Nurse Practitioner – Anaesthesia

Heather Whittle RN (EC) NP - Adult, MScN, and Pam Hubley RN, MSC, ACNP (diploma) on behalf of Nurse Practitioners’ Association of Ontario Interest Group


Nurse anaesthetists have been providing care in the United States for over a century, beginning with the Civil War. In the U.S., the first school of Nurse Anesthesia was founded in 1909 in Oregon.

In the 1970s, several primary care educational programs for nurse practitioners were developed in Canada. In Ontario, the role declined due to lack of funding and legislative support. Political interest in the role in primary care resurfaced in the early 1990’s. Education programs for NPs in primary care were introduced. The Expanded Nursing Services for Patients Act was proclaimed in 1998. This legislation enabled the College of Nurses of Ontario (CNO) to establish the Registered Nurse in the Extended Class - RN (EC) category. In 1999, Post-Masters Acute Care Nurse Practitioner (ACNP) courses were established at the University of Toronto and the University of Western Ontario in response to an identified need for the role in teaching hospitals. In 2006, the College of Nurses of Ontario moved to protect the title of Nurse Practitioner (NP). CNO also protected the title of NP – Anaesthesia to facilitate the future development of the role in Ontario.

Specialty Education

The University of Toronto offers two programs to obtain specialty knowledge in anesthesia care for NPs. (1) A Post – Master of Nursing (Nurse Practitioner Field) Diploma in Anaesthesia Care for current NPs. (2) A Master of Nursing (Nurse Practitioner Field)

Concurrent Diploma in Anesthesia Care offered for candidates enrolled in the Master of Nursing-NP program.

Scope of Practice

Currently NPs interested in practising in the context of anaesthesia care practise within the scope of the RN (EC) NP standards. The scope of practice of the NP - Anaesthesia is similar to other NP specialities, however, their work is often done within the context of anaesthesia care teams, perioperative settings or acute pain services.

Practice Environment

NPs who have completed the anaesthesia care diploma are usually working in a collaborative practice with anaesthesiologists. These NPs are leading the way to defining new scopes of practice and new opportunities for NPs to practise in the context of caring for patients undergoing procedures that require sedation, pain management and anaesthesia services to maximize patient outcomes. The future for NP roles in this context is promising and once formal regulatory parameters are in place, the scope of practice will be more clearly articulated.

Liability Protection

Nurse Practitioners who are RNAO members are automatically eligible for liability protection through Canadian Nurses’ Protective Society (CNPS).


Nurse Practitioners’ Association of Ontario:
Canadian Association of Advanced Practice Nurses: