canada, disclosure of certain past or ongoing legal proceedings, disclosure of certain proceedings involving practice of nursing in other jurisdictions and disclosure of certain kinds of health conditions and disabilities. in 2008, there were 27,432 rpns registered as practicing with the cno. by 2017, this has increased to 48,748. by comparison to other classes of nursing in ontario, there were 104,483 rns and 3,083 nps. 90.9% of the 2017 rpns were female and the average age was 40.8 years. 89.9% attended a nursing school in ontario; however members who previously attended nursing schools outside ontario which were not accepted as valid by the cno at the time of their registration are not reflected in that number. the cno's definition for a nurse's scope of practice is: "the practice of nursing is the promotion of health and the assessment of, the provision of care for, and the treatment of health conditions by supportive, preventive, therapeutic, palliative, and rehabilitative means in order to attain or maintain optimal function". the college of nurses of ontario (cno) outlines 13 controlled acts, 4 of which can be performed by rpns and rns. the 4 controlled acts available to be performed by rns and rpns are: performing a prescribed procedure below the dermis or mucous membrane administering a substance by injection or inhalation putting an instrument, hand, or finger: beyond the external ear canal beyond the point in the nasal passages where they normally narrow beyond the larynx beyond the opening of the urethra beyond the labia majora beyond the anal verge or into an artificial opening in the body dispensing a drug the college of nurses of ontario (cno) has 4 principal roles in the regulation of ontario nurses: articulating and promoting practice standards establishing requirements for entry to practice administering a quality assurance program enforcing standards of practice and conduct the cno has set 7 standards of practice for all nurses in ontario: accountability continuing competence ethics relationships (therapeutic nurse-client relationships and professional relationships) knowledge knowledge application leadership registered nurses are expected to have a higher level of competency in the last three of these standards of practice than rpns. in alberta, lpn's have a greater scope of practice than most provinces. they can perform most tasks that an rn can do, however, the complexity of the patient's condition determines if the lpn is in charge of care, or collaborating on care with an rn. in ontario, rpns are actively expanding their roles and scope of practice, modelling similarly to alberta, with the exception that in ontario, both rns and rpns are regulated by the same regulatory body. this model allows for both categories of nurses to be practising under the same guidelines and accountability models. in canada, in home-care settings lpns sometimes act as the liaison between the care provider and the local health authority, coordinating care. united kingdom the state enrolled nursing qualification can no longer be gained in britain. prior to the implementation of project 2000 which radically altered the face of nurse education in the mid-1990s, sen students used to be trained within two years. their course was a simplified version of the longer training offered to state registered nurses (srns, later to be renamed rgns, registered general nurses and now known as level-one nurses). some auxiliary nurses with many years of experience were selected to progress to enrollment as a sen. people training to be srns who failed their exams at the third attempt were also able to enter the nursing register as a sen. no new sens are trained in the uk today. the nursing and midwifery council (the regulatory body for nurses in the uk) previously used to allow people to be added to the register as level two nurses if they are moving from a similar position from within the european union, however this has now stopped. level-two nurses from the eu wishing to gain entry to the register in the uk must be willing to train as a first level (staff) nurse. this is by two different means: starting their training from scratch as a pre-registration student nurse, or by joining an existing cohort of student nurses starting their second year of training, and completing years 2 and 3 with them formerly, there was a large segregation between the "green" sens and "blue" srns, which were the colour of uniform typically worn. sens were very much complementary to the nursing team, however did not have the status of srns and were ineligible to be promoted, e.g., to ward sister. many sens sat or re-sat the srn exams, however a large number did not and were quite content being a sen. nowadays, the divide between level one and two nurses is diminishing due to the small number of sens still in practice. the demise of the sen is lamented by many who saw it as a balanced way to staff a ward. however, the divide also meant that potentially, the gap in clinical excellence could be too wide. in many areas, ens and sens are being replaced with lesser qualified healthcare assistants educated to s/nvq level 3 or 4, being awarded titles such as senior healthcare assistant, senior auxiliary nurse, senior clinical support worker, care team leader or senior care assistant. although originally viewed as a less qualified nurse, ens and sens are now able to hold the rank of deputy charge nurse in the nhs and deputy home manager in the private sector, as well as unit manager, both within the nhs and the private sector, and in some instances higher, technically out-ranking a staff nurse (first-level rn). auxiliary nurses draw blood samples, change bandages, and record ecgs. at present, they work under the direct supervision of a registered nurse. as of 2018 the enrolled nurse has been re introduced to the uk and these practitioners hold the title of registered nurse associate. rna's must complete a two-year foundation degree and hold formal registration with the nmc. rna's must also revalidate every three years as is also the case for rn's. they are placed at band 4 in the nhs banding system. rna's are responsible for their own allocated patients and are certified to administer most medications. this bridged the gap between the lesser qualified hca and rn. as far back as 2004 the enrolled nurse role was brought back in a limited fashion, placed at band 4 and called assistant practitioners. whilst they continue to work within the nhs today they are not registered practitioners. australia the national australian health practitioner regulation agency (ahpra) issues permission to practise. endorsed enrolled nurses (en), or division 2 nurses, in australia must now complete the diploma of nursing and usually spend 18 months training, consisting of 36 weeks theoretical component at tafe colleges, some universities or private institutions, followed by practical experience in hospital wards for the remainder of the time. the majority of eens eventually move on to attend university and become registered nurses, although a substantial number remain as eens in public and private hospitals, and nursing homes. trainee enrolled nurses (tens) become employees of the hospital for the twelve-month training period, meaning that, as well as gaining practical experience on the wards, they are paid for hours worked. this attracts a substantial number of applicants, who may wish to pursue nursing as a career, but are unable to afford to become full-time university students. as of 2009, however, the government has stopped working with the nsw department of health, and those wishing to become enrolled nurses are not being paid. the enrolled nurse programme also allows people to ascertain whether or not they are suited to nursing before they make the decision to study it at university level. the role of enrolled nurses in australia has greatly increased in recent years in response to the continuing shortage of registered nurses in the australian public health care system. in 2004, a medication endorsement certificate was introduced, allowing ens to administer some oral medication (excluding schedule 8 drugs of addiction) upon completion. although medication endorsement is now included in the diploma. endorsement also permits the administration of some intravenous (iv) medications and fluids (intravenous therapy or ivt), as well as intramuscular (im) and subcutaneous (sc) injections. endorsed enrolled nurses (eens) are also permitted to check & give s4d and s8 medications with a registered nurse. most enrolled nurses working in public hospitals are permitted to conduct ecgs, collect pathology specimens, and routinely take a patient load under the direct supervision of a registered nurse. despite the fact that the role of the en in australia has been greatly expanded in recent years, opportunities for career progression remain somewhat limited, and for this reason, many choose to go on and study to become registered nurses. in terms of financial remuneration, the earning capacity of an enrolled nurse is capped at five years of service, whereas registered nurses continue to eight years before salary capping is applied.