It is evident a lot of work was out into this presentation and information provided was very interesting.

I have one area of disagreement with this presentation in slide 9; where it states that RPN are only taught the how to and not the whys is not quite accurate; yes the depth of knowledge is different but one is the why as an PN student. The reason one is taught the why is because one must understand the reason for all intervention one is doing for a patient/resident. Take this situation for example; a RPN walks into a patient room and finds the patient unresponsive; the intervention that the RPN does requires the knowledge and critical thinking of to the clients situation i.e. do the nurse check the patients blood sugar because the patient is diabetic or does the RPN does a set of vital sign as the patient is diagnosed with hypotension or a patient appears disorientated one must know the whys to be able to address the situation. As a RPN was be able to answer the whys to follow protocols whether it be to do an intervention or call a RN. In the case of the first scenario if the person is a diabetic you will check the blood sugar and give glucagon if prescribe and appropriate to the readings and call the RN or if the patient is hypotensive you do a set of vital signs and report it to the RN who will inform the MD or you might just have to call the MD your-self or 911 according to the agencys policies. Question #2 Answer: When a RN holding dual licence and is working in a RPN position if the client situation changes and becomes unstable; they are in a medical crisis the nurse has to function at his/her highest level of capabilities. At the same time, a nurses primary accountability is to the client, not to the employer. For example, an RN remains accountable as an RN even when employed as an RPN. This means that an RN who is employed as an RPN must balance knowledge of the role with an assessment of when her/his RN skills must be employed in the interest of client safety. When an RN works in an RPN job category and uses the RPN title, she/he is responsible for using RPN knowledge, skills and judgment. If the clients condition becomes complex, and there are no other RNs available, an RN working as an RPN is expected to function as an RN until another RN becomes available. CNO Practice Guidelines, Working in Different Role