August 12, 2026
August 2026

Dear CNO

A nurse asks whether they can begin caring for adult patients under the new single NP classification and what they should consider before expanding their practice.

A nurse practitioner talking to an adult patient.

Dear CNO,

I am currently registered as a Nurse Practitioner (NP) in the pediatric category. With the move to a single NP classification on July 1, can I start providing care to adult patients? Do I need additional education or approval from CNO?

Thank you for your question. In short, yes. You can provide care to adult patients if you have the knowledge, skill and judgment to do so safely and competently. As with any area of practice, you are responsible for ensuring you have the competence to provide safe care. CNO does not require specific education or approval before NPs move into a new area of practice.  Your employer may, however, have expectations for your role.

Since the move to a single NP classification on July 1, 2026, NPs now have greater flexibility to practice across different patient populations and care settings. However, you must still practice within your own competence.

If you’re considering expanding your practice to include adult patients, take time to reflect on whether you have the knowledge, skill and judgment needed to provide safe, competent care. It may help to discuss your readiness and any learning needs with colleagues or your employer. If you determine that there are gaps in your knowledge or experience, there are different ways to build your competence, such as additional education, training or mentorship. 

Ongoing reflection and learning are part of CNO’s Quality Assurance Program and QA Every Day. To support NPs who are moving into new areas of practice or caring for different patient populations, we developed Quality Assurance resources and sample learning plans for NPs.

If you were previously registered with a specialty certificate (Primary Health Care, Adult or Pediatric), the population focus of your entry-level NP education will continue to appear in the new “NP education” section on the public register, Find a Nurse.

As you continue to grow your practice, remember that competence is the key consideration. Taking time to reflect on your knowledge, skills and learning needs will help ensure you're well prepared to provide safe, effective care for the patients you serve.

Warmly,
Allie Turner, RN, MN
Advanced Practice Consultant, Practice Quality

About CNO

The College of Nurses of Ontario (CNO) is the regulator of the nursing profession in Ontario. It is not a school or a nursing association. CNO acts in the public interest by:

  • assessing qualifications and registering individuals who want to practice nursing in Ontario.
  • setting the practice standards of the profession that nurses in Ontario are expected to meet.
  • promoting nurses' continuing competence through a quality assurance program.
  • holding nurses accountable to those standards by addressing complaints or reports about nursing care.

The College was founded in 1963. By establishing the College, the Ontario government was acknowledging that the nursing profession had the ability to govern itself and put the public's well-being ahead of professional interests.

For the latest information, please see our Nursing Statistics page.

Anyone who wants to use a nursing-related title — Registered Nurse (RN), Registered Practical Nurse (RPN) or Nurse Practitioner (NP) must become a member of CNO.

Frequently Asked Questions

Go to the public Register, Find a Nurse, to conduct a search for the nurse. Contact us if you can't find the person you are looking for.

All public information available about nurses is posted in the public Register, Find a Nurse, which contains profiles of every nurse in Ontario. Publicly available information about nurses include their registration history, business address, and information related to pending disciplinary hearings or past findings.

Unregistered practitioners are people who are seeking employment in nursing or holding themselves out as being able to practice nursing in Ontario, but who are not qualified to do so. They are not registered members of CNO. Only people registered with CNO can use nursing-related titles or perform certain procedures that could cause harm if carried out by a non-registered health professional. CNO takes the issue of unregistered practitioners seriously. See Unregistered Practitioners for more information.

To ensure procedural fairness for both the patient (or client) and the nurse, the Regulated Health Professions Act requires that information gathered during an investigation remain confidential until the matter is referred to the Discipline Committee or Fitness to Practise Committee. CNO will not disclose any information that could identify patients (or clients) or compromise an investigation. See Investigations: A Process Guide for more information.

Information obtained during an investigation will become public if the matter is referred to a disciplinary hearing. If a complaint is not referred to a hearing, no information will be available publicly.

See CNO's hearings schedule, which is updated as hearing dates are confirmed. Hearings at CNO are open to the public and the media. For details on how to attend a hearing, contact the Hearings Administration Team.

A summary of allegations and the disciplinary panel outcomes can be found on the public Register, Find a Nurse. Full decisions and reasons are also available.

Where a disciplinary panel makes a finding of professional misconduct, they have the authority to reprimand a nurse, and suspend or revoke a nurse's registration. Terms, conditions and limitations can also be imposed on a nurse's registration, which restricts their practice for a set period. Nurses can also be required to complete remedial activities, such as reviewing CNO documents and meeting with an expert, before returning to practice.

For detailed information see the Sexual Abuse Prevention section.

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