COLLEGES OF APPLIED ARTS AND TECHNOLOGY
Practical Nursing Program Standard
The approved program standard for Practical Nursing programs approved by the Ministry of Training, Colleges and Universities (MCU Code 51407) for delivery by Ontario Colleges of Applied Arts and Technology
©
2001, Ontario Ministry of Training, Colleges and Universities
ISBN 0-7778-7663-9
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Acknowledgments
Table of Contents
Acknowledgments
The Ministry of Training, Colleges and Universities acknowledges with thanks the significant contribution of the many individuals and organizations who participated in the development of this program standard. In particular, the Ministry of Training, Colleges and Universities would like to acknowledge the important roles of
- Members of the Practical Nursing Program Standard Committee: Doreen Beath, Perth-Smith Falls Hospital; Sandra Brewer, Georgian College; Debbie Burton, Lasalle Residence; Denise Dietrich, College of Nurses of Ontario; Hélène Desjardins, La Cité Collégiale; Paula Donahoe, Centennial College; Charlotte Koso, Care Partners, Inc.; Gaston Lavigne, College Boréal; Trish Nesbitt, Registered Practical Nurses Association of Ontario; Linda O’Neill, Canadore College; Paula Price, George Brown College; Gladys Rangaratnam, Cambrian College; Anitta Robertson, Ontario Long Term Care Association; Beth Siurna, Loyalist College; Evelyn Smith, Victorian Order of Nurses; Dawn Thomas, Rideaucrest; Sandra Tully, University Health Network; and Anna Wilson, Fanshawe College.
- The many individuals and organizations who participated in consultations with the project; and the project officer who led the development of the vocational standard: Linda Buschmann, Canadore College.
- All those involved in the work of the CSAC Generic Skills Council and the development of the generic skills standard.
- All those involved in the work of the CSAC General Education Council and the development of the general education standard.
I. Introduction
This document is the Program Standard for Practical Nursing Programs delivered by Ontario colleges of applied arts and technology. The program standard applies to all programs approved by the Ministry of Training, Colleges and Universities under MCU code 51407
Development of System-Wide Program Standards
In 1993, the Government of Ontario initiated program standards development with the objectives of bringing a greater degree of consistency to college programming offered across the province, broadening the focus of college programs to ensure graduates have the skills to be flexible and to continue to learn and adapt, and providing public accountability for the quality and relevance of college programs.
The Colleges Branch of the Ministry of Training, Colleges and Universities has responsibility for the development and approval of system-wide standards for programs at colleges of applied arts and technology of Ontario.
Program Standards
Program standards apply to all similar programs offered by colleges across the province. Each program standard for a postsecondary program includes the following elements:
- Vocational standard (the vocationally specific learning
outcomes which apply to the program in question),
- Generic skills standard (the generic skills learning
outcomes which apply to programs of similar length), and
- General education standard (the requirement for general education courses that applies to postsecondary programs).
Collectively, these elements outline the essential skills and knowledge that a student must reliably demonstrate in order to graduate from the program.
Individual colleges of applied arts and technology offering the program determine the specific program structure, delivery methods, and other curriculum matters to be used in assisting students to achieve the outcomes articulated in the standard. Individual colleges also determine whether additional local learning outcomes will be required to reflect specific local needs and/or interests.
The Expression of Program Standards as Learning Outcomes
The vocational and generic skills components of program standards are expressed in terms of learning outcomes.
Learning outcomes represent culminating demonstrations of learning and achievement. They are not simply a listing of discrete skills, nor broad statements of knowledge and comprehension. In addition, learning outcomes are interrelated and cannot be viewed in isolation of one another. As such, they should be viewed as a comprehensive whole. They describe performances that demonstrate that significant integrated learning by graduates of the program has been achieved and verified.
Expressing standards as learning outcomes ensures consistency in the outcomes for program graduates, while leaving to the discretion of individual colleges curriculum matters such as the specific program structure and delivery methods.
The Presentation of the Learning Outcomes
The learning outcome statement sets out the culminating demonstration of learning and achievement that the student must reliably demonstrate before graduation.
The elements of performance for each outcome define and clarify the level and quality of performance necessary to meet the requirements of the learning outcome. However, it is the performance of the learning outcome itself on which students are evaluated. The elements are indicators of the means by which the student may proceed to satisfactory performance of the learning outcome. The elements do not stand alone but rather in reference to the learning outcome of which they form a part.
In some cases, in order to ensure clarity, an explanation of the outcome is also provided.
The Accreditation of Programs
The Ministry of Training, Colleges and Universities will establish a process to accredit college programs, with the objective of determining whether program graduates have achieved the learning outcomes and general education requirement established in a program standard.
The Development of a Program Standard
In establishing the standards development initiative, the Government determined that all postsecondary programs should include vocational skills coupled with a broader set of essential skills. This combination is considered critical to ensuring that college graduates have the skills required to be successful both upon graduation from the college program and throughout their working and personal lives.
A program standard is developed through a broad consultation process involving a range of stakeholders with a direct interest in the program area, including employers, professional associations, universities, secondary schools, and program graduates working in the field, in addition to students, faculty, and administrators at the colleges themselves. It represents a consensus of participating stakeholders on the essential learning that all program graduates should have achieved.
Updating the Program Standard
The Ministry of Training, Colleges and Universities will continue to undertake regular reviews of the vocational learning outcomes for this program, as well as a review of the generic skills learning outcomes and the general education requirement, to ensure that the Practical Nursing Program Standard remains appropriate and relevant to the needs of students and employers across the Province of Ontario. To confirm that this document is the most up-to-date release, contact the Ministry of Training, Colleges and Universities at the address or telephone number noted on the inside cover page.
II. Vocational Standard
All graduates of Practical Nursing Programs must have achieved the ten vocational learning outcomes listed in the following pages, in addition to achieving the generic skills learning outcomes and meeting the general education requirement.
Preamble
The program standard for practical nursing programs in the colleges of applied arts and technology includes a foundation of generic skills outcomes and general education requirements that are achieved concurrently with the vocational standard. In addition, programs of practical nursing comply with legislation* and the College of Nurses of Ontario’s professional* standards, practice expectations, and Entry to Practice Competencies for Ontario Registered Practical Nurses as of January 2005 (September 1999).
Through achievement of the program standard, the graduates as entry-level workers, will have the knowledge, skills, attitudes, and judgement that are necessary to perform their role within the scope of nursing practice. Entry level practice is with stable* clients*. The stability of the client* and the appropriateness of an assignment to an entry level Registered Practical Nurse (RPN) must be established by someone with the experience and competence to make that determination, prior to the Registered Practical Nurse initiating care. There are elements of nursing practice that the entry level Registered Practical Nurse is not expected to do independently and that will require consultation*. For those areas requiring consultation*, the level of knowledge and ability that the new Registered Practical Nurse has will be less than for those areas where the expectation is for them to have the ability to practise autonomously. In addition, graduates are required to know the specific areas in which they are expected to seek consultation* before proceeding with an action. They are always expected to recognize their own knowledge and practice boundaries and when and how to seek out the expertise of other nurses and team members and as appropriate, to consult with and/or ask for assistance.
Practical nursing is a profession with its foundation in caring, nursing theory, health related theory* including the biopsychosocial sciences, and research. Graduates of practical nursing programs carry out nursing interventions* that promote health and habilitation*; prevent injury and disease; maintain and restore health; and provide palliation. Given the serious and challenging nature of this career, graduates have completed a program that has been informed by the theory, principles, practices, and values needed to practise as a Registered Practical Nurse. Through continuous learning and experience, graduates will be able to build on this foundation to deliver care to complex clients*.
Upon completion of this program graduates, as part of their nursing practice, work together with clients*, families, and groups in a variety of practice settings*. Graduates demonstrate strong interpersonal and communication skills and respect for the uniqueness of clients* and colleagues. Graduates use reflective practice*, critical-thinking*, problem-solving, and decision-making strategies competently and effectively to provide nursing care and to promote optimal health and well-being of individuals, families, and groups. Graduates are expected to act always within the legislated scope of practice and according to professional* standards and practice expectations.
Graduates demonstrate the knowledge, skills, attitudes, and judgement needed to be competent entry-level practitioners. As independent practitioners, in collaboration and in consultation* with other nursing professionals and interdisciplinary team members, graduates demonstrate leadership within their own practice role. Graduates work with individuals, families, groups (autonomously or in consultation* with nursing and other team members, as appropriate) to plan, implement, and evaluate outcomes-based nursing care, services, and programs. Nursing, as a regulated health profession, requires registrants to engage in reflective practice* and ongoing learning as the basis of their continued competence.
Graduates of practical nursing programs have employment opportunities in practice settings* such as hospitals; community, long-term care, and other health care facilities, services, and programs. In addition, they may find employment opportunities within other organizations and agencies which require nursing knowledge and expertise.
After successful completion of an approved program of practical nursing and of the national registration examination, graduates are eligible for registration by the College of Nurses of Ontario, under the Nursing Act (1991). Following registration by the College of Nurses of Ontario and by maintaining and improving competence and by the payment of annual fees, the registrant is entitled to use the professional* designation of Registered Practical Nurse (RPN).
Synopsis of the Vocational Learning Outcomes
Practical Nursing Programs
The graduate has reliably demonstrated the ability to
- practise in a professional* manner within a legislative and ethical framework.
- develop and sustain therapeutic relationships* with clients*.
- communicate effectively with clients*, health care team members, and others.
- participate effectively as a team member to support clients’* achievement of their expected health outcomes.
- integrate theory, principles, and concepts into competent nursing practice.
- complete assessments in a holistic*, comprehensive, and analytical manner.
- prioritize and organize nursing and health care.
- implement and evaluate nursing interventions* competently.
- use a variety of technological tools to support clients’* achievement of their expected health outcomes.
- apply principles of teaching-learning to promote clients’* health and wellness.
Note: The learning outcomes have been numbered as a point of reference; numbering does not imply prioritization, sequencing, nor weighting of significance.
The Vocational Learning Outcomes
1. The graduate has reliably demonstrated the ability to
practise in a professional* manner within a legislative and ethical framework.
Elements of the Performance
- Understand the role and responsibility of regulatory bodies to protect the public
- Understand the role the professional* associations have in promoting the profession
- Understand professional* self-regulation and its implications for individual responsibilities and accountability*
- Understand the implications that legislation*, the professional* standards, and the practice expectations have on nursing practice
- Know and comply with legislation*, professional* standards, and practice expectations
- Know and comply with the practice setting’s* established standards, policies and procedures
- Work within own role and responsibilities, independently and collaboratively
- Recognize that the need may arise at any time to seek out consultation*
- Accept accountability* for own decisions and actions
- Practise within an ethical framework and professional* ethical guidelines
- Recognize the effect that personal belief systems, values, and assumptions have on nursing practice
- Promote public recognition and understanding of the role of the practical nurse*.
- Promote professionalism in practice by acting as a role model
- Recognize the importance of participation in activities that support leadership such as a preceptor, mentor, and committee member
- Engage in reflective practice*
- Develop a collegial support network
- Provide constructive criticism and peer feedback appropriately
- Identify trends and issues in society, health, and nursing which may influence nursing practice
- Collaborate* with experienced colleagues to recognize the influence that government has on health care including funding, accessibility, availability, quality, health promotion, prevention, intervention, and habilitation*
- Support access, equity, quality, and accountability in health and social care
- Challenge appropriately all questionable orders, directives, and behaviours
- Participate in the practice setting’s* quality improvement processes
- Advocate for the practice setting* to implement a quality improvement process if none exists
- Implement self-care practices to promote own health, wellness, and lifestyle such as developing a balance of nutrition, rest, leisure, and work, and by using techniques such as stress management
2. The graduate has reliably demonstrated the ability to
develop and sustain therapeutic relationships* with clients*.
Elements of the Performance
- Distinguish between social interactions and professional* communication
- Balance technical and technological aspects of nursing with a humanistic attitude and holistic* approach
- Employ a supportive and client*-centered approach
- Base nurse-client* relationships on trust, respect, intimacy, and appropriate use of the power inherent in the care provider’s role
- Use a nonjudgmental attitude, empathy, and genuineness when interacting with clients*
- Establish and maintain a caring environment in accordance with nursing standards
- Establish and maintain partnerships* with clients* which support achievement of the clients’* expected health outcomes
- Apply theory and practices of effective communication and interpersonal, family, and group dynamics to establish, maintain, and to bring closure to therapeutic relationships*
- Use the therapeutic relationship* as a framework to promote the clients’* health and wellness and for engaging in illness prevention, habilitation*, and palliation activities
- Display a sensitivity to diversity*
- Promote an understanding of beliefs, values, and practices of various cultures
- Employ culturally appropriate strategies
- Support clients’* decision making
- Facilitate the empowerment* of clients* and where appropriate, act as a client* advocate
- Respect decisions made by clients* about their health, wellness, safety, well-being, and lifestyle Respect the right of clients* who are competent to make decisions, to choose to be at risk
- Negotiate with clients* to determine when consultation* with other health care team members, including other health sectors, is required
3. The graduate has reliably demonstrated the ability to
communicate effectively with clients*, health care team members, and others.
Elements of the Performance
- Communicate accurately, confidently, and respectfully with clients* and others
- Apply principles of communication and family and group interaction when observing, monitoring, interpreting, and reporting client* communication
- Adapt communication strategies to meet the needs of clients*
- Use communication techniques effectively to facilitate clients’* understanding of health related information
- Maintain client* confidentiality and rights to privacy
- Share client* information relevant to the client’s health outcomes and status with the health care team while protecting confidentiality
- Use communication and conflict management skills appropriately to participate in health care team interactions
- Use terminology and their abbreviations and symbols correctly in written, oral, and electronic communication and documentation
- Use a variety of written, oral, nonverbal, and electronic communication techniques, according to nursing standards and the practice settings’* policies
- Document and maintain clear, concise, accurate, and timely records using both paper-based and electronic methods, in accordance with nursing standards and the practice setting’s* policies
- Maintain all information, records, and files according to nursing standards and the practice setting’s* policies
- Use appropriate communication protocols, policies, and procedures to communicate with health care team members within the specific practice setting* and across the health system
4. The graduate has reliably demonstrated the ability to
participate effectively as a team member to support clients'* achievement of their expected health outcomes.
Elements of the Performance
- Demonstrate an understanding of the role that practical nursing has in promoting the client’s* health, wellness, safety, and quality of life
- Promote understanding of the role of the practical nurse* and its relationship to the roles of other team members
- Respect the role, rights, and responsibilities of clients* and other team members
- Develop partnerships* with clients*, nurses and other team members
- Use effective critical-thinking*, problem-solving, and decision-making skills when participating as a member of a team
- Gather information relevant to the clients’* health status, situation, and expectations and communicate this to other health care team members in an ongoing manner
- Consult and collaborate* with clients* and with other team members when developing outcome-based plans
- Consult and collaborate* with clients* and health care team members in diverse practice settings* when developing outcomes-based plans including discharge plans
- Work together with clients*, team members, and with other health related sectors to support clients’* achievement of their expected health outcomes
- Act independently within a team and collaboratively with other team members, according to the situation and at own competency level
- Recognize when it is necessary to seek assistance from a more experienced Registered Practical Nurse (RPN)/Registered Nurse (RN) or other health care professionals to meet the client’s* care needs
- Apply knowledge of the fundamental principles of leadership and management
- Assign client* care activities to, provide direction to, and assume a supervisory role with unregulated care providers, as appropriate
- Participate in the evaluation of the services and programs provided by nursing and other teams
5. The graduate has reliably demonstrated the ability to
integrate theory, principles, and concepts into competent nursing practice.
Elements of the Performance
- Use effective decision-making strategies when assessing clients’* and when providing and evaluating client care
- Apply critical-thinking*, problem-solving, and decision-making skills with a variety of clients* across the life span and in diverse practice settings*
- Adapt knowledge and skills to a variety of client* situations across the life span and in diverse practice settings*
- Make safe and effective clinical judgements about clients* by using evidence-based knowledge, autonomously and where appropriate, in collaboration with other team members
- Recognize when consultation* or assistance from an experienced health care professional is required
- Consult with clients’* to provide flexible, innovative, and safe care
- Provide competent nursing practice for clients* across the life span and in diverse practice settings*
- Seek out and read relevant nursing, health related, and agency information and incorporate this information into nursing practice
6. The graduate has reliably demonstrated the ability to
complete assessments in a holistic*, comprehensive, and analytical manner.
Elements of the Performance
- Apply relevant nursing and health related theory* when assessing* clients* and when interpreting the results of nursing and other health related assessments
- Use appropriate assessment and data collection strategies and techniques safely, effectively, and efficiently
- Individualize assessment and data collection strategies and techniques to meet clients’* needs
- Recognize when there is need to involve a more experienced Registered Practical Nurse (RPN) or Registered Nurse (RN) or other health care professionals to complete an assessment and/or interpret assessment data
- Ensure client* privacy and confidentiality when performing nursing assessments
- Perform and interpret client* assessments as part of a holistic* and comprehensive approach
- Complete nursing-related client* assessments, report, and record these in an ongoing and accurate manner
- Collect, analyze, report, and record assessment information from a variety of sources correctly, accurately, autonomously, and where appropriate, in consultation* with experienced health care professionals
- Identify actual and potential problems and use critical-thinking* skills to determine appropriate action
- Collaborate* with clients* and other experienced nurses and/or other health care professionals, as appropriate, to develop holistic* and comprehensive plans that support clients’* achievement of their expected health outcomes
7. The graduate has reliably demonstrated the ability to
prioritize and organize nursing and health care.
Elements of the Performance
- Work within the practical nurse’s* role responsibilities as an individual practitioner and as a member of nursing and interdisciplinary teams
- Use time management skills to organize and prioritize a workload, including carrying out multiple nursing interventions*
- Consider the client’s* requirements and expected health outcomes, the nursing and health care team’s goals, and the availability of resources to establish priorities when providing care
- Seek out and use resources appropriately and in a self-directed manner
- Contribute to the effective use and evaluation of resource management tools such as workload monitoring systems, budgets, and schedules
8. The graduate has reliably demonstrated the ability to
implement and evaluate nursing interventions* competently.
Elements of the Performance
- Collaborate* with clients* and with experienced Registered Practical Nurses (RPN)/Registered Nurses (RN) and/or other health care professionals, to develop and implement innovative plans that support clients’* achievement of their expected outcomes
- Provide competent nursing practice for clients* across the life span and in diverse practice settings*
- Understand the requirements of informed consent and how to establish that consent is present
- Obtain informed consent for nursing interventions*
- Apply knowledge of substitute decision-making, where appropriate.
- Assess* for the appropriateness of a nursing intervention* prior to carrying it out, using a decision-making framework
- Perform a range of nursing interventions* competently
- Perform nursing interventions* as indicated in mutually established plans and according to nursing standards and the policies and procedures of the practice setting*
- Use professional* judgement to deviate from the established plan, where appropriate
- Evaluate the effectiveness of nursing interventions* in relation to clients’* expected health outcomes and take appropriate action
- Comply with relevant legislation* and established nursing standards, policies, and procedures to ensure a safe and healthy environment for the client*, self, and team members
- Recognize, report, and where appropriate, intervene in situations which are potentially unsafe for clients* and others
9. The graduate has reliably demonstrated the ability to
use a variety of technological tools to support clients'* achievement of their expected health outcomes.
Elements of the Performance
- Use relevant technology effectively and efficiently when providing client* care
- Keep current with technological changes that support the client’s* achievement of her/his expected outcomes
- Use appropriate equipment for the purpose
- Use the equipment correctly according to the practice setting’s* standards, policies, and procedures and the manufacturer’s guidelines
- Access, using current technology, relevant information effectively and efficiently to plan, coordinate, and implement client*-centered care and to maintain cost-effectiveness
- Be aware of the documentation, workload, budgeting, and scheduling software which are used to enhance the effectiveness and efficiency of nursing practice
- Use appropriate methods for protecting client* confidentiality when accessing, documenting, and transmitting information electronically
10. The graduate has reliably demonstrated the ability to
apply principles of teaching-learning to promote clients'* health and wellness.
Elements of the Performance
- Use the therapeutic relationship* as a framework for learning
- Collaborate* with clients* and with an experienced Registered Practical Nurse (RPN)/Registered Nurse (RN) and/or other health care professionals to assess* the client’s* learning needs and to develop learning plans
- Apply teaching and learning principles and theories to develop, implement, and evaluate learning plans
- Adapt, in consultation* with experienced health care professionals, health related information to meet clients’* specialized needs.
- Select and implement strategies related to health promotion and maintenance, and illness prevention, independently and as part of a team
- Use appropriate resources to support clients’* achievement of their learning outcomes
- Provide information to facilitate clients’* decision making and that will promote health and wellness, safety, well-being, and lifestyle changes
- Accept and respect clients’* rights to make decisions about their health and wellness, safety, well-being, and lifestyle
- Engage clients* in activities to promote their health and wellness
- Verify clients’* acquisition of the essential information and skills
- Advocate for clients* to receive pertinent and timely health care information
Glossary of Terms
- Accountability
- The obligation to accept responsibility for one’s own professional
knowledge, skills, judgement, attitudes, conduct and outcome. Accountability
includes self-evaluation, compliance with legislation and the accepted
ethical guidelines, and adherence to the principles and practices of
nursing.
- Assess
- The ongoing and timely collection, organization, and analysis of relevant
client information. Assessment is based on relevant nursing and health
related theory and practices. Entry level Registered Practical Nurse
assessment commences only after patient stability has been established
by an experienced professional competent to make that judgment.
- Client
- The stable individual, family, or group who is the focus of a practical
nurse’s care and with whom the nurse is engaged in a professional
therapeutic relationship. The appropriateness of independent or consultative
interventions depends on the circumstances. [Adapted from the Entry
to Practice Competencies for Ontario Registered Practical Nurses as
of January 2005, College of Nurses of Ontario, September 1999.]
- Collaborate
- Working together with one or more members of the health care team
each of whom makes a unique contribution to achieving a common goal.
Each individual contributes from within the limits of her or his scope
of practice. [Adapted from the Entry to Practice Competencies for Ontario
Registered Practical Nurses as of January 2005, College of Nurses of
Ontario, September 1999.]
- Consultation
- Seeking advice/information from a more experienced and knowledgeable
member of the nursing profession (Registered Practical Nurse, RPN, or
Registered Nurse, RN) or a member of another profession when a nursing
activity is outside the entry-level Registered Practical Nurse’s
present level of practice. The entry-level Registered Practical Nurse
may also seek advice from other sources as appropriate. [Adapted from
the Entry to Practice Competencies for Ontario Registered Practical
Nurses as of January 2005, College of Nurses of Ontario, September 1999.]
- Critical Thinking
- Reasoning by which the use of language is analyzed, problems formulated,
assumptions clarified and explained, evidence weighed, conclusions evaluated,
discrimination between good and bad arguments is done, and those facts
and values that result in credible beliefs and actions are justified.
[Adapted from the Entry to Practice Competencies for Ontario Registered
Practical Nurses as of January 2005, College of Nurses of Ontario,
September 1999.]
- Diversity
- A wide variety of ethnic and cultural backgrounds, beliefs and practices,
socioeconomic statuses, ages, creeds, sexual orientation and identity,
ableness, and health states representative of clients and colleagues
with whom graduates will interact. Diversity may encompass some or all
of these categories of differences.
- Empowerment
- The process of imparting or transferring power from one individual
or group to another. The elements of empowerment include authority,
power, choice, and permission. [Adapted from Hein, Eleanor, C. (1999).
Contemporary Leadership: Selected Readings. (5th ed.).
Lippincott-Raven Publishers.]
- Habilitation
- The provision of the means by which individuals, families, and groups
become fit or improve health status. [Adapted from the Entry to Practice
Competencies for Ontario Registered Practical Nurses as of January 2005,
College of Nurses of Ontario, September 1999.]
- Health Related Theory
- The foundational knowledge for practical nursing that is based on
nursing theories and the biopsychosocial sciences. Depending on the
situation, the entry-level practical nurse may use health related theory
independently, collaboratively, or in consultation to consider, frame,
implement, and evaluate client outcomes and nursing care.
- Holistic
- The collection, organization, and analysis of client information as
an integrated whole. A holistic approach considers the client’s
biopsychosocial, cognitive, cultural, developmental, emotional, and
spiritual dimensions and as well, takes into account the client’s
health, determinants of health, values, beliefs, and goals.
- Legislation
- All relevant and current law including related regulations. Examples
of legislation include the Regulated Health Professions Act, Nursing
Act, Health Care Consent Act, Substitute Decisions Act,
Controlled Drugs and Substances Act, Public Hospitals Act,
Mental Health Act, Long Term Care Act, and the Occupational Health and Safety Act.
- Nursing Interventions
- The safe and competent performance by a practical nurse of actions,
treatments, and techniques that are directed toward supporting clients'
achievement of their health outcomes. These include interventions that
address clients' health and wellness; self-care; safety; function
and mobility; management of airway, nutrition, elimination, fluid and
electrolytes, infusion therapy, medication, wounds; aseptic technique;
therapeutic relationships; mental health; and promoting health. Nursing
interventions are performed by entry-level practical nurses at a level
consistent with their educational preparation. Interventions that are
part of an established plan of care are carried out independently. Creative,
innovative interventions that go beyond the established plan of care
must be carried out in consultation.
- Partnership
- Situations in which the nurse works with the client and other members
of the health care team to achieve specific health outcomes for the
client. Partnership implies consensus building in the determination
of these outcomes. [Entry to Practice Competencies for Ontario Registered
Practical Nurses as of January 2005, College of Nurses of Ontario,
September 1999.]
- Practical Nurse
- A health care professional who, after graduation from an approved
program of practical nursing and after successfully completing the registration
examination, is eligible for registration by the College of Nurses of
Ontario under the Nursing Act (1991). Following registration by the
College of Nurses of Ontario and by maintaining and improving competence
as well as paying annual fees, the registrant is entitled to use the
professional designation of Registered Practical Nurse (RPN).
- Practice Setting
- The environment in which a Registered Practical Nurse (RPN) practices.
Practice settings include ambulatory, acute, rehabilitation, and continuing
care hospital settings; long-term care facilities, and other health
care facilities, community; organizations, and agencies.
- Professional
- Practical nurses practise in accordance with the knowledge, skills,
and values of nursing which are embodied in the College of Nurses of
Ontario's standards and practice expectations and supported by
legislation and regulations. Nurses are accountable individually for
their practice, decisions, and actions when they act autonomously, in
consultation, or in collaboration with other members of the health care
team.
- Reflective Practice
- The critical thinking skills that are needed for continuous self-awareness
about one's own strengths and learning opportunities and the development,
implementation, and evaluation of plans to enhance nursing practice.
Reflective practice is an essential aspect of the value system of nursing.
- Therapeutic Relationship
- The use of professional nursing knowledge, skill, and caring attitudes
and behaviours in order to provide nursing services that contribute
to the client's health and well-being. This relationship between
the client and the nurse is based on trust, respect, and intimacy and
requires the appropriate use of the power inherent in the care provider's
role and requires the nurse to advocate for the client when needed.
[Adapted from the Standard for the Therapeutic Nurse-Client Relationship,
College of Nurses of
Ontario, 1999.]
- Stable
- Situations in which the client's health status can be predicted or anticipated. Interventions have predictable outcomes and/or a known level and range of negative outcomes. [Adapted from the Entry to Practice Competencies for Ontario Registered Practical Nurses as of January 2005, College of Nurses of Ontario, September 1999.]
III. Generic Skills Standard
All graduates of Practical Nursing Programs must have achieved the thirteen generic skills learning outcomes listed on the following pages, in addition to achieving the vocational learning outcomes and meeting the general education requirement.1
Synopsis of the Generic Skills Learning Outcomes
Practical Nursing Programs
The graduate has reliably demonstrated the ability to
- communicate clearly, concisely, and correctly in the written, spoken, and visual form that fulfills the purpose and meets the needs of audiences.
- reframe information, ideas, and concepts using the narrative, visual, numerical, and symbolic representations which demonstrate understanding.
- apply a wide variety of mathematical techniques with the degree of accuracy required to solve problems and make decisions.
- use a variety of computer hardware and software and other technological tools appropriate and necessary to the performance of tasks.
- interact with others in groups or teams in ways that contribute to effective working relationships and the achievement of goals.
- evaluate her or his own thinking throughout the steps and processes used in problem solving and decision making.
- collect, analyze, and organize relevant and necessary information from a variety of sources.
- evaluate the validity of arguments based on qualitative and quantitative information in order to accept or challenge the findings of others.
- create innovative strategies and/or products that meet identified needs.
- manage the use of time and other resources to attain personal and/or project-related goals.
- take responsibility for her or his own actions and decisions.
- adapt to new situations and demands by applying and/or updating her or his knowledge and skills.
- represent her or his skills, knowledge, and experience realistically for personal and employment purposes.
The Generic Skills Learning Outcomes
1. The graduate has reliably demonstrated the ability to
communicate clearly, concisely, and correctly in the written, spoken, and visual form that fulfills the purpose and meets the needs of audiences.
Explanation
Communicating in a clear, concise, and correct manner requires producing the written, spoken or visual material that best suits the situation. Graduates will have developed their ability to analyze their audiences to identify what is required and to match those needs with the means that is most appropriate. They will have produced material according to the style and conventions required, and they will have checked their products for accuracy and clarity. Finally, graduates will have used the tools available to them to create and correct their written, spoken, and visual messages.
Elements of the Performance
- Plan and organize communications according to the purpose and audiences
- Choose the format (e.g., memo, illustration, video, multimedia presentation, diagram) appropriate to the purpose
- Incorporate content that is meaningful and necessary
- Produce material that conforms to the conventions of the chosen format
- Use language and style suitable to the audience and purpose
- Ensure that the material is free from mechanical errors
- Use the computer technology that will enhance the production of materials
- Evaluate communications and adjust for any errors in content, structure, style, and mechanics
2. The graduate has reliably demonstrated the ability to
reframe information, ideas, and concepts using the narrative, visual, numerical, and symbolic representations which demonstrate understanding.
Explanation
Responding to messages from many sources requires the ability to receive and to comprehend what has been received. One way to demonstrate that comprehension is to reframe, or restate in other forms, the original message. This requires graduates to have developed the skills to read, listen to, and observe messages contained within narrative and visual forms. It also requires the ability to construct unique narrative and visual representations that are consistent with the original messages.
Elements of the Performance
- Develop and use strategies to read, listen, and observe effectively
- Clarify what has been read, heard, and observed
- Reproduce original information in other formats (e.g., written and spoken summaries; tables, figures, charts, diagrams, maps, drawings, photographs, and computer-generated graphics; terms represented by numbers; and values represented by letters or signs)
- Use technology, where appropriate, to aid in reframing
- Evaluate the representation for consistency of meaning with the original
- Acknowledge the use of material from other sources according to the conventions of the medium used
3. The graduate has reliably demonstrated the ability to
apply a wide variety of mathematical techniques with the degree of accuracy required to solve problems and make decisions.
Explanation
Using mathematics effectively in everyday situations requires the ability to apply a wide variety of mathematical skills accurately. Graduates will have demonstrated their ability to apply the concepts of number and space to situations which include quantities, magnitudes, measurements, and ratios. They will have developed their ability to identify the need for mathematics, to apply mathematical techniques (concepts, conventions, strategies, and operations) and to check the results of their applications. This will require graduates to be flexible and creative and to be confident in their mathematical skills and abilities.
Elements of the Performance
- Recognize situations that require mathematics
- Assess potential mathematical strategies (including models, geometric representations or formulas, elementary algebraic equations, descriptive statistical methods, and mathematical reasoning) for suitability and effectiveness
- Decide on the degree of accuracy required for answers
- Estimate probable answers
- Execute mathematical operations necessary to implement selected strategies
- Use calculators or appropriate technological tools to perform mathematical operations accurately
- Check for errors in numerical answers and the appropriate fit between problems and answers
- Express answers clearly
- Transfer the use of mathematical strategies from one situation to another
4. The graduate has reliably demonstrated the ability to
use a variety of computer hardware and software and other technological tools appropriate and necessary to the performance of tasks.
Explanation
Using computers and other technologies as tools to increase productivity and to enhance tasks requires graduates to have the confidence and ability to use the tools well. Graduates will have demonstrated the ability to recognize when computers and other technologies contribute to completing tasks, solving problems, performing research, and creating products. They will use the technological tool most appropriate to the task and use it accurately. Finally, they will have gained confidence in continuing to learn about and cope with new technologies in the future.
Elements of the Performance
- Use basic operating system functions competently (e.g., load software, store, retrieve data)
- Determine which tasks can best be handled by computers and other technology
- Select suitable software, equipment, and tools for the task
- Use the software, equipment, and tools effectively, correctly, and ethically
- Deal with equipment and software problems and errors in a logical and systematic manner
- Transfer concepts, knowledge, and skills from one technology to another
- Evaluate one’s own use of hardware, software, and technological tools
5. The graduate has reliably demonstrated the ability to
interact with others in groups or teams in ways that contribute to effective working relationships and the achievement of goals.
Explanation
Working in teams or groups in either a work or personal context requires the ability to assume responsibility for collective duties and decisions. It also requires interacting effectively with the members of the group. Therefore, in achieving this outcome, graduates will have demonstrated their ability to understand and complete the various tasks required of them as group members. They will also have demonstrated their ability to understand and respond to others.
Elements of the Performance
- Identify the tasks to be completed
- Establish strategies to accomplish the tasks
- Identify roles for members of the team/group
- Clarify one’s own roles and fulfill them in a timely fashion
- Treat other members of the group equitably and fairly
- Contribute one’s own ideas, opinions, and information while demonstrating respect for those of others
- Employ techniques intended to bring about the resolution of any conflicts
- Regularly assess the group’s progress and interactions and make adjustments when necessary
6. The graduate has reliably demonstrated the ability to
evaluate her or his own thinking throughout the steps and processes used in problem solving and decision making.
Explanation
Solving a range of complex problems and dealing with a variety of tasks require the thinking skills and strategies that will allow graduates to identify what has to be done and to select and implement the most suitable approach. In applying thinking skills and strategies, graduates will have understood the limits as well as the potential of their own thought processes. As well, in attempting various strategies, they will have explored styles of thinking that may be new to them. This will allow graduates to understand the way they think and how they approach decisions and problems.
Elements of the Performance
- Clarify the nature and extent of problems or required directions
- Explore various thinking skills and strategies that could be used
- Identify limits as well as the potential of one’s own thought processes
- Choose and apply thinking skills and strategies (e.g., inductive and deductive thinking; creative and intuitive thinking; inquiry; critical thinking; and reflection)
- Evaluate results of the thinking skills and strategies used in problem solving and decision making
- Appreciate the benefits of the use of alternative types of thinking
7. The graduate has reliably demonstrated the ability to
collect, analyze, and organize relevant and necessary information from a variety of sources.
Explanation
Making decisions and completing tasks often requires information that can be used as support. Graduates, therefore, must be able to access current, relevant, and useful information and to organize that information in understandable ways. In achieving this outcome, graduates will have developed and used strategies to locate and gather a wide range of information, most particularly through technological means. They will have learned how to select pertinent information and to sort it so that it can be displayed in useful formats like databases and spreadsheets. This information can then be used to support decisions and to assist in the completion of tasks.
Elements of the Performance
- Identify the nature of the information required
- Investigate sources of information (including people, text, databases, and the Internet)
- Gather information from the most appropriate sources using various data collection techniques, including technology
- Examine the information and select what is relevant, important, and useful
- Employ a variety of techniques to organize the information (e.g., spreadsheets, databases, graphs, charts)
- Draw conclusions about how the information can be used
- Evaluate the processes used
- Cite sources according to the conventions of the medium used
8. The graduate has reliably demonstrated the ability to
evaluate the validity of arguments based on qualitative and quantitative information in order to accept or challenge the findings of others.
Explanation
With the wealth of numerical and non-numerical information available, graduates must be able to interpret, understand, and draw conclusions about what others have produced. Graduates will have used their mathematical abilities to question the validity of statistics and other numerical claims. Graduates also will have used their language and critical thinking skills to analyze the assumptions and evidence that others use to support more qualitative arguments and conclusions. As a result, graduates will have developed the ability to question and make decisions about what they read, hear, and observe.
Elements of the Performance
- Identify conclusions and claims made by others
- Detect any fallacies, biases, misrepresentations, and assumptions and judge their relevance to supporting arguments
- Check for accuracy and credibility of claims or arguments
- Be prepared to defend acceptance or rejection of claims or arguments
9. The graduate has reliably demonstrated the ability to
create innovative strategies and/or products that meet identified needs.
Explanation
Creating strategies and products that are original and innovative will require graduates to develop their creative thinking skills to find alternative ways to address situations. Graduates will have developed the confidence to use old information in new ways; to see unique relationships; and to practice the lateral, divergent, and intuitive thinking that will yield new approaches.
Elements of the Performance
- Analyze needs
- Generate creative ideas for strategies and products that will meet needs
- Choose alternatives to pursue based on needs and criteria of projects/plans
- Create strategies/products
- Evaluate strategies/products according to meeting needs
10. The graduate has reliably demonstrated the ability to
manage the use of time and other resources to attain personal and/or project-related goals.
Explanation
Achieving task-related goals in their personal and professional lives requires graduates to use their time, money, space, and other, often limited, resources as efficiently as possible. Graduates will have developed their ability to plan and predict ways of achieving goals. They will have developed and used tools intended to assist in the process. Finally, they will have attempted to follow their plans and use the tools, assessing regularly how realistic the goals, plans, and processes are and adapting when it is necessary.
Elements of the Performance
- Define reasonable and realistic goals
- Use planning tools (e.g., budgets, schedules) to achieve goals
- Monitor the process and goals and respond to changes
- Use resources (e.g., money, space, time) efficiently to accomplish tasks
- Re-evaluate goals and the use of resources and make appropriate adjustments
11. The graduate has reliably demonstrated the ability to
take responsibility for her or his own actions and decisions.
Explanation
Making decisions, taking positions, and completing tasks require graduates to be accountable for actions taken and to defend their convictions. Graduates will have demonstrated their ability to evaluate what they do and why they do it. They will have taken into consideration their individual values, beliefs, and opinions and the effects these have on their actions. Not only will graduates be able to justify their decisions, they will be able to advocate positively on behalf of themselves.
Elements of the Performance
- Review the results of one’s actions and decisions
- Reflect on the processes and practices used
- Identify any errors and make corrections
- Identify successes for adaptation to other situations
- Account for how one’s own values and beliefs affect actions and decisions
- Evaluate and act upon constructive feedback
- Be prepared to defend decisions made and actions taken
12. The graduate has reliably demonstrated the ability to
adapt to new situations and demands by applying and/or updating her or his knowledge and skills.
Explanation
Transferring skills from one context to another enables graduates to be lifelong learners. Graduates will have developed the confidence to know that their current skills are applicable to a range of changing, novel and unexpected situations. They will have demonstrated their ability to reflect on what they can do, match those skills to the new demands, and apply previous skills or develop the additional ones that will make them as effective in the new situations.
Elements of the Performance
- Assess current skills, knowledge, and learning styles
- Identify skills and knowledge required for new situations
- Adapt current skills and knowledge to new situations
- Identify new skills and knowledge required
- Choose the most appropriate learning and working styles to acquire new skills and knowledge
- Evaluate success of the processes and actual adaptations
13. The graduate has reliably demonstrated the ability to
represent her or his skills, knowledge, and experience realistically for personal and employment purposes.
Explanation
Preparing for changes in their personal and professional lives requires graduates to assess and present their accomplishments and abilities. In achieving this outcome, graduates will have developed their ability to reflect on what they have done and learned. They will also have summarized their abilities in ways that are attractive and useful to potential recipients. These ways may include portfolios and resumes. Finally, graduates will have developed the skills to present themselves and their accomplishments personally and with confidence.
Elements of the Performance
- Summarize one's own skills, knowledge, and experience realistically
- Choose formats (e.g., resume, portfolio, interview) which best display skills, knowledge, and experiences according to the situations
- Evaluate responses to the representations and make any adjustments
IV. General Education Standard
All graduates of Practical Nursing Programs must have met the general education requirement described on the following pages, in addition to achieving the vocational and generic skills learning outcomes.
The General Education Requirement
The Government of Ontario has established that each college postsecondary program shall include a minimum of one three-hour-per-week general education course of approximately 45 instructional hours per semester. Learners should experience a breadth of goals through their general education studies; and, wherever possible, they should have the opportunity to exercise choice in the selection of their general education courses.
This general education requirement is an integral component of the Practical Nursing Program Standard, along with the vocational and generic skills learning outcomes.
The general education requirement shall be met consistent with the following guiding principles:
- General education in the colleges shall identify and deal with issues
of societal concern in a manner relevant to the lives of students. General
education courses shall be structured in such a way as to guide students
through the historical context of such issues, their theoretical bases,
and application to contemporary life.
- All general education courses offered in the colleges shall be designed
to provide benefits to one or more of the three areas: learners' personal
growth and enrichment, informed citizenship, and working life.
- An essential component of the mission of Ontario’s colleges is the encouragement and support of continuous learning. This commitment to lifelong learning shall be reflected in each of the general education courses offered in the colleges.
General education appropriate for Ontario colleges is defined as those postsecondary learning experiences that enable learners to meet more effectively the societal challenges which they face in their community, family, and working life. General education in the colleges provides learners with insight into the enduring nature of the issues being addressed and into their particular relevance to today and the future. It is intended to encourage and support continuous learning. It is delivered as discrete courses which are designed to address one or more of the following goals and associated broad objectives established for general education:
Goals and Broad Objectives
1. Aesthetic Appreciation
understand beauty, form, taste, and the role of the arts in society
Broad Objectives
- develop critical awareness of arts in society
- perceive and evaluate the role of the arts
- heighten critical appreciation through development and application of personal and formal judgment factors
2. Civic Life
understand the meaning of freedoms, rights, and participation in community and public life
Broad Objectives
- develop knowledge of the structure and function of governments in Canada: legislative, judicial, and administrative arms; roles of elected officials and public servants; and a personal awareness of citizen responsibility
- develop historical understanding of major issues affecting Canadian politics and a critical awareness of related public policy
- develop awareness of international issues and their effects, and the place of Canada in international communities
- develop awareness of the history, significance, and organization of the voluntary sector in community life
3. Cultural Understanding
understand the cultural, social, ethnic, and linguistic diversity of Canada and the world
Broad Objectives
- develop an understanding of cultural identity by linking personal history to broader cultural study
- develop an understanding of the diversity of cultures and subcultures represented in Canadian society and of their interactions within the Canadian society
- develop intercultural understanding through reasoned reflection on various cultures’ responses to universal human issues
4. Personal Development
gain greater self-awareness, intellectual growth, well-being, and understanding of others
Broad Objectives
- consider one's expectations and values and analyze their impact on personal goal
- apply an understanding of the individual and human development to personal life and relationships
- integrate the concept of well-being into one’s lifestyle
- understand oneself as a learner and articulate one’s own learning style
5. Social Understanding
understand relationships among individuals and society
Broad Objectives
- develop informed understanding of social organization and institutions and of ongoing issues in relationships between individuals, groups, and societies
- develop informed understanding of social trends, social change, and social problems and of implications for social and personal response
- develop informed understanding of contemporary social problems and issues
6. Understanding Science
appreciate the contribution of science to the development of civilization, human understanding, and potential
Broad Objectives
- develop an understanding of the history, philosophy, contributions, perspectives, and limitations of the sciences
- develop an understanding of the scientific method and its uses in measuring quantifiable entities and confirming laws of nature
7. Understanding Technology
understand the interrelationship between the development and use of technology and society and the ecosystem
Broad Objectives
- relate implications of current transformations in technological knowledge and development to our physical and biological world
- develop awareness of ethical positions on enduring issues regarding the place of the human species in the physical and biological world
8. Work and the Economy
understand the meaning, history, and organization of work; and working life challenges to the individual and society
Broad Objectives
- set personal expectations for efficiency, effectiveness, ethics, and rewards and reconcile them with the changing work environment
- apply knowledge of the organization and structure of work, its institutions, and history; and of social and cultural attitudes to work
- develop an understanding of the changing nature of work and the economy
- The generic skills learning outcomes listed in this program standard form part of the program standard for each two- and three-year college program. Additional information about these generic skills learning outcomes is contained in the Generic Skills Learning Outcomes for Two and Three Year College Programs in Ontario's Colleges of Applied Arts and Technology. CSAC: 1995.
