SUNstoppable Spotlight

Registered Nurses Achieve Success through Independent Assessment Committee

The RN staff from Local 105 Regina Pasqua Hospital - Unit 3B Collaborative Inpatient Care Unit and SUN Provincial have successfully escalated 55 Work Situation Reports (WSRs).

Since 2022, a pattern of workload and professional practice concerns have been documented on WSRs without collaborative problem-solving or resolution obtained with the Joint Nursing Advisory Committee, Unit Leadership, or through escalation to the SHA Board of Directors.  

An Independent Assessment Committee (IAC) is the last resort within the collective agreement to address workload concerns specific to registered nurses and resolve WSRs. 

The IAC Panel of three RN experts unanimously confirmed the concerns brought forward by SUN members and stated:

Within the current context of a nursing shortage in the province, Canada and internationally, it behooves the IAC to ensure that RNs are valued to their full scope of practice, capitalizing on their expertise. It is from this perspective the IAC formulates the following recommendations, which should all be instituted as soon as possible, with a target date for all new positions of October 31,2024 (2024, p. 47).

The IAC Panel made 11 recommendations reflecting 4 primary themes:

  • Challenges with communication, teamwork and organization of work,
  • Inadequate staffing,
  • Patient complexity affecting safe patient care and nursing workload, and
  • Need for clinical mentorship and support to aid retention (2024, p. 3).

Binding recommendations have been confirmed between SHA Leadership, SUN Provincial, and Local 105 and are inclusive of:

  • Addition of a Supernumerary Charge Nurse on the Night shift.
  • Enhance Clinical Resource Nurse Supports
    • Implement flexible hours to accommodate the learning and support of nursing staff (Day, Evening, Weekend).
    • Additional Temporary full-time Clinical Resource Nurse (1-year term) with an ongoing and annual review (Days, Evenings, Weekend).  
  • Implement relief lines to ensure 1 RN is scheduled 24/7 (Day and Night shifts).
    • Annual review of Article 37.12 to create and fill relief positions.
  • Fill known vacancies by offering shifts to casuals and other than full-time staff in advance. 

The IAC Panel binding recommendations are in addition to the additional RN baseline staffing (Day and Night shift), increasing the Clinical Nurse Educator position to full-time, and additional Continuing Care Aides provided by the SHA Leadership before escalation to the SHA Board of Directors. These additions were part of an initial Employer offer that was insufficient to address critical workload concerns in the WSRs. The decision to proceed to an IAC Hearing was validated when the IAC Panel stated:

While this [initial employer offer] is a step forward, it seems the unit is still in a trying position, and nursing morale is low (2024, p. 7)

SUN is encouraged by the advice provided by the IAC Panel to the SHA on needs across the medicine service line when they stated:

Implementing incremental changes via the IAC process across single units is a frustrating and divisive process that is not timely for all (2024, p. 48).

The IAC Panel non-binding recommendations are now referred to Local 105 and the SHA Leadership to create a healthy quality work environment focused on safe, competent, high-quality, and appropriate RN practice and healthcare services.   

To learn more about WSRs, the Nursing Advisory Process, and the Joint Nursing Advisory Committee, you can review the SUN website's WSR/NAC Learning Modules & Resources and NAC Leadership.