SRNA NewsBulletin Winter 2013

Volume 15, Number 1, WINTer 2013

SaSkatchewan RegiSteRed nuRSeS’ aSSociation

Competent, caring, knowledge-based registered nursing for the people of Saskatchewan

Primary Health CareSaskatchewan’s Front-line Health Care

Connections • Ask a Practice Advisor • Continuing Competence Rural and Remote PPG • RN Image • Optimizing the Role of the RN

Interview with Dr. Susan Frampton • Health Quality CouncilAnnual Meeting and Conference • Registration Renewal Online

The Saskatchewan Registered Nurses’ Association

(SRNA) is a professional licensing body established in

1917 by the Registered Nurses Act of the provincial

legislature. Its purpose is to set standards of

education and practice for the nursing profession,

and to license and support nurses as RNs to ensure

the public receives quality nursing care.

The SRNA Newsbulletin is published four times

a year by the SRNA. Its purpose is to inform RNs

about the Association’s activities, provide a forum

for discussion and information of topical interest.

Inclusion of items in the SRNA Newsbulletin does

not imply endorsement or approval by the SRNA.

A subscription is $21.40 per year, outside Canada,

$30.00 per year.

ISSN 1494-76668

Managing Editor: Shelley Svedahl

E-mail: [email protected]

The SRNA office is located at 2066 Retallack Street,

Regina, SK S4T 7X5

Phone: 306-359-4200 FAX: 306-359-0257

Toll Free: 1-800-667-9945


Website: www.srna.org

SRNA COUNCIL

President: Kandice Hennenfent, RN 306-694-3949

President-elect: Signy Klebeck, RN 306-659-4289

Members-at-large

Jeannie Coe, RN(NP) 306-425-2174 (Ext. 3)

Sherry Culham, RN 306-766-8484

Robin Evans, RN 306-337-3354

Glen-mary Christopher, RN 306-786-0420

Pamela Komonoski, RN(NP) 306-966-2397

Janice Giroux, RN 306-842-8652

Noreen Reed, RN 306-883-4471

Public Representatives

Karen Gibbons 306-729-4306

James Leach 306-244-4800

Heather McAvoy 306-652-5442

Executive Director

Karen Eisler, RN 306-359-4200

Copy Deadlines:

November 15 for Winter; February 10 for Spring; May

15 for Summer; and August 15 for Fall. The complete

rate sheet is available online at: http://www.srna.org/

images/stories/srna_2012_nb_ad_rates.pdf

To place advertising in the SRNA Newsbulletin please

contact:

Avonlea Communications

Telephone: 306-584-2159

Email: [email protected]

WINTER 2013 Vol.15 N0. 1

SRNA Video Messages 3

Interview With Dr. Susan Frampton 4

RN(NP) News 7

ASK A PrACTICe ADVISor Collaborative Emergency Centres in Saskatchewan 8

Connections 10

ProFIle Workplace Representative Educator 11

ProFeSSIoNAl PrACTICe GrouPS Supporting the Specialty Practice of Rural and Remote Nurses 12

ProFeSSIoNAl PrACTICe GrouPS Reconnect With Your Environment 13

Optimizing the Scope of the RN Project 14

Registered Nurses’ Image: It’s Up to Us 16

The Evolution of Ethics in Nursing 18

Collaborative Emergency Centres That Work for SK 20

HeAlTH QuAlITY CouNCIl Lean Builds on Foundation Laid by Releasing Time to Care™ 23

Therapeutic Use of Self 24

New Roles for Health Providers in Meadow Lake 28

Primary Health Care and Building a Healthy Community 30

Annual Meeting & Call for Nominations 32

infolAW Emergency Room Closures 34

Resources 37

Calendar of Events and Directory 40

Contents

2 SRNA NewsBulletin WINTER 2013

On the Cover:

Left to Right - Rosalie Longmoore, RN; the Honourable Dustin Duncan, Minister of Health; Marlene Smadu,

RN; and Karen Eisler, RN. See story on page 39.

mailto:[email protected]


http://www.srna.org


SRNA NewsBulletin WINTER 2013 3 SRNA NewsBulletin WINTER 2013 3

Departments

New Video Format:messages from the SrNA President, President-elect and executive Director

SRNA Video Messages

from the SRNA Staff and Council. We wish you all the best in 2013!During the holiday season our office will be closed on December 24, 2012, and reopen on January 2, 2013.

In this issue, we are using a video format for these messages.

Visit our website to view the complete message at www.srna.org

President’s Message

by Kandy Hennenfent, rN

As President of the Saskatchewan Registered Nurses’ Association (SRNA), I encourage you to get involved and run for Council. You can find information about nominations on page 21. Please visit our website for further information. Thank you for watching my message online.

http://vimeo.com/55100042

President-elect, Council Highlights by Signy Klebeck, rN

Our new ENDs documents is on page 6. Each year, Council defines the priorities (ENDs) for the SRNA based on information from the environmental scan and feedback from our members. This year we have changed END 3.4; watch my message online.


Message from the Executive Director by Karen eisler, rN

Primary Health Care needs:• Collaboration Client-care

focus• Multi-faceted approach• Team-based learning structure• Structure for clear, flexible

communicationFor further information,

please refer to the Expert Commission Report at http://www.cna-aiic.ca/en/on-the-issues/national-expert-commission/


http://www.srna.org



http://www.cna-aiic.ca/en/on-the-issues/national-expert-commission/



available. That could have been because my mother was admitted on a Friday afternoon and on the weekends, hospitals are not run full staff although they certainly should be. The specialists that needed to see her to do some of those important tests were simply not available. That was a challenge. Even the nursing staff that were there, were just running in and out. They had so many patients to see - so many things to do. Even though I did feel that most of them were kind and compassionate, they had limited time.

1 What is the greatest innovative

change that RNs can do to

lead patient- and family-

centred care?

The one most impactful innovations that RNs can lead is integrating the patient and the family into the care team. We talk a lot about that - but we don’t really do it. We need to treat them like colleagues - as we would the RN, the physician, the pharmacist and the social worker in a multidisciplinary health care team. The patient and family have to have a seat at that table - that is where I think RNs can have a tremendous impact. They need to say “We’re not having this conversation without the patient and their loved ones here.”

2 In your personal experiences,

what did you learn about the

health system and nursing

care?

Those personal experiences reiterated for me a number of the challenges being faced right now, particularly in acute care settings. One was the fact that there are not enough staff

Humanity, Kindness and CompassionFive Questions for Dr. Susan Frampton

by Susan Smith brazill, Director, Communications & Corporate Services, SrNA

i

had the great pleasure of

speaking with dr. Susan

Frampton, the keynote

speaker at the Saskatchewan

union of nurses innovators

conference in September, who

graciously agreed to respond

to my “five questions.” dr.

Frampton is the President

of Planetree, a not-for-profit

consultation and membership

organization, working with

a growing network of

hospitals and continuing care

communities around the world

to implement Planetree’s

comprehensive patient-centred

model of care, resulting in

improvements in both clinical

and operational outcomes. She

proved to be a gifted speaker

and responded to my questions

with eloquence, charm and

insight.

SRNA NewsBulletin WINTER 2013 5

3 How do interdisciplinary

collaboration and the concept

of Primary Health Care (PHC)

fit into your vision of this

patient and family-centred

care?

I think that’s really where it needs to start. It’s interesting to me that the patient- and family-centred care movement started in hospitals, not in primary care. I think in an ideal world, we wouldn’t see so many people or such a need for patient-centredness in hospitals because they would be involved in ongoing meaningful relationships with their primary care system, whose focus would be on health promotion and wellness. A goal would be to help them to be involved in managing their own health risks and chronic conditions so they didn’t end up in the hospital.

4 What is the role of

communications and

technology in your vision of

patient- and family-centred

care?

I think communications and technology can be a wonderful advantage if we use it properly. For instance, one of the most important things we could do at this point in time would be to create an interconnected system where health information is available consistently

The other thing I learned, is that there are still a lot of simple things that we could do that we’re not doing that make a difference to patients and families. One thing I will share is two-way communication and whiteboards in the room - I think that’s a great innovation. There was a whiteboard in my mom’s room. When the nursing team changed shifts - they would write the name of the RN and the nurse’s aide. That was fine. They never asked us who we were. So, after the third or fourth staff person came in and called my mother “dear”, I wrote on the board that the patient prefers to be called “Mrs. Frampton” and then I wrote our cell phone numbers so they could find us if we stepped out.

This comes back to my first point: we have a mindset that still puts the patients and the families as passive recipients of the things we are going to do to them. It doesn’t truly include them as partners that we ask into the dialogue. We don’t even care to find out what their names are. There’s no question in my mind that my sisters and I were part of my mom’s care team. We were.

across settings. I hope that ten years from now everything will be up there on the web - you’ll be able to access your records. Your providers will all be able to access your records. It will be real-time information. On the downside, technology can be dehumanizing at a time when people need human touch.

5 What would you like your

legacy to be with regards to

this work you are doing with

patient- and family-centred

care?

I would say, at this point in my life, I’d love to have helped to change some of the practices that have been in place for decades that really are not healing practices for human beings. I mean, the simple things, like, making sure that if a patient wants a loved one by their side, that they can have that. Not any sort of rocket science, just some basic humanity - that we have a system that’s a little more supportive of basic humanity, kindness and compassion.

There are still a lot of simple things that we could do that we’re

not doing that make a difference to patients and

families.

Technology can be dehumanizing at a

time when people need human touch.


Registered Nurses as partners in an informed healthy society


The Saskatchewan Registered Nurses’ Association exists so that:There is profession-led regulation ensuring accountability and professionalism in the public

interest.

1.1. Competent and ethical RN and RN(NP) practice in present and future roles and practice settings.

1.2. RNs and RN(NP)s influence practice environments for improved health outcomes.1.2.1. RNs and RN(NP)s develop evidence-informed practices.1.2.2. RNs and RN(NP)s use evidence-informed practice.

1.3. All RNs and RN(NP)s provide leadership for excellence, empowerment and professionalism in nursing.1.3.1. Individual RNs and RN(NP)s consistently use their first and last name and title for identification to the

public.

1.4. There is a just, timely, transparent, effective process, of which the public is aware, to address a concern regarding the practice of a RN or RN(NP).

RNs and RN(NP)s provide individual and family-centred, ethical, compassionate care for the

public.

2.1. RNs and RN(NP)s provide respectful care to culturally diverse and/or vulnerable populations.

2.2. RNs and RN(NP)s work in partnership with individuals and/or populations in helping them make informed decisions about their health and well-being.

The nursing profession contributes collaboratively to a proactive health system that meets

the present and emerging health needs of the public.

3.1. RNs and RN(NP)s participate in life-long learning.

3.2. Health human resource planning results in sufficient numbers and diversity of RNs and RN(NP)s to meet present and emerging health needs in Saskatchewan.3.2.1. The Baccalaureate nursing degree is the minimum education level for entry as a RN.3.2.2. The Masters nursing degree will be the minimum education level for entry as a RN(NP).

3.3. Public policy makers have compelling evidence to make them aware of the potential health impact of their decisions.

3.4. RNs and RN(NP)s have and use skills and technology to lead change for a quality health system.

Public policy makers have compelling evidence of the value of a health system that is

universal, accessible, publicly administered, comprehensive, portable and accountable and

the value of primary health care.

ViSion

miSSion

In the Public InterestThe SRNA is the professional self-regulatory body for the province’s RNs and RN(NP)s. The Registered Nurses Act (1988) describes the SRNA’s mandate in setting standards of education and practice for the profession and registering nurses to ensure competent, caring knowledge-based care for the people of Saskatchewan. The SRNA is responsible for ensuring continuing competence, professional conduct, standards of practice, a code of ethics and the approval of education programs.

These ENds are in order of priority.

(Effective January, 2013)


DepartmentsRN(NP) News

It is very exciting that a long awaited announcement from Health Canada has finally arrived.

Nurse Practitioners have been given federal legislative authority by Health Canada to prescribe narcotics under the federal Controlled Drugs and Substance Act. The New Classes of Practitioners Regulations (NCPR) was published in Part II of the Canada Gazette on November 21, 2012, and is available on the Health Canada web site.

http://canadagazette.gc.ca/rp-pr/p2/2012/2012-11-21/html/sor-dors230-eng.html

Prior to this change in federal legislation, only doctors of medicine, dentists and doctors of veterinary medicine had the authority to prescribe. Patients being treated by a midwife, nurse practitioner or podiatrist required an additional referral to a physician. The benefits of the NCPR include:• expanded scope of practice for

midwives, nurse practitioners and podiatrists;

• increased flexibility and timeliness for health care delivery in Canada; and

• reduction of unnecessary referrals.

In Saskatchewan there are 155 Registered Nurse (Nurse

Practitioners), licensed with the Saskatchewan Registered Nurses’ Association. The Saskatchewan Registered Nurses’ Association is working in collaboration with other jurisdictions to establish national competencies and standards that would promote consistent practice and mobility for nurse practitioners.

Provincial legislation, regulation and policy is required before the NCPR can be implemented in Saskatchewan and the RN(NP)s are able to prescribe narcotics, controlled drugs, benzodiazepines, and other targeted drugs.

Collaborative efforts from the Saskatchewan Ministry of Health, College of Pharmacists, College of Physicians and Surgeons, and the Saskatchewan Registered Nurses’ Association will ensure that provincial

legislation, policy and processes are developed for RN(NP)s to prescribe narcotics, controlled drugs, benzodiazepines, and other targeted drugs for Saskatchewan residents. Additional education and a monitoring process are foundational requirements in this provincial legislation approval.

Until provincial legislation, regulation or policy is established, Saskatchewan RN(NP)s do not have the authority to prescribe narcotics, controlled drugs, benzodiazepines, and other targeted drugs. Prescribing narcotics, controlled drugs, benzodiazepines, and other targeted drugs cannot be delegated to an RN or RN(NP) under any physician Transfer of Medical Function. The SRNA will update members as the provincial processes unfold.

Policy Changes and New Classes of Practitioners‘ Regulations

by Donna Cooke, rN, Nursing Policy Advisor, Practice, SrNA

http://canadagazette.gc.ca/rp-pr/p2/2012/2012-11-21/html/sor-dors230-eng.html


of the paramedics they will be working with (CRNNS, 2012).

• Work environment resources, including human, material and environmental, are such that the RN can meet practice standards and competencies. This includes appropriate staff coverage for the RN should they be assigned other duties while working in a CEC. This includes if/when necessary, the ability for the RN to call in additional staff for coverage of either the CEC or the inpatient unit.

• RNs receive appropriate education including: ACLS, PALS, TNCC, CTAS [based on Nova Scotia

Collaborative Emergency Centres in SaskatchewanThe Role of the Registered Nurse

based on best practices. To ensure RNs deliver safe care and that there is consistency in service delivery of the CECs, the SRNA supports the following requirements be established prior to a CEC site implementation:• All resources for providing safe

care within the 24-hour period are in place prior to opening a CEC. This includes: sufficient numbers of appropriately educated RNs, paramedics and medical oversight physicians for the CEC; and sufficient community and ER physicians and/or RN(NP)s to work in the ER and PHC clinic during hours of operation.

• Clear roles and responsibilities are defined for those who are providing care and are outlined and understood by the RNs, paramedics and medical oversight physicians.

• RN managers, who are familiar with the CEC, are available at all times to support the RN.

• RNs receive adequate education to understand the competencies

The SRNA supports the vision of CECs for the people of Saskatchewan to obtain accessible, consistent and safe emergency care when community physician emergency services are not available.

More information about CECs can be found on the Government of Saskatchewan website http://www.health.gov.sk.ca/nova-scotia-cecs.

The SRNA is committed to providing competent, caring, knowledge-based registered nursing for the people of Saskatchewan. SRNA recognizes the contribution RNs provide as collaborative health care team members in the provision of Primary Health Care (PHC) and emergency care services in areas of the province where there is a need for the CEC model.

The College of Registered Nurses of Nova Scotia (CRNNS) has been working with RNs as they transition into a CEC model. For the development of this document, the SRNA consulted CRNNS to ensure all information and requirements are

Clear roles and responsibilities are defined for those

providing care and are outlined and understood by the RNs, paramedics and medical oversight

physicians.

by Terri belcourt, rN, Nursing Advisor, Practice, SrNA

ASK A PrACTICe ADVISor

What is the role of the RN in Collaborative Emergency Centres (CECs) in Saskatchewan?

http://www.health.gov.sk.ca/nova-scotia-cecs


the training and competence to perform these activities.

• Clear roles and responsibilities are established for the RN when assigning care to other health care team members as part of coordination of care.

• Extra RN resources may be required during the early phase of implementation to support the team members in adjusting to their new roles.

As CECs are developed in Saskatchewan, the above information will be updated.

The SRNA provides support to the RNs to ensure they can provide safe, competent care in their role in this new practice setting. Nursing practice advisors are available face-to-face, by telephone, or email for RN or employer consultation.

For current information please contact:

Terri Belcourt, RN, Nursing Advisor, Practice [email protected]

Barb Fitz-Gerald, RN, Nursing Advisor, Practice [email protected]

Emergency Care Standards (Ross, 2010)] and other education the individual RN identifies is required to maintain their competencies to provide safe and competent care when working in a CEC model.

• RNs receive training to ensure they have optimal communication skills for working with team members (i.e., Situation Background Assessment Recommendations, SBAR).

• Contingency plans are established to ensure adequate staffing levels to provide the expected level of care of a CEC. For example, policy is in place to address emergency room closure if any of the CEC team is unavailable (medical oversight physician, RN or paramedic).

• Employer policies and procedures are in place to support the RN in their role in the CEC.

• RNs have a clear understanding of their roles and responsibilities when working with evidence-based medical protocols or directives.

• RNs have a clear understanding of which treatment activities require further involvement from a physician and ensure they have

ReferencesCollege of registered Nurses of Nova Scotia. (2012). registered nurses

working in collaborative emergency centres. retrieved from http://www.crnns.ca/documents/CrNNSCollaborativeemergencyCentresQandA.pdf

ross, J. (2010). Nova Scotia emergency care standards. retrieved from http://www.gov.ns.ca/DHW/publications/emergency-Care-Standards.pdf

Saskatchewan RNs Volunteer for the NCLEX Item Development Program!

c

anadian Rns can now volunteer

for the ncLeX item development

Program. the national council of State

Boards of nursing (ncSBn) develops

the ncLeX-Rn used to measure the

competencies needed to perform safely

and effectively as an entry-level Rn. an

important step in this process is the

ncLeX item development program,

a key component in creating and

maintaining high quality examination

items. the development of the ncLeX

examination depends on qualified Rn

volunteers from all jurisdictions that

use the ncLeX for entry to practice.

canadian Rns now have the opportunity

to become part of this process, and

contribute to the ncLeX-Rn exam

bank prior to the exam being offered in

canada in January 2015.

By volunteering, you may be selected

to participate as an item writer (Rn

with master’s degree) or item reviewer

(practising Rns).

Some of the benefits of volunteering are:

• Opportunitytocontributetothe

continued excellence in the nursing

profession

• Internationalnetworking

• Gainingexperienceandskillintest

development

to volunteer, please visit the exam

Volunteer opportunities page at https://

www.ncsbn.org/1227.htm


http://www.crnns.ca/documents/CrNNSCollaborativeemergencyCentresQandA.pdf

http://www.gov.ns.ca/DHW/publications/Emergency-Care-Standards.pdf

http://www.gov.ns.ca/DHW/publications/Emergency-Care-Standards.pdf

https://www.ncsbn.org/1227.htm

https://www.ncsbn.org/1227.htm

Connectionsby barb Fitz-Gerald, rN, Nursing Advisor, Practice, SrNA


T he best practice guideline (BPG) Professionalism in Nursing (2007), published by

the Registered Nurses Association of Ontario (RNAO), is one in a series of BPGs that RNAO publishes on healthy work environments. Healthy work environments are “a practice setting that maximizes the health and well‐being of nurses, quality patient/client outcomes, organizational performance and societal outcomes” (RNAO, p.15). Based on the research, the benefits of a healthy workplace are found in improved client care, cost‐savings for the health system, better utilization of human resources, increased work satisfaction, and ultimately improved population health.

Many definitions of professionalism exist. This BPG defines it as “qualities or typical features of a profession or professional; a collection of attitudes and actions” (p.58). While there is no consensus on the meaning of professionalism, there is agreement that certain attributes are fundamental and beneficial to professional nursing practice. A number of the “attitudes and actions” or attributes for professionalism are highlighted in the guidelines. Two attributes that stand out when a RN is a member of

the health care team are collegiality and collaboration. Both are essential components for maintaining successful and effective working relationships and demonstrate a high level of professionalism when put into practice.

A number of strategies from the BPG can be used to enhance our collegiality and collaboration skills, which will in turn increase our professionalism and contribution to the health care team. Examples include:• Participating in team development

initiatives and acknowledging member achievements

• Supporting mentorship and preceptorship programs

• Initiating and joining in interdisciplinary rounds and team meetings

• Supporting colleagues who identify problems and issues in professional practice, and actively participate in the resolution of these issues

• Actively responding to colleagues experiencing challenges through dialogue, problem solving and advocacy

• Engaging in inter-professional relationships and activities that enhance patient care

• Respecting and working towards achieving the vision, mission and values of the organization

The Professionalism in Nursing BPG connects individual nursing practice with the work environment and shows that when individuals make personal and professional change, the vision of a healthy workplace becomes a reality. This document is full of strategies and resources for initiating transformative and meaningful change in workplaces and health organizations where RNs are employed. It also allows us as RNs to reflect how our own behaviour contributes to a healthy work environment.

Check out a copy of this document today. RNAO BPGs are available for download at no‐charge at: www.rnao.org.

Professionalism in Nursing

http://www.rnao.org


PROFILE

Workplace Representative EducatorSRNA Continuing Competence Review Committee Update

T he SRNA Ad Hoc Continuing Competence Review Committee

met on October 11, 2012, at the SRNA office to review and provide recommendations from the Brendalynn Ens Consultant Report on Scan of Selected Continuing Competence Programs (December 2011); feedback from the Member Survey Report (January 2012); the reports from the 2012 focus groups held at the SRNA Annual Meeting; and the May and June focus groups conducted by consultants Floralyn Wessel and Norma Wildeman. The four components (self-assessment, feedback, learning plan, and evaluation) of the current continuing competence program (CCP), the audit and other areas were reviewed. The committee will complete its work this winter and provide recommendations to the SRNA Council for approval in the spring.

The work will then begin on revising and updating the current continuing competence documents. Members will be consulted on the documents as they are developed.

Watch for additional information on the review in the upcoming SRNA Newsbulletin. For information on the review please contact Cheryl Hamilton, RN, Deputy Registrar at [email protected] or Barb Fitz-Gerald, RN, Nursing Advisor, Practice at [email protected].

by Frank Suchorab, rN, Nurse manager, Herb basset Home, Prince Albert

Hello my name is Frank Suchorab, RN. I have worked as a RN in both a clinical and managerial role since 1993. In 2011, I was honoured to be asked to be a SRNA

Workplace Representative Educator. The experience has been a valuable and reciprocal learning opportunity for me. In this role I have been able to represent the SRNA by educating a variety of health care staff on SRNA resources including the continuing competence program (CCP), code of ethics, medication administration and documentation guidelines.

During this time I have furthered my working knowledge of nursing standards and have interacted with local health care professionals from all three nursing professions including SALPN, RPNAS and SRNA. This has strengthened my understanding of interdisciplinary collaboration and our shared scopes of practice. The feedback I have received from the participants is positive and I am excited to see how these learning events translate into improved care for clients.

Around the SRNA




by Noreen reed, rN, President, rural and remote Professional Practice Group (rrPPG)

expertise to enable this PPG to achieve its many goals. Our goals include: addressing disparities of rural and remote populations; promoting health and wellness; promoting mentorship; supporting the SRNA Optimizing the Role of the RN project; facilitating networking and communication; and promoting research. The RRPPG executive is: President Noreen Reed, RN Secretary Dinys Reed, RN Treasurer Allison Batty-Simonar, RN

There is no membership fee to join the group. Meetings are held by teleconference, and in person. If you are interested in learning about or joining the group, contact Noreen at [email protected]

team members such as physicians and RN(NP)s that are located in other communities.

Recognizing the needs and issues experienced by rural and remote RNs, a group of SRNA members recently formed the Rural and Remote Professional Practice Group (RRPPG). It is open to students and SRNA members. The PPG supports a collaborative team approach and welcomes LPNs, RPNs, Social Workers and others. The PPG has 15 members and anticipates expanding its membership base. We need RNs to share their experiences and

Rural and remote nursing is a unique specialty of nursing practice that addresses the

health care needs of people living in rural and remote areas (Kulig, 2005). For decades, RNs working in rural and remote communities have been an integral part of Saskatchewan health care. They have become strong advocates for the determinants of health for a clientele with diverse population health needs. RNs and RN(NP)s have provided exceptional leadership in these roles and are critical members of the health care team.

RNs working within rural and remote communities are considered multi-specialists. Their services include PHC, acute care, long term care, home care, and community. They use a wide scope of nursing practice in situations where there are limited materials and human resources. Sometimes they work with

Supporting the Specialty Practice of Rural and Remote Nurses

Reference

Kulig, J. (2005, may). What educational preparation do nurses need for practice in rural and remote Canada? The Nature of Rural & Remote Nursing, 2. retrieved from http://www.ruralnursing.unbc.ca/factsheets/factsheet2.pdf.

RNs working in rural and remote communities

have been an integral part of Saskatchewan

health care.


http://www.ruralnursing.unbc.ca/factsheets/factsheet2.pdf


permission, we will include this information in the toolkits.

Consider nominating a RN for the 2013 Nurses for the Environment Award who has addressed an environmental issue either at work or in their community. Contact [email protected] for a nomination form.

We have approximately 50 people on our PPG list. If you want to be added to the list, or be a member of the PPG, please email Jocelyn at the address above.

by Jone barry, rN (NP) CDe

dealing with toxic chemicals how have you been affected and what have you done to mitigate this ever increasing risk? With your

Although we’ve been pretty quiet for the last year, the Environmental Sustainability

in Nursing PPG is alive and kicking and we would like to reconnect with RNs across the province.

Looking ahead to 2013-14, the PPG will focus its efforts on reducing toxic chemicals in the home, at work and in our communities. We are creating a toolkit of resources for RNs that include vital information on the chemicals we’re commonly exposed to, how they impact our health, and what we can do to protect ourselves, our families, patients and communities. The toolkits will be available on flash drives and through DropBox. We will include information specific to the workplace on hospital cleaning chemicals, volatile organic compounds (found in paints and furnishings), pharmaceuticals, radiation and sterilizing agents. Chemicals in the home will include body care products, yard and garden agents. Chemicals in our community will provide information on threats to air and water quality from numerous sources. We’d like to hear about your experiences in

Looking ahead to 2013-24, the PPG will focus its efforts on reducing toxic chemicals in the

home, at woek and in our communities.

Reconnect With Your Environment and Join Our Professional Practice Group (PPG)

by Jocelyn orb, rN, President environmental Sustainability in Nursing PPG



DepartmentsProject Update

The SRNA Optimizing the Scope of the RN project has the following goals:

• The seamless dissolution of the Transfer of Medical Function (TMF) process through optimizing the scope of the RN practice;

• Competent, caring, knowledge-based registered nursing for the people of Saskatchewan.

1. RN Specialty Practice:• RN Specialty Practice is specialized

client care specific to clients’ health conditions in specialized areas of nursing practice. Upon entry to the profession, a RN possesses a comprehensive basic education aimed at providing wide-ranging types of nursing care for clients with stable to highly complex needs. When commencing work in a specific area of nursing practice, a RN will need to provide specialized client care that is specific to the clients’ health conditions in that area of nursing practice.

• RN Specialty Practice activities are health care services that are within the scope of registered nursing, and range from uncomplicated procedures (glucose monitoring) to highly complex treatments (defibrillation).

• RN Specialty Practice activities require additional knowledge, skill and judgement, as the basic RN program does not provide sufficient theory and practice for the RN to safely provide the care that the clients’ health conditions require.

• Education for the RN Specialty Practice activities will be delivered by the employer, by qualified professionals and include the competencies to provide safe, competent care.

• Clinical protocols will be required for complex activities such as defibrillation.

The SRNA continues to gather information on this area, but will soon provide a framework document in draft for members to provide feedback.

2. RN with additional authorized practices will:• Be authorized by SRNA to

perform certain interventions that formerly were supported through the TMF process.

• Provide services in the areas of community health, primary care, public health and emergency, according to the SRNA Scope of Practice: Competencies for the Registered Nurse with additional authorized practices and SRNA Clinical Decision Tools (CDT).

• Order select diagnostic tests, diagnose and treat limited common medical disorders, prescribe within a strict set of limitations, and perform limited minor surgical procedures as outlined in the CDTs, specific documents that support the assessment, diagnosis, and treatment of limited common medical disorders.

• Practice as part of an interdisciplinary collaborative team of a physician and other health care team members providing patient-centred, community focused care.

Optimizing the Scope of the RN Project

by the SrNA optimizing the Scope of the rN Project Team


• Consult with an available physician and/or RN(NP) in order to promote quality client outcomes. It is not a replacement for the RN(NP).

• Require additional formal education, as recognized by the SRNA. There will be an opportunity for prior learning to be recognized.

For more information on the project or to provide feedback, please visit the SRNA website at www.srna.org and click on the SRNA Optimizing the Scope of the RN project logo.

Task

competencies

Bylaws

council approval

annual meeting member

approval

ministerial approval

Registering

new Scope document

RNs with Additional Authorized Practices

in draft now

in draft now

February 2013

may 2013

By September 2013

2014

2014

RN Speciality Practice

Fall 2012

not required

may 2013

not required

not required

not required

2014

Timeline for Optimizing the Scope of RNs

Optimizing the Scope of Practice of the Registered Nurse General Category

Basic

education

Registered nurse with

additional authorized

practice (SRna approved)

Registered nurse

Specialty Practice

delegation

Scope of Practice of the Registered nurse

general caregory

http://www.srna.org

http://www.srna.org


and unsafe in our work. A positive image will promote nursing and create awareness about how RNs provide optimal care, improve patient outcomes and are cost-effective. We must challenge negative perceptions and move beyond an outdated image to one that defines nursing as caring, affordable and effective. Not only do the media contribute to messages about nursing but what we say to friends, family and colleagues also influences how we are portrayed. Nothing positive is achieved when we do nothing or when we complain about our work. Each of us has a responsibility to identify our challenges and suggest strategies for change. We must all realize that opportunities exist for new beginnings.

overtime, and receiving exorbitant salaries. An underlying message of blame has become inherent in these stories. Yet, numerous studies provide evidence that RNs are cost-effective, they improve patient outcomes and they are integral to managing patients’ health and creating healthy communities (Aiken, 2008; Browne, 2012).

I cannot count the number of times I have been asked about a person’s health or about what I do in my work as a RN. When was the last time you discussed your role with someone? We all have a part to play in educating and sharing stories about nursing. Each of us needs to consider how we contribute to the image of nursing. Do we complain about our work? Or do we share stories that promote our strong knowledge and compassion in providing safe and competent care for the people of this province?

Negative images of nursing not only impact the public’s perception of nursing but compromise our role in the health care system. If RNs are perceived as ‘overpaid’ and ‘sick’ we will be considered expensive

In 2004, the Nursing Standard, a United Kingdom journal, launched the campaign, Nursing

the Future, to enhance the image of and dispel myths about nursing.

During the development of this campaign, interviews with RNs revealed several themes related to the perception of nursing including the public’s underestimation and undervaluing of RNs, nursing’s invisibleness, the unique relationship between a patient and a RN, and the misunderstanding that RNs really do make a difference (Waters, 2005). In our province, the Saskatchewan Union of Nurses (SUN) launched the Making a Difference campaign, the website http://makingthedifference.ca/ and television ads which provide stories from patients, RNs and RPNs about their work. More recently, CNA’s National Expert Commission released the report A Nursing Call to Action, which discusses how RNs can change the delivery of health care in Canada. All of this demonstrates how nursing’s image is critical in moving the system to a new and better place.

Too often, RNs are portrayed in the media as sick, working excessive

Registered Nurses’ Image:It’s Up to Us

ReferencesAiken, l. (2008). economics of nursing. Policy, Politics & Nursing Practice,9(2),73–79.browne, G. (2012, July 25). Transforming health delivery: Nurse-led care is solution. Herald opinions.

retrieved from http://thechronicleherald.ca/opinion/120562-transforming-health-delivery-nurse-led-care-is-solution

Waters, A. (2005). Nursing is the most emotionally rewarding career. Nursing Standard, 19(30), 22-28.

“Change will not come if we wait for some other

person or some other time. We are the ones

we’ve been waiting for. We are the change that

we seek.” Barack Obama

by Ann-marie urban, rN, Assistant Professor, Faculty of Nursing, university of regina

http://makingthedifference.ca/

http://thechronicleherald.ca/opinion/120562-transforming-health-delivery-nurse-led-care-is-solution


DepartmentsSRNA Registration and Voting

Registration Renewal 2013Registration Renewal for 2013 ended November 30, 2012, with a 93 per cent online renewal rate. We are interested in quality improvement so we have designed an online registration renewal survey. The survey will be on our website www.srna.org from January 7 to 31, 2013.

Effective 2014, the SRNA will be discontinuing paper licence cards. Confirmation of registration and licensure is available through the Verification Service (e-register) located on the SRNA homepage (www.srna.org). Discontinuation of the paper licence is becoming a best practice across Canada in promoting public safety. The use of the e-register provides an accurate means of confirming a member’s licensure status. The paper licence may not accurately reflect changes that have occurred in a member’s registration status since he/she was issued the

paper licence. In addition, use of the e-register will eliminate the risk of lost or stolen licences; minimize the risk of identity theft and the use of fraudulent licences. Effective 2014, it will be mandatory for all SRNA members to complete their registration renewal online.

In Spring/Summer 2013, the SRNA will be implementing a new database. The new database will bring several changes to the way the SRNA interacts with applicants and members. Once implemented, applicants and members will be able to apply for any registrations route (graduate nurse, internationally educated nurse) online. There will also be a member section on the website where members will be able to self-manage registration and personal information, such as address or employer changes.

Online Voting For SRNA Elections 2013The SRNA will use an electronic voting system again for the annual election in May 2013. Eligible voters will vote on a secure electronic ballot by clicking on the VOTE NOW icon on the SRNA website. Each member will be able to vote online until noon on the first day of the annual meeting. Computers will also be set up on-site at the Annual Meeting in Saskatoon. More information will be posted on the SRNA website at www.srna.org when the elections begin. See page 33 for Nominations information.

Interested individuals can apply to lesley at [email protected] by January 16, 2013. Please include a brief note (maximum 150 words) stating the SrNA activities you participate in and the reasons the SrNA membership Advisory Committee should choose you to be the SrNA nominee. The nominee will be approved by SrNA Council at their February meeting and then sent to the CNA board for final approval. If selected the nominee will receive up to $1500 to cover expenses to attend the CNA Annual meeting.

This is a call for expressions of interest to be nominated by the SRNA as a scrutineer for the CNA Annual meeting being held on June 19, 2013, in Ottawa, Ontario. Information on the role of the scrutineer can be obtained by contacting Barb at [email protected]


http://www.srna.org

http://www.srna.org

http://www.srna.org



Welcome to a new Ethics in Action – I am excited to begin my role here at the

SRNA, and write, this, my first ethics article! I will explore the history of nursing ethics and then discuss my own evolving understanding about ethical nursing practice.

Ethics is about doing the right thing, the right way. As such, in ethics the means are as important as the ends. In nursing, this relates to how RNs ought and ought not to act, so is intrinsically linked to nursing practice (Oberle & Bouchal, 2009).

Historically, nursing ethics in Canada has evolved over time. The values of the nursing profession in Canada were influenced by French Roman Catholic nuns, who provided care for the sick in Canada’s early days. Thus etiquette and general comportment were highly valued. The desired characteristics for a nurse were that of being courteous, quiet, loyal, obedient and respectful (Oberle & Bouchal, 2009). Florence Nightingale also considered character to be the key component of ethical conduct, and she sought such attributes as honesty, kindness, ad truthfulness in potential nurses (Lamb, as cited in Storch, 2007).

As nursing ethics were so closely related to the characteristics of loyalty and obedience, unfortunately it was also seen as embodying a primary loyalty to the physician and the

organization, with the patient as secondary (Storch, 2007). By the late nineteenth century, nursing leaders in North America were interested in establishing a code of ethics for nurses. However, that attempt to create a code of ethics for nursing at a national convention was thwarted when a physician urged that a code would be more trouble than it was worth, adding that being “good women” was all that was really needed (Dock, as cited in Storch, 2007).

As nursing was becoming professionalized by the mid-1920s, the ideal of unquestioning respect for authority was considered inappropriate. Ethics began to focus on the nature of the nurse-patient

relationship and human rights (Oberle & Bouchal, 2009). In 1926, a nursing code of ethics was finally presented at the national convention of American nurses, and its purpose was that of creating a sensitivity to ethical situations and formulating general principles to guide action in specific situations (Mooney, as cited in Storch, 2007). Financial difficulties of the 1930s and then the Second World War contributed to the postponement of the adoption of the code.

The code of ethics for nurses wasn’t finally a reality until the International Council of Nurses adopted it in 1953. Between the 1930s and 1960s, it became clearer that nurses were responsible for their own choices, and able to exercise independent professional judgement (Storch, 2007). Nursing was no longer considered to be under the absolute control of medicine, and it was becoming clear that nurses had responsibility for decision-making about their own practice (Oberle & Boucahl, 2009). Since that time,

Ethics in Action

The Evolution of Ethics in Nursing A brief History and Application

by marg olfert, rN, Nursing Advisor, Policy, SrNA

Ethics is about doing the right thing, the

right way.

The code of ethics for nurses wasn’t

finally a reality until the International Council of Nurses

adopted it in 1953.


nursing ethics has been viewed as unique and distinct from medical ethics, and has continued to evolve.

I believe that the application of the code to individual nursing practice continues to evolve as well. Consider confidentiality and privacy. In our initial basic nursing education, we were all instructed on the importance of maintaining confidentiality in our nursing practice. As I reflect on my early nursing career, I recall learning how to put this theory into practice.

In my first full-time, permanent position as an RN in a regional hospital almost thirty years ago, I learned how to maintain confidentiality in a small community. Everyone knew everyone, and tended to stop you in the grocery store to ask about someone they knew that had been hospitalized. I recall discussing such situations with my nursing colleagues and coming to some decisions about what to do. Over time, I learned how to respond to the questions, while not appearing to be rude.

In this same setting, all patients were given the option of signing

consents when they were admitted to hospital, allowing their name and condition to be announced on a local radio program each day. As RNs on the night shift, we then provided an update for the local radio reports each day as to their condition. This included a brief description – the patient status was described as “progressing favourably”, or “satisfactory”, or “fair”. As a new RN, I wondered about this practice, and usually determined each patient was “progressing favourably” even if I knew their condition was deteriorating. Thus I wondered about the usefulness and, yes, the ethics of the radio report, but the community seemed to value the information.

Years later, in my teaching career, maintaining confidentiality and privacy about patient information took on a different application. The impact of social media was prevalent as students learned about confidentiality and maintaining privacy. What should be shared and with whom? Communication by

electronic means was becoming so much more social and communal – experiences between students were shared instantly and frequently, and students did not always know how to consider the values of privacy in their day to day practice. Students, like me years earlier, accepted the principles of ethical practice but the application of those values and principles was more challenging, and often required guidance and discussion.

While the code of ethics will continue to evolve over time, I know that how I apply it to my nursing practice will also evolve. It is this after all that helps to define our profession and informs others of the responsibilities that RNs accept in their practice (CNA, 2008).

I believe that the application of the code to individual nursing practice continues to

evolve as well.

While the code of ethics will continue to evolve over time, I know that how I apply it to my nursing practice will

also evolve.

ReferencesCanadian Nurses Association. (2008). Code

of ethics for registered nurses. ottawa, oN: Author.

oberle, K., & bouchal, S. r. (2009). Ethics in Canadian nursing practice: Navigating the journey. Toronto: Pearson Prentice Hall.

Hardingham, l. (2003). ethical and legal issues in nursing. In m. mcIntyre & e. Thomlinson (eds.), Realities of Canadian nursing: Professional, practice, and power issues (pp. 339-356). Philadelphia: lippincott, Williams, & Wilkins.

Storch, J. (2007). enduring values in changing times: The CNA code of ethics. Canadian Nurse 103(4), 29-33, 37.


education, resources and managerial oversight requirements must be considered to ensure teams are fully equipped to provide the care expected under this new model.

Each team member will bring their own professional competencies based on their education and expertise making role clarity and clear channels of authority and decision-making essential. Finally, all policies and procedures must support team members in meeting their individual standards of practice.

CECs are a viable option; however, they are not the only option. In some instances the optimization of existing RN roles or introducing a community RN(NP) may be the answer. It’s a matter of looking at each community on a case-by-case basis to find the right fit.

We are, however, on the right track if we continue to learn from best practices, evidence and research in order to create models of care that work for Saskatchewan. At times things may feel daunting, but nothing is insurmountable when we work collaboratively from design through to implementation.

Collaborative Emergency Centres That Work for Saskatchewan

by rosalee longmoore, rN, President, Saskatchewan union of Nurses

for next-day follow-up or treat and transfer to the regional hospital. CEC ambulance calls are treated with the same priority as private residence calls.

Building a Saskatchewan CEC model must start with what makes us unique. Saskatchewan is in many ways vastly different to Nova Scotia in population density, culture, climate, industry and geographical distances and access to nearby rural hospitals. These factors shape community health care needs and challenges.

Provincial standards for both emergency services and CECs should be established and additional

The word ‘crisis’ is increasingly being used to describe the primary and emergency

health care delivery challenges facing Saskatchewan’s rural and remote areas and no one can attest to this more than the residents of these communities who are living this reality each and every day.

There is no arguing that something radical and innovative needs to be done to avert this crisis. That’s where the Collaborative Emergency Centre (CEC) comes in. This new way of delivering team-based care with an intended purpose of streamlining primary and emergency health care services is definitely one of many potential solutions worth exploring.

CECs, a Nova Scotia model of care, are open 24 hours a day, seven days a week. During the 12-hour day, they provide access to Primary Health Care (PHC) by a team of professionals, including physicians or NPs and RNs. Patients presenting to the night team will be assessed by both a RN and paramedic based on their individual expertise with an online physician being consulted to determine one of three care options: treat and release, treat and release

Building a Saskatchewan CEC model must start with

what makes us unique.

At times things may feel daunting, but nothing

is insurmountable when we work collaboratively from design through to

implementation.


Fresh FacesLois VanDerVelden, RN, Advisor, Competence Assurance, SRNA

Lois has been providing care to clients in the clinical setting for more than 30 years in the areas of plastics, urology and critical care, however the majority of her nursing career has been in Emergency Services.

In 1999, she began her role as Manager of the Emergency Department at the Regina General Hospital, Regina Qu’Appelle Health Region

(RQHR), followed by the position as Director of Emergency & Ambulatory Care – Pasqua & Regina General Hospitals, from 2006 until 2012.

In her role as Director, she was the Team Lead for the Accreditation process for Emergency & Ambulatory care (at both sites), co-lead of the streaming project for the Emergency Department, and participated in the development and implementation of the electronic patient tracking system in Emergency.

Lois graduated in 1979 from SIAST Regina with a Diploma in Nursing. In 2005 she completed a Masters in Leadership from Royal Roads University in Victoria, BC.

She’s a strong advocate for the voice of the client and has worked extensively with risk mitigation and proactive management for improved care provision.

Lois is passionate about client care and is committed to health care excellence for all stakeholders in Saskatchewan.

Lesley Stronach, Practice Assistant, Member Relations, Practice, SRNA

Lesley joined the SRNA in November, 2012. She has a Bachelor of Science in Geography from the University of Regina and many years experience working in professional agencies including customer relations, administration and project coordination. Lesley is actively involved in the community and volunteers her time coaching and mentoring young people.

Lesley looks forward to the new challenge and is working with members of the SRNA.

Fresh Faces & Nurse to Know

Nurse to Know

Greg Riehl, RN, Aboriginal Nursing Student Advisor, SIAST, Wascana Campus“I have left my Program Head position, having accomplished many issues that I had set out to address. The opportunity came up for the Aboriginal Nursing Student Advisor, which I was very interested in, and I have made the move to this position and new challenge in my career. For all Nursing Re-entry correspondence, please forward to Sandi Pettit, my mentor, who is taking on this challenging position and program in the interim.”

Greg Riehl, RN


of the visibility of the nursing profession and the frequency of the public’s interactions with us as health providers, we can utilize our connections, build partnerships and facilitate the implementation of wide-ranging programs and plans to address this pervasive, but not necessarily permanent, social issue.

Poverty Free Saskatchewan recently concluded a series of community consultations validating the pillars of their poverty elimination strategy. In their concluding remarks they stated, “The overall message was that we need to define ourselves as a community of communities and work together to create a more empowering and inclusive society.” How do we as RNs define a role for ourselves and then come together and foster a sense of community within our profession?

Through the diversity of our strengths and perspectives, our participation could be pivotal in tipping the balance and making poverty elimination a reality.

a newly diagnosed diabetic, we share knowledge with the client and their social supports because we understand the importance of their environment and lifestyle. Moreover, we understand that it is not only environment and lifestyle factors but also the interaction of these facets that often confound a patient’s management of their disease process. Every day we work with clients from different backgrounds, tailor our practice to their circumstances, connect them to various resources and advocate for their health needs both inside and outside traditional health boundaries.

Through coming together as a profession and connecting with each other, we can affect so many areas of our client’s lives and their communities. With an inclusive perspective, we can play multiple roles in advocacy. A coordinated approach is vital to both addressing poverty and nursing practice. Because

RNs and RN(NP)s work with diverse clients in many areas of the community and have

diverse avenues through which they influence well-being. As members of collaborative teams, we work with clients, other care providers, and systems as a whole, to address the complex factors that influence health. Our practice includes a diversity of roles within a variety of areas such as research, education, leadership and policy and patient care.

The key to addressing poverty is the same principle that enables nursing practice to be successful: embracing diversity. RNs are active in rural, urban and remote settings; we provide care to clients at work, in their homes, and in response to things done at play. Our care intersects clients’ lives during periods of wellness, throughout chronic illness and in moments of acute injury and recovery. Poverty elimination also requires a comprehensive approach.

To address this social issue, a strategy must incorporate the social determinants of health with attention given to multiple contextual factors. As RNs, we understand the need for such an integrated approach because this is the very essence of our practice. As we administer insulin to

Collaborative Integrated Care: The Basis of Nursing Practice the Key to Poverty Elimination

by Sarah liberman, rN, Nursing Instructor, SIAST, Wascana Campus

The key to addressing poverty is the same principle

that enables nursing practice to be successful:

embracing diversity.

References and Resources Communities respond – Highlights:

PFS Consultations 2011-2012 www.povertyfreesask.ca

http://www.povertyfreesask.ca


In 2012, the Saskatchewan health care system committed to using a management system called Lean to transform the way health care is delivered in our province. Lean is a patient-first approach that puts the needs and values of patients and families at the forefront and uses proven methods to continuously improve the health system. This is the first

time in Canada a province has taken this approach to transforming care across an entire health system.As the Lean Management System rolls out, some people are asking, “What happens to Releasing Time to Care™

(RTC)?” The short answer is that RTC and Lean share many concepts, and Lean builds on what has been achieved with RTC in Saskatchewan:

Health Quality Council

Lean Builds on Foundation Laid by Releasing Time to Care™

Provides more opportunities to learn about continuous improvement through upcoming training courses such as “Kaizen basics” and lean leadership Certification.

You may be asked to participate in Kaizen (Improvement) events, 3P events, rapid Process Improvement Workshops (rPIWs), and/or “report outs” to hear the results from these various improvement events. many of the activities will be similar to those worked on by teams in rTC with extra time, attention, and support provided to achieve results more quickly.

The continued rollout of rTC within regions will now be under the direction of health regions. Some wards/facilities may choose to move directly into the lean management System if they have not yet started rTC.

over four years, 880 managers and leaders will be trained as lean leaders across the system so they can work alongside care providers and other staff to identify problems and find solutions to the issues that prevent us from providing the highest quality of care to every patient, every time. A key aspect of lean is leaders going to where the work is done / the care is delivered to see and understand the daily work of staff, and learn what will make things better for staff and patients.

Learning about improvement

Coordination

Management and leadership support

Introduces continuous improvement tools and methods.

Health Quality Council coordinated the provincial rollout of the rTC program.

managers and leaders provide support for your efforts by participating in pyramid visits.

Releasing Time to Care™ (RTC) Lean

To see the complete table, send a note to Sheila ragush ([email protected]).



you are, how you feel inside, and the attitude that you convey also have a profound effect on the patient…Learning to listen deeply to your own heart and your own truth allows you to connect in a deeply caring way with your patients” (p. 34-35).

Each of us have our own strengths, passions, and attributes that make us unique in our practice. We chose our profession partially because of who we truly are. Bringing all of who we are to the care we provide is how we utilize our therapeutic use of self. Finding a moment of peace can help provide clarity, connect us to our intuition, and enhance our interactions.

Whatever practice domain, this tool helps guide you through a moment of reflection and self-awareness, it has worked for me and my students and I hope it can help enable your own unique strength and perspective in your role.

Thornton (2008) created a tool for dealing with the static that can fill our minds.

Consider your own personal state before a big speech, an interaction with a patient, or a meeting with other health care professionals. How often do you take a few seconds to use the opportunity to connect with yourself and find grounding? When you have, does the experience feel more fulfilling? Does taking a moment to pause help create a sense of peace that enables authentic involvement? Thornton (2008) commented, “who

As a profession we have acknowledged that so many of

us can feel overwhelmed, stressed and anxious dealing with ethical and moral dilemmas that are inherent in the nature of our work. As individuals we encounter friends, family members, and coworkers who may be caught up in something, busy rushing around, or otherwise distracted. Whether it is us or the other individual, whatever is going on in their lives at that moment in time creates a context that shapes our interaction. The thoughts running through our mind or the energy left over from a confrontation or an emotionally engaging event has the ability to impact our level of comfort, communication, sense of feeling heard, and if we are truly present during when we relate to others.

Sometimes I need to stop for a moment and take a deep breath before I walk into a classroom or onto a clinical ward. These experiences remind me of many situations where my own state of mind needed to be addressed before I am able to apply my brain to the task at hand.

Therapeutic Use of Self

by Sarah liberman, rN, Nursing Instructor, SIAST, Wascana Campus

References and Resources Thornton, l. (2008). Holistic Nursing A Way

of Being, a Way of Living, a Way of Practice!, NSNA Imprint, 55(1), 32-39.


apply is February 15th, 2013. If you have questions, please call Cheryl Hamilton, RN, at 1-800-667-9945 or 359-4200 in Regina.

Continuing Competence ProgramNow that members have renewed their registration for the 2013 licensure year, it is a good time to start working on your 2013 CCP requirements. Please refer to the CCP tutorial and the SRNA website (www.srna.org) if you need assistance. CCP workshops will be arranged by request. Contact the SRNA office 1-800-667-9945 or in Regina 359-4200 for more information.

SRNA Registered Nurse and Registered Nurse (Nurse Practitioner) 2013 Membership SurveyThe SRNA will be inviting all RNs and RN(NP)s to participate in the 2013 SRNA membership survey. The voluntary survey will only take about five minutes to complete, however we encourage you to take the time to complete the survey because your input is valuable in providing direction to the SRNA. Please note that all data is collected and analyzed by an independent consultant, and your identity and responses will remain confidential. Only the combined results of all respondents will be reported and made available.

Watch for the survey in the New Year.

Call for Continuing Competence Program (CCP) AuditorsThe SRNA is seeking two RNs and two RN(NP)s who are interested in serving as auditors for the continuing competence program (CCP). Auditors will review continuing competence documents and surveys submitted from a random sample of the SRNA membership.

The documents will be reviewed to ensure:• All steps of the reflective practice

have been completed• Logical linkages between the self-

assessment, peer feedback, learning plan, and evaluation are evident

Auditors are:• Currently registered in good

standing with the SRNA• Attentive to detail• Knowledgeable of the CCP• Interested in becoming involved

with the SRNA• Not a member of another SRNA

regulatory committee

Time Commitment:• RN(NP) auditors will be required

for one full day at the SRNA office in Regina.

• RN auditors will be required for two full days at the SRNA office in Regina.

How to apply:Send a brief resume which includes an explanation of why you are interested in being a CCP auditor to [email protected]. Deadline to

SRNA Updates

DISCIPLINE PENALTY DECISION

Carissa L. Viel, RN #38283, Delisle, Saskatchewan

Carissa L. Viel was found guilty of professional incompetence pursuant to Section 25 and professional misconduct pursuant to Sections 26(1) and 26(2)(l) of The Registered Nurses Act, 1988 (The Act); Standard I: Professional Responsibility and Accountability (Competencies 1, 2 & 3); Standard II: Knowledge Based Practice (Competencies 39, 45, 62, & 64); Standard III: Ethical Practice (Competency 66); Standard IV: Service to the Public (Competencies 81 & 85); Standard V: Self Regulation (Competency 95) of The Standards and Foundation Competencies for the Practice of Registered Nursing (Effective March 1, 2007); and the CNA Code of Ethics for Registered Nurses, Providing Safe, Compassionate, Competent and Ethical Care (item 1); Being Accountable (items 1, 2 & 3). For a copy of the Penalty Decision, please refer to the SRNA website (www.srna.org).

http://www.srna.org


http://www.srna.org


Saskatchewan Health Information Resources Partnership (SHIRP) is a provincially funded electronic library that provides licensed health care practitioners including social workers practicing in Saskatchewan free access to thousands of electronic resources. There are over 6,000 journals, 13 databases and 150 books available through SHIRP. Some examples are:

BE RECOGNIzED FOR YOUR GOOD WORK – submit an application for the new Pursuing Excellence Awards!

The Pursuing excellence Awards have been designed to recognize and celebrate all the good work being done in our province to achieve better Health, better Care, better Value and better Teams (ministry of Health’s Plan for 2012-2013).

The deadline for awards applications is January 30, 2013. The awards presentations and banquet will be held at the Health Care Quality Summit at evraz Place in regina on April 10th, 2013.

Save April 10 & 11, 2013 on your calendar, and find more information about the awards at www.qualitysummit.ca

Share your story. As a registered Nurse how are you making the Difference? each and every day rNs and rN(NP)s make a difference in the lives of their patients and their families.

Check out the latest Making the Difference commercials now on Global, CTV, CBC and CityTV. Long-term care: http://www.youtube.com/watch?v=8rWVheubWYY&feature=plcp

http://www.youtube.com/watch?v=8rWVheubWYY&feature=plcp http://www.youtube.com/watch?v=8rWVheubWYY&feature=plcp

Psychiatric care: http://www.youtube.com/watch?v=6rGnuYpwinQ&feature=plcp http://www.youtube.com/watch?v=6rGnuYpwinQ&feature=plcp http://www.youtube.com/watch?v=6rGnuYpwinQ&feature=plcp>

Acute care: http://www.youtube.com/watch?v=30Qj2oqGyQm&feature=plcp http://www.youtube.com/watch?v=30Qj2oqGyQm&feature=plcp http://www.youtube.com/watch?v=30Qj2oqGyQm&feature=plcp>

Patient’s story: http://www.youtube.com/watch?v=tYI4HkC3oQs&feature=plcp http://www.youtube.com/watch?v=tYI4HkC3oQs&feature=plcp http://www.youtube.com/watch?v=tYI4HkC3oQs&feature=plcp

The patients, registered nurses and stories are real.

10% off products & treatments.

Expires Jan. 31, 2013

306.522.1078 [email protected] www.invuskin.com

• DatabasessuchasCINAHL,Medline,HealthSource:Nursing/Academic,HealthStar;

• JournalssuchasCancerNursing,Evidence-basednursing,NurseEducator,PediatricNursing;and

• BookssuchasDrugsinPregnancyandLactationandNurses’PocketGuide:Diagnoses,PrioritizedInterventionsandRationales.

IfyouarenotabletofindanarticlethroughSHIRP,youcanrequestthearticlethroughSHIRPdocumentrequestandthearticlewillbemailedtoyoufreeofcharge.ContactSHIRPforfurtherdetails.

TheSHIRPlibrarianMahaatwillalsobeavailabletoofferSHIRPtrainingatyourhealthregionsandyourworklocations.PleasecontactMahaatmaha.kumaran@usask.caor966-8739.

http://www.qualitysummit.ca

http://www.youtube.com/watch?v=8RWVheUbWYY&feature=plcp

http://www.youtube.com/watch?v=8rWVheubWYY&feature=plcp

http://www.youtube.com/watch?v=8rWVheubWYY&feature=plcp

http://www.youtube.com/watch?v=6rGnUYpwinQ&feature=plcp

http://www.youtube.com/watch?v=6rGnuYpwinQ&feature=plcp

http://www.youtube.com/watch?v=6rGnuYpwinQ&feature=plcp

http://www.youtube.com/watch?v=30Qj2OqGyQM&feature=plcp

http://www.youtube.com/watch?v=30Qj2oqGyQm&feature=plcp

http://www.youtube.com/watch?v=30Qj2oqGyQm&feature=plcp

http://www.youtube.com/watch?v=tYI4HkC3OQs&feature=plcp

http://www.youtube.com/watch?v=tYI4HkC3oQs&feature=plcp

http://www.youtube.com/watch?v=tYI4HkC3oQs&feature=plcp


http://www.invuskin.com



differs from person to person; for some populations and in some circumstances the better option is to abstain or to drink at lower rates. For more information see the Canadian Centre on Substance Abuse (CCSA) at http://www.ccsa.ca/Eng/Search/Pages/results.aspx?k=low%20risk%20drinking%20guidelines.

Social gatherings can be fun and safe, supported by thoughtful planning. Holiday seasons and special events are windows of opportunity to speak to patients about moderate drinking. If your patients decide to drink alcohol, have them consider safety tips beforehand and plan for moderation.

Providing Support Toward Making Celebrations Safe and Memorable

SaSkatchewan MiniStry of health

Keep track of drinks.

Pre-drinking before a person goes out can sabotage these plans and increase the risk of harm to oneself and others. Suggest that patients drink slowly and finish their drink before getting another. Let them know that they don’t need to finish a bottle of wine they’ve ordered at a restaurant or bar. Wine recorking is offered by liquor permitted venues in Saskatchewan. See Saskatchewan Liquor and Gaming Authority (SLGA) at http://www.slga.gov.sk.ca/Prebuilt/Public/Wine%20Recorking%20Fact%20Sheet.pdf.

Follow Canada’s low risk alcohol drinking guidelines (LRDG).

Special occasion limits are defined as a maximum of 3 drinks for women and 4 for men. The rate at which one’s body metabolizes alcohol

Providing information and helping people be proactive is an important part of patient

care. RNs & RN(NP)s can support people to make safe and informed decisions about alcohol use in order to reduce the risk to themselves and others. Here are some helpful tips:

Know what a ‘standard drink’ is.

Different glass sizes and volumes of alcohol in beverages can influence how fast a person becomes intoxicated. Knowing the definition of a standard drink helps a person keep track of how much they drink. This refers to: 12 oz. beer (with 5% alcohol content) = 5 oz. wine (with 10-12% alcohol content) = 1.5 oz. liquor (with 40% alcohol content).

Be selective.

If a person is making a decision to drink, have them consider drinks with lower alcohol content, and avoid doubles, shooters, and alcohol-energy drink mixtures. Encourage them to alternate alcoholic drinks with non-alcoholic ones (e.g., water, punch, coffee/tea or mocktails). For mocktail recipes go to www.whatsurcap.ca.

http://www.ccsa.ca/Eng/Search/Pages/results.aspx?k=low%20risk%20drinking%20guidelines

http://www.slga.gov.sk.ca/Prebuilt/Public/Wine%20Recorking%20Fact%20Sheet.pdf

http://www.whatsurcap.ca


Clinic Manager Dione Fleury emphasizes that this is critical in the continuum of care. With a strong base of support, “the patient feels better cared for,” says Fleury.

“The process is smoother and wait times have decreased,” adds Becky Lockhart, RN, Case Manager.

Dr. Gavin Van de Venter, a family physician, says that before the new changes were implemented in Meadow Lake, “patients were struggling to get access.” With a RN case manager, patients are now guided through the system based on their specific needs.

Changing how PHC is delivered means a different way of thinking for providers. As Dr. Van de Venter notes, “[the new model] means the doctor doesn’t need to be the expert. He just needs to be a very good family physician. It’s a complete paradigm shift for physicians but I now can’t imagine working any other way.”

The introduction of multi-skilled health care teams is just one of the ways the clinic better serves patients. It has also introduced Clinical Practice RedesignTM and Continuous Improvement methodologies to focus on improving access to services and enhancing the patient experience.

including higher job satisfaction and better information sharing. It also ensures that every patient has access to a team that meets their unique health care needs.

Meadow Lake resident Amber Stang says “we get what we need here.” While her family members encouraged her to move to a bigger centre, the holistic approach in Meadow Lake has been great for her family. “The support is fantastic.”

Now that most of the groundwork has been completed, practitioners are concentrating on their areas of expertise and quickly conferring with colleagues when they have questions. Better communication between practitioners improves not only patient service, but fosters better relationships between team members.

A s a Primary Health Care (PHC) innovation site, Meadow Lake is at the

forefront of offering an innovative approach to service delivery that benefits both patients and health care providers.

Meadow Lake is using a team approach to service delivery, introducing RN case managers, chronic disease educators, dieticians, mental health and addictions workers, pharmacists and exercise therapists, among others, to work alongside physicians in the Meadow Lake Primary Health Centre. This creates a one-stop shop for patients and provides holistic health care services.

Melanie Bauman, RN, Case Manager, says that there are now “many providers with the same goal but a slightly different focus so that the patient benefits from all the interactions.”

This approach supports Saskatchewan’s new PHC framework which outlines a new PHC system that will make better use of a full range of health professionals, working collaboratively at the top of their scope of practice. The team approach allows health care professionals to enjoy the benefits of team-based care,

New Roles for Health Care Providers in Meadow Lake

The team approach allows health care professionals

to enjoy the benefits of team-based care, including higher job

satisfaction and better information sharing.

SaSkatchewan MiniStry of health


PHC the foundation of the health care system, and the best practices gleaned from Meadow Lake will result in a stronger and more robust system that is better able to meet the needs of Saskatchewan’s diverse population. A patient- and family-centred health system means not only a healthier population, but stronger communities as well.

For more information on this PHC team, and Saskatchewan’s new approach to PHC, visit http://www.health.gov.sk.ca/primary-health-care.

...“[the new model] means the doctor doesn’t need to

be the expert. He just needs to be a very good family physician. It’s a complete

paradigm shift for physicians but I now can’t imagine working any other way.”

Four Directions Community Health Centre offers a broad range of services to support the overall health needs of individuals and familiesPHoTo CourTeSY meDICAl meDIA SerVICeS, reGINA Qu’APPelle HeAlTH reGIoN

http://www.health.gov.sk.ca/primary-health-care


assessment with a focus on the PHC principles. The first step in this process is to initiate discussion with members of the health centre. The purpose is to obtain the needs and resources of the community from their point of view. The dialogue reveals the community suffers from a high rate of substance abuse and teen pregnancy. This information highlights two principles of PHC; the process of enabling people to increase control over their health - health promotion, and collaboration among all staff employed at the health centre – inter-professional collaboration (CNA, 2005).

Following your discussion with staff, it is prudent to evaluate the needs and resources as perceived by community members. To ensure that quality health care is accessible and achievable, interventions for health and well-being must be routed in the community and reflect the community it serves (Ministry of Health, 2012). Every community will contain distinct assets and deficits – the key is to increase member awareness in assessing its needs and planning how to meet those needs (Ministry of Health).

The thought of implementing PHC in its entirety can appear

health centre. Though the primary focus is on the role of a new RN, all principles apply to both experienced RNs and RN(NP)s.

You have accepted a position as a RN in a rural community located two hours from the nearest urban centre. Located in this community is a health centre staffed by one other RN, one RN(NP), and an addictions counsellor; with a physician available to provide services three days a week. Within the first six weeks of your employment, you recognize that PHC could play a greater role in empowering community members, as well as building a stronger community capacity.

Your first inclination is to create and implement a community

Opportunities for RNs in Saskatchewan are infinite. A recently graduated RN

may choose to be employed in a large urban centre where the achievement of Primary Health Care (PHC) is a significant goal of their organization; or to relocate to a rural community where PHC is still a growing concept.

Even though the Nursing Education Program of Saskatchewan (NEPS) strives to produce graduates who have a comprehensive understanding of their role within the PHC framework, do graduates believe they have the knowledge, skills and judgement to practice competently?

As NEPS students, we have the ability to identify the five principles of PHC: accessibility, public participation, health promotion, appropriate technology, and inter-sectoral collaboration. However, the challenge resides in understanding how all five principles are interrelated, how they fit within the PHC framework, and how they will support our practice in a broader context. We have developed a hypothetical scenario that will demonstrate the role of a recently graduated RN and their influence on PHC within their facility; whether that is a regional health centre or a rural community

Primary Health Care and Building a Healthy Community

by Stefanie banilevic & April mackey, 4th Year NePS Students

...the challenge resides in understanding how all five principles are interrelated,

how they fit within the PHC framework, and how they will support

our practice in a broader context.


to be overwhelming; however, applying PHC in its entirety is not the point. PHC is a system which can only function when all health care professionals and stakeholders collaborate, understand and accept their roles within that system. A critical piece of the RN role in this scenario is health promotion based on the needs of the population. Through health promotion, RNs are encouraging public participation and facilitating accessibility with the foundation of inter-professional collaboration to reach these goals.

In the context of this scenario, we can:• Provide health promotion

interventions such as substance abuse focused on prevention and improvement within the community by providing a supportive and non-judgemental environment as a staff member can help to reduce inequities and remove barriers to healthy choices;

• Focus on education to prevent teen pregnancies.

The concept of PHC is both broad and complex. To understand PHC, we need to immerse ourselves into our practice and embrace self-reflection. We hope this scenario has provided

a perspective that is similar to what some of you may be experiencing. As a RN you have the ability to make a difference. Apply the information you have received throughout your education and experience, and be receptive to the potential that is present in all communities and populations.

Despite progress in the Provincial PHC Framework, our health care system is still demonstrating provider-centred care, versus patient- and family-centred care. Both graduate and experienced RNs have the capability to become change agents in the workplace and the PHC framework. It is imperative to the transformation of our health care

that RNs respect the role of other health care providers in patient care and develop an understanding of their scope of practice.

We must trust our counterparts and their abilities to establish a strong working relationship within our teams. More importantly, we must be open and willing to listen to our patients and hear their individual perspectives; respecting the impact that social determinants of health may have on their well-being. It is critical that RNs empower patients to make decisions regarding their personal health, and support their judgment in a collaborative partnership.

References

Canadian Nurses Association. (2005). Primary health care: A summary of the issues. retrieved from http://www2.cna-aiic.ca/CNA/documents/pdf/publications/bG7_Primary_Health _Care_e.pdf

ministry of Health. (2012). Patient centered community designed team delivered: A framework for achieving a high performing primary health care system in Saskatchewan. retrieved from http://www.health.gov.sk.ca/phc-framework-report

...we must be open and willing to listen to our patients and hear their individual perspectives;

respecting the impact that social determinants of

health may have on their well-being.

http://www2.cna-aiic.ca/CNA/documents/pdf/publications/bG7_Primary_Health _Care_e.pdf

http://www.health.gov.sk.ca/phc-framework-report


JOIN US IN SASKATOON for our Annual meeting. SrNA members and the public are invited to attend the annual meeting in the afternoon. Join us in the morning for a series of interactive sessions,

information and dialogue about where we’ve been as your professional regulatory organization and where we’re going. This is your opportunity to participate

in the business of the SrNA. In the evening, our banquet and awards recognition night is a tradition not to be missed.

THE EVENT PROVIDES an opportunity for rNs & rN(NP)s to take time to rejuvenate and have fun, network with colleagues from across the province and learn about a broad range of evidence-informed nursing practice applications. A series of concurrent sessions will round out our day.

MEMBERS OF THE SRNA can provide input on particular issues facing the profession or on initiatives in which you think the Association could be involved through submitting a resolution. A letter of resolution/motion can be submitted to SrNA Council at any time.

resolutions/motions can be presented to the Council, by person, group, annual or special meeting assembly at any time. Persons who wish resolutions/motions published in the Annual report should have resolutions submitted to Council, for presentation at the Annual meeting, by January 31 of each year.

resolutions not submitted by this date can be presented at the Annual meeting as a motion from the floor.

Resolutions must include:A title: subject

A resolution statement: an expression of intent or what action you are proposing the Association take in relation to the subject of the resolution. This statement begins with: “be it resolved ...”, and should be written in a clear and concise manner.

Annual Meeting and Conference 2013

Conference Day –

May 2, 2013

Resolutions

Linking with members –

April 30, 2013

Annual Meeting Day –

May 1, 2013

Explanatory notes: identify why you believe the issue should be addressed. If you are making a number of points, order them numerically. (remember that resolutions must be a provincial basis and relate to the mandate of the Association.)

Identification: names of “mover” and “seconder” of resolution (must both hold active-practising status with the Association). either the “mover” or “seconder” should be available to speak to the resolution at the Annual meeting.

resolutions/motions that are approved by the membership at the Annual meeting will be reviewed by Council to make reasoned decisions regarding any actions to be taken.

For more information contact the SRNA or send resolutions/motions to:

Kandice Hennenfent, rN, SrNA Presidentc/o SrNA, 2066 retallack Street, regina, SK S4T 7X5or by email to: [email protected]

The Nominations Committee is seeking RNs and RN(NP)s to stand for election

in 2013 for the following positions listed below. The 2013 election is on May 1, 2013 at the

SRNA Annual Meeting in Saskatoon.

Council members are elected to represent registered nursing in Saskatchewan

President-elect (two-year term followed by two-year term as President)

one member-at-large is open for election in each of the following regions:

SrNA electoral region III Prairie North and Prince Albert Parkland and region VII regina Qu’Appelle Health region (three-year term)

Candidate nominations must comply with the requirements stated inThe registered Nurses Act (1988), SrNA bylaws (2012) and SrNA Policies.

David Kline, rN, Chair, Tu Cam Duong, rN, Deanna Barlow, rN(NP), and Karen Marchuk, Public representative

For information on The registered Nurses Act (1988), SrNA bylaws (2012), SrNA Governance Process, electoral regions and nomination forms are found at www.srna.org call toll free: 1-800-667-9945 or in regina 359-4200.

4:30 PM FEBRUARY 2, 2013 Submit completed nominations forms to the SrNA election 2013 by: email to [email protected] fax 1-306-359-0257 or by mail to 2066 retallack St, regina S4T 7X5

Election 2013 Call for

Nominations for SRNA

Council and Nomination

Committee

COUNCIL POSITIONS

2012 - 2013

Nominations Committee:

CELEBRATE REGISTERED NURSING EXCELLENCE IN SASKATCHEWAN

SRNA ANNUAL MEETING and CONFERENCE SPONSORSHIP OPPORTUNITIES

Gold $10,000 and over

Silver $5,000 - $9,999

Bronze $2,000 - $4,999

Refreshment Breaks $500 - $1,999

Contact: [email protected]

DEADLINE FOR

NOMINATIONS




http://www.srna.org




infoLAWEmergency Room Closures

In the face of scarce health human resources, amalgamation of health services andchanging demographics, some hospitals have been forced to close their emergencydepartments temporarily or permanently. Communications to this effect must be madewidely to the public by the hospital or health region. Consequently, a nurse encounteringan emergent patient during a closure would be by chance rather than by design.

Emergency room and outpatient department nurses may worry about their legalobligations during a closure. Given that a health institution can generally set theparameters for the administration of nursing care on its premises, nurses may feel dividedbetween their professional inclination to assist patients who present despite the closure,a belief that they are prohibited from doing so by the decision to close the emergencyroom, and the challenge of providing emergency assistance without the resourcesavailable when the department is open.

At present, Canadian courts have yet to address this specific situation. However, at leastone decision suggests that in a true emergency, where the life of a patient may be at risk,a court may not consider itself bound by internal organizational rules to determine if a dutyof care existed. In that case,1 a patient presented in the emergency department withsuspected myocardial infarction. The emergency physician on duty was otherwiseoccupied in the surgical suite. The court found that another physician who was workingin the hospital, but not on duty or on call in the emergency department, had a legal dutyto provide assistance to the patient when asked to do so by nursing staff. Similarly, acourt may find that a nurse who encounters an emergent patient during a closure has aduty to assist by acting within the scope of nursing legislation and regulation,2 by actingwithin her knowledge and skills, and by calling for help, if intervening in the above notedways would be of greater benefit to the patient than being redirected to the closestemergency service.

Risk Management Considerations in Planning for a ClosureA contingency plan formulated in advance of a closure would address any uncertaintyand likely lead to better patient outcomes. The plan should include a public componentto notify the population of the closure, and an internal plan to adequately inform staff ofthe closure and how to attend to the emergency patients that may present despite thenotification.

Communication to the publicThe hospital must take steps to communicate to the public and external emergencyservices (ambulance services, after care clinics, etc.) if it cannot offer emergencymedical care temporarily or permanently.3 Various methods of media could be used,including public broadcast and signage at strategic locations advising would-be patientsof the recommended course of action, such as going to the closest hospital withemergency services.

Does a nursehave a duty toa patient whopresents at aclosedemergencyroom?

Vol. 20, No. 3,July 2012

More thanl iabi l i ty

protect ion

Canadian NursesProtective Society

®


Communication between management and nursing staffGood communication with frontline staff will be key. Nurses affected by the closure should be given informationabout the timing of the closure, any diversions to other hospitals that have been arranged, what is expected ofnurses by their employer, and contact details for the most responsible administrator. This is particularly importantif an outpatient department entrance remains open for persons to access the building for reasons other thanemergent care. That fact alone may mean patients, or those accompanying them, arrive in the hope and expectationof emergency care despite posted information about the closure.

Patient ManagementIt is common and usual practice for doctors and nurses to work as a team in emergency care. Medical directives,verbal orders, regulations and policies empower nurses to act very quickly. As a result, nurses can act prior to aphysician assessment and written orders. In normal circumstances, medical assessments and orders will be madesoon after, during the same episode of care. In the altered circumstances of a closure, this will not occur since theunit will generally not be staffed with doctors and nurses.

A plan regarding patient management might identify approved practices to assist patients who seek urgent caredespite the closure. The plan may consist of nursing assessments, any legally authorized nursing practices(including First Aid, BCLS or ACLS for nurses with this extra certification), and assisting the patient or companionto obtain other emergency medical services. It would be based on the scope of nursing practice and would be incompliance with the hospital’s efforts to redirect such patients to a facility where their needs could be met. Suchintervention cannot and will not encompass all of what emergency and outpatient nurses are accustomed toproviding their patients in usual circumstances. It may also identify practices which are outside the scope of nursingpractice and should not be implemented in these altered circumstances, such as ordering tests or administeringunprescribed medications,4 which are usually implemented pursuant to an order, directive or protocol. If there aredirectives for nurses in place, by a physician or nurse practitioner orders, the health facility should decide if theyare suspended during a closure since there will not be a doctor or nurse practitioner to oversee the course ofpatient care.

Please contact CNPS at 1-800-267-3390 if you have questions regarding the professional implications ofemergency room closures and visit our website at www.cnps.ca.

N.B. In this document, the feminine pronoun includes the masculine and vice versa except where referring to a participant in alegal proceeding.

1. Egedebo v Windermere District Hospital Assn, 1991 CanLII 1921 (BCSC) (online: http://canlii.ca/t/1crqw).

2. For example, Ontario Regulation 275/94 (General) made pursuant to the Nursing Act, 1991, s15(4)2 and s15(5)authorizes Ontario RNs and NPs to start an i.v. of normal saline if they have the knowledge, skill and judgment toperform the appropriate assessment and procedure, when delaying its establishment would harm the patient.Section 15(4)2 reads as follows:

Venipuncture to establish peripheral intravenous access and maintain patency, using a solution ofnormal saline (0.9 per cent), in circumstances in which,

i. the individual requires medical attention, and

ii. delaying venipuncture is likely to be harmful to the individual.

3. Baynham v Robertson (1993), 18 CCLT (2d) 15 (Ont Gen Div).

4. An example of a medication a nurse might assist a person in taking is their own prescription nitroglycerin.

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

©Canadian Nurses Protective Societywww.cnps.ca 1.800.267.3390 [email protected]

Related infoLAWs of interest: Emergency Room Nursing, Negligence. Available at www.cnps.ca.

http://www.cnps.ca

http://canlii.ca/t/1crqw

http://www.cnps.ca

http://www.cnps.ca



Saskatchewan Archives board r-A15549-5

A Portrait of Saskatchewan Nurses in Military Times

Saskatchewan nurses have a long history of enlisting and serving in the military. In

1917, lacking equality and the right to vote, nurses formed a professional licensing body while working tirelessly to provide safe and competent care to the citizens of Saskatchewan. When the call came to enlist, many nurses volunteered for war and many more remained at home and took care of the individuals, families, and communities in Saskatchewan. The nursing profession, as we know it today, has evolved from the changes and decisions made by brave and innovative nurses of the past. A Portrait of Saskatchewan Nurses in Military Times is a historical book that focuses on the lives and experiences of many Saskatchewan nurses who served both at home and overseas during World Wars I and II. Authored by Dr. Sandra Bassendowski, with contributions from several nursing students from the Nursing Education Program of Saskatchewan (NEPS), this book delves into the past so that we may gain a different perspective of the nursing profession.

All proceeds from book sales go towards a bursary with the Saskatchewan Nurses Foundation.

Books can be purchased directly from Sandra Bassendowski at [email protected] or from the Saskatchewan Nurses Foundation. The book is $30 plus shipping fees.

Université d’Ottawa | Faculté des sciences de la santé

L’École des sciences infirmières de la Faculté des sciences de la santé de l’Université d’Ottawa souligne la contribution des infirmières et infirmiers au mieux-être de la population.

Joignez-vous à l’équipe!

Programmes d’études de 2e et 3e cycles :

Renseignements : www.sante.uOttawa.ca* À l’Université d’Ottawa, le Consortium national de formation en santé (CNFS) contribue à offrir un accès

accru à des programmes d’études dans le domaine de la santé, aux francophones issus des collectivités en situation minoritaire.

• M.Sc. (Sc.Inf.) / Diplôme en soins de santé primaire pour infirmières et infirmiers praticiens (Composantes majeures d’enseignement à distance)*

• M.Sc. (Sc.Inf.) / Spécialisation en études des femmes

• Diplôme en soins de santé primaires pour infirmières et infirmiers praticiens

• Ph.D. (Sc.Inf.)

• M.Sc. (Sc.Inf.) (Composantes majeures d’enseignement à distance)*


http://www.sante.uOttawa.ca


Florence Nightingale Medal – from the International Committee of the Red Cross

The Florence Nightingale medal will be awarded on May 12, 2013, to candidates who have shown exceptional courage and devotion to the wounded, sick or disabled or to civilian victims in crises. It will also be awarded in recognition of exemplary services or a creative and pioneering spirit in the areas of public health or nursing education.

Nomination forms can be found on our website www.srna.org and sent directly to the Canadian Red Cross to Isabelle Daoust ([email protected]) of the Canadian Red Cross (CRC) 170 Metcalfe Street, Suite 300, Ottawa, ON, K2P 2P2.

The deadline for nominations is March 1, 2013.

Helen K. Mussallem, 1914-2012Dr. Helen K. Mussallem, CNA Executive Director from 1963 to 1981 passed away on November 9, 2012, in Ottawa. She was one of the most compelling and influential figures in Canada’s nursing history, and is still Canada’s most decorated nurse.

Executive Training for Research Application (EXTRA) CNA is partnering with the Canadian Foundation for Healthcare Improvement to promote this program to RNs across the Canada. These 14-month fellowships support teams of health care executives in initiating and leading evidence-

informed improvements in their own organizations, or across jurisdictions involving multi-site teams and cross-boundary quality and performance improvement initiatives. Please contact Don Wildfong at [email protected] for more information.

Awarding of Diamond Jubilee medalsCNA is collaborating with all jurisdictional members to award thirty commemorative Queen’s Diamond Jubilee medals to exemplary RNs across the country. SRNA has received two medals to award to outstanding emerging and mid-career RNs. Thank you to everyone who nominated a worthy RN here in Saskatchewan. The medals will be awarded in 2013. Watch our website for more information.

Conference to Debut Nursing Leadership StreamCNA and its partner organizers have joined the National Health Leadership Conference (NHLC) to provide RNs their own leadership stream at the June 2013 conference in Niagara Falls, Ontario. For more information visit the CNA website www.cna-aiic.ca

New CNA Specialty Certification - Perianesthesia NursingWith the establishment of the first perianesthesia exam competencies this fall, the development of CNA’s 20th certification exam is underway. The first administration of the perianesthesia nursing certification exam is scheduled for 2014. www.cna-aiic.ca.

CNPSCNPS has updated their Social Media infoLaw, you can find it and other infoLaws on their website http://www.cnps.ca/index.php?page=191

Interested in Doing Some Work with the SRNA?We are seeking experienced RNs and RN(NP)s who are interested in consulting and projects for the SRNA. If you are interested in developing documents/guidelines/position statements and/or working with stakeholder focus groups, or assisting with/managing specific projects please send your resume including areas of interest and availability to Debbie Cummings at [email protected] .

If this sounds like something you may be interested in, please provide your resume.

We look forward to hearing from you.

World Health Organization – Primary Health CareThe ultimate goal of primary health care is better health for all. WHO has identified five key elements to achieving that goal: • reducing exclusion and social

disparities in health (universal coverage reforms);

• organizing health services around people’s needs and expectations (service delivery reforms);

• integrating health into all sectors (public policy reforms);

• pursuing collaborative models of policy dialogue (leadership reforms); and

• increasing stakeholder participation. For more information on World

Health Organization go to http://www.who.int/en/index.html.

Resources

Feel like you’re missing out on all the buzz? Please go online and update your contact information. www.srna.org

http://www.srna.org



http://www.cna-aiic.ca

http://www.cna-aiic.ca

http://www.cnps.ca/index.php?page=191


http://www.who.int/en/index.html

http://www.srna.org


http://nursing.ucalgary.ca/gradprogram


Reinvent yourself with SIAST

CE-12-085 - SRNA Newsbulletin - 4.95” x 7.25”- October 2012

Enhance your skills and knowledge through distance education.SIAST offers flexible learning opportunities for career advancement. The following courses are offered through distance education allowing you to maintain employment and family responsibilities while furthering your education.

Advanced Pathophysiology (PATH 1600)You will learn about the concepts of pathophysiology to support your clinical decision making for the diagnosis and treatment of acute and chronic conditions that commonly present in a primary care setting. You will study the mechanism(s) underlying various conditions to assist in understanding how and why the signs and symptoms of these conditions appear so that rational therapy can be devised. Your knowledge gained in this course will lay a foundation for the management of primary care issues for the family and its members.Start date(s): Jan 17 – May 18, 2013. Cost: $893

Cervical Screening for RNs (NURS 1671)You will learn to perform cervical screening according to the clinical practice guidelines in Saskatchewan. As a registered nurse participating in this interactive workshop, you should ideally be working in an environment where women’s health is a regular part of your role. Start date(s): Mar 15, 2013 Cost: $250

Clinical Drug Therapy (PHAR 271)New research and clinical experience result in ongoing changes in the drug therapy field. As an experienced health care provider, you will review essential information that reflects current clinical drug therapy by examining the common classification of drugs. The course content includes strategies to promote safe, effective and rational drug therapy and non-pharmacological approaches while considering the client’s individual characteristics.Start date(s): Mar 25 – June 21, 2013. Cost: $520

Health Assessment (NURS 225)You will study the theory related to interviewing techniques, history taking and a head-to-toe physical assessment. You will have the opportunity to attend a two-day lab where you will focus on performing a comprehensive assessment of the adult client. Attendance at the lab is not required. However, an evaluation of the assessment skills will be scheduled with an experienced instructor/evaluator at a site close to you.Start date(s): Jan 7 – Apr 5, 2013. Regina lab date(s): Mar 23 and Mar 24, 2013 Cost: $750

Register now. Call SIAST Wascana Campus Registration Services at 1-866-467-4278.

www.goSIAST.com/CE

Transforming Health Care Together

Stakeholder Breakfast

on November 21, 2012 the Saskatchewan union of Nurses hosted a stakeholder breakfast in regina. Keynote speaker marlene Smadu, rN, edD, Vice-President of Quality and Transformation, regina Qu’Appelle Health region, in regina spoke about the National expert Commission: A Nursing Call to Action. marlene Smadu, rN talked about the Commission’s Nine-point Plan of Action and encouraged rNs to read the report and access the online resources. minister Duncan addressed those in attendance.

In may 2011 the Canadian Nurses Association (CNA) launched its independent National expert Commission – the first of its kind to be spearheaded by rNs, Canada’s largest group of health-care professionals- to engage Canadians in transforming our country’s health-care system. led by maureen mcTeer and marlene Smadu, rN, the Commission engaged and consulted rNs and other health-care providers, the Canadian public of all ages, educators, policy and decision-makers, while spanning provinces and territories to learn their views on the most pressing health care issues and to discover possible solutions.

In June 2012, the Commission presented a Nursing Call to Action, its final report to Canadians, the rN community and CNA leaders. Aiming to achieve better health, better care and better value, the report sets out a number of recommendations to drive Canada through a fundamental shift in the way health and health care is funded, managed and delivered.

more resources are available online at: http://www.cna-aiic.ca/expertcommission/commission-progress/report-and-recommendations/

The SrNA Newsbulletin reaches all Saskatchewan registered Nurses, as well as a variety of other health professionals and stakeholders.

The newsbulletin is published quarterly and distributed via mail, and through the SrNA web site, where the issues remain in full, page-turnable magazine format, including the possibility of live web links.

This represents an excellent and ongoing value for advertisers. A revised rate card is available on the SrNA web site, or by contacting Avonlea Communications.

To book your advertising space, please contact:SRNA Newsbulletin Advertisingc/o Avonlea CommunicationsTelephone: 306-584-2159Email: [email protected]

Make Your Pitch!Advertise in

the SRNA

Newsbulletin

http://www.goSIAST.com/CE

http://www.cna-aiic.ca/expertcommission/commission-progress/report-and-recommendations/



Prince Albert Parkland Health Region The Prince Albert Parkland Health Region offers excellent opportunities for fulfilling careers while providing an exceptional

quality of life. Nursing career opportunities in:

Acute Care Home Care Public Health Community Health

Mental Health Rural Long-term Care

For detailed career opportunities and bursary incentives visit:

www.princealbertparkland.com

Applicants are invited to submit their resumes to: [email protected] or contact Human Resources

Phone: (306) 765-6481 Fax: (306) 765-6446

Human Resources Department

Prince Albert Parkland Health Region

Third Floor—1521 6th Ave. West Prince Albert, SK S6V 5K1

Healthy Living in Healthy Communities

Live Work

Play

Staying Resilient in the Face of Change

Jan 21, 2013 Regina

Jan 28, 2013 Saskatoon

Feb 4, 2013 Swift Current

Feb 25, 2013 Yorkton

One-day workshop with Greg Wensel of

CoachingConfidential Inc.

http://www.srna.org/images/stories/pdfs/

communications/pdf/resilience_post-

er_2012_11_13.pdf

MARCH

7 & 8Nursing Leadership Conference, Saskatoon, SK http://www.usask.ca/nursing/cedn/calendar.php

APRIL

10 & 11Inspire Health Care Quality Care Summit, Regina, SK http://us1.campaign-archive1.com/?u=b1e925d701ca2b0b84d7fd27b&id=af011c93ab&e=rWJ8C7rreo

April 30-May 2SRNA Annual General Meeting & Conference, Saskatoon, SKhttp://www.srna.org/srna-annual-meetingconference

MAY

6-10Nursing Foot Care Management Course, Edmonton, ABDeadline is March 29, 2013 http://www.devonfootcare.com/education.html

Upcoming Events 2013

SRNA Directory

Phone: (306) 359-4200/

Toll-free: 1-800-667-9945

Fax: (306) 359-0257


Website: www.srna.org

Internationally Educated Nurses [email protected]

RN Registration [email protected]

Renew RN Registration [email protected]

Nursing Examinations [email protected]

Competence Assurance/

discipline/Investigations [email protected]

Member Links [email protected]

SRNA Newsbulletin [email protected]

Executive director [email protected]

General Enquiries [email protected]

Nursing Practice [email protected]

http://www.usask.ca/nursing/cedn/calendar.php

http://us1.campaign-archive1.com/?u=b1e925d701ca2b0b84d7fd27b&id=af011c93ab&e=rWJ8C7rreo

http://www.srna.org/srna-annual-meetingconference

http://www.devonfootcare.com/education.html

http://www.princealbertparkland.com


http://www.srna.org/images/stories/pdfs/communications/pdf/resilience_post-er_2012_11_13.pdf


http://www.srna.org












Advice to make your dreams a realityCome see how we can help

reTurN uNDelIVerAble mAIl To: Saskatchewan registered Nurses’ Assoc. 2066 retallack St. regina, SK S4T 7X5

Publication Agreement #40005137

Technology & Communication Innovation Challenge Have you embraced technology to advance quality care in

your nursing practice (i.e. assessment, care plan, implementation, evaluation)?

To enter the Contest, email your submission and all required elements of the submission to

[email protected]. What we need in your response is:

• thenameoftheRN/RN(NP)ornursingstudentwhocontributedtothesubmission

where you work or study, and

•atitlethatclearlydescribesyoursubmissionandyoursubmissionofnomorethan

250 words – that summarizes need, audience, goals and the technology

& communications solution

You may also create additional supports for your entry, which can be submitted in the

form of a video, audio recording, blog entry or other means of communication.

The following criteria will be used by the panel of external judges in reaching their

decisions – need, audience, goals, solution and evidence –based. There will be three

prizes awarded.

Winners will be featured onscreen at the annual award

ceremony, in the Spring Newsbulletin and on the SrNA website.

We look forward to hearing from you.

Deadline for

Submissions, April 2


SRNA NewsBulletin Winter 2013

Documents

Transcript of SRNA NewsBulletin Winter 2013