Virtual Nursing Licensure Requirements
The Newfoundland and Labrador College of Nurses1 is the regulatory body for nurses in Newfoundland and Labrador (NL). The primary mandate of the College is public protection. The College achieves this by ensuring that nurses meet the requirements for registration and annual licensure, and by promoting standards for safe, competent, and ethical nursing practice. This fact sheet addresses licensure requirements for engaging in Virtual Nursing Practice (VNP) in NL.
What is Virtual Nursing Practice?
Virtual Nursing Practice (VNP) encompasses all types of nursing care and services that are delivered across distances via virtual care technologies. Nursing care and services may include, but are not limited to, education, counselling, assessment, initiation, and evaluation of treatment, and health care monitoring. VNP may encompass the totality of nursing services being provided (i.e., providing nursing services only via virtual care technologies) or VNP may be only one of many different modalities in which nursing services are being delivered (i.e., community clinic/hospital setting where face-to-face, as well as VNP services are offered).
Is licensure with the College required to engage in VNP?
If a nurse is physically located in NL, they must be licensed with the College to provide nursing services, including VNP.
If a nurse is outside of NL and providing nursing services, including VNP, to residents of NL they do not require licensure with the College. However, they must contact the regulatory body in the jurisdiction they are located to determine if they require licensure in that jurisdiction. Key to remember: the nurse must be licensed in at least one jurisdiction.
- With respect to the provision of telehealth services/virtual nursing practice to clients in this province, the College would consider that a nurse is practicing in the province/jurisdiction in which the nurse is physically located. The nurse would need to advise their clients where they are licensed (e.g., Ontario) and how they can validate their licensure status (e.g., licence verification or member search function on the regulatory body website). If a client wanted to file a complaint/allegation against the nurse, they would need to know where the nurse holds a licence to practice and the name of the Regulatory Authority where the nurse holds the licence (e.g., CNO).
Should the nurse’s position change and travel to this province to see clients becomes part of the nurse’s role, the nurse must contact the College to determine if licensure is required.
If a nurse is physically located in NL, and providing VNP to clients in another jurisdiction, the nurse must be licensed in NL, and they must contact that jurisdiction’s nursing regulatory body to determine if they are required to be licensed in that jurisdiction.
I’m a Nurse Practitioner. Can I order medications and diagnostic tests for a resident of NL if I am not licensed with the College?
Newfoundland and Labrador Health Services (NLHS) currently will not accept an order for blood work or any other diagnostic tests unless the practitioner is licensed with the College. Therefore, if the NP is required to order bloodwork or diagnostics for any NL residents, the NP will need to apply for full licensure.
Pharmacists/Pharmacies may or may not choose to fill a prescription from a prescriber outside of NL. It is within their clinical judgment to refuse to fill a prescription. If a pharmacist is unable to confirm that the prescriber has a license to practice in the jurisdiction they are located, the pharmacist may refuse to fill the prescription. The prescriber must also determine if a tamper resistant prescription pad is required for those medications that falls under the NL Prescription Monitoring Program.
What Liability Insurance do I need for VNP?
Nurses must obtain/maintain the appropriate liability insurance for VNP. Nurses are responsible for contacting their liability insurance provider (e.g., Canadian Nurses Protective Society-CNPS) to ensure they have adequate coverage if providing VNP.
For those nurses who engage in virtual nursing practice for clients of NL, regardless of where they are located, the nurse must be knowledgeable of the College’s Virtual Nursing Practice document. It is required that the nurse be knowledgeable of and apply their professional standards2, and relevant regulatory documents for the nursing jurisdiction in which they are providing virtual nursing practice and services. For further information or for assistance, please connect with registration services at registration@nlcn.ca