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Professional Standards

For registered psychiatric nurses

Professional Standards for Psychiatric Nursing

The Professional Standards for Psychiatric Nursing describes, in broad terms, the expected level of performance of all registered psychiatric nurses (RPNs). These were developed for national use by the Registered Psychiatric Nurse Regulators of Canada and adopted by BCCNP in November 2019 (in effect date Jan. 3, 2020).

Professional Standards, along with the Code of Ethics, address the overarching professional requirements for all registered psychiatric nurses practicing in B.C. Under each standard there are a number of indicators that help determine how to meet the professional standard. The indicators are representative but not comprehensive for each standard.

Terms defined in the glossary at the end of the document appear in blue.

Standard 1: Therapeutic Relationships

The registered psychiatric nurse establishes collaborative professional, interpersonal, and therapeutic relationships with clients.

A registered psychiatric nurse:

  1. Continually applies the therapeutic use of self within professional practice.
  2. Recognizes and addresses power imbalances in therapeutic relationships.
  3. Ensures client needs remain the focus of the therapeutic relationship.
  4. Does not exploit the vulnerability of persons encountered through their practice.
  5. Will not engage in any sexual behaviour while in a therapeutic relationship with a client, with or without consent.
  6. Will not enter into a close personal or intimate relationship with a client or a former client who has received psychotherapeutic treatment from the registered psychiatric nurse.
  7. Uses professional judgment, effective communication and interpersonal skills, and practices with integrity to establish, maintain and terminate the therapeutic relationship.
  8. Recognizes and addresses transference and counter-transference and their impact on the therapeutic relationship.
  9. Applies critical thinking and professional judgment in therapeutic relationships.
  10. Establishes and negotiates boundaries in therapeutic relationships.
  11. Practices according to the principles of informed consent and confidentiality.
  12. Will make best efforts to find suitable alternatives to treating their own family or friends.
  13. Develops partnerships using a client-centred, integrated and holistic approach.

Standard 2: Competent, Evidence-Informed Practice

The registered psychiatric nurse continually acquires and integrates evidence-informed knowledge and builds on psychiatric nursing education and lifelong learning.

A registered psychiatric nurse:

  1. Applies evidence-informed knowledge, skill, critical thinking and professional judgment to assess, plan, implement, and evaluate in the practice of psychiatric nursing.
  2. Incorporates evidence-informed knowledge to promote safety and quality in psychiatric nursing practice.
  3. Uses communication skills effectively.
  4. Integrates cultural competence and cultural safety into their practice with diverse clients.
  5. Recognizes potential risks and hazards, and implements interventions to promote a safe environment.
  6. Integrates infection prevention and control principles in providing psychiatric nursing care.
  7. Documents the application of the clinical decision-making process in a responsible, accountable and ethical manner.
  8. Applies documentation principles to ensure effective written/electronic communication.
  9. Remains current in knowledge relevant to their practice.
  10. Incorporates knowledge of therapeutic modalities and conceptual models of psychiatric nursing.
  11. Coordinates client care and/or health services throughout the continuum of care.
  12. Establishes, maintains and coordinates a plan of care based on a comprehensive psychiatric nursing assessment.

Standard 3: Professional Responsibility

The registered psychiatric nurse is accountable and responsible for safe, competent and ethical psychiatric nursing practice that meets the standards of the profession and legislated requirements.

A registered psychiatric nurse:

  1. Maintains current registration/licensure.  
  2. Practises in accordance with all relevant legislation and regulation including the Professional Standards for Registered Psychiatric Nurses.  
  3. Exercises professional judgment when agency policies and procedures are unclear or absent.  
  4. Assumes responsibility and accountability for continuing competence, and for meeting continuing competence requirements.
  5. Seeks out the necessary resources using skill and professional judgment to address personal and professional limitations.   
  6. Recognizes the competencies and limitations of colleagues and/or students when assigning responsibilities.  
  7. Responds to and/or reports unsafe practice, professional incompetence, professional misconduct, and incapacity or fitness-to-practice issues to the appropriate authority.  
  8. Complies with any legal duty to warn and report, including abuse or potential harm to the public. 
  9. Self-reports to the regulatory body conditions that compromise their fitness to practice.  
  10. Uses technology, electronic communication and social media responsibly and professionally.

Standard 4: Leadership and Collaboration in Quality Psychiatric Nursing Practice

The registered psychiatric nurse enhances the safety, quality and effectiveness of psychiatric nursing practice through leadership and collaboration.

A registered psychiatric nurse:

  1. Engages in practices that promote physical, environmental and psychological safety.
  2. Evaluates the effectiveness of interventions in psychiatric nursing practice.
  3. Participates in quality improvement activities to initiate change in psychiatric nursing practice and in the health care system.
  4. Collaborates with client, team members, families and other stakeholders to develop comprehensive psychiatric nursing care to achieve the client's health goals.
  5. Mentors colleagues and stakeholders for the advancement of psychiatric nursing practice and quality health care.
  6. Promotes collaborative practice among health care professionals through respectful working relationships and appropriate documentation practices.
  7. Acts as a leader, teacher and role model to students, beginner practitioners and colleagues, supporting, Instructing and/or mentoring them in their professional development.
  8. Takes action to resolve professional practice issues.
  9. Collaborates with and advocates for clients.
  10. Demonstrates professional leadership through:

    i)

    Building trusting relationships

    ii)

    Creating empowering environments

    iii)

    Supporting knowledge development and integration within the health care team

    iv)

    Advancing psychiatric nursing practice and quality health care

    v)

    Leading and sustaining change and balancing competing values and priorities

Standard 5: Professional Ethical Practice

The registered psychiatric nurse understands, upholds and incorporates the profession’s Code of Ethics into their professional practice.

A registered psychiartic nurse:

  1. Practises with honesty, integrity and respect, demonstrating the ethics, standards, principles, guidelines and values of the profession.
  2. Applies the Code of Ethics in all areas of their practice.
  3. Identifies the effect of their own values, beliefs and experiences in relationships with clients, recognizes potential conflicts, and takes action to prevent or resolve them.
  4. Applies ethical and legal considerations in maintaining confidentiality in all forms of communication.
  5. Supports the human, legal and moral rights of clients, including the right to make informed decisions and the right to live at risk.

Glossary

The following glossary aims to clarify the meaning of specialized working terms found in the Professional Standards for Registered Psychiatric Nurses. This glossary is not intended to contain a comprehensive definition of those terms.

Boundaries: Limits that protect the space between the professional's power and the client's vulnerability.  Boundaries define and separate professional roles from other roles. Boundaries are the limits that allow a safe connection between a professional and a client and are always based on the client's needs (Peterson, M. 1992).

Client: Individual, groups, families, and communities (Registered Psychiatric Nurses Entry-Level Competencies, Registered Psychiatric Nurses Canada, 2014).

Competencies: The integrated knowledge, skills, professional judgment and attitudes required by a registered psychiatric nurse to practice competently, ethically and safely (Verma, Paterson & Medves, 2006).

Continuing Competence: The ongoing ability of a registered psychiatric nurse to integrate and apply the knowledge, skills, professional judgment, attitudes, values and interpersonal attributes required to practice safely and ethically in their current role and setting (CRPNA, September 2013).

Continuum of Care: A comprehensive system of services and programs, ranging from mental health promotion  and illness prevention to specialized services, and designed to match the needs of individuals and populations with appropriate care and treatment, and which vary according to levels of service, structure, and intensity of care. (Austin et al. 2019).

Counter-Transference: The nurse's reactions to a client that are based on the nurse's unconscious needs, conflicts, problems, and views of the world. See also Transference (Austin & Boyd, 2010).

Cultural Competence: The ability of nurses to apply knowledge and skill appropriately in cross-cultural situations, and to adapt care delivery to meet the patient's cultural needs and preferences (Pollard, Ray & Haase, 2014).

Cultural Safety: Both a process and an outcome whose goal is to promote greater equity. It focuses on root causes of power imbalances and inequitable social relationships in health care, and includes cultural awareness, cultural sensitivity and cultural competence (Canadian Nurses Association, 2013).

Empower: To make others stronger and more confident, especially in controlling their life and claiming their rights (Oxford Dictionary, 2019).

Evidence-Informed: Care based on the collection, interpretation and integration of valid, important, and applicable patient-reported, clinician-observed, and research-derived evidence. (Halter, 2014).

Leadership: The efforts by leaders who may, but do not necessarily, hold formal positions of authority to engage followers in the joint pursuit of mutually agreed-upon goals (Kellerman, 1999).

Professional Judgment: The evaluation of evidence to a make a clinical decision. It is the ability to make critical distinctions and achieve a balanced viewpoint, including the reaction of the registered psychiatric nurse to the client. (RPNRC Entry Level Competencies, November 2014).

Quality: Quality of health care is comprised of multiple dimensions, including five that focus on the patient/client experience:

  • Acceptability: Care is respectful and responsive to user preferences, needs and values
  • Appropriateness: Care is evidence-informed and specific to individual clinical needs
  • Accessibility: Care and services are reached with ease
  • Safety: Care avoids resulting in harm
  • Effectiveness: Care that is known to achieve intended outcomes (BC Patient Safety and Quality Council, 2017).

Therapeutic Relationship: An interpersonal process that is purposeful, goal directed and focused on achieving outcomes in the best interest of the client, in which the nurse maximizes their communication skills, understanding of human behaviour, and personal strengths to advance the client's interests and personal growth, and to promote health and well-being.

Therapeutic Use of Self: A complex process of self-awareness through one's own growth and development, as well as one's interactions with others, that guides the process of developing, maintaining and terminating the therapeutic relationship.

Transference: The client's experience of feelings toward the nurse, that were originally held toward significant others in their life. See also Counter-Transference (Halter, 2014).

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  • Email practice@bccnp.ca
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