Courtenay is an ENP who works in a large urban centre. Courtenay has been approached by their supervisor to be trained in intraoperative monitoring (IOM). When performing IOM, ENPs utilize a variety of tests to assess the functional status of the patient’s nervous system throughout the surgical procedure while the patient is under anesthesia. Surgeons use IOM to help guide surgical decision-making during procedures (e.g., scoliosis correction, spine surgery, epilepsy surgery, brain, spinal cord tumours) to prevent devastating outcomes, such as paralysis.

Is Courtenay authorized to perform IOM?

As an ENP, Courtenay is not primarily authorized to perform IOM. IOM is an enhanced practice authorization that ENPs may apply for once they have completed advanced training that has been approved by the College’s Council.

What does Courtenay have to do to be trained?

Courtenay must complete a training program that has been approved by Council. A current list of approved programs may be found on Additional and Enhanced Practice Authorization page. Once Courtenay completes this training and applies to the College for this authorization, the application must be reviewed and approved by the Registrar prior to them performing these tasks independently. Courtenay must also reapply for this authorization every year when renewing their practice permit online by selecting “Yes” to renewing the authorization and entering information about their supervisor, who will verify that Courtenay is still competent to perform the activity.

What Standards of Practice apply to this scenario?

Standard 1.2 Clinical Procedures

To demonstrate this Standard, a regulated member will:

e. Possess the necessary competence to perform the procedure safely and effectively.

g. Ensure patient safety (e.g., transfers, physical environment).

m. Identify and communicate with the appropriate healthcare provider any procedural concerns or patient’s expressed wishes (e.g., appropriateness of or modifications to the procedure, patient’s gender expression).

Standard 2.2 Professional Competence

To demonstrate this Standard, a regulated member will:

b. Practice within the limits of the member’s competence.

c. Maintain knowledge of current and evolving technologies and integrate new learning into practice, as appropriate.

Standard 2.3 Restricted Activities/Enhanced Practice

To demonstrate this Standard, a regulated member will:

a. Perform only those restricted activities for which they have the required competence and current authorization.

c. Be responsible and accountable for safely performing the restricted activity.

d. Understand the risks associated with performing the restricted activity and ensure that measures are in place to manage any critical or unexpected events associated with performing it.

Standard 4.2 Professional Competence

To demonstrate this Standard, a regulated member will:

u. Ensure electrical safety for patients (e.g., indwelling catheters, proper grounding of patients).

Code of Ethics

Principle 3 – Responsibility to oneself

b. Accountability – A regulated member takes responsibility and is accountable for their professional activities.

There are many documents that help guide a regulated member’s practice. View these documents on our Resources page.