College of Registered Psychiatric Nurses of Manitoba General Regulation

College of Registered Psychiatric Nurses of Manitoba General Regulation, M.R. 60/2022 The Regulated Health Professions Act , C.C.S.M. c. R117 Regulation 60/2022 Registered May 20, 2022 bilingual version (HTML) Table of Contents Section PART 1 INTERPRETATION 1.1 Regulatory scheme 1.2 Definitions 1.3 Competent to practise PART 2 MEMBERSHIP 2.1 Overview 2.2 Register of regulated members 2.3 Register information 2.4 What information is available to the public? 2.5 Labour mobility 2.6 Application contents 2.7 Registration requirements — registered psychiatric nurse 2.8 Registration requirements — registered psychiatric nurse (interim practice) 2.9 Conversion and cancellation 2.10 Registration requirements — registered psychiatric nurse (temporary practice) 2.11 Registration requirements — graduate psychiatric nurse 2.12 Appeal 2.13 Cancellation 2.14 Requirements for issuing a certificate of practice 2.15 Additional requirements for registered psychiatric nurse (authorized prescriber) 2.16 Renewal requirements 2.17 Continuing competency program 2.18 Records 2.19 Continuing competency committee 2.20 Review 2.21 Notifying the registrar 2,22 Report conduct to the registrar 2.23 Professional liability protection or insurance 2.24 Conditions on a certificate of practice 2.25 Change in information 2.26 Additional checks 2.27 Expiry of certificate 2.28 Conversion 2.29 Cancellation 2.30 Titles and abbreviations 2.31 Use of term "licensed" restricted to practising members 2.32 Registration or certificate of practice not required PART 3 RESERVED ACTS 3.1 Overview 3.2 Definitions 3.3 Performing reserved acts 3.4 Reserved acts — registered psychiatric nurse 3.5 Reserved acts — registered psychiatric nurse (interim practice) 3.6 Reserved acts — registered psychiatric nurse (temporary practice) 3.7 Reserved acts — graduate psychiatric nurse 3.8 Reserved acts — registered psychiatric nurse (authorized prescriber) 3.9 Practice setting policies 3.10 Delegating a reserved act 3.11 Supervising students PART 4 STANDARDS OF PRACTICE 4.1 Definitions 4.2 Client-centred practice 4.3 Collaborative care 4.4 Follow-up to diagnosis and test results 4.5 Practice environment 4.6 Client records 4.7 Application 4.8 Accepting clients in self-employed practice 4.9 Prohibited grounds for refusing clients 4.10 Ending client relationship 4.11 Notice of required payment 4.12 Client records retention 4.13 Closing, leaving or moving a self-employed practice 4.14 Storage and disposition of client records and supplies 4.15 Practice directions PART 5 MISCELLANEOUS 5.1 Restricted to certain membership class 5.2 Health profession corporation permit 5.3 Permit renewal 5.4 Additional contents of record 5.5 Notice of changes 5.6 Error on the record 5.7 Name of health profession corporation 5.8 Name removed from record 5.9 Professional misconduct fines 5.10 Chair may perform certain responsibilities of the investigation committee 5.11 Notice of suspension or conditions pending decision PART 6 COMING INTO FORCE 6.1 Coming into force Schedule PART 1 INTERPRETATION Regulatory scheme 1.1 Persons who practise registered psychiatric nursing are regulated under The Regulated Health Professions Act , this regulation, the Practice of Registered Psychiatric Nursing Regulation , and the College of Registered Psychiatric Nurses of Manitoba's by-laws and practice directions. Definitions 1.2 The following definitions apply in this regulation. "Act" means The Regulated Health Professions Act . («  Loi  ») "adult abuse registry check" means an adult abuse registry check under The Adult Abuse Registry Act . (« relevé des mauvais traitements infligés aux adultes ») "approved" means approved by the council except when the approval is indicated to be given by the registrar. (« approuvé ») "child abuse registry check" means a child abuse registry check under The Child and Family Services Act . (« relevé des mauvais traitements ») "college" means the College of Registered Psychiatric Nurses of Manitoba. (« Ordre ») "continuing competency committee" means the continuing competency committee established under section 2.19. (« comité de la formation continue ») "continuing competency program" means the continuing competency program described in section 2.17. (« programme de formation continue ») "council" means the council of the college. (« conseil ») "course of instruction" means a remedial, bridging, re-entry or preparatory course or program approved by the council, and includes an educational course or program designed specifically for an individual for the purpose of establishing or maintaining registration or a notation under the Act. (« cours de formation ») "criminal record check" means a record, including a vulnerable sector search, obtained from a law enforcement agency about a person stating (a) whether the person has a conviction or outstanding charge awaiting court disposition under any federal, provincial or territorial enactment; and (b) the details of any conviction or charge. (« relevé des antécédents judiciaires ») "First Nation" means a band as defined in the Indian Act (Canada). (« Première nation ») "initial registration" means a person's registration as a member in the member's first membership class. (« inscription initiale ») "member" means a person registered as a member of the college. (« membre ») "psychiatric nursing education program" means an education program that is a prerequisite for registration in the registered psychiatric nurse membership class. (« programme de formation en sciences infirmières psychiatriques ») "registered psychiatric nurse (authorized prescriber)" means a registered psychiatric nurse who holds a valid certificate of practice with the notation "(authorized prescriber)" issued under section 2.15. (« infirmier psychiatrique (prescripteur autorisé) ») "registered psychiatric nurse entry-to-practice examination" means an examination of the competencies required to engage in the practice of registered psychiatric nursing that is a prerequisite for registration in the registered psychiatric nurse membership class. (« examen d'admission pour les infirmiers psychiatriques ») "satisfactory" means satisfactory to the registrar. (« satisfaisant ») "Schedule" means the Schedule to this regulation. (« annexe ») M.R. 50/2024 Competent to practise 1.3 To be competent to engage in the practice of registered psychiatric nursing, a member must have the requisite knowledge, skill and judgment to perform the act or service as part of that practice. PART 2 MEMBERSHIP Overview 2.1 This Part deals with membership in the College of Registered Psychiatric Nurses of Manitoba. It supplements Part 4 of the Act. The membership classes are established and described. The registration requirements for each class are set out in this Part. They are in addition to the requirements set out in the Act. A certificate of registration does not entitle a member to engage in the practice of registered psychiatric nursing or to use a protected title. To do so, a member must hold a certificate of practice. This Part also supplements the requirements in the Act for the issuance, renewal and cancellation of a certificate of practice. A member's professional liability protection or insurance requirements are also set out. REGISTRATION Register of regulated members 2.2 The register of regulated members is comprised of the following subregisters and membership classes: REGISTER OF REGULATED MEMBERS Subregister Membership class Registered Psychiatric Nurses registered psychiatric nurse registered psychiatric nurse (interim practice) registered psychiatric nurse (temporary practice) Graduate Psychiatric Nurses graduate psychiatric nurse Register information 2.3 A register of regulated members must contain the information set out in subsection 28(1) of the Act. A register must also contain the following information for each member: (a) the member's registration number; (b) the member's initial registration date; (c) if applicable, the date of each subsequent registration of the member in another membership class; (d) the name of the educational institution from which the member graduated, the psychiatric nursing degree, diploma or certificate granted and the graduation or completion date; (e) if applicable, the course or courses of instruction that the member was required to complete and the completion date; (f) if applicable, an indication that the member holds a valid certificate of practice; (g) any cancellation of a member's certificate of practice; (h) any censure accepted by the member under section 102 of the Act and a description of the circumstances that led to the acceptance of the censure; (i) any undertaking from or agreement with a member, including an undertaking accepted under section 102 of the Act, that provides for one or more of the following: (i) an assessment of the member's capacity or fitness to practise registered psychiatric nursing, (ii) counselling or treatment of the member, (iii) monitoring or supervision of the member's practice, (iv) completion by the member of a specified course of studies by way of remedial education, (v) the placement of one or more conditions on the member's ability to practise, which may include the conditions on reinstatement set out in section 106 of the Act; (j) any voluntary surrender of the member's certificate of practice accepted by the complaints investigation committee under section 102 of the Act and, if applicable, any direction given under section 105 of the Act to the member that the member do one or more of the following to the satisfaction of a specified person or committee before the member's certificate of practice may be reinstated: (i) take counselling or receive treatment, (ii) complete a specified course of studies, (iii) obtain supervised experience under a certificate of practice issued with conditions for that purpose; (k) any suspension of the member's registration or certificate of practice as permitted by section 110 or subsection 127(3) of the Act; (l) the name of the facility or location at which the member primarily practises registered psychiatric nursing. What information is available to the public? 2.4(1) The following information must be made available to the public during normal business hours: (a) the information described in clauses 2.3(a) to (d) and (f); (b) the information described in clause 2.3(g), if the member has not had their certificate of practice reinstated or been issued a new certificate of practice; (c) the information described in clause 2.3(h), if the censure was accepted by the member in the current calendar year or the 10 previous calendar years; (d) the information described in subclause 2.3(i)⁠(v), if the undertaking or agreement is in effect; (e) the information about a voluntary surrender described in clause 2.3(j), if the member has not had their certificate of practice reinstated or been issued a new certificate of practice; (f) the information described in clauses 2.3(k) and (l). This information is in addition to the information that must be made available to the public under subsections 28(3) and (4) of the Act. 2.4(2) For greater certainty, clauses (1)⁠(b) to (f) apply, with necessary changes, to all conditions imposed on or accepted by a member under The Registered Psychiatric Nurses Act that were in effect on the day before the coming into force of this regulation. Labour mobility 2.5 For greater certainty, subsection 32(3) of the Act applies to this Part. Registration Requirements Application contents 2.6(1) An applicant for registration as a member must submit to the registrar the following: 1. An application in the approved form. 2. The fees provided for in the by-laws. 3. Satisfactory proof of identity and current legal name. 4. If applicable, evidence of good standing in each jurisdiction in Canada or elsewhere in which the applicant is or has been registered or licensed within the current practice year. 5. If applicable, evidence of good standing in each jurisdiction in Canada or elsewhere in which the applicant has been registered or licensed within the previous seven practice years to practise registered psychiatric nursing or another health profession. 6. A satisfactory criminal record check, child abuse registry check and adult abuse registry check. 7. Evidence that the applicant meets the requirements for registration (a) set out in subsection 32(1) of the Act; and (b) for the applicable membership class as follows (i) registered psychiatric nurse membership in section 2.7, (ii) registered psychiatric nurse (interim practice) membership in section 2.8, (iii) registered psychiatric nurse (temporary practice) membership in section 2.10, (iv) graduate psychiatric nurse membership in section 2.11. 8. Information as to whether (a) the applicant is the subject of a current investigation or proceeding relating to the applicant's suitability to practise a health profession in Canada or elsewhere; (b) the applicant is or has been the subject of a finding of conduct unbecoming or professional misconduct or incompetence related to the practice of a health profession in Canada or elsewhere; (c) the applicant is or has been the subject of a finding of professional negligence or malpractice in Canada or elsewhere; (d) the applicant has current conditions or has had previous conditions placed on the applicant's ability to practise a health profession in Canada or elsewhere; (e) the applicant is or has been the subject of a denial of an application to practise a health profession in Canada or elsewhere; (f) the applicant has a charge, conviction or a finding of guilt (including a conditional discharge, absolute discharge or suspended sentence) for any offence, including a criminal offence or an offence under any narcotic or controlled substances legislation, in any jurisdiction in Canada or elsewhere. 9. Any other information requested by the registrar, including information pertaining to the criminal record check, child abuse registry check or adult abuse registry check provided by the applicant. 2.6(2) As an exception to subsection (1), an applicant for membership in the registered psychiatric nurse (temporary practice) is not required to submit the evidence referred to in item 5 of that subsection. 2.6(3) To apply for registration in another membership class on another subregister or to convert a membership to another class, a member must submit to the registrar the following: 1. An application in the approved form. 2. The fees provided for in the by-laws. 3. Evidence that the member meets the requirements for registration in the other membership class. 4. Any other information requested by the registrar. Registered Psychiatric Nurse Registration requirements 2.7(1) For the purpose of clause 32(1)⁠(g) of the Act, an applicant for registration in the registered psychiatric nurse membership class must establish (a) that the applicant has successfully completed one of the following: (i) an approved psychiatric nursing education program in Manitoba, (ii) a psychiatric nursing education program in any other jurisdiction in Canada that the council considers to be comparable to a psychiatric nursing education program in Manitoba, (iii) a psychiatric nursing education program outside Canada that the council considers to be comparable to a psychiatric nursing education program in Manitoba; (b) that the applicant meets the English proficiency criteria established by the council; (c) that the applicant has passed the registered psychiatric nurse entry-to-practice examination within the period established by the council; (d) that the applicant has done one of the following: (i) the applicant has passed an approved registered psychiatric nurse entry-to-practice examination within the four-year period immediately before the application date, (ii) the applicant has engaged in the practice of registered psychiatric nursing as a registered psychiatric nurse in another jurisdiction for the minimum number of approved practice hours, (iii) the applicant has successfully completed a course of instruction; (e) that the applicant does not have a physical or mental condition or disorder, including an addiction, that may impair the applicant's ability to engage in the practice of registered psychiatric nursing in a safe and effective manner and that makes it desirable in the public interest that the applicant not engage in the practice of registered psychiatric nursing; (f) that the applicant has not previously misrepresented the applicant's status with respect to registration and practice and that the applicant will engage in the practice of registered psychiatric nursing in a manner that demonstrates competency, decency, integrity and honesty and in accordance with the law; and (g) that the applicant has completed the approved jurisprudence learning module. These requirements are in addition to the requirements in subsection 32(1) of the Act. 2.7(2) [Repealed] M.R. 50/2024 2.7(3) An applicant who establishes under subclause (1)⁠(a)⁠(iii) that the applicant has successfully completed a psychiatric nursing education program outside Canada that the council considers to be comparable to a psychiatric nursing education program in Manitoba must also (a) establish that the applicant was registered in good standing or was eligible for registration in the jurisdiction in which the applicant completed that psychiatric nursing education program (unless the registrar determines that due to extenuating circumstances in that jurisdiction the applicant was unable to become registered or is unable to establish that the applicant was registered); (b) establish that the applicant has successfully completed an approved prior learning assessment; and (c) if required by the registrar, establish that the applicant has successfully completed a course of instruction as a result of the assessment under clause (b). 2.7(4) As an exception to clause (1)⁠(c), an applicant for registration as a registered psychiatric nurse is not required to meet the registered psychiatric nurse entry-to-practice examination requirement if the registrar is satisfied that (a) the applicant will be employed as a full-time member of the faculty of psychiatric nursing of a university or college in Manitoba; and (b) based on the applicant's prior learning assessment, the applicant is qualified to engage in the practice of registered psychiatric nursing while carrying out their duties at the university or college. M.R. 50/2024 Registered Psychiatric Nurse (Interim Practice) Registration requirements 2.8(1) An applicant who is authorized to practise as a registered psychiatric nurse in another jurisdiction in Canada and is in good standing in that jurisdiction may be registered in the registered psychiatric nurse (interim practice) membership class if the applicant establishes that they (a) have requested and are waiting to obtain the evidence needed to satisfy the requirement in item 5 of subsection 2.6(1); and (b) meet each of the requirements for registration as a registered psychiatric nurse under subsection 32(1) of the Act and subsection 2.7(1) of this regulation. 2.8(2) A person may be registered in the registered psychiatric nurse (interim practice) membership class for four months. Conversion and cancellation 2.9(1) The registrar may convert a registered psychiatric nurse (interim practice) membership to a registered psychiatric nurse membership after the member meets the requirement in item 5 of subsection 2.6(1). 2.9(2) A registered psychiatric nurse (interim practice) membership may be cancelled if the registrar determines based on the evidence obtained under item 5 of subsection 2.6(1) that the member does not meet the requirements for registration in the registered psychiatric nurse membership class. Registered Psychiatric Nurse (Temporary Practice) Registration requirements 2.10(1) An applicant for registration in the registered psychiatric nurse (temporary practice) membership class must (a) establish that the applicant is authorized to practise registered psychiatric nursing as a registered psychiatric nurse in another jurisdiction in Canada and is in good standing in that jurisdiction; (b) establish that the applicant meets the requirements for registration under subsection 32(1) of the Act and subsection 2.7(1) of this regulation other than clause (g); and (c) submit to the registrar a signed declaration that the applicant will engage in the practice of registered psychiatric nursing for no more than four months and only for one or more of the following purposes: (i) to conduct or participate in a training course or clinical presentation related to the practice of registered psychiatric nursing, (ii) to conduct or engage in a research program related to the practice of registered psychiatric nursing, (iii) to demonstrate equipment or techniques to be used in clinical care related to the practice of registered psychiatric nursing, (iv) to engage in the practice of registered psychiatric nursing for any other approved purpose. 2.10(2) A person may be registered in the registered psychiatric nurse (temporary practice) membership class for four months. 2.10(3) Despite subsection (2), the registrar may, upon application, renew the membership of a registered psychiatric nurse (temporary practice) for a second consecutive four-month period if the registered psychiatric nurse (temporary practice) establishes that the extension is required to continue to engage in the practice of registered psychiatric nursing as specified in the signed declaration. The registered psychiatric nurse (temporary practice) must submit another signed declaration in respect of the extension. 2.10(4) The registrar must promptly give the registered psychiatric nurse (temporary practice) written notice of a renewal decision under subsection (3) and, if denied or renewed with conditions, notice of the right to appeal that decision to the council. 2.10(5) After receiving the notice under subsection (4), the registered psychiatric nurse (temporary practice) may appeal the registrar's decision not to renew the membership or to renew it subject to conditions to the council. Sections 38 and 39 of the Act apply, with necessary changes, to the appeal. 2.10(6) A registration in the registered psychiatric nurse (temporary practice) membership class is cancelled when the membership period ends. 2.10(7) A registered psychiatric nurse (temporary practice) membership may be cancelled if the registrar determines that the member engaged in the practice of registered psychiatric nursing for a purpose other than the one specified in the registered psychiatric nurse's signed declaration. Graduate Psychiatric Nurse Registration requirements 2.11(1) An applicant who meets the requirements for registration under subsection 32(1) of the Act and subsection 2.7(1) of this regulation except for clause (c) may be registered in the graduate psychiatric nurse membership class if the applicant establishes that they (a) are scheduled to take the registered psychiatric nurse entry-to-practice examination; or (b) have taken the registered psychiatric nurse entry-to-practice examination but have not yet received notice of the examination results. 2.11(2) A person may be registered in the graduate psychiatric nurse membership class for the period established by the council. 2.11(3) Despite subsection (2), the registrar may, upon application, renew a graduate psychiatric nurse's membership for a second consecutive period established by the council if the graduate psychiatric nurse establishes that they (a) have taken the registered psychiatric nurse entry-to-practice examination for the first time but have not yet received notice of the first examination results; or (b) are scheduled to take the registered psychiatric nurse entry-to-practice a second time. 2.11(4) A membership that is renewed under subsection (3) may be further renewed by the registrar, upon application, for a third consecutive period established by the council if the graduate psychiatric nurse establishes that they have taken the registered psychiatric nurse entry-to-practice examination for the second time but have not yet received notice of the examination results. 2.11(5) The registrar must promptly give the graduate psychiatric nurse written notice of a renewal decision under subsection (3) or (4) and, if denied or renewed with conditions, notice of the right to appeal that decision to the council. Appeal 2.12 After receiving the notice under subsection 2.11(5), the graduate psychiatric nurse may appeal the registrar's decision not to renew the membership or to renew it subject to conditions to the council. Sections 38 and 39 of the Act apply, with necessary changes, to the appeal. Cancellation 2.13(1) A registration in the graduate psychiatric nurse membership class is cancelled (a) 30 days after the college receives notice of the member's registered psychiatric nurse entry-to-practice examination results; or (b) when the membership period ends; whichever is earlier. 2.13(2) Despite subsection (1), a registration in the graduate psychiatric nurse membership class is cancelled 24 hours after the college receives notice of the member's failure to pass the registered psychiatric nurse entry-to-practice examination a second time. CERTIFICATE OF PRACTICE Issuing a Certificate of Practice Requirements for issuing a certificate of practice 2.14(1) To engage in the practice of registered psychiatric nursing, a member must submit an application in a satisfactory form to obtain a certificate of practice and must (a) meet the requirements set out in subsection 40(1) of the Act; (b) meet the requirements in subsection 32(1) of the Act and, depending on the applicant's membership class, the requirements for (i) registered psychiatric nurse membership set out in section 2.7, (ii) registered psychiatric nurse (interim practice) membership set out in section 2.8, (iii) registered psychiatric nurse (temporary practice) set out in section 2.10, (iv) graduate psychiatric nurse membership set out in section 2.11; (c) provide satisfactory evidence of the member's beneficiary status with the Canadian Nurses Protective Society. 2.14(2) The registrar may request additional information from the applicant for the purpose of issuing the certificate of practice. 2.14(3) This section is subject to the obligations of the college under subsection 3(1) of The Labour Mobility Act . 2.14(4) For greater certainty, a certificate of practice is issued subject to any conditions imposed on the member's certificate of registration. Registered Psychiatric Nurse (Authorized Prescriber) Additional requirements for registered psychiatric nurse (authorized prescriber) 2.15(1) To obtain the notation "(authorized prescriber)" on a registered psychiatric nurse's certificate of practice, the member must establish that the member has (a) successfully completed (i) a course of instruction, or (ii) an approved prior learning assessment and, if required by the results of the assessment, a course of instruction in the approved competencies for practise as a registered psychiatric nurse (authorized prescriber); and (b) obtained approval from the registrar to practise as a registered psychiatric nurse (authorized prescriber) for the patient populations that require registered psychiatric nursing care in any of the following areas: (i) reproductive health, sexually transmitted infections and blood borne pathogens, (ii) diabetes health. 2.15(2) If the requirements in subsection (1) are met, the registrar must include the notation "(authorized prescriber)" and indicate the approved patient population on the member's certificate of practice. 2.15(3) A registered psychiatric nurse (authorized prescriber) with an approved patient population for diabetes health may practise as such only in (a) collaboration with a physician or registered nurse (nurse practitioner); or (b) any of the following settings: (i) a hospital designated under The Health Services Insurance Act , (ii) a personal care home designated under The Health Services Insurance Act , (iii) a hospital or health care facility operated by the government, the government of Canada, a municipal government, a health authority or a First Nation, (iv) a setting other than a hospital or health care facility described in subclause (iii) if the registered psychiatric nursing care provided at that setting is part of a program operated by the government, the government of Canada or a health authority, (v) a health care facility that is operated by a non-profit corporation and is funded by the government or a health authority, (vi) a residential treatment centre. 2.15(4) A registered psychiatric nurse (authorized prescriber) with an approved patient population for diabetes health may prescribe the following devices: (a) glucometers; (b) glucose test strips; (c) lancets; (d) lancing pen devices; (e) lancing pen needles; (f) insulin syringes; (g) urine ketone strips. 2.15(5) A registered psychiatric nurse (authorized prescriber) with an approved patient population for reproductive health, sexually transmitted infections and blood borne pathogens may prescribe a diaphragm. M.R. 50/2024 Renewing a Certificate of Practice Renewal requirements 2.16(1) For the purpose of clause 46(1)⁠(c) of the Act, the requirements for renewal of a certificate of practice are as follows: (a) the member must meet the requirements under clause 40(1)⁠(a) and subsection 46(1) of the Act; (b) the member must meet the requirements in clauses 32(1)⁠(c) to (e) of the Act and, depending on the membership class, the requirements for (i) registered psychiatric nurse membership set out in clauses 2.7(1)⁠(e) and (f), (ii) registered psychiatric nurse (temporary practice) membership set out in section 2.10, or (iii) graduate psychiatric nurse membership set out in section 2.11; (c) the member (other than a member registered in a temporary practice membership class) must complete the continuing competency program; (d) the member must complete any other requirements established in the practice directions; (e) if the member is registered in the registered psychiatric nurse membership class, the member must establish (i) that the member has engaged in the practice of registered psychiatric nursing as a registered psychiatric nurse for a minimum of 1,400 hours within the five-year period immediately before the year for which the renewal is sought, or (ii) that the member has (A) successfully completed a course of instruction, or (B) passed the registered psychiatric nurse entry-to-practice examination, within the four-year period immediately before the year for which renewal is sought; (f) the member must provide satisfactory evidence of the member's beneficiary status with the Canadian Nurses Protective Society; (g) the member must provide any other information requested by the registrar. 2.16(2) Every fifth year, a member must also provide the registrar with a satisfactory criminal record check, child abuse registry check and adult abuse registry check at the time of renewing their certificate of practice. The registrar may request additional information respecting the criminal record check, child abuse registry check and adult abuse registry check provided by the member. Continuing Competency Program Continuing competency program 2.17 The continuing competency program consists of (a) the completion of a jurisprudence learning module that includes an evaluation component; (b) the undertaking of a self-assessment process; and (c) the preparation and implementation of a self-development plan. Records 2.18(1) A member must make records in a satisfactory form that indicate that the member has complied with the continuing competency program. The records must be kept for the current year and each of the immediately four preceding practice years. 2.18(2) Upon the registrar's request, a member must submit the member's records. The registrar may request additional information or supporting documentation from the member about the member's continuing competency. Continuing competency committee 2.19 A continuing competency committee is comprised of at least six individuals who meet the eligibility criteria established by the council. At least 1/3 of the individuals must be public representatives. Review 2.20(1) A member may be required by the continuing competency committee to undergo a continuing competency review in any of the following circumstances: (a) the member fails to meet the requirement under clause 2.17(b); (b) the member fails to make and keep the required records; (c) the member is randomly or specifically selected to participate in the review. 2.20(2) After completing the review, the continuing competency committee may (a) decide that no further action is required; (b) direct the member to take any action it considers necessary to address any issue identified in the member's review; or (c) refer the member to the registrar if the committee considers it necessary to address any issue identified in the review. 2.20(3) The member must report to the continuing competency committee about the member's progress with respect to any action directed by the committee under clause (2)⁠(b). Notifying the registrar 2.21(1) If the continuing competency committee is of the opinion that the member has not remedied any identified issue under clause 2.20(2)⁠(b), the committee must notify the registrar and may make recommendations to the registrar. 2.21(2) Before making a recommendation to the registrar, the continuing competency committee must give the member (a) written notice of its intention to make the recommendation; (b) a copy of the documentation and information considered by the committee in making the recommendation; and (c) at least 15 calendar days to make written submissions to the committee. Report conduct to the registrar 2.22 The continuing competency committee may report to the registrar that the conduct of a member may constitute conduct about which a finding could be made under subsection 124(2) of the Act. If it makes such a report, the committee must take no further action in respect of the member's conduct. Professional Liability Protection or Insurance Professional liability protection or insurance 2.23(1) A member who holds a valid certificate of practice must obtain and maintain professional liability protection or liability insurance for a minimum of $5 million for each occurrence or claim with a minimum aggregate amount for each year of $5 million (a) as a beneficiary of the Canadian Nurses Protective Society; or (b) under a policy of professional liability insurance of an approved type if the Canadian Nurses Protective Society is unable to provide the protection or the member is ineligible for the Canadian Nurses Protective Society's professional liability protection. 2.23(2) The member must immediately notify the registrar if the member is no longer eligible for the Canadian Nurses Protective Society professional liability protection or covered by the liability insurance. 2.23(3) If the member is no longer eligible for the required liability protection or covered by the liability insurance, the member's certificate of practice is cancelled. At the time of notifying the registrar under subsection (2), the member must also promptly surrender the certificate of practice to the registrar. Conditions and Obligations Conditions on a certificate of practice 2.24(1) It is a condition of the certificate of practice for a member registered in the registered psychiatric nurse (temporary practice) membership class that the member engage in the practice of registered psychiatric nursing only in accordance with the purpose for which registration has been granted. 2.24(2) The following are conditions of the certificate of practice for a member registered in the graduate psychiatric nurse membership class: (a) the member is not permitted to engage in the practice of registered psychiatric nursing as the nurse in charge of a unit in a health care facility; (b) the member is not permitted to engage in the practice of registered psychiatric nursing without a registered psychiatric nurse or registered nurse being readily available for guidance and consultation. 2.24(3) It is a condition of the certificate of practice of a member who is registered as a result of meeting the requirements under subsection 2.7(4) that the member (a) must not engage in the practice of registered psychiatric nursing outside of the member's employment as a full-time faculty member; and (b) must not (i) provide direct clinical care to a client, (ii) supervise or guide the provision of direct clinical care to a client, or (iii) delegate a reserved act. 2.24(4) The conditions set out in this section are in addition to any other conditions imposed on a member's certificate of registration or certificate of practice. Change in information 2.25 A member who holds a valid certificate of practice must promptly submit any change in the information referred to in items 3 to 9 of subsection 2.6(1) to the registrar. Additional checks 2.26(1) If at any time the registrar receives information that causes the registrar to believe that a member may pose a risk to the public or may be unable to engage in the practice of registered psychiatric nursing, the registrar may require the member to provide an additional satisfactory criminal record check, child abuse registry check or adult abuse registry check. 2.26(2) The registrar may request additional information respecting the criminal record check, child abuse registry check or adult abuse registry check provided by a member under subsection (1). Expiry, Conversion and Cancellation Expiry of certificate 2.27(1) Subject to subsection 46(3) of the Act, a certificate of practice is valid from the date it is issued or renewed until the expiry date specified on the certificate. 2.27(2) Despite subsection (1), a certificate of practice is no longer valid if the member ceases to be registered as a member. Conversion 2.28 A member's certificate of practice is converted when the member's registration is converted. Cancellation 2.29 A member's certificate of practice is cancelled when the member's registration is cancelled. TITLES Titles and abbreviations 2.30(1) While engaged in the practice of registered psychiatric nursing, a member who is registered in the class listed in the first column of the following table and who holds a valid certificate of practice is entitled to use the title and abbreviation set out opposite in the second column. Column 1 Membership class Column 2 Title and abbreviation registered psychiatric nurse Registered Psychiatric Nurse RPN registered psychiatric nurse who also meets the authorized prescriber requirements set out in subsection 2.15(1) Registered Psychiatric Nurse (authorized prescriber) RPN (AP) registered psychiatric nurse (interim practice) Registered Psychiatric Nurse (interim) RPN (interim) registered psychiatric nurse (temporary practice) Registered Psychiatric Nurse (temporary) RPN (temporary) graduate psychiatric nurse Graduate Psychiatric Nurse GPsyN 2.30(2) No person — other than a person who is registered in a membership class listed in the first column of the table in subsection (1) and who holds a valid certificate of practice — shall use any title or abbreviation listed in the second column of the table in that subsection or a variation of any of those titles and abbreviations alone or in combination with other words, in a manner that states or implies that the person is a member of that membership class. Use of term "licensed" restricted to practising members 2.31 Only a member who holds a valid certificate of practice is entitled to use the term "licensed" or a variation or abbreviation of it to describe the member's practice of registered psychiatric nursing. Practising in Manitoba for No More than 72 hours Registration or certificate of practice not required 2.32(1) A person who engages in the practice of registered psychiatric nursing in a jurisdiction within Canada may practise in Manitoba without being registered under the Act or obtaining a certificate of practice if the following conditions are met: (a) the person holds a current authorization to practise registered psychiatric nursing and is in good standing in that jurisdiction; (b) the person undertakes to engage in the practice of registered psychiatric nursing in Manitoba for no more than 72 hours; (c) the person undertakes to engage in the practice of registered psychiatric nursing only in the approved circumstances. 2.32(2) Subsection 2.30(2) does not apply to a person who engages in the practice of registered psychiatric nursing in Manitoba in accordance with this section. 2.32(3) Upon request, the registrar may permit a person to engage in the practice of registered psychiatric nursing in Manitoba for a specified period that is more than 72 hours. PART 3 RESERVED ACTS Overview 3.1 This Part sets out which reserved acts may be performed by a member of a membership class and under what conditions. It also includes the rules for delegating the performance of reserved acts to others and the supervision of students. (The reserved acts that form part of the scope of practice of registered psychiatric nursing are established by the Practice of Registered Psychiatric Nursing Regulation .) Definitions 3.2 The following definitions apply in this Part. "additional education" means a course, program of study, training or other structured process that meets the approved criteria and whose purpose is to provide a member with the competency to perform a reserved act. (« formation complémentaire ») "an order" means an instruction or authorization for a specific client that is given to a member to perform a reserved act by (a) a registered nurse (nurse practitioner); (b) a registered nurse (authorized prescriber) or registered psychiatric nurse (authorized prescriber); (c) a physician; or (d) any other person who engages in health care as a practising member of a health profession regulated under the Act or a profession-specific Act listed in Schedule 2 of the Act; who is legally permitted and competent to give the order. (« ordre ») "approved practice setting" means any of the following: (a) a hospital designated under The Health Services Insurance Act ; (b) a personal care home designated under The Health Services Insurance Act ; (c) a hospital or health care facility operated by the government, the government of Canada, a municipal government, a health authority or a First Nation; (d) a setting other than a hospital or health care facility described in subclause (c) if the registered psychiatric nursing care provided at that setting is part of a program operated by the government, the government of Canada or a health authority; (e) a health care facility that is operated by a non-profit corporation and is funded by the government or a health authority; (f) a residential treatment centre. (« environnement autorisé d'exercice de la profession ») "clinical assistant" means a person who is registered on the clinical assistant register of the College of Physicians and Surgeons of Manitoba. (« assistant médical ») "clinical decision tool" means a document whose purpose is to guide, based on evidence, the assessment, diagnosis or treatment of a client-specific clinical problem. (« outils de décision clinique ») "graduate psychiatric nurse" means a person who is registered in the graduate psychiatric nurse membership class and who holds a valid certificate of practice. (« infirmier psychiatrique diplômé ») "physician assistant" means a person who is registered on the physician assistant register of the College of Physicians and Surgeons of Manitoba. (« auxiliaire médical ») "registered psychiatric nurse" means a person who is registered in the registered psychiatric nurse membership class and who holds a valid certificate of practice. (« infirmier psychiatrique ») "registered psychiatric nurse (interim practice)" means a person who is registered in the registered psychiatric nurse (interim practice) membership class and who holds a valid certificate of practice. (« infirmier psychiatrique (exercice provisoire) ») "registered psychiatric nurse (temporary practice)" means a person who is registered in the registered psychiatric nurse (temporary practice) membership class and who holds a valid certificate of practice. (« infirmier psychiatrique (exercice temporaire) ») M.R. 50/2024 Performing reserved acts 3.3 A member may perform a reserved act only if the member is legally permitted and competent to perform it and it is safe and appropriate for the procedure being performed. Reserved acts — registered psychiatric nurse 3.4 A registered psychiatric nurse may perform the following reserved acts: 1. reserved act 1: A registered psychiatric nurse may make a diagnosis that is appropriate to the registered psychiatric nurse's practice and communicate it to an individual or the individual's representative in circumstances in which it is reasonably foreseeable that the individual or representative will rely on the diagnosis to make a decision about the individual's health care. 2. reserved act 2: A registered psychiatric nurse may (a) order; or (b) receive; reports of screening or diagnostic tests for the purpose of assessing, diagnosing or resolving a health condition that is appropriate to the registered psychiatric nurse's practice if the registered psychiatric nurse practises in an approved practice setting and the registered psychiatric nurse (c) uses a clinical decision tool in place at the approved practice setting; or (d) collaborates with (i) a registered nurse (nurse practitioner), (ii) a registered nurse (authorized prescriber), (iii) a registered psychiatric nurse (authorized prescriber), (iv) a physician, (v) a physician assistant, (vi) a clinical assistant, or (vii) a pharmacist, who is legally permitted and competent to order or receive those reports. 3. reserved act 3(a): Subject to item 4, a registered psychiatric nurse may perform any procedure on tissue below the dermis. 4. reserved act 3(a): If a registered psychiatric nurse has completed additional education, the registered psychiatric nurse may perform a procedure on tissue below the dermis for the following purposes: (a) sharp wound debridement; (b) suturing; (c) venipuncture; (d) establishing intravenous access. 5. reserved Act 3(b): A registered psychiatric nurse may perform a procedure on tissue below the surface of the mucous membrane. 6. reserved Act 3(c): If a registered psychiatric nurse has completed additional education, the registered psychiatric nurse may perform a procedure on the surface of the cornea for the purpose of fluorescein staining. 7. reserved act 4(a): A registered psychiatric nurse may insert or remove an instrument or a device, hand or finger into the external ear canal. 8. reserved Act 4(b): A registered psychiatric nurse may insert or remove an instrument or a device, hand or finger beyond the point in the nasal passages where they normally narrow. 9. reserved act 4(c): Subject to item 10, a registered psychiatric nurse may insert or remove an instrument or a device, hand or finger beyond the pharynx. 10. reserved act 4(c):

If a registered psychiatric nurse has completed additional education, the registered psychiatric nurse may insert or remove an instrument or a device, hand or finger beyond the pharynx for the purpose of establishing an advanced airway. 11. reserved Act 4(d): A registered psychiatric nurse may insert or remove an instrument or a device, hand or finger beyond the opening of the urethra. 12. reserved act 4(e): Subject to item 13, a registered psychiatric nurse may insert or remove an instrument or a device, hand or finger beyond the labia majora. 13. reserved Act 4(e): If a registered psychiatric nurse has completed additional education, the registered psychiatric nurse may insert or remove an instrument or a device, hand or finger beyond the labia majora for the purposes of cervical cancer screening or pelvic examination. 14. reserved act 4(f): A registered psychiatric nurse may insert or remove an instrument or a device, hand or finger beyond the anal verge. 15. reserved Act 4(g): A registered psychiatric nurse may insert or remove an instrument or a device, hand or finger into an artificial opening in the body. 16. reserved Act 5(a): A registered psychiatric nurse may administer a substance by injection. 17. reserved Act 5(b): A registered psychiatric nurse may administer a substance by inhalation. 18. reserved Act 5(c): A registered psychiatric nurse may administer a substance by mechanical ventilation. 19. reserved Act 5(d): A registered psychiatric nurse may administer a substance by irrigation. 20. reserved act 5(e): A registered psychiatric nurse may administer a substance by enteral instillation. 21. reserved act 5(e): A registered psychiatric nurse may administer normal saline by parenteral instillation. 22. reserved act 5(e): If there is an order, a registered psychiatric nurse may administer a substance (other than normal saline) by parenteral instillation. 23. reserved act 5(f): If a registered psychiatric nurse has completed additional education and there is an order, a registered psychiatric nurse may administer a substance by transfusion. 24. reserved act 9: A registered psychiatric nurse may administer a drug, except a vaccine, by any method (except by intravitreal injection) in any of the following circumstances: (a) there is an order for the drug to be administered; (b) the drug is a non-prescription drug. 24.1. reserved act 9: A registered psychiatric nurse may administer a drug by any method for the treatment of uncomplicated gonorrhea, chlamydia and syphilis if the registered psychiatric nurse (a) provides communicable disease nursing care in a hospital or health care facility operated by a health authority, the government, the government of Canada or a First Nation or in another practice setting as part of a communicable disease response program funded by a health authority, the government, the government of Canada or a First Nation; (b) uses a clinical decision tool in place in the practice setting referred to in clause (a); and (c) administers the drug in accordance with a protocol for controlling communicable disease approved by the chief public health officer appointed under The Public Health Act . 25. reserved act 9: A registered psychiatric nurse may administer a vaccine by any method in accordance with the provincial requirements in any of the following circumstances: (a) the vaccine is included in a publicly-funded provincial immunization program; (b) the vaccine is required as part of a communicable disease response; (c) there is an order for the vaccine to be administered. 26. reserved act 10(a): A registered psychiatric nurse may apply ultrasound for the purpose of bladder volume measurement. 27. reserved act 10(a): If a registered psychiatric nurse has completed additional education and there is an order, a registered psychiatric nurse may apply ultrasound for the following purposes: (a) blood flow imaging; (b) fetal heart monitoring. 28. reserved act 10(b)⁠(iv): If a registered psychiatric nurse has completed additional education and there is an order, the registered psychiatric nurse may apply electricity for the purpose of defibrillation. 29. reserved act 10(b)⁠(vi): If a registered psychiatric nurse has completed additional education and there is an order, the registered psychiatric nurse may apply electricity for the purpose of electroconvulsive shock therapy. 30. reserved act 10(b)⁠(x): If a registered psychiatric nurse has completed additional education and there is an order, the registered psychiatric nurse may apply electricity for the purpose of transcutaneous cardiac pacing. 31. reserved act 10(e): A registered psychiatric nurse may order X-rays for the purpose of diagnosing a health condition or fracture that is appropriate to the registered psychiatric nurse's practice if the registered psychiatric nurse practises in an approved setting and the registered psychiatric nurse (a) uses a clinical decision tool in place at the approved practice setting; or (b) collaborates with (i) a registered nurse (nurse practitioner), (ii) a registered nurse (authorized prescriber), (iii) a registered psychiatric nurse (authorized prescriber), (iv) a physician, (v) a physician assistant, or (vi) a clinical assistant; who is legally permitted and competent to order X-rays. 32. reserved act 11(a): In relation to a therapeutic diet that is administered by parenteral instillation, a registered psychiatric nurse may select ingredients for the diet if the registered psychiatric nurse has completed additional education and the registered psychiatric nurse collaborates with (i) a registered dietitian, (ii) a registered nurse (nurse practitioner), or (iii) a physician; who is legally permitted and competent to select ingredients for the diet. 33. reserved act 11(b): In relation to a therapeutic diet that is administered by parenteral instillation, a registered psychiatric nurse may administer the diet if there is an order. 34. reserved act 11(b): In relation to a therapeutic diet that is administered by enteral instillation, a registered psychiatric nurse may compound or administer the diet if there is an order. 35. reserved act 13(a): A registered psychiatric nurse may put into the external ear canal, up to the eardrum, water that is under pressure equal to or less than the pressure created by the use of an ear bulb syringe or ear wash system. 36. reserved act 20: A registered psychiatric nurse may perform a psycho-social intervention with an expectation of modifying a substantial disorder of thought, mood, perception, orientation or memory that grossly impairs judgment, behaviour, the capacity to recognize reality, or the ability to meet the ordinary demands of life if the registered psychiatric nurse collaborates with a person who engages in health care as a practising member of a health profession regulated under the Act or a profession-specific Act listed in Schedule 2 of the Act and who is legally permitted and competent to perform it. M.R. 50/2024 Reserved acts — registered psychiatric nurse (interim practice) 3.5 A registered psychiatric nurse (interim practice) may perform a reserved act as set out in section 3.4. Reserved acts — registered psychiatric nurse (temporary practice) 3.6 A registered psychiatric nurse (temporary practice) may perform a reserved act as set out in section 3.4 only if the act relates to the purpose for which the registered psychiatric nurse has been granted registration in this membership class. Reserved acts — graduate psychiatric nurse 3.7 A graduate psychiatric nurse may perform a reserved act as set out in section 3.4 if the graduate psychiatric nurse is supervised by a registered psychiatric nurse, registered nurse or registered nurse (nurse practitioner) who is legally permitted and competent to perform the reserved act and is readily available and accessible for guidance and consultation, including by telephone. Reserved acts — registered psychiatric nurse (authorized prescriber) 3.8(1) A registered psychiatric nurse (authorized prescriber) may perform a reserved act as set out in section 3.4. 3.8(2) A registered psychiatric nurse (authorized prescriber) may also perform the following reserved acts in respect of the registered psychiatric nurse's approved patient population: 1. reserved act 1: A registered psychiatric nurse (authorized prescriber) may make a diagnosis that is appropriate to the member's practice as a registered psychiatric nurse (authorized prescriber) and communicate it to an individual or the individual's personal representative in circumstances in which it is reasonably foreseeable that the individual or representative will rely on the diagnosis to make a decision about the individual's health care. 2. reserved act 2: A registered psychiatric nurse (authorized prescriber) may order or receive reports of screening or diagnostic tests listed in the Schedule. 3. reserved act 6: A registered psychiatric nurse (authorized prescriber) may (a) prescribe a drug or vaccine listed in the Schedule; or (b) prescribe a drug or vaccine belonging to a category listed in the Schedule. 4. reserved act 10: A registered psychiatric nurse (authorized prescriber) may order the application of renal ultrasound for diagnostic or imaging purposes. Practice setting policies 3.9 A member must comply with any policy respecting the performance of a reserved act that is in place in the practice setting where the member performs that act if (a) the member has been made aware of the policy; and (b) the policy is not inconsistent with the Act or the college's regulations, by-laws, practice directions, standards of practice or code of ethics. DELEGATION Delegating a reserved act 3.10(1) A member may delegate the performance of a reserved act listed in subsection (2) to a person referred to in clause 6(1)⁠(c) of the Act only if the member (a) is legally permitted and competent to perform the reserved act; (b) is satisfied on reasonable grounds that the person accepting the delegation is competent to perform the reserved act; (c) is satisfied on reasonable grounds that it is safe and appropriate for the person accepting the delegation to perform the reserved act; and (d) is readily available for consultation while the person accepting the delegation performs the reserved act. 3.10(2) For the purpose of subsection (1), the following reserved acts are listed: 1. reserved act 3(a): performing a procedure on tissue below the dermis other than those procedures referred to in item 4 of section 3.4. 2. reserved act 3(b): performing a procedure below the surface of a mucous membrane. 3. reserved act 4(a): inserting or removing an instrument or device, hand or finger into the external ear canal. 4. reserved act 4(e): inserting or removing an instrument or device, hand or finger beyond the labia majora other than for the purpose of cervical cancer screening or pelvic examination. 5. reserved act 4(f): inserting or removing an instrument or device, hand or finger beyond the anal verge. 6. reserved act 4(g): inserting or removing an instrument or device, hand or finger into an artificial opening in the body. 7. reserved act 5(b): administering a substance by inhalation. 8. reserved act 5(d): administering a substance by irrigation. 9. reserved act 5(e): administering a substance by enteral instillation. 10. reserved act 9: administering a drug by a method specified in the practice directions. 11. reserved act 11: compounding or administering a therapeutic diet that is administered by enteral instillation. 3.10(3) For the purpose of subsection (1), a person referred to in clause 6(1)⁠(c) of the Act is considered to be competent to perform a reserved act if they have the requisite skill, knowledge and judgment to perform the act. 3.10(4) A delegation to perform a reserved act must not be further delegated. SUPERVISION OF STUDENTS Supervising students 3.11(1) A member may supervise the performance of a reserved act by (a) a person who is enrolled in an approved psychiatric nursing education program; (b) a person who is enrolled in an education program of another regulated health profession; or (c) a person who is (i) an applicant for registration in the registered psychiatric nurse membership class, and (ii) enrolled or plans to enroll in a course of instruction that the registrar requires the person to successfully complete in order to be registered in the registered psychiatric nurse membership class; only if the member is legally permitted and competent to perform the reserved act. 3.11(2) The member must be physically present and available to assist while the person performs the reserved act. 3.11(3) Despite subsection (2), the member does not need to be physically present if the member determines that the person does not require that level of supervision. But the member must be available for consultation while the individual performs the reserved act. M.R. 155/2023 PART 4 STANDARDS OF PRACTICE Definitions 4.1(1) The following definitions apply in this Part. "client record" means a record containing the information described in section 4.6. (« dossier du client ») "health care professional" means a person who engages in health care as a practising member of a health profession regulated under the Act or profession-specific Act listed in Schedule 2 of the Act. (« professionnel de la santé ») "nursing care" means the health care that a member provides in the course of their practice of registered psychiatric nursing. (« soins infirmiers ») "representative" means a person referred to in section 60 of The Personal Health Information Act . (« représentant ») 4.1(2) In addition to this Part, a member must meet the Standards of Psychiatric Nursing Practice as established by the council. PRACTICE Client-centred practice 4.2(1) A member may engage in the practice of registered psychiatric nursing only if the member is legally permitted, competent and fit to do so. A member must acknowledge their limitations in skill, knowledge and judgment and must ensure that they practise registered psychiatric nursing within those limitations. 4.2(2) The practice of registered psychiatric nursing encompasses a number of domains such as clinical practice, education, administration and research. A client of a member may be an individual, a family, a group of people, a community or a population. Depending on the member's domain or domains of practice, a client may be a patient, a nursing student, a research participant or another member or health care provider. 4.2(3) When engaging in the practice of registered psychiatric nursing, a member must apply, as a framework, the nursing process, which is the systematic approach to the practice that encompasses all steps taken by the member in planning for the needs of the member's client, including assessment, diagnosis or determination, planning, implementation and evaluation. 4.2(4) The principles of client-centred practice in a clinical practice setting also apply to the practice of registered psychiatric nursing in the other domains such as, education, administration and research. 4.2(5) When engaging in the practice of registered psychiatric nursing in a clinical practice setting, a member must provide nursing care that includes (a) an assessment to determine the needs and circumstances of the client; (b) a care or treatment plan with the client or the client's representative and any other person who the client wishes to involve that takes into account the client's needs, circumstances, preferences, values, abilities and culture; (c) an evaluation of the outcomes of the care or treatment plan and the modification or discontinuance of the care or treatment plan as required and as discussed with the client or the client's representative; (d) sufficient and timely communication with the client or the client's representative that takes into account the client's needs, circumstances, understanding and use of health information and enables the client or the client's representative to make informed decisions about the client's health care; (e) a referral of the client to another member or health care professional when appropriate; and (f) support for the client in self-management of their health care by way of the provision of information, resources and referrals to enable informed decision making by the client or the client's representative. Collaborative care 4.3(1) When a member is involved in providing for the health care of a client, the member must (a) work collaboratively and cooperatively with clients, families and other health care providers in providing for the health care of the client and communicate effectively and appropriately with them; (b) ensure that they understand their role and the role of the other health care providers in providing for the health care of the client; (c) explain to the client or the client's representative the member's role and responsibility; (d) comply with any collaborative care decision tool in place at the practice setting where the member and other health care providers are providing for the health care of the client; (e) give the member's full name and designation of membership class to the client, the client's representative and any other person involved in the client's health care; (f) treat other health care providers with respect; and (g) recognize the skills, knowledge and roles of others involved in the client's care. 4.3(2) A member must document on the client record the nursing care provided by the member with enough information for another member or health care professional to be sufficiently informed of the care provided. Follow-up to diagnosis and test results 4.4(1) A member who orders a diagnostic test or makes a referral must have a system in place to review the test results and the results of referrals and have reasonable arrangements in place to follow-up with the client. 4.4(2) A member who orders a diagnostic test and directs a copy of the result to another member or health care professional remains responsible for any follow-up care required unless the member to whom the copy of the results is directed has agreed to accept responsibility for the client's follow-up care. Practice environment 4.5 In providing nursing care, a member must demonstrate procedures that safeguard the hygiene and sanitation of the practice environment and the hygiene and sanitation of the equipment used in that nursing care. Client records 4.6(1) A member must appropriately document the nursing care provided by the member in a record specific to each client. 4.6(2) A member must document the nursing care provided by the member in the client's record as the nursing care is provided or as soon as possible after the care is provided. SELF-EMPLOYED PRACTICE Application 4.7 Sections 4.8 to 4.14 apply only to a member who provides nursing care by way of self-employed practice. Accepting clients in self-employed practice 4.8(1) If a member restricts or selects clients for the member's practice or has a practice that is closed to new clients, the member must establish criteria for restricting or selecting the acceptance of clients. The criteria must be relevant to the member's competence in the restricted or selected area of practice, the nursing care to be provided by the member and the client's health care needs. 4.8(2) On request, the member must give a prospective client a written copy of the restrictions or selection criteria. 4.8(3) In special or exceptional circumstances, the member may accept as a client a person who does not meet the criteria or falls outside the restrictions for accepting clients established under subsection (1). 4.8(4) If a member meets with a prospective client and does not accept them as a client, the member must explain the reason to the person unless disclosure of the reason could, in the member's opinion, be reasonably expected to (a) threaten the person's mental or physical health or safety; (b) threaten another person's mental health or physical health or safety; or (c) pose a threat to public safety. Prohibited grounds for refusing clients 4.9 A member must not refuse to accept a person as a client because (a) the nursing care required could or will be complex, unless the care the client requires is beyond the competency of the member; (b) the nursing care will or is likely to require the member to complete more documentation than is required for other clients; or (c) the nursing care required will or may take the member more time than is required for other clients. Ending client relationship 4.10(1) A member who ends a professional relationship with a client must give notice to the client or the client's representative, have reasonable grounds for doing so and must document those reasons on the client record. 4.10(2) A member must not end a professional relationship with a client because the nursing care required by the client (a) is or will be complex, unless the care the client requires is beyond the competence of the member; (b) requires the member to complete documentation in addition to the client record; or (c) takes the member more time to provide than is required for the member's other clients. 4.10(3) Despite subsection (2), a member may immediately terminate a professional relationship with a client if (a) the client poses a safety risk to the office staff, other clients or the member; (b) the client is abusive to the office staff, other clients or the member; (c) the client does not respect professional boundaries or acts in an inappropriate manner; or (d) the member is leaving the practice of registered psychiatric nursing because of personal illness or other urgent circumstances. The member must document on the client record the reason for terminating the relationship. Notice of required payment 4.11 Before providing nursing care, the member must notify the client of any fee or charge the client will be required to pay for that care. Client records retention 4.12(1) A client record must be retained by the member having last custody of the record for at least 10 years after the date of the last entry on the record and the client records of minors must be retained for at least 10 years after the date the minor becomes 18 years old. 4.12(2) If a client or the client's representative requests a member to transfer client records to another member, the requested member must ensure that the request is completed as promptly as required in the circumstances but not later than 30 days after the member receives the request. 4.12(3) The obligations under this section are in addition to any other requirements relating to client records under the Act, The Personal Health Information Act and any other enactment, by-law, standard of practice, code of ethics and practice direction with which a member must comply. Closing, leaving or moving a self-employed practice 4.13(1) A member must give to the member's clients or their representatives and the college written notice of the member's intention to close the member's practice, to take a leave of absence or to relocate their practice or otherwise cease to practise in Manitoba. 4.13(2) The notice must include information about where the client records are to be located and how the records can be transferred to another member or how copies of the records can be obtained. Storage and disposition of client records and supplies 4.14(1) A member who closes the member's professional practice or takes a leave of absence must (a) ensure the secure storage of any client records for the remainder of the retention period required and ensure the destruction of the information in accordance with The Personal Health Information Act ; and (b) give the college a copy of the notice sent to clients, information about to whom the notice was sent and the arrangements that have been made for the secure storage of client records. 4.14(2) A member who ceases to engage in the practice of registered psychiatric nursing, temporarily or permanently, must safely dispose of medications, laboratory specimens, equipment and supplies. 4.14(3) The obligations under this section are in addition to any other requirements relating to client records under the Act, The Personal Health Information Act and any other enactment, by-law, standard of practice, code of ethics and practice direction with which a member must comply. PRACTICE DIRECTIONS Practice directions 4.15 Nothing in this Part limits or restricts the council from issuing practice directions under section 85 of the Act to enhance, explain, add or guide members with respect to the subject matters described in this regulation or any other matter relevant to the practice of registered psychiatric nursing. PART 5 MISCELLANEOUS HEALTH PROFESSION CORPORATIONS Restricted to certain membership class 5.1 Only a member who is registered in the registered psychiatric nurse membership class is permitted to establish a health profession corporation. Health profession corporation permit 5.2 Subsection 60(1) of the Act sets out the requirements for the issuance and renewal of a health profession corporation permit. For the purpose of clause 60(1)⁠(i) of the Act, a corporation must provide to the registrar (a) a copy of the articles of incorporation and any articles of amendment, continuance or amalgamation; and (b) a current certificate of status issued under The Corporations Act . Permit renewal 5.3 For renewal of its permit, a health profession corporation must provide to the registrar on or before the expiry date of its current permit the following: (a) a copy of the most recent annual return filed under The Corporations Act ; (b) if applicable, information about any conviction of the corporation, its directors, officers, voting shareholders, or any person through whom the corporation carries on the practice of registered psychiatric nursing for a criminal offence since the date the corporation last applied for registration or renewal of its permit. M.R. 50/2024 Additional contents of record 5.4 The record of health profession corporations must contain the information set out in subsection 73(3) of the Act. The record must also contain the following applicable information for each health profession corporation: (a) the corporation's address, telephone number, fax number and e-mail address; (b) the time period during which the corporation's permit is valid; (c) information about any suspension or cancellation of the corporation's permit or alternative action taken under section 66 of the Act, including any conditions placed on the permit. Notice of changes 5.5 In addition to the requirement under section 68 of the Act, a health profession corporation must notify the registrar, within the time period and in the form and manner determined under the college's by-laws, of any change in the particulars set out in the documents filed by the corporation under section 5.2. Error on the record 5.6 The registrar may correct any error or remove any entry made in error on the record of health profession corporations. M.R. 50/2024 Name of health profession corporation 5.7 A health profession corporation may include an individual's name but only if that individual is a member who is permitted to establish a health profession corporation. Name removed from record 5.8 When a health profession corporation's permit is cancelled, the registrar must remove the corporation's name from the record of health profession corporations. OTHER PROVISIONS Professional misconduct fines 5.9 Column 3 of the table of professional misconduct fines in Schedule 1 of the Act is specified for the purpose of clause 127(1)⁠(b) of the Act. Chair may perform certain responsibilities of the investigation committee 5.10 For the purpose of subsection 96(4) of the Act, the chair of the complaints investigation committee or the registrar may perform the duties imposed and exercise the powers conferred on the committee under subsection 96(1) or (2) of the Act. Notice of suspension or conditions pending decision 5.11 For the purpose of subsection 110(2) of the Act, the registrar must, upon receiving a direction under subsection 110(1) of the Act, give written notice of the suspension or conditions of an investigated member's registration or certificate of practice and the committee or chair's reasons for the suspension or conditions to (a) a person who engages the member to practise registered psychiatric nursing on a full-time or part-time basis, including as a contractor, consultant or, if known to the college, a volunteer; (b) a health care facility if the member is a member of the health care facility's professional staff; (c) a health care facility or health authority that has granted privileges to the member; (d) any minister who administers the payment of fees for the psychiatric nursing care provided by the member; and (e) an external regulatory body in another jurisdiction inside or outside Canada. M.R. 50/2024 PART 6 COMING INTO FORCE Coming into force 6.1 This regulation comes into force on June 1, 2022. SCHEDULE (Subsection 3.8(2)) Screening and Diagnostic Test reports 1 For the purpose of performing reserved act 2, a registered psychiatric nurse (authorized prescriber) may order or receive reports of the following screening or diagnostic tests for the registered psychiatric nurse's approved patient population: Reproductive Health, Sexually Transmitted Infections and Blood Borne Pathogens Bacterial Vaginosis Clinical Microbiology Swab for microscopy Candidiasis Clinical Microbiology Swab for culture and microscopy Chlamydia Clinical Microbiology Urine for Chlamydia trachomatis nucleic acid test Genital swab for Chlamydia trachomatis nucleic acid test Rectal, eye or throat swab for direct fluorescent antibody microscopy Aptima STI Testing Portfolio Gonorrhea Sexually Transmitted Infections (STI) Bacteriology Urine for Neisseria gonorrhoeae nucleic acid test Genital swab for Neisseria gonorrhoeae nucleic acid test Genital swab for Neisseria gonorrhoeae culture Rectal, eye or throat swab for Neisseria gonorrhoeae culture Hepatitis B Serology Hepatitis B surface antigen Hepatitis B surface antibodies Hepatitis B core antibodies Herpes Simplex Virus (HSV) Virus Detection Swab for HSV nucleic acid testing Syphilis Serology Blood or serum Clinical Microbiology Swab for Treponema pallidum (PCR) Treatment of Genital Warts Human papillomavirus nucleic acid testing Trichomonas Clinical Microbiology Vaginal swab for fixed stain microscopy culture Vaginal swab for Trichomonas vaginalis antigen Vaginal swab for Trichomonas vaginalis nucleic acid test Other Diagnostics for Sexual and Reproductive Health Biochemistry Albumin-to-Creatinine Ratio (ACR) — (urine) Creatinine — (serum) Urinalysis, complete — (urine) Pregnancy test (serum and urine) Serology Hepatitis A immunoglobulin G antibodies Hepatitis A immunoglobulin M antibodies Hepatitis C virus antibodies Human Immunodeficiency Virus (HIV) antibodies Cervical cancer screening and Pap testing Human papillomavirus nucleic acid testing Diabetes Health Biochemistry Albumin-to-Creatinine Ratio (ACR) — (urine) Apolipoprotein B — (serum) Cholesterol, low density lipoprotein (calculated) — (plasma) Cholesterol, total — (plasma) Cholesterol, high density lipoprotein — (plasma) Creatinine — (serum) Estimated glomerular filtration rate — (plasma) Glucose — (plasma) Glucose tolerance test, 2 hour — (plasma) Glucose tolerance test, 75 g — (plasma) Glycosylated hemoglobin — A1C (blood) Potassium — (serum) Sodium — (serum) Triglycerides — (plasma) Urinalysis, complete — (urine) Specified drugs and vaccines 2 For the purpose of performing reserved act 6, a registered psychiatric nurse (authorized prescriber) may prescribe the following drugs or vaccines for the registered psychiatric nurse's approved patient population: Reproductive Health, Sexually Transmitted Infections and Blood Borne Pathogens Drugs for Reproductive Health, Sexually Transmitted Infections and Blood Borne Pathogens Oral Combined Estrogen and Progestin Oral Progestin only pills Depo-Provera Medroxyprogesterone Acetate Transdermal Combined Estrogen and Progestin Monophasic patch Hepatitis A vaccine Human papillomavirus vaccine (HPV) Topical estrogen or estradiol cream Emergency Medications Injectable epinephrine Injectable diphenhydramine Hepatitis B Post-Exposure Management Hepatitis B vaccine Hepatitis immune globulin Treatment of Genital Warts Imiquimod Liquid nitrogen Trichloroacetic acid (TCA) Diabetes Health Combined formulations Metformin and Sitagliptin Metformin and Sitagliptin modified release Metformin and Linagliptin Metformin and Saxagliptin Metformin and Empagliflozin Metformin and Dapagliflozin Categories of drugs and vaccines 3 For the purpose of performing reserved act 6, a registered psychiatric nurse (authorized prescriber) may prescribe a drug or vaccine belonging to the following categories for the registered psychiatric nurse's approved patient population: Diabetes Health Antihyperglycemic Agents Thiazolidinediones (TZD) Biguanides Incretin agents GLP-1 receptor agonists SGLT2 inhibitors Insulin secretagogues Alpha-glucosidase inhibitors (AGI) Cardiac/Renal Angiotensin-converting enzyme (ACE) inhibitors Angiotensin II receptor blockers (ARB) Statins Fibrates Insulin Bolus (prandial) insulins Basal insulins Premixed insulins Other Glucagon kit Glucose tablets Reproductive Health, Sexually Transmitted Infections and Blood Borne Pathogens Bacterial Vaginosis Nitroimidazoles Lincomycins Lincosamides Chlamydia Trachomatis Macrolides Tetracyclines Cephalosporins Beta Lactam Drugs for Reproductive Health Antifungals Intrauterine devices Intrauterine systems Vaginal rings Emergency hormonal contraception Herpes Simplex Virus (HSV) Antivirals Human Immunodeficiency Virus (HIV) Exposure Management Antiretrovirals Neisseria Gonorrhea Cephalosporins Macrolides Tetracycline Syphilis Beta Lactams Tetracyclines Trichomoniasis Nitroimidazoles Lincomycins Lincosamides