June 26, 2025

New scope of practice changes coming into effect for Nurse Practitioners and Registered Nurses

A female nurse filling out a form on a clipboard.

Starting Tuesday, July 1, 2025, the Ontario government will implement scope of practice changes impacting nurses in the province.

The new regulations will allow Nurse Practitioners (NPs) to perform additional diagnostic tests and procedures, and Registered Nurses (RNs) in the General Class will be able to complete a medical certificate of death under specific circumstances.

“We are looking forward to supporting nurses and our system partners in implementing the new scope changes safely and effectively across different practice settings,” said Silvie Crawford, RN, CNO’s Registrar/Executive Director and CEO. “The changes will provide new opportunities for patients to access and connect to quality care in Ontario.”

Ahead of the upcoming changes, CNO has published several resources to support NPs and RNs in understanding their professional accountabilities and to ensure changes are implemented safely for all patients.

The new resources include updated information about

Here is what’s new as of July 1, 2025

Changes impacting NPs

  • NPs will be able to order and perform the following procedures: defibrillation, cardiac pacemaker therapy, transcutaneous pacing and electrocoagulation.
  • Expanding the range of circumstances in which NPs are authorized to complete a medical certificate of death.
  • Changes to the Mandatory Blood Testing Act, 2006 will come into effect on July 1, 2025. The Act was recently updated to allow NPs to complete certain public health forms on behalf of patients who were possibly exposed to infectious diseases. Please visit the Ministry of Health’s website for more information on mandatory blood testing.

Changes impacting RNs

  • RNs will be authorized to complete a medical certificate of death in specified circumstances when death is expected. This is not permitted in all practice settings. After reviewing information on our website, RNs should consult with their employers to confirm if this applies to their role.

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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