Delegating the communication of a diagnosis

I am an RN who has been delegated to communicate a diagnosis to a patient? Am I authorized to do this? If so, what should I consider in order to communicate the diagnosis safely, effectively and ethically?

Communicating a diagnosis is a controlled act. An RN or RPN cannot communicate a diagnosis to a patient or their representative unless a physician or an NP delegates that act to you.

Delegation has a specific meaning in the Nursing Act, 1991. Delegation is a formal process through which a regulated health professional (delegator) who has the authority and competence to perform a procedure under one of the controlled acts delegates the performance of that procedure to another individual (delegatee). Delegation can be oral or written, and appropriate documentation of the particulars of the delegation must be maintained by one of the practitioners involved.

To delegate or accept a delegation of any controlled act, both the delegator and delegatee must meet all requirements outlined on pages 89 in CNO’s Authorizing Mechanisms practice guideline.

If a physician or NP feels that delegating the controlled act of “communicating to a patient or a patient’s representative, a diagnosis” is appropriate, they can use their professional judgement to delegate the activity to an RN or RPN.  Before accepting this delegation, the RN or RPN should consider:

  • their organization’s policies that support this delegation
  • the plan for patient follow-up 
  • a communication strategy to inform the delegator of any important information.
Page last reviewed June 29, 2020