Currently, restricted licence members awaiting examination results are allowed to work within their scope of practice while under direct supervision by an unrestricted licence holder.
The College wishes to advise that Council has approved a revision to the restricted requirement for PCP members awaiting examination results. These changes will go into effect on Thursday, January 9, 2025.
PCP members with an exam restriction will continue to be allowed to practice to the full scope of an unrestricted PCP member during direct supervision. The revised policy will allow for patient care under indirect supervision, with certain activities prohibited. The motion passed is as follows.
“Revise the restriction to allow a restricted member to work under indirect supervision while performing low risk activities.”
- Restricted members would be required to perform specific skills (high risk) under direct supervision and could work under indirect supervision during other patient care activities.
- This restriction would apply to Primary Care Paramedics (PCPs) only. There would be no change to the EMR restriction requiring direct supervision at all times during patient care.Advanced Care Paramedics (ACPs) already can work as a PCP when not directly supervised and can perform their ACP skills when directly supervised.”
The following is a list of the prohibited activities and medications that require direct supervision in all situations:
- Intravenous initiation
- Manual defibrillation
- Supraglottic airways insertion
- Nasopharyngeal airways insertion
- Urinary catheter insertion
- Continuous Positive Airway Pressure (CPAP)
Prohibited Medications:
- Nebulized and IV administered medications (does not include those being monitored during an IFT)
- Epinephrine, epi-pen administration is permitted.
An inclusion to the motion was passed regarding direct supervision requirements.
“that all reasonable efforts should be made to have a minimum of 2 years’ of fully licenced experience in order to supervise.”
This is to ensure that adequate means of monitoring have been established to ensure patient safety, as well as to provide adequate mentorship for restricted PCP members.
To answer some questions that may arise from members and employers with this new revision please see the following frequently asked questions below.
Does this apply to all restricted licenses including EMRs and ACPs?
This revision to restricted licences applies only to PCP members awaiting COPR examination results. Many PCP graduates do not hold a current EMR licence and would not be able to practice at that preceding licence level.
Restricted ACP members awaiting examination results will remain unchanged from the current standard of direct supervision. Restricted EMRs awaiting examination results will not be able to provide patient care without direct supervision.
I have a current restriction in place as a new PCP graduate, do I have to notify the College to change my licence?
For all new PCP graduates including those with this current restriction, the College will apply this to the licence on their behalf. It is still recommended that restricted members notify their employer of this new revision prior to adjusting their practice.
Am I able to perform the prohibited skills while my partner is present?
The prohibited skills are only able to be performed under direct supervision. This means that any time you are providing patient care with the supervising member you can perform these activities.
If the supervising member is not within arm’s reach, you are prohibited from performing these activities. This includes during patient transport if you are the lone attendant in the patient compartment.
I will be working with a restricted PCP member, what are the College’s expectations of me?
You will continue to work to your scope of practice, however you will be placed in a position of providing direct supervision of your colleague when they are performing prohibited activities. This is to ensure that adequate and safe patient care is being provided.
If a prohibited skill is indicated, you will now have to be present during the activity. If a high-risk procedure is required, such as CPAP utilization, you will be expected to assume care of the patient at this time.
Continue to work as a team and support your colleague in their practice. This is how optimal patient care is provided, and professional development occurs.
I am an employer and need to maintain my staffing requirements. How will this affect my service and staff?
The revisions to the restricted PCP licence awaiting examination results will allow for a more balanced task load amongst all providers.
We understand that staffing requirements are diverse and situations may change on a daily basis. We ask that you take all reasonable efforts in providing restricted members an experienced provider as a partner to allow for this supervision to take place. If this is unable to be provided, ensure that restricted members are aware that prohibited activities are not to be performed.
Are all restricted licences able to perform as indicated in the new revision?
This only applies to restricted PCP members awaiting examination results. Restricted licences may be imposed for various reasons. If you have a restriction for other reasons, this revision will not apply to your licence.
How can I determine if a member has a licence restriction?
The member’s certificate of licensure will identify if a restriction has been placed on their licence. To identify what level of restriction has been applied, please check the members licence certificate or visit the Member List on the Saskatchewan College of Paramedics website. Go to http://collegeofparamedics.sk.ca/ and choose Verify a Member.
How long does this licence restriction last for?
Restrictions are applied for various reasons. For the purposes of a restricted licence awaiting examination results the period is 6 months. An extension can be issued for an additional 6 months if required. If you are successful in your examination, the College will automatically revise your licence to reflect unrestricted status.
If you are unsuccessful after 1 year in achieving your unrestricted status or after 3 examination attempts have been made, you will need to reapply for a restricted licence after completing an approved retraining program.
For more information on this process please follow this link, https://collegeofparamedics.sk.ca/licensing/registration-process/new-graduates/
What defines direct supervision and experienced unrestricted member?
Direct supervision is defined as an experienced unrestricted member of the same licence level or higher working within arm’s reach. An example of this would be on-scene patient, dual attendants in the patient compartment, or offload delay with both providers present.
Once the supervising member is unable to maintain direct supervision, such as leaving the patient care environment or to drive the ambulance, this now is defined as indirect supervision. All prohibited activities performed by a restricted PCP member awaiting examination results require direct supervision.
Experienced unrestricted members are individuals who have held an unrestricted licence at the level of practice for a minimum of 2 years.
When will this revision take place and when can I start practicing to this level?
The revised licence restriction will come into effect January 9th, 2025. Until this time we ask that members who currently hold this restriction to continue assuming the restriction as stated.
“New graduate waiting to pass licensing exam are Restricted. Can only work under direct supervision. Direct supervision is defined as the supervising member being no more than an arms-length away from the restricted member at all times while they are providing patient care.”
Once the College staff have updated the member statuses for those that qualify for this restriction and the January 9th deadline has been met, you will be able to practice to this new revision. Be sure to inform your employer of this change in status.