1. careers
2. nursing

A public ation of the College of Regis tered Nur ses of Nova Scotia
Volume 15, Number 1, Spring 2014
Have a
Practice
Question?
We can Help
The 2013 Practice
Consultation Report (p.20)
focus
In this issue:
College’s Award Recipients (p.7)
RN & NP New Grad Survey Results (p.13)
NP Controlled Drugs & Substances
Education (p.26)
Staff Directory
Contents
Phone: 902.491.9744
NS Toll free: 1.800.565.9744
In this issue …
Telephone Extensions and E–mail Addresses
Executive Office
President’s Message
01
Executive Director’s Message
02
College News
03
Annual General Meeting
05
Council Highlights
08
Corporate Services
Professional Development
10
iN Practice
24
Colleen Arnold, Director (235) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ca@crnns.ca
Colleen Burke, Communications Officer (230) . . . . . . . . . . . . . . . . cb@crnns.ca
Hillary MacEachern, Communications Consultant (231). . . . . . .hm@crnns.ca
Sheri MacLellan, Corporate & Registration Services Assistant (252)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . sm@crnns.ca
Karen Mahoney, Multimedia Designer (243) . . . . . . . . . . . . . . . .km@crnns.ca
Edith Mosher, Finance Officer (234). . . . . . . . . . . . . . . . . . . . . . . . em@crnns.ca
Song Peng, Technology Applications Specialist (253) . . . . . . . . . sp@crnns.ca
Lee Whynot, Technology & Information Systems Officer (237). lw@crnns.ca
Jia Zhu, Records Management Analyst (251) . . . . . . . . . . . . . . . . . . jz@crnns.ca
Telehealth30
Events Calendar
32
Nursing in Focus is a publication of the College of
Registered Nurses of Nova Scotia, published Spring and
Fall. The Editor welcomes comments and suggestions
from readers. Letters to the Editor are also welcome.
Members’ articles will be printed according to
availability of space, and may be edited for length or
content. Articles submitted should not exceed 1500
words, and electronic copies are required. Signed
articles represent the views of their authors and do
not necessarily reflect the College’s position or policies
on a specific topic. Submission deadlines: February 15,
August 15.
Advertisements are accepted at the discretion of
the Editor, but not necessarily endorsed by the College.
Advertsing deadlines: February 1, September 1.
Material printed in Nursing in Focus may be re–
printed, with permission, if reference is made to the
source and credit is given to the author(s).
Nursing in Focus is indexed in the Cumulative
Index to Nursing & Allied Health Literature.
ISSN 1492–2878.
Mailed under Canada Post Publications Mail Sale
Agreement No. 40008039.
Donna Denney, Executive Director (233) . . . . . . . . . . . . . . . . . . . . dd@crnns.ca
Shelley Farouse, Executive Assistant (223). . . . . . . . . . . . . . . . . . . sf@crnns.ca
Jane Wilson, Communications Consultant (203). . . . . . . . . . . . . . . jw@crnns.ca
Professional Conduct & Registration Services
Heather L. Totton, Director (241). . . . . . . . . . . . . . . . . . . . . . . . . . . . ht@crnns.ca
Karen Boutilier, Administrative Assistant (232). . . . . . . . . . . . . . . kb@crnns.ca
Ann Marie Cameron, Registration Officer (239). . . . . . . . . . . . . amc@crnns.ca
Matthew Lafond, Professional Conduct Consultant (245). . . . . . ml@crnns.ca
Darlene Mott, Professional Conduct Consultant (227). . . . . dmott@crnns.ca
Cathy Rose, Policy Consultant (225) . . . . . . . . . . . . . . . . . . . . . . . . .cr@crnns.ca
Shelly Spears, Registration Services Assistant (221). . . . . . . . . . . ss@crnns.ca
Haley Young, Registration Services Assistant (249) . . . . . . . . . . . hy@crnns.ca
Policy, Practice & Legislation Services
Teri Crawford, Director (242). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . tc@crnns.ca
Jennifer Best, Nursing Practice Consultant (256). . . . . . . . . . . . . .jb@crnns.ca
Clare Brown, Policy Consultant (226). . . . . . . . . . . . . . . . . . . . . . . ceb@crnns.ca
Trent MacIsaac, Nursing Practice Consultant (250). . . . . . . . . . . tm@crnns.ca
Darlene Martin, Administrative Assistant (224). . . . . . . . . . . . . . dm@crnns.ca
Lynn Miller, Policy Consultant (228). . . . . . . . . . . . . . . . . . . . . . . . . lm@crnns.ca
Crystal Morgan, Administrative Assistant (255) . . . . . . . . . . . . . cm@crnns.ca
Paula Prendergast, Policy Consultant (244) . . . . . . . . . . . . . . . . . . pp@crnns.ca
President’s
Message
It hardly seems possible that almost
two years have passed since I become
President of the College’s Council and
that this is my last Nursing in Focus
message to members. It’s cliché to say,
“time flies” but close to two years have
passed by in a blink.
As you may know, I am a registered
nurse practicing at Capital Health in
addition to being President of the
College, our regulatory body. The
concept of a regulated profession is
not always well-understood. Making
this more easily understood and
valued is something the College has
been working on. In simple terms,
regulation exists as government’s way
of protecting members of the public.
As registered nurses, we belong to a
self-regulating profession, which means
that registered nurses have been
entrusted to set and enforce the rules
of nursing. This is quite a privilege. The
College’s role is to provide oversight
for the practice of registered nurses.
One of the functions of the College
is to provide us as registered nurses
with the tools that support our
practice. The work of the College and
registered nurses – both frontline and
management - are intricately linked to
one another and we are part of a proud
nursing community in Nova Scotia.
When I started as President one
of my goals was to create more
opportunities for meaningful and
impactful engagement with members.
I am proud to say that we were able
to do just that through the Real
eNgagement initiative. 2013 saw both
Donna Denney, Executive Director
of the College, and I having new
conversations with registered nurses
throughout Nova Scotia that I feel have
well-positioned us to shape a stronger
future for the profession.
This work started because
members raised a Motion at one the
College’s Annual General Meetings and
led to the development of the Real
eNgagement project, which has the
capacity to positively impact all of us.
The fact that we, as registered nurses,
have the ability to create positive
change in the profession is something
I’ve always believed in and am
honoured to have been a part of at the
College and throughout my career. It
is my personal belief and the belief of
the College that an engaged profession
better leads to the provision of safe
and quality nursing care for the public.
Nursing has given back to me
more as a profession than I could have
imagined when I was a young nursing
student. I have always felt compelled
to give back to the profession and
one way I have been able to do this
is through my engagement with
the College. The College is not just
a President, a Council of your peers,
and staff members. It is your nursing
regulator. The College includes
registered nurses, just like you, and
public representatives that participate
in College activities to regulate nursing
in the public interest.
Nursing has been a self-regulating
profession in Nova Scotia since 1910.
It took an incredible amount of trust
in registered nurses for government
to first delegate registered nurses
with the responsibility to regulate
the profession themselves 104
years ago. It is a testament to the
incredible work of registered nurses,
and effective oversight on the part
of the College, that the legacy of
trust and self-regulation has been
maintained throughout this time.
The strong history of nursing in Nova
Scotia is something that we should
all take pride in and cultivate for the
generations that follow.
My advice to all of my nursing
peers throughout Nova Scotia is
to get involved. Your participation
in College activities contributes to
self-regulation of the profession. The
2014 Annual General Meeting will
be held on May 13th and I encourage
you all to take part. It will be my last
AGM as President and I welcome the
opportunity, as always, to connect with
as many of you as I can.
Finally, my term does not end until
July of 2014 but this is my last direct
message to members in Nursing in
Focus and I have many people to thank
for making my term as President a
memorable one. First and foremost,
I would like to thank my peers
throughout the province who have
offered kind words and support and
sometimes appropriate challenges. It
has been inspiring and comforting to
know that I am one of 10,000 strong
registered nurses committed to the
nursing profession in Nova Scotia. I
would like to thank my fellow Council
members for their ongoing support
and encouragement over the past
two years. It has truly been a pleasure
working with all of you. As I step down
as your President for 2012-2014, it is
with great pride that I welcome Jackie
Garden-Jaysinghe as your President
for 2014-2016. A sincere thank you to
Donna Denney, our Executive Director,
for her support and guidance. This has
truly been a privilege and one I will
honor. Please stay connected to the
College and work collectively to guide
and direct the future of nursing in
Nova Scotia.
Peter MacDougall
COLLEGE OF REGISTERED NURSES OF NOVA SCOTIA
1
EXECUTIVE DIRECTOR’s
Message
Spring is a time of renewal, growth and
rejuvenation. It’s the time of year when
hope seems to spring eternally – and
not just in our gardens - as we ease our
way out of winter into a fresh start and
new beginning.
It’s difficult not to be affected by
the metamorphosis that surrounds us
this time of year and it reminds me
that this evolution is something we
can model ourselves. At the College,
we want our work to develop and
grow and to have meaning to both our
members and to Nova Scotians. We
want to find new ways of rejuvenating
the nursing profession within our
regulatory mandate. This is a large
responsibility and it cannot be done
alone. It requires trust, engagement,
inspiration and hard work from all of
us – the Council, the College staff, our
members and stakeholders. Public
protection is something we all aim to
achieve together and cannot be done
without you.
As you flip through this issue of
Nursing in Focus, you may notice that it
looks a little different from past issues.
Things are changing at the College and
the good news is that this is only the
beginning. We have been inspired by
the work of the College of Registered
Nurses of British Columbia as they
implement ‘relational regulation’, an
interactive and engaging initiative
sweeping the country. Relational
regulation won’t change what we do
at the College but will change how
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NU R S I N G I N FO CU S S pr i n g 2 0 1 4
we do things, allowing us to improve
the relationships we have with our
stakeholders. We are still learning
but are encouraged by the shift we
are witnessing elsewhere in the
country and look forward to making
similar changes here in Nova Scotia.
So stay tuned because you will be an
important part of this work as we move
forward.
We must start by giving credit
where credit is due. It is thanks to
our members that the College’s Real
eNgagement project was born and
that initiative has been a significant
catalyst for change. Throughout 2013,
Peter MacDougall, President of the
College, and I travelled throughout
Nova Scotia speaking with registered
nurses about issues of importance to
them. Nurses came together to discuss
the core issues facing the nursing
profession and to envision the future
they wanted to create. The following
themes were prevalent across the
province. Registered nurses told us
they want to:
•
•
•
Reignite pride in the profession,
Lead with a solution-focused approach, and
Be decision makers in health system change.
We have already seen positive
engagement from our members
these past few months. We’ve had
increased participation in Council
election participation, better email
open rates for College communications
and we are honoured to have the
largest groups of participants at
this year’s AGM, taking place on May
13th. Much like spring, we see the
seeds of something new and feel a
responsibility to nurture this growth
into something that has the ability to
impact us all for the better. The College
believes that when registered nurses
are engaged in their profession that
there is a positive impact on patient
care and their nursing practice.
In closing, I would be remiss
if I did not take the opportunity to
publicly thank Peter MacDougall for
his commitment and leadership during
his term as President of the College’s
Council. While he remains as President
until July of 2014, this issue of Nursing
in Focus will be the last time our
messages appear together. It has been
a sheer joy to work with Peter and to
bear witness to his contributions not
only to the College but to the nursing
profession in Nova Scotia. Please
plan to join Peter, the rest of Council,
College staff and your colleagues
across the province for our May 13th
AGM and education sessions. Enjoy the
best of spring in Nova Scotia and we
look forward to connecting with you
all soon.
Donna Denney
COLLE G E NE W S
Changes are
coming to the
Internationally
Educated Nurse
Application
Process
Changes are coming to the application
process for internationally educated nurses
(IENs). Starting August 12th, 2014, in order
to be a nurse in Canada, all IEN applicants
will require their documents and credentials
to be submitted and verified by the National
Nursing Assessment Service (NNAS).
Once NNAS receives all documents and
an assessment of international credentials
is complete, applicants will be notified by
the NNAS. Those applicants who then wish
to practice in Nova Scotia may apply to
the College to complete the assessment
of eligibility for registration and licensure.
For many applicants, this may include the
completion of a competence assessment.
So what does this mean to international
applicants? IEN applicants who wish to
practice in any province in Canada (excluding
Quebec) will have one single point of contact,
which will help streamline the online
application process. The new changes will also
allow IEN applicants to complete applications
and initial payments online, send documents
to one central location, access a customer care
telephone line and track the status of their
applications through the NNAS website.
If the College has received a paid
application from an IEN applicant, it will
continue to be assessed under the current
process. The changes will not take place until
the new NNAS application process is launched
on August 12, 2014.
Nurses Engaging in Leadership
for the Profession
Now is your time to learn more about the Real ENgagement initiative
sweeping the nursing profession in Nova Scotia! What started as two
motions put forward by members at the College’s past two AGMs has
evolved into an inspiring process of transformation involving more than
300 registered nurses from across the province.
Join RN representatives of the Real eNgagement Advisory
Committee on May 13th at the College’s AGM. The committee will be
hosting interactive booths to highlight the future direction of the Real
eNgagement initiative. Come share your ideas about how RNs can lead
with a solution focused approach, be decision-makers in health system
change and re-ignite pride in our nursing profession.
For more information, feel free to check out the “Real eNgagement for
Real Action” Report on our website, which reflects the input of RNs across
the province on how to address core issues facing the nursing profession
in Nova Scotia.
The Jurisprudence Exam is
Underway in Nova Scotia
In a 2013 edition of Nursing In Focus, the College shared news with you
about our plans to introduce a jurisprudence exam as a requirement for
the 2014 licensure year. This year, the jurisprudence exam is underway
and is a mandatory requirement for new registered nurses (RNs) and
nurse practitioners (NPs) who wish to practice in Nova Scotia.
The jurisprudence exam tests an individual’s awareness of legislation,
standards and regulatory policies impacting the nursing profession. In
the interest of public safety, the College has a regulatory accountability
for its RNs and NPs to be knowledgeable about these topics, including
over 25 laws that govern and inform the nursing practice in Nova Scotia.
The ‘open book’ exam has been available online since September
2013 and will be required of every individual applying for a first-time
license to practice nursing as an RN or NP in Nova Scotia.
The College is committed to raising awareness of the jurisprudence
exam as a requirement of licensure within the nursing community
and amongst those who will be most impacted by its implementation.
Please visit our website for the latest information, including a recent
Jurisprudence Telehealth session.
COLLEGE OF REGISTERED NURSES OF NOVA SCOTIA
3
Our Continuing
Competence
Program: Advancing
the Practice
of Nursing
In the last 20 years, health regulators across Canada have
focused on developing programs to promote the continuing
competence of their members, in part to respond to increasing
public expectations for safe, competent and ethical health care.
In recent years, there has been an
increased focus by Canadian and
international registered nurse (RN)
regulators on the development and
implementation of meaningful and
rigorous continuing competence
programs (CCP). In 2002, the College
introduced a mandatory CCP called
Building Your Profile, and regular
review with modifications have
occurred.
The legislative requirements for
the College’s CCP are defined in the
RN Act and Regulations. In 2002, the
approach selected by the College
for the CCP was the completion of
a self-reflective process based on
the standards for nursing practice,
code of ethics and entry-level
competencies. Based on a provincial
working group’s recommendations,
minor revisions were made to
the program in 2008, however, no
changes were made to the CCP
components.
Increasingly, health care
regulators are identifying the need
for more rigorous and meaningful
4
N U R S ING IN FOC U S S pr i n g 2 0 1 4
CCPs to provide increased public
protection as well as to provide an
opportunity for their members to
benefit professionally. In response
to that, the College began a
review process in 2011 and has
now completed a comprehensive
review and analysis of existing
CCP programs for health care
professionals, and in particular, for
RNs currently licenced in Canada. It
became apparent during this review
that the College is the only RN
regulatory body that does not have a
verification process as a component
of the CCP.
Based on this analysis, Council
has approved the following
components to the College’s CCP:
a) a continuation of the
requirement for maintaining
nursing practice hours or nursing
education according to the RN
Regulations Section 10(g);
b) a continuation of reflective
practice, including a selfassessment and the development
of a learning plan;
c) confirmation on the initial and
annual application for licensure
to demonstrate that the member
has completed a learning plan
based on their self-assessment
(new requirement);
d) verification of a learning plan
from a random sample of
members. The addition of a
verification process to the CCP
requires changes to the RN
Regulations (new requirement);
and
e) The College developed
mandatory education with
verification of completion
(new requirement). This new
requirement will be done
through the development of
e-learning modules, and will
require Information Technology
and external vendor support.
Beginning in 2015, the new CCP
components are to be phased in
for the 2016 licensure year. To date,
the College has met and consulted
with both NSNU and NSGEU about
these changes. The next step will
be to consult with our members
about the details of implementing
these changes (e.g., topics for the
mandatory education, tools to support
self-assessment, development of
learning plans, etc.). More details
about these consultations and the
phased-in changes to the CCP will
be made available soon.
celebrate
Annual General Meeting
the year together at our
2014 Annual General Meeting
Tuesday, May 13, 2014, 1 p.m.
Holiday Inn Harbourview, Dartmouth
During the afternoon of May 13th, the ‘Leading the Way’ education forum will break in order to host
our 2014 Annual General Meeting (AGM). The AGM is an opportunity to present our priorities and
accomplishments in 2013 and allows us to remain accountable and transparent to our members.
Resolution 1:
2015 Election Date
Be it resolved that the election date
for the 2015 election of councillors,
and the deadline by which eligible
ballots must be received, is set as
1500 hours on Friday, April 10, 2015.
Explanatory Notes
Agenda for the Day
8:00a.m. – 12:55p.m.
Registration (including on-site voting for delegates),
networking and display participation
9:00a.m. – 12:00p.m.
‘Leading the Way’ Education Forum
12:00 – 1:00p.m.
Lunch is provided, networking, display participation
According to College By-Law 15(2),
at the annual general meeting each
year, the Council shall fix an election
date for the election of councillors
required by the College By-Laws, and
shall also set the deadline by which
eligible ballots for the election must
be received at the College.
1:00 – 3:30p.m.
2014 AGM Business Meeting
Moved by: Rosalind Benoit
Seconded by: Tim Guest
6:30 – 9:00p.m.
‘Celebration of Nursing’ Awards Banquet
3:30 – 4:30p.m.
‘Leading the Way’ Education Forum Closing Address
5:30 – 6:30p.m.
Awards Banquet Reception
(The College promotes a scent-free and smoke-free environment)
COLLEGE OF REGISTERED NURSES OF NOVA SCOTIA
5
Motions from the Floor
The deadline for submitting
resolutions for the 2014 AGM was
February 12, 2014. Motions from the
floor can be presented at the AGM if
they meet the criteria noted in the
College By-Law 17(4).
Voting Delegate Registration
• Voting at the AGM will be
limited to only those activepractising RNs who register as
voting delegates prior to the
afternoon meeting.
• Pre-registration to be a voting
delegate is available on
the College’s website at
http://events.crnns.ca
• Pre-registration closes on May
5, 2014. Pre-registration is
recommended.
• Onsite voting delegate
registration and check-in takes
place from 8:00 a.m. – 12:55 p.m
on the morning of the AGM.
Parking for all attendees is complimentary
in areas designated for hotel guests.
Voting Delegate Subsidies
In appreciation of members’ time
to participate as a voting delegate,
all voting delegates who purchase
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N U R S ING IN FOC U S S pr i n g 2 0 1 4
a banquet ticket will be reimbursed
for the ticket upon submission of a
claim (to be reimbursed, you must
attend the banquet or cancel before
May 7th).
Limited travel subsidies will
be available, on a first-come, firstserve basis for those members who
travel from outside Halifax Metro
to attend the AGM (ie. All districts
and established geographical
boundaries in Atlantic district
beyond Hubbards, Mount Uniacke,
Enfield, or Musquodoboit Harbour).
Subject to approval and availability
of funds, the following out-of-pocket
expenses may be requested by
pre-registered voting delegates to
claim for a meal, mileage or hotel
accommodations:
• One night of hotel
accommodations at the College’s
corporate rate. However, if
two voting body members
register in one room, they are
eligible to apply for two night
accommodations together for
the nights of May 12th and 13th.
• Vehicle mileage for return trip to
Dartmouth
• Breakfast (other meals and
refreshments are provided at
the event)
Voting delegates must attend the
AGM to receive a travel subsidy.
Subsidies are available for those
who attend the AGM business
meeting and are not available for
members who attend the education
forum only.
For those travelling from out
of town, a conference room rate
has been set at the Holiday Inn
Harbourview at $127.00 per night
(plus marketing levy and HST) for
single/double occupancy. This price
also includes overnight parking. To
reserve, call 463-1100 or toll-free
1-888-434-0440. Please indicate
that you will be attending the
College’s education forum and
AGM. To book online, visit www.
Hiharbourview.ca and use the group
booking code of SF3.
The deadline for hotel booking
is April 29, 2014. After April 29th,
you will have to call the hotel
directly and the group rate will be
subject to room availability.
Have A Question?
If you have any questions
regarding the AGM,
please contact:
Shelley Farouse,
Executive Assistant at
491.9744, ext. 223,
toll free at 1.800.565.9744
or via email at sf@crnns.ca.
Annual General Meeting
Celebration
of Nursing
Tuesday, May 13, 2014
5:30 – 9:00 p.m.
Holiday Inn Harbourview,
Dartmouth
Join us as we celebrate the success of registered nurses and nurse practitioners across
the province at our 2014 Awards Banquet. The banquet and awards presentation is an
evening to recognize the accomplishments of outstanding role models within the nursing
profession, each of whom have been nominated by her or his colleagues.
The evening will begin with a
reception at 5:30 p.m., followed by
an official opening at 6:30 p.m. The
awards banquet will host guest
speaker Barbara Fry, MEd, RN, as she
speaks about the future of nursing
excellence. The evening will also
include a full course meal and
presentation of awards. Tickets
can be purchased online at
http://events.crnns.ca until May 9th
and each ticket is $50 (including HST).
The presentation of awards will
be the highlight of the evening as we
present eight awards for Excellence
in Nursing, Health Advocacy and
Honorary Life Membership.
The Excellence in Nursing Award
and the Health Advocacy Award
are given to deserving nurses in
recognition of their exceptional
accomplishments in nursing
administration, clinical practice,
nursing education and research.
This year, the award recipients are
Sylvia Wist, Marsha Campbell-Yeo,
Joanne Cumminger, Keith Cockersell,
Barbara Currie, Eleanore Howard
and Vicky Martin.
Eleanore Howard is awarded
with the Excellence in Nursing
Clinical Practice Award. She is an
Enterostomal Therapy Nurse with
the Annapolis Valley District Health
Authority. Eleanore was nominated
by Debora Mander and Rita
vanVulpen.
Sylvia Wist is awarded with
Vicky Martin is awarded the
the Excellence in Nursing
Administration Award. She is
currently a Professional Practice
Leader in Policy at Capital District
Health Authority. Sylvia was
nominated by Mary Ellen Gurnham
and Cathy Walls.
Keith Cockersell is awarded with
the Excellence in Nursing Clinical
Practice Award. He is a nurse
practitioner with Capital Health
District Health Authority. Keith was
nominated by Marilyn Rutherford
and Alison Keay.
Barbara Currie is awarded the
Excellence in Nursing Clinical
Practice Award. She is a nurse
practitioner at Capital District
Health Authority. She was
nominated by Marsha Campbell-Yeo
and Sheri Price.
Excellence in Nursing Clinical
Practice Award. She is currently
a Charge Nurse at Capital Health
District Health Authority. Vicky was
nominated by Linda Hutchins and
Jennifer Hyson.
Marsha Campbell-Yeo is awarded
the Excellence in Nursing Research
Award. She is currently a Clinician
Scientist at the IWK Health Centre.
Marsha was nominated by Denise
Penny and Patsy Smith.
Joanne Cumminger is awarded
the Health Advocacy Award. She is
currently a Patient Navigator at the
Pictou County Health Authority. She
was nominated by Shirley Manos
and Bruce Tobin.
We also acknowledge the lifetime
achievements of nurses who have
retired from practice through the
Honorary Life Membership Award.
The 2014 award recipient of this
award is Edith Menzies, former
College President and retired RN
who worked at the Annapolis Valley
District Health Authority. She was
nominated by Rita vanVulpen and
Debora Mander.
Congratulations to each award
recipient and we look forward to
hosting all attendees at the Awards
Banquet as we celebrate nursing
excellence.
COLLEGE OF REGISTERED NURSES OF NOVA SCOTIA
7
COUNCIL
HIGHLIGHTS
Fiscal responsibility
Council Meeting
February 11, 2014
At the request of Council, the College’s new auditor,
Grant Thornton, provided an educational session on the
roles and responsibilities of Council in terms of their
fiduciary responsibility. Among the items discussed were:
identification of the required skills and gaps on Council;
linking the financial monitoring reports and the Ends;
identifying gaps in the Council’s financial policies; and
conducting a review of financial elements.
Nova Scotia Prescription Monitoring Board Nominations
In anticipation of regulation changes to the Nova Scotia
Prescription Monitoring Program, the Council approved
the nominations of Donna Denney, Executive Director,
and Lynn Miller, Policy Consultant to be forwarded to the
Department of Health and Wellness.
Nurse Practitioner Quality Monitoring
and Improvement Program
Council approved the continuation of the Nurse
Practitioner Quality Monitoring and Improvement
Program (NP-QMP) for the next five-year cycle. The NPQMP first implemented in 2009 is a legislated program
approved by Council. Designed to review the practice
of individual NPs every five-years, the program is a
means for the College to support the provision of safe,
competent, ethical and compassionate NP nursing care.
Adult and Pediatric Nurse Practitioner
Licensure Exams
Ownership Linkage
With plans to strengthen the College’s relationship
with those it is accountable to (Nova Scotians), Council
developed a strategy to gather data from the public that
would be instrumental in setting the College’s upcoming
Strategic Ends. This data, in addition to information
gathered through a vast environmental scan, will be
used to develop Ends that will establish the results
to be achieved in the next three years (2015-2017).
A facilitator was chosen to work with Council on the
development of the new Ends.
8
N U R S ING IN FOC U S S pr i n g 2 0 1 4
Nurse practitioners (NPs) who graduated from an NP
program on or after January 1, 2007 and are applying for
initial licensure are required to successfully complete
an NP examination in their focus of practice (family all/
ages, pediatrics, adult, neonatal). Council approved the
following two entry-level NP examinations, effective
2014:
• American Academy of Nurse Practitioners
Certification Program’s (AANPCP) Primary Care AdultGerontology NP Exam
• Pediatric Nursing Certification Board’s (PNCB)
Primary Care Pediatrics NP Exam.
c o u n c i l h i gh l i gh t s
The Canadian Nurse Practitioner Family All Ages Exam
will continue to be offered to Nurse Practitioners whose
focus is family All Ages
Registered Nurse Entry-Level Examination
Between 1982-2015
The Council has signaled its intent to accept the NCLEXRN as the approved registration exam for registered
nurses from 1982 to December 31, 2014. Council
previously approved in May 2012 the NCLEX-RN in Nova
Scotia to be effective January 1, 2015.
Report of Nominations Committee
The College’s Nominations Committee presented its
2014 College Council election slate of candidates
pursuant to By-Laws section 15(4)(a). In response to the
call for nominations, the following nominations were
received and accepted as the slate of candidates for the
2014 Council elections:
President- Elect (1)
-Kelly Ann Lackie
-Ruth Whelan
Councillor- at- Large (1)
-Cameron Boys (acclamation)
District Councillor – Annapolis (1)
-Tim Guest
-Amy MacDearmid
District Councillor – Atlantic (2)
-Marlene Ash
-Lindsay Burke
-Sheri Price
Executive Director Recruitment
After a five year terms as Executive Director of the
College, Donna Denney will be retiring from the
College in January 2015. The Council is in the process
of recruiting for this executive leadership position by
securing the support of an executive recruitment agency.
Peter MacDougall, on behalf of Council, would like to
thank Donna Denney for her leadership, vision and
commitment to the College and the nursing profession
both provincially and nationally.
Organizational Performance
Council reviewed monitoring reports for the following
Ends:
A. Public receives safe, competent, ethical and
compassionate care from RNs and NPs.
B. RNs and NPs work to their optimal scope of practice
in an evolving healthcare system.
B.1Clients receive coordinated care within and across
the care continuum.
C. RNs and NPs are competent to practise in intra- and
interprofessional collaborative teams.
D. RNs and NPs practise self-regulation.
Council accepted all reports as reasonable
interpretations of its policies and deemed the Executive
Director to be in compliance with these policies. Data
from a number of surveys conducted in 2012 (i.e., public,
member, employer, new graduates) were included in
these reports as evidence of progress toward meeting
these Ends.
District Councillor - Western (1)
– Angela Clifton
– Joyce d’Entremont
AGM Resolution #1: 2015 Council Election Date
The following resolution was put forward to Council
to be voted upon at the 2014 annual general
meeting:
Candidates will be profiled on the ballot to be sent to all
active practising registered nurses electronically on or
before March 14, 2014 in compliance with the College
By-Laws.
Be it resolved that the election date for the 2015
election of councilors, and the deadline by which
eligible ballots must be received, is set as 1500
hours on Friday, April 10, 2015.
COLLEGE OF REGISTERED NURSES OF NOVA SCOTIA
9
Leading the
Way Education
Forum
Tuesday, May 13th, 2014
9 – 4:30 p.m.
Holiday Inn Harbourview,
Dartmouth
You are invited to join us for the day as we
engage with speakers around optimizing
the scope of registered nurses and nurse
practitioners. This free education forum is
an opportunity to enhance your professional
development and help shape the future of the
nursing profession.
The education forum is held on the
same day as the College’s AGM and Awards
Banquet so take advantage of this opportunity
and register for all three separate events.
Registration for this forum is on our website so
register now and save a seat for yourself and
share this opportunity with your colleagues!
The education forum day includes a
keynote address, two concurrent sessions and
a closing address. Do you want a sneak peek
of Sara Lankshear’s keynote address?
Keynote Address:
Optimized Scope: Why Now? Presented by
Sara Lankshear, RN, PhD. Check out a sneak
peek of her address to the right.
Concurrent Sessions: Working to Optimal
Scope, Opportunities and Challenges in the
Nova Scotia Environment presented by Clare
Currie, RN, MN; Sue Daniels, RN, MN and Lynn
Cragg, RN.
Difficult Conversations: It’s Not Personal, It’s
Professional by Jean Hughes, RN, PhD.
Closing Address: Kathleen MacMillan, RN, PhD
10
N U R S ING IN FOC U S S pr i n g 2 0 1 4
Sneak Peek of
Keynote Address
Sara Lankshear, RN, PhD is President of Relevé Consulting Services
in Penetanguishene, Ontario. Sara has over 20 years of experience in
health care including direct care, education, and administrative roles
within various sectors in the health care system. Most recently, Sara was
honoured as the first recipient of the Nursing Leadership Award from
the Niagara University School of Nursing Alumni Council. Sara is the
keynote speaker at the College’s ‘Leading the Way’ Education Forum.
1. Can you give us a sneak peek of your keynote address topic called
‘Optimized Scope: Why now’?
This is a topic that I am very passionate about so I am excited to
be able to contribute to this educational event. Without giving too
much away, my plan is to provide a mix of the evidence, humor
and some practical suggestions and strategies that can be easily
implemented for optimizing scope.
2. The theme of the education forum is optimized scope for RNs and
NPs. Why do you think this is an important topic for nurses?
The nursing profession has the distinct characteristic of being a
self-regulated, autonomous profession with multiple designations/
registration categories under the protected title of ‘nurse’,
resulting in a distinct and overlapping scope of practice. Changes
to educational preparation and scope of practice, coupled with
variations in nursing care delivery models, have resulted in varying
degrees of role ambiguity and in some instances, role conflict.
In order to optimize the impact nurses have on patients, we
need to fully understand and embrace our distinct and overlapping
scopes of practice. This is not about carving out territory but about
embracing the collective impacts.
3. How can the nursing profession remove the impediments that block
nurses from working to their full scopes of practice?
We have a tendency to focus on the external barriers, which are
those in place within organizations and practice settings (e.g.
policies and procedures, organizational rules). But many of the
impediments are also at the individual level; the existing mental
models held by many nurses about “who should be doing what”
and attitudes about “that not my job”. So I think as a profession, we
need to focus on both the internal and external barriers in order to
effectively address this very complex issue.
4. How does an understanding of a nurse’s optimized scope affect the
nursing profession?
If RNs and NPs do not fully understand, appreciate and embrace
their distinct and overlapping scope of practice, there is a risk of
inappropriate or underutilization of the scope of practice for both
RNs and NPs. This may result in a lack of appreciation of the true
impact of nursing on patient and system outcomes.
5. Why should nurses come to the education forum?
This presentation will challenge RNs and NPs to consider the
enablers and barriers for optimizing scope of practice at the
individual, organizational and professional levels and what needs to
change now in order to lead the way in optimizing the knowledge,
skills and contribution of RNs and NPs in high quality patient care
and health system outcomes.
ask
P r o f e s s i o n a l D e v e l o pm e n t
a Practice Consultant
Q: As an RN, can I transport
controlled drugs (ie:
morphine) to clients in a
rural community that cannot
access a pharmacy?
A: As advances are made in the
delivery of health services in
communities, so are changes to the
role of the registered nurse (RN).
More clients are receiving care
in their homes, such as palliative
services, and this has posed
challenges to the clients, their
families and to the RNs delivering
care. Some of the challenges are
the result of rural communities
not having a local pharmacy to
access controlled drugs or the local
pharmacy not being open when
the client(s) require the drug. For
example, a client who experiences
a pain crisis at 9:00 p.m. may not be
able to access the pharmacy to fill
a prescription for the medication
needed.
The need for RNs to transport
controlled drugs in rural communities
has been recognized as a barrier
to practice and has recently been
addressed by Health Canada. In
October 2013, an exemption to the
Controlled Drugs and Substances
Act (1996) was released. Section 56
“Class Exemption for RNs Delivering
Primary Health Care at a Health
Facility in a Remote and/or Isolated
Community”. This exemption gives
the authority for RNs to possess,
provide, administer, transport, send
and deliver controlled substances
when providing primary health care
services to patients located in a
remote and/or isolated community,
subject to the terms and conditions
of this exemption. Any client that
needs this service must be a patient
of a district health authority or
agency that is delivering the service.
If you are not clear if this exemption
applies to your practice setting,
please speak with your management
team.
The exemption does allow for the
College Practice Consultants,
Jennifer Best, MN, RN and Trent MacIsaac, MN, RN.
transportation of the controlled drug
but there are conditions that must be
in place for this practice to occur. The
client must be under professional
treatment of the nurse, the controlled
substance must be required for
treatment by the client, the nurse
must have a signed and dated order/
prescription for the controlled
substance and the RN must follow
the policies and procedures for
handling the controlled substance.
This practice is not without risk.
The risk of the ability to maintain
accurate drug counts, proper disposal
and to protect the safety of the
nurse all exist. We therefore advise
you consider these risks when you
consider implementing this practice
in your district health authority or
agency and to consult with your risk
management team when developing
policies related to this practice.
There should be policies in place
that clearly outline what processes
the RN most follow when counting,
disposing narcotics, and providing
safety considerations.
COLLEGE OF REGISTERED NURSES OF NOVA SCOTIA
11
Have a flare for
writing? We are
looking for YOU!
If you have a flare for writing and a story to tell,
please submit an article to Nursing In Focus. Nursing
In Focus is published in the spring and fall and the
editor welcomes comments, suggestions, articles
from members and letters to the editor. Get involved
and see how your words can inspire members and
promote excellence within the nursing profession.
Articles from members will be printed according to
availability of space and may be edited for length
of content. Articles should not exceed 1500 words
and electronic copies are required. Signed articles
represent the views of their authors and do not
necessarily reflect the College’s position or policies
on a specific topic. For more information, contact
Hillary MacEachern, Communications Consultant at
hmaceachern@crnns.ca.
Submission Deadlines: February 15 & August 15.
12
N U R S ING IN FOC U S S pr i n g 2 0 1 4
ask
a Practice Consultant
Continued
Q. How should controlled drugs be
stored safely in the client’s home?
A. In the hospital or long term care setting,
controlled drugs and substances are kept in
locked cupboards and are subject to regular
inventory measures (e.g. periodic counts by
nursing staff). While this requirement is clearly
stated in the legislation and regulations for
health care facilities, these same regulations do
not apply once the controlled substances are in
the client’s home. Because a high percentage
of drug diversion occurs from family member’s
prescriptions, it is important that clients receive
education on the best ways to safely store their
prescribed controlled drugs in the home.
Registered nurses need to advise their
clients to only keep the minimum amount of
their controlled drug in the home, preferably by
requesting a smaller supply from their provider
or pharmacist. Diversion and theft of controlled
substances occur more frequently when these
medications are left in plain sight or there is
open discussion about their presence in the
home. Once in the home, controlled drugs and
substances should be kept in a secure location,
preferably a locked box or cupboard with the
key kept in the custody of a responsible adult.
Q. How can unused controlled drugs
and substances in the home setting
be disposed of safely?
A. Similar to regulations and policies for
storage of controlled drugs and substances,
health care facilities also have policies on
disposal of these medications. However, there
are no such mechanisms regarding disposal of
controlled drugs and substances in the home
once the medications are no longer required.
As with any other prescription, individuals
should not take or share a prescribed controlled
drug that is not their own. Registered nurses
need to advise clients to return any controlled
drugs that are no longer required directly to a
pharmacy for proper disposal.
P r o f e s s i o n a l D e v e l o pm e n t
Through
A New
Grad’s
Eyes
For several years, the College has conducted surveys of
new RN and NP graduates to gather information about
employment and practice trends impacting these two
groups in order to inform recruitment and retention
strategies. New RN graduates are surveyed annually and
new NP graduates are surveyed every two years, given
the low numbers of new NP grads.
In 2013, the College once again surveyed both
new RN and NP graduates from the class of 2012,
along with employers of new RN graduates.
Findings from the survey will inform employers,
universities, the College, provincial and federal
governments and other key stakeholders
regarding issues facing new registered nurses.
The responses provided valuable information
and supported the themes seen in previous surveys.
First, we’ll look at the survey results for the new RN
graduates and their employers, followed by results
from the new NP graduates.
Eighty-two of the 411 new RN grads responded to
the survey; 68 respondents were employed and 14 were
unemployed. Seventeen new NP grads responded out of
a possible 23; 16 respondents were employed and one
was unemployed.
COLLEGE OF REGISTERED NURSES OF NOVA SCOTIA
13
NEW RN GRADUATES SURVEY
The Predicted Nursing Shortage and Nova Scotia’s
Current Nursing Population
The economic downturn discussed in the 2012 report
continues to keep many late-career RNs in the work
force, which in turn, has delayed the predicted nursing
shortage even further. The table below shows a
breakdown of the nursing workforce as of November 1,
2012 which captures the new graduates captured in this
survey.
Historical perspective of new graduates finding regular
full-time employment
YEAR
2012
2011
71%
57%
2010
82%
2009
89%
2008
87%
2007
Active-practising RNs, by age
2006
72%
Age
2005
71%
Number of Number of
Active-Practising Active-Practising
RNs 2011
RNs 2012
<25 336346
25-29929 925
30-34820 879
35-39904 877
40-441097 1041
45-4916641569
50-5416691649
55-5915611585
60-64846 884
65+ 400416
Total 1022610171
It is important to note that the number of RNs over
55 years of age and the increasing percentage of the
workforce who are eligible to retire makes recruitment
and retention of new graduates an important focus for
the next several years.
New RN Graduate Employment Status
The number of new RN graduates who secured
permanent full-time employment in 2012 increased
from 2011 to almost 71%, but figures are not back to
the 89% seen in 2009. In addition, 19.8% of respondents
worked in temporary full-time positions at the time of
completing the survey, which is virtually unchanged from
the previous year. Finally, almost twice as many new RN
graduates are working in casual positions than last year.
These trends could be due to postponed retirements
or fewer positions being created; however regardless
of the reason, it is important to note that research on
successful new graduate transition supports the need for
consistent practice.
14
80%
NU R S I N G I N FO CU S S pr i n g 2 0 1 4
More new RN graduate respondents were employed in
hospital-based positions in 2012 at 89%, up from 82%
for the 2011 cohort. The remaining 11% of respondents
report working in long term care, community settings
and public health, which is a drop from 18% reported in
the 2011 cohort and a reversal of a trend to non-hospital
based positions that had been increasing since 2007.
Interestingly, the number of new graduates working
in only one agency climbed from 80% in the 2011
group to 84% in 2012, perhaps reflective of the increase
in permanent full-time positions reported by survey
respondents. There was also less movement to different
positions or different institutions in the 2012 group, with
only 27% moving to a second position and 19% moving
to a third position. Finally, 61% of respondents obtained
employment in their desired area of practice, with the
remaining 39% of new grads citing a lack of positions
and lack of experience as the reasons for being unable
to secure a position in their preferred setting.
The Impact of Education Debt
Debt incurred as part of obtaining their nursing
education continues to have an impact on new RN
graduates. Almost 34% of respondents reported a debt
of less than $10,000; a significant rise from the 21%
reported in the last survey. While these figures are an
improvement, this still leaves over 60% of new graduates
facing a sizable debt load in a challenging employment
market. Evidence shows that financial challenges can
impact employment decisions, and indeed several new
RN graduate respondents indicated that their debt
impacted the type of employment they sought and
accepted and may force them to seek employment
outside of the province.
P r o f e s s i o n a l D e v e l o pm e n t
Breakdown of Financial Debt of New RN Graduates
$ (thousands)
o debt
N
< 5
5-10
10-20
20-30
30-40
40-50
> 50
from two to six weeks in length. Almost 75% of the
new RN graduate respondents reported having access
to a preceptorship program as part of their transition
experience and felt that experienced RNs were willing to
support them in the preceptor role. In addition, 70% felt
confident in their ability to meet the expectations of their
new RN role at the end of their orientation.
Both the new graduates and managers were asked
a series of questions about the new graduates’ abilities
to function in intra- and interprofessional teams. Of the
new RN graduate respondents, 92% to 97% felt they were
able to perform various roles within the team, and 66%
to 86% of managers agreed.
% of resondents
9%
21%
4%
7%
10%
10%
15%
24%
Career Intentions
Transitioning the New RN Graduate into the
Workplace
Transitioning to the workplace is a complex process that
includes orientation, preceptorship and becoming part of
the intra- and interprofessional teams. The 2012 new RN
graduates and managers were asked a series of questions
about the orientation process and their experience. Here
are the results of those questions:
Yes, 2012 Yes, 2012 Yes, 2011 Yes, 2011
GraduatesManagersGraduatesManagers
Was there an assessment
of the individualized
learning needs?
Was the graduate’s
learning style taken
into consideration?
46%
90%
57%
When asked about their career intentions for the next
year or so, 50% of new graduates indicated that they
would remain in their current position, which is an
increase from the 42% reported in the last survey. Almost
30% of respondents plan to look for a new nursing
position within their same agency. The remaining 20% of
survey respondents told us they would leave Nova Scotia
and/or Canada but would remain in nursing. None of
those surveyed plan to leave nursing altogether.
Career Intentions of New RN Graduates
3%
85%
6% 2%
10%
85%
68%
79%
55%
Did the clinical experiences
match the new graduate’s
learning needs?
85%84%86%85%
Was the length of the
orientation individualized
to facilitate independent
practice?
50%
29%
70%
100%
61%
95%
Orientation experiences varied depending on factors
such as the practice setting (e.g. hospital, long term
care, community, etc.), budgets, staffing and previous
experience with the facility as a nursing student, as
well as in the duration, organization and content of
the orientation. Most orientation experiences included
a general facility orientation followed by a nursing
department orientation to prepare the new graduates
for their unit orientation. The unit orientation occurred
on the unit(s) where they would be working and ranged
Remain in current position
Remain in current agency, but look for another position in nursing
Leave my current agency, but remain in nursing in Nova Scotia
Leave my current position/agency, and return to school
Leave Nova Scotia for another province, but remain in nursing
Leave Canada for another country, but remain in nursing
COLLEGE OF REGISTERED NURSES OF NOVA SCOTIA
15
NEW NP GRADUATES SURVEY
Since 2007, the College has been surveying new NP
graduates, but due to the relatively small numbers of
annual graduates, NPs are only surveyed every two years.
Similar themes from the new RN graduate survey were
identified in the new NP graduate responses. Because of
the small number in the group and not all respondents
answered all questions, it is difficult to generalize the
findings but the trends are useful to monitor.
New NP Graduate Employment Status
Eight of eleven new NP graduates who responded to the
practice setting question work in primary care settings
and the remaining three indicated they work in an acute
care settings. These figures represent a shift from previous
surveys where 67% of new NP graduates worked in a
hospital-based setting and 22% (2 of 9) worked in primary
care.
Practice Setting of
New NP Graduates
18%
Orientation continues to be a challenge for the new
NP graduates, maybe due to assumptions that new NP
graduates do not need orientation because of their
RN background or past RN experience in their agency
or district health authority. This lack of NP-focused
orientation, as well as limited access to preceptorship
and mentorship opportunities, can make role transition
challenging.
Several of the new NP graduates who responded to
the survey felt there was still confusion around the NP
role and reported being expected to cover for RN staff
shortages or perform non-clinical tasks such as cleaning
equipment, booking appointments and other clerical work.
These expectations reduce NP-client access by decreasing
the amount of time available for providing direct clinical
care.
Fewer new NP graduates report being satisfied
with their new role, 81% feel satisfied with the role in
comparison to the 100% reported in the last survey.
Reasons for this drop are not clear but need to be
monitored to ensure there is a stable NP workforce to
meet the needs of Nova Scotians.
For more information and to learn about the registered
nurses survey conclusions and recommendations, please
see the 2012 study on our website titled “Employment and
Practice Trends among New Registered Nurse Graduates”.
Acute Care
35%
Did not answer
question
47%
Primary Care
2014 Nova Scotia Hospice
Palliative Care Association Conference
The Future of Dying:
Hospice Palliative Care
in the Next 10 Years
May 8 - 10, 2014
The Impact of Financial Debt
Nurse practitioner education in Canada is now
predominantly at the Masters level, either in part-time or
full-time programs. Seven new NP graduates answered
the question about debt incurred from their NP graduate
programs; and three indicated that their accumulated debt
impacted the type of NP position they sought.
Themes from the Survey Responses
It is becoming more challenging and taking longer
for new NP graduates to secure full-time employment.
There has been a shift in NP practice settings, with more
new NPs now working in primary health care settings. This
may be due to efforts to improve access to services for
rural communities, as well as the advent of Collaborative
Emergency Centers (CECs) throughout the province, a
trend which has created huge potential in expanding the
number of NP positions.
16
NU R S I N G I N FO CU S S pr i n g 2 0 1 4
Comfort Hotel Bayer's Lake
Halifax, NS
Registration
recommended
before April 15
www.nshpca.ca/conference
College of Registered Nurses of Nova Scotia
Professional Presence
are you making the grade?
At the completion of the workshop Registered Nurse Managers
and RN Leaders will be able to:
1. Define the term professional presence.
2. Describe the significance of professional presence in clinical
practice and among care providers.
3. Explore the impact of manager/ team leader accountabilities on
professional presence according to the Standards of Practice
4. Reflect on their personal (and private) report card to determine
their grade in meeting each leadership indicator.
5. Articulate barriers to demonstrating professional presence within
the healthcare system in Nova Scotia.
6. Develop a specific plan to initiate/renew/or strengthen professional
presence in their own practice settings.
7. HAVE FUN!
Trent MacIsaac, MN RN
CRNNS Practice Consultant
Jennifer Best, MN RN
CRNNS Practice Consultant
Barb Fry, MEd(Adult) RN
Workplace Relationship Strategies
May 1
June 10
October 20
November 6
|
|
|
|
Wolfville
Dartmouth
Baddeck
Truro
a professional development opportunity for registered nurses working in leadership roles
register at events.crnns.ca | more details at crnns.ca/workshop
Through the Eyes of
Cameron Boys, New RN Grad
Cameron Boys is a new registered nurse (RN) graduate who hails from
Tillsonburg, Ontario. As a nursing student at St. Francis Xavier University, he
received the university’s silver medal and was awarded the Dean of Science
Excellence in Clinical Practice Award and the Sr. Simone Roach Caring
Award. He graduated in 2013 and currently works as a RN at St. Mary’s
Memorial Hospital in Sherbrooke. His nursing areas of interest include
emergency nursing, palliative care and gerontology and he enjoys learning
about collaborative practice, environmental health and health equity.
What was your experience
like as a nursing student at St.
Francis Xavier University?
St. Francis Xavier University is
truly a special place. As a primarily
undergraduate institution, the
opportunities to participate in
research, committees, and societies
as an undergraduate student were
endless. The four year nursing
program was busy. It was a challenge
to balance elective courses and
extracurricular activities with
mandatory lectures, labs and
clinical rotations. I believe the goal
of the university is to produce a
well-rounded nursing graduate
with knowledge and skills in both
community health and acute care.
What was your favorite aspect
of the nursing program?
The emphasis on the CNA Code of
Ethics and the Standards of Nursing
Practice were my favorite aspects of
the nursing program. The program’s
perspective that every patient and
coworker deserves to be treated with
compassion and dignity resonated
with me as a student.
I also enjoyed the passion and
18
N U R S ING IN FOC U S S pr i n g 2 0 1 4
wisdom of the nursing instructors.
I still remember quotes from my
professors that have stuck with me
in practice. For example, I remember
quotes from Professor Marion Alex, RN
who said, “If the benefits of physical
activity could be placed in pill form,
it would be unethical for nurses not
to administer it” and Professor Marie
Arnott, RN, who explained, “When
you walk into a patient room, have a
glance at their breathing, it alone can
tell you so much.”
What were your motivation(s)
for choosing your current
position at St. Mary’s Memorial
Hospital?
I was looking for full time
employment because I believe full
time employment is the best way I
could consistently build my practice
as a new grad. I approached Andrea
Boyd-White, RN, Director of Nursing
for GASHA, about employment
opportunities for new grads within
GASHA. She encouraged me to apply
to St. Martha’s Regional Hospital
float pool, with the first year spent
at St. Mary’s Memorial Hospital. I
am so pleased I did because rural
P r o f e s s i o n a l D e v e l o pm e n t
nursing has exposed me to a client
population with diverse care needs.
When you were a student,
you were the nursing student
representation on the College’s
Council. Now that you are a
RN, you were chosen to be a
RN representative on Council.
How do you think your Council
presence change with this new
role?
Being the nursing student
representative on Council was
a learning experience. Council
members and College staff
both provided me with patient
and thorough mentoring on
policy governance. As a student
representative, I was also unable to
vote. As an RN representative, I will
be able to participate in the voting
process.
Does your knowledge of the
College and its role within the
nursing profession help shape
your day-to-day interactions as
an RN? If so, how?
I used to view the College solely as
a professional conduct organization.
Having served as a previous Council
member, I have learned that
professional conduct is only one of
the many services the College offers
to support quality nursing practice
in this province. The College offers
many learning opportunities for
RNs and NPs through Telehealth,
E-Learning, and workshops.
The mandate of the College is
to promote excellence in nursing
practice in the interest of the public
good and understanding this has
influenced my practice. For example,
I no longer view documentation as
a way of “protecting my license,” but
more as a way of “protecting the
client.” I document to communicate
the nursing process in the interest of
the client’s plan of care.
As a new graduate, what have
been the most rewarding
aspects of becoming a fulltime RN?
There have been countless aspects!
Nurses truly touch the lives of so
many individuals, families, and
communities. It is amazing what we
can accomplish together.
As a new graduate, what have
been the most challenging
aspects of becoming a fulltime RN?
When I entered the workforce as
a new graduate, I had entry-level
knowledge or competencies. The
challenge for me, as well as other
new graduates, coworkers and
management, is the transition from
new graduate to a more experienced
nurse equipped with post-entry level
competencies specific to the new
work environment. Acquiring postentry level competencies is both
exciting and challenging for me.
There are growing pains mixed with
“pat on the back” moments.
...It is amazing what
we can accomplish
together...
What are you most looking
forward to in your near future
nursing career?
I am most looking forward to
growing in the nursing profession,
such as working towards a CNA
specialty certification or graduate
studies. I am also looking forward to
conferences, courses, and workshops
where I can network with nurses
from different facilities and areas
of practice and hear their unique
stories.
What was your favorite
moment/experience as a
new grad?
My favorite experience as a new grad
was witnessing the camaraderie
between nurses, hospital staff,
physicians, and paramedics. We’ve
experienced moments of laughter
and sadness together and we’re a
working family.
What do you feel has made
your transition from student to
RN successful?
A thorough new grad orientation
both in the classroom and on
the floor was a huge help for me.
The orientation showed me that
knowledge powers good nursing
care. As G.I. Joe famously said,
“Knowing is half the battle.”
Has there been anything
that has surprised you about
your transition from nursing
student to new grad?
I was amazed at what I remembered
from university when I was in
emergency situations. New grads
have a growing body of knowledge
which we draw from in every patient
care experience.
What supports have been most
valuable in your new role as
RN?
Coworkers and management have
been excellent in helping me
make the transition from school
to practice. I look at the practice of
talented senior nurses, such as Myrna
Johnstone, RN, or Val Chisholm, RN,
and I want to practice just like them.
They are beginning to rub off on me!
What is one piece of advice
you would give a nursing
student upon graduation?
I have a few pieces of advice. First,
I encourage nursing students to
always have an attitude of inquiry.
Learning is never over for new grads
because we are constantly learning
new approaches to delivering
evidence-based care. Stay involved
and stay in the learning game.
Second, keep nursing friends
close. I have an amazing group of
nursing friends, such as Braden
Davie, RN, or Ivy Cawley, RN, that
listen to and support me as a new
grad. Sometimes we even call each
other on night shift breaks even
though we’re working in different
facilities across the province.
Lastly, keep a positive attitude.
There will be days when your
nursing practice will be extremely
challenging as a new grad but a
positive attitude makes the days or
nights go by a little bit easier. Stay
positive.
COLLEGE OF REGISTERED NURSES OF NOVA SCOTIA
19
The College 2013 Practice
Consultation Report:
A Service That Could Enhance
Your RN or NP Practice
One of the College’s roles is to provide support to the nursing profession
through practice consultations. A practice consultation is a confidential
interaction between a practice consultant and an individual in order to
provide expert advice on a nursing topic or issue.
This service provides daily practice consultation to registered nurses
(RN) and nurse practitioners (NPs) in Nova Scotia, RNs and NPs in other
jurisdictions, employers, nursing students, other healthcare professionals,
regulators, government and members of the public. The purpose is to provide
information, advice and guidance about issues that directly or indirectly affect
the delivery of safe, competent, compassionate and ethical nursing care, policy
and legislation. The consultation can take place in person, on the phone,
through the College’s website or via email.
The majority of consultations are conducted with RNs and NPs to help
resolve practice/workplace issues affecting their ability to meet their practice
standards and/or assisting them in the interpretation of legislation or policy.
Although all practice consultations are
confidential, the nature of the consultations
and the feedback provided is documented
in the College’s electronic database. The
College’s Consultants use this information to
identify and analyze trends and issues affecting
RNs, NPs and other nursing stakeholders. The
following information provides an overview of the
practice consultation trends in 2013.
The College offers consultation services to its
9598 registered nurses (9457) and nurse practitioner
(141) members (CRNNS, February 3, 2014).
20
N U R S ING IN FOC U S S pr i n g 2 0 1 4
P r o f e s s i o n a l D e v e l o pm e n t
1%
Nurse Practitioners
College Members
In 2013, the nursing practice
consultants responded to a total of
802 requests for advice or information.
Of these, 569 were from RN members,
69 were from NP members and 164
were from other stakeholders.
99%
Registered Nurses
Types of Callers
20%
Other
stakeholders
9%
NPs
71%
RNs
1%
Patient
Safety
1%
Violence in
the Workplace
28%
28%
Scope of
Practice
Policy
42%
Professional
Practice Issues
As in previous years, the top three
themes reflected in the consultations
with RNs, NPs and other stakeholders
were professional practice, policy
(legislation, regulation, licensure), and
scope of practice, followed by patient
safety and violence in the workplace.
Consultants received 336 calls
related to professional practice issues,
227 related to policy, 228 related to
scope of practice, 7 related to patient
safety, and 4 related to violence in the
workplace.
Theme Comparison
Within each of the top three themes,
there were many emerging topics,
including:
Professional Practice
• Documentation and medication
administration standards
• Duty to provide care/patient
abandonment
• Questions related to continuing
competence
• RNs role in methadone
administration programs
• Concern around client
confidentiality
• NPs inability to obtain a full-time
NP position
• legislative and policy barriers to
NP practice (e.g., inability for NPs
to discharge clients in their care,
completion of forms for clients
such as medical disability or
driver’s medical forms)
Policy
• RN sensitive outcomes
• Resolving professional practice
issues
• RN licensure (e.g., maintenance of
practice hours, temporary license
holder restrictions)
• Non-College related (e.g.,
assistance in development
of organizational policy,
interpretation of legislation,
maintenance of client records in
self-employed practice)
• NP-QMP (e.g., questions related
to NP prescribing, questions about
the process when NP changes
practice setting or population)
• NP licensure (e.g., requirements for
licensure)
Scope of Practice
• Authorization of RNs/NPs to
perform certain procedures
• Determining what is within the RN
scope
• RN versus LPN scope of practice
(e.g., clarification, accountability)
• Development of care directives
and delegated functions
• Specific interventions within
NP scope of practice (e.g., IUD
insertion)
• Collaborative practice
relationships for NPs
• Whether NPs can prescribe
medicinal cannibinoids
Patient Safety
• Concerns about RN competence
• RN fitness to practice
• Resources for abuse prevention
• Questions related to medication
errors
Violence in the workplace
• Bullying the in the workplace
• Combative clients
If you have a nursing practice question, please contact one of our highly qualified
Practice Consultants, Jennifer Best or Trent MacIsaac at practice@crnns.ca.
COLLEGE OF REGISTERED NURSES OF NOVA SCOTIA
21
Legal Status of an Apology English gilmore_Layout 1 2014-03-17 5:18 PM Page 1
infoLAW
®
Canadian Nurses
Protective Society
Legal Status of an Apology
Vol. 21, No. 3,
December 2013
Most Canadian provinces and territories have enacted legislative protection for those
who apologize 1 for their actions. British Columbia was the first to bring in an Apology Act
in 2006, with others following suit quickly afterwards. Some provinces enacted a statute
called the Apology Act, whereas others amended existing legislation, e.g. an Evidence
Act, to include protections for apology. Apology provisions tend to be very brief and do not
specify any particular subject matter of apology to which they apply.
The key concepts embedded in the statutory provisions to protect apology are that:
●
saying sorry does not constitute an admission of fault or civil liability;
●
an apology is inadmissible in any judicial or quasi-judicial court proceeding as
evidence of fault or liability; and
●
the insurance coverage for the person or entity offering an apology is
unaffected by an apology.
For health care professionals, the significance of apology legislation arises when a critical
incident occurs. Despite great efforts, patients can be harmed by the provision of health
care services. Afterwards, health care providers and administrators must ensure patients
are informed of what happened if the incident meets the criteria set out in legislation
governing critical incidents or adverse events.
Saying sorry
does not
constitute an
admission of
fault or civil
liability.
Historically, offering an apology was fraught with difficulty for several reasons, one of
which was fear of an inference of legal liability when none was intended or warranted.
Nurses and other health care professionals have stated they empathized with their
patients very much after a critical incident and wanted to express sympathy but were
discouraged from doing so for fear that it would be interpreted as an admission of guilt.
Other reasons included fear of loss of insurance coverage or liability protection if an
apology was offered and the fact that the persons disclosing to a patient may not be those
who were involved in the incident, for example, a hospital administrator apologizing on
behalf of a nurse employee. The nurse would then not have any control over what was
said. Conversely, if an employee undertook to offer an unauthorized and possibly
inappropriate apology, the employer might have been placed in legal jeopardy. Patients
had reported that it added insult to injury in the aftermath of a critical incident when no
apology was forthcoming; it seemed that no one cared.
A meaningful apology can assist patients, affected families, and health care professionals
to heal after the event. There are many ways in which early resolution between parties
is encouraged in the justice system. Apology legislation is one such way, and is seen as
one element of provincial and territorial patient safety legislation.
Nurses must be mindful that apology legislation does not disentitle a patient from
launching a civil action or making a complaint to a regulatory body. The burdens and
22
NU R S I N G I N FO CU S S pr i n g 2 0 1 4
More
than
l i ab i l i t y
pr ot ec t i on
P r o f e s s i o n a l D e v e l o pm e n t
Legal Status of an Apology English gilmore_Layout 1 2014-03-17 5:18 PM Page 2
standards of proof remain unchanged, as do the legal remedies. Therefore, an admission of fault should be
avoided, primarily because:
●
experience has shown that the actual cause of an adverse event is often not what it first appears to
be and indeed may never be established. By admitting to an error or breach of a practice standard too
soon, nurses may be taking responsibility for something that ultimately will be found to have another
cause or an unknown cause;
●
although an apology may not be admissible as evidence of fault or liability, it could still be admitted
as evidence for another purpose, for example, to show what nurses did in response to the adverse
event, such that the fact an apology was made would still be before the Court; and
●
an apology may be admitted as evidence if the protections for apologies in a particular jurisdiction do
not apply to the legal proceeding underway.
Courts and tribunals have considered the effect of legislative provisions protecting apology. When an apology has
been made in the course of a legal proceeding covered by that jurisdiction’s apology legislation, the apology has
been insulated from use as evidence of fault by the party who apologized. However, the fact an apology was
offered has been used in some cases as evidence of what the parties did. The fact an apology was made can also
be recorded in the written reasons for the legal decision. An example of how a tribunal considers the fact an
apology was made comes from a situation in which a patient complained about a registered dietician’s care. The
tribunal acknowledged the purpose of the provincial Apology Act and did not infer guilt from the registered
dietician’s apology, saying in its decision:
…it is worthy to note that the intent of this Act, at least in part, was to promote the openness
of health professionals in dealing with patients or family members. We prefer to view the
[registered dietician’s] letter in this light rather than as an admission of guilt. In our opinion,
the words of the [registered dietician] showed that she acknowledged the seriousness of the
situation and expressed remorse “if” she failed to deal with the [patient] in a sensitive manner.2
Best Practices Regarding Apologies
●
The legislative requirements and your employer’s framework for critical incident investigations and
disclosures should guide your actions during and after an adverse event.
●
In collaboration with other members of the treatment team, it is part of the nursing role to help your
patient understand what is happening to him or her when a critical incident or adverse event is
unfolding.3 Do not speculate to the patient about information that is unknown to you. Regret or
sympathy may be expressed at this time but care providers should refrain from accepting or
assigning blame.
●
Understand the possible implications for yourself prior to apologizing to a patient, if you are asked to
do so.
Please contact CNPS at 1-800-267-3390 if you have questions and visit our website at www.cnps.ca.
1.
Apology is generally defined in legislation as including expressions of sympathy or regret, a statement that a
person is sorry or any other words or actions indicating contrition or commiseration.
2.
DP v PB, 2011 CanLII 11785 (ON HPARB).
3.
infoLAW ®, Reporting & Disclosure of Adverse Events (Vol. 17, No. 1, October 2008).
Related infoLAW of interest: Patient Safety. Available at www.cnps.ca
THIS PUBLICATION IS FOR INFORMATION PURPOSES ONLY. NOTHING IN THIS PUBLICATION SHOULD BE CONSTRUED AS LEGAL ADVICE FROM ANY
LAWYER, CONTRIBUTOR OR THE CNPS®. READERS SHOULD CONSULT LEGAL COUNSEL FOR SPECIFIC ADVICE.
© Canadian
www.cnps.ca
Nurses Protective Society
1.800.267.3390
info@cnps.ca
COLLEGE OF REGISTERED NURSES OF NOVA SCOTIA
23
Compassionate Care
in Challenging Times:
An Interactive
Workshop
Nurses and other professionals working within
today’s health care system are confronted with
increasingly complex patient care situations. While
health care professionals have the knowledge
and skill to meet these multifaceted needs, it is
becoming apparent that the capacity to remain
engaged, attentive and compassionate can be
compromised when the everyday demand for
continuous response sometimes exceeds the
individual and organizational resources available.
In this engaging workshop, participants
will explore a wide range of issues related to
compassion, including how compassion is defined
and understood by patients, health care providers,
organizations and regulators as well as ways in
which compassion is enacted in everyday care
encounters. Through interactive activities as well
as stories from their own practice, participants will
2014,
Frid a y, M a y 23,
9 – 4 p. m .
s
B e st W e st e rn P lu ro
Tru
Gle n g a rry H o t e l,
have an opportunity to identify challenges and
specific opportunities related to the provision of
compassionate care – for others and for self.
The workshop will be of interest to registered
nurses and other health care professionals
in direct care, administration, education and
regulation of practice. Register on our website
at http://events.crnns.ca. Please contact
dm@crnns.ca if you have any questions.
Date: Friday, May 23, 2014
Times: 9:00 a.m. to 4:00 p.m.
Cost: $75 (early bird rate), $85 as of May 1st. HST is included in both rates.
Location: Best Western Plus Glengarry Hotel, Truro
Presenters: Anne Simmonds, PhD, RN, and David Whitehorn, PhD, MSN
Anne Simmonds holds a doctorate from the combined nursing and bioethics program at the
University of Toronto. Her scholarly work focuses on ethical considerations in nursing practice and
understanding the meaning and limits of compassion in nursing and healthcare.
David Whitehorn is an Assistant Professor in the Dalhousie University Department of Psychiatry
and Director of the Atlantic Contemplative Centre. Before retirement, he worked for many years as a
Clinical Nurse Specialist in the Mental Health system in Halifax.
24
N U R S ING IN FOC U S S pr i n g 2 0 1 4
IN Practice
The NP Practice Analysis:
What you need to know
Nurse practitioners (NPs) have been an integral part of the healthcare system in Canada for many
years. Over the years however, the NP practice has evolved differently within each provincial /
territorial jurisdiction as a result of differing legislative frameworks for healthcare delivery. In
addition, various entry–level examinations have been utilized by the jurisdictions as one of their
requirements for licensure, which has limited mobility for NPs across the various jurisdictions.
In support of a national approach for NP licensure,
the Canadian Council of Registered Nurse Regulators
(CCRNR) embarked on a project to analyze NP practice
across Canada. In November 2013, CCRNR was awarded
a grant from Employment and Social Development
Canada (formerly Human Resources and Skills
Development Canada) to carry out a Nurse Practitioner
Practice Analysis for three streams of NP practice:
Family/All Ages, Adult and Pediatrics. This analysis will
provide a comprehensive description of the entry-level
knowledge, skills and abilities required for practice in
one these three streams.
The project was officially launched in late February
with an orientation meeting between the working
group members and Professional Examination Services
(ProExam), the vendor selected for the project. ProExam
is a non-profit organization based in New York City that
has provided leadership in the field of professional
licensure and certification exams since 1941. ProExam
brings extensive experience in conducting practice
analysis studies for a wide variety of professions in
Canada and the United States. The project will be
conducted in three phases over approximately 15
months; the final report being completed by April 2015.
The outcomes of the NP Practice Analysis will inform
the development of a consistent process for entry-level
examination of NPs in Canada, which will facilitate NP
mobility as well as help internationally educated NPs to
more readily integrate into the workforce.
CCRNR has established a national working group,
consisting of representatives from nine of the twelve
nursing regulators in Canada to coordinate the various
phases of this project. Donna Denney, the College’s
Executive Director, is the project lead, Teri Crawford,
Director of Policy, Practice and Legislative Services at the
College is Chair of the working group, and Lynn Miller,
College Policy Consultant is one of the two NP members
of the working group.
A Research Advisory Committee (RAC), comprised
of six nursing researchers from across Canada, will
provide guidance on the literature ,document analysis,
activity statements and NP survey tools, and assist in the
analysis of results.
In the near future, three Subject Matter Expert
(SME) panels, one for each of the three streams of NP
practice, will be created to provide clinical expertise to
the working group, the RAC and ProExam in continued
development and validation of the NP survey tools.
Nurse practitioners in Nova Scotia and across Canada
can become involved with the project by volunteering
to serve on one of these three SME panels or by offering
to be pilot testers for the survey tool. Watch for further
information by your regulator on how you can become
involved with this important process and contribute to
the evolution of the NP practice in Canada.
If you have any questions or wish to learn more
about the NP Practice Analysis project, please do not
hesitate to contact Teri Crawford, Director of Policy,
Practice and Legislation Services at tcrawford@crnns.ca
or Lynn Miller, Policy Consultant at lmiller@crnns.ca.
COLLEGE OF REGISTERED NURSES OF NOVA SCOTIA
25
Controlled
Drugs &
Substances
Education for NPs in Nova Scotia
Preparations are moving forward for Nova Scotia
nurse practitioners (NPs) to begin prescribing
controlled drugs and substances (CDS) in late 2014.
As part of this process, the CDS Advisory Committee
and CDS Working Group were formed and both
have been instrumental in supporting development
of new standards of practice specific to CDS
prescribing, in preparing mandatory CDS education
for NPs, and working on policies to guide changes to
licensure requirements and continuing competence
once CDS prescriptive authority is in place.
26
NU R S I N G I N FO CU S S pr i n g 2 0 1 4
IN Practice
The NP CDS Prescribing
Standards have been developed
in consultation with government,
the College of Physicians and
Surgeons of Nova Scotia, the Nova
Scotia College of Pharmacists,
employers, NP educators, and
practicing NPs. Four new standards
statements have been added to the
existing NP Standards document to
accommodate this new prescriptive
authority. They include legislative
and regulatory standards,
clinical standards for prescribing
controlled drugs and substances,
clinical standards for prescribing
methadone maintenance
therapy and clinical standards
for prescribing methadone for
management of chronic non-cancer
pain. The new CDS standards
will come into effect once a
new Prescription Monitoring
Act Regulation comes into force.
This regulation gives the CRNNS
authority to regulate NPs under the
Act and it is only then that NPs can
be listed under the Nova Scotia
Prescription Monitoring Program (a
requirement for CDS prescriptive
authority.)
All NPs are required to
complete the two-part CDS
education, consisting of an online
theory course and a one-day CDS
Regulatory Workshop for NPs in
order to obtain an active practicing
NP license for the 2015 licensure
year. Methadone maintenance
therapy and methadone for
management of chronic noncancer pain are not a requirement
for NP licensure and, as such, are
not included in the mandatory
education.
The CRNNS has
approved three CDS theory
courses based on
All NPs are required to
complete the two-part
CDS education, consisting
of an online theory
course and a one-day CDS
Regulatory Workshop for
NPs in order to obtain
an active practicing NP
license for the 2015
licensure year.
recommendations from the
Canadian Council of Registered
Nurse Regulators (CCRNR). All
courses have been recently
developed and/or updated and
are currently available online. NPs
must complete the theory course
before attending the CDS regulatory
workshop.
The CRNNS would like to
extend our thanks to the Nova
Scotia Department of Health and
Wellness for the provision of a
one-time grant to support NPs
in completion of the online CDS
Theory Course in 2014. This grant
will allow NPs to be reimbursed
for the cost of tuition for the CDS
Theory Course of their choosing.
Details on the three theory courses
and the process for obtaining
reimbursement are posted in NP
Bulletins section of the College’s
website.
The one-day CDS Regulatory
Workshops will be held at various
sites throughout the province.
The workshop topics will give
NPs the opportunity to apply the
information from their theory
course to relevant situations
around prescribing CDS in Nova
Scotia. Workshop topics include a
review and practical application
of the federal, provincial and
CRNNS legislation, regulation
and policies on CDS prescribing,
an introduction to the Nova
Scotia Prescription Monitoring
Program, and discussions on safety
measures for prescribers, patients
and communities including risk
assessment tools, treatment
agreements, etc.
Workshop
Schedule
May 14th – Halifax
May 21st – Kentville
May 28th – Sydney
May 30th – Antigonish
June 2nd – Amherst
June 3rd - Bridgewater
June 10th – Halifax
June 16th – Yarmouth
If required, an additional
workshop will be held in Halifax in
September.
NPs can register for the
workshop of their choice. Meals
and breaks will be provided. Cost of
the workshop is $50.00. Travel and
accommodations (if required) will
be the responsibility of the NP and/
or the employer. Further details on
venues and times will follow soon.
This is an exciting time for NPs
in Nova Scotia! This expanded
prescriptive authority will enable
NPs to increase options for patient
access to safe and comprehensive
care. If you have any questions,
please contact Lynn Miller, Policy
Consultant at lmiller@crnns.ca.
COLLEGE OF REGISTERED NURSES OF NOVA SCOTIA
27
Five Years Later:
The NP Quality Monitoring Program
The College established the Nurse
Practitioner Quality Monitoring
Program (NP-QMP™) to meet the
requirements of the RN Act 2006.
Introduced in May 2009, the NPQMP™ is a mandatory program for
nurse Practitioners (NP) practising
in Nova Scotia and is the first
program of its kind in Canada. In
2013, the NP-QMP completed its
first five-year cycle.
The program is designed
to support NPs in continuously
improving their practice by
providing them with detailed
performance feedback. The feedback
includes a comprehensive selfassessment as well as survey
responses from NP and physician
colleagues, co-workers, other health
professionals, patients and/or
parents/guardians.
Since its inception, 85 NPs
from across the province have
participated in the NP-QMP.
Forty-four percent of these NPs
worked urban communities with
populations greater than 50,000,
29% in medium sized rural
communities with populations
between 5,000 and 49,000, and 27
% small rural communities with
populations of less than 5000. One
quarter of NPs worked in primary
care clinics, four in 10 worked in
hospital settings, one in ten worked
in community health centers, and a
few NPs worked in long term care.
Over the five-year period, a total
of 2,999 respondents provided
feedback regarding the NPs practice:
556 physicians/NP colleagues, 605
colleagues, 1548 patients/residents,
and 290 parents/guardians. Survey
respondents were asked to rate
nurse practitioners on a scale of 0 –
28
N U R S ING IN FOC U S S pr i n g 2 0 1 4
2.0, with a score of 1 indicating that
the NP is ‘meeting expectations’ and
a score of 2 indicating that the NP is
‘exceeding expectations’. The survey
respondents evaluated the NPs in
the following practice areas:
• Management of health
(assessment and diagnosis,
therapeutics, consultation and
referral, procedures, health
promotion/prevention)
• Communication
• Professional accountability and
leadership.
Overall, the results
of the NP-QMP™
for 2009-2013
demonstrate that the
public and health
professionals are
confident that nurse
practitioners provide
safe, competent and
effective health care
and that they add
value to Nova Scotia’s
health system.
Physician/NP colleagues and
health care colleagues rated a NPs
overall practice assessment at 1.5
out of 2.0. The client/resident and
parent/guardian rating was 1.9 out
of 2.0. The NPs self-assessment of
their practice was 1.3 out of 2.0.
Consistently, nine out of ten NPs
and physicians would refer their
NP colleague to family and friends.
The report data also revealed how
NPs spend their time at work. NPs
identified that they spend 70% of
their work time in direct client care,
11% doing administrative work and
9% of time is spent on leadership
and mentorship. Slightly less time is
spent on advocacy and research, 7%
and 6% respectively.
Nearly all NPs agreed that there
are systems in place to support
their practice. Though most NPs are
satisfied with the supports that are
in place in their practice settings,
one quarter of NPs surveyed
stated that administrative support
personnel were not available to
facilitate NP practice.
Overall, the results of the NPQMP™ for 2009-2013 demonstrate
that the public and health
professionals are confident that
nurse practitioners provide safe,
competent and effective health
care and that they add value to
Nova Scotia’s health system. In
an environment of high public
accountability, the NP-QMPTM is
both a measure of competence and
a means of assisting the College
in regulating nurse practitioner
practice. The program also provides
a measure of public and health
practitioner acceptance and
satisfaction with the practice of NPs
in Nova Scotia.
The College is currently in the
process of developing a 5-year
summative NP-QMPTM report which
will provide more details regarding
the NP-QMP process, cumulative
result and other findings including
themes regarding the facilitators or
inhibitors of NP practice. Stay tuned
for the report, which will be posted
on our website.
IN Practice
Approval of NP Adult
and Pediatric Exams
The Canadian Council of Registered Nurse Regulators
(CCRNR) is pleased to announce that Canadian
jurisdictions are approving the following adult
and pediatric nurse practitioner (NP) examinations
effective spring of 2014 for NP registration/licensure
in their jurisdiction:
(i) American Academy of Nurse Practitioners
Certification Program’s (AANPCP) AdultGerontology Primary Care NP Examination for
candidates in the Adult stream
(ii) Pediatric Nursing Certification Board’s (PNCB)
Primary Care Pediatric NP Examination for
candidates in the Paediatrics stream.
Both examinations are valid, reliable and address the
Canadian competencies expected for the practice of
entry-level NPs. All member jurisdictions are expected
to have Council approval by April 2014.
The College ended its contractual agreement with
the American Nurses Credentialing Center (ANCC) to
provide the Adult and Pediatric exams to Canadian
applicants as of February 28, 2014. The ANCC exam
provider will still be offering their exams to those
applicants in the United States and other countries.
In addition, CCRNR announced in November 2013,
the launch of the NP Practice Analysis. Check out the
NP Practice Analysis article in this issue for more
information on the analysis.
For more information on the NP examinations,
please visit our website.
COLLEGE OF REGISTERED NURSES OF NOVA SCOTIA
29
Changes to the
RN Continuing
Nursing
Education (CNE)
Telehealth
Program
The College would like to recognize the 14 RNs who have
recently volunteered to form a committee to support CNE
Telehealth planning. The committee consists of RNs from
across the province in various clinical areas, bringing their
varied experiences to the planning process. The committee
meets twice a year via teleconferencing to brain storm
possible presenters and related topic ideas based on topic
requests sent in to us by our members.
The CNE Telehealth program is just one of many
continuing education resources available to RNs. The
Canadian Nurses Association (CNA) and the Canadian Nurses
Protective Society (CNPS) offer free webexes throughout the
year. Check their web sites for upcoming presentations they
have scheduled. If you work for a district health authority,
The Building a Better Tomorrow Together program (BBTT)
have sessions on inter professional collaboration, conflict
resolution and communication and you likely have access to
the Provincial Nursing Competency Program through your
intranet.
If you have requested a topic and it is not offered
through the CNE Telehealth program, it could be that it is
already offered by another organization or is a taped session
currently on the College’s website at. Please visit our website
and search under the ‘Education & Events’ tab for more
details. Any time you have questions or would like to suggest
a topic idea for CNE Telehealth, please email Clare Brown,
Practice Consultant and CNE Telehealth Coordinator at
ceb@crnns.ca.
30
NU R S I N G I N FO CU S S pr i n g 2 0 1 4
T e l e h e a lt h
Telehealth
Continuing
Nursing Education
Programs via
Telehealth
The College’s Continuing Nursing Education (CNE) is available to 84
health care sites via the Nova Scotia Telehealth Network. See below
for the latest sessions and visit crnns.ca for details including times
and locations. For more information, please contact Crystal Morgan at
cmorgan@crnns.ca or call 902.491.9744 (1.800.565.9744), ext 255.
May 5 Chronic kidney disease and dialysis
May 8 What New RN Graduates Have Told
Us: Results of the new grad survey
2012 – How do we retain new
graduates, what type of support do
they need, what issues do they face
as they start out in their nursing
careers?
May 15
Assessing chronic abdominal pain
in children (This is a NP education
session open to all health care
professionals.)
May 22
Supporting mothers following
caesarean birth
May 26
The Many Facies of Lewy Body
Dementia: Lewy body Dementia
and its relationship to Parkinson’s
Dementia: understanding the link
May 29
June 16
Applying the NS Tool for Risk
Assessment to Assess Youth and
Adult Suicide Risk: An opportunity
to learn about the suicide risk
assessment checklist, policies
and procedures used at the IWK
and Capital Health. (This is a NP
education session open to all health
care professionals.)
Psychiatric disorders in seniors:
A presentation on how the
presentation and
management of common psychiatric
disorders, such as schizophrenia,
bipolar and personality
disorders change in the senior
population
June 4
Addressing swallowing issues
Review of the Nurse Practitioner
(NP) New Grad Survey Results (This
is a NP education session open to
all health care professionals.)
June 9
Pediatric Physical Assessment:
Differences between pediatric
patients & adults - what makes
them unique?
June 18
June 23
How to complete a post falls
assessment
June 26
Hepatitis C update
June 11
Protecting the public by supporting
registered nurse and nurse
practitioner practice: Understanding
the role of the College of Registered
Nurses of Nova Scotia
COLLEGE OF REGISTERED NURSES OF NOVA SCOTIA
31
Calendar of Events
April
29 - May 1
WINN/NTF Conference Every Mountain... Forge Every
Stream: Successfully Transitioning Newly Graduated
Nurses. Banff, AB. Contact: Sherry Denesha at (416)
491.2886 or sherryd@taylorenterprises.com
www.winn-ntf.com
MAY
1-2 Ontario Network of Educators and Supporters of
Internationally Educated Nurses 8th Annual Partners
in Education & Integration of Internationally Educated
Nurses’ Conference. Toronto, ON. Contact: ONESIEN at
info@onesien.ca www.onesien.ca
2
Canadian Network of National Associations of Regulators
Conference “Changing the Playing Field: Increasing
Member and Public Engagement through Effective
Use of Technology and Social Media.” Toronto ON.
Contact: CNNAR at info@cnnar.ca
http://www.cnnar.ca/en/index.html
4-7
The Canadian Orthopaedic Nurses Association 37th
National CONA Conference “Trailblazing in Orthopaedics.”
Calgary, AB. Contact: Canadian Orthopaedic Nurses
Association. http://www.cona-nurse.org
8-10
12
13
2014 Nova Scotia Hospice Palliative Care Association
Conference “The Future of Dying: Hospice Palliative Care
in the Next 10 Years”. Halifax, NS. Contact: Nova Scotia
Hospice Palliative Care Association.
http://www.nshpca.ca/conference
30th Nova Scotia Gerontological Nurses Association AGM,
Dinner, & Education Sessions “Violence in Long Term Care:
Media Hype or the Tip of the Iceberg?”
Contact: Suzanne Stevens at (902) 487.0603 or
suzanne.stevens@cdha.nshealth.ca
CRNNS Education Forum “Leading the Way - Optimized
Scopes for RNs and NPs”, Annual General Meeting and
Celebration Banquet. Dartmouth, NS. Contact Shelley
Farouse at (902) 491.9744 ext. 223 or sf@crnns.ca
www.crnns.ca
23-25 5th National Foot Care Conference & Annual Meeting.
Halifax, NS. Contact: Canadian Association of Foot Care
Nurses. http://www.cafcn.ca/
26-29 Canadian Public Health Association - Public Health 2014
Conference. Toronto, ON. Contact: CPHA Conference
Department at (613)725.3769 ext. 126.
http://www.cpha.ca/en/conferences/conf2014.aspx
30-June 1
12th Annual National Conference National Association of
PeriAnesthesia Nurses of Canada “The Sky’s the Limit ...
in PeriAnesthesia Nursing”. Regina, SK. Contact: LaVonne
Kolb RN, President Elect, PANGS. lavonne.kolb@rqhealth.
ca or kathy.jellow@rqhealth.ca http://www.napanc.org/
conference/2014-national-conference
32
NU R S I N G I N FO CU S S pr i n g 2 0 1 4
JUNE
2-4 Community Health Nurses of Canada (CHNC) 9th National
Community Health Nurses Conference. Ottawa, ON.
Contact the Conference Registrar:
chnc@absolutevents.com or (416) 595.1414 www.chnc.ca.
4-7
Canadian Ophthalmological Society Annual Meeting
& Exhibition. Halifax, NS. Contact: Canadian
Ophthalmological Society at cos@cos-sco.ca
http://www.csorn.ca/
7
Canadian Council of Cardiovascular Nurses (CCCN)
Spring Nursing Conference “Update Your Cardiovascular
Nursing Toolkit”. Calgary, AB. Contact: Canadian Council of
Cardiovascular Nurses at (613) 599.9210 or info@cccn.ca
http://www.cccn.ca
13
The 31st Annual Jewish General Hospital Department of
Nursing Symposium on Nursing, Health and Healthcare
“The Aging Adult and Critical Illness: Mastering the
Complexities of Care.” Montreal, Quebec.
Contact: 2014 Annual Symposium Planning Committee
at info@jghnursing-soinsinfirmiershgj.org
www.jghnursing-soinsinfirmiershgj.org
16-182014 Canadian Nurses Association Annual Meeting and
Biennial Convention - Explore. Reflect. Design. Act. A
Showcase of Nursing Answers. Winnipeg, SK.
Contact: Debbie Ross at 1(800) 361.8404 ext. 214 or
dross@cna-aiic.ca www.cna-aiic.ca
SEPTEMBER
18-20The first joint conference of the Urology Nurses of Canada
(UNC) and the Canadian Nurse Continence “Merging into a
New Frontier”. Ottawa, ON. Contact: UNC. http://unc.org/
21-23Canadian Association of Critical Care Nurses Dynamics
2014 Conference. Quebec City, QC. Contact: CACCN at (519)
649.5284 or caccn@caccn.ca http://www.caccn.ca
30-October 1
Canadian Occupational Health Nurses Association
Conference. Saint John, NB. Contact: Karen Mazerolle at
karengmaz@hotmail.com http://www.cohna-aciist.ca/
october
26-29Canadian Association of Nurses in Oncology (CANO/ACIO)
Conference 2014 “Patient Engagement.”Quebec City, QC.
Contact: CANO/ACIO Head Office at (604) 874.4322 or
cano@malachite-mgmt.com www.cano-acio.ca
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33
Get Involved
with the College
Do you want to influence the future of nursing in Nova Scotia? If so, apply now
to be a member of one of the College’s committees. Your participation will help
facilitate the College’s work and will support the nursing profession in Nova Scotia.
Being a committee member will also provide you with
a number of different personal experiences, including
collaborating with others on ideas and plans, engaging
with new areas of nursing and being a leader and
critical decision-maker within the nursing profession.
The College is looking for members that are active,
practicing and in good standing to serve on the
following four committees:
• Nominations Committee & Registration Appeals
Committee – the term starts in September, 2014 and
the deadline for application is September 4, 2014.
• Complaints Committee & Professional Conduct
Committee – the term starts on January 1st, 2015 and
the deadline for application is November 13, 2014.
For information on committee terms of reference, please
visit our website and click on ‘Get Involved’. If you are
interested in applying, you can also access, complete
and submit a College participation form online.
Members interested in applying or reapplying for these
committees can submit at any time during this year and
their application will be maintained in the database for
consideration in the fall.
visit www.crnns.ca
Mailed under Canada Post Publications
Mail Sales Agreement No. 40008039
Suite 4005 – 7071 Bayers Road
Halifax, NS B3L 2C2 Canada
Tel 902.491.9744
Toll–free (NS) 1.800.565.9744
Fax 902.491.9510
info@crnns.ca