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New practice standard for discontinuing or declining care

CNO has a new practice standard: Discontinuing or Declining to Provide Care. The standard was developed to help nurses understand their accountabilities when it comes to refusal of care or discontinuing nursing service. It was approved by Council on June 6.

Every nurse is responsible to understand and practice professional expectations when it comes to discontinuing or declining to provide care to patients. To assist with that understanding, CNO wrote a practice standard that adopted a broad principle-based framework. The framework sets out clear accountabilities that align with expectations found in the Code of Conduct and the professional misconduct regulations under the Nursing Act, 1991. This framework will help nurses navigate challenging practice situations they may face. This streamlined approach moved away from case scenarios to create a standard focused on principles and accountabilities for nurses.

“Nurses have a duty to provide care that is accessible, inclusive, culturally safe and free from discrimination,” said Catriona Mill, RN, Manager of Practice Quality. 

That means nurses cannot abandon or neglect patients to whom they have a duty to provide care. In cases where nurses need to discontinue care, the new standard explains how nurses ensure patients have ongoing access to care that complies with relevant legislation, professional standards of practice and service agreements.

“This new standard provides clarity on what nurses need to know so they can ensure the safety of their patients and meet their professional accountabilities,” said Mill. 

This new standard was developed in consultation with nurse and health care partners, who requested clarity on the subject in easy-to-understand language. It replaces the Refusing Assignments and Discontinuing Nursing Services guideline that was retired in 2023. The difference between the guideline and the new standard is that while the guideline provided practice considerations, the standard describes professional accountabilities applicable to all nurses in all practice settings. The new document also includes links to other standards and practice resources and a glossary with key terms. 

Read the new standard now 

Page last reviewed June 06, 2024