Partnerships in Nursing A Look at the Changing Roles in Nursing
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Partnerships in NursingA Look at the Changing Roles in
Nursing
Partnerships in NursingA Look at the Changing Roles in
Nursing
June 20, 2005
HEABC AGM
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Partnership PanelAnne Sutherland BoalChief Nurse Executive, Assistant Deputy Minister, Clinical Innovation and IntegrationMinistry Of Health Services
Lynne GrayDirector, Practice Support ServicesRegistered Nursed Association of British Columbia
Dr. Lynn StevensonLeader, Professional Practice & Chief Nursing Officer Fraser Health Authority
Karen JewellSenior Consultant, Advocacy and Special ProjectsHealth Employers Association of British Columbia
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PartnershipsA Ministry of Health – Nursing
Directorate Perspective
Goal:
To support the Ministry of Health Services Service Plan in the stewardship of a quality health care system
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Providers of Care
1 in 10 employed Canadians work in health care
228,000 RNs 60% of RNs work in
the hospital sector 1/3 eligible to
retire in 10 years
In BC, – 29,000 RNs – 5,000 LPNs – 2,000 RPNs – 600 new
graduates per year
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Nursing Directorate
•Strategies to recruit, retain and educate nurses
•$63M invested since 2001
•RN Graduates in 2001 – 570; in 2005 – 800
•LPN Upgrade – 700 / OR LPN Pilot
•Specialty Education – over 6000 supported
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Future Trends for Health Care Future Trends for Health Care and Nursingand Nursing
Emphasis on:
Primary Care
Gerontology
Mental Health
Community Health
Chronic Disease Management
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Average Age of Regulated Nursing Professionals Employed in Nursing by Province/Territory of Registration 2002
35.0
37.0
39.0
41.0
43.0
45.0
47.0
49.0
51.0
53.0
55.0
P rovinceRegistered Nurses Licensed P ractical Nurses Registered P sychiatric Nurses
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Number of Regulated Nursing Professionals Employed in Nursing per 10,000 Population by Province/Territory of Registration Canada 2002
0
10
20
30
40
50
60
70
80
90
100
110
120B
C
ALT
A
SA
SK
MA
N
ON
T
QU
E NB
NS
P.E
.I NL
YT
NW
T
NU
N
CA
N
W.C
AN
Province
Num
ber p
er
10,0
00 p
op
Registered Nurses Licensed P ractical Nurses Registered P sychiatric Nurses
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Policy Initiatives
•Amendments to the Health Professions Act
•Implementation of the Nurse Practitioner
•HEABC/NBA Nursing Policy Discussions
•Interprofessional Rural Placement Program
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The Future
•Partnerships across professions / stakeholders / continuum of care
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Partnerships RNABC partnered with both the
College of Psychiatric Nurses of BC and the College of Licensed Practical Nurses of BC
RNABC partnered with the College of Licensed Practical Nurses of BC to develop a pamphlet and workshop called Practice Expectations: RNs and LPNs
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Partners at the National Level
Evaluation Framework to determine the Impact of Nursing Staff Mix Decisions
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Key RNABC PrinciplesReflected in the Regulations
• Scope of practice should reflect the reality of registered nursing practice
• Clear responsibility and accountability is fundamental to safe client care
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Delegation
Delegation must be agreed to by both Colleges
Delegation is an individual professional responsibility
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Orders
For a named individual
Pre-printed orders are included
Can be written by the practitioners listed in the Regulations
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Limits on Practice
Regulation
• CRNBC Limits and Conditions• Agency Policies• Individual RN• Competence
Decision to Act
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RNABC’s Regulatory Framework
for Nurse Practitioners Competencies and Approval of
Educational Programs Initial Registration of Nurse
Practitioners Regulatory Oversight of Nurse
Practitioners
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Partnerships for the FutureThe Changing Face(s) of Nursing
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Educational PreparationLicensure
Criteria for entrance – ‘good sturdy stock’ - high GPA
Education – ‘on the job’ – College preparation for LPNs, RPNs and University for RNs (RPNs)
Each school/employer hired based on their specifications – Regulatory Colleges (CLPNs, CRPNs, RNABC)
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Learning Practice Partnerships - Action/Experiential Learning Practice Partnerships - Action/Experiential Learning ModelLearning Model
PRACTICE to consolidate learning
UGN New Grads Post Grads
prpr PRACTICE
prpr PRACTICE
prpr PRACTICE
1-3 Years Students 4th Year RN Continuing Ed
to develop post basic knowledge and skills
LEARNING to develop new knowledge
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Clinical Learning Continuum
kdougherty feb 2005
expert
competent
Novice NG
Practice
Competence
attain maintain sustain
work experience
orientation
continuing ed
Clinical Learning Continuum
UGN
student preceptorship
clinical learning unit consolidation
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Learning Practice Partnerships
kdougherty feb 2005
UGN (500 hrs) New Grad (up to 1 year) Post Grad (life-long learning)
3rd & 4th year Students4th year RN
Continuing Education Acute Specialty Long Term Care Case ManagerPalliative Care
Learning Practice Partnerships
K.Dougherty October 2004
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New Partnerships
Educational Institutions (EI) – areas of focus in 4th year (RNs)
Joint appointments between EI and HAs Innovative student placements –
collaborative learning units HAs – expanding placement options –
public health, home health, OR and all areas “U”
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Facilitators for the Future Flexibility to utilize the newly educated Flexibility in relation to real or perceived
seniority barriers Flexibility from HAs to experiment with
innovative student experiences Realization that learning is life-long and
shared responsibility between professional and employer
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HEABC provides labour relations and human resources and related services that contribute to:
Sustainability, innovation and service excellence in health care
Consistent practices that contribute to quality care
Constructive labour-management environment
Effective employer representation at the bargaining table
HEABC Mission Statement
HEABC Health Employers Association of BC
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One of HEABC’s objectives is to assist health authorities, health employers and the Ministry of Health Services achieve their goals and objectives related to effective, sustainable health care delivery services.
Among other services, HEABC provides Labour Relations Services, Human Resource Planning, and Compensation Services and conducts Collective Bargaining on behalf of its members.
HEABC Health Employers Association of BC
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Human Resource PlanningHEABC provides advice and assistance in areas such as:
Recruitment and Retention Professional Development and Education Supportive Work Environments, e.g. Occupational
Health and Safety Effective Management Team support through
workshops: Selection Discipline and Performance Evaluation Managing Grievances Occupational Health and Safety Claims Management and Early Safe Return to
Work Attendance Management Managing Leaves
HEABC Health Employers Association of BC
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Compensation Services
HEABC provides advice and assistance with:
Classification issues Job Descriptions Compensation Determinations
HEABC Health Employers Association of BC
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Labour Relation Services
HEABC provides advice and representation on a wide variety of issues, including:
Scope of Practice Health Professions Council submissions Interpretation of Legislation Work jurisdiction disputes Collaborative practice
Practice/performance issues Certifications
HEABC Health Employers Association of BC
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Collective BargainingTraditional Bargaining Focuses on each party’s own solutions to
problems These “solutions” are found in proposals
that are typically in conflict with the other’s
Often involves each party strategically adopting polarized positions and asking for more than they expect to receive so they will have something to “give away” to achieve a settlement
HEABC Health Employers Association of BC
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Collective Bargaining cont.
Interest Based Bargaining (IBB) Emphasizes a more cooperative approach Begins with understanding the problems
and identifying mutual common interests that compliment each other
Negotiations occur over “interests” (needs, desires, fears and concerns of both parties) rather than “positions” (each parties proposed solutions)
HEABC Health Employers Association of BC
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2004 Policy framework for NBA bargaining
Ongoing Policy discussions with the NBA: Utilization and regularization of casual
and overtime hours Responsive shift scheduling Early retirement/new graduate
partnerships Duty to accommodate Long term care staffing
HEABC Health Employers Association of BC
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Panel Contact Information
Anne Sutherland BoalChief Nurse Executive, Assistant Deputy Minister, [email protected]
Lynne GrayDirector, Practice Support [email protected]
Dr. Lynn StevensonLeader, Professional Practice & Chief Nursing Officer [email protected]
Karen JewellSenior Consultant, Advocacy and Special [email protected]