SUNstoppable Spotlight
Registered Nurses Achieve Success through Independent Assessment Committee
The RN staff from Local 106 Regina General Hospital - Unit 3E Internal Medicine and SUN Provincial have successfully escalated 78 Work Situation Reports (WSRs), and 63 subsequent WSRs.
Since 2022, a pattern of workload and professional practice concerns have been documented on WSRs without collaborative problem-solving or resolution by 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 to resolve WSRs.
The IAC Panel of three RN experts unanimously confirmed the concerns brought forward by SUN members stating:
For RNs on 3E to fulfill the requirements of their nursing role and responsibilities and to have an appropriate workload, sufficient staff and resources must be in place to manage the overall care and unit requirements. Without these appropriate supports, non-nursing tasks and function by default become the work of the RNs who are on the unit 24/7, negatively impacting their workload and ability to fulfill their RN roles and responsibilities (2024, p. 5).
The IAC Panel made 14 recommendations related to the ability of the RNs to safely practice in Unit 3E, including staffing, the Charge Nurse role, Peritoneal Dialysis care, orientation, training, and Junior/Senior mix needs.
Binding recommendations have been confirmed between SHA Leadership, SUN Provincial, and Local 106 and are inclusive of:
-
Increased relief lines to provide a minimum 24/7 RN coverage.
-
Supernumerary Charge RN (Day and Night shifts) 7 days/week and removing expectations for a patient assignment.
-
Charge Nurse orientation should be timely and planned to prevent assignments from being made without appropriate orientation.
-
Supernumerary Peritoneal Dialysis RN (Day and Night shifts), 7 days/week.
-
Peritoneal Dialysis training should be timely and planned to have a sufficient pool of trained RNs for appropriate staffing.
-
Increase the Clinical Resource Nurse to 12 hours/day, 7 days/week.
The IAC Panel binding recommendations are in addition to the additional RN baseline staffing (Day and Night shift) 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 our focus in this process has been to address areas of concern for RNs in their ability to meet the practice expectations outlined in their professional standards and competencies documents, our ultimate concern is for safety and wellbeing of the patients and their families. We trust that this report will be helpful in resolving these important challenges (2024, p. 75).
SUN is encouraged that a 2nd IAC Panel has advised the SHA on needs across the Medicine Service line when they stated:
The IAC Panel believes that the learning and outcomes of this IAC process has applicability to other medicine units at RGH and in Regina generally, given the comparator data provided by the SHA. It would be appropriate for other medicine units to benefit from solutions to address workload, such as the recommendation to increase CCAs on two of the medicine units that arose from the IAC processes, without having to complete the IAC process for each unit, one unit at a time (2024, p. 75).
Local 106 and SHA Unit Leadership will have ongoing discussions on those recommendations deemed non-binding from the report for an improved 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.
