ARNNL RECOGNIZES NURSING IN THIS ISSUE EXCELLENCE · Canadian Nurses Association (CNA)...

ARNNL RECOGNIZES NURSING EXCELLENCE PAGE 9

IN THIS ISSUECouncil Bestows Honorary ARNNL Membership – 5

Upcoming Changes in Licensure Renewal Process – 7ARNNL Continuing Education Teleconference Sessions – 11

Technology Tips for Your Practice – 20

Vol. XXXVI No. 3September 2015

The Magazine of the Association ofRegistered Nurses of Newfoundland and Labrador

2

Regina Coady President 2014-16Julie Nicholas President-Elect 2014-16Patricia Rodgers Eastern Region 2014-17Tracy MacDonald Central Region 2015-18Lacey Sparkes Western Region 2014-17Beverly Pittman Labrador/Grenfell Region 2015-18Dena King Advanced Practice 2013-16Lisa Jesso Practice 2013-16Alexia Barnable Education/Research 2015-18Elaine Warren Administration 2015-18Carmel Doyle Public Representative 2014-17Ray Frew Public Representative 2014-17Irene Baird Public Representative 2014-17Walter Arnold Public Representative 2014-17Lynn Power Executive DirectorRepresentatives from nursing student societies (observers)

CONTENTS

ARNNL COUNCIL

Lynn Power, Executive Director753-6173 I [email protected]

Michelle Osmond, Director of Regulatory Services753-6181 I [email protected]

Lana Littlejohn, Director of Corporate Services753-6197 I [email protected]

Trudy L. Button, Legal Counsel752-1903 I [email protected]

Jennifer Barry, Communications Officer753-6198 I [email protected]

Siobhainn Lewis, Nursing Consultant, Policy & Practice753-0124 I [email protected]

Pamela King-Jesso, Nursing Consultant, Policy & Practice753-6193 I [email protected]

Vacant, Nursing Consultant, Policy & Practice

Bradley Walsh, Regulatory Officer757-3233 I [email protected]

Rolanda Lavallee, Regulatory Officer753-6019 I [email protected]

Julie Wells, Research & Policy Officer and ARNNL Trust Coordinator753-6182 I [email protected]

Christine Fitzgerald, Administrative Assistant, Executive Director & Council753-6183 I [email protected]

Jeanette Gosse (on leave), Administrative Assistant, Director of Regulatory Services753-6060 I [email protected]

Kirsty Wiik, Administrative Assistant, Director of Regulatory Services753-6060 I [email protected]

Jennifer Lynch, Administrative Assistant, Policy & Practice753-6075 I [email protected]

Carolyn Rose, Administrative Assistant, Registration753-6025 I [email protected]

Jessica Howell, Administrative Assistant, Registration753-6041 I [email protected]

ARNNL STAFF

ACCESS is the official publication of the Association of Registered Nurses of Newfoundland and Labrador. ACCESS is published three times a year in January, May and September. Subscriptions are available to non-members for $25 per year.

Advertise in the next issue of ACCESSContact Jennifer Barry at [email protected] or call 709-753-6198

©Association of Registered Nurses of Newfoundland and Labrador (ARNNL). All rights reserved. For editorial matters, please contact the editor. The views and opinions expressed in the articles and advertisements are those of the authors or advertisers and do not necessarily represent the policies of ARNNL.

Editor Jennifer BarryCreative Design Brenda Andrews, Image 4

Contributing Editor Danielle Devereaux

Message from the President ........................................................................... 3From the Executive Director’s Desk ................................................................ 4ARNNL Council Matters .................................................................................. 5Q & A: You Asked ............................................................................................ 6Registration Update ........................................................................................ 7Canadian Nurses Protective Society .............................................................. 8Nurses of Note ................................................................................................ 9Advanced Practice View ............................................................................... 10ARNNL Continuing Education Teleconference Sessions ............................. 11Federal Election Primer: Health Is Where the Home Is ................................ 12Survey Says .................................................................................................. 13Goings On/Conferences and Workshops ...................................................... 14Volunteer Spotlight ....................................................................................... 16Workforce of 100 ........................................................................................... 17Regulatory Notes .......................................................................................... 18Discipline Decisions ...................................................................................... 19Clinical Corner .............................................................................................. 20Trust News ................................................................................................... 21Painting a Philosophy of Nursing In Undergraduate Nursing Education ...... 22Congratulations, Nursing Graduates ............................................................ 23CNPS InfoLAW – Legal Risks of Email (Part 2) ........................................... 24

On the cover: ARNNL Awards for Excellence in Nursing Luncheon (June 2015). Left to right: Dena King, RN, NP, BN, Award for Excellence in Nursing – Practice; Cyril Daley (accepting ARNNL Honorary Membership on behalf of Kay Daley); Regina Coady, RN, BN, MN, ARNNL President; Dr. Carla Wells, RN, MN, PhD, GNC(C), Award for Excellence in Nursing – Education; Lily LeDrew, RN, BN, Award for Excellence in Nursing – Administration (photo credit: Don Lane)

Correction: In the May 2015 issue of ACCESS, the article “Evidence in Practice” was incorrectly attributed to author Sheila Tucker, Liaison Officer (NL), Canadian Agency for Drugs and Technologies in Health (CADTH). The submission was written by Kasia Kaluzny, Knowledge Mobilization Officer, CADTH.

3The Magazine of the Association of Registered Nurses of Newfoundland and Labrador

It was truly a privilege to preside over our 61st Annual Business Meeting (ABM) with almost 200 participants, great participation, questions, motions and debate. The June meeting brought together registered nurses, nurse practitioners and students from all areas of the province. Canadian Nurses Association (CNA) President-elect Barb Shellian also joined us and shared details on the future directions and priorities of CNA.

Provincial Nursing Forum 2015 preceded the ABM and featured Barb Langlois, a powerful and impactful speaker who focused on better understanding our own communication patterns. She encouraged us to look inward at our own assumptions and interpersonal styles, gave us guidance for working in teams and strategies to effectively and respectfully give constructive feedback. Lifelong skills beneficial to any registered nurse!

MESSAGE FROM THE PRESIDENT

Regina Coady, RN, BN, [email protected]

The importance of advancing our leadership capability as registered nurses and nurse practitioners is essential in today’s health care system. Leadership is not a job, it’s a passion to make a difference, a commitment to strong team work, advocacy for those in need and unable to speak on their own behalf, ensuring a respectful workplace, “leading self” – self-awareness and self-growth – and so much more.

In addition to the ABM and Leadership Conference, the “icing on the cake” was the Awards for Excellence in Nursing where we celebrated the contributions of three outstanding award winners – Dena King, Lily LeDrew and Carla Wells (see p. 9 for more details). As well, Honorary Membership was bestowed posthumously to Katherine (Kay) Daley, who dedicated most of her 34-year career to the advancement of nursing education in Newfoundland and Labrador.

As we move into fall, I encourage you to be active and raise important issues of health and health care as the federal and provincial elections approach. CNA have a dedicated website focused on important issues in the federal debate (http://www.election.cna-aiic.ca/en) and a federal election primer is available on p. 12. I encourage you to also visit ARNNL’s Document Library at https://www.arnnl.ca/document-library to review a wide range of background documents on health care and healthy public policy.

In closing I offer my congratulations to the BN Collaborative Program (Centre for Nursing Studies, Memorial University and Western Regional School of Nursing), which has achieved seven-year accreditation status from the Canadian Association of Schools of Nursing. This demonstrates excellence in academic performance and assures us that the preparation of future registered nurses is in good hands.

AS WE MOVE INTO FALL, I ENCOURAGE YOU TO BE ACTIVE AND RAISE IMPORTANT ISSUES OF HEALTH AND HEALTH CARE AS THE FEDERAL AND PROVINCIAL ELECTIONS APPROACH

4

FROM THE EXECUTIVE DIRECTOR’S DESK

We’re all familiar with check-ups when it comes to our health. It’s also important to take time to check-up on our profession and ask: How are we doing as a self-regulated profession? A very complex question, but it’s imperative we check the vitals. The privilege of nurses regulating nurses either through an organization (e.g. ARNNL), as an employer or as individuals, demonstrates that we all have roles to play to ensure that RNs are safe, competent and ethical practitioners. This challenge is more easily accomplished when we break it down into meaningful pieces.

The results of the ARNNL Member Survey on Progress Towards Ends (2015) can give us some insight into how we’re doing in terms of a professional check-up. The survey covered topics such as quality of care, supportive work environments, continuing competence, professional development, nursing leadership and knowledge of ARNNL (see p. 13 for more information).

Lynn Power, RN, [email protected]

To enter into the nursing profession, a student nurse has a lot to learn and even more to synthesize; thus an important component in our check-up is our commitment to students and new graduates. In our survey, 43 per cent of respondents said that they’d volunteered as preceptors and 64 per cent said they were mentors. Barriers to volunteering revealed that we have work to do to increase these numbers. As I write this column, the NCLEX-RN exam is being written. Although at this point I do not know the full picture, I believe there is further need to help students master the leap from education to practice.

Thirty-four per cent of you had participated in an ARNNL activity in the past year and in our annual report we cite that over 2,000 members and students participated in one of 50 activities offered by ARNNL – these numbers are good, but with almost 6,500 RNs and NPs in practice, they could be better. Kudos to those who participated in a workplace improvement initiative, however, professional decisions affect everyone – is hearing from a limited sample enough? Our survey also showed that 60 per cent of respondents had been involved in a proactive activity to improve quality of care – not a bad showing, but it indicates that there is room for improvement. Survey results also told us that just over a third of you (37 per cent) participated in a community activity to support

health promotion. With health care being the number one public policy topic, and with both provincial and federal elections around the corner, we need more voices.

And while I am pleased to report that nurses are meeting their continuing competency requirements, I’m sad to say that the number of allegations that an RN has failed to meet the standards of practice are rising, with most cases involving challenges in competency … why is this?

Another mark in our checkup is professional development. The ARNNL Education and Research Trust awarded over 61 bursaries and grants, but the Trust had a few categories where there were no applications at all. The Survey respondents gave the nursing profession a strong grade, with 82 per cent rating the overall level of professionalism as an “A.” While this is encouraging, data from national sources tell a tale of absenteeism, workplace bullying, psychological stress and more.

How are we doing overall? We need to collectively improve our check-up results. Let’s talk. Over the coming year, ARNNL will be organizing a number of opportunities to hear solutions from you.

Stay tuned and stay in touch.

A MORE IMPORTANT QUESTION IS WHAT CAN AND MUST WE ALL DO AS A SELF-REGULATING PROFESSION TO IMPROVE?


ARNNL COUNCIL MATTERS

*More details about the business of ARNNL’s Council are available in UPDATE, ARNNL’s e-newsletter. Email [email protected] to subscribe. Visit https://www.arnnl.ca/update-newsletter to read past issues.

Council Bestows 51st Honorary ARNNL Membership

Cyril Daley, Kay Daley’s husband, proudly accepting the honour on her behalf

On June 16, Council bestowed Honorary Membership posthumously to Katherine (Kay) Daley, who dedicated most of her 34-year career to the advancement of nursing education in Newfoundland and Labrador. Established in 1954, Honorary Membership is awarded to individuals who have helped advance the nursing profession and/or the Association. Kay graduated from nursing school in 1964. In 1968 she became the first director of Western Memorial Hospital School of Nursing. From 1974-1995, Kay was the director of St. Clare’s School of Nursing. In 1995 she took the helm as the first director of the Centre for Nursing Studies. Her appointment was the culmination of years of effort to establish the Bachelor of Nursing Collaborative Program and merge the three diploma schools of nursing in St. John’s. Her vision for the Centre saw the development of a centre for nursing excellence that subsequently included the Practical Nursing Program, the Nurse Re-entry Program, the Nurse Practitioner Program and a Research and Development Department to facilitate nursing research and community-based service activities. Kay served as a member of ARNNL Council and was actively involved in many ARNNL committees. In 1996 she was awarded the ARNNL Award for Excellence in Nursing – Administration.

Annual Report AvailableARNNL’s 2014-15 Annual Report, Regulating Registered Nurses in the Public Interest, was released in June. In addition to highlighting Council’s policy direction and governance accomplishments during 2014-15, the report provides details on the many important initiatives undertaken by staff and members to achieve ARNNL’s legislative and policy mandate. Visit https://www.arnnl.ca/annual-report to view the report and financial statements.

ARNNL Welcomes New Council Members

Following the first electronic-based vote for ARNNL Council Elections this past spring, two new Council members were elected and two familiar faces were re-elected by acclamation. Official election results were revealed at ARNNL’s ABM in June. Tracy MacDonald, a Risk and Patient Safety Manager at the Central Newfoundland Regional Health Centre, was elected to the role of Central Region Councillor, and Alexia Barnable, a Nurse Educator with Western Regional School of Nursing will fulfill the Education/Research position. Beverly Pittman and Elaine Warren were re-elected to their positions by acclamation. In addition to welcoming new and returning members, ARNNL wishes to thank and recognize outgoing Council members Madonna Manuel (Education/Research Councillor from 2009-15) and Sandra Evans (Central Region Councillor from 2008-15) for their dedication and commitment to the work of Council.

Tracy MacDonald

Attend an ARNNL Council Meeting! The next in-house Council meeting takes place on Oct. 22-23 at ARNNL House in St. John’s. Contact Christine Fitzgerald, Executive Assistant, at (709) 753-6183 or [email protected] for details.

Alexia Barnable

Council Deliberated on Annual Meeting MotionIn early July, a motion brought to the floor at ARNNL’s 61st Annual Business Meeting (ABM) was discussed by Council. The motion was in regard to ARNNL’s recent career posting for a “Nursing Consultant.” The motion read: “Be it resolved that one of the three nursing consultant positions at ARNNL, in addition to the existing job requirements, be held by an experienced licensed nurse practitioner. Be it resolved that this resolution will go to Council for further analysis.” Council met to discuss the motion and, after a review of Council policies, determined that staffing decisions are within the authority of the Executive Director of ARNNL and proposed no restrictions or other policy recommendations. All Council policies are available for review at https://www.arnnl.ca/council-policies. A separate motion related to long-term care will be discussed by Council at a future meeting.

Memorial Day Parade Honours Veterans and the Role of Registered NursesARNNL President Regina Coady laid a wreath on behalf of ARNNL at the Memorial Day parade on July 1 in downtown St. John’s. In 2004, on the occasion of the 50th Anniversary of ARNNL, the anniversary planning committee started the practice of ARNNL’s participation in the July 1 ceremony at the provincial war memorial, as well as the Veterans Parade and wreath laying. Since then, both retired and practicing RNs, dressed in traditional nursing attire, take part in the annual ceremony. All are welcome next July.

6

By: Siobhainn Lewis, RN, BN, MN – Nursing Consultant-Policy and Practice

Q & A: YOU ASKED

There is no longer a list of activities you can reference in determining what you are “allowed” to do in your practice. Since 2006, RNs and NPs in Newfoundland and Labrador have used a decision-making framework to understand and identify the scope or depth and breadth of nursing practice. The framework for RN scope of practice is outlined in the ARNNL documents1 Scope of Nursing Practice: Definition, Decision-Making and Delegation (2006) and Standards of Practice for Registered Nurses (2013). NP scope of practice is articulated in the Registered Nurses Regulations (2013) and the Standards for Nurse Practitioner Practice in Newfoundland & Labrador (2013). By definition, Scope of Practice is the range of roles, functions, responsibilities and activities that RNs and NPs are educated and authorized to perform; in essence, the “circle” you work within. It is important to note that there are differences in the circle of the whole profession of nursing, and within individual circles or scopes of practice. Any one practitioner does not know how to do everything that can possibly be done within the practice of their profession.

There are factors that determine the outer limits of your circle. The boundaries for that circle are identified by what you are educated and authorized to do.

Every RN and NP accepts responsibility for knowing what they are educated to do, either as part of their basic nursing education or as continuing education. Education may be formal or informal, but always consists of both theoretical and practical components. It is important that you identify if additional education is needed and that you obtain the necessary education to safely and competently carry out your practice.

Each RN and NP must also be aware of what they are authorized to do. Authority comes in a variety of ways – through validation that a practice is part of nursing practice, through legislation and through employer support. Firstly, you must validate that the practice you wish to engage in is part of nursing practice in this province. Some considerations are that it must belong in the realm of nursing, not belong in the exclusive legislated domain of another profession, builds on the body of nursing knowledge, is safe for an RN or NP to perform and the RN or NP must be able to manage the outcomes of care. Many practices are easily identified as nursing practice, but others may not be. Consultation with ARNNL is advised here.

As well, you must ensure there is no limitation in legislation. Some Acts list which categories of health care professionals are permitted to perform a function. For example, the Vital Statistics Act in NL is one such legislation and it authorizes RNs and NPs in certain circumstances to certify death. The Registered Nurses Regulations (2013) provide authority for NP practice to include prescription of forms of energy, lab tests and drugs.

Furthermore, employees of an organization must ensure that their employer supports them in carrying out this practice in their practice area. For example, RNs working in select long term care facilities may be authorized by their employer to certify death, but the same employer may not authorize RNs on Med/Surg to do the same. These authorizations are often articulated in a workplace policy.

So before you forge ahead or hold yourself back, think about these two key words: educated and authorized. Ask yourself: Do I have the knowledge, skill and ability to perform the task? Does my education prepare me to perform the task using evidence-informed knowledge, skill and judgment? Have I attained a level of proficiency to provide safe, competent care? Can I manage the outcomes of the care I provide? Does my employer support my carrying out this practice? Are there legislative considerations?

Seek out professional practice resources within your employer setting and/or consult with ARNNL practice consultants. After all, as an RN or NP your practice must safely, competently, ethically and compassionately meet the needs of your clients.

How do I know what I am allowed to do in my practice? I cannot find “the list.”

A:Q:

Q & A: YOU ASKED reflects member questions frequently asked about general topics. Members can access confidential practice consultation with ARNNL Nursing Staff. Visit www.arnnl.ca/contact for ways to get in touch.

1All ARNNL documents are located in ARNNL’s Document Library at https://www.arnnl.ca/document-library.

educated

authorized

Every RN is responsible for knowing their scope of practice and working

within it.


By: Bradley Walsh, RN, MN, Regulatory Officer

REGISTRATION UPDATERenewal 2016-17: Change in Process for Professional Liability Protection

The Registered Nurses Regulations (2013), made pursuant to the Registered Nurses Act (2008), stipulates it is a condition of a license that all RNs and NPs must have professional liability protection in order to practice nursing in Newfoundland and Labrador. Since 1998, the Canadian Nurses Protective Society (CNPS) has been the provider for professional liability protection for ARNNL members who hold annual licensure. CNPS is a not-for-profit organization that has a fiduciary duty to continually assess ongoing liability risks and determine relevant fees to ensure the long-term sustainability of the liability fund available to assist nurses when in professional legal jeopardy. Consequently, in 2014, ARNNL changed its reporting to members such that you can now see the actual cost of CNPS services during your annual licensure renewal process.

All members applying to renew a practicing RN or NP license for the 2016-17 licensure/membership renewal period can expect to see another change in the application process related to registration and payment for CNPS professional liability protection.

Notice Beginning in January 2016, when you complete your ARNNL practicing RN or NP licensure application online, you will be transferred to the CNPS website to register and make direct payment for your professional liability protection. Upon completion of the CNPS registration and payment process, you will then be automatically directed back to the MyARNNL site to finalize and submit your licensure renewal application. ARNNL and CNPS anticipate that the movement between websites will be seamless.

Why is ARNNL changing this process? With CNPS fee increases in 2014 and 2015, and potential increases in the future, ARNNL wants to ensure that all members have current information on the actual costs of CNPS professional liability protection and services. Further, over 50% of our membership are enrolled in a payroll deduction program through their employer. To collect annual licensure fees, some employers require a notice of fee change six or more months in advance of payment submission to ARNNL. In the event of any future increases in fees, CNPS will now be able to notify ARNNL members directly, thus bypassing any employer limitations. Another benefit to this new process is the direct connection you can make with CNPS to learn more about its services.

Will my payroll deduction be affected for the 2016-17 year? The 2016-17 licensure period will be a transition year. If you are enrolled in a payroll deduction program and the full amount has already been deducted from your pay, when ARNNL receives your licensure fee from the employer the professional liability protection portion of the fee will be forwarded directly to CNPS for this year only. Members whose licensure fees are not submitted via an employer will see the fee collection change this year. In the 2017-18 licensure year, all members will be required to register and make payment directly to CNPS when they renew with ARNNL.

Will ARNNL provide additional information on this change? More information will be emailed to the entire membership this fall, and an open education teleconference is scheduled for Dec. 15 (see p. 11 for details). CNPS offers a wide variety of services, including legal advice, legal assistance, risk management and education. It is the hope of ARNNL and CNPS that through direct engagement with CNPS, beneficiaries will avail of these opportunities.

See CNPS article on p. 8 for additional information.

Please select one of the following options:

April 1, 2016 - March 31, 2017 Licensure or Membership Renewal Application

You must complete the following steps, in order, to complete your application.

Step 1: Complete the ARNNL Registration Renewal Form In Progress

Step 2: Provide Payment Direct to CNPS

Step 3: Awaiting ARNNL Approval

Screenshot of ARNNL’s online licensure application, launching in 2016.

8

Legal AdviceCNPS beneficiaries have access to immediate, confidential legal advice from lawyers who will explain the legal steps to take and actions to avoid when an incident occurs and answer your questions.

Legal AssistanceCNPS provides beneficiaries with assistance in legal proceedings including civil litigation, criminal investigations and prosecutions, statutory offences and witness appearances. CNPS also assists with pre-contractual reviews and offers an early intervention program.

Risk Management and EducationCNPS delivers relevant, customized, and current education offerings including presentations, webinars, infoLAWs and articles about new legislation, the legal implications of changes in nursing practice and evolving risk management strategies.

Professional Liability ProtectionCNPS ensures beneficiaries are adequately protected by closely monitoring court awards and adjusts the levels of professional liability protection accordingly.

The Canadian Nurses Protective Society (CNPS) helps nurses effectively manage their professional legal risks and appropriately assists them when in professional legal jeopardy. As a benefit of membership with ARNNL, registered nurses and nurse practitioners are eligible for the professional liability protection and broad range of legal services offered by the CNPS.

What services does CNPS offer ARNNL nurses?

Our goal is to provide you, our beneficiary, the best legal resources and risk management information and support available while you strive to provide high quality professional care to your patients.

www.cnps.ca

For more information, or if you have questions or concerns pertaining to your professional nursing practice, please do not hesitate to call CNPS to speak to a Legal Advisor at 1-844-4MY-CNPS (1-844-469-2677) or visit our website at www.cnps.ca.

More TransparencySeparate fees for licensing and professional liability protection will be clearly indicated during the registration and renewal process.

Quicker ServiceNurses will receive CNPS’ confidential services promptly without the need to send proof of licensure.

Improved AccessNurses will have the option to receive timely updates from CNPS about professional liability considerations, legal risk management, educational webinars and new publications and articles of interest.

What are the benefits of ARNNL and CNPS creating a new

registration / renewal process?


By: Jennifer Barry, BA, Communications Officer

NURSES OF NOTE

ARNNL’s Awards for Excellence in Nursing were presented to three RNs at a luncheon ceremony on June 16. ARNNL congratulates this year’s recipients, and is inspired by their leadership and commitment. Nominate an outstanding RN for a 2016 Award for Excellence! Deadline for submissions is Dec. 11. For more information, visit www.arnnl.ca/about-awards.

Dena King, RN, NP, BNNurse Practitioner, James Paton Memorial Regional Health Centre, Central Health, Gander, NLAward for Excellence in Nursing – Practice

Dena King graduated from the Grace General Hospital School of Nursing in St. John’s with a diploma in nursing in 1984. She furthered her education through completion of a certificate in Home Health Nursing in 1999 and a Bachelor of Nursing degree in 2004. That same year, Dena completed the ARNNL Nurse Practitioner Competency Assessment Program under the Prior Learning Assessment Stream and was registered and licensed as a nurse practitioner (NP). Dena has practiced for 30 years in communities throughout Newfoundland and Labrador and in the Northwest Territories, and demonstrates a population health and client-centred focus. Her passion for nursing is also evident in her participation in professional activities. She has served on ARNNL Council since 2013. Dena was the first NP to practice in the emergency department at James Paton, and it seems that her love of nursing was felt by her family – Dena’s youngest daughter is also a registered nurse, working alongside her mother in the emergency department. Dena is the first NP to be awarded the ARNNL Award for Excellence in Nursing – Practice.

Lily LeDrew, RN, BNRegional Primary Health Care Consultant, Central Health, Springdale, NLAward for Excellence in Nursing – Administration

In 1976, Lily LeDrew graduated from Western Memorial Hospital School of Nursing with a Diploma in Nursing. She received a Diploma in Community Health Nursing from Memorial University in 1981 and, in 1998, completed a Bachelor of Nursing degree. Although she has held numerous roles over the years, she has always practiced in Central Newfoundland. Engaging communities is Lily’s number one priority, and she has been at the forefront of the development of primary health care teams and advisory committees throughout the Central region. She has also been instrumental in heading the development, implementation and evaluation of a multidisciplinary primary health care model of service delivery. Lily views community members as partners and has a realistic, inclusive, solution-focused approach to the development of strategies to improve care and service delivery. Through her administrative roles, Lily is committed and dedicated to activities that ultimately change the way that communities identify and resolve their health care issues.

Dr. Carla Wells, RN, MN, PhD, GNC(C)Nurse Educator, Western Regional School of Nursing, Corner Brook, NLAward for Excellence in Nursing – Education

Dr. Carla Wells graduated from Western Memorial Hospital School of Nursing with a Diploma in Nursing in 1975. She received a Bachelor of Science in Nursing from the University of Ottawa in 1984 and a Master’s degree in Nursing from Dalhousie University in 1992. In 2011, Carla was awarded a PhD through the University of Calgary. Carla has practiced as a nurse educator for the past 10 years. A former Clinical Nurse Specialist, in 2000 she received the ARNNL Award for Excellence in Nursing – Practice and is the first RN to receive ARNNL awards in both categories of Practice and Education. Carla has volunteered with ARNNL through participation in advisory and awards committees, and disciplinary panels. She has served as president of a Clinical Nurse Specialist Interest Group in Ottawa, President of the Newfoundland and Labrador Gerontological Nurses Association and President of the Canadian Gerontological Nurses Association. Carla holds memberships in several professional associations, has presented numerous times provincially and nationally, boasts several publications and is a recipient of a Queen’s Jubilee Medal for her lifelong volunteer work.

10

By: Melissa Manning, RN, BScN, MN, NP-Pediatrics, [email protected]

ADVANCED PRACTICE VIEW

A Tuckamore in Paradise: A Treatment Centre for Youth with Complex Mental Health Needs

For additional information, please contact Program Manager Susan MacLeod at (709) 752-4950 or via email at [email protected]. For referral information, please contact one of our social workers and intake coordinators: Darlene Didham at (709) 752-4529 or via email at [email protected] or Lawrence Avery at (709) 752-8151 or via email at [email protected].

“The Tuckamore Tree” – an original piece by a youth residing at the Tuckamore Centre

Background: I hold a Bachelor’s of Science in Nursing from Trent University in Peterborough, ON and received my Masters in Nursing and Pediatric Nurse Practitioner specialty from the University of Toronto. I started my nursing career working on the multi-organ transplant unit at the Hospital for Sick Children in Toronto. My career also involved working on a maternity, newborn care and pediatric unit, as well as teaching with Sir Sanford Fleming College and Trent University. I was employed at the Partners in Pregnancy Clinic in Peterborough as a Nurse Practitioner (NP) and returned to Newfoundland to develop the NP role at the Tuckamore Centre. I also provide instruction at the Centre for Nursing Studies.

capacity for up to 12 young people between the ages of 12 and 18 years. It is divided into three living areas which each house a maximum of four youth. There is also a school area with three classrooms, recreational space, an administrative/office area and an apartment for visiting families. In addition to a program manager, the Centre includes staff from a number of specialized clinical fields, including child and youth care, nurse practitioner, psychology, psychiatry, social work and occupational therapy, as well as professionals in recreation, art and music therapy and from the public school system.

The youth at the Centre come from a wide variety of backgrounds and struggle with an array of complex mental health issues. Some may have a diagnosis such as depression, bipolar disorder, conduct disorder or attention deficit hyperactivity disorder. They may have a combination of mental health issues that cause them to have difficulty coping at home or in the community, and experience self-harming behaviour or thoughts of suicide.

Most of the young people referred have already received mental health services in the community; however, they now require a more intensive treatment environment to achieve their goals. The average length of stay at the Tuckamore Centre will be six months, though some may stay longer, depending on their individual needs.

I have had the pleasure of developing the part-time role of the NP at the Tuckamore Centre. From initial policy and program development, my NP role continually evolves to meet the needs of our clients and staff. I meet with each new youth shortly after they are admitted to the Tuckamore Centre and, using a client centered and harm reduction approach, I help to identify client goals for health. I am engaged in primary health promotion, such as vaccine catch-up and STI screening, and also see clients for acute issues, whether from self harm or illness. I continually collaborate with the multi-disciplinary team, other programs and community partners to develop a holistic care plan for our clients.

While developing a new role in a new province has been challenging, it has also been very rewarding. Working within the full scope of NP practice with the Tuckamore youth has inspired me professionally and personally, and has enabled me to further explore the complexities of pediatric mental health.

Tuckamore trees are known for surviving and thriving despite living in the harsh coastline environment of Newfoundland and Labrador. Appropriately, the Tuckamore Centre name reflects the resilience of the youth staying at the treatment centre and their potential to overcome and flourish despite challenges.

The Tuckamore Centre was developed under the direction of the Department of Health and Community Services and is operated by the Mental Health and Addictions Program of Eastern Health. In the past, youth who needed this level of treatment were required to travel outside the province for extensive periods of time. The facility has the


ARNNL CONTINUING EDUCATION TELECONFERENCE SESSIONS Fall 2015, Tuesdays 1400-1500h (Island Time)

*SEPTEMBER 15Celebrating Excellence in Nursing: The Nomination Process

Awards for Excellence Committee Members: Nicole Cheator RN, Charmaine Lane RN, Lorraine Mitchell RN, Pam Ward RN, Nicole Woodman RN

*SEPTEMBER 22RNs, NPs and Provincial and Federal Elections: Influencing Public Policy

Lynn Power RN, MN, Executive Director, ARNNL *OCTOBER 6 Community Rapid Response Team: Enhancements at Home

Dawn Gallant RN, BN, CCHN(C), Primary Health Care Manager, Eastern HealthJennifer Williams RN, BN, BA, NP, Eastern Health

*OCTOBER 27Legal Issues in Nursing Practice

Trudy Button ARNNL Legal Counsel

*These sessions will be audio recorded and available online after the event. To access archived teleconference sessions, visit www.arnnl.ca.

HOW TO ATTEND A LIVE TELECONFERENCE SESSION1. Access is provided five minutes prior to start time.2. Dial 1-888-875-1833. 3. When prompted, enter the Participant Passcode 304371659 #4. If you experience technical difficulties, press *0 (star-zero).5. All participant lines will be muted during the presentation. To mute

your line during Q & A, press *6 to mute and *6 to turn off mute.

*NOVEMBER 17Evidence on the Front Line of Health Care: What Counts?

Sheila Tucker M.L.I.S, B.Ed, B.A(Hon), CPAD., Canadian Agency for Drugs and Technology in Health

*NOVEMBER 24 The “Self” in Self-Regulation: Being Involved in Your Professional Association

Pam King-Jesso RN, BN, MN, Nursing Consultant—Policy & Practice, ARNNLSiobhainn Lewis RN, BN, MN, Nursing Consultant—Policy & Practice, ARNNL

DECEMBER 8 Connecting With Your President: An Annual Linkage Session

Regina Coady RN, BN, MN, ARNNL President

*DECEMBER 15Registration Updates: Preparing for Licensure 2016-17

*this session will include information on the new application process for CNPS liability protectionBrad Walsh RN, MN, Regulatory Officer, ARNNL

REGISTRATION • To register go to https://www.arnnl.ca/events-calendar.• If you need assistance with registration, contact Jennifer Lynch at

[email protected], 709-753-6075 or 1-800-563-3200.

SPECIAL EVENT: President’s Town HallWednesday, Oct. 21, 2015Lecture Theatre D, Health Sciences Centre (Main Floor, Medical School)7:30 p.m. – 9 p.m.

Join ARNNL President, Regina Coady, and ARNNL Council, for an in-person discussion. Members are encouraged to attend and share their thoughts on where the nursing profession should be directing its attention in the future.

12

HEALTH IS WHERE THE HOME IS- 2015 FEDERAL ELECTION PRIMER -

On October 19 Canadians go to the polls for the next federal election. This primer will help you extend your influence beyond the ballot box. Join the Canadian Nurses Association: Declare that seniors home health care must be an election issue. How does CNA want federal candidates and parties to improve seniors health?1. Common standards for home health care2. More support to family caregivers3. Better community- and home-based health promotion

Why home health care standards?Canada’s home health care is a patchwork of public and private services. That means getting health care at home has more to do with where we live than what we need. In helping establish common standards across Canada by working with the provinces, territories and stakeholders — including CNA — federal parties could give Canadians equitable access to care.

Why more support for family caregivers?Canadians who serve as caregivers for aging family members or friends are indispensable to the well-being of our seniors and our health-care system. More support would give them a hand up as they work to balance jobs and raise families.

Why healthy and active aging?Preventive activities and programs can help seniors maintain or improve their health and reduce falls — the leading cause of seniors’ injury-related hospitalizations. Increasing balance and strength are among the most effective and low-cost ways to gain stability, manage chronic disease and get seniors more socially engaged.

Extend your influence beyond the ballot boxRemember: Your candidates are running for office to represent you. Reach out and talk to them about the issues you care about (or use our handy online Contact Candidates tool), whether these are in your own riding or the nation as a whole.

Here’s some tips to get you started.1. Know your stuff. Prepare 2 or 3 key issues ahead of time.

You never know when you’ll run into a candidate — at a neighbourhood event, grocery store or on your very own doorstep (during dinner, of course).

2. Be concise and direct. Prepare to put your ideas across in just a

few minutes. You won’t always get a 30-minute meeting. 3. Start a conversation. Get candidates talking with open-ended

questions. Asking if they support more assistance for caregivers may only get a resounding “yes.” Instead, ask how they and their party will assist caregivers.

4. Get face time. Contact your local campaign offices for an appointment with the candidate or their staff. Be persistent and follow-up if you don’t get an immediate response.

5. Work the scene. Check with your local riding association or campaign offices to find town halls, all-candidate meetings and other public events where you can raise questions.

Don’t forget: Use our #homeishealth hashtag on social media while you’re out and about!

How to get candidates talking Get your candidate talking with “how” and “what” questions on CNA’s election goals.

How will you and your party help establish standards to give all Canadians fair and equitable access to home health care?• What are you going to do to fix the gaps in the home health care

system so that a senior in B.C. has the same basic level of care as a senior in New Brunswick?

• How will you and your party collaborate with the provinces and territories that deliver health care?

How will you and your party secure more support for caregivers?• What are you going to do to help compensate family caregivers

who pay out-of-pocket for prescriptions, groceries and transportation for aging relatives or lose wages for time taken off work?

• How will you help Canadians balance caregiving to seniors with raising families and maintaining careers?

How will you nurture and enhance community- and home-based healthy and active aging programs that promote and protect good health?• What are you going to do to bring chronic disease prevention and

management supports into seniors’ homes and communities?• How will you support programs to keep seniors healthy and active?

cna-aiic.ca/election2015 #homeishealth /cna.aiic /canadanurses /CNAVideos

© Canadian Nurses Association. Reproduced with permission. Further reproduction prohibited.


By: Julie Wells, BSc, MSc, ARNNL Research & Policy Officer

SURVEY SAYSIn February 2015, ARNNL conducted a telephone survey to obtain members’ input on issues important to the future of nursing. The survey results also serve to measure ARNNL’s progress on Council’s long term goals (ENDs) and provides data to help staff strategically plan our programs and activities.

This year, 500 randomly selected practicing members provided feedback on the following areas: continuing education, leadership, nursing management, professionalism, communications, practice environments, client safety and knowledge of ARNNL.

A new series of questions in which members were asked about the level of agreement with statements about the model of care in

their area was added to the 2015 survey. While the results of these questions cannot tell us how members feel about specific models of care, they can provide a picture of the key points that are applicable to all models.

Results showed that the majority of members agreed with all statements related to the model of care in their area, although to varying degrees for each (Table 1). Most members agreed that the model allows RNs to work to their full scope of practice (85%), enables RNs to develop therapeutic relationships with clients (74%) and supports continuity of care (72%). Members also agreed, but to a lesser extent, that the model of care allows for safe and appropriate RN-Client assignment (63%).

Table 1. Percentage of Members Who Agree or Disagree with Statements About the Model of Care Delivery Used in Their Practice Environment

2015 Survey Highlights:• 77% agreed that the Continuing Competence Program helped them to identify areas to strengthen in their

practice;• 86% agreed that RNs have autonomy to make decisions about their professional practice;• The average rating of the level of professionalism displayed by RNs was 8.54 out of 10;• The average rating of the quality of communication and collaboration among members of the interdisciplinary

team was 7.64 out of 10;• 87% of members whose scope of practice changed within the last year felt they had adequate support to

meet the requirements of the new role/responsibility; and• 7% of members who were not in a management role rated the likelihood they would pursue a career in

management as 8 or higher on a scale of 1-10.

If you would like to know more about what ARNNL members had to say about these and other important issues, the full report of the 2015 Member Survey on Progress Towards ENDs is available online at: www.arnnl.ca/member-survey.

Strongly Agree Agree Disagree Strongly

Disagree Don’t Know/NA

Allows RNs to work to their full scope of practice 18 67 9 1 6Enables RNs to develop therapeutic relationships with clients 15 59 15 3 8Supports continuity of client care 13 59 17 4 7Allows for safe and appropriate RN-Client assignment 10 53 26 4 7

Thank you to the 500 members who took the time to respond to the survey!

14

Left to right: Paul Fisher, Executive Director/Registrar, CLPNNL; Regina Coady, ARNNL President; and Steve Kent, Deputy Premier and Honourable Minister of the Department of Health and Community Services

GOINGS ONProvincial Nursing Forum Hailed a SuccessOver 200 registered nurses, licensed practical nurses, bachelor of nursing students and practical nursing students gathered at the Sheraton Hotel Newfoundland in St. John’s June 15-16 for Provincial Nursing Forum 2015, an education event hosted by the Department of Health and Community Services, ARNNL and the College of Licensed Practical Nurses of Newfoundland and Labrador (CLPNNL). The Forum, entitled “Enhancing Communication: RNs and LPNs, Let’s Talk,” included a communications workshop with keynote speaker, author and facilitator Barb Langlois; education sessions on leadership, scope of practice and self-regulation; as well as both ARNNL and CLPNNL annual meetings and awards recognition events. ARNNL President Regina Coady said that the expert knowledge and education offered during the Forum will enable nurses to strengthen communication amongst the health care team and enhance positive professional relationships in the interest of safe, competent, compassionate and ethical nursing practice.

Advance Breastfeeding Through “The Physician’s Breastfeeding Toolkit”The Baby-Friendly Council of Newfoundland and Labrador wishes to inform nurses about the recent launch of “The Physician’s Breastfeeding Toolkit” in an effort to validate the supportive breastfeeding care that they practice with families. Nurses often support families who have had their breastfeeding goals unfulfilled or mothers who have prematurely weaned their babies based on a lack of updated breastfeeding knowledge. “The Physician’s Breastfeeding Toolkit” provides consistent, current information to physicians to guide their breastfeeding management practices. It offers a concise reference source for assessment, diagnosis and treatment of common problems. Topics such as medication safety, diagnostic procedure considerations and resources, both local and national, are addressed.

MUNSON Faculty Member Receives Grant Funding for Healthy Aging Research

In April, Dr. Caroline Porr, faculty member with the School of Nursing at Memorial University, was awarded $9,480 for her research project “Developing and Testing a Dialect-Sensitive and Culturally Appropriate Diabetes Educational Tool for Older Adults of Rural Newfoundland and Labrador.” The project is among seven that have received a total of $108,980 through the Newfoundland and Labrador Healthy Aging Research Program. The grant supports the development of research teams in the province capable of obtaining funding from national and international granting agencies in

Links to public health nurses and other community care providers are highlighted in an attempt to promote comprehensive, interdisciplinary collaboration.

Dr. Caroline Porr

the area of applied health research. The Healthy Aging Research Program is administered by the Newfoundland and Labrador Centre for Applied Health Research at Memorial University. Since its inception in 2008, the Healthy Aging Research Program has provided close to $1.1 million in support of research into healthy aging.

Best Wishes for Outgoing ARNNL Practice ConsultantIn late June, ARNNL staff bid farewell to Beverley McIsaac, ARNNL Nursing Consultant – Regulatory Services and Advanced Practice. Beverley had been a member of the ARNNL team since 2008. In her role, she managed files related to nurse practitioners, clinical nurse specialists and nursing education. Beverley developed standards for nursing education for entry to the profession and advanced nursing practice, and facilitated the development and implementation of approval processes. She was also integral to the implementation of ARNNL’s Continuing Competence Program for RNs and NPs. ARNNL wishes Bev well in her return to full-time nurse practitioner practice, providing primary health care services to the people of Jeffrey’s and St. Georges.


If you would like to nominate an RN or NP for Nurse of Note, please email [email protected].

Conferences and WorkshopsProvincial ConferenceNewfoundland and Labrador Operating Room Nurses Association (N&LORNA)

Oct. 2-4, 2015Mount Peyton HotelGrand Falls-Windsor, NLEmail [email protected] for details

Janeway Kids Rock Pediatric Emergency Conference & WebinarOct. 2-4, 2015Email [email protected] for detailsWebsite: www.kidsrocknl.caRegister by Sept. 6

WRSON Nurse Educator Receives National Award

In May, Western Regional School of Nursing educator, Dr. Carla Wells, received an Honorary Lifetime Membership Award from the Canadian Gerontological Nursing Association (CGNA) at its 18th National Conference in Prince Edward Island. Dr. Wells, a founding member of CGNA in 1984, has served the association in a variety of executive positions (including President) as well as co-chair or chair for three national conferences. Dr. Wells is also President of the Newfoundland and Labrador Gerontological Nurses Association and welcomes new members. Members can join through www.cgna.net. If you would like more information about the association, email [email protected].

Dr. Carla Wells Left to right: ARNNL Workplace Representative, Karen Morris, RN and her daughter, Kayla, attended Provincial Nursing Forum 2015 in June. Kayla, who is in her 4th year of studies at the Centre for Nursing Studies, is an ARNNL Nursing Student Representative.

“Representing” Nursing Today and Tomorrow

GI Education DayThe Newfoundland and Labrador Chapter of the Canadian Society of Gastroenterology Nurses & Associates (NL-CSGNA) held its annual GI Education Day on June 13. Over 50 attendees participated in seven 45-minute education sessions at the Health Sciences Centre in St. John’s. June Peckham, RN, CGN(C), NL-CSGNA Treasurer, said that evaluations of the event were positive. Kudos to all who participated!

Memorial University School of Nursing (MUNSON) Classes of ‘75, ‘80, ‘90 Reunion 2015

Oct. 16-17, 2015For more information, and contact names, visit:http://www.mun.ca/mundays/events/reunion_nursing.phpRegister at https://crm.stuaff.mun.ca/reunion.htm

Breastfeeding in NL – Committing to Best PracticesA Research and Clinical Symposium

Nov. 5-7, 2015Abstract submission deadline: Sept. 14, 2015www.surveymonkey.com/r/bfconference2015 or [email protected]

National Nursing Week May 11-17, 2015

Chapel Service led by RNs at Charles S. Curtis Memorial Hospital in St. Anthony

RNs in 2 North at the Leonard A. Miller Rehabilitation Centre in St. John’s

Zone 4, Community Health, St. John’s

Canadian Nurses Protective Society: Upcoming WebinarsVisit www.cnps.ca to register:Legal Issues for New Grads – Sept. 15The Nurse, the Chart and the Law – Sept. 23*On Dec. 15, join ARNNL for a special education teleconference on new CNPS enhancements to ARNNL’s licensure/registration renewal process. See p. 11 for details.

*NEW! LINKING WITH MEMBERSPRESIDENT’S TOWN HALLMARK YOUR CALENDARS

On Oct. 21 in Lecture Theatre D, Health Sciences Centre (Main Floor, Medical School), St. John’s, join Regina Coady, ARNNL President, and ARNNL Council, for an in-person member discussion about the future of the nursing profession. This event runs from 7:30 p.m. - 9 p.m.

16

Being part of a self-regulated profession means that RNs and NPs govern nursing, and are the ‘self’ in self-regulation. ARNNL engages its members, and members of the public, to contribute their knowledge and expertise to its work, and their involvement has a meaningful impact on nursing and health care in the province. These important volunteers serve ARNNL in many capacities, and we are pleased to introduce them to you in this edition of ACCESS.

VOLUNTEER SPOTLIGHT: THE ‘SELF’ IN SELF-REGULATION

If you would like to volunteer with ARNNL, visit www.arnnl.ca/get-involved.

Continuing Competence Program (CCP) Auditors: RNs Answering the Call

Left to right: Brenda Hayter, Rhonda McDonald, Krista Crane

Sitting (left to right): Marie Clarke, Rhonda McDonald, Krista Crane, Karen StreetStanding (left to right): Anne Kearney, Cathy Burke, Glenda Roy, Tracy MacDonald, Suzanne Kendall, Dorothy Bragg, Paul Alyward, Patricia Grainger, Brenda Hayter

• Use the most current CCP forms available at https://www.arnnl.ca/continuing-competence. You should have your self-assessment completed by now and be working on activities identified in your learning plan.

• Ensure your learning activities fall within the correct licensure year – April 1, 2015 - March 31, 2016.

• Review your target dates to ensure they include a month/year that falls within the licensure year April 1, 2015 - March 31, 2016.

• Review the CCP Continuous Learning Activities sheet available on ARNNL’s website for examples of what constitutes formal and self-directed learning activities.

From the Auditors: Tips for Helping You Complete Your 2015-2016 CCP

In the January 2015 edition of ACCESS, there was a Call for Continuing Competence Program (CCP) Auditors to participate in the 2015 CCP audit. RNs and NPs within our province answered the call! On June 4, eight volunteer RNs and five members of the Staff Advisory Committee on Continuing Competency met at ARNNL House to audit 150 CCP forms. Stay tuned for audit results and the upcoming call for CCP auditors for 2016 in the January 2016 edition of ACCESS.

Here’s what some auditors had to say about the CCP audit process:

“It was a great experience. Participating in this process will assist me in completing my own CCP forms more effectively and efficiently. I am quite impressed with the amount of education RNs are currently engaged in in this province, as well as the diversity of educational opportunities. It is apparent that overall RNs take CCP very seriously and are committed to lifelong learning!”

“I enjoyed the process and was impressed by how well the CCP documents were prepared. I would encourage others to participate – a great learning experience.”

“I was so delighted to be involved with the CCP audit process. It provided me the opportunity to better complete my own personal learning plan and see the great work being submitted by fellow colleagues. In a world of increasing accountability and self-directed learning, it is a pleasure to be part of the valued profession of nursing.”

“Positive experience from a personal and professional perspective. Reaffirms the importance of lifelong learning and the pursuit of excellence in caring for our clients and protecting the integrity of our profession.”

“Great insight into the CCP auditing process and the accountability of RNs in our province.”


By: Julie Wells BSc., MSc. - Research and Policy Officer

A Workforce of 100

NP

Registered nurses are the largest group of regulated health professionals in the province. Theprovincial nursing workforce consists of over 6,000 registered nurses. If there were only 100* RNs it would be easier see the demographic characteristics of the workforce. If there were 100 RNs in the workforce there would be...

95 Females 5 Males 98 Registered Nurses 2 Nurse PractitionersRN

71full time

65 working in a hospital

10 in community health8 in long-term care3 in an educational institution

14 in other workplaces

42.9 yearsAverage Age

59 in Eastern Health

14 in Western Health

12 in Central Health

6 in Labrador-Grenfell Health

6 employed outside the RHAs

*statistics based on year-end 2014-15 membership data; for more nursing statistics see the ARNNL Annual Report or www.arnnl.ca/statistics.

91 educated in NL

7 educated in anotherCanadian province

1 internationally educated

16casual

13part time

10age 58+

51 with a Bachelor of Nursing degree

42 with a Diploma in Nursing4 with a Master of Nursing degree 3 with a degree in other disciplines

75 staff/community health nurses

13 employed in other positions

4 instructors/educators

3 advanced practice nurses (NP or CNS)

6 managers/administrators

The concept for Workforce of 100 is based on the “A Village of 100” infographic in the Newfoundland and Labrador Vital Signs 2014 report.

60+

50-59

40-49

30-39

< 30 years old

15

24

29

24

6

By: Julie Wells, BSc, MSc, ARNNL Research & Policy Officer

WORKFORCE OF 100

18

By: Michelle Osmond, RN, MS(N), Director of Regulatory Services and Professional Conduct Review

REGULATORY NOTESReview of an Allegation by the Complaints Authorization Committee: Authority to Take Action

Who is the CAC? The Complaints Authorization Committee (CAC) is a legislated committee set out in the RN Act and is made up of Council members. A quorum of the CAC, two RNs and a public representative, is required for an allegation to be reviewed.

What decisions can the CAC make when they review an allegation?The CAC has the authority to order an investigation and ADR (or both), require an RN to meet with them or dismiss the allegation. In the event that the CAC dismisses an allegation, the complainant has the right to appeal the decision. If following its review, which in most cases will include a report of an investigation, the CAC is of the opinion that there are reasonable grounds to believe that an RN has engaged in conduct deserving of sanction, the allegation becomes a complaint. At this point, the CAC may counsel or caution the RN, or refer the complaint to a hearing by an Adjudication Tribunal. When the complaint is referred to a hearing, the CAC also has the authority to recommend to ARNNL Council that the nurse’s license be suspended or restricted, or an investigation of the RN’s practice be completed, pending the outcome of the hearing.

What is involved if an allegation is referred for an investigation?The DPCR or an ARNNL Regulatory Officer will complete the investigation. A written report containing the facts gathered during the investigation, such as witness statements and copies of documents/records, is prepared by the investigator. The investigator is authorized under the Act to request documents and to require persons having knowledge of the allegation to meet with him/her. A redacted3 copy of the report is forwarded to the registered nurse or his/her lawyer. The RN is provided an opportunity to respond to the report and to provide

1 An allegation is a written document alleging an RN has engaged in conduct deserving of sanction. For the definitions of conduct deserving of sanction see https://www.arnnl.ca/sites/default/files/Examples_of_Conduct_Deserving_of_Sanction_Feb_2015.pdf

2ADR is an agreement process where an RN completes terms and conditions such as remedial courses or other measures to resolve an allegation.3Identifying patient information is removed for privacy/confidentiality reasons.

a written submission to the CAC. The CAC will meet to review the report. In the event that the CAC dismisses an allegation, the complainant has the right to appeal

When does the CAC order a counsel or caution? A counsel or caution may be given when the CAC is of the opinion that an RN has engaged in conduct deserving of sanction but, bearing in mind ARNNL’s primary mandate of public protection, referral to the disciplinary panel is not warranted. In deciding to issue a caution/counsel, the CAC considers the circumstances specifically related to the RN’s practice/conduct, including: whether the issue is isolated versus a recurring pattern of conduct/practice; whether the RN has demonstrated insight and accountability; and whether any remedial or corrective actions have been taken by the RN. Guidance, specifically referencing the standards of practice or the code of ethics, is given in writing and the CAC may also recommend the registered nurse undertake remedial courses or other measures.

What happens when the CAC refers a complaint to a hearing?The DPCR, as instructed by the CAC, will itemize each issue that the ARNNL alleges is conduct deserving of sanction with respect to the registered nurse’s practice/conduct, collectively referred to as the “Complaint.” The RN is provided notice of the hearing, including the date and the names of the Adjudication Tribunal members and a copy of the Complaint. ARNNL posts notice of a hearing on the website, as the RN Act requires a hearing be conducted in public unless an Adjudication Tribunal orders the hearing be conducted in private.

To learn more about the Professional Conduct Review Process, please see the ARNNL Annual Report at https://www.arnnl.ca/annual-report.

The Registered Nurses Act (2008) (the “Act”) provides the Director of Professional Conduct Review (DPCR) with authority to resolve an allegation1 with the consent of the RN and the individual submitting the complaint (the “Complainant”) when it appears that an allegation may be satisfactorily resolved. While 67 per cent of allegations over the past five years have been resolved in this manner, allegations that the DPCR has been unable to resolve, or in the opinion of the DPCR are unsuitable for Alternative Dispute Resolution (ADR)2, are referred to the Complaints Authorization Committee (CAC) for review.


DISCIPLINE DECISIONSPauline HollettNewfoundland and Labrador Registration No. 14033

On May 6, 2015, the ARNNL Council suspended the license renewal of Pauline Hollett, Registrant No. 14033 pending the decision of the Adjudication Tribunal of the Disciplinary Panel.

Heidi MacNeilNewfoundland and Labrador Registration No. 18045In the matter of a Complaint against Heidi MacNeil, Association of Registered Nurses of Newfoundland and Labrador, Registration # 18045 (the “Registrant”), an Adjudication Tribunal, in a Decision dated May 29, 2015, found the Registrant guilty of conduct deserving of sanction under the Registered Nurses Act (2008), sections 18(c)(i) professional misconduct; and 18(c)(v) acting in breach of the Code of Ethics.

At the hearing the Registrant entered a guilty plea to four issues in the Complaint, admitting that she had accidentally but carelessly discussed patient confidential health care information, unintentionally breached a patient’s confidentiality and gave inconsistent information to her Employer and ARNNL regarding matters related to the Complaint.

Pursuant to section 28(3) of the Registered Nurses Act (2008) the Adjudication Tribunal ordered: 1. The Registrant’s license to practice nursing to be suspended immediately and the license to be returned to her pending her

successful completion of the following: a. Learning Modules: i. Canadian Nurses Association Code of Ethics for Registered Nurses; ii. Direct Contact with Personal Health Information: PHIA 2011; iii. Jurisprudence Module: The Legislation and Rules Governing the Practice of Nursing in Newfoundland and Labrador; b. Review of the ARNNL Interpretative Document: The Therapeutic Nurse-Client Relationship: Expectations for Registered

Nurses; and c. A meeting with a Nursing Consultant – Policy and Practice, ARNNL to reflect on privacy, confidentiality and accountability.

2. The Registrant shall pay the ARNNL $1,250 towards its costs incurred.

The conduct deserving of sanction occurred on or about August 11, 2012 in Brigus, NL, and September 26, June 10, 2013 and December 3, 2013 while the Registrant practiced as a registered nurse at Health Sciences Centre, St. John’s, Newfoundland and Labrador. The Complainant was Eastern Health.

Disciplinary UpdateOn June 8, 2015, Heidi MacNeil, Registration No. 18045, met the terms and conditions of the Order of the Adjudication Tribunal dated May 29, 2015 such that her practicing license has been returned.

20

Reprinted with permission from the College of Registered Nurses of Manitoba.

CLINICAL CORNER

PASS

TECHNOLOGY TIPS FOR YOUR PRACTICE

Protect your computer, mobile device and social

media passwords

Keep your social media photos, videos and

postings professional

Know and follow your organization’s policies on

technology use

Access personal health information only if it is required for client care

Do not become a client’s “electronic friend”

on social media

Ensure encryption when sending external emails

Use employer-issued mobile devices (where available)

instead of your own device

Never post work-related comments on your social media pages

Visit https://www.arnnl.ca/document-library for ARNNL resources, including Social Media (2013) and The Therapeutic Nurse-Client Relationship: Expectations for Registered Nurses (2014).


By: Julie Wells, BSc, MSc, Trust Coordinator

TRUST NEWS

Trust Elects New Board of DirectorsMembers of the Trust elected a new Board of Directors at the annual meeting on June 15. Congratulations to the members of the 2015-16 Board:

• Penny Grant, President• Janet Templeton, President-Elect• Sara Seymore, Eastern Urban Regional Director• Wayne Smith, Eastern Rural Regional Director• Tina Drainville, Central Regional Director• Anna Marie Alteen, Western Regional Director• Brenda Whyatt, Northern Regional Director• Paulette Roberts, Labrador Regional Director• Joan Whelan, Director-at-Large• Vacant, Director-at-Large• Lynn Power, Secretary-Treasurer (non-voting)• Julie Wells, Coordinator (non-voting)

The Board extends thanks to out-going members Starlene Lundrigan (Eastern Rural Regional Director), Anita Ludlow (Director-at-Large) and Beverley Reid (Central Regional Director). It is through the willingness of members to dedicate their time and expertise that the Trust is able to achieve its goals.

Call for ApplicationsApplications are now being accepted for awards in the following categories: Continuing Education Awards• Bursaries for Conferences & Post Basic Courses (up to $1,000)• Florrie Penney Continuing Education Bursary ($500)• Kay Daley Scholarship for Nursing Leadership ($1,000)• NL Gerontological Nurses Association Bursary ($500)• Nursing Leadership Awards ($500-$3,000)• Violet Ruelokke Primary Health Care Award (up to $1,000) Bachelor of Nursing Scholarships ($1,000 each)• BN Years 2, 3, 4• BN Fast Track Year 2• Flo Hillyard Memorial Scholarship Post Basic Bachelor of Nursing Scholarships ($750 - $1,500)• BN Post RN Scholarship• St. Clare’s Alumni Association Scholarship ARNNL Bay St. George Chapter Scholarship• Available to RNs from the Bay St. George area Graduate Scholarships ($1,000- $2,000)• ARNNL 50th Anniversary Scholarship• Masters or PhD Scholarships (Nursing & Non-Nursing) • Marcella Linehan Scholarship • NL Nurses Respiratory Society Legacy Scholarship RN Re-Entry Scholarship ($500) Nursing Research Awards (up to $2,500 each)

Criteria and application forms are available at: www.arnnl.ca/trustDeadline for applications is Oct. 15. Late or incomplete applications will not be considered.

Canadian Nurses Foundation Scholarship and Bursary RecipientsThe Trust extends congratulations to the following ARNNL members who received scholarships and bursaries from the Canadian Nurses Foundation (CNF):

• Kathleen Stevens ARNNL Education & Research Trust 25th Anniversary

Scholarship • Jill Bruneau TD Meloche Monnex Doctoral Scholarship• Renee Crossman AstraZeneca Doctoral Scholarship• Holly LeDrew CNA Certification Bursary

For more information about funding from the CNF, please visit www.cnf-ficc.ca.

22

By: Paula Kelly, MNBNRN, Faculty MUN SON, and Dr. April Manuel, PhD RN, Faculty MUN SON

PAINTING A PHILOSOPHY OF NURSING IN UNDERGRADUATE NURSING EDUCATION

Background and RationaleA philosophy of nursing creates a deeper understanding of an issue (Noble & Pearce, 2014), an enhanced level of self-awareness (Bereiter, 2002; Sawyer, 2004; Bloomqvist, Pitkala & Routasalo, 2007; Gibson, 2007; Mitchell & Hall, 2007; Welsh & Welsh, 2008), an appreciation of how nurses influence society and a framework to provide rationale for approaches to care. These attributes are critical given the complexity of the existing health care system. Art based approaches to teaching have been shown to promote critical thinking (Oliver, 2010) and increase students’ interest and motivation to learn (Chang & Hsu, 2010).

GoalThe goal of this project was to help nursing students craft a personal philosophy of nursing through art based inquiry.

Method Second year fast track nursing students (n=24) enrolled in Nursing 4103: Issues in Nursing and Health Care were asked to paint a representation of their personal philosophy of nursing. Prior to the exercise, students were assigned readings and given a presentation related to various ontological and epistemological approaches to nursing. A question on the final exam asked students to describe their personal philosophy of nursing. FindingsStudents were able to articulate a deeper understanding of nursing philosophy and how their practice is informed by nursing theory. Art based inquiry is a unique and enjoyable teaching strategy that helped students problem solve in a more creative manner. Students spoke of a greater sense of awareness of oneself and others. This awareness was seen as a powerful tool that they could use to guide their nursing practice.

The colours in this painting are meant to reflect a sunrise/sunset effect, representing continuous change throughout a patient’s lifespan. The symbols are arranged in the shape of a heart to reflect caring. The symbols within the heart represent health from a holistic viewpoint and nursing as a holistic practice, as each symbol represents different roles RNs hold to maintain a holistic perspective. The black and white colours demonstrate the importance of upholding standards and maintaining the visibility of nursing as a respected profession.

This image is meant to evoke a sense of mindfulness and peace, ideals that all nurses should seek to foster in themselves and the patients they care for. Through mindfulness and knowledge of one’s self, nurses gain insight into personal bias that may impact their care.

This painting compares nursing with trees; both are multilayered, multifunctional and multifaceted. Trees have deep roots and strong trunks. Similarly, the nursing profession is composed of diverse areas of practice, each contributing to the totality of the profession. The core of the tree is made up of “heartwood” which provides trees with strength and resiliency. Likewise, the core of nursing is the heart – caring for people, helping them to find resiliency and strength.

The lighter, orb-like painting reflects idealized nursing practice. The more dynamic areas that consist of tendril-like growths and greenery represent the students’ current nursing practice – that is new growth, continually developing and growing towards idealized practice. Some areas grow faster than others and via their own routes. Patients are like this current practice – individualized and therefore requiring specialized care to facilitate growth towards optimal health. The mosaic background in this painting represents

patients’ uniqueness and multicultural backgrounds. The hands represent partnerships that nurses develop with patients while at the same time, empowering them to seek control over their own health. The hands are placed at the centre to signify reaching out to all aspects of health with the ultimate goal being holistic health.

ConclusionArt based inquiry is an effective method to foster the development of a personal philosophy of nursing in undergraduate education. It encourages imagination, self-reflection, abstract thinking, creative problem solving and knowledge of the discipline’s core values.

References available upon request.

The Art


CONGRATULATIONS, NURSING GRADUATESof the Bachelor of Nursing (Collaborative) Program - May 2015Jessica Danielle ABBOTT ..................................St. John’sNicholas ANDREWS ............................................ EnglandTiffany Carolyn ANDREWS ............................... Ship CoveApril Ilene ANSTEY ...........................................TwillingateMegan Mary ANTLE ...................................... Mount Pearl Samantha ARBOUR .......................Conception Bay South Breanne AYLWARD ........................................... St. John’sChantal BAGGS ........................................ Fall River, N.S.Glenda Jean BAKER ..............................................GamboAmanda BARRINGTON ........................................ BadgerCherilyn Marie BARRY ....................................... Placentia Kayla BARTER ............................................... Grey RiverSara Patricia BATTEN ...................Conception Bay SouthHeather BARTLETT...................................... Corner BrookAmy BATTISTE ..................................... Port aux BasquesChristopher Joseph BEER ............................. Mount PearlMegan BELL ................................................. Corner BrookKelsey Jeanette Louise BISHOP .........Upper Island CoveLibby BLAXLAND .................................. Bridgewater, N.S.Allison Lucy BOUZANE .......................................Little BayTara Carlyn BOYD ..........................................SummerfordAllison Nicole BRAGG ...................................Greenspond Christina Michelle BRAGG ................Grand Falls-WindsorMelissa BRAKE .................................................. MeadowsRobhen Julia BURRY .........................................BonavistaAlyssa Ashley BURT ...........................................BonavistaNicole Beverley BUSSEY .............................. Bay RobertsMarilyn Ruth BUTLER ........................................St. John’sElizabeth Ann BUTTON ..................................... WarehamHeather CADIGAN-HAWKINS............................ Paradise Sarah Marie CAHILL.......................................... St. John’sMegan Alexandra CAREY .................Grand Falls-Windsor Claire Julia CARSON ..............................Saint John, N.B. Sara Nicole CARTER .....................Conception Bay SouthJessica Alexandra CAVE ...................Grand Falls-Windsor Emily Jean CHURCHILL.................................Halifax, N.S.Justin George CHURCHILL .......................Spaniard’s Bay Kristen Lee CHURCHILL .....................Port Colborne, Ont.Keisha Elizabeth CLARKE ............. English Harbour East Heather COBB ............................... Conception Bay SouthOlivia Claire COBBS ..................................... Mount PearlAshley COFFIN .......................................... Bishop’s FallsChantelle Netta COFFIN ........................................... FogoMichael COLEMAN ...................................... Corner BrookKrista COLLIER ................................................. CartwrightRenee COMPTON ............................................. Deer LakeJennifer CRANE ........................................... Steady BrookJerica Anne CROSBY .............................. Wedgeport, N.S.Amy CULL ......................................................... PasadenaCountry CUNARD ................................................. Brig BayJennifer Ashley DALTON ...................................... CatalinaTonya Dawn Judy DALTON ............................ Mount PearlJessica Gertrude Mary DAWE ..............Upper Island CoveRoslynn DECKER .......................................Rocky HarbourCourtney Mary DOODY ............................Admiral’s BeachNancy Marie DOOLEY .......................................St. John’sEmilee Marie DOWNEY .....................................St. John’sGraham DOWNEY-SUTTON ........................ Corner BrookMelissa DWYER .............................Conception Bay South Patrick Lloyd EDISON ...................................... SpringdaleAshley Mary EDMUNDS .....................................St. John’sIfunanya EJECKAM .............................................. GanderJessica ELLSWORTH ....................Conception Bay SouthRobyn Lynn ENNIS.............................................St. John’sAmie Winsor ESPERANZA .................................St. John’sJeffrey ESTABROOKS ...................................Halifax, N.S.Tawsha EVOY ..............................................Benoit’s CoveLeah Beth FAIRN ............................... Lawrencetown, N.S.Jasmine Mary FÉLIX ............................. Black Duck BrookKayla Mary FITZPATRICK ................................ MarystownVanessa Elizabeth FOLEY ............................. Mount PearlJason FONTAINE .........................................Windsor, Ont.Felicia FORD ............................................................. Fogo

Kristin Joanne FRANCIS ................................ Grand BankAlicia Dawn Charlene FRY .................................. ParadiseBrittany Patricia GALWAY ................................ WhitbourneMonique Ariel GAMACHE .................Lower Sackville, N.S.Hilary GEAR ...............................Happy Valley-Goose BayErin Marie GILLESPIE ........................................St. John’sVicki Louisa GILLINGHAM ......................................TorbayStacie Cora-Lee GOUDIE ................................ SpringdaleStephanie Nicole GREEN .......................................... BurinTracie GREEN ........................................................... BurinLindsay Elizabeth GRENNING ................................TorbayCindy Dawn GRIMES ..................................... Mount PearlAllison Elizabeth GRIST .....................................St. John’sBrooke Patricia HAMEL ..............Happy Valley-Goose BayCaitlin Dorothy Mary HANLON ........................ North RiverElizabeth Mary HANN .........................................St. John’sJulie Catherine HARRISON ....................... Hubbards, N.S. Ashley Natasha HEAD ...................................Wing’s PointAmanda Rose HEAL............................................. DunvilleRodolfo Guerreiro HENRIQUES ........................... PortugalMegan HENSTRIDGE .......................Grand Falls-WindsorCarmel Mary HIGDON ........................Fort McMurray, Alta. Leslie Mary HIGDON ......................Conception Bay SouthElizabeth HILLIER ............................... St. Lunaire-GriquetKeegan HILLIER ............................................ Stephenvillie Victoria Lindsay HILLIER ................Conception Bay South Myah April HOPKINS .........................................TwillingateHedi HOTHER-YISHAY ....................... Kibutz Beeri, Israel Lauren Elaine HOWELL .........................................VictoriaJennifer Louise HOWLAND .......................... Berwick, N.S.Alicia Dawn HOWSE ............................................ EastportKristen Lee HUNT ................................................. ConcheMichelle Florence HUNT ....................................... ConcheNicholas HURLEY ........................................ Corner BrookNatasha Melissa HYNES ................................ StephenvilleAmanda Shirley Violet JOY ............................ Mount PearlDeborah-Anne JOYCE ................................ Steady BrookRosemary Diane JUDD .......................... Fredericton, N.B.Lori Ann KALYTA-LOWE ............................ Suwanee, Ga.Samantha Marie KELLY ................................St. Lawrence Kayla Victoria KENNEDY ...............Conception Bay South Helen Taylor KERR .........................................Halifax, N.S.Brittany Sue KILFOY ...........................................Little Bay Omolade Ifedolapo KOLA-ONI ..................... Tede, Nigeria Katelyn LAWRENCE ................................... Rose Blanche Leslie LEWIS ................................................ Corner BrookDanielle Jasmine LOCKE ....................... Little Bay IslandsAmanda LOVELL .................................................. McIversNadine LOVELL .................................................. Sops ArmKimberley Anne LUCAS .....................................St. John’sEmily Julia LUSH ............................................ Mount PearlJennifer Dawn MAHONEY ............................... MakinsonsEmily MAJOR .............................................Rocky HarbourCara Elizabeth MALONEY ...........................Southern Bay Jennifer Donna Suzanne MARKS .......................... BurgeoStephanie MARSH .......................................Bishop’s FallsCassondra Sarah Ann MARSHALL ............. Churchill FallsLaura Jean MARSHALL .....................................St. John’sKayla Christine MAYE ...................................... LewisporteRyan MCDONALD ............................................. Deer LakeBrittany MCFATRIDGE .....................................Cold BrookAndrea MCKAY ............................................Carter’s CoveRobyn Victoria MELINDY .......................................GanderNatasha MICHELIN ................................ North West RiverLeeanne MILLER .......................Portugal Cove-St. Philip’s Audrey Catherine Doris MOLLOY .......................... Goulds Michelle Alexandra MOODY ...............................St. John’sSarah MOORE .............................................Codroy ValleyJanessa Nicole MOORES ................................... ParadiseVictoria Samantha MORGAN .............................St. John’sAshley Mary MURPHY ..........................................DunvilleKelly Anne MURPHY ................................. Apohaqui, N.B.Heather Michelle NASH ............................... Mount Carmel

Kaleigh Lauren NEWTON ..............................Halifax, N.S.Janine Eliza NOBLE .................................... Churchill FallsJessica Pauline NOEL ........................................St. John’sJody Ann NOLAN ........................................... Mount Pearl Elizabeth NOONAN ..................................... Churchill FallsBrittany NORMAN ........................................ Labrador CityHeather Danielle NOSEWORTHY ......................St. John’sSarah Beth NURSE ........................Conception Bay SouthEunice ONODENALORE ....................................St. John’sJoshua James Michael O’SHEA .........................St. John’sStephanie OUELLETTE ...............................Windsor, Ont.Laura Marie Lucy PACK .................................... HermitageAnna Victoria Naomi PADDOCK ...................Robert’s Arm Bruce PARSONS ..................................................BotwoodEmily Krista PARSONS .....................Grand Falls-WindsorKrista Gladys PARSONS ...................Grand Falls-WindsorLaura Marie PEACH ..........................................CarbonearRebecca Dawn PEDDLE ..................................... ParadiseMelissa PENNEY ............................Conception Bay SouthMelissa Desirée PENNEY ................................... St. LewisKelsey Marie PHILPOTT .........................Plate Cove WestChristina Maria PICKETT ............................... Pouch CoveKatrina Pauline PICKETT ..................................CentrevilleStephaine PICKETT .......................................... PasadenaJenna Christine PIERCEY ............................... WhitbourneTiffany POIDEVIN .............................................. PasadenaAshley Marie POWER ............................................... BurinJessica Robyn POWER .....................Grand Falls-WindsorCourtney Nicole POWERS ............................. Mount PearlNatalie Gladys QUINLAN ................................. Birchy BayVicki RANDELL .............................................Benoit’s CoveApril Jean REID ......................................................... DildoErica Megan RENDELL ......................................St. John’sSamantha Charlotte RIDEOUT ......Conception Bay SouthAlana Janet ROGERS .......................................... CatalinaAmanda Anne ROGERS ...................................TwillingateLeanna Michelle ROWE .....................................St. John’sKimberly RYAN ............................................Port SaundersTiffany RYDER ...................................................BonavistaLisa SAMOTOWKA ...................................... Nepean, Ont.Jessica SCEVIOUR ..............................................BotwoodPaula Katherine SEVIGNY ........Portugal Cove-St. Philip’sStephanie Lynn SHARPE .............................. Mount PearlChantal Cathy SHEAVES ................ Lower Sackville, N.S.Jennifer Michele SHEPPARD .............................St. John’sSarah SIMMS ............................................... Corner BrookMeaghan Catherine SLANEY .............................St. John’sAshley SMITH ...........................................Dartmouth, N.S.Jennifer Mary SMITH .................................................TiltonRuth Anne SPENCER .............................................TorbayChelsea Myra Della STAMPLECOSKI ................ ParadiseKelsi Dawn STAPLETON.................................. WinterlandAnna STOCKWELL ................................. Cambridge, Ont.Tina Deanne SURRIDGE ............................... Mount PearlNatasha TATCHELL .............................Castor River NorthAmanda Jane THOMAS ......................................... GouldsRebecca May TIDSWELL ................... Aberdeen, ScotlandCaroline Sarah TOOTON ...............................Halifax, N.S.Jessica TOMS .................................................King’s PointLaura Alice TRAHEY .............................................. GouldsNatasha Cynthia VERGE .................................WesleyvilleTyson Jeremy Dylan VERGE ............................... BrightonChelsea VINCENT ............................................. PasadenaKelsey Elizabeth VIVIAN ................................ Mount PearlMegan Catherine WALBOURNE ............................... FogoIan Shawn WARREN ....................................... St. AnthonyVictoria WARREN ..............................................Pike’s ArmAlanna WELLS .................................................... AppletonBeth WILLIAMS ................................................. Deer LakePeter Christian WILSON .....................................St. John’sMollie Anne YETMAN ........................................CarbonearElizabeth Susan Mary YOUNG ...........................Logy Bay

More than liability

protection

Canadian Nurses Protective Society

infoLAW®

Vol. 22, No. 3, December 2014

Legal Risks of Email - Part 2

Practical Considerations

Email, in some cases, may be the preferred option to communicate with patients or others effi ciently and expeditiously. Before using email, it is important for nurses to be aware of the risks and alternative ways to transmit information. In addition to the privacy and confi dentiality considerations set out in the infoLAW, Legal Risks of Email – Part I, nurses may wish to consider the following practical issues relating to email use with patients and others in their practice.

Managing Expecta ons

Some nurses are using email to communicate directly with patients, both during and after hours. In addition to managing the privacy and security concerns associated with these communications, nurses should consider how to best manage patient expectations about the appropriate uses of these communications, how quickly they will respond to enquiries and what steps should be taken if a timely response is not forthcoming. Reasonable limits and response times may then be clearly communicated to patients.

Further, even when a patient has consented to email communication, a nurse may insist on an alternate mode of communication in certain circumstances. For example, if there is uncertainty as to the identity of the recipient, where the patient should be given an opportunity to ask questions, if it is necessary to ascertain whether the patient properly understood the information or if the information is simply too sensitive to be communicated by email, the nurse may consider a more traditional method of information exchange.

Documenta on

Nurses are cautioned to maintain copies of all email messages to and from patients. These copies should be kept in the patient’s electronic or paper chart. This acknowledges that such communications are professional and that they have potential clinical and legal implications.

Personal Use of Email at Work

Nurses using email at work for personal purposes should be aware of potential disciplinary consequences. In some cases, using an employer’s email system for personal communication or including inappropriate language and jokes has resulted in disciplinary action by employers and even termination of employment. One example involved an employee whose employment was terminated after 26 years of service for accessing inappropriate material that had been emailed to him at work by others. He forwarded such emails to some of the company’s employees, suppliers and contractors. The court concluded that the company’s code of conduct allowed employees to use its computers for “limited” personal use but expressly prohibited sending pornographic, obscene, inappropriate, or other objectionable communications. The employee was found to have read, understood and accepted the terms of the code of conduct.1

Communicating by email:

Are your patientsaware of the potential risks?

Practical Considerations

24

©Canadian Nurses Protective Societywww.cnps.ca 1-844-4MY-CNPS [email protected]

Use in Legal Proceedings

Generally speaking, most documents (including electronic documents like emails) are producible in legal proceedings if their content is relevant to matters in the proceeding. As such, emails with patients or other health care practitioners that contain clinical information or other information about a patient may need to be disclosed in the event of a patient request for access to personal health information, civil action or complaint to a regulatory body or investigation by another statutory body.

It is important to recognize that email has traditionally been seen, and used, as a manner of sending informal communications and less care may be taken drafting an email than would be taken if sending a letter or writing in a patient chart. Language used in emails tends to be less factual, less precise and less professional. For these reasons, caution should be exercised when communicating via email and nurses are reminded to use a professional tone and clear content for all email communications.

Nurses should also be aware that any email communications should be considered permanent. Although email programs have a delete function, IT professionals can retrieve deleted emails with relative ease, even years later. Multiple copies may continue to reside in back-up fi les, the recipients’ email, or in the email of third parties to whom the email was forwarded.

Risk Management Considera ons

To limit the potential legal risks related to email communications, consider implementing the following risk management strategies:

• Let patients and other health care providers know when the use of email is appropriate, the turnaround time for received messages and what to do in the event that symptoms worsen or there is a delay in responding;

• Place emails of a clinical nature in the patient’s chart;

• Be aware that when using an employer’s email system, the employer has the ability to access the email communications;

• Use a professional tone, and generally take as much care as when using any other formal mode of communication or documentation; and

• Follow employer guidelines and policies regarding email communications.

Please contact CNPS at 1-844-4MY-CNPS if you have any questions regarding legal risks in email and visit our website at www.cnps.ca.

1. Poliquin v Devon Canada Corporation, 2009 ABCA 216 (CanLII).

Related infoLAWs of interest: Mobile Devices in the Workplace and Legal Risks of Email – Part 1. Available at www.cnps.ca

THIS PUBLICATION IS FOR INFORMATION PURPOSES ONLY. NOTHING IN THIS PUBLICATION SHOULD BE CONSTRUED AS LEGAL ADVISE FROM ANY LAWYER, CONTRIBUTOR OR THE CNPS®. READERS SHOULD CONSULT LEGAL COUNSEL FOR SPECIFIC ADVICE.

The TD Insurance Meloche Monnex program is underwritten by SECURITY NATIONAL INSURANCE COMPANY. It is distributed by Meloche Monnex Insurance and Financial Services Inc. in Quebec,by Meloche Monnex Financial Services Inc. in Ontario, and by TD Insurance Direct Agency Inc. in the rest of Canada. Our address: 50 Place Crémazie, Montreal (Quebec) H2P 1B6.

1Certain conditions and restrictions may apply. *Average based on the home and auto premiums for active policies on July 31, 2014 of all of our clients who belong to a professional or alumni group that has an agreement with us when compared to the premiums they would have paid with the same insurer without the preferred insurance rate for groups and the multi-product discount. Savings are not guaranteed and may vary based on the client’s profile.

® The TD logo and other TD trade-marks are the property of the Toronto-Dominion Bank.

Projet : Annonce MMI 2015

Client : TD Assurance

Dossier # : 11-MM9534-15_MMI.PR5.EN•arnnl(7.5x10)

Province : Atlantic

Publication : ACCESS

Format : 7.5x10

Couleur : Quad

Épreuve # : 1

Date de tombée : 01/13/2015

Graphiste : Marie-Josée Proulx

Hamelin-Martineau Inc. • 505, boul. de Maisonneuve O, Bureau 300 • Montréal (Québec) H3A 3C2 • T : 514 842-4416 C : [email protected]

ATTENTION : MERCI DE VÉRIFIER ATTENTIVEMENT CETTE ÉPREUVE AFIN D’ÉVITER TOUTE ERREUR/PLEASE CHECK THIS PROOF FOR ERRORS

HOME | AUTO | TRAVEL

Get more out of your ARNNL membership.

Get preferred insurance rates today!

Because you’ve earned it.At TD Insurance we believe your efforts should be recognized. That’s why, as a member of the Association of Registered Nurses of Newfoundland and Labrador, you have access to the TD Insurance Meloche Monnex program, which offers you preferred insurance rates and highly personalized service, along with additional discounts. Request a quote and find out how much you could save!

Our extended business hours make it easy. Monday to Friday: 8 a.m. to 8 p.m.Saturday: 9 a.m. to 4 p.m.

1-866-269-1371or visit melochemonnex.com/arnnl

On average, professionals who have home and auto insurance with us

save $400*

Home and auto insurance program recommended by

SPECIAL OFFER FOR REGISTERED NURSES OF NEWFOUNDLAND AND LABRADOR Bense Medical Group of Companies appreciates the hard work, dedication and professionalism registered nurses demonstrate every day and we thank our nurses for all that you do for our communities. Bense Medical Group are offering you and your family these exclusive rates.

BENSE VISION is pleased to be your provider for laser vision correction. Dr. Michael Bense was the first to bring laser vision correction to Atlantic Canada more than 20 years ago and he has performed almost 30,000 laser vision correction procedures. We ensure your doctor is with you every step of the way – from evaluation, the iLASIK procedure, and aftercare. At Bense Vision we exclusively perform the blade free all laser LASIK method using the most advanced true custom wavefront- guided technology, with amazing results. For the most trusted and established laser vision correction CALL 722.2020.

BENSE OPTICAL & OPTOMETRY will take care of all your eye examination needs with one of our two highly qualified optometrists and onsite Ophthalmologist. With a large selection of prescription glasses, sunglasses, and contact lenses our talented Opticians will help you select the best products to fit your prescription, budget and lifestyle. Our 2nd pair ½ OFF any glasses is the best in the city! For quality products, service and equipment CALL 754.1250.

BENSE SURGISPA offers a broad range of medical aesthetic treatments to rejuvenate your appearance including BOTOX®, JUVÉDERM®, minimally invasive cosmetic surgery and more. Kristine Feaver-Noseworthy R.N. CPN (C) is recognized in Canada in the art & technique of facial enhancement injection. All patients are assessed and treatments ordered by Dr. Michael Bense, leading provider of blade-free iLIDLIFT™ in Atlantic Canada and certified in all popular facial and aesthetic procedures. To learn about our procedures & the advanced technology we are offering our clients for over 12 years CALL 722.4060.

This is a paid advertisement by Bense Medical Group of Companies.

$300 OFF iLASIK

709.722.2020

2.220

15% OFF

(Including frames & prescription lenses, contact lenses,

sunglasses and eye examinations)

709.754.1250

15% OFF

(Offering minimally invasive surgical procedures such as

iLIDLIFT™ and Silhouette Lift. An advanced range of non-surgical solutions such as

BOTOX®, JUVÉDERM®, Skin resurfacing,

microdermabrasion, glycolic peels, body contouring, IPL, laser hair removal, tattoo

removal & many other aesthetic and skincare

treatments) 709.722.4060

100 Elizabeth Avenue St. John’s, NL

A1B 1S1

www.bensemedical.com

See The Difference

CALL FOR NOMINATIONSNominate an RN or NP for an ARNNL Award for Excellence in Nursing!

PM40

0691

17

55 Military RoadSt. John’s NL A1C2C5Tel 709 753-6040Toll Free 1 800 563-3200 (NL only)Fax 709 [email protected]

The Association of Registered Nurses of Newfoundland and Labrador (ARNNL) is the regulatory body and professional organization representing all registered nurses and nurse practitioners in the province. In pursuit of its mission, ‘Nursing Excellence for the Health of the Population,’ ARNNL exists so there will be accountability for self-regulation, professionalism, quality professional practice environments, and healthy public policy.

PRAC

TICE

ADM

INIS

TRAT

ION RESEARCH EDUCATION

NOVICE

Nomination Deadline: Dec. 11, 2015ARNNL’s Awards for Excellence in Nursing recognize RNs and NPs who set a standard for nursing excellence. Nominate a colleague in one of the following categories:· Nursing Practice· Nursing Education· Nursing Administration · Nursing Research· Elizabeth Summers Novice Nurse Award

Visit www.arnnl.ca/about-awards.

Dial in on Sept. 15 for ARNNL’s teleconference session on the nomination process! See p. 11

ARNNL RECOGNIZES NURSING IN THIS ISSUE EXCELLENCE · Canadian Nurses Association (CNA)...

Documents

Transcript of ARNNL RECOGNIZES NURSING IN THIS ISSUE EXCELLENCE · Canadian Nurses Association (CNA)...