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Licensed Practical Nurse
Non-Traditional Roles Attestation Form

Non-Traditional Roles Attestation Form

Licensed Practical Nurse, Nurse Practitioner, Registered Nurse, Registered Psychiatric Nurse

Is what I am doing considered practice as an RPN, LPN, RN, or NP?

When practising as a Registered Psychiatric Nurse (RPN), Licensed Practical Nurse (LPN), Registered Nurse (RN), or Nurse Practitioner (NP) in Newfoundland and Labrador (NL), ranging from initial orientation to traditional hospital-based practice, to any non-traditional role or domain, you must:

hold a current licence with the College.
use the protected title for the nursing role in which you practice.

Most times RPNs, LPNs, RNs, and NPs are hired as employees where the job description requires them to perform nursing services in accordance with the College’s Scope of Practice Framework specific to their particular designation. In this employment situation, the types of nursing services being provided are credited as practice hours for licensure with the College. However, a growing number of nurses are working outside the traditional nursing-based roles/settings, where it is more difficult to determine if the services being provided are within the realm of practice as an RPN, LPN, RN, or NP and if the hours can be used for licensure renewal.

This information is meant to assist RPNs, LPNs, RNs, and NPs who are in non-traditional roles, and/or are employed in a role that does not specifically require an RPN, LPN, RN, or NP. The RPN, LPN, RN, or NP must be able to answer yes to the following reflective statements to determine if their individual practice is within the realm of practice as an RPN, LPN, RN, or NP. If unable to answer yes or are uncertain about any statement, you must contact the College before beginning employment (Note: A similar form is used for nurses who are setting up a self-employment practice or contract work).

This form has three sections. Section one is for all RPNs, LPNs, RNs and NPs; section two is for NPs only, and section three is attestation for all RPNs, LPNs, RNs, and NPs to be completed prior to submission of the document to the College.

Email

This field is for validation purposes and should be left unchanged.

Are you a Nurse Practitioner?(Required)

Yes

No

For LPNs, RPNs, RNs and NPs

I introduce myself as an RPN, LPN, RN, or NP.(Required)

Yes

No

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

I sign my credentials as an RPN, LPN, RN, or NP (e.g., client chart, business cards, etc.).(Required)

Yes

No

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

My employer required me to be licenced as an RPN, LPN, RN, or NP (e.g., the job description requires a licence to practice as an RPN, LPN, RN, or NP).(Required)

Yes

No

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

I would direct clients/public to the College website (public directory) to validate to validate my licence to practice.(Required)

Yes

No

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

I am practising under my nursing or psychiatric nursing licence even if I also hold a licence from another discipline(s) (e.g., also registered as an acupuncturist).(Required)

Yes

No

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

I have ensured that my practice setting has liability protection for nursing or psychiatric nursing practice.(Required)

Yes

No

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

I use nursing or psychiatric nursing philosophical and/or theoretical perspectives to guide my practice, as the recipients of my nursing services expect that I apply nursing or psychiatric nursing knowledge and competencies in my role.(Required)

Yes

No

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

I regularly apply my nursing or psychiatric nursing knowledge, competencies, and judgement in the provision of my services (e.g., a non-traditional role such as providing alternative and complementary therapies).(Required)

Yes

No

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

I attend professional development opportunities (e.g., conferences, education sessions, etc.) that specifically add to my nursing or psychiatric nursing knowledge to maintain my continued competency in my role.(Required)

Yes

No

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

I have policies and procedures to guide/accomplish my role as RPN, LPN, RN, or NP (e.g., evidence-based guidelines or best practice, collaborative teams, etc.).(Required)

Yes

No

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

I reflect on and use the full nursing process as the focus of my employment/practice and I use nursing knowledge or psychiatric nursing knowledge, competencies, and judgement if using interventions from another discipline based upon my nursing assessment and as part of my treatment plan (e.g., using acupuncture as an intervention/modality/treatment option).(Required)

Yes

No

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

I have reviewed my nursing or psychiatric nursing practice, and I am not aware of any interventions that I use being exclusively recognized to be within the domain of another profession or a restricted activity by another health care profession (e.g., I am not practising within the legal domain of medicine).(Required)

Yes

No

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

My practice as an RPN, LPN, RN, or NP has a direct or indirect impact on clients* health care systems or the health of the public (e.g., an RN, LPN, RPN, or NP in an executive position in a health organization will have an indirect impact though their contribution to health system management).(Required)

Yes

No

* Client – Individuals, families, groups, populations, or entire communities who require nursing expertise. The term client reflects the range of individuals and/or groups with whom nurses may be interacting. In some settings, other terms may be used such as patient or resident. In education, the client may also be a student; in administration, the client may also be an employee; and in research, the client is usually a subject or participant.

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

The healthcare services I provide require critical thinking, problem solving, professional judgement, and accurate interpretation of information from a variety of sources.(Required)

Yes

No

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

Additional Statements for Nurse Practitioners (NPs)

In addition to the statements provided above for practice as an RPN, LPN, RN or NP, NPs must also be able to answer yes to the following additional statements to determine if their individual practice is within the realm of practice as an NP. If you answer no or are uncertain about any statement in this section, you must contact the College before commencing your practice. For NPs:

I apply the advanced NP competencies to independently diagnose and communicate a medical diagnosis (i.e., disease, disorder, injury, or condition), order and interpret diagnostic and laboratory tests, prescribe pharmaceuticals, non-pharmaceuticals and perform procedures, in care of the client population consistent within the category of NP licensure that I currently hold, OR I apply advanced NP competencies in one of the other domains of nursing practice (e.g., administration, policy, research, education) in which I practise as an NP.(Required)

Yes

No

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

I apply advanced knowledge, competencies, and advanced decision-making skills in my NP nursing practice (e.g., primary health collaborative clinic, occupational health setting or management position).(Required)

Yes

No

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

I am employed and practising as an NP (i.e., I am not employed as an RN).(Required)

Yes

No

You answered No to this question. You must contact the College at practiceteam@nlcn.ca before proceeding.

Attestation

Attestation 1(Required)

I have read the most current version of the College’s professional standards,* and Scope of Practice Framework relevant to my designation.(Required)

* Professional standards include but are not limited to the Code of Professional Conduct, Standards of Practice, and Codes of Ethics

Attestation 2(Required)

I understand I must answer yes to all the reflection statements and if I answer no to any question, I must connect with the College.(Required)

Attestation 3(Required)

I understand that if my role changes, I must connect with the College to determine if my scope of practice still meets the definition of practice as an RPN, LPN, RN or NP(Required)

Attestation 4(Required)

I understand I must self-declare the number of practice hours during licensure renewal as an RPN, LPN, RN or NP in the non-traditional role or domain in the Alinity Member Portal.(Required)

Attestation 5(Required)

I declare that my individual practice is within the realm of an RPN, LPN, RN or NP and acknowledge that I may be selected for a registration audit.(Required)

Annually, it is the responsibility of each RPN, LPN, RN or NP, prior to commencing any practice, to validate that a current practicing licence has been issued in their name by checking the College’s Search for a Nurse directory.

Registrant Information

Name(Required)

First Last

College Licence Number(Required)

Email(Required)

Enter Email Confirm Email

Employment Position/Role(Required)

Employer(Required)

Date(Required)

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