Briefing Note for Candian Council of Registered Nurse Regulators

Briefing Note for Candian Council of Registered Nurse Regulators

Briefing Note for Recommendation

Pan Canadian Nurse Practitioner (NP) Title Alignment 

Date:                                            February 19, 2019    


                                                                       BRIEFING NOTE for RECOMMENDATION, LEGISLATIVE AMENDMENT


                                                                       NPAC-AIIPC BOARD OF DIRECTORS


The purpose of this briefing note is to present to the Canadian Council Of Registered Nurse Regulators the challenges with lack of title alignment for Nurse Practitioners among provincial and territorial regulators. This note details a need for title alignment for NPs in all jurisdictions and the need to clearly license nurses to avoid ambiguity and confusion for the public we serve, for stakeholders and to promote the autonomous role of the NP.


The title Nurse Practitioner may have title protection in Canada however, its use by nursing regulators is varied in accordance with provincial and territorial legislation.

For example:

Nurse Practitioners in Ontario are known as RN (EC) or NP1

Nurse Practitioners in Saskatchewan are known as RN (NP)2

Nurse Practitioners in British Columbia may be known as an RN, NP or RNP3

Nurse Practitioners in Alberta are known as NP4

Nurse Practitioners in Manitoba are known as RN (NP) in a sub-register of extended practice5

Nurse Practitioners in the Yukon may be known as NP, RNP6

Nurse Practitioners in the North West Territories and Nunavut may be known as NP or RNP7

Nurse Practitioners in Newfoundland & Labrador be known as RN NP8

Nurse Practitioners in New Brunswick are known as NP9

Nurse Practitioners in Prince Edward Island may be known as NP, RNNP, RN(NP), N.P., R.N.N.P. or R.N.(N.P.)10

Nurse Practitioners in Nova Scotia may be known as N.P. or NP11

The above examples provided demonstrate that across Canada we have varying titles to identify a Nurse Practitioner and are confusing to Nurse Practitioners let alone the public and our fellow health care providers.

The Nurse Practitioner community in Canada has identified title irregularity as a public safety issue and requires the attention of government and nursing regulators to resolve.


Most recently a media news story in Saskatchewan in the fall of 2018 stated that Registered Nurses could now prescribe Mifegymiso for patients. This story caused concern about health care providers and the public. The statement was inaccurate and demonstrated that even after 40 years of practice, Nurse Practitioners are still known as Registered Nurses creating confusion among the public.

            Donald et al. (2010) publication state the following “Interview and focus group participants widely                 agreed that the NP is the most recognized advanced practice nursing title; yet the variety of NP titles for                 similar positions across provinces and territories creates confusion for the public and those in the healthcare                 system. For instance, a nursing regulator stated, Some of the issues are actually around the title “nurse                 practitioner,” what does that mean to people, and not only to the community but other disciplines as well?                 We’re still using a lot of different titles. We’re still using advanced practice, nurse practitioner, nurse                 practitioner specialist, nurse practitioner primary healthcare, nurse practitioner family-all ages. So, I think                 that’s confusing in itself around the title”.

Donald et al. (2010) paper highlights the challenges that nurse practitioners face on a daily basis in the work they do. Nurse Practitioners want to be titled as Nurse Practitioners! Over the years Nurse Practitioners have been described as registered nurses with advanced education. While we were registered nurses, we advance our education becoming Nurse Practitioners. The reference to nurse practitioners being registered nurses creates confusion, undervalues the scope of practice and utilization in our health care system. It’s time we had unity in title and clarity in the health care system and for the public.


  1. Promote title alignment for Nurse Practitioners among council membership.
  2. Work with provincial and territorial governments to address title alignment in legislation and regulation across Canada.
  3. Engage the Nurse Practitioner Association of Canada – Association des infirmières et infirmiers praticiens du Canada in further discussion around these irregularities that are causing provider and public safety issues.


Donald, F., Bryant-Lukosius, D., Martin-Misener, R., Kaasalainen, S., Kilpatrick, K., Carter, N., … DiCenso, A. (2010). Clinical Nurse Specialists and Nurse Practitioners: Title Confusion and Lack of Role Clarity. Nursing Leadership, 23(sp), 189–210.

Provincial and Territorial Acts

  1. Ontario –
  2. Saskatchewan –
  3. British Columbia –
  4. Alberta –
  5. Manitoba –
  6. Yukon –
  7. NWT & Nunavut –
  8. Newfoundland & Labrador –
  9. New Brunswick –
  10. Prince Edward Island –
  11. Nova Scotia –


NP – Nurse Practitioner

RNP – Registered Nurse Practitioner

RN (EC) – Registered Nurse, Extended Class

RN – Registered Nurse