April 2011 - College and Association of Registered Nurses of Alberta
Transcription
April 2011 - College and Association of Registered Nurses of Alberta
M A R C H / A P R I L 2 011 V O L U M E 67 N O 2 Review of policy and practice consultations PAGE 17 2011 CARNA Awards Recipients Announced PAGE 6 InfoLAW Bulletin on SOCIAL MEDIA PAGE 13 www.nurses.ab.ca CARNA Provincial Council PRESIDENT Joan Petruk, RN, MHS Camrose 780.909.7058 [email protected] CENTRAL REGION Lisa A. Barrett, RN, MN Ponoka 403.350.8218 [email protected] Andrea Miller, RN, BN Camrose 780.781.8472 [email protected] P R E S I D E N T- E L E C T Dianne Dyer, RN, BN, MN Calgary 403.943.3602 [email protected] NORTHWEST REGION Jerry Macdonald, RN, BScN Grande Prairie 780.978.1348 [email protected] NORTHEAST REGION Debra Ransom, RN, BN Lac La Biche 780.623.2473 [email protected] EDMONTON/WEST REGION Scott Fielding, RN, BsN, MBA Edmonton 780.432.8543 [email protected] Joann Nolte, RN, BScN Edmonton 780.439.5731 [email protected] Marg Spilchen, RN Edmonton 780.633.7591 [email protected] PUBLIC R E P R E S E N T AT I V E S Murray Donaghy Airdrie 403.912.3242 [email protected] Margaret Hunziker, BA, MA Cochrane 403.932.2069 [email protected] Mark Tims, QC Westlock 780.349.5366 [email protected] Rene Weber, DVM Red Deer 403.346.5956 [email protected] Mark L. Zivot, DPM, FACFAS, CALGARY/WEST REGION Kevin Champagne, RN, BN Calgary 403.670.9960 [email protected] Sandra Cook Wright, RN, BN Calgary 403.256.8044 [email protected] Kerry Hubbauer, RN, BN Calgary 1.877.859.5054 [email protected] FACFAOM Calgary 403.259.4626 [email protected] SOUTH REGION Leslie McCoy, RN, BN, MN Lethbridge 403.388.6263 [email protected] 16 20 22 26 Volunteer Opportunities 2011 CARNA Awards Recipients Honour a Nurse in a Special Way Celebrate National Nursing Week Publications Ordered by Hearing Tribunals Update on Continuing Competence Program Revisions Review of Policy and Practice Consultations MyCARNA: Your 24/7 One-stop Destination for Managing Your Personal Information and So Much More Meet your Regional Coordinators The Official Memory of Registered Nursing in Alberta In Memoriam Notice Board/Reunions CEO’s Message: Healthy Aging Should Drive Health-care Reform Alberta RN is published six times a year by: College and Association of Registered Nurses of Alberta 11620-168 Street Edmonton, AB T5M 4A6 Phone: 780.451.0043 Toll free in Canada: 1.800.252.9392 Fax: 780.452.3276 www.nurses.ab.ca ALL STAFF CAN BE REACHED BY CALLING: 780.451.0043 or toll free 1.800.252.9392 Chief Executive Officer: Mary-Anne Robinson Complaints Director/Director, Conduct: Sue Chandler Director of Communications and Government Affairs: Margaret Ward-Jack Managing Editor: Margaret Ward-Jack Editor: Rachel Champagne Assistant Editor: Rose Mary Phillip Designer: Julie Wons Director of Corporate Services: Jeanette Machtemes Director of Policy and Practice: Lynn Redfern Registrar/Director, Registration Services: Cathy Giblin Deputy Registrars: Jean Farrar, Terry Gushuliak, Rosie Thornton, Barbara Waters Registration Consultants: Nan Horne, Nancy MacPherson, Loreta Suyat Conduct Counsel: Gwendolyn Parsons Conduct Counsel/Senior Investigator: Jane Corns Please note CARNA does not endorse advertised services, products or opinions. Policy and Practice Consultants: Debra Allen, Marie-Andrée Chassé, Donna Hogg, Debbie Phillipchuk NEPAB Consultants: Lori Kashuba, Margareth Mauro Librarian and Archivist: Lorraine Mychajlunow Alberta Registered Nurses Educational Trust: Margaret Nolan Northwest: Karen McKay Northeast: Barb Diepold 780.826.5383 Edmonton/West: Penny Davis Leeca Sonnema 780.484.7668 780.457.8361 Central: Heather Wasylenki 403.782.2024 Calgary/West: Christine Davies Beverlie Johnson 403.500.9943 403.625.3260 South: Pat Shackleford Valerie Mutschler 403.394.0125 403.504.5603 Alberta RN March/April 2011 Volume 67 No 2 Advertising Representative: Jan Henry, McCrone Publications Phone: 800.727.0782 Fax: 866.413.9328 [email protected] Competence Consultants: Michelle Morrison, Barb Perry 2 5 6 8 9 10 15 27 32 46 CARNA Staff Directory Regional Coordinators: C O N T E N T S 780.830.7850 www.nurses.ab.ca US Postmaster: Alberta RN (USPS #009-624) is published six times per year in February, April, May, July, October and December by the College and Association of Registered Nurses of Alberta. c/o U.S. Agent: Transborder Mail, 4708 Caldwell Rd E, Edgewood, WA 983729221. Alberta RN is published at a rate of $42 per year. Periodicals postage paid at Puyallup, WA and at additional mailing offices. US Postmaster: Send address changes (covers only) to Alberta RN, c/o Transborder Mail, PO Box 6016, Federal Way, WA 98063-6016. ISSN 1481-9988 Canadian Publications Mail Agreement No. 40062713 Return Undeliverable Canadian Addresses to: Circulation Dept., 11620-168 Street, Edmonton, AB T5M 4A6. [email protected] PLACE FSC LOGO HERE update President’s Update Highlighting the Association Side This spring, the Canadian Medical Association (CMA), in partnership with Maclean’s magazine, is holding a series of town hall meetings as part of a campaign called “Healthcare Transformation in Canada.” The campaign is intended to foster dialogue regarding the future of our health-care system. On March 29, a town hall was held in Edmonton and a number of registered nurses attended. Three questions provided the focus for the meeting: whether the Canada Health Act should be broadened to include things like national pharmacare and long-term care; what constitutes receiving good value for money spent in health care; and what a patient’s responsibilities for their own health care are and should be in future. CARNA promoted the meeting in its March electronic newsletter and posted information which could help members develop comments for the meeting. I don’t think that there can be any doubt that The Canada Health Act has served us well, providing essential health-care services that are part of a cost-efficient, reasonably equitable, single-payer system. Yet much has changed since the Canada Health Act was passed in the 1980s. Today, hospital stays are shorter, new technologies have changed the way medical conditions are treated and care is increasingly delivered in the community by interdisciplinary care teams. At this time, the act addresses the issue of treating illness but not promoting health. We need a health system which places equal value on health promotion and treatment of chronic illness in community and primary care settings. For that reason, CARNA supports broadening the Canada Health Act to include services delivered outside of hospitals by health providers other than doctors. Effective treatment of chronic disease by interdisciplinary primary care teams in the community would help people avoid expensive care in hospitals. Besides, broadening the Canada Health Act is consistent with Canadian support for the publicly-funded health system. In poll after poll, Canadians consistently choose not-for-profit solutions to our health-care system. It can be challenging to sift out the facts when it comes to health-care spending though. For instance, research shows that, over the last 35 years, medicare costs have remained stable at four to five per cent of Canada’s GDP (gross domestic product). Many governments, including Alberta’s, have implemented tax regimes which reduce the amount of revenue available. At the same time, government expenditure has been decreasing which makes health-care spending look higher because it has been cut less than other program areas. It is also important to remember that 30 per cent of all Canadian health spending is in the private sector including prescription drugs and private prescription drug insurance, dental care and private dental insurance. In fact, the increase in health-care costs is being driven by the private sector, particularly prescription drugs. Between 1985 and 2007, Canadian drug prices rose an average of 9.2%, far faster than in any other Organization for Economic Co-operation and Development (OECD) country. CARNA’s support for members with respect to CARNA supports broadening the CMA town hall is one the Canada Health Act to example of our activity as include services delivered an association. Provincial outside of hospitals by health council is continuing to providers other than doctors. consider new ways to engage Effective treatment of chronic and involve members in advocacy for healthy public disease by interdisciplinary policy in the best interest primary care teams in of Albertans. the community would help This issue of Alberta RN people avoid expensive care in provides an overview of hospitals. Besides, broadening other areas that support our the Canada Health Act is dual mandate. Members can contact CARNA’s nursing consistent with Canadian support for the publicly-funded practice consultants for confidential individual health system. In poll after or group consultations on poll, Canadians consistently any professional practice choose not-for-profit solutions concern. The regional to our health-care system. coordinators offer a two-way information flow, providing information about CARNA and professional topics as well as collecting your feedback. The CARNA library has a wide range of resources that CARNA members can access. We also maintain an archives to preserve the history of nursing in Alberta. Your membership in CARNA also provides you with liability coverage through the Canadian Nursing Protective Society, and the work of the Canadian Nurses Association is supported, in part, by your CARNA registration renewal fee. I hope you will take a moment to learn more about these services and more. RN J o a n P e t r u k , RN, MHS E-mail: [email protected] Phone: 780.909.7058 www.nurses.ab.ca March/April 2011 Volume 67 No 2 Alberta RN 3 Toward a national report card for nursing February, over 50 nurse leaders from across Canada participated in a collaborative forum hosted by the Canadian Nurses Association, the Academy of Canadian Executive Nurses (ACEN), and supported by Health Canada’s Office of Nursing Policy and Canada Health Infoway. The purpose of the forum was to create a shared vision for a national report card on nursing. The report card is intended to more clearly document the link between nursing and patient outcomes. Consumers, employers and legislators are increasingly demanding objective measures of health-care quality which has led to the development of report cards. The nursing report card is envisioned as a selected minimum set of data on input, process and output indicators that can be collected nationally (initially using pilot sites) and benchmarked. Classification systems, such as the Nursing Interventions Classification (NIC) system, will inform the development of nursing minimum data sets by providing IN language for classifying the concepts/ phenomena of interest. Reliable and valid nursing sensitive indicators and outcomes have been identified for both safety and quality outcomes for patients. In preparation of the forum, a knowledge synthesis paper titled Toward a National Report Card for Nursing was commissioned. The paper summarizes what is known about outcomes/performance monitoring initiatives in nursing, including specific indicators and reporting systems, and what is known about the development, implementation and use of nursing report cards. Alberta RN Dr. Kathryn Hannah was a member of the forum planning committee. She reviewed and provided feedback on the paper that was used to enable and advance dialogue and decision-making. To read the Toward a National Report Card knowledge synthesis, go to www.nurses.ab.ca and click on Health Policy Issues under the News tab. CARNA no longer accepting personal cheques As of June 1, 2011, CARNA will no longer accept personal cheques for payment of registration fees or other services. The number of members who pay by cheque has steadily declined since the introduction of online renewal 10 years ago. Last year, less than six per cent of fees were submitted by cheque. We will continue to accept payment: through your bank’s telephone or online banking service Interac online money transfer Visa, MasterCard or American Express money order cash (in person at the CARNA office) If you have any questions, please contact CARNA at 780.451.0043/1.800.252.9392 or via email at [email protected]. Timely data, quality care… Verify the information in your member profile Data is an asset for any organization and for any profession. At CARNA, the information on our database affects decisions about the health-care system and that’s a responsibility we take to heart. We hope you will too. Some member records are incomplete or inaccurate and we encourage you to take the time to check yours. CHECK THE FOLLOWING: Is your mailing address correct? The mailing address listed in your MyCARNA profile is used to mail Alberta RN, the Canadian Nurses Association magazine Canadian Nurse and to mail other documents not suited to online communication. If you move or make a change, you only need to submit your changes in one place: updating your address on MyCARNA will update your record for all CARNA and CNA related communication. Is your employer information accurate and complete? Check the information listed for the following: • name of employer • work setting • area of responsibility • position title • average working hours 4 Alberta RN March/April 2011 Volume 67 No 2 www.nurses.ab.ca Regulated practicing members are required under section 33 of the Registered Nurses Profession Regulation to provide the names and addresses of all employers or agencies where the member provides professional nursing services. While CARNA is committed to protecting the privacy of your information, this information in aggregate is critical to help provide timely, accurate and comparable information to inform health policies, support the delivery of health services and raise awareness among Albertans and Canadians about the factors that contribute to a healthy nursing workforce. We also support those who use data for health and healthservices research, health professionals and health-records staff who are involved in the collection of data, and academics who help educate our future registered nurses. Login to www.nurses.ab.ca/MyCARNA to verify that your information is included and up-to-date. VOLUNTEER OPPORTUNITIES Nursing Education Program Approval Board One member needed to complete a current term of office that expires July 31, 2012 Members of the Nursing Education Program Approval Board (NEPAB) are appointed by CARNA Provincial Council. The board is comprised of registered nurses, nursing educators, employers and members of the general public. NEPAB reviews and approves nursing education programs in Alberta leading to initial entry-to-practice as a registered nurse. The authority to approve education programs leading to initial entry-to-practice as a nurse practitioner was also recently delegated to NEPAB. Work to develop the requirements and processes for nurse practitioner education program approval is underway. Qualifications • experienced nurses involved in direct nursing practice as a front-line nurse manager, clinical specialist, advanced practice or preceptor for nursing students • not currently serving as a member of another CARNA regulatory committee Expectations • complete the remaining term of office that expires July 31, 2012 • attend quarterly meetings held for two-to-three days • commit to preparatory time for meetings • adhere to the code of ethical conduct and maintain confidentiality • participate in the reviews of and render decisions about nursing education programs • make decisions in the best interest of the public, nursing education and the registered nursing profession Questions If you have questions about the work of the board or the expectations of members, please contact: Lori Kashuba, NEPAB Consultant 780.451.0043/1.800.252.9392, ext. 425 [email protected] Margareth Mauro, NEPAB Consultant 780.451.0043/1.800.252.9392, ext. 359 [email protected] Election Tellers Election Two members needed CARNA is seeking an election teller and an alternate teller for the 2011 Provincial Council election. The teller: • is required to be present during the ballot count at the CARNA office in Edmonton on July 11, 2011 for approximately two hours • will determine the admissibility of all questionable ballots in accordance with election rules • will prepare teller reports for the CARNA president and chair of the Elections and Resolutions Committee The alternate teller will serve as teller if the teller is unable to fulfill their duties. CARNA reimburses travel expenses and offers a salary replacement/ per diem to compensate for time away from work for the teller. 2011 Qualifications • RN or NP member of CARNA • not a candidate seeking election to Provincial Council Questions? If you have questions about the role of the teller, please contact: Sandra Cook Wright Chair, Elections and Resolutions Committee 403.256.8044 [email protected]. How to apply: Download an application at www.nurses.ab.ca (click on Volunteer Opportunities under the Member Info tab) or contact: Diane Wozniak 780.453.0525/1.800.252.9392, ext. 525 [email protected]. How to apply Download an application at www.nurses.ab.ca (click on Volunteer Opportunities under the Member Info tab) or contact: Ruby Sutton 780.451.0043/1.800.252.9392, ext. 522 [email protected] APPLICATION DEADLINE: APRIL 18, 2011 APPLICATION DEADLINE: MAY 13, 2011 www.nurses.ab.ca March/April 2011 Volume 67 No 2 Alberta RN 5 Excellence deserves recognition 12TH ANNUAL CARNA AWARDS of NURSING EXCELLENCE Congratulations to the recipients of the 2011 CARNA Awards of Nursing Excellence NURSING EXCELLENCE IN CLINICAL PRACTICE NURSING EXCELLENCE IN RESEARCH LIFETIME ACHIEVEMENT COMMITTEE’S CHOICE Donna Stelmachovich Ruth Aronetz Cossever Susan Horsman Dr. Nancy Jean Moules Cross Cancer Institute University of Calgary Alberta Health Services – Seniors Health Boyle McCauley Health Centre NURSING EXCELLENCE IN EDUCATION NURSING EXCELLENCE IN ADMINISTRATION RISING STAR PARTNER IN HEALTH Lisa Chau Dr. Barrie Strafford Jacalynne Glover Sherry LaRose Lethbridge College NOVA Chemicals Alberta Health Services – Public Health The Brenda Strafford Foundation Recipients were selected from almost 50 nominations submitted by their RN colleagues. All nominees will be acknowledged by name at the CARNA Awards Gala and listed in the gala program. Celebrate nursing excellence at the CARNA Awards Gala Dinner 12 th Join us as we honour recipients and nominees of the Annual CARNA Awards and celebrate the profession at this gala event. June 9, 2011 Hyatt Regency Hotel Calgary Champagne reception at 6 p.m. followed by dinner at 7p.m. This premiere gala event for registered nursing will also recognize several RNs for their educational achievements with ARNET’s most prestigious scholarships, including the TD Meloche Monnex scholarship. One ticket to the gala is included with registration to the Annual CARNA Conference. Visit www.carnaconference.ca for more details. 6 Alberta RN March/April 2011 Volume 67 No 2 www.nurses.ab.ca SUPPORTED BY HARNESSING THE POWER, PASSION and PRIDE OF NURSING 2011 C ARNA CONFERENCE A N D AG M Join your nursing colleagues from across Alberta for the one and only provincial conference for RNs and NPs in all roles and at all levels of experience. This uplifting program will give you a fresh perspective on your future and the future of the profession. June 9 –10, 2011 Annual General Meeting Hyatt Regency Hotel All CARNA members are encouraged to attend the annual general meeting Calgary on June 9, 2011 at the Hyatt Regency Hotel in Calgary. Pre-registration is required if you are not registered for the CARNA conference. There is no fee to attend. Members who are not registered for the conference are welcome to join us for lunch with guest speaker Dr. Ann Tourangeau from 11:30 AM –1:15 PM. The formal proceedings of the annual general meeting will begin immediately following Dr. Tourangeau's presentation, “Choices and Tradeoffs: Nurse Staffing and Hospital Mortality Rates.” Pre-register online at www.carnaconference.ca. Need accommodation? A special room rate of $259 per night is available for conference delegates at the Hyatt Regency Hotel in Calgary. To guarantee this rate, book before May 9, 2011. To book, go to www.carnaconference.ca and click on the Location tab or call the hotel direct at 1.800.633.7313. Quote conference code “Registered Nurses of Alberta.” Register at www.carna conference.ca / 780.419.6070 www.nurses.ab.ca March/April 2011 Volume 67 No 2 Alberta RN 7 Follow us on Facebook! Honour a nurse in a special way For over 25 years, the Alberta Registered Nurses Educational Trust (ARNET) has provided the opportunity for nurses and the community to recognize and thank RNs and NPs who mentor, inspire and play a valuable role in the lives of colleagues and the public. Whether it is during Nursing Week, the holidays, at a retirement tribute or anytime you want to say thank you, ARNET’s Notes for Nursing donation program lets you honour a nurse in a very special way. For a minimum donation of just $20, ARNET will send a card to your chosen nurse advising them of your appreciation for the priceless role that they have played in your life and career. You’ll receive a charitable tax receipt and each of you will share in the knowledge that you are supporting continuing nursing education in Alberta and creating healthier families and communities. Barbara’s true story about the impact of Notes for Nursing Barbara, an RN and mother, was in the hospital with her daughter as her first grandchild was being born. She noticed how the RNs went above and beyond the call of duty to care and advocate for her daughter and tiny granddaughter. After such an incredible experience, Barbara sought a meaningful way to show her appreciation and thanks. Here’s what Barbara had to say about the card ARNET sent on her behalf: “The cards that were sent to the registered nurses at the hospital brought me to tears. The words captured the support and care my daughter received and expressed so eloquently how much I appreciated them and all that they did. It was wrapped up like a present and that made it feel really special.” To order a Notes for Nursing card, go to www.nurses.ab.ca/ARNET and click on Honour a Nurse. ARNET in action 2010 was an incredibly active year for our charity. With your support and investment in nursing education, ARNET was able to distribute over $750,000 to Alberta RNs and NPs in the past year alone! Your contributions have supported: Over 1,000 RNs and NPs with their educational pursuits: From High Level to High River… from Lake Louise to Lloydminster… and everywhere in between. 164 RNs with their specialty nursing certification studies: Specialty nursing certification ensures that Alberta’s RNs and NPs continue to have a contemporary compliment of skills to support their nursing practice. Distribution of over $135,000 in event registration fees: Nursing conferences and educational workshops provide the opportunity for nurses to keep current on new technologies, drugs, techniques, procedures and equipment. Degree level studies for over 250 RNs and NPs: ARNET is committed to growing Alberta’s nursing future by supporting degree level funding for studies at the post-RN, master’s and doctoral levels of study. On behalf of Alberta RNs and NPs, thank you for your support. For more information about ARNET, please visit us on Facebook or at www.nurses.ab.ca/ARNET or contact us at 1.800.252.9392, ext. 523. Alberta RNs and NPs are now eligible for enhanced educational support through ARNET’s professional development funding. This time-limited funding is the result of recent negotiations with Alberta Health and Wellness and supplements the current educational support our charity provides. Go to www.nurses.ab.ca/ARNET to download an application form for more information. 8 Alberta RN March/April 2011 Volume 67 No 2 www.nurses.ab.ca Expert caring makes a difference. Celebrate National Nursing Week May 9–15, 2011 Show us your RN pride Between now and May 1, 2011, go to www.nurses.ab.ca and upload a short video of yourself telling us why you’re proud to be an RN. To see sample videos, go to www.nurses.ab.ca and click on the Show us Your RN Pride link. Start your video with “I’m [say your first name ] and I’m a registered nurse in Alberta” and then finish by answering one or all of the following statements: • “I became an RN because… ” • “The best/most rewarding part of/My favourite thing about being a nurse is… ” • “I feel best when… ” End your video with “I’m [say your first name ] and I’m proud to be a registered nurse.” Web cam and cellphone video are welcome. Videos will be posted on www.expertcaring.ca during Nursing Week and will serve as a testament to the RN profession and the caring individuals within it. Nurses impact the health and life of communities in every imaginable situation, providing solutions and touching the human heart. National Nursing Week provides an opportunity to celebrate the nursing profession. It also gives the public an opportunity to understand and appreciate the contributions nurses make to people’s health and well-being. This Nursing Week, CARNA will continue to reach out to government, media and the public to increase understanding of the diversity of RN/NP roles in the health system and provide information about the importance of RNs/NPs in the delivery of safe, quality care. CARNA encourages members to continue the tradition of celebrating each other’s accomplishments during Nursing Week. Celebrate Nursing Week in your Facebook status, tweet about it and include it in your blog posts. More celebration ideas and materials are available on the Canadian Nurses Association website at www.cna-aiic.ca. www.nurses.ab.ca Nursing Week Events Go to the Events section of www.nurses.ab.ca for an up-to-date list of Nursing Week events in your area. CALGARY Calgary/West Nurses’ Dinner May 9, 2011 CONTACT: Chris Davies, 403.500.9943, [email protected], Sarah Kopjar, 403.282.4095. RED DEER Celebrate Registered Nurses: Past, Present and Future May 10, 2011 CONTACT: Heather Wasylenki, 403.782.2024 or [email protected]. GRANDE PRAIRIE Nurses Week Dinner and Comedy Show May 13, 2011 CONTACT: Karen McKay, [email protected], Casandra Jordan, [email protected], Bonnie Kennedy, bonnie.kennedy2@ albertahealthservices.ca. March/April 2011 Volume 67 No 2 Alberta RN 9 P ublications ordered by Hearing Tribunals Publications are submitted to Alberta RN by the Hearing Tribunal as a brief description to members and the public of members’ unprofessional behaviour and the sanctions ordered by the Hearing Tribunal. Publication is not intended to provide comprehensive information of the complaint, findings of an investigation or information presented at the hearing. CARNA Member A Hearing Tribunal made a finding of unprofessional conduct against a member who failed to ensure her practice permit was renewed with the result that she practised in the position of an RN for five and a half months without a practice permit. The Tribunal issued a reprimand and ordered the member to write a paper on accountability and RN licensure; pass the course in responsible nursing and pay a fine of $1,000 by a deadline. Conditions shall appear on the member’s practice permit. Failure to comply with the order may result in suspension of CARNA practice permit. CARNA Member A Hearing Tribunal made a finding of unprofessional conduct against a member who, despite advice from RN co-workers to not do so, proceeded to start an IV and administer a bolus of saline to his bed manager at her request, without a physician’s order. The member received a caution. CARNA Member Registration number: 28,004 A Hearing Tribunal made a finding of unprofessional conduct against member #28,004 who failed to respond appropriately when told by an LPN that a patient was in pain and required more pain medication when she indicated to the LPN that the patient had to wait; failed to come and assess the patient at that time; failed to phone the physician for further analgesic orders until directed to do so by another RN; and left for a meeting instead of attending to the patient; and who made chart entries without indicating they were late entries and then incorrectly deleted some by obliterating the writing so that it was unreadable. The Tribunal issued a reprimand, ordered courses in responsible nursing and charting and ordered the member to write a paper titled “Ensuring Ethical Standards in my Registered Nursing Practice” by a deadline. Conditions shall appear on the member’s practice permit. Failure to comply with the order may result in suspension of CARNA practice permit. CARNA Member Registration number: 47,635 A Hearing Tribunal made a finding of unprofessional conduct against member #47,635 who administered insulin to a patient in error; did not report the insulin error to the physician or co-workers; and did not report the insulin error until the next day; and when a co-worker checked a heparin dose drawn up by this member for administration to a patient, it was discovered that there was only air in the syringe. The Tribunal issued a reprimand, directed the member to take a course/courses in Responsible Nursing from MacEwan University and the Teleconference for Gerontology offered by her employer by a deadline and ordered the member to provide a performance evaluation from her current employer by a deadline. 10 Alberta RN March/April 2011 Volume 67 No 2 www.nurses.ab.ca Conditions shall appear on the member’s practice permit. Failure to comply with the order may result in suspension of CARNA practice permit. CARNA Member Registration number: 55,001 A Hearing Tribunal made a finding of unprofessional conduct against member #55,001 who on one shift made several inappropriate sexual comments to a female colleague. The Tribunal took into account discipline already imposed by the employer of a one-month unpaid suspension and ordered a reprimand; and ordered the member to write a paper by a deadline titled “Reflections on How to Interact in a Respectful Professional Manner with Female Colleagues.” A condition shall appear on the member’s practice permit. Failure to comply with the order may result in suspension of CARNA practice permit. CARNA Member Registration number: 55,222 A Hearing Tribunal made a finding of unprofessional conduct against member #55,222 who removed a foreign body from the foot of a patient with diabetes mellitus; documented inaccurately; and provided syringes, pre-filled with saline to a patient without teaching or determining the reason for the patient’s request for the syringes. The member has since retired from nursing. The member gave a promise not to apply for a practice permit until she provides proof that she has passed courses in charting and clinical nursing skills. A condition shall appear on the member’s practice permit. CARNA Member Registration number: 57,331 A Hearing Tribunal made a finding of unprofessional conduct against member #57,331 who despite being previously warned by her employer about inappropriate behaviour, handled a crying 16-month-old baby inappropriately when she changed her diaper in a very rough manner and yelled at her. The Tribunal issued a reprimand and suspended the member for 10 days. The member was ordered to undergo counselling; write a communication improvement plan and a frustration/anger management plan; provide a performance evaluation from her employer; is restricted to working at her current employment setting; and was assessed costs for three days of hearing in the amount of $19,102. Conditions shall appear on the member’s practice permit. CARNA Member Registration number: 71,248 A Hearing Tribunal made a finding of unprofessional conduct against member #71,248, who on one night shift had to be sent home due to inappropriate behaviours, failed to follow the employer’s policy on narcotic wastage, and made a narcotic medication error. The Tribunal made a second finding of unprofessional conduct as a result of a section 70 admission from the member who admitted that for several years she had been pilfering medications including injectable morphine, dilaudid, oxycodone and midazolam from employers; and who on numerous occasions attended at work when her ability to practice as an RN was impaired by drugs. The Tribunal gave the member a reprimand and accepted an undertaking to not practise as a registered nurse pending proof from a physician and counsellor that she is safe to return to practise at which time, the member has a choice to return to either a practice setting where there is no access to narcotics or controlled substances, or do a supervised practice in a setting where the member is expected to administer medications, including narcotics and controlled substances. In either setting, the member’s employer will report back to a Hearing Tribunal. The member is required to continue drug screening and provide further medical reports to a Hearing Tribunal. Conditions shall appear on the member’s practice permit. Failure to comply with the order may result in suspension of CARNA practice permit. a letter from her RN supervisor. This was the second hearing for this member involving unethical, dishonest behaviour. The Tribunal issued a reprimand and suspended the member for a minimum of two years. Prior to returning to nursing to apply for supervised practice, she must pay the fine due under the previous order; pay an additional $3,000 fine; prove that she has passed a course in ethics and provide comprehensive medical letters from her physician and a forensic psychologist confirming her fitness to practise. Thereafter, the member may apply to do 960 hours of supervised practice. For a period of five years following supervised practice she must advise CARNA of all employment sites and provide an annual performance evaluation which comments specifically on her honesty and ethics. In addition, she must provide further reports from her physician and treating psychologist. The member was ordered to pay 50 per cent of the actual costs of the hearing prior to commencing supervised practice. Conditions shall appear on the member’s practice permit. Failure to comply with the order may result in further suspension of the CARNA practice permit. CARNA Member Registration number: A Hearing Tribunal made a finding of unprofessional conduct against member #86,087, who over approximately a two-month period stole over 50,000 micrograms of Fentanyl; created over 50 false entries on the narcotic administration record using fictitious patient names to cover up the theft; and fraudulently used physicians’ names on the narcotic administration record. The Tribunal suspended the member until she provided proof from a physician and counsellor that she is safe to return to practise, at which time the member has a choice to return to either a practice setting where there is no access to narcotics or controlled substances, or, do a supervised practice in a setting where the member is expected to administer medications, including narcotics and controlled substances. In either setting, the member’s employer will report back to a Hearing Tribunal. The member is required to continue drug screening and provide further medical reports to a Hearing Tribunal. In the event the member runs out of practice hours prior to applying for supervised practice, she will be permitted to do the nursing refresher, on notice to the program and with ongoing drug screening and medical reports and thereafter do supervised practice. Conditions shall appear on the member’s practice permit. The Tribunal assessed a contribution of $1,000 against the member towards the costs of the hearing. 71,609 A Hearing Tribunal made a finding of unprofessional conduct against member #71,609 who posted on Facebook information about a critical incident at her place of work in sufficient detail that those involved in the incident or with the patient may be able to identify the patient. The member received a reprimand. CARNA Member Registration number: 74,402 A Hearing Tribunal made a finding of unprofessional conduct against member #74,402 who did not do a thorough assessment of the patient whose daughter had mentioned her mother had slurred speech and wondered about the possibility of a stroke. The Tribunal ordered a reprimand and required the member to take a course in physical assessment by a deadline. A condition shall appear on the member’s practice permit. Failure to comply with the order may result in suspension of CARNA practice permit. CARNA Member: Registration number: Shannon Finnigan 83,560 A Hearing Tribunal made a finding of unprofessional conduct against Shannon Finnigan #83,560 who violated an order of a Hearing Tribunal when she worked as an RN in a setting not approved by the Tribunal; lied at her interview for the position at the setting not approved by the Tribunal when she told the interviewer she was not under investigation by CARNA; she misrepresented the conditions on her practice permit when she failed to inform her supervisor that she was not allowed to work at that site, and continued to work in violation of the order of the Hearing Tribunal; she created a fraudulent letter addressed to the CARNA Hearing Tribunal and forged her RN supervisor’s signature on that letter; and submitted that fraudulent letter to a CARNA Hearing Tribunal to deceive the Tribunal into believing that she had complied with the part of the order that required CARNA Member Registration number: CARNA Member Registration number: 86,087 88,349 A Hearing Tribunal made a finding of unprofessional conduct against member #88,349, who administered an I.M. injection of Toradol to a patient in ER and failed to notify the physician, obtain a physician’s order for the Toradol or document the administration of the medication in the patient’s chart. The member had made an admission of the behaviour under section 70 of the Health Professions Act. The Tribunal issued a reprimand and ordered the member to take a course in basic medication administration. A condition shall appear on the member’s practice permit. Failure to comply with the order may result in suspension of CARNA practice permit. RN www.nurses.ab.ca March/April 2011 Volume 67 No 2 Alberta RN 11 We’ve got you covered! CARNA registrants automatically entitled to professional liability protection for nursing practice The Canadian Nurses Protective Society (CNPS) is a not-for-profit organization that offers legal advice, risk management services and professional liability protection related to nursing practice. All inquiries are directed to nurse legal advisors, who are lawyers with extensive nursing experience. They provide prompt, practical, confidential advice on a broad range of issues arising from your practice. They understand your work environment and the challenges of the profession. CNPS also offers presentations on request and delivers a wealth of educational materials online. As a CARNA registrant, you are eligible for CNPS services. Call CNPS at 1.800.267.3390 or visit the website at www.cnps.ca for more information. CNPS offers: • support and advice about professional liability issues • defence of claims and civil litigation • assistance with criminal investigations and prosecutions • defence of statutory offences • support for witness appearances • risk management and education 12 Alberta RN March/April 2011 Volume 67 No 2 FREE learning resources Independent practice? CNPS publishes infoLAW bulletins to help RNs and NPs manage legal risks in their practice. Topics include consent for treatment, inquests and fatality inquiries and legal risks in nursing. Download these and other infoLAWs from the CNPS website at www.cnps.ca. CNPS offers optional extended coverage for NPs and RNs working in independent practice. Visit www.cnps.ca for more information on the CNPS Plus program. RN New topics added regularly to respond to emerging issues. Recently, CNPS released infoLAWs on emergency room nursing, long-term care and social media. All three include examples from Alberta, including a situation where a Calgary man left two ERs because of long wait times and died in the third hospital from asthma complications after an appendectomy. See pages 13–14 for a reprint of the social media infoLAW that includes professional risks associated with social media and how they can be managed. Other risk management and educational resources • online publications on a wide range of subjects to help nurses understand their legal obligations, manage their legal risks and reduce the risk of harm to their patients • information specific to nurse practitioner practice • interactive presentations on legal issues available in person, via video-conference, or online • upcoming events: Find out where CNPS nurse legal advisors will be speaking and learn how to book a presentation for your organization • case study quizzes: Find out what you know and what you don’t know about why nurses can be sued • e-learning educational modules – coming soon to the new CNPS website • and more www.nurses.ab.ca When you need to call CNPS Call CNPS if any of the following occurs: • any unusual occurrence or incident • a patient or family member complains about care • you receive court documents or a notice that you are being sued • you receive a warning or threat advising of intent to begin legal action or to sue • you become aware of a request for information concerning a patient’s record or care • you have knowledge of acts or omissions that, if disclosed, could result in legal proceedings • you receive a subpoena or court order to appear as a witness • the police wish to speak with you regarding an alleged criminal activity related to nursing practice • if you feel uncertain about the appropriate course of action in your nursing practice When you telephone CNPS, you will be able to speak to a nurse legal advisor who will confidentially discuss the matter with you. Some online materials are password protected. As a CARNA member, you have access to this information. To access the password-protected section on www.cnps.ca, use: USERNAME: CARNA PASSWORD: assist Committed to Competence: UPDATE on revisions to the Continuing Competence Program Last spring, over 5,000 members responded to a member survey about the CARNA Continuing Competence Program that was introduced five years ago. These responses, combined with a review of current literature, an environmental scan of the practices of other regulatory colleges and feedback from other stakeholders, helped inform the recommendations of the Competence Committee to strengthen the program. Provincial Council approved the committee’s recommendations in September 2010. Survey respondents identified the following program strengths: • The Continuing Competence Program provides motivation to learn and encourages improvement. • The process is flexible, simple, well-structured and easy to complete. • The program helps determine learning needs or gaps. • The program promotes professionalism, awareness of professional standards and increases accountability. Members also indicated that: • they were dissatisfied with their understanding of documentation requirements • it is easy to forget to document learning • it is difficult to organize and keep continuing competence records for multiple years and to retrieve the records if required Suggestions for improvement included making documentation more user-friendly. In response, council approved a recommendation to develop an online documentation tool that would be used by all members and make it easier to track continuing competence activities as well as to store and retrieve the information. CARNA is exploring a number of applications to simplify the recording and reporting processes and will update members as this initiative progresses. Audit questionnaire eliminated Council also approved the recommendation to eliminate the audit questionnaire, also known as the “basic audit.” The Competence Committee determined that this form of reporting continuing competence activities was inefficient and did not always result in clear and sufficient information. The “advanced audit,” whereby members forward copies of their actual documents for review, is a much more informative and effective tool and will continue to be administered annually as part of practice permit renewal. Members randomly selected for audit will again be notified by email during renewal and will be reminded of their selection on the renewal welcome screen when they login to renew their practice permit. Audit selection will also show under the continuing competence section of the MyCARNA profile of those who have been selected. If you are selected for audit, you must submit all requested materials, your renewal application and full renewal fee to CARNA no later than Sept. 1, 2011. New Nurse Practitioner Competencies In February, CARNA notified NPs that at renewal they will select their continuing competence indicators using the new 2011 CARNA Nurse Practitioner Competencies. For the purposes of CARNA Continuing Competence Program requirements, NPs will continue to use the 2005 CARNA Nurse Practitioner Competencies for the remainder of the current practice year. Please note, however, that for the purposes of practice, NPs are accountable for the 2011 CARNA Nurse Practitioner Competencies. Notable changes to the previous document dated 2005 include: • the addition of assumptions used in the development of the core competencies • the addition of professional requirements for practising in Alberta as an NP • a revised glossary of terms • revised competencies • updated references The 2011 NP competencies are available on the CARNA website at www.nurses.ab.ca. RN www.nurses.ab.ca March/April 2011 Volume 67 No 2 Alberta RN 15 RN Expertise for RNs Whether you want advice on issues related to legal or ethical dilemmas, scope of practice, networking, interdisciplinary teams or any other aspect of nursing practice, CARNA’s policy and practice consultants are here to help. CARNA’s team of policy and practice consultants possess advanced nursing knowledge, leadership and expertise on a variety of issues. They provide confidential consultations to RNs, NPs and others seeking help with issues that directly or indirectly affect the delivery of care. Research shows that clarifying and interpreting the practice of RNs and NPs provides an opportunity to support and enable safe, competent, ethical nursing care. care networks and address barriers that hamper the delivery of primary care. The position statement on seniors health provides guidance and support to RNs and NPs for evidencebased decision-making, policy development and planning. For a full list of documents, go to www.nurses.ab.ca. Click on CARNA Documents under the Resources tab. Help for nursing groups In addition to individual consultations, the consultants often work with groups of nurses to help them understand and address issues related to staffing mix or strategize about effective approaches for changes to service delivery models that affect not only the health-care facility but also the community it serves. Last year, policy and practice consultants facilitated 38 group consultations with 984 participants across Alberta. RN Expertise for RNs PHONE: 78 0.451.00 43 Resource development to support practice Each year, the consultants publish a review of consultations in aggregate to identify emerging trends and issues. To ensure confidentiality, no identifying information is reported. When a gap is identified, they follow-up by analyzing literature, researching the issue and finding an appropriate resource to address the concern. For example, to help members articulate the visible and invisible aspects of care, the online version of Nursing Inventions Classification (NIC) was made available to members on the CARNA website. EMAIL: FAX: How policy and practice consultants can help you > assist you in understanding how legislation, regulations, Documents to support practice Documents are developed to address gaps and support practice and decision-making for CARNA members, staff, employers and policy makers. Documents include position statements, standards, guidelines and interpretive documents. CARNA periodically reviews its policy statements to address changing societal needs, values and conditions that challenge nurses in their practice. When members are asked to provide feedback, CARNA strongly encourages participation. Most recently, members were asked via the February AB RN Online electronic newsletter to provide feedback on the draft Standards for Limited Registered Nurse Prescribing document. All documents are reviewed and approved by CARNA Provincial Council. At its January 2011 meeting, council approved position statements on primary care and seniors’ health. The primary care document advocates for a deliberate strategy to attract RNs to primary care roles, integrate NPs in primary 16 Alberta RN March/April 2011 Volume 67 No 2 www.nurses.ab.ca 1.8 00.252.9392 [email protected] 78 0.452.3276 > > > > > > standards, guidelines and position statements apply to your practice act as an informed sounding board to help identify problems or questions related to nursing practice propose a range of viable options that foster valid decision-making related to your nursing practice, policy or education guide you to develop problem-solving/conflict resolution strategies that you can use in your practice setting provide constructive and supportive feedback focused on improvements related to patient safety, work environments, etc. collaborate with stakeholders to support a professional practice environment that fosters the delivery of quality patient care suggesting other relevant practice resources that may help (e.g., CNPS, ISMP, best practice guidelines) Review of CARNA Practice Consultations Sept. 30, 2009 –Oct. 1, 2010 BY: DEBBIE PHILLIPCHUK, RN, MN SUMMARY OF CONSULTATIONS POLICY AND PRACTICE CONSULTANT DEBRA ALLEN, RN, MN POLICY AND PRACTICE CONSULTANT DONNA HOGG, RN, MS, CAE POLICY AND PRACTICE CONSULTANT MARIE-ANDRÉE CHASSÉ, RN, MN POLICY AND PRACTICE CONSULTANT FOR THE FOURTH CONSECUTIVE YEAR, legal/ethical concerns, nursing practice standards and scope of practice topped the list of practice consultation categories and comprised more than 65 per cent of total consultations. Most consultations address a number of practice issues but consultants assign each consultation to a category based on the major concern discussed. The annual review of consultations helps CARNA identify issues and gaps for RN and NP practice which drive policy development to guide practice or advocacy for change. This year, policy and practice consultants added two new categories to the annual review of consultations: pandemic and graduate nurse. The pandemic category was added in the fall of 2009 in anticipation of a need by members for practice consultations related to the then-looming H1N1 pandemic. The graduate nurse category was added in response to the number of calls received last year about the scope of practice of graduate nurses. Graduate nurses are either new graduates or internationally-educated nurses who are on the temporary register until they complete their registration requirements, including writing the Canadian Registered Nurse Exam. Last year, CARNA published the interpretive document The Graduate Nurse: Scope of Practice to provide guidance in practice settings where graduate nurses are employed. Consultation Issue Category 2008 2009 2010 Legal/Ethical 175 (18%) 191 (21%) 238 (24%) Nursing Practice Standards 313 (32%) 241 (27%) 218 (22%) Scope of Practice 169 (17%) 175 (20%) 201 (20%) Safety 102 (10%) 88 (10%) 111 (11%) Information Networking 98 (10%) 101 (11%) 96 (10%) Health-Care Reform 40 36 (4%) Pandemic (4%) – Relationships 26 Internationally-Educated Nurses Transitions/Independent Practice (3%) (1%) 18 (2%) 7 (0.7%) 10 (1%) 17 (2%) 22 (3%) 13 (1%) 13 (1%) 1 (1%) 27 TOTAL 30 12 (2%) – Education (4%) (3%) 21 Graduate Nurse – 43 978 – (3%) 15 (2%) 981 1,010 * * 1,221 requests for consultations were followed-up on by consultants, but 221 individuals did not return calls. Legal/Ethical Concerns: 24% of consultations Documentation Questions related to documentation were the most frequent legal issue identified. Some of the concerns identified were lack of time to document care; challenges with transition from paper to electronic records and related inconsistencies in process; charting for someone else; and appropriate documentation in a critical incident. CARNA RESPONSE These concerns were addressed by providing guidance for members and the practice setting with reference to the CARNA document Documentation Guidelines for Registered Nurses. www.nurses.ab.ca Volunteering Another frequent legal and ethical issue related to volunteering. Most commonly, the issue or question asked of RNs was to provide injections for a friend or family member. This issue was discussed in the 2008/2009 review of consultations that was published in the May/June 2010 issue of Alberta RN. CARNA RESPONSE Consultants guided members in exploring the context of care and other considerations. In these situations, RNs must decide whether the relationship is a therapeutic one or if the relationship is a social connection and therefore not appropriate for the provision of nursing care. The CARNA document Professional Boundaries for Registered Nurses: Guidelines for the Nurse-Client Relationship provides guidance relevant to this issue. March/April 2011 Volume 67 No 2 Alberta RN 17 Nursing Practice Standards: Scope of Practice: 22% of consultations Competency Profile Members still have difficulty in applying the nursing practice standards indicators to their specific practice. Issues identified included the need for policy development to address specific issues such as best practices for medication administration, the use of over the counter medications, working extra hours and the roles and responsibilities of graduate nurses and health-care aides. The discussion of scope of practice was heightened as practice settings grappled with shortages of staff during the time when Alberta Health Services accepted only internal applications for job openings. RNs have become increasingly concerned about describing their scope of practice and competency profile to support evidence-based staffing. This trend was reflected in a number of calls within different categories of consultations where RNs wanted to discuss their scope of practice to be in a better position to influence decision-making. Much of the discussion focused on identifying the differences between the RN scope of practice and that of other health professionals and the research that supports RN practice in order to facilitate the development of appropriate roles and responsibilities for all members of the team. CARNA RESPONSE Policy and practice consultants provided guidance and direction to members to address these issues by applying the principles and standards outlined in CARNA documents. The nursing practice standards are a foundation for supporting nurses in their practice, giving them a framework to ask questions in a proactive way and identify concerns, issues and solutions in their practice setting. Documents were used to assist in problem-solving and the development of practical approaches to address issues, including the following: • Working Extra Hours: Guidelines for Registered Nurses on Fitness to Practise and the Provision of Safe, Competent, Ethical Nursing Care • Medication Administration Guidelines for Registered Nurses • Decision-Making Standards for Nurses in the Supervision of Health-Care Aides CARNA also developed Stand Up for Standards, a companion resource booklet that assists in applying the standards to everyday daily practice. Stand Up for Standards includes reflection/discussion questions for each indicator to help nurses relate the indicator to their individual practice and provides resources for further learning. 18 Alberta RN March/April 2011 Volume 67 No 2 20% of consultations CARNA RESPONSE RNs needed easy access to a resource to help understand and articulate their competency profile and how it differs from that of other members of the health-care team. In response, the online version of Nursing Interventions Classification (NIC), a key component of the RN competency profile, was made available at no cost to members via the CARNA website to help them to better understand their competency profile and articulate the visible and invisible aspects of their expert care. Also, a series of articles and instructions on how to access NIC was published in Alberta RN and regional coordinators were made available to discuss further. NIC identifies a very comprehensive list of RN competencies at the level of specific nursing interventions. It categorizes the interventions into types of practice, such as medical-surgical nursing, emergency nursing and occupational health nursing, just to name a few. Because nursing interventions encompass a broad range of nursing practice, no RN could be expected www.nurses.ab.ca to competently perform all interventions within the full scope of practice for the profession. Full scope of practice is that which the profession is educated to perform. Scope of practice for a particular RN is in reference to that which an individual practitioner is authorized, educated and competent to perform. As RNs used NIC to examine interventions specific to their practice, they found they were better able to articulate their role as RNs, the interventions specific to their practice and understand the differences between their role and responsibilities and that of other members of the nursing team. Primary Care Networks The growth of primary care networks in Alberta generated discussion related to RNs/NPs in this setting. Members contacted CARNA to discuss program development within the primary care network, chronic disease management, scope of practice and the development of infrastructure supports. CARNA recognized that written information on the roles and responsibilities of RNs and NPs working in primary care would be useful in providing information on RN and NP contributions to the interdisciplinary team. CARNA RESPONSE In response, CARNA hosted forums and tele-conferences with RNs and NPs employed in primary care settings. The main barriers identified by members were: lack of funding mechanisms that facilitate inter-professional care or support team development, a lack of understanding of RN and NP scopes of practice within primary care and a lack of dedicated infrastructure to support their role. The feedback was included in the new CARNA document Primary Care: Vision, Roles and Opportunities that was approved by CARNA Provincial Council at its January 2011 meeting. The document articulates CARNA’s vision of primary care, describes the roles and responsibilities of RNs and NPs as members of the interdisciplinary team and identifies the issues that must be addressed to continue primary care reform. Access NIC online at www.nurses.ab.ca GROUP CONSULTATIONS 1. On the top right corner of the homepage, click “Login” and enter your user ID (your registration number) and password. In addition to individual practice consultations, CARNA policy and practice consultants conducted numerous group consultations and facilitated discussions in response to complex issues that arose in practice settings. From Aug. 1, 2009 – June 30, 2010, the consultants facilitated 38 group consultations involving 994 participants across Alberta. The main topics of discussions were nursing practice standards, the RN scope of practice and competency profile, assignment of care, teamwork, medication best practices and professional responsibility and accountability. 2. Click on the Nursing Interventions Classification icon. 3. Click on the Contents tab. 4. In the Contents section, click on Part Three: Classification to view nursing interventions listed in alphabetical order. 5. Click on an intervention for a definition and associated activities. Safety Concerns: Pandemic Concerns: 11% of consultations 3% of consultations Safety continues to be a major issue. Concerns identified included lack of sufficient orientation, over capacity, shortages of staff and changing processes for staff mix, roles and responsibilities that relate to scope of practice concerns. It’s not surprising that between Oct. 1, 2009 and Dec. 31, 2009 a major issue of concern was H1N1. As the prevalence of influenza-like illness increased and a vaccine became available, there were a number of questions related to policy development, such as: • What type of orientation/education is appropriate for those unfamiliar with providing immunization to adults and children? • What are the recommended processes for safe administration of the vaccine where there were high volumes of clients? After Alberta Health Services opened influenza assessment clinics to relieve pressure on emergency departments, they identified gaps in access to timely care that might be addressed if RNs working in these clinics were authorized to prescribe anti-viral medication. CARNA RESPONSE To increase public understanding and support for the breadth and depth of the RN role, CARNA launched the “Expert Caring Makes a Difference” advocacy campaign in January 2010. As part of the campaign, members, government, the public and other stakeholders were directed to www.expertcaring.ca, a website that provides evidence to support informed practice and facts on the benefit of RN care. The website points to research that shows expert care delivered by RNs and NPs: • delivers benefits to long-term care residents • shortens hospital stays • prevents hospital deaths • reduces hospital infections • cuts wait times • controls health-care costs CARNA RESPONSE As a result, Alberta Health Services requested the assistance of CARNA and Alberta Health and Wellness to develop a process to authorize RNs working in influenza assessment clinics to prescribe anti-virals without patients having to see a physician or nurse practitioner. A comprehensive orientation procedure to support decision-making was defined by a team of nursing and medical practitioners and reviewed by Alberta Health Services, Alberta Health and Wellness and CARNA. CARNA worked with Alberta Health and Wellness to provide eligibility criteria for authorization to prescribe anti-virals and to provide advice on the terms and conditions for performance of this restricted activity. It was agreed that RNs must have at least two years of nursing experience specifically in assessment of patients with influenza-like illness or respiratory illness as a minimum requirement to prescribe antiviral drugs. The temporary authorization, which lasted from Oct. 29, 2009 to Jan. 31, 2010, helped Albertans access appropriate treatment more quickly and demonstrated the capacity of RNs to take on additional restricted activities. This is an example where limited RN prescribing was appropriate. This experience illustrated the benefits of limited RN prescribing and supports CARNA’s proposed revisions to the Registered Nurses Professions Regulation to authorize RN prescribing under specific conditions. RN All documents referenced in this article re available on the CARNA website at www.nurses.ab.ca. Click on the CARNA Publications link under the Resources tab. www.nurses.ab.ca March/April 2011 Volume 67 No 2 Alberta RN 19 MyCARNA Your 24/7 one-stop destination for managing your personal information and so much more. You don’t have to wait for practice permit renewal to update your contact and other information. In fact, you shouldn’t. We know you’re busy contributing to the health and well-being of Albertans, so we’ve made it simple – just log in with your user ID (registration number) and password. With the click of a mouse, you can: >> Manage your personal information Changed email addresses? Recently moved? Transferred positions? Update your personal information anytime, anywhere. >> Manage your continuing competence information Now that we are over half way through the practice year, you may have decided to change the focus of your professional development indicators. You don’t have to wait for renewal to report the change. Go to MyCARNA to update the indicators selected for your learning plan. >> Access tools and resources MyCARNA gives you access to member-only tools and resources, including a comprehensive database for nursing literature. The Nursing Interventions Classification (NIC), a key element of the RN competency profile, is also available on MyCARNA. 20 Alberta RN March/April 2011 Volume 67 No 2 www.nurses.ab.ca + http://www.nurses.ab.ca Chances are good that you are one of the 95 per cent of members who visited the CARNA website last year to renew your practice permit. Did you know that you can also use the website to find information on trends and issues affecting the profession, a listing of nursingrelated events, resources to inform your practice and so much more? From the homepage, you can see upcoming events, what’s new at a glance and quick links. With just one click you can: > read the latest edition of AB RN Online, CARNA’s electronic newsletter > go to the ARN Careers job board (see page 31 for more information on ARN Careers) > browse the CARNA Online Bookstore > access NurseOne > go to the CARNA conference and AGM website > and much more Click on the About Us tab for: > CARNA’s mandate, mission and values > information on Provincial Council and CARNA committees > financial information and annual reports > archives, artifacts and photos from the CARNA Museum and Archives (see page 26 for information) Click on the Registration tab for: > registration information for Alberta graduates, Canadian applicants, internationally-educated nurses, nurse practitioners, former members, courtesy permit holders, self-employed nurses and nurses in non-traditional practice Click on the Member Info tab for: > information on registration renewal, eligibility requirements and the online renewal guide > continuing competence resources, including helpful worksheets and frequently asked questions > requirements and information on reporting of blood-borne virus infection > professional conduct information, including how to file a complaint, the complaint process and frequently asked questions > practice support, including details on how you can access individual and group consultations > regional coordinator contact information and the CARNA region map > a list of specialty practice groups and links to their websites and contact infromation > information on educational funding, including scholarship applications and a list of ARNET events in support of continued RN/NP education Click on the Events tab for: > a list of conferences, education sessions, reunions and general events Do you have a nursing event coming up? Recommend an event using the online submission form. All approved events will be listed in the events section of the website and are automatically submitted for inclusion in the Alberta RN Notice Board (see page 32 ). PLEASE NOTE: Publication of events in Alberta RN is subject to available space. Click on the Resources tab for: > access to resources from CARNA Library, including the online library catalogue, the CINAHL database (see page 28 for more information) > a complete list of CARNA documents, including standards, position statements, guidelines and more > current and back issues of CARNA publications, including Alberta RN, the AB RN Online electronic newsletter, CARNA Council Highlights and the NP Update > infection prevention and control resources > information on the competency profile for registered nurses > exclusive offers for TD Meloche Monnex home and auto insurance > descriptions for the education sessions offered by the regional coordinators > volunteer opportunities > downloads and links to legislation and regulation affecting RN and NP practice Click on the News tab for: > media releases issued by CARNA > information and resources on health policy issues > information on current and past CARNA public awareness campaigns > and much more Click on the Contact Us tab for: > an online contact form > the CARNA staff directory > media contact information > information on how to request a speaker from CARNA for your upcoming nursing even > applications, information and donation opportunities from the Alberta Registered Nurses Educational Trust (ARNET) Not sure where to find what you are Search looking for? Click the button in the top right corner to search the CARNA web pages and documents. You can search with a general term or by exact phrase. > nomination criteria and information about the CARNA Awards of Nursing Excellence > employment opportunities at CARNA www.nurses.ab.ca March/April 2011 Volume 67 No 2 Alberta RN 21 Meet your regional coordinators The CARNA regional coordinators are registered nurses employed by CARNA to provide RNs and NPs with a resource and communication link to their regulatory college and professional association. Rainbow Lake High Level Fort Vermilion Fort Chipewyan La Crete Northwest They have a broad range of nursing experience across numerous practice settings and enjoy thought-provoking exchanges with members. They are committed to representing member concerns to CARNA and to ensuring that RNs and NPs in their regions are aware of the resources and support available to them from CARNA. Regional Coordinators facilitate two-way communication with CARNA members where they live and work by: > listening to concerns and issues at nursing meetings > directing concerns and issues to appropriate persons/ committees at CARNA > providing educational presentations for RNs and NPs on topics such as nursing practice standards and continuing competence > providing information about the nursing profession and the role of CARNA > organizing and supporting CARNA regional volunteer activities and special events such as Nursing Week Northeast Manning Fort McMurray Peace River Fairview Wabasca Spirit River McLennan Beaverlodge Grande Prairie Slave High Prairie Lake Lac La Biche Valleyview Cold Lake Athabasca Swan Hills Bonnyville Smoky Lake Fox Creek St. Paul Westlock Whitecourt Elk Fort Point Edson Hinton Saskatchewan Vegreville Edmonton Lloydminster Drayton Jasper Wetaskiwin Valley Camrose Grande Cache Edmonton/West Wainwright Ponoka Rocky Mountain House Red Deer Stettler Central Olds Provost Coronation Hanna Banff Calgary Drumheller Strathmore Calgary/West They are energetic and enthusiastic members of the CARNA team and travel widely throughout the CARNA regions. Each of our nine RCs is based in a home-office in one of CARNA’s six regions: Northwest, Northeast, Edmonton/West, Central, Calgary/West and South. Oyen Empress High River Vulcan Brooks Medicine Hat Claresholm Taber Blairmore Lethbridge Bow Island Pincher Creek South Cardston Learning Opportunities CARNA Regional Coordinators are available to provide education sessions on the topics listed below. Open (public) sessions are advertised on the CARNA website in the Events section. If you would like more information on a session or wish to request a session in your region or at your facility, please contact your regional coordinator. • • • • • • • • 22 Best Practices Resources for RNs Documenting Your Continuing Competence Activities Establishing a Nursing Practice Group Ethical Practice Health Professions Act Nursing: A Regulated Profession Nursing Leadership Nursing Leadership: Leadership Practices and Core Competencies Alberta RN March/April 2011 Volume 67 No 2 www.nurses.ab.ca • • • • • • Nursing Practice Standards Paperwork or Patient Care: What Matters? Preparing for the Canadian Registered Nurses Exam Professional Boundaries for Registered Nurses Registered Nurse Competency Profile in Practice Understanding Your Regulatory College and Professional Association • A Career as a Registered Nurse Northwest Northeast Edmonton/West Karen McKay Barbara Diepold Penny Davis Leeca J. Sonnema RN, BN RN RN, BScN RN, BScN PO Box 22037 Grande Prairie, AB T8V 6X1 c/o Bonnyville Health c/o c/o PHONE: FAX: 780.830.7850 780.830.7859 [email protected] Centre PO Bag 1008 Bonnyville, AB T9N 2J7 PHONE: FAX: 780.826.5383 780.826.5383 [email protected] CARNA 11620-168 Street Edmonton, AB T5M 4A6 PHONE: FAX: CARNA 11620-168 Street Edmonton, AB T5M 4A6 780.484.7668 780.484.7682 PHONE: FAX: [email protected] 780.457.8361 780.457.8361 [email protected] Central Calgary/West Heather Wasylenki Christine Davies Beverlie Johnson Valerie Mutschler Pat Shackleford RN, BScN, OHNC RN, BN RN RN, BN RN, BN Box 5846 Lacombe, AB T4L 1X4 PO Box 698 Cochrane, AB T4C 1A8 PO Box 1119 Claresholm, AB T0L 0T0 Box 20135, Kensington PO 880 Heritage Blvd West, Suite #431 Medicine Hat, AB Lethbridge, AB T1A 8M4 T1K 7V5 PHONE: 403.504.5603 PHONE: FAX: 403.782.2024 403.782.2052 [email protected] PHONE: FAX: 403.932.7243 403.851.1313 [email protected] South PHONE: FAX: 403.625.3260 403.625.5417 FAX: [email protected] 403.504.5605 [email protected] www.nurses.ab.ca PHONE: FAX: 403.394.0125 403.380.6283 [email protected] March/April 2011 Volume 67 No 2 Alberta RN 23 ISMP MEDICATION SAFETY ALERT! NURSE ADVISE-ERR Preventing catheter/tubing misconnections: Much needed help is on the way! Catheter/tubing misconnections remain a serious problem in health care. Last year, we learned of another fatal event. A 19-month-old child who was receiving treatment for a chronic gastrointestinal disorder died at a paediatric care centre. A suspension of QUESTRAN (cholestyramine) was accidentally given via a central line intravenous catheter instead of through an enteral feeding tube. In May 2010, another report was published about an incident where barium sulfate was administered to a 17-month-old child via the superior vena cava during an upper gastrointestinal study (Soghoian S, Hoffman RS, Nelson L. Unintentional IV injection of barium sulfate in a child. Am J Health-Syst Pharm. 2010;67: 734-36). The patient had a central venous catheter (CVC) in place for antibiotic therapy. As the procedure began, approximately 3 mL of barium sulfate was injected into the CVC, which was mistaken as the child’s gastrostomy tube. Fortunately, no respiratory distress or other major problems developed and the child was discharged four days later. Luer connector systems, common to many health-care catheters, tubes, administration sets, extension sets and syringes, have been at the heart of many catheter/tubing misconnections. One of the most commonly reported problems is that some manufactured enteral catheters still have ports that only accept parenteral administration sets and syringes. So, even if a liquid medication is prepared in an oral syringe, the medication must be transferred to a parenteral syringe for administration, risking the accidental administration of the drug via a parenteral line. Below are examples of the type of events associated with catheter/tubing misconnections reported to the ISMP Medication Errors Reporting Program: peripheral IV infusions connected to epidural lines and epidural solutions connected to peripheral IV lines vinca alkaloids (e.g., vinCRIStine) in a syringe given via an intrathecal catheter IV tubing connected to the inflation balloon port of an endotracheal tube or tracheostomy tube sequential compression device tubing or pneumatic blood pressure cuff tubing attached to the port of an IV administration set oxygen tubing connected to port of an IV administration set breast milk accidentally administered intravenously into neonates bladder irrigation solutions given IV or TPN solutions administered via a foley catheter port 24 Alberta RN March/April 2011 Volume 67 No 2 an enteral nutrition container spiked with an IV administration set resulting in administering the enteral solution intravenously topical solutions intended to be used with the V.A.C. (Vacuum Assisted Closure) Instill System (used for wound healing) prepared in “IV” bags that accommodate IV tubing which could be inadvertently connected or attached to an IV catheter or line Albuterol meant for continuous inhalation set-up using an IV bag and tubing that is accidentally administered intravenously The International Organization for Standardization (ISO) has been working on a standard (ISO/IEC/FDIS 80369-1, “Small-bore connectors for liquids and gases in health-care applications”) that will make various health-care catheter connections and associated tubing sets or syringes incompatible with one another. The standard will include connectors for the flow of gases, enteral feedings, liquid medications via an www.nurses.ab.ca intravenous route, gastric tube, limb cuffs (e.g., sequential compression devices, pneumatic tubes to blood pressure cuffs), urological access (e.g., bladder irrigation) and neuraxial access (e.g., epidural, intrathecal, intracranial). In addition, the current Luer connector standard (ISO 594) will be updated. Designs for the connectors for enteral tubes and catheters, as well as containers, administration sets and syringes, are expected to be finalized soon, with clinical testing by manufacturers accomplished during the standards development process. As part of the new enteral standard, a female Luer connector will not be present on feeding tubes, except for the inflation balloon that anchors some long-term use feeding devices. A final version of the standard should be completed by 2013. Although compliance with the standard will be voluntary, product vendors should have revised devices available soon after that. On July 9, 2010, the U.S. Food and Drug Administration (FDA) sent a letter to product manufacturers, health-care practitioners and hospital purchasing departments, which offered advice regarding the prevention of catheter/ tubing misconnections, which are similar to recommendations you will find in the check it out! column. The FDA also mentioned that the agency is considering recognizing the ISO/IEC/FDIS 80369-1 standard when it is published, due to the significant impact it will likely have on the safety of these devices. If this happens, the FDA will provide guidance to manufacturers regarding issues such as whether there will be a set period of time for currently marketed devices to come into compliance and the effect of the standard on new devices. The standard will be a much-welcomed addition toward improved patient safety. Coupled with additional safety measures found in the check it out! column, we are optimistic that patient harm from tubing misconnections will be greatly reduced. RN Reprinted with permission from ISMP Medication Sa fety Alert! Nurse Advise-ERR (ISSN 1550-6304) December 2010 Volume 8 Issue 12 ©2010 Institute for Safe Medication Practices (ISMP). Visit ismp-canada.org or ismp.org. As part of CARNA’s commitment to patient safety, an ISMP Medication Safety Alert! Nurse Advise-ERR is reprinted in every issue of Alberta RN. This column focuses on best practices for nurses who transcribe medication orders, administer medication and monitor the effects of medication on patients. ISMP Canada regularly offers webinars as a convenient way for health-care professionals to stay ahead of new trends in medication safety. Go to www.ISMP-canada.org to see what’s coming up. check it out! Follow these recommendations to prevent catheter/tubing misconnections. Perform a Failure Mode Effects Analysis (FMEA) to identify the various types of catheters and connectors used in your organization. Identify the possibility for misconnections, assess the potential frequency and severity of misconnections and address process changes that need to be made. Be sure to include front-line staff who use the equipment. Never attempt to force or use a makeshift connection that does not fit easily and securely into an access port. Provide education to staff before using new tubes, catheters or connectors. Include discussion about possible sources of errors uncovered during the risk assessment and steps to avoid these errors. Also, use tubing misconnections in simulation training during orientation and annual safety competencies. Avoid using a dual channel pump for infusions via different routes of administration. For example, use pumps for epidural infusions that look different than pumps for IV infusions, if available. Label the epidural pump as “EPIDURAL ONLY.” Limit the staff who are allowed to connect or disconnect tubing from medication devices to licensed health-care professionals who have been educated and are knowledgeable about the serious risks associated with misconnections. During orientation, include prohibitions to connecting/disconnecting tubing so all hospital staff are aware of who may perform this task. Always trace from the source to the connection port to verify attachments before connecting or reconnecting tubing, and/or administering drugs or solutions. This action is particularly important, as awareness of each tube’s location and insertion site is easily lost if tubing is obscured by protective coverings, bedclothes and sheets. Adjust lights or use flashlights if necessary. Recheck connections and trace all tubes and catheters to sources upon patient transfer and hand offs. www.nurses.ab.ca Affix labels on lines near insertion sites if the patient has more than one connection to a port of entry into the body (e.g., IV, arterial, umbilical, enteral, epidural, bladder balloon port, tracheostomy balloon port). Place pumps on opposite sides of the bed when administering infusions via different routes of administration; when possible, do not keep them next to each other or place them on the same pole. Use equipment the way it is intended to be used. For example, only use yellow-lined tubing without injection ports for epidural infusions and only use oral syringes for oral medications. Always hang infusion bags with labels facing out so they can be read. Make sure labels are on the same side of the infusion that includes any other important preprinted information. Do not use parenteral syringe pumps to administer breast milk enterally; nasogastric tubes should only connect to oral syringes via syringe extension sets (e.g., CORFLO by Corpak Medsystems). Limit the frequency of disconnecting and reconnecting tubing (particularly IV tubing) to reduce the risk of misconnections and infections. March/April 2011 Volume 67 No 2 Alberta RN 25 The official memory of registered nursing in Alberta The CARNA Museum and Archives collects, preserves, documents and interprets the history of registered nursing in Alberta. Located in the CARNA Provincial Office in Edmonton, all are welcome to explore, learn and share in the rich history of the RN profession, whether for research purposes or purely for enjoyment. The collection includes artifacts and archival material of the profession and of associated organizations such as schools of nursing, alumni chapters, specialty practice group records and the records of those closely connected to the work of CARNA. Permanent and temporary exhibits include displays of major themes in nursing, including education, pioneer nursing and Canadian nurses in WWII. Among the treasures is a lamp similar to the one Florence Nightingale used during the Crimean War. The collection was started in 1978 by a group of volunteer retired nurses. With 10 schools of nursing closing in the 1970s, they became concerned that the records would disappear. Their efforts resulted in a relatively complete collection of caps, pins, yearbooks, diplomas, photos of hospitals and other memorabilia. In 1981, the collection was presented to CARNA (then known spital in 18 89 as AARN). For over a decade, the items t General Ho Medicine Ha were displayed in cabinets at the CARNA Provincial Office. In 1991, for the 75 th anniversary of AARN, the collecting mandate was broadened. With the help of grant funding, the program was expanded to provide research space and environmentally-controlled storage. At the ribbon cutting ceremony in 1993, then-AARN President Mary Pat Skene said “We are often characterized as a throwaway society. By establishing the Museum and Archives, nursing has an excellent opportunity to preserve its past and thereby secure its future.” Visit the CARNA Museum and Archives History and technology collide Monday to Friday Archives available online 8:30 a.m. to 4:30 p.m. or Access archives, artifacts and photos in CARNA’s go to www.nurses.ab.ca any time. collection online. Click on the “Museum and Archives” link under the About Us tab. Ask the archivist CARNA Archivist Lorraine Mychajlunow is available to answer any questions you may have regarding personal or family nursing memorabilia and to answer questions about the Museum and Archives. To contact her, email [email protected]. 26 Alberta RN March/April 2011 Volume 67 No 2 www.nurses.ab.ca “ We are often characterized as a throwaway society. By establishing the Museum and Archives, nursing has an excellent opportunity to preserve its past and thereby secure its future.” MARY PAT SKENE AARN PRESIDENT IN 1993 The 1916 graduating class of the Royal Alexandra Hospital school of nursin g IN MEMORIAM Our deepest sympathy is extended to the family and friends of: Armstrong, Catherine (née Norman), a 1948 graduate of Royal Columbian Hospital school of nursing in New Westminter who passed away on Jan. 25, 2011. Dallison, Lou Anne, a 1960 graduate of the University of Alberta Hospital school of nursing who passed away on Nov. 12, 2010. Dolinsky, Anne (née Grykuliak), a 1952 graduate of the Misericordia Hospital school of nursing who passed away on Nov. 26, 2010. Elson, Claire Marie, a 1960 graduate of the Edmonton General Hospital school of nursing who passed away on Dec. 24, 2010. Fong, Anna Yuen-Ying (née Lok), a 1978 graduate of the Vancouver Community College who passed away on Dec. 17, 2010. Harms, Marion “Adelle” (née Hodgson), a 1950 graduate of the Calgary General Hospital school of nursing who passed away on Feb. 19, 2011 in Calgary. Martin, Mercedes, a 1976 graduate of the Holy Cross school of nursing who passed away on Oct. 18, 2010 in Edmonton. McRae, Ellen (née Rowden), a 1956 graduate of the University of Saskatchewan Hospital school of nursing who passed away on Jan. 22, 2011. Moore, Judith, a 1970 graduate of the Grey Nuns Hospital school of nursing who passed away on Jan. 23, 2011. Roberts, Dorothy (née Kiniski), a 1938 graduate of the Edmonton General Hospital school of nursing who passed away on Oct. 21, 2010 in Westlock. Semenya, Mary (née Burke), a 1976 graduate of the Misericordia Hospital school of nursing who passed away on Oct. 26, 2010. Mae Anna Geneva Purcell 1910 – 2011 CARNA PRESIDENT 1969 –1971 CARNA past president Geneva Purcell passed away on Feb. 10, 2011 at age 100. In 1993, at the ribbon cutting ceremony for the archives, Purcell represented the founding group of nurses who, with great vision, began the collection in 1978. A passionate supporter of nurses and nursing education, Purcell also served on the Board of Directors of the Alberta Registered Nurses Educational Trust from 1985–1988. In 2000, at the age of 89, Purcell served as the charity’s honorary chair for the successful Million for the Millennium campaign. Purcell graduated from the Royal Victoria Hospital school of nursing in Montreal, Québec in 1935 and went on to receive her bachelor of nursing at McGill University and her master’s degree in maternal health from Boston University. During her career, Purcell developed post-graduate programs to prepare nurses to care for premature babies and piloted a program at the Royal Victoria Hospital in Montreal in 1957 that allowed babies to stay in the same room as their mother while in hospital, rather than move immediately to the hospital nursery. During her time as the director of nursing for the University of Alberta Hospital (1962–1975), Purcell was a progressive champion of the profession. In 1963, she conducted a survey that found “nurses were doing a lot of nonnursing functions… a lot of the nursing budget was paying for housekeeping services.” In 1972, in a University of Alberta Hospital report, she reported staff shortages so drastic that nurses were being recruited overseas. “[The] nursing class [of] Sept. ’64 at the University of Alberta Hospital remember Miss Purcell with fondness and much respect. She was a warm, unassuming woman who always had a kind word and ready smile for all she encountered. Dedicated to nursing and to her staff, she was a gift to the nursing profession. Nursing has lost a true professional. Our condolences to her family and loved ones.” Loretta Shobe “I entered the nursing profession as a frightened young teenager from small town Alberta in 1962. I was new to the city and to all of my surroundings. As if it were yesterday, I can still see Geneva Purcell. She held the prestigious position of director of nursing. Instead of being aloof and superior, she was so kind and loving. [She] always [had] a smile [and] a kind word. I don’t think she ever raised her voice. Although it’s been many years since I’ve seen her, she will always remain in my heart as a role model. [She was] professional [and] intelligent with a heart of GOLD!” Judy Salamandick (née Flewelling) Charitable donations in Mae Anna Geneva Purcell’s memory may be made to the Alberta Registered Nurses Educational Trust. www.nurses.ab.ca March/April 2011 Volume 67 No 2 Alberta RN 27 Knowledge, research and insight: Welcome to the CARNA Library The CARNA Library is open to members, students and the public and consists of an extensive reference and general collection of books, videos, journals, government documents, newsletters and bulletins from associations, other health professions and health-related organizations available for borrowing. A complete list of journals is available from the library and is updated annually. The articles of the Healthy Workplaces, Healthy Nurses bibliography are also available. The articles cover 11 distinct topics, including: • change • communication • job satisfaction • leadership • nurse abuse/workplace violence • nurse-physician relationships • nursing shortage Card free and online borrowing No need to remember your library card. Just walk in to the CARNA Library or browse the online catalogue to borrow up to five books and/or videos at a time from the general collection. Live outside the Edmonton area? No problem. Search for and request your materials online using the library catalogue. The library will mail books and hard copies of articles to you for just $2.50 per package (an additional charge of $0.10/page may apply to photocopying). We’ll even enclose a postage-paid mailing label for you to return the materials you borrow. Reference materials, including journals, newsletters, bulletins and government documents cannot be borrowed, but are available for use by those visiting the library in person. Looking for resources to inform your front-line practice? The CARNA Library gives you unlimited access to the CINAHL database The Cumulative Index of Nursing and Allied Health Literature (CINAHL) is available at no cost to members on the CARNA website. The database includes: • books • book chapters • audio/visual material • software • dissertations • conference proceedings • foreign language journals • systematic reviews • clinical trials • more than 1,200 nursing and allied health journals and publications from 1982 to present • Selected material is available in full text. To access CINAHL, click on the CINAHL link in the library section of the CARNA website or contact the library for the user ID and password. Visit the CARNA Library Monday to Friday Ask a librarian 9:0 0 a.m. to 4:0 0 p.m. or The CARNA library staff are here to go to www.nurses.ab.ca help you with reference services and any time. literature searches for professional needs. If you’re looking for information, materials or need help accessing library resources, contact the library at 780.453.0533/ 1.800.252.9392, ext. 533 or via email at [email protected]. 28 Alberta RN March/April 2011 Volume 67 No 2 www.nurses.ab.ca New materials acquired regularly Listed below are some of the latest materials acquired by the CARNA Library. A complete library catalogue is available at www.nurses.ab.ca/library. Boswell, C. & Cannon, S. (2011). Introduction to nursing research: Incorporating evidence-based practice (2nd ed.). Sudbury, MA: Jones and Bartlett. [WY 20.5 B7475 2011] Burke, K. M., Mohn-Brown, E. L., & Eby, L. (2011). Medical-surgical nursing care (3 rd ed.). Boston, MA: Pearson. [WY 150 B9585 2011] Chikwe, J., Walther, A., & Jones, P. (2009). Perioperative medicine: Managing surgical patients with medical problems. Oxford: Oxford University Press. [WY 162 C53253 2009] De Brún, C. & Pearce-Smith, N. (Eds.). (2009). Searching skills toolkit: Finding the evidence. Chichester, England: Wiley-Blackwell. [WY 16 S439 2009] Dolan, S. & Vizzard, A. (2009). The end of life advisor: Personal, legal, and medical considerations for a peaceful, dignified death. New York: Kaplan Publishing. [WY 152 D6565 2009] Dreeben, O. (2010). Patient education in rehabilitation. Sudbury, MA: Jones and Bartlett. [WY 150.5 D765 2010] Falvo, D. R. (2011). Effective patient education: A guide to increased adherence (4 th ed.). Sudbury, MA: Jones and Bartlett. [WY 87 F197 2011] Guido, G. W. (Ed.). (2010). Legal and ethical issues in nursing (5th ed.). Boston, MA: Pearson. [WY 33 L4945 2010] Huston, C. J. (2010). Professional issues in nursing: Challenges & opportunities (2nd ed.). Philadelphia, PA: Lippincott Williams & Wilkins. [WY 16 H972 2010] Lachman, V. D. (2009). Ethical challenges in health care: Developing your moral compass. New York: Springer. [W 50 L138 2009] Mateo, M. A. & Kirchhoff, K. T. (2009). Research for advanced practice nurses: From evidence to practice. New York: Springer. [WY 128 R4281 2009] Paola, F. A., Walker, R., & Nixon, L. L. (Eds.). (2010). Medical ethics and humanities. Sudbury, MA: Jones and Bartlett. [W 50 M4855 2010] Schaffer, M. & Norlander, L. (2009). Being present: A nurse’s resource for end-of-life communication. Indianapolis. IN: Sigma Theta Tau International. [WY 152 S295 2009] Smeltzer, S. C. (Ed.). (2010). Brunner & Suddarth’s textbook of medical-surgical nursing (12th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. [WY 150 B898 2010] Spath, P. T. (Ed.). (2008). Engaging patients as safety partners: A guide for reducing errors and improving satisfaction. Chicago, IL: Health Forum. [WA 250 E557 2008] FEATURED BOOK Being Present A nurse’s resource for end-of-life communication Being Present offers strategies to help nurses talk with patients and families about their needs, hopes and wishes as they face their own death or that of a loved one. Each chapter presents a real-life account of nurses dealing with near-death patients and their families and includes communication techniques. Chapters also include topics for discussion and further reflection that are useful in group learning. In Being Present, you will learn how to: • • • • respond to patient and family wishes and hopes cope with conflict help patients say goodbye at the end of life incorporate cultural needs in end-of-life care tore.ca s k o o b a n r a c www. Rather buy than borrow? CARNA has partnered with Login Canada to provide you with access to the largest health sciences and scientific/ technical book wholesaler in the country. The CARNA Online Bookstore puts over 600,000 active titles at your finger tips. And unlike buying books at other retailers, a portion of your sale is reinvested into CARNA and your profession. • same day shipping on all in-stock items ordered before 1:30 p.m. (EST) • reliable and trustworthy site • a wide range of titles on nursing, consumer health, allied health, health science and psychology • shop from the comfort of your home or office • shop 24/7 Shop today at www.carnabookstore.ca www.nurses.ab.ca March/April 2011 Volume 67 No 2 Alberta RN 29 Your National Voice CNA provides national leadership and advocacy to bring key nursing issues to the forefront As a CARNA member, you automatically receive membership to the Canadian Nurses Association (CNA), a federation of 11 provincial and territorial nursing associations and colleges representing more than 143,000 registered nurses and nurse practitioners. CARNA encourages members to take advantage of the many CNA resources that are supported in part by CARNA membership fees. In fact, 11 per cent of registered nurse fees ($54.95 per member) is paid to CNA by CARNA. This amounts to 73 per cent of CARNA’s governance budget and 12 per cent of the total budget. Advocacy Regulatory Support CNA provides RNs and NPs with a strong national association through which they can support each other and speak with a powerful, unified voice. CNA also works to advance the practice and profession of nursing to improve health outcomes and strengthen Canada’s publically-funded, not-for-profit health system. CNA provides strong professional nursing leadership in the interest of the public by coordinating the development and review of the Canadian Registered Nurse Exam, Canadian Nurse Practitioner Exam and administration of the nursing certification exams. As well, CNA’s Code of Ethics for Registered Nurses is widely used by all CNA jurisdictions. CNA has developed an e-learning tool called CNA’s Learning Modules: Bringing the Code of Ethics to Life. All eight of the e-learning modules are now available on nurseone.ca. This new tool has been well received with almost 2,000 users to date. It contains interesting discussions, case scenarios, a self-test and a certificate for users to print once they’ve completed a module. Public Policy Take advantage of the many CNA resources which are supported in part by your registration fees. Services include: a 20 per cent discount on more than 100 CNA nursing publications a subscription to Canadian Nurse a national certification program for nurses working in designated specialty areas financial planning and investment services membership in the International Council of Nurses Check out www.cna-aiic.ca for: CNA’s Primary Care Tool Kit information on CNA’s international programs position statements fact sheets National Nursing Week resources research on the financial value of RN expert care 30 Alberta RN March/April 2011 Volume 67 No 2 As part of CARNAs ongoing commitment to advancing the RN/NP profession, CARNA staff serve on a number of national CNA committees and initiatives, including: CRNE and CNPE Exam Councils National Project on Nursing Practice Standards Multi-Jurisdictional Staff Mix Working Group Strengthening Nursing Networks and Associations Program (i.e., the technical mission to Ethiopia) Infoway Nursing Informatics Reference Group And many, many more CNA now Stay up-to-date with CNA activities by signing up for the CNA Now electronic newsletter. Go to www.cna-aiic.ca to subscribe. www.nurses.ab.ca On Parliament Hill, CNA is an energetic national voice, lobbying to influence and change health policy. CNA has made sure that politicians know one in 70 voters is a nurse. CNA continues its efforts to ensure that the voice of nursing is present in the issues and debates around health system renewal. Of particular interest is the area of health human resources and addressing the nursing shortage and retention of nurses. International Policy and Development CNA membership includes membership in the International Council of Nurses (ICN). With more than 112 member countries, ICN is a powerful voice for nursing and health internationally. CNA also continues to build partnerships around the world in an effort to improve global health and social justice. Over the past two years, CNA continued to play a leadership role in fostering national and international networks for Canadian nurses and international health interest groups. RN ARN Careers connects Alberta RNs and NPs with Alberta employers Looking for a job is as easy as checking your inbox Whether you are actively looking for a job, casually searching or would just want a place to store your resumé, the ARN Careers job board is the right place for you. It’s quick, easy-to-use and using your preset criteria, you can receive job opportunities in your inbox as soon as they are posted. ARN Careers is a partnership between CARNA and Workopolis, Canada’s number one job site. As with all Workopolis career sites, ARN Careers is free to job seekers. Employers pay a small fee to post jobs. In return, they are linked with qualified, professional candidates to fill open positions – an extremely cost-effective recruitment strategy. Because CARNA is committed to retaining our nursing talent, this site is available only to Canadian employers hiring for vacancies in Alberta. Revenues from the job board are invested back into CARNA and the RN/NP profession. Find what you’re really looking for Set up to five personalized job searches and 10 different search criteria. You can filter your results by location, job stream, job type, company salary/hourly rate and more. See only the job opportunities that match your career aspirations. Control the confidentiality of your information ur Search for yo today at perfect job s .ab.ca/career www.nurses ARN Careers takes your privacy seriously. Be assured that you have complete control over the accessibility of your resumé and profile at all times. There are several levels of privacy to choose from: • display details of full resumé and contact information to all registered employers • display only resume without contact information to registered employers • do not include resumé in searchable database for registered employers www.nurses.ab.ca March/April 2011 Volume 67 No 2 Alberta RN 31 calendar NOTICEBoard N O R T H W E S T NURSES WEEK DINNER AND COMEDY SHOW May 13, 2011. Grande Prairie. CONTACT: Karen McKay, [email protected], Casandra Jordan, [email protected], Bonnie Kennedy, [email protected] E D M O N T O N / W E S T I N T E R N AT I O N A L C O N F E R E N C E S IN COMMUNITY HEALTH NURSING RESEARCH BIENNIAL SYMPOSIUM Embracing Equity and Diversity in Community Health Nursing Research May 4–6, 2011. Edmonton. CONTACT: www.nurs.ualberta.ca/icchnr C E N T R A L C E L E B R AT E R E G I S T E R E D N U R S E S : P A S T, P R E S E N T A N D F U T U R E May 10, 2011. Red Deer. CONTACT: Heather Wasylenki, 403.782.2024 or [email protected]. N U R S E P R A C T I T I O N E R A S S O C I AT I O N OF ALBERTA ANNUAL CONFERENCE AND AGM May 27–28, 2011. Red Deer. CONTACT: www.albertanps.com C A L G A R Y / W E S T CALGARY/WEST NURSES’ DINNER May 9, 2011. Calgary. CONTACT: Chris Davies, 403.500.9943, [email protected], Sarah Kopjar, 403.282.4095. 2011 AOHNA ANNUAL CONFERENCE Refresh... Mind Body Spirit May 25–27, 2011. Banff CONTACT: www.aohna.ab.ca CARNA CONFERENCE, A G M A N D AWA R D S G A L A Harnessing the Power, Passion and Pride of Nursing June 9–10, 2011. Calgary. CONTACT: www.carnaconference.ca N A T I O N A L CANADIAN ORTHOPAEDIC NURSES A S S O C I AT I O N A N N U A L C O N F E R E N C E “An Ortho Mosaic” – A “BONE” Afide Alberta RN March/April 2011 Volume 67 No 2 Misericordia Hospital School of Nursing Nurses Alumni Annual Reunion and General Meeting April 16, 2011. Edmonton. CONTACT: Cheryl Mittelstadt, 780.438.1967, [email protected] June 5–8, 2011. Winnipeg. CONTACT: www.cona-nurse.org Royal Alexandra Hospital School of Nursing Class of 1976 • 35-Year Reunion April 29–May 1, 2011. Edmonton CONTACT: Ruth Hammer, [email protected] D I V E R S I T Y I N A D VA N C E D N U R S I N G PRACTICE: BOUNDLESS HORIZONS Sept. 28–30, 2011. Saskatoon. CONTACT: www.caapn.com Royal Alexandra Hospital School of Nursing Class of 1971 • 40-Year Reunion April 29–May 1, 2011. Edmonton CONTACT: [email protected] C A N A D I A N A S S O C I AT I O N F O R S U I C I D E P R E V E N T I O N N AT I O N A L CONFERENCE Oct. 3–5, 2011. Vancouver. CONTACT: www.casp2011.ca Royal Alexandra Hospital School of Nursing Annual Reunion Weekend April 29–30, 2011. Edmonton CONTACT: Myrene Couves, 780.967.2748 Prairie Experience N E T W O R K I N G O P P O R T U N I T I E S C A L L I N G A L L H E A R T FA I L U R E C A R E RNS AND NPS A CARNA speciality practice group for nurses who care for those with heart failure is in the beginning stages of formation. This group will bring together a diverse group of nurses from across the province to provide opportunities for networking, education and information sharing. To learn how you can get involved, contact Terry Kawahara at 403.406.5505 or via email at [email protected]. C A R N A S P E C I A LT Y P R A C T I C E G R O U P S Contact your CARNA regional coordinator or go to www.nurses.ab.ca and click on “Member Info.” Submission deadline for events listed in Alberta RN July/August 2011 is May 31. Go to www.nurses.ab.ca for an up-to-date listing of events or to submit an event for publication in Alberta RN. 32 Reunions www.nurses.ab.ca Calgary General Hospital School of Nursing Class of 1971 • 40-Year Reunion May 13–14, 2011. Calgary CONTACT: Carolyn Robertson, 403.686.6536, [email protected] Medicine Hat College School of Nursing Class of 1990 • 20-Year Reunion June 3–6, 2011. Medicine Hat. CONTACT: Denise Hellman, 403.504.2246, [email protected]. University of Alberta School of Nursing Class of 1976 • 35-Year Reunion Sept. 9–11, 2011. Pigeon Lake. CONTACT: Connie Lee, 780.462.7596, [email protected]. University of Alberta School of Nursing Class of 1971 • 40-Year Reunion June 3–5, 2011. Nordegg Submission deadline for reunions listed in Alberta RN July/August 2011 is May 31. Go to www.nurses.ab.ca for an up-to-date listing of reunions or to submit an event for publication in Alberta RN. Closing Perspectives Healthy aging should drive health care reform Our aging population is often linked with the inevitability of soaring health-care costs despite a growing body of evidence to the contrary. This perception is fuelled by reports of aging patients lying in hospital corridors and filling up hospital beds. The fact that acute-care beds continue to be occupied by patients who could safely receive an alternative level of care in rehabilitation care, long-term care, nursing home or even a home setting, if the right supports could be put in place. In January, CIHI released Seniors and the Health Care System: What Is the Impact of Multiple Chronic Conditions? The report indicated that multiple chronic conditions, not age, were the main driver of health system use by seniors and had a much higher impact on health-care resources than age alone. The study found that older seniors (85 and older) with no chronic conditions made less than half the number of health-care visits as younger seniors (65 to 74) with three or more chronic conditions, such as diabetes, hypertension and heart disease. Although Canada and Alberta have made great strides in health promotion and prevention initiatives, our healthcare system continues to primarily focus on curing and treating symptoms rather than preventing diseases or injuries. Investment in primary prevention strategies to prevent, or at least postpone, the onset of the first chronic disease with healthier lifestyles is a sensible approach to tackling health system pressures. An increased emphasis on secondary prevention strategies to diagnose and treat disease in its early stages would also go a long way in supporting healthy aging and reducing demand on acute-care services by reducing disease-related complications. At its January meeting, CARNA Provincial Council approved Seniors and Healthy Aging, a position statement developed through a process of consul46 Alberta RN March/April 2011 Volume 67 No 2 tation with members including the Alberta Gerontological Nurses Association (AGNA), a CARNA specialty practice group. The position statement outlines nine beliefs which form the foundation for evidence-based decision-making, policy development and care planning. One of those beliefs is that investment in community supports is required to help seniors and other at-risk populations live disease- and illness-free for as long as possible. CARNA recommends that all business plans submitted by health system providers include measurable strategies to promote healthy aging through good nutrition, active living, immunization, smoking cessation, the prevention of falls, supportive living arrangements and flexible home-care services. While research has shown that it is cheaper to care for someone at home than in long-term care facilities, recent evidence also demonstrates that an increasing emphasis on communitybased care increases the care-giving burden for other family members (CIHI, 2010). In turn, caregiver distress may increase older adults’ vulnerability to abuse. Millions of caregivers are currently paying a heavy price financially and personally, while at the same time contributing an estimated $25 billion in unpaid care to our health-care system. If a sustainable health-care system must rely on the informal support network to help keep seniors at home and avoid institutionalization for as long as possible, supporting caregivers’ contribution to healthy aging is a social responsibility. National groups like VON, CARP, the Canadian Caregiver Coalition, the Canadian Cancer Society and the Canadian Nurses Association are pressing government for a National Caregiving Strategy to ensure that family caregivers can continue their vital social role by providing them with financial support, www.nurses.ab.ca workplace protection and integration of the formal health care and social services system and the informal caregiving sector. Along the same line, CARNA believes the Canada Health Act should be expanded to include services delivered outside of hospitals by health providers other than doctors. CIHI’s report showed that while the majority of seniors reported having a family physician, only two out of five (42%) reported that at least some time in the past year they had talked with a health professional about what they could do to improve their health or prevent illness (including quitting smoking, increasing exercise or limiting alcohol consumption). The results were similar for tomorrow’s seniors, as only 45% of adults between the age of 45 and 64 spoke with their health care provider about things they could do to improve their health. This evidence supports CARNA’s advocacy for a deliberate strategy to attract RNs to roles within primary care, integrate NPs in primary care networks (PCNs) and address barriers which hamper the delivery of primary care. While acknowledging that the risk of developing chronic conditions increases with age, Jeremy Veillard, Vice President of Research and Analysis at CIHI made an excellent point by saying that “good primary care plays a strong role in managing them and even possibly delaying or preventing their onset.” I’d like to echo that statement by saying that good primary care delivered by RNs and NPs plays a strong role in managing chronic conditions and even possibly delaying or preventing their onset. RN M a ry- A n n e R o b i n s o n , RN, BN, MSA Chief Executive Officer Phone: 780.453.0509 or 1.800.252.9392, ext. 509 E-mail: [email protected] HARNESSING THE POWER, PASSION and PRIDE OF NURSING 2011 C ARNA CONFERENCE A N D AG M June 9 –10, 2011 Hyatt Regency Hotel Calgary Join RNs and NPs from across Alberta for the one and only provincial conference designed for nurses in all roles and levels of experience – all 33,000 of you! We’ve put together a program unlike any other previous conferences. This uplifting program is designed to provide you with a fresh perspective on your future and on the future of the profession. Come prepared to be inspired. www.carna conference.ca / 780.419.6070 PM40062713