Redeployment and taking on new roles and tasks

Updated: March 2026.

Practice Question

My employer has asked if I can support team-based care by assisting with nursing tasks. These tasks may include taking vital signs or providing suctioning for patients. Am I able to help? What should I consider?

Increasing demands for care sometimes result in dietitians being asked to work in areas they do not typically practise in. Sometimes a dietitian may be asked to work outside the traditional dietetic scope of practice. This occurred, for example, during the Covid-19 pandemic.

There are no simple answers to whether a dietitian can perform these tasks.  Each situation depends on the practice environment and the task itself, and the dietitian’s competence.

When considering new responsibilities, dietitians should work with their employer and consider:

• client needs;
• personal competence (knowledge, skills and judgment);
• interprofessional care;
• professional obligations, including legislation relevant to the practice setting and organizational policies; and
• risk management, including confirming liability insurance coverage if asked to perform tasks outside one’s usual role or scope of practice.

College Tools to Support Decision-Making

Two CDO resources can help dietitians determine whether they can take on new responsibilities.

1. RD role and task decision framework.

This framework helps dietitians evaluate new tasks, responsibilities or opportunities in practice.

2. Standard of Practice – Practising Through a Delegation of a Controlled Act.

This standard applies when a dietitian is asked to perform a controlled act that is outside the dietetic scope of practice.

In these situations, dietitians must receive delegation through a direct order or a medical directive. The Standard outlines the minimum expectations for safe practice when accepting a delegation.

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Applying the RD role and task decision framework

Example: Taking a temperature

Below is an example of how the framework can be applied to assess whether a dietitian performs temperature screening.

Question 1: Is the task within the dietetic scope of practice?

Temperature checks may fall within dietetic scope when used as part of nutrition assessment (such as assessing hydration and fluid status or estimating energy needs).

However, if the temperature check is for reasons unrelated to nutrition care (for example, routine screening), the organization must determine whether the task is considered a screening procedure, diagnostic procedure or a treatment. They may vary depending on how the information is used and the practice setting.

Question 2: Are there legal or organizational considerations?

Taking a temperature is not a controlled act.

If the organization considers the activity a screening procedure, dietitians may perform it without additional authority.

However, in hospital settings, if the temperature check is considered a diagnostic or treatment procedure, an order or medical directive is required under the Public Hospitals Act.

Dietitians must avoid communicating a medical diagnosis. For example, they may state that a temperature is elevated but cannot communicate a diagnosis of a medical condition unless authorized through a delegation.

Question 3: Do I have the knowledge and skill to perform the task?

Dietitians must have the appropriate training to perform the task. This includes:

• Using the thermometer correctly.
• Taking accurate readings.
• Following screening protocols and escalation procedures.

Question 4: Who is best positioned to perform the task?

Given increasing pressures on the healthcare system, dietitians performing tasks such as temperature checks may support team-based care. Dietitians should use professional judgement and follow direction from their employer.

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When a Task is a Controlled Act

Some tasks (such as injections) are controlled acts under the Regulated Health Professions Act.

Controlled acts pose a risk of harm when performed by someone without appropriate authority.

Authorized professionals may delegate controlled acts to dietitians when appropriate. Delegation can help improve timely care and optimize health-care resources.

When considering whether to accept a delegation, dietitians should ask:

1. Is the delegation in the client’s best interest?
2. Do I have the knowledge, skill, and judgement to perform the act safely?
3. Am I aware of relevant legislation and organizational policies?
4. Am I meeting standards for informed consent and record keeping?
5. Do I understand the accountability and quality assurance processes in my workplace?
6. Have I reviewed CDO’s delegation standard?

Applying the delegation standard

Example: Administering an injection

Practice Scenario

A dietitian works in a retirement home. The medical director asks whether the dietitian can administer a subcutaneous vitamin B12 injection for a resident who has difficulty traveling to outside appointments.

Administering an injection is a controlled act under the Regulated Health Professions Act.

The dietitian applies the delegation standard to determine whether it is appropriate to accept the delegation.

1. Is the delegation in the client’s best interest?

The dietitian considers:

• The resident requires regular vitamin B12 injections for treatment.
• Receiving the injection on-site would prevent unnecessary travel.
• Timely administration supports the resident’s care plan.

2. Do I have the knowledge, skill, and judgment to accept this delegation?

The dietitian asks:

• Do I understand the purpose, benefits, and risks of vitamin B12 injections?
• Have I been trained to administer subcutaneous injections?
• Can I recognize and respond to complications (for example, allergy, bleeding)?
• Can I demonstrate competence to the delegator?

The dietitian has prior training but arranges a refresher demonstration with the physician. Competence is confirmed. Developing knowledge and skills can be supported by creating a SMART learning goal as part of the annual Self‑Directed Learning (SDL) Tool. An example is provided at the end.

3. Am I aware of relevant legislation and organizational policies? 

The dietitian confirms:

• Administering an injection is a controlled act and requires delegation.
• The retirement home has no policy prohibiting dietitians to accept delegated controlled acts.
• The delegator (physician) is authorized to perform and delegate the act.
• The organization has clear documentation and medical directive processes.

4. Am I meeting standards for informed consent and record keeping?

Before performing the injection, the dietitian must:

• Explain the purpose, benefits, risks, and alternatives.
• Obtain informed consent and document this conversation.
• Document the delegated authority, dose, time, site, and resident response.

5. Do I understand accountability and quality assurance processes in my workplace?

The dietitian ensures:

• They understand ongoing reporting and evaluation expectations.
• They know who to contact for questions or if complications occur.
• They follow organizational protocols for safe medication administration.
• They maintain competence through regular practice and training.

6. Have I reviewed the minimum performance expectations in the delegation standard?

The dietitian reviews CDO’s delegation standard to confirm:

• Responsibilities when accepting delegated authority.
• Documentation expectations.
• Requirements for ensuring safe client care.
• When to refuse delegation (for example, unsafe, unclear orders, lack of competence).

Outcome

After completing all steps, the dietitian confirms:

• The task is safe and appropriate.
• Delegation is properly authorized.
• Competence has been demonstrated.
• Policies and documentation requirements are met.

The dietitian accepts the delegation and provides the subcutaneous B12 injection safely, consistent with the delegation standard. 

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How to turn this learning into a SMART learning goal for the SDL Tool

Goal

My learning goal is to develop and demonstrate the knowledge, skill, and judgment required to safely administer subcutaneous vitamin B12 injections under delegated authority in my current practice setting by [insert date, for example, June 30, 2026].

This learning goal applies to my practice because I have received delegated authority from a physician to administer vitamin B12 injections for a client. Vitamin B12 deficiency is a nutrition‑related condition that requires ongoing replacement therapy as part of a nutrition care plan, and timely administration supports safe, effective client care.

I will know I have achieved this learning goal when:

• I can safely and competently administer subcutaneous vitamin B12 injections in accordance with the delegation, organizational policy, and professional standards
• My competence is demonstrated and confirmed through direct observation or feedback from the delegating physician or appropriate supervisor
• I consistently document informed consent, administration details, and client response according to workplace requirements

Action Plan

I will achieve this learning goal by completing the following activities:

• Reviewing the College of Dietitians of Ontario Standard for Practising Through the Delegation of Controlled Acts and relevant legislation related to controlled acts by [insert date]
• Reviewing my organization’s policies and procedures related to medication administration, documentation, and escalation of concerns by [insert date]
• Completing training and/or a refresher demonstration with the delegating physician (or qualified trainer) on subcutaneous injection technique by [insert date]
• Practising injection technique through simulation and supervised injections until competence is demonstrated by [insert date]
• Reviewing potential risks, contraindications, and complications related to subcutaneous injections and applying appropriate medication administration and escalation protocols by [insert date]
• Applying this learning in practice while ensuring informed consent, accurate documentation, and adherence to organizational and professional standards by [insert date]

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References

College Standards, Guidelines, and other articles
College of Dietitians of Ontario (2026). RD role and task decision-making framework.
College of Dietitians of Ontario. (2020). Standard: Practising through the Delegation of Controlled Acts.
College of Dietitians of Ontario (n.d.). The 14 Controlled Acts under the RHPA. 

Legislation
Public Hospitals Act, R.S.O. 1990, c.P40. R.R.O. 1990, Reg. 965: Hospital Management Regulation.
Regulated Health Professions Act, S.O. 1991, c. 18.