A message to registered nurses from Denise Dick, RN (SUN First Vice President)
I was shocked to read Steven Lewis’s May 9, 2016 opinion piece in the Leader Post. It was literally riddled with inaccuracies from start to finish and was frankly disrespectful to Registered Nurses.
Read the article: http://leaderpost.com/opinion/columnists/whats-really-behind-the-saskatchewan-rn-dispute-with-lpns
Lewis claims that only SUN has raised concerns with SALPN’s scope expansion project. In fact, the SRNA has repeatedly raised concerns about role clarity and requested that the Minister delay his approval of practice changes until a collaborative decision-making framework to guide staffing and skill mix decisions could be developed and finalized. In a letter to the Minister of Health, they insisted that “any decision about assignment of care must utilize a clear framework to determine responsibility and accountability for patient care that includes principles regarding client needs, complexity, and predictability. Without it, there will be role confusion and research has demonstrated that this can lead to patient safety issues.”
The need for a clear decision-making framework to ensure nursing role clarity and safe patient care is a position SUN has always shared and endorsed.
Unfortunately SALPN withdrew from collaborative discussions between nursing stakeholders and has so far refused to agree that a framework is required. The SRNA informed its membership of SALPN’s decision in a message from the Executive Director on November 26, 2015, stating that “SRNA is attempting to clarify SALPN’s position on the intent of its participation since it was suspended by SALPN. We are hopeful that the collaborative process will continue.” Read the full message.
Disappointingly, the Minister ignored Registered Nurses’ concerns and approved the changes anyway, leaving the province with no clear framework to guide the assignment of care.
Lewis accuses Registered Nurses of wanting to expand their roles while denying similar opportunities to Licensed Practical Nurses. He cites the process that lead to the expanded medical role of Nurse Practitioners in primary care. The example is instructive. In this case, practice changes were accompanied by extensive consultation regarding roles and role clarity, clear evidence of appropriateness and demonstrated need, and rigorous and in-depth expanded educational requirements for practitioners. Registered Nurses, including both SRNA and SUN, have only expected the same from SALPN and the Ministry. Needless to say, they have been disappointed by the process.
Lewis claims that Registered Nurses’ concerns about role clarity and public safety have no evidence supporting them and are just “camouflage” for the “real agenda” of turf protection. Leaving aside the inflammatory language, Lewis lacks the facts to provide real insight on the issue. The majority of evidence shows that there are serious patient safety concerns related to role clarity and nursing skill mix.
The Registered Nurses Association of Ontario (RNAO) just released a report summarizing these issues (Mind the Safety Gap in Healthcare Transformation), and calling for a moratorium on changes to models of care that replace Registered Nurses with other providers. Read the report here: http://rnao.ca/sites/rnao-ca/files/RNAO_Mind_The_Safety_Gap_REPORT_.pdf
Read the incredibly strong RNAO media release publicizing this report here: http://rnao.ca/news/media-releases/2016/05/09/mind-safety-gap-health-system-transformation-rnao-issues-recommendati
Lewis is clearly uninformed about the motivation and process for the changes in nursing models of care and skill mix that are happening. These are not occurring through a rigorous process of evidence-based regulatory change and accompanying collaboration on role clarity and appropriate assignment of care, but instead they are being introduced to save money in the short term without due consideration of very real concerns about the quality and safety of patient care.
That is what has RNs upset and what is “really behind” the controversy over nursing regulation. This issue should never be a political one; it’s always been about patient safety.
Some recent research supporting safe RN staffing can be viewed here.
