Glossary

The obligation to acknowledge the professional, ethical, and legal aspects of one’s activities and duties, and to answer for the consequences and outcomes of one’s actions. Accountability resides in a role and can never be shared or delegated.

This term is used in health care to refer to people's daily self-care activities. These activities can include getting dressed, preparing meals and attending to personal hygiene.

A level of severity of an illness. An acuity level is based on the type and number of nursing interventions required in a 24-hour period to provide safe, competent and ethical nursing care for a client.

An ongoing process of reflection, communication and documentation regarding a person’s values and wishes for future health and personal care in the event they become incapable of consenting to or refusing treatment or other care. Conversations to inform health-care providers, family and friends — and especially a substitute decision-maker — are regularly reviewed and updated. Such conversations often clarify their wishes for future care and options for their end of life. Attention must also be paid to provincial/territorial legal and health guidelines

Reflects the integration and application of a broad range of theoretical and evidence-based knowledge that occurs as part of graduate nursing education. ANP encompasses all the domains of nursing practice, the entire field of nursing and does not necessarily refer only to direct clinical care. Nurses in ANP roles may include those with graduate education working in policy, administration, nursing informatics, etc.

Advanced knowledge, skills and judgment gained through additional education, training and clinical experience outside the core knowledge, skills and judgment obtained through entry-level nursing programs. These competencies are not currently part of RN or NP work expectations, and are being introduced into nursing practice in specific practice settings.

Any noxious and unintended response to a drug that is caused by the administration of any dose of the drug. Nurses are employed throughout the healthcare system and play a crucial role in identifying and reporting any incidents, drug reactions, adverse events and “near misses”. The Protecting Canadians from Unsafe Drugs Act (Vanessa's Law) includes rules that strengthen the regulation of therapeutic products and improve the reporting of adverse reactions by healthcare institutions.

Actively supporting, protecting and safeguarding clients’ rights and interest. It is an integral component of nursing and contributes to the foundation of trust inherent in nurse-client relationships.

One component of the program approval framework used to approve entry-level nursing education programs. A subset of the program approval indicators (the outcome indicators) are examined yearly for each program and the program’s approval score is calculated. Programs are approved annually based on the annual monitoring review results or the comprehensive review as required.

This term designates an education program has met the prescribed standards set out in the Nurses Association of New Brunswick (NANB) program approval process. Program approval is a mandatory process based on the entry-to-practice competencies for RNs or NPs.

Systematically gathering data, sorting and organizing the collected data, and documenting the data in a retrievable format; an assessment can include nursing history and behavioural and physical exam such as inspection, palpation, auscultation, and percussion. May include but is not limited to: observation, interview, history taking, interpretation of laboratory data, mental health assessment, physical assessment, etc.

An assignment is the allocation of clients or client care responsibilities or interventions that are within the provider’s scope of practice and/or scope of employment. Assignment describes the distribution of work that each staff member is to accomplish.

Allocation of duties (e.g., responsibility for client care, interventions, or specific tasks as part of client care) to individuals whose scope of practice or scope of employment authorizes the performance of these duties.

A practitioner lawfully entitled to prescribe treatments or medications. According to the Controlled Drugs and Substances Act, a practitioner means a person who is registered and entitled under the laws of a province to practise in that province the profession of medicine, dentistry or veterinary medicine, and includes any other person or class of persons prescribed as a practitioner. In addition, a practitioner is defined by the New Classes of Practitioners Regulations as midwives, nurse practitioners and podiatrists. In NB current authorized prescribers include physicians, nurse practitioners, optometrists, dentists, pharmacists, midwives, veterinarians and physician assistants.

Having the authority to make decisions and the freedom to act in accordance with one’s professional knowledge base.

A boundary in the nurse-person relationship is the point at which the relationship changes from professional and therapeutic to unprofessional and personal (see professional boundaries).

See workplace bullying.

Promotes excellence in professional nursing regulation. An organization made up of representatives from Canada’s 12 provincial (territorial) bodies that regulate the practice of registered nurses. CCRNR serves as a national forum and voice regarding interprovincial, national and global regulatory matters for nursing regulation.

The Canadian National Nursing Assessment Service coordinates a consistent national approach for the internationally educated nurses (IENs) seeking registration/licensure to practice in Canadian jurisdictions.

• Registered Nurses (RNs)
• Licensed Practical Nurses (LPNs)
• Registered Practical Nurses (RPNs) in Ontario
• Registered Psychiatric Nurses (RPNs)

Being able to understand and appreciate the consequences of various options and make informed decisions about one’s own life, care and treatment.

A system for organizing and delivering nursing care to clients and their families. It represents both the structural and contextual elements of nursing practice.

The circumstances where health information custodians rely on an individual's implied consent when collecting, using, disclosing or handling personal health information for the purpose of providing direct health care.

Client abuse as the misuse of power or a betrayal of trust, respect or intimacy between the nurse and the client, which may cause physical or emotional harm. This includes all types of abuse, such as:

• neglect (e.g., failing to provide the necessities of life);
• physical abuse (e.g., striking a client or causing discomfort);
• verbal/emotional abuse (e.g., shouting at or insulting a client);
• financial abuse (e.g., soliciting gifts from a client); or
• sexual abuse (e.g., inappropriately touching a client).

The reduction and mitigation of unsafe acts within the health care system, as well as through the use of best practices shown to lead to optimal client outcomes. It is meant to be inclusive of psychosocial, physical, cultural and spiritual wellbeing

An approach in which clients are viewed as whole persons. It is not merely about delivering services where client is located. Their care involves advocacy, empowerment, and respecting the clients’ autonomy, voice, self-determination and participation in decision-making

A complex cognitive process that requires nurses to recognize a clinical problem in their client and respond promptly through implementing interventions to improve their client’s health status. Clinical decision-making is a dynamic process where care choices are made based on balanced involvement between the health professional and the client

The proficiency or judgment that a license holder in a particular profession acquires through clinical experience or clinical practice and that is not possessed by a lay person. Clinical expertise means demonstrated proficiency in a specialized area of direct patient care

Includes the provision of consultation and support

Clinical Nurse Specialists (CNSs) are advanced practice nurses prepared at the Master’s or Doctoral level who possess advanced nursing knowledge, skills and judgment, as well as clinical experience within a focused area of care. CNSs do not have an expanded legislated scope of practice or a separate professional designation; they are regulated as Registered Nurses.

A skill, process, or outcome where a clinician observes, collects, and interprets data to diagnose and treat clients. Multiple components of clinical reasoning include information gathering, hypothesis generation, forming a problem, generating a differential diagnosis, selecting a leading or working diagnosis, providing diagnostic justification, and developing a management or treatment plan

Engaging in an intentional relationship for the purpose of creating something together. It goes beyond collaboration and client-focused care as it requires the dynamics of the relationship to build something. It means that clients and nurses are equal partners and share power in the relationship.

A set of rules that outlines the social norms and behavioural expectations of an individual, group or organization.

Working together with one or more members of the health care team, each of whom makes a unique contribution toward achieving a common goal. Collaboration is an ongoing process that requires effective communication among members of the health care team and a clear understanding of the roles of the individuals involved in the collaboration process. Nurses collaborate with clients, other nurses and other members of the health care team in the interest of client care.

A baccalaureate nursing education program offered in partnership between a College and a University. The students may take all or part of their nursing curriculum at the College or the University. The program degree is granted by the University.

All health-care providers and nurses working in all domains of practice.

A dominant society that “discovers” and claims rights to unsurrended lands already lived upon by its original (i.e. Indigenous) inhabitants. The colonial power (or colonizer) then determines and shapes laws, languages, economies, social relations, and cultural life, and subject all people on the land to these dominant norms (e.g. Christianity, nuclear families, western biomedicine). Colonization denies sovereignty and self-determination of the original inhabitants by asserting that dominant norms are superior, subjecting everyone to live by these norms. This denies Indigenous peoples’ freedom to their language, culture, land, and social values.

The transmission of verbal and/or non-verbal messages between a sender and a receiver for the purpose of exchanging or disseminating meaningful, accurate, clear, concise, complete and timely information (includes the transmission using technology)

Home and community care services help people to receive care at home, rather than in a hospital or long-term care facility, and to live as independently as possible in the community. Home and community care is delivered by regulated health care professionals (e.g., nurses), non-regulated workers, volunteers, friends and family caregivers.

An organized group of people bound together by social, ethnic, cultural or occupational ties, or by geographic location.

The ability to recognize and be aware of the suffering and vulnerability of another, coupled with a commitment to respond with competence, knowledge and skill.

An individual’s capability for consistently integrating the required knowledge, skill and judgment for safe, ethical, and effective nursing practice.

A component of knowledge, skill, and/or judgement, demonstrated by an individual, for safe, ethical, and effective nursing practice.

The terms “complementary medicine” and “alternative medicine” refer to a broad set of health care practices that are not part of that country's own traditional or conventional medicine and are not fully integrated into the dominant health care system.

Terminology related to care practices and approaches continue to evolve; ‘integrative and functional medicine’ is emerging as a more inclusive term to replace ‘complementary and alternative medicine’. While functional medicine focuses on creating individualized therapies tailored to treat underlying causes of illness, integrative medicine seeks to understand the individual as a whole and applies many forms of therapy to improve wellness. As ‘integrative and functional medicine’ is not yet common nomenclature, the more traditional terminology ‘complementary and alternative medicine’ has been used.

The combining or mixing together of two or more ingredients (of which at least one is a drug or pharmacologically active component) to create a final product to meet the client’s unique needs when a required dosage is not available commercially or remove a non-essential ingredient from a drug to which a client is allergic. It can involve the alteration of the form and strength of commercially available products, or reformulation to allow for a novel drug delivery. Compounding does not include mixing, reconstituting, or any other manipulation that is performed in accordance with the directions for use on an approved drug's labelling material. Compounding is not within the scope of nursing practice.

One component of the program approval framework used to approve entry-level nursing education programs. For the comprehensive review, all program approval indicators are reviewed every seven years, unless annual review results are unsatisfactory, and the program’s approval score is calculated.

The ethical obligation to keep someone’s personal and private information secret or private.

Occur when the nurse either makes or is in a position to make a decision based upon what is good for the nurse’s own best interests, not the best interest of others who might be affected.

A situation in which a nurse informs their employer about a conflict of conscience and the need to refrain from providing care because a practice or procedure conflicts with the nurse’s moral beliefs.

The state of being aware of and attaching importance to a behaviour or action.

The voluntary agreement to some act or purpose made by a capable individual. Clients and their substitute decision makers have the legal right to agree to, refuse or revoke permission of proposed care, service, treatment or research provided by a health care professional, at any time.

To seek information or advice. For example, from a person or a book.

The act or an instance of consulting. Consultations may be formal or informal. A formal consultation is the referral of a client to a specialist or another health provider for advice on care. Informal consultation is when a provider informally seeks advice or answers to specific questions from another provider. Informal consultation may involve coordination of care in addition to advice seeking.

There are three layers of contextual factors

• Micro contextual factors involve the client’s immediate environment – their own health status, family, friends, and their physical environment.
• Meso contextual factors involve the policies and processes embedded in the organization and health system that affect the client.
• Macro contextual factors involve the larger socioeconomic and political context around the client – social and cultural values and beliefs, laws, and public policies.

The ongoing ability to assess one’s own practice, identify learning needs and obtain, integrate and apply the knowledge, skills and judgement required to practice safely and ethically. It is a necessary component of practice and public interest is best served when registered nurses constantly improve their application of knowledge, skill and judgment.

A philosophy of the quality management process that encourages all health care team members to continuously ask the questions, “How are we doing?” and “Can we do it better?”

Expands upon critical thinking to encompass critical reflection on actions. Critical inquiry is a process of purposeful thinking and reflective reasoning where the nurse examines ideas, assumptions, principles, conclusions, beliefs, and actions in the context of nursing practice.

Reasoning in which an individual analyzes the use of language, formulates problems, clarifies and explains assumptions, weighs evidence, evaluates conclusions, distinguishes between pros and cons and seeks to justify those facts and values that result in credible beliefs and actions. Critical thinking is performed by all nurses at a level consistent with their educational preparation and scope of practice.

The imposition of a dominant way of life which intends to cease distinct legal, social, cultural, and religious ways of life. The purpose is to integrate all people into one way of life, which is the dominant social and cultural norm. In a Canadian context, cultural assimilation has been a process, through legislation and policy, to attempt to abolish Indigenous peoples’ distinct governments, cultures, and identities.

The acknowledgment and observance of cultural differences. Cultural awareness focuses on seeing beyond one’s culture and understanding that many forms of culture co-exist.

Cultural safety is an outcome based on respectful engagement that recognizes and strives to address power imbalances inherent in the healthcare system. It results in an environment free of racism and discrimination, where people feel safe when receiving health care.

Recognizing the need to respect cultural differences. Cultural sensitivity involves exhibiting “behaviours that are considered polite and respectful by the [person who has cultural differences from your own]”.

Culturally safe care is a refinement of the “cultural safety” concept. Nurses do everything they can to provide culturally safe care, but they remain aware that they are in a position of power in nurse-client relationships, and some clients may never feel entirely safe. Nurses allow those who receive care to determine what they consider to be safe. Nurses support them in drawing strength from their personal identity, culture, background, and community.

An environment, which is safe for people, where there is no assault, challenge or denial of their identity of who they are and what they need. It is about shared respect, shared meaning, shared knowledge and experience, of learning together with dignity.

An individual’s beliefs, norms, and values that influence their opinions, thoughts, and behaviours in everyday decision-making. Culture is a complex relational process influenced by history, personal experiences, and perceptions of society. Culture evolves and is not limited to ethnicity or race; it also comprises age, language, gender expression, sexual orientation, and socioeconomic status.

The planned process for achieving a nursing education program’s intended outcomes. For purposes of program approval, nursing curricula includes theoretical foundations, learning activities to foster theory application by students and evaluation of student learning.

A process for collecting and documenting curriculum related information against specific criteria or standards. This process ensures an alignment between the standards of nursing practice, entry-to-practice competencies and the educational content being taught. It also identifies and addresses academic gaps, redundancies and misalignments between courses and entry-to-practice competencies.

Each entry-level nursing program is required to map its curriculum to ETP competencies, for both preliminary approval (new programs) and the comprehensive review process (established programs), using the curriculum mapping tool. Programs use the tool to provide evidence that the entry-to-practice competencies, required to prepare graduates to be competent and safe practicing nurses are embedded in the teaching and learning experiences.