Nursing Leadership

Nursing Leadership 32(1) March 2019 : 30-41.doi:10.12927/cjnl.2019.25850
Special Focus on Nursing Scope of Practice

Getting Comfortable with "It Depends": Embracing the Impermanence of Scope of Practice

Sara Lankshear and Dianne Martin


Scope of practice of nursing roles is continually evolving to meet the ever-changing needs of patient populations and the healthcare system and to reflect changes in legislation, regulation and education requirements. As such, leaders must embrace the impermanence of scope of practice rather than constructing mental models, policies and practices as if the foundation will never change. Impermanence is the only constant, as the complexities within healthcare require that nurses be knowledgeable and flexible to fully leverage our individual and collective contributions to not only our patients but also our profession.

This paper will present an overview of scope of practice and the challenges nurses experience when navigating the complexities of legislation, regulation, education and organizational factors that all contribute to the perceived ambiguity and role confusion within the nursing profession. Leadership plays a vital role in setting expectations for collaborative practice and optimizing the scope of practice of health professionals, yet there is a lack of support for leaders to navigate this complex phenomenon. If leaders are not clear, this extends to the entire team. The ability of nurse leaders to confidently and effectively navigate these nuances through the lens of "it depends" will be presented as a core leadership competency, with a discussion of strategies designed specially to support leaders and their teams.



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