The College of Nurses of Ontario (CNO) is the regulatory body responsible for governing the nursing profession in Ontario in the public interest and in accordance with the Regulated Health Professions Act (the “RHPA) and Health Professions Procedural Code, the Nursing Act, and other governing laws.

The CNO governs its members which include Registered Nurses (RN), Registered Practical Nurses (RPNs), and nurse practitioners registered in the extended class (NPs).

When the CNO a nurse to complete a Specified Continuing Education and Remediation Program (SCERP), it means that a concern about the nurse’s practice, conduct or competence has come to the CNO’s attention, and the CNO has identified that the nurse’s practice needs improvement or remediation.

Here’s an overview of what typically happens when a nurse is required to complete a SCERP:

1. Identification of concerns: The CNO may identify concerns about a nurse’s practice through different means, including:
   • complaints from patients, colleagues or other members of the public,
   • incidents reported by the nurse’s employer or the healthcare facility where the nurse works, and/or
   • during the CNO’s regular practice assessments (Quality Assurance program).
2. Investigation and assessment: Once concerns are identified, the CNO initiates an investigation and assessment process. The investigation is overseen and assessed by the Inquiries, Complaints and Reports Committee (ICRC). The investigation process typically involves a staff member of the CNO or an appointed investigator gathering relevant documents and records, and interviewing relevant witnesses, and obtaining the nurse’s written response to the identified concerns.A panel of the ICRC will review the information gathered and make a decision based on their assessment of the concerns raised, and the information obtained about the nurse’s practice during the investigation. The ICRC’s review is conducted in private. It does not involve a hearing and the nurse does not participate in the review.
3. Decision and notification: Based on the information gathered during the investigation, the CNO’s ICRC makes a decision regarding the nurse’s practice. The decision-making powers of the ICRC are set out in section 26 of the Health Professions Procedural Code.If the panel determines that the nurse’s practice requires improvement, it may require the nurse to complete a SCERP. The nurse is then notified of this decision, and provided with details of the program requirements.
4. SCERP requirement: A SCERP is a customized education and remediation program designed to address the specific areas of concern identified in the nurse’s practice.The nurse is provided with a clear outline of the program requirements, including timelines and expectations. The program may include a combination of requirements including,
   • reviewing specified learning materials,
   • preparing a written reflection about the nurses’ practice and how the nurse can improve their practice in the future,
   • one or more meetings with a regulatory expert designated by the CNO,
   • completion of educational courses and/or workshops,
   • completion of clinical assessments, and/or
   • supervised practice for a defined period of time.
5. Completion of SCERP: The nurse is responsible for actively participating in and completing the required components of the SCERP within the specified timeframe. This may involve attending educational sessions, submitting assignments, undergoing assessments, and meeting with a designated program supervisor or mentor. If the nurse requires additional time to complete the requirements, an extension request must be formally made in writing to the CNO.
6. Progress monitoring: Throughout the SCERP, the nurse’s progress is closely monitored by the CNO monitoring department, and a designated assessor if applicable. The nurse may be required to provide regular updates, documentation, and evidence of their learning and improvement.
7. Program evaluation and outcome: Once the nurse completes the SCERP, the CNO evaluates the nurse’s performance and progress. If the nurse has successfully met the program requirements and demonstrated the necessary improvement, the CNO may consider the matter resolved. However, if further improvement is needed, additional measures may be taken.
8. Notion on “Find a Nurse”: when the CNO required a nurse to complete a SCERP, the fact and basic details about the requirement will be posted on the nurses’s public register profile on the CNO’s website (CNO Find a Nurse).

It’s important to note that the SCERP is designed to support nurses in enhancing their practice and ensuring public safety. It is not considered a punitive outcome. It provides an opportunity for nurses to address any identified concerns, learn new skills, and demonstrate competence in their professional responsibilities.

If you have been asked to respond to a CNO complaint or facility report and are worried that the CNO may require you to complete a SCERP, schedule an initial consult to find out how we can help.