SUN members have a voice and mechanism for action, influence and change in their workplaces. The Nursing Advisory Committee (NAC) is a proven tool that can achieve healthy, quality work environments.
SUNstoppable Action is SUN's bi-annual report on the successes being earned using the Nursing Advisory Committee process. It's important to show SUN members just how much can be achieved by filling out WSRs and using the NAC process!
SUNstoppable Action
SUNstoppable Action 2022
SUN members have a voice and mechanism for action, influence, and change to address safe patient care and healthy, quality work environments... and it works
Congratulations to the SUN Locals who achieved 26 gains for their units, facilities, patients/clients, registered nurses, and professional practice, with the majority obtaining increased baseline staffing:
- Local 2 - Rosthern Hospital
- Local 15 - Wynyard Hospital
- Local 33 - Battlefords Union Hospital
- Local 53 - Biggar Hospital
- Local 62 - Prince Albert, Victoria Hospital
- Local 68 - Dr. F.H. Wigmore Regional Hospital
- Local 69 - Swift Current, Cypress Regional Hospital/Home Care
- Local 75 - Saskatoon, Royal University Hospital
- Local 89 - Shellbrook Hospital
- Local 101 - Saskatoon, St. Paul’s Hospital
- Local 102 - Melville, St. Peter’s Hospital
- Local 103 - Maple Creek, Southwest Integrated Health Care Facility
- Local 104 - Estevan, St. Joseph’s Hospital
- Local 107 - Saskatoon, City Hospital
- Local 257 - Saskatoon District Public Health & other Community Nurses
- Local 312 – Fort Qu’appelle, All Nations Healing Hospital
Achievements include:
- Increased registered nurse baseline staffing,
- Support for additional certification (i.e.: chemotherapy),
- Implementation of professional practice policy/process to support suicide assessment and patient care,
- Increased staffing of other healthcare providers, unlicensed care providers, and support staff, and
- Increased security officers.
Strong collective agreement articles exist to address registered nursing professional practice, workload, and staffing concerns for every network, location, facility, and practice setting in Saskatchewan.
When solutions cannot be found by the Nursing Advisory Committee, concerns can be escalated to the Executive Oversight Committee, Employer Board of Directors, and/or an Independent Assessment Committee.
Consistent documentation of professional practice, staffing and workload concerns by members, and continued persistence by Locals, have led to achievements.
Local NAC Chairpersons should contact their Nurse Practice Officer to ensure all NAC gains and successes are documented for member communication.
2022 Professional Practice Escalations
Executive Oversight Committee and SHA Board of Directors
Executive Oversight Committee: 1
SHA Board of Directors Referrals: 7
- Completed Presentations: 4
- Pending Presentations (2023): 1
Local 34 - Humboldt District Hospital: Emergency Department and Local 109 - La Ronge Health Centre were able to successfully withdraw on a ‘without prejudice basis’ their Board of Directors referrals as a direct result of increases to baseline staffing and new master schedules.
Independent Assessment Committee
Independent Assessment Committee Referrals: 4
Independent Assessment Committee Reports: 3
- St. Paul’s Hospital – Emergency Department
- Dr. F.H. Wigmore Regional Hospital – Emergency Department
- Saskatoon City Hospital – Emergency Department
Three IAC Hearings resulted in significant binding recommendations concerning registered nurses and professional practice improvement, including:
- multiple registered nurse positions (Nurse A & B)
- validating appropriate Charge Nurse and Triage Nurse assignments, and
- supporting orientation and education.
Local 43 – Yorkton Regional Health Centre: Intensive Care Unit withdrew an Independent Assessment Committee referral on a ‘without prejudice basis’, and continues to monitor the implementation of baseline staffing and improvement to professional practice concerns.
Future Activity (2023)
SHA Board of Directors Referrals - In Development: 5
Independent Assessment Committee Hearings: 4
- March 2023:
- Irene and Leslie Dube Cenre for Mental Health
- Jim Pattison Children’s Hospital - Children’s Emergency Services
- Pending Dates
- St. Paul’s Hospital - 5th Medicine Unit
- Lafleche Health Centre
To learn more about the concluded Independent Assessment Committee outcomes see the SUNstoppable Spotlight (below).
Watch your inbox for the next SUNstoppable Action in Summer 2023.
SUNstoppable Spotlight
SUNstoppable Spotlights: June 2023
Local 75 Jim Pattison Children's Hospital Children's Emergency Services — Registered Nurses Achieve Success through Independent Assessment Committee
SUN is pleased to share that the RN staff from Local 75 at the Jim Pattison Children’s Hospital Children’s Emergency Services and SUN Provincial have successfully escalated 68 Work Situation Reports (WSRs).
A pattern of workload and professional practice concerns has developed since 2019 without collaborative problem-solving by the Joint Nursing Advisory Committee or 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.
The IAC Panel of three registered nurse experts unanimously confirmed the concerns brought forward by SUN members and stated:
Staff shortages combined with high workloads and acuity contribute to RN concerns that the IAC members heard from the IAC presentations and review of submitted documentation (IAC, 2023, p. 46).
The current staffing model is not sustainable and makes it increasingly difficult for the nurses in the department to meet the standards they are held accountable for and the policies of the SHA (IAC, 2023, p. 46).
Binding recommendations have been confirmed between SHA Leadership and SUN. Work will continue between Local 75 and unit leadership to implement the increased baseline staffing for Saskatchewan's dedicated pediatric trauma and emergency children's care site, including:
- One Supernumerary Charge Nurse 24 hours per day, 7 days per week without a patient assignment
- Increase baseline RN staffing, 24 hours per day, 7 days per week:
- One additional baseline permanently funded Registered Nurse for the core nursing unit.
- One additional Triage Registered Nurse.
- One additional Psychiatric Nurse Liaison, 12 hours per day, 7 days per week.
- Retain temporarily funded RN (for viral surge) from 10:00 until 22:00 until May 2024.
- Pilot Project: One Nurse Practitioner 8 hours per day, 7 days per week to support primary care and/or ‘fast track’ model. To be operationalized within 18 months and last 2 years.
- Collaboration on the status of wait room space and enhancement and role of an NP within the unit.
Additional non-binding recommendations were received that will support further development for improved patient care, services, and work environment.
SUN Local 75 and the Local Nursing Advisory Committee will continue to work collaboratively with the employer to create a healthy work environment focused on safe, competent, high-quality, and appropriate registered nursing practice and healthcare services.
You can review WSR/NAC Learning Modules & Resources and NAC Leadership on the SUN website to learn more about work situation reports and the nursing advisory process.
Local 75 Royal University Hospital (Irene and Leslie Dube Centre for Mental Health) — Registered Nurses & Registered Psychiatric Nurses Achieve Success through Independent Assessment Committee
SUN is pleased to share that the RN/RPN staff from Local 75 (Royal University Hospital, Irene and Leslie Dube Centre for Mental Health), and SUN Provincial have successfully escalated 81 Work Situation Reports (WSRs) to an Independent Assessment Committee (IAC) and were awarded numerous gains for safe patient care.
An IAC is the last resort within the SUN/SAHO collective agreement to address workload concerns specific to registered nurses.
The registered nurses and Local have worked diligently with the employer since their last IAC Report (December 2014) and have documented progressive workload and professional practice concerns for resolution. Repeated attempts at finding solutions were unsuccessful at the Joint Nursing Advisory Committee and from the SHA Board of Directors.
The IAC Panel of three registered nurse experts unanimously confirmed the concerns brought forward by SUN members and responded with expanded recommendations for professional practice, patient safety, and work environment improvement.
"The issues identified at the Dube Centre are enduring. As identified in this report, nursing staff are feeling unsafe and vulnerable, unable to deliver appropriate, timely, and safe care to their patients. They are presently unable to meet several professional standards and obligations." (IAC, 2023, p. 50)
"It is the hope of the IAC that the detail and the recommendations provided in this report heighten awareness of the serious, unstable situation existing at the Dube Centre and facilitate the path towards improvements." (IAC, 2023, p. 50)
The IAC Panel provided 39 recommendations across four primary themes:
- High Patient Acuity/Complex Patient Needs
- RN/RPN Staff Complement and Ancillary Staff Mix
- Dysfunctional Physical Space, and
- Environmental Safety and Security
Binding recommendations have been confirmed between SHA Leadership and SUN. Work will continue between Local 75 and unit leadership to implement the increased baseline staffing and address the complex workload needs inclusive of:
- Immediately implement an increase in baseline RN/RPN staffing:
- For the Adult Inpatient Units:
- Two RN/RPN for Day Shift
- Four RN/RPN for Night Shift
- For the Child and Youth Unit:
- One RN/RPN for Day Shift
- One RN/RPN for Night Shift
- For the Adult Inpatient Units:
- Immediately implement sufficient and more balanced Charge Nurse coverage by ensuring two Supernumerary Charge Nurses for the Dube Centre on all shifts.
- SUN and SHA should collaborate on a roster that addresses proper staff mix to promote balance between junior and senior nursing staff.
- Clinical nurse educators to organize and deliver ongoing in-service/staff education sessions on current factors influencing psychiatric care delivery to supplement up-to-date, knowledge-based patient care.
- Clinical nurse educators and nursing coordinators should collaborate to provide a systematic process of mentoring and support for newly hired RN/RPN staff with emphasis on the night shift.
- Implement consistent, planned mentoring to support nurses to move progressively into leadership/charge positions to provide incentives for nurses to assume this role.
- Post all temporary ECT positions as permanent to create stability in the area (re: RN/RPN).
SUN Local 75 and the Local Nursing Advisory Committee will continue to work collaboratively with the employer to create a healthy, quality work environment focused on safe, competent, high-quality, and appropriate registered nursing practice and healthcare services for this complex and vulnerable patient population.
You can review WSR/NAC Learning Modules & Resources and NAC Leadership on the SUN website to learn more about work situation reports and the nursing advisory process.
SUNstoppable Spotlight: January 2023
Local 107 Saskatoon City Hospital — Emergency Department Registered Nurses Achieve Success through Independent Assessment Committee
SUN Local 107, Saskatoon City Hospital Emergency Department RN staff, and SUN Provincial are pleased to share the successful escalation of 63 Work Situation Reports (WSRs) using the SUN/SAHO collective agreement. These WSRs described patterns of unresolved workload and professional practice concerns
Concerns have been raised since 2018 without resolve at the Nursing Advisory Committee, Executive Oversight Committee, and the SHA Board of Directors levels.
An Independent Assessment Committee (IAC) is the last resort within the collective agreement to address registered nurse workload concerns.
The IAC Panel, made up of three RN experts, unanimously confirmed the staffing, workload, and overcapacity concerns presented.
“The current staffing model is not sustainable and makes it increasingly difficult for the nurses in the department to meet the standards they are held accountable for and the policies of the employer (i.e. reassessments after narcotic administration, documentation)” (IAC, 2022, p. 24).
The IAC Panel provided seven primary recommendations to increase RN staffing, address workload, and provide support staff resources addressing:
- Patient Flow
- Staffing for Appropriate Care, and
- Inability to Consistently Decant ED/Overtime
Binding recommendations have been confirmed between SHA Leadership and SUN. Work continues to implement the increased staffing and workload needs as follows:
- Increase RN baseline by funding five Permanent FTE positions:
- Two RNs: Night Shift (12 hours)
- One RN Triage Nurse: Day Shift (12 hours)
- One RN Float Nurse: Day Shift (12 hours)
- One RN Clinical Coordinator (Nurse B): Day Shift (12 hours)
- Remove Charge Nurse duties from the RN assigned to the Minor Assessment and Care Area.
- Charge Nurse assignment is to be supernumerary without patient assignment.
SUN Local 107 and the Local Nursing Advisory Committee will continue to work collaboratively with the employer to create a healthy, quality work environment that is focused on safe, competent, high-quality, and appropriate registered nursing practice and healthcare services.
To learn more about work situation reports and the nursing advisory process, you can review WSR/NAC Learning Modules & Resources and NAC Leadership on the SUN website.
SUNstoppable Spotlight: October 2022
Local 101 St. Paul’s Hospital - Emergency Department: Registered Nurses Achieve Success through Independent Assessment Committee
SUN Local 101, St. Paul’s Hospital Emergency Department Registered Nurses, and SUN Provincial are thrilled to share the successful escalation of 241 Work Situation Reports (WSRs) describing patterns of unresolved workload and professional practice concerns using the SUN/SAHO collective agreement.
Concerns have been raised since 2016 without adequate solutions found by the Nursing Advisory Committee, Executive Oversight Committee, or the SHA Board of Directors. An Independent Assessment Committee (IAC) is the last resort within the Collective Agreement to address workload concerns.
The IAC Panel, made up of three Registered Nurse experts, unanimously validated the concerns brought forward by SUN members, saying “It is the hope of the committee that the discernments provided in this report will aid in fostering a wide sweeping, efficient and focused approach to repairing the grave situation at St. Paul’s Emergency” (IAC, 2022).
The IAC Panel provided 37 recommendations addressing:
- Dysfunctional Physical Space/Structural Constraints
- Dysfunctional Patient Flow
- Chronic Understaffing with Deficit/Loss of Senior Nurses
- Hight Patient Acuity and Unsafe Practice Environment
- Challenging High Needs Population Demographic
Binding recommendations have been confirmed between SHA Leadership and SUN. Work continues to interpret the recommendations, increase staffing and address workload, including:
- Dedicated Triage Captain 24/7
- Increase in RN Triage baseline staffing 24/7
- Baseline staffing increase by four RNs 24/7
- Registered Psychiatric Nurse 12 hours/day, 7 days per week
- Dedicated Emergency Department Clinical Nurse Educator (full-time)
A significant number of non-binding recommendations were made that can positively support safe, competent, high-quality, and appropriate registered nursing practice and healthcare services at St. Paul’s Hospital Emergency Department.
SUN Local 101 and the Local Nursing Advisory Committee will continue to work collaboratively with the Employer to create a healthy, quality work environment.
To learn more about Work Situation Reports and the Nursing Advisory Process, you can review WSR/NAC Learning Modules and Resources and NAC Leadership on the SUN website.
SUNstoppable Spotlight: December 2022
Local 68 Dr. F. H. Wigmore Hospital — Emergency Department: Registered Nurses Achieve Success through Independent Assessment Committee
SUN Local 68, Dr. F. H. Wigmore Regional Hospital Emergency Department RN staff, and SUN Provincial are thrilled to share that they have successfully escalated 18 WSRs describing patterns of unresolved workload and professional practice concerns using the SUN/SAHO collective agreement.
Concerns have been raised since 2020 without adequate solutions found by the Nursing Advisory Committee, Executive Oversight Committee, or the SHA Board of Directors. An Independent Assessment Committee (IAC) is the last resort within the collective agreement to address workload concerns.
The IAC Panel made up of three Registered Nurse experts unanimously confirmed the concerns brought forward and supported 100% of the recommendations proposed by SUN members.
“The current staffing model is not sustainable and makes it increasingly difficult for the nurses in the department to meet the standards they are held accountable for and the policies of the employer. This has resulted in an exodus of senior staff” (IAC, 2022).
The IAC Panel provided recommendations addressing:
- Staffing
- Staffing Workload Assessment
- Emergency Department Orientation Program
- Quality Improvement Opportunities
The IAC Panel provided an additional consideration for workflow and skill task alignment in the Emergency Department by other healthcare providers and support staff.
Binding recommendations have been confirmed between SHA Leadership and SUN. Work continues to interpret and implement the increased staffing and address workload, including:
- Separate the Charge Nurse role from the Triage role, ensuring the Charge Nurse has no patient assignment.
- Increase Emergency Department RN baseline staff by one RN permanent 12-hour shift seven days per week.
- Continue with Emergency Department orientation plans as described in the SHA IAC submission.
- Orientation shifts should be supernumerary and not be used for baseline staffing.
- Ensure that Emergency Department orientation shifts are specific to the needs of RNs who have recently graduated from a nursing program and those who do not have experience in an Emergency Department unit.
SUN Local 68 and the Local Nursing Advisory Committee (NAC) will continue to work collaboratively with the employer to create a healthy work environment that is focused on safe, competent, high-quality, and appropriate registered nursing practice and healthcare services.
To learn more about work situation reports and the nursing advisory process, you can review WSR/NAC Learning Modules & Resources and NAC Leadership on the SUN website.
