alicia?

Chinook2 · Nov 22, 2010

It seems to me like Alicia's getting piled on here pretty hard. While I understand and agree with the general sentiment expressed in previous posts I'm not sure that it's fair to assume that Alicia is being insensitive to or prejudiced against people with mental illness. I have seen similar admission criteria on nursing program websites and I wonder what such a vague phrase as "...not be suffering from a physical or mental condition that makes it desirable in the public interest that he or she not practice..." really means. While I'm sure that equal opportunity human rights legislation offers protection against overt discrimination I wonder how much 'weeding out' actually occurs covertly during the admissions process under the auspices of such a vague guideline. Not to put words in anyone's mouth, but maybe trying to find out what such a vague admission criterion really means was Alicia's original intent. I'd be interested in knowing exactly what conditions such criteria preclude against too.

FutureRNontario · Nov 23, 2010

maybe trying to find out what such a vague admission criterion really means was Alicia's original intent. I'd be interested in knowing exactly what conditions such criteria preclude against too.

Thank you Chinook! You seem to be the only one who actually read any of my posts. I actually emailed the CNA on this subject and the response I got may surprise those of you who think that there are no regulations on a mental illness. I was told the exact same thing that is posted on the College website.

"graduates wishing to be registered will be asked by the College of Nurses of Ontario to sign a declaration of their status regarding not be suffering from a physical or mental condition that makes it desirable in the public interest that he or she not practice. An applicant for registration who does not meet one or more of these requirements must inform CNO and provide details about the incident or situation. The applicant will not be necessarily refused registration because CNO's Registration Committee will review information about the incident or situation to determine if an exemption from the requirement(s) will be granted. An applicant for registration, who does not inform CNO, may have the application for registration canceled, or any certification of registration which may have been issued revoked."

They informed me that this also applies to ADHD. All I wanted to know. This started out as simple curiosity from a student and has somehow turned into a ridiculous battle of prejudice and discrimination. I don't know how most of you derived that conclusion from my original post.

And as for your comments Balder- I'm not the only one saying that if someone has any mental health dx then they should be "assessed to ensure proper patient care", that's coming straight from the CNO. Are they wrong as well? But shouldn't you know this info as someone who had to sign a form stating they didn't have any disorders? And your "examples" are a little extreme don't you think? Now you're the one being judgmental of me, assuming I'm silly enough to think that way. And if you think mental health is not a serious issue, you are the one who is misinformed, because it is. Like I said, I've had first hand experience with it and there are some things I have gone through that I wouldn't wish upon anyone. Maybe that's where my so called "discrimination" stems from. People can be completely competent and normal for years, and with the snap of a finger, they lose it. So don't try and tell me that people treat mental health issues like substance abuse or whatever you were going for there. But that is completely different from my initial question anyway!

To quote myself again, in case you didn't catch it the first time " I'm not looking to pass judgment or say that anyone is incapable, I'm just curious to know how situations where common mental health issues are looked at. "

But it doesn't matter anyway, I've learned not to ask simple questions to people who don't know the answer, it just upsets them. Next time I have a question I'll just go straight to the source, like I had to do anyway. The didn't jump down my throat, just gave me the answer I was looking for.

Thanks for all your help!:)

flyingchange · Nov 23, 2010

Hey, that's interesting - I stand corrected. I hope you didn't take my post offensively, I did go through the Act and didn't see anything like that from CARNA. I am curious if it applies to AB as well. Thank you for the update. Take care :)