PRC success story: How members were empowered in their workplace

Alison Bateman, a part-time RN, spearheaded a campaign to overturn a directive at Sandfield Place Long-Term Care that didn’t meet College of Nurses of Ontario (CNO) standards and negatively impacted the RN workload at the 40-bed long-term facility.

RN supervisors are assigned resident treatments to be completed on shift, and care of palliative or less clinically stable residents. They document the care provided to these residents. Registered practical nurses and personal support workers provide care and document on the other residents.

In December 2025, without prior consultation or notification, the employer announced a new directive requiring RNs to document every resident on every shift, regardless of whether they had provided care or not.

PRC process helped

Enter ONA’s landmark professional responsibility clause (PRC) process.

The PRC is a formal process for ONA members to address professional practice and workload concerns that might impact patient safety or their ability to meet regulatory standards.

During a meeting, the Sandfield Place director of care (DOC) told staff that this change in practice represented a “standard of care,” and non-compliance would result in progressive discipline.

“The DOC mandated the RNs document ‘something’ in the progress notes for every resident on every shift, regardless of whether we had provided care or interacted with the resident,” says Bateman. “We knew this was problematic because it failed to meet the College’s documentation standard, which requires documentation to be timely, relevant and focused on changes in condition, assessments or interventions.

“It also impacted on our ability to provide required direct resident care, clinical oversight and supervisory responsibilities.”

The RNs recommended the employer discontinue the directive as it didn’t meet the CNO documentation standard or enhance resident care or safety.

“We discussed the issue with management but there was no change to the directive,” explains Bateman.

The members set about advocating for a practice environment that allowed them, at minimum, to comply with CNO standards of practice, and contribute to safe resident care.

Backed by evidence

“We went to the best tool available to us, completing two professional responsibility workload report forms that were concise, backed by evidence and included a clear actionable recommendation,” Bateman adds.

They also called in ONA Professional Practice Specialist Tanya Beattie and Labour Relations Officer Spencer Jones for assistance.

“They were tremendous help to us,” says Bateman.

Beattie contacted the CNO for input on the issue and the response supported the members’ and ONA’s position. Essentially, by continuing this mandate, the DOC would be in violation of CNO standards and their accountability to the College.

CNO agreed with members

The CNO responded to agree with ONA members.

CNO Advanced Practice Consultant Chantal Rioux notes that, “it is not entirely clear what the employer is expecting RNs to document when they have not provided care, completed an assessment, or exercised professional nursing judgment for a particular resident.”

The documentation standard requires nurses to document care they provide, including relevant assessments, interventions, communications, clinical decisions and outcomes. Documentation must be accurate, timely, relevant and clinically meaningful, and reflect the application of the nurse’s knowledge, skill and judgment.

While employers are responsible for outlining roles, responsibilities and organizational expectations for nurses and other employees, the CNO regulates nursing practice, not employers. Employer documentation directives should align with CNO standards and support safe, ethical and effective nursing care.

Adds Rioux, “The health record is a legal document, and nurses are professionally accountable for determining what information appropriately belongs in that record. Given the legal and professional accountability associated with documentation, it would be appropriate for RNs to discuss this guidance with their employer or consult their legal representative or Professional Liability Protection provider on the employer’s directive and its potential implications.”

The information and response were provided to the employer.

Ultimately, the nurses took the issue to a labour-management committee meeting this past January. The directive was not only to overturn the new documenting practice of charting on every resident every shift, but there will be two RNs on 24/7 in a new facility being built for this employer.