Registered nurses are a knowledgeable, passionate, and incredibly tough group of men and women who work tirelessly to meet patient needs. RNs finish a challenging four-year degree comprising classroom learning and practicums. Their value is immense within our health care system. According to the Canadian Nurses Association, a higher proportion of registered nurses have been associated with shorter length of stays and lower rates of shock, cardiac arrest, medication errors, pneumonia, and respiratory failures. Higher proportion of care by registered nurses is associated with net cost savings with reduced length of hospital stays and less adverse outcomes. Finally, registered nurses improve child and maternal abuse outcomes, as a study found that registered nurse home visits had a profoundly positive effect on mitigating negative abuse outcomes.
Registered Nurses keep patients safer, save the health care system money, and provide positive social impacts within our communities. But, their value continues to be undermined.
Recently, the Saskatchewan Union of Nurses and Saskatchewan Association of Health Organizations reached a tentative mediated agreement on a new collective bargaining agreement. The terms of the deal are unknown, as it is undergoing a ratification process. What is upsetting about the negotiations is why the negotiations required a mediator in the first place.
According to the SUN president, the negotiations stalled not because of wages, but rather SAHO’s attempt to restrict nurses deciding on staffing levels. To deal with critical real-time patient safety, charge nurses are allowed to call in more staff upon consulting with a manager. In the latest round of negotiations, the SUN president stated that SAHO is considering transferring the charge nurses’ staffing authority to a non-nurse manager who has no clinical experience or knowledge of the patients.
Although the SUN’s claims may seem like mere negotiation tactics and hearsay, the current reality back up her claims. According to a RN from Yorkton, nursing staffing levels at Yorkton Regional Health Centre’s outpatient chemotherapy department have not changed, while the patient load has increased 20 per cent. Same goes for the maternity ward in Yorkton, where staffing levels have remained constant while the number of babies born each year have doubled. All the while, health regions are incurring incredibly large amounts of nursing overtime. According to the Canadian Federation of Nurses Unions, nurses are working 19.4 million hours of overtime work every year, which equals $872 million dollars of taxpayer money. This has resulted in RNs experiencing stress, anxiety, and burnout, which is very troubling knowing that these RNs deal with life and death situations every day.
Some have called for policies that replace RNs with LPNs and care aids. This suggestion is a misguided solution to a grave issue. RNs and LPNs receive different training. Comparing their value and substituting them for one another is ineffective, because they are trained to perform different tasks. The College of Licensed Practical Nurses of Alberta, states that the three groups of nurses (RNs, LPNs and care aids) “each have a defined scope of practice and is educated to function safely and effectively within their legislated scope.” This means that these nurses perform different roles. RNs, are trained to think critically and to solve complex, unstable and unpredictable situations. LPNs focus on more practical and predictable patient care. This is not to say one is more superior or more educated than the other. It is to say they are different. Their breadth and scope of practice is different. It would be irresponsible to replace one for another based on their costs, because they perform different functions and roles.
We need to take a responsible approach in maintaining our nursing sector. This means leaving critical decisions of staffing to charge nurses, who are knowledgeable about the profession and the patients. It means that not overworking our nurses, by maintaining staff levels that are congruent to amount of patients. It means establishing each nursing group, whether it be RNs, LPNs, or care aids, based on their relative competencies and training, instead of focusing on cutting costs. It means setting up our nurses to succeed, because their expertise positively impacts our health care system socially and economically.
We have a nursing faculty here at the University of Regina and we also have loved ones that receive treatment at our hospitals. Now, think about what it would mean if we were to compromise the safety of our nurses and loved ones. Think about our nursing graduates working 60 hours a week to attend to our loved ones. Think about the wards that are understaffed, whether that may be for babies or chemotherapy. Why are we compromising the health of our health care system and our patients?
Let’s foster registered nurses’ passion and vigor, place nurses on a platform to succeed, and maintain the safety of our patients and nurses.