In response to persistent nursing shortages post-pandemic, hospitals across Canada have increasingly relied on registered practical nurses (RPNs) to help meet growing patient care needs. A new study from The Institute for Education Research at UHN suggests that as RPNs take on expanded responsibilities in care settings, clearer role expectations, stronger professional development opportunities, and improved workplace supports are needed to improve retention and strengthen collaboration. 

In Canada, both RPNs and registered nurses (RNs) are licensed nurses, but RNs complete more extensive education and are more common in hospital settings. Traditionally, RNs care for patients with more complex or unpredictable health needs, while RPNs care for patients in more stable conditions. However, with ongoing staffing shortages, RPNs’ roles continue to evolve and grow. To better understand the unique role of RPNs and how they work alongside other health care team members, the research team interviewed 24 participants, including RNs, RPNs, nurse leaders, and personal support workers in hospital care settings. 

Participants described teamwork, cross-team collaboration, and clear communication as essential during key care decision points and in managing increasingly complex patient care needs. However, many participants expressed uncertainty about the boundaries between RN and RPN responsibilities, particularly when patient conditions changed or became more complex. Participants identified a need for greater role clarity and more consistent guidance from both nursing regulatory agencies and health care organizations. 

Participants also acknowledged the value of the RPN role in providing an accessible entry point to the nursing profession and supporting a cost-effective staffing model for organizations. However, these benefits also highlight the need for more targeted strategies for retaining RPNs, including appropriate compensation and opportunities for career advancement. 

The findings suggest that hospitals and nursing regulatory bodies could improve collaboration and retention by providing clearer guidance on nursing roles and creating more opportunities for professional growth. As health care systems continue to evolve, supporting the retention and development of RPNs may be an important step toward maintaining high-quality patient care and building a more sustainable nursing workforce.  

Dr. Alyssa Indar, lead author of the study, is an Education Investigator at The Institute for Education Research at UHN. Dr. Indar is also an Adjunct Lecturer at the Lawrence Bloomberg Faculty of Nursing at the University of Toronto.

Dr. Sherry Espin, co-author of the study, is an Affiliate Scientist at The Institute of Education Research at UHN. Dr. Espin is also a Professor in the Daphne Cockwell School of Nursing at Toronto Metropolitan University.

This work was supported by UHN Foundation and the Registered Practical Nurses Association of Ontario (WeRPN).  

Indar A, Espin S, Jones A, Bookey-Bassett S, Martina K, Hubley P, Teodoro J, Aiello M, Browne C. Intraprofessional collaboration in acute care: Generating evidence to inform nursing workforce retention strategies. Nurs Outlook. 2026 Jun 11. doi: 10.1016/j.outlook.2026.102832.