A Search for Role Clarity: A Critical Discourse Analysis of the RN and RPN Entry-to-Practice Competencies That Shape Nursing Curriculum in Ontario, Canada
Abstract
There is confusion regarding the practice expectations of Registered Nurses (RN) and Registered Practical Nurses (RPN) for employers, educators, nurses, nursing students, and the public, in Ontario, Canada. As the entry-to-practice competencies (ETPC) serve as a guide to the curricular content of nursing programs, a critical discourse analysis of the entry-to-practice documents available to the public was performed to: 1) attempt to understand the meaning and intent of the ETPC, 2) to answer the question of what are the differences in practice expectations for RN versus RPN graduates, and 3) how can role clarity be improved through this process. Critical discourse analysis affords the opportunity to understand these documents, not just through the words on the page, but understand the social, cultural, political, and contextual forces and processes that led to their creation by the nursing regulators in Canada. However, there are competency interpretation documents available only to nursing educators embarking on the College of Nurses of Ontario (CNO) program approval process, which are not made readily available to nurses, the public or employers. These interpretation documents provide a clearer picture of the key differences and similarities between RN and RPN practice expectations. Despite this increased clarity, some language use and sentence construction confound even a seasoned educator as these words have different meanings depending on the context and common understanding of the meaning. As a useful tool for nursing practice, a table of comparison was made to guide nursing educators, employers, nurses, nursing students, and the public to make visible these differences and similarities in both the competencies and the interpretation documents. This analysis also suggests that the College of Nurses of Ontario make the interpretation documents available to a wider audience to support the link between nursing practice and nursing education to create a living curriculum that can be responsive to the ever-changing needs of the profession.