Summer is Time to Renew

Transcription

1 IN THIS ISSUE Provincial Council Highlights CARNA Award Recipients ISMP Medication Safety Alert Nursing for First Nations Hiker Remembers RN Rescue Discipline Decisions Notice Board JULY 2008 VOLUME 64 NO 6 Summer is Time to Renew SEE PAGE 5 Sept. 19, 2008 Shaw Conference Centre Register Now... Early-bird registration ends August 22. Use the registration form on page 32 or register online at Conference agenda on page 31. New in September... Live opening keynote by John Lantos New closing keynote speaker, Dr. Margaret Somerville New concurrent session by Dr. Somerville World Café for more interaction Global Mardi Party Lunch hosted by the Alberta Registered Nurses Educational Trust Don t Miss this One! Calgary conference sold out in May.

2 CARNA Provincial Council PRESIDENT Margaret Hadley, RN, MN Edmonton PRESIDENT-ELECT Joan Petruk, RN, MHS Camrose NORTHWEST REGION Ellen Jones, RN Grimshaw NORTHEAST REGION Debra Ransom, RN, BN Lac La Biche EDMONTON/WEST REGION Cheryl Deckert, RN, BN Wetaskiwin Debbie Elliott, RN, M.Ed. Edmonton CENTRAL REGION Tammy Syrnyk, RN Camrose CALGARY/WEST REGION Shirley Chandler, RN, BTSN Calgary Dianne Dyer, RN, BN, MN Calgary Maureen Jamison, RN, BScN Calgary SOUTH REGION Heidi Watters, RN, BN, MEd, GNC(C) Lethbridge PUBLIC REPRESENTATIVES Maggie Fulford, BSc, DC Edmonton Margaret Hunziker, BA, MA Cochrane Mark Tims, QC Westlock Rene Weber, DVM Red Deer CARNA Provincial Council Meeting Sept. 19, 2008 All CARNA members are welcome to attend. To confirm your attendance, please contact: Wendy Buckley in Edmonton or toll-free , ext. 510 Alberta RN is published nine times a year by: CARNA Staff Directory ALL STAFF CAN BE REACHED BY CALLING: or toll free Executive Director: Mary-Anne Robinson Director of Communications: Margaret Ward-Jack Director of Corporate Services: Jeanette Machtemes Director of Policy and Practice: Lynn Redfern Registrar/Director of Regulatory Services: Kim Campbell Deputy Registrars: Terry Gushuliak, Jean Farrar, Terri Fortunaso Competence Consultant: Barb Perry Complaints Director: Sue Chandler Conduct Counsel: Gwendolyn Parsons Conduct Counsel/Senior Investigator: Georgeann Wilkin Nursing Consultants Policy and Practice: Debra Allen, Marie-Andrée Chassé, Donna Hogg, Debbie Phillipchuk Librarian and Archivist: Lorraine Mychajlunow NEPAB Consultant: Lori Kashuba Alberta Registered Nurses Educational Trust: Margaret Nolan Regional Coordinators: Northwest: Kathleen Waterhouse Northeast: Barb Diepold Edmonton/West: Penny Davis Alison Adams Central: Heather Wasylenki Calgary/West: Christine Davies Beverlie Johnson South: Pat Shackleford Valerie Mutschler College and Association of Registered Nurses of Alberta Street Edmonton, AB T5M 4A6 Phone: Toll free in Canada: Fax: Managing Editor: Margaret Ward-Jack Editor: Rachel Champagne Assistant Editor: Rose Mary Phillip Designer: Julie Wons Advertising Representative: Jan Henry, McCrone Publications Phone: Fax: mccrone@interbaun.com Please note CARNA does not endorse advertised services, products or opinions. US Postmaster: Alberta RN (USPS # ) is published monthly except June, August 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 Alberta RN is published at a rate of $40 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 ISSN Canadian Publications Mail Agreement No Return Undeliverable Canadian Addresses to: Circulation Dept., Street, Edmonton, AB T5M 4A6. carna@nurses.ab.ca Alberta RN is printed on recycled paper. 2 Alberta RN July 2008 Volume 64 No 6

3 update President s Update In my message at the AGM in May, I focused on the trends which are shaping the framework of our profession in this province. While they may seem far removed from your daily work, they do influence the environment in which you work and are strongly affecting the work that CARNA is doing on your behalf. I wanted to take a moment, though, to share one of my greatest pleasures in my role as president of CARNA and that is the opportunities I have had to visit registered nurses throughout the province. In the past few months I have visited and talked with nurses in Barrhead, Red Deer, Westlock, Gunn, Onoway, Whitecourt, Mayerthorpe, Fox Creek, Drayton Valley, Wetaskiwin, Edson, Hinton, Jasper, Canmore, Calgary, and Edmonton. Hello to all of you again. As well as being skilled and knowledgeable, the RNs I meet display a passionate commitment to excellence in patient care and I never fail to be impressed by the depth of knowledge and skill they bring to their work as Registered Nurses. I want to say thank you for making me proud to be an RN. The following is the President s Address delivered at the CARNA Annual General Meeting on May 23, A CHANGING LANDSCAPE This has been a very busy year for the College and Association of Registered Nurses of Alberta (CARNA). Regulatory trends and issues have lead to significant decisions by council and affected CARNA operations. Today, I am going to take a few moments to highlight some of the global forces and trends in regulation affecting CARNA s work, illustrate the impact of these trends in Alberta and then share some thoughts about nursing leadership. Global Trends First of all, the regulatory environment is becoming more complex. There is a growing emphasis on creating a level playing field that enables competition and innovation. Another trend is the global shortage of health professionals, a growing crisis which affects the quality and quantity of health services. The shortage is also contributing to a shift in roles and responsibilities from regulated professionals to unregulated workers. CARNA is committed to helping address the nursing shortage in Alberta. Building the capacity of the registered nursing profession means addressing workplace issues which are affecting recruitment and retention of RNs as well as increasing nursing education seats and facilitating inter- national recruitment. It also means removing barriers to RNs fulfilling their role and helping to ensure they have the knowledge required to assume new roles within the health system. Another global trend is the perception that regulatory bodies are a barrier to recruitment, setting unnecessarily high standards to protect their turf. All of these global forces have contributed to the concept of meta-regulation or regulating the regulators. Trends in Meta-Regulation Increased government regulation is an attempt to rebuild public trust in social institutions and regulators. While it has an economic or policy expertise basis, the focus is clearly on public safety and public health. There is also an emphasis on accountability, transparency and trust. Regulations are being refocused on the needs of society versus that of the profession and regulators are expected to pay more attention to monitoring, compliance and enforcement of members. Adherence to privacy principles is also expected. Finally, there is a trend towards inter-professional collaboration, which includes a move to common standards and professional practice guidelines when professions share the same restricted activities. Continued on page 26 July 2008 Volume 64 No 6 Alberta RN 3

4 Provincial Council Highlights June 6-7, 2008 New Code of Ethics Council agreed to adopt the Canadian Nurses Association Code of Ethics for Registered Nurses (2008) effective Oct. 1, CARNA members will be able to access both the current Code of Ethics for Registered Nurses (2002) and the new Code of Ethics for Registered Nurses (2008) as appendices to the CARNA Nursing Practice Standards on the CARNA website until the new code takes effect on October 1. The revised Code of Ethics is the result of an extensive review and consultation process over three years between CNA, CARNA and other provincial nursing jurisdictions. The review will be complete with the release of the CNA Code of Ethics at the CNA Biennium in June Guidelines Approved Council approved the revised document Evidence-Informed Staffing for the Delivery of Nursing Care: Guidelines for Registered Nurses (June 2008). Revisions include the addition of language emphasizing the role of the registered nurse (RN) in the staffing process and the integration of knowledge related to the types and levels of decision-making required within the staffing process. A resource list was also added and the document title was revised to align with current terminology used in the literature. The revisions incorporate a literature review and the results of a consultation with members conducted over the past year which indicated that the document continues to be timely and relevant and that it provides essential information to support the practice of registered nurses. Council approved the revised document Guidelines for Assignment of Client Care and Staffing Decisions. Based on a literature review and feedback from members, a section on the charge nurse role was added and the staffing decision tool was removed since staffing is addressed in the document Evidence Informed Staffing for the Delivery of Nursing Care: Guidelines for Registered Nurses (June 2008). Protection of Titles Provincial Council carried a motion to authorize staff to work with government to revise Schedule 24 of the Health Professions Act (HPA) and the Registered Nurses Profession Regulation to: protect the titles Graduate Nurse and the initials GN allow regulated members on the CARNA Courtesy Register to use the title Registered Nurse or the initials RN protect the title Graduate Nurse Practitioner and the initials GNP No titles are currently assigned to members who are registered on the Temporary or Courtesy Registers. The title Graduate Nurse and the initials GN are commonly used in practice for new graduates or internationally educated nurses (IENs) authorized to practice in Alberta by CARNA. Both groups are regulated by CARNA and entered on the Temporary Register until they complete all outstanding registration requirements for full licensure, which typically includes the successful completion of the Canadian Registered Nurse Exam (CRNE). CARNA s Courtesy Register lists RNs from other jurisdictions who are regulated by CARNA and authorized to practice in Alberta for a limited period of time and a specific purpose. Common practice has been to use the title Registered Nurse or the initials RN while in Alberta. The title Graduate Nurse Practitioner and the initials GNP are proposed in preparation for the future implementation of a NP examination(s) as a registration requirement for NP status. The addition of the titles Graduate Nurse Practitioner and GNP will help all stakeholders distinguish between these members waiting to write the NP exam to finalize registration and new graduates on the Temporary Register waiting to write the exam. The specific exams for NPs have not yet been selected by the jurisdictions. Appointments Council selected four public members for appointment by the Minister of Health and Wellness to meet HPA requirements. Council put forward the names of Sybilla M. Lane and Dr. Mark L. Zivot and the names of Margaret Hunziker and Rene Weber for reappointment for a second, two-year term. The reappointment of two current representatives supports continuity on Council for the purposes of discussing issues and ongoing implementation of HPA and the selection of new members will fill the vacant positions in time for the orientation of new council members scheduled to coincide with the Council meeting in September. Christopher Sheard resigned as public member in late February 2008 and Maggie Fulford is not seeking reappointment. Council reappointed Mary Haase for a one-year term to the Hearing Tribunal. Council appointed RNs Drucilla Edmiston and Anna Tsang, both of Edmonton, to serve as scrutineer and alternative scrutineer, respectively during the opening and counting of ballots on July 11, 2008 for the election of CARNA provincial councilors in four regions. Council appointed Katherine Chubbs to serve as CARNA representative on the board of directors of the Canadian Nurses Protective Society. CARNA s current representative, Lorraine Way, will complete her three-year term on Jan. 31, Vogel Award Recipients After two successive tie votes, Council voted to confer the Vogel Award on two recipients, Shirley Chandler (Calgary/ West) and Debbie Elliott (Edmonton/ West). The award recognizes contribution through service on Provincial Council and is awarded annually to a registered nurse member of council, excluding the president, who has served for at least one year of the current term. The award will be presented at the September 2008 meeting of council. RN 4 Alberta RN July 2008 Volume 64 No 6

5 SUMMER...is registration renewal time and we re making it easy for you. Profile management Personal information is easily accessed with less navigation through site Review and change personal information with ease Why wait for renewal? Update your information year round Renew online at Simpler, faster and always secure All you need is Internet access and an address. We encourage all members, both returning online users and new online users, to try renewing online. We ve made changes based on feedback from last year s renewal, so you ll find the site easier to access and more user-friendly. July 2008 Volume 64 No 6 Alberta RN 5

6 Information packages are being sent to all members If you indicated last year that you wanted to renew online and receive your renewal information by , you will still receive a package by mail this year. The online renewal process has been revised based on feedback provided last year from members, and we thought all members would appreciate a copy of the step by step instructions included in the enclosed renewal guide. You can complete the paper form in preparation for renewing online, retain it for your own records, or simply recycle it. Next year, any members who indicate they wish to receive their renewal information by will not receive a package by mail. You will also find that your password is printed on the top right-hand corner of your renewal form, for easy reference. Renew your membership in five easy steps. The entire online renewal process has been redone for clarity and efficiency. Fewer pages mean less waiting. Renew in August and WIN. This year, registering early could make you a winner. One lucky registrant who renews before Sept. 1, 2008 will win a VIP Package for the 2009 Tri-Profession Conference May 21-23, 2009 at The Fairmont Banff Springs hotel including conference complimentary registration and special events and three nights accommodation at The Fairmont Banff Springs hotel. Your name will be entered automatically when you submit your completed registration either by mail or online, including payment before September Read and agree to the privacy statement. Things to remember about renewal Renewal deadline is Sept. 1, 2008 Please renew online or return your form and payment to the CARNA office by Sept. 1, 2008 to allow us enough time to process the more than 30,000 registrations we anticipate receiving. Your current practice permit expires Sept. 30, Registrations are processed in order of arrival, and if we receive your form after September 1, we cannot guarantee it will be processed by September 30. Without a current practice permit, you will not be able to work on October 1 st. Individuals practising without a current practice permit are in contravention of provincial legislation (the Health Professions Act), and CARNA is required to notify both the individual and the employer of this contravention. After September 30, a $50 reinstatement fee is charged on renewals. Even if you are not practising as of Oct. 1, 2008, you need to answer the questions on the renewal form, sign it and return it to us prior to September 30. Reporting key information from the completed practice year to CARNA is each nurse s professional responsibility and will ensure that you maintain good standing with your regulatory body. Continuing competence requirements You must report on your continuing competence activities: > if you held a CARNA RN, NP or CGN practice permit for any portion of time from Oct. 1, 2007 to Sept. 30, 2008 and/or > if you are applying for a practice permit for any portion of time in the 2009 practice year (Oct. 1, 2008 to Sept. 30, 2009). Reporting on the 2008 practice year (Oct. 1, Sept. 30, 2008) > Mandatory for everyone who held a RN, NP or CGN practice permit during any portion of the 2008 practice year. > The indicators you selected for your professional development will be preprinted on your renewal form. 6 Alberta RN July 2008 Volume 64 No 6

7 3. Confirm your registration type. 5. Pay. > Collect feedback about your nursing practice. > Prioritize specific indicator(s) for your professional development for the 2009 practice year. RNs must select at least one and up to three Nursing Practice Standard indicators; NPs must select at least two and up to three indicators, at least one of which must be a NP competency indicator. > Begin a written learning plan to address each indicator you have chosen. > Record your selected indicator(s) on your renewal form Throughout the 2009 practice year, you should further develop and implement your learning plan. When you complete your learning activities, evaluate the influence this learning has had on your practice and document your evaluation. Please do not submit your continuing competence documents with your renewal form. Keep your documents for five years so that, if requested, you are prepared to provide evidence of participating in the Continuing Competence Program. For detailed information on CARNA s Continuing Competence Program, please refer to the CARNA website and your Continuing Competence information package. 2. Review your member profile to ensure all information is correct. 4. Enter relevant renewal information. Click the question mark icon for help at any time. > For each indicator, report on the implementation of your learning plan, meeting your learning objective and the influence this learning has had on your nursing practice. > If you changed your professional development focus to a different indicator, please record the change and report on the implementation of your learning plan for the new indicator. Identifying indicators for the 2009 practice year (Oct. 1, Sept. 30, 2009) > Mandatory when applying for or renewing RN, NP or CGN practice permits for the 2009 practice year. > Complete a written comprehensive self-assessment of your nursing practice using the CARNA Nursing Practice Standards. Nurse Practitioners must also use the CARNA Nurse Practitioner Competencies registration fees Annual registration fees for the 2009 practice year will be: Registered Nurse $ ($410 + $20.50 GST) Certified Graduate Nurse $ ($410 + $20.50 GST) Nurse Practitioner $ ($435 + $21.75 GST) Non-practicing (Associate, Retired, Student) $42.00 ($40 + $2.00 GST) For complete details on the registration fees approved by Provincial Council for the next three years, please refer to the May 2008 issue of Alberta RN. The registration fee includes membership in the Canadian Nurses Association and liability protection from the Canadian Nurses Protective Society. Make renewal easier. You don t have to wait until you receive your renewal information to update information. In fact, you shouldn t wait. You can update your Member Profile online any time during the year, including your contact information, employer, Continuing Competence information, and practice hours for the current year. Log in to your Member Profile on CARNA s website We re here to help If you have any questions about your current registration or renewing your registration, please contact CARNA s registration department at , or toll-free at RN July 2008 Volume 64 No 6 Alberta RN 7

8 Committed to Competence As you prepare for your registration renewal, it is also time to prepare to report your continuing competence activities completed during the 2008 practice year and identify your professional development goals for the 2009 practice year. Here is an example of how to report on the implementation of your learning plan(s): The Nursing Practice Standards (NPS) indicators you selected during last year s registration renewal will be preprinted on your 2009 renewal form. For each indicator, report on the implementation of your learning plan, meeting your learning objective and the influence this learning has had on your nursing practice. If you changed your indicator during the practice year, record the change and report on the implementation of your learning plan for the new NPS indicator. Documenting your professional development plans and reporting your continuing competence activities at registration renewal provides the evidence required to demonstrate that you have engaged in learning and participated in the CARNA reflective practice process. Indicator Indicator 2.2 If you changed this indicator during the year, which indicator did you change to? Learning plan implemented? Learning goal met? Learning influenced your practice? Yes No Yes Partial No Yes No Unsure If no, check reason: Chose too many indicators If no, check reason: Did not work in Alberta If yes, how: Increased knowledge/skill/competence Did not work in Alberta Other: Other: Enhanced critical thinking/ decision-making Increased confidence Enhanced accountability Improved communication skills Other: 4.1 If you changed this indicator during the year, which indicator did you change to? Learning plan implemented? Learning goal met? Learning influenced your practice? Yes No Yes Partial No Yes No Unsure If no, check reason: If no, check reason: If yes, how: Chose too many indicators Did not work in Alberta Other: Did not work in Alberta Other: Increased knowledge/skill/competence Enhanced critical thinking/ decision-making Increased confidence Enhanced accountability Improved communication skills Other: 2.8 The next step is to identify NPS indicators you would like to focus on for the 2009 practice year. First, assess your nursing practice using the NPS. If you are a nurse practitioner (NP), assess your practice using both the NPS and the NP Competencies. Next, collect feedback about your nursing practice. Based on your self-assessment and feedback, select at least one NPS indicator as your priority focus for the 2009 practice year. NPs must select at least two indicators; one indicator from the NP Competencies. Record your self-assessment, priority indicators and begin writing a learning plan for each indicator you selected. Here is an example of how to report your priority indicator(s) on your registration renewal form: I have assessed my nursing practice, collected feedback, and initiated 1.7 the development of a learning plan(s) for the following indicator(s): RNs and CGNs enter minimum one (1) indicator. NPs enter minimum two (2) indicators, one of which must be a NP Competency indicator. NP 4.1 Throughout the 2009 practice year, you should further develop and implement your learning plan. Continue to reflect on your practice and record any new priorities or other changes. Keep your documents for five years so that, if requested, you are prepared to provide evidence of participating in the CARNA Continuing Competence Program. For more information about the Continuing Competence Program, please visit the CARNA website or contact the CARNA office by phone: /toll-free at or continuingcompetence@nurses.ab.ca. 8 Alberta RN July 2008 Volume 64 No 6

9 NATIONAL NURSING WEEK MAY 12-18, 2008 Think you know nursing? Take a closer look! In support of members celebrating National Nursing Week, the College and Association of Registered Nurses of Alberta (CARNA) distributed approximately 1,100 celebration kits to members across Alberta. Around Alberta, several towns proclaimed National Nursing Week and many employers and community groups sent out media releases honouring the contributions of nurses. Nidia McIntosh, RN (right) and Florence Nightingale (3rd year nursing student Andra Cooper from Mt. Royal College) at the Calgary/West nurses dinner held on Florence s birthday, May 12. Nursing Week Proclaimed in the Legislature RN letter featured in CARNA s National Nursing Week advertising campaign: There are approximately 38,500 nurses who are registered in Alberta. These dedicated health professionals provide care when and where it is needed. Nurses deliver quality healthcare each and every day by making the safety and well-being of their patients a top priority. They are a key part of the strong health-care delivery system we have in our province today. I m sure I speak for all Albertans when I say thank you to all our nurses here in Alberta. I encourage everyone to salute the nurses in their communities as we give special recognition to the importance of the nursing profession during Nursing Week. ~ Genia Leskiw, MLA Bonnyville-Cold Lake The above is an extract from the Alberta Hansard on May 12, July 2008 Volume 64 No 6 Alberta RN 9

10 2008 Awards Gala More than 250 guests attended the CARNA Awards Gala to honour this year s nominees and award recipients and ARNET s top scholarship recipients. Emcee Fred Keating, musical director Jan Randall and professional singer and RN, Dylis Kulchitsky guided the evening s program with music, song and commentary that was at times touching and often comical. In addition, two of Canada s finest, RCMP Constables Dean Caithcart and Matt Sailor, were on hand to escort award recipients to the stage. During dinner, CARNA also honoured Alberta recipients of the Canadian Nurses Association Centennial Awards with a special video presentation incorporating historical nursing photos from the CARNA archives. CARNA appreciates the commitment of TD Meloche Monnex to supporting tomorrow s nursing leaders with its sponsorship of the Awards Gala and the creation of the CARNA TD Meloche Monnex Scholarships. SUPPORTED BY 1 Those nominated, those doing the nominating, and those not yet nominated help make nursing what it is. You make us collectively proud Start thinking of next year s awards. There are more than 30,000 RNs practicing in Alberta, and I know that each and everyone of you can name someone who deserves to be recognized with a nomination for an award of excellence. Executive Director and Chair, Awards Selection Committee Mary Anne Robinson Ceremonies like tonight s awards gala are deeply symbolic events. While we recognize a few exceptional individuals, we are also celebrating something much bigger. In this instance, we are honouring a legacy of professional nursing excellence that stretches back for nearly a century within our province. That profession not only continues to stand proud today, but is also exploring different horizons as it shapes the health-care system of tomorrow. President Margaret Hadley at the 2008 CARNA Awards Gala 1. L to r: Constable Dean Caithcart, Greta Cummings (Research), CARNA President Margaret Hadley, Marion Allen (Education), Mary Ellen Williams (Partner in Health), Angela Craig (Rising Star), Inge Brown (Partner in Health), CARNA Executive Director Mary-Anne Robinson, Lynn Martin (Partner in Health), Ilene Burton (Clinical Practice), Cathy Giblin (Administration), Maureen Best (Lifetime Achievement), Constable Matt Sailor 2. Maureen Best (centre) receives the CARNA Lifetime Achievement Award from CARNA President Margaret Hadley (left) and CARNA Executive Director Mary-Anne Robinson. 3. L to r: Joanne Penner Herron, Chair, ARNET Board of Directors; Sheila Elliott, Chair, ARNET Allocations Committee; Carrie McDonagh, recipient of the CARNA TD Meloche Monnex Scholarship; Lone St. Croix, Vice-president and Aurelia Festa, Coordinator, TD Meloche Monnex Affinity Market Group. 4. Rising Star Angela Craig is escorted to the podium by Constable Dean Caithcart. 5. Dylis Kulchitsky, RN leads the celebration with a rendition of O Canada. 6. Master of Ceremonies Fred Keating. 7. Friends and colleagues enjoy reconnecting at the Awards Gala. 10 Alberta RN July 2008 Volume 64 No 6

11 Who will you nominate in 2009? 3 July 2008 Volume 64 No 6 Alberta RN 11

12 The College and Association of Registered Nurses of Alberta salutes the recipients of the 2008 Awards of Nursing Excellence LIFETIME ACHIEVEMENT Maureen Best Calgary Health Region Maureen Best has advanced the nursing profession on local, provincial and national levels. Throughout her 34-year career, she has been a strong role model for leadership and continuing education. We all want to develop a sense of competency in the work we do; this is a process rather than an end point, says Best. The process of learning and integrating new knowledge into our practices keeps our work interesting and ensures our patients receive state of the art care. Best played a significant role in reorganizing community health nursing, resulting in a strengthened practice model. She also provided local leadership relating to the Canadian Community Health Nursing Standards. At the provincial level, Best has been an active member of CARNA. She has served on Provincial Council and committees, including the Competence Committee. She helped champion CARNA s position on the baccalaureate preparation for entry-to-practice efforts and help reassure all diploma-prepared nurses of their continued status within the profession. Participating on committees and boards is an excellent way to stay current on issues in healthcare and have a voice in decisions that affect our practice, says Best. It s also an excellent way to develop networks and learn different approaches to similar issues in practice. Other benefits are developing leadership skills and developing mentoring relationships. Nationally, she helped develop the Canadian Nurses Association Community Health Certification Exam, including item writing. She also participated in the first National Community Health Nursing Education Conference. Best has been an adjunct professor with the University of Calgary for over 19 years. She developed the Nurses Work Life Satisfaction Survey, resulting in action plans addressing satisfaction issues. She worked tirelessly to advance the profession in areas of education, policy, multi-disciplinary collaborative approaches, scope of practice and research. None of my achievements were accomplished by me alone. I ve had some truly exceptional mentors. I m sincerely grateful for their encouragement, patience, generosity and wisdom, says Best. The most exciting part of entering a new phase is my career is working with new mentors. Nurses never retire, we just move on to new challenges! Trudie Lee Photography 12 Alberta RN July 2008 Volume 64 No 6

13 Images Studios (Craig), Tina Chang (Giblin) RISING STAR Angela Craig Registered Nurse Cold Lake Healthcare Centre Angela began work at the Cold Lake Healthcare Centre as a nursing student. Less than two years later, she secured a permanent position in the emergency room. I really appreciate the nurses who took time to invest in my learning, says Craig. Her persistent positive attitude conveys her compassion and desire to help. It also fosters teamwork and open communication with co-workers and management. Craig aims to make those around her feel included and appreciated. During a recent pink day, in support of a co-worker with breast cancer, Craig worked her shift wearing pink from head to toe, including pink hair! Craig s dedication to her patients and profession is inspiring and she is often asked to speak with new recruits. She shares with them her knowledge and her passion in hopes that they will share in her love of nursing and the Cold Lake community. The mystery of the human body is so exciting, says Craig. I take amusement and pleasure in it all like someone with really nice veins! In recent years, Craig travelled abroad, taking her care and kindness to Rwanda and the Ukraine. While there, she gained an appreciation for circumstances in Canada. It made me thankful for the life I have here, says Craig. I ve changed the filter I use to look at the world. Craig s co-workers refer to her as a dedicated nurse, a wonderful community member and very special person. They have no doubt she will make a wonderful contribution to the nursing profession in coming years. NURSING EXCELLENCE IN ADMINISTRATION Cathy Giblin Regional Manager, Nursing Affairs Capital Health Cathy Giblin is a true leader. Her anything is possible attitude encourages staff to continually improve and challenge themselves, both in and outside of the work setting. Giblin actively looks for opportunities for improvement and seeks possibilities for change. She s open and accepting of new ideas, thereby cultivating a team environment where everyone s voice is heard and appreciated. I encourage them to look at things from new perspectives, says Giblin. The goal is to get them to do more than ask questions. It s to find possible solutions. Giblin works to promote maximizing nursing scopes of practice and leadership. She is an intense defender and avid supporter of the profession. Nurses know what they need to do. Their primary focus is the duty to care, says Giblin. Access to information, professional development and education are part of what they need to do to fulfill this duty. That s where I come in. Giblin is a member of the Clinical Nursing and Practice Leaders Network and the Canadian College of Health Services Executives. She has been co-chair of the Nursing Advisory Council of Alberta and is a member of the Academy of Canadian Executive Nurses. Each month, Giblin ensures she finds the time to meet with each of her staff one-on-one. She empowers them by providing guidance and support. Dedicated to building effective relationships within multi-disciplinary health-care teams, she encourages staff to become associate professors for the University of Alberta faculty of nursing and accommodates work plans to enable them to participate in interdisciplinary collaborative education activities. Giblin s leadership abilities are described by her colleagues as enterprising, passionate and supportive. July 2008 Volume 64 No 6 Alberta RN 13

14 NURSING EXCELLENCE IN RESEARCH Dr. Greta Cummings University of Alberta Dr. Greta Cummings has embarked on a program of research on leadership in healthcare. She has identified gaps in knowledge relating to factors that contribute to absenteeism, improved quality of nursing work life and cultures of patient safety and works to examine how these contribute to the health-care system. When I finished my doctoral work at the Alberta Cancer Board, I was struck by the results and realized there was a gap in knowledge I could work toward filling, says Cummings. She is the principal investigator of the Connecting Leadership Education and Research Outcomes program, focused on development of leadership to achieve better outcomes for health-care providers and patients. Research is essential to support the evolution of nursing practice, says Cummings. It will help provide knowledge for evidence-based practice. A well-funded researcher, Cummings completed 11 research studies that were supported by local, provincial and national agencies and organizations. Additionally, she has been the recipient of several awards, including doctoral awards from the Canadian Institutes of Health Research and the Alberta Heritage Foundation for Medical Research. Cummings has an exceptional publication record, having published 30 peer-reviewed papers and has several in preparation. She has also published three chapters in three separate refereed books. NURSING EXCELLENCE IN CLINICAL PRACTICE Ilene Burton Nurse Manager, Adult Outpatient Heart Transplant Clinic University of Alberta Hospital Ilene Burton has been caring for heart transplant patients since the opening of the adult-outpatient transplant program at the University of Alberta Hospital. Collaborating with other health-care professionals, Burton facilitates holistic care to work toward the best possible patient outcomes. Our patients are at the end of the line and won t survive without a transplant. When I first started, I had trouble working with the terminally ill, says Burton. We do our best to encourage their hope. I m more comfortable dealing with death now due to the strength of my patients. She understands the emotions involved in waiting for test results and does her best to ease anxiety for her patients. After a long day, Burton often waits for patient results of cardiac biopsy or blood work, so she can call patients as soon as possible. I know that if it were me, I would want to know the results before I could sleep, says Burton. Burton was instrumental in developing policies and procedures for care of outpatient heart transplant recipients. Based on work done at Standford University, she worked with surgeons, cardiologists and other health-care professionals developing policy. In addition, she led a rewrite of education material in areas of nursing, nutrition, social work, physiotherapy, occupational therapy and pastoral care for transplant recipients. Burton instils confidence in those around her and fosters a team environment. She is readily available to provide direction and information regarding cardiac care. An invaluable member of the transplant team, Burton offers insight and assistance to colleagues to ensure patient care is not compromised. Tina Chang 14 Alberta RN July 2008 Volume 64 No 6

15 NURSING EXCELLENCE IN EDUCATION Dr. Marion Allen Associate dean, faculty of nursing University of Alberta Dr. Marion Allen is described by her colleagues and students as a master teacher. Her passion for nursing and education is evident and translates into enthusiasm for learning. Today s students are our future nursing leaders, says Allen. I want them to see that everyday there is something new to learn in nursing. It is not just in the tasks we do, but also in how the complexity of what we do helps our patients. A proven leader in education development, she was the first to offer a doctorate level course via the internet, reaching students unable to learn on site. More recently, she began teaching the online course Nursing 502: Nature and Development of Nursing Knowledge. Not everyone can be here in person. We have to look at different ways students and nurses can be engaged, says Allen. We are only limited by our imagination. Allen s breadth of knowledge enables her to relate complicated, abstract concepts into straightforward, tangible notions for her students to grasp, empowering them to get the most from their education. In response, her students have twice selected her to receive a graduate teaching award. In 2001, her expertise and knowledge led to participation in a project, funded by the Canadian Internationally Development Agency, for development of a master s program at the University of Ghana. In 2006, Allen taught a course for PhD nursing students at the Chulalonghorn University in Thailand. I want my students to stay open to new knowledge and to recognize that it is okay to not know something it s a stimulus to learn, says Allen. Learning is a never ending process. PARTNER IN HEALTH Healing Connections Volunteer Group Misericordia Community Hospital Capital Health The Healing Connections Volunteer Group is comprised of breast cancer survivors dedicated to supporting those journeying through recent diagnosis. They visit women on surgical units and share their personal cancer stories, offering support and the hope that survival is possible. They provide a phone number for each patient in the program to call at any time of the day or night for encouragement, and ensure they are able to attach a compassionate face to the number. This group of remarkable ladies is giving of their time and offer a much needed service during a difficult and vulnerable period. They are dedicated, objective, yet empathetic. All volunteers are past patients of Healing Connections, a unique program designed to provide support from diagnosis to surgery then to long-term treatment. Volunteer support is one element of the program, which also offers choices in physiotherapy, occupational therapy, nursing education and dietary recommendations. Patient response has been overwhelmingly positive. Many report decreased anxiety and an increased perception of self. The caring and compassion does not end with treatment. The volunteers continue to connect with patients after they have left the program a tribute to the strong bonds formed. Back row, left to right: Mary Ellen Williams, Karen Campbell, Inge Brown, Margaret Lemoine. Front row, left to right: Claire Lefebvre, Joan McCann. Missing: Lynn Martin and Diane Monych. Tina Chang July 2008 Volume 64 No 6 Alberta RN 15

16 Alberta Registered Nurses Educational Trust Investing in the Heart of Healthcare 2008 ARNET Scholarship Recipients The Alberta Registered Nurses Educational Trust (ARNET) is pleased to announce this year s recipients of the prestigious Alberta Registered Nurses Educational Trust Annual Scholarships. The Annual Scholarships are awarded to registered nurses who best exemplify ARNET s commitment to promoting nursing excellence. Scholarships are awarded based on superior academic achievement and the applicant s strengths in nursing leadership, nursing research, professional contributions, administration, education and/or nursing practice. The University of Alberta faculty of nursing provided matching scholarship supports for the second year in a row to qualifying full time graduate students and ARNET distributed a total of $121,500 in scholarships through this year s competition. Please join us in congratulating the 2008 ARNET Scholarship recipients and expressing our sincere thanks to our donors who made this possible! CARNA TD Meloche Monnex Scholarship Carrie McDonagh James Veenstra CARNA Presidents Scholarship Nora Landon Diane Heather Kunyk Leanne Fontanie ARNET Board of Directors Scholarship Terryl Pfannmuller Louise Folkmann Ada Chan 2008 ARNET Scholarship Tamara Van Tassell Claudia Steinke Christina West Tracy Mitchell Nadine Strilchuk Edith Zrodowski Kelly McDonald Shelley Jeske Marcia Ellinger Louise Rawluk Suzanne Basiuk Deanna Malcolm Tammy Troute-Wood Jocelyn Jubinville Susan Horsman Kyla Craig Leanne Craig Deanna Koot Andrea Schroeder Hazel Duddy Anil Kurian Angela Morck Tara Elliott Joanna Szabo Linda Watson Nelley Oelke Colleen Maykut Joanne Hewitt Maureen Chrusch Shannon Lemire Colleen Cuthbert Davidson Memorial Scholarship Shelina Gangji Caroline Porr Nicola Skelly International Conference on Community Health Nursing Research Scholarship Wendi Lokanc-Diluzio Sisters of Service Centennial Scholarship Danielle Gagnon Karen Polowick Scholarship for Nursing Leadership Jocelyn Jubinville 16 Alberta RN July 2008 Volume 64 No 6

17 TM ARNET thanks everyone who participated in our fundraising activities during the CARNA Annual General Meeting and Gala and Conference on May 22 and 23, With your help, we raised over $6500 in support of continuing nursing education! We would like to thank the following sponsors who helped make our event an overwhelming success! Guests had the chance to win airfare for two to Mexico courtesy of Uniglobe Geo Travel. Cheryl Gagne was the winner, Congratulations Cheryl! Johnson and Johnson supported the event with star themed decorations to help celebrate our nursing stars. Thank you Johnson and Johnson and Uniglobe Geo Travel! From l to r: ARNET Board Chair Joanne Penner Herron, Scholarship Recipients Carrie McDonagh, Diane Kunyk, Nora Landon, Louise Folkmann, ARNET Selections Committee members Marion Allen, Sheila Elliott. A Special Thank You to the following Supporters who donated to the ARNET Silent Auction! Patricia Walker Scholarship for Studies of Childbirth Education and Maternal and Child Health Nursing Neda Etemadi Applications for the 2009 ARNET Scholarships will be available Jan. 1, 2009 with an application deadline of March 15, Information regarding alternate educational funding supports is available on the CARNA website at or by contacting the Educational Trust office at , ext Alanna Nolan Beijo Bags Betty Gourlay Brenda Fisher Caley Fisher Calgary Stampede Canadian Breast Cancer Foundation Prairies/NWT Region CARNA Regional Coordinators Cheryl Gagne Collette Shrivell-Simmers Corona Rejuvenation Spa Cosmetic Laser and Vein Centre Councilor Linda Sloan Eden Lilly Flowers on Whyte Edmonton Kinsmen Pitch & Putt Ella Smith Eternity Limousines Ev Henderson Incredibly Comfortable Uniforms Janet O Donnell Jeanette Machtemes Joan Petruk Joanne Penner Herron Lella Blumer Lori Kashuba Lorraine Way Margaret Malo Marilyn Wacko Marion Allen and Friends Mark Anthony Wine Merchants Nursing Faculty and Staff at Red Deer College Peggy Ann Field Prairie Gardens Sante Spa SDI Digital Imaging Sheila Elliott Sheila McKay Sobeys Lakeland Ridge Sunnyside Greenhouses Tammy Syrnyk Treena Hrytsak Uniglobe Geo Travel July 2008 Volume 64 No 6 Alberta RN 17

18 MEMBERS WANTED! If you are a registered nurse seeking an opportunity to advance the profession by sharing your knowledge and experience, you are invited to apply for a volunteer position on one of the following CARNA committees. Elections and Resolutions Committee Three members Term beginning Oct. 1, 2008 The Elections and Resolutions Committee (ERC) is responsible for: recommending a slate of qualified candidates for members of Provincial Council and president-elect, whenever an election for that office is required developing the rules governing the CARNA campaign and election process for review and approval by council providing support for members submitting resolutions for CARNA s annual general meeting supporting the development of resolutions for proposal at the 2009 CNA Biennium for council s consideration soliciting names of members interested in becoming members of ERC to be considered by council Qualifications CARNA attempts to achieve broad representation of membership by appointing members from a variety of geographic regions. Preference will be given to RNs working outside of Edmonton and Calgary. Expectations of Members serve a two-year term prepare for meetings and teleconferences attend four to six teleconferences and up to two face-to-face meetings in Edmonton network to generate nominations Questions If you have questions about the work of the committee or the expectations of members, please contact: Margaret Ward-Jack Director, Communications T: or toll-free at , ext. 515 E: mwardjack@nurses.ab.ca How to Apply: Visit for an application form or contact Diane Wozniak at or toll-free at , ext Awards Selection Committee Three members Term beginning Oct. 1, 2008 The CARNA Awards Selection Committee is an operational committee composed of five volunteer RN members and the executive director. The committee reviews criteria, reviews nominations and selects qualified recipients for the CARNA annual awards program. Qualifications To complement the composition of the committee, preference will be given to RNs working in clinical practice, education or research. Expectations of Members serve a two-year term, beginning Oct. 1, 2008 prepare for meetings and teleconferences review nomination submissions and objectively apply award criteria participate in two to four meetings per year Questions If you have questions about the work of the committee or the expectations of members, please contact: Rachel Champagne Manager, Communications T: or toll-free at , ext. 516 E: rchampagne@nurses.ab.ca How to Apply Visit for an application form or contact Diane Wozniak at or toll-free at , ext. 525 Application deadline: Aug. 24, 2008 Registration Committee One member Term beginning Oct. 1, 2008 The Registration Committee is a regulatory committee composed of seven RN members who review applications for registration and initial or renewed practice permits. They also consider requests for exemption to the application of a standard registration committee policy, due to extraordinary circumstances. The committee members are responsible for determining if an applicant/member has met the legislated registration requirements and whether a danger to the public would result from the applicant engaging in, or continuing to engage in, nursing as a registered nurse or nurse practitioner. The committee may approve, defer, or deny eligibility for registration and/or practice permits. The committee may also identify needed conditions or restrictions that should be placed on a permit in the interest of protecting the public. Qualifications CARNA attempts to achieve broad representation of membership by appointing members from a variety of practice settings and geographic regions. Preference will be given to applicants who: have a minimum of three years nursing experience practice in acute care, community-based care or administration reside in the CARNA Northwest or South regions Expectations of Members serve a three-year term attend a minimum of 10 meetings per year attend a full-day orientation session participate in urgent teleconferences when required accept the responsibility of chair or vice-chair after sufficient exposure to role and responsibilities Questions If you have questions about the work of the Registration Committee or the expectations of members, please contact: Kim Campbell, Registrar T: or toll-free at , ext. 508 E: kcampbell@nurses.ab.ca How to Apply obtain an application form at contact: Laura Andre at or toll-free , ext. 513 request an application by fax: Alberta RN July 2008 Volume 64 No 6

19 ISMP MEDICATION SAFETY ALERT! It doesn t pay to play the percentages The concentration of most injectable medications is expressed as mg/ml or mcg/ml. But a few drugs have concentrations expressed as a dilution ratio (e.g., epinephrine 1:1,000) or per cent (e.g., lidocaine 1 per cent). Studies have shown that practitioner knowledge of dilution ratio and per cent concentrations is inadequate, even among physicians. 1-3 While expressing concentrations this way may be less dangerous for topical products or local anesthetics, harmful errors have occurred with IV medications. For instance, there are numerous reports of practitioners administering undiluted epinephrine 1:1,000 (1mg/mL) IV to patients instead of using the 1:10,000 (0.1 mg/ml) concentration. One such error happened to a nurse in radiology who administered medications on an infrequent basis. Her patient had developed a reaction to the contrast media, with visible hives and respiratory distress. The physician prescribed 3 ml of epinephrine 1:10,000 IV, but the nurse administered the 1:1,000 concentration by mistake. The two concentrations are hard to differentiate; on the small label, 1:1,000 could look like 1:10,000. The same error occurred in an urgent care clinic after a physician s assistant ordered the wrong concentration. The nurse who gave the dose did not notice the mistake. In fact, the ampoule bears no warning that the 1:1,000 concentration must be diluted before IV administration. In both cases, the patients developed rapid heart rates and increased blood pressures, requiring unplanned overnight hospital stays. Most alarming, these poorly understood expressions of concentration are particularly prevalent with drugs used for resuscitation (e.g., calcium, epinephrine, lidocaine, magnesium sulphate, neostigmine, sodium bicarbonate). Thus, an inappropriate dose or a life-threatening delay in treatment is possible, even more so if these drugs are prescribed in mg (which requires knowledge of dilution ratio or percent concentrations and calculations) or ml (a problem if multiple concentrations of the drug exist). At a neonatal code, a physician ordered a dose of epinephrine in ml, assuming that only the 1:10,000 concentration was available. The order caused much confusion because both concentrations were stocked on the code cart. To prevent these types of errors, see the suggestions in checkitout! Adverse Drug Event: An injury from a medicine or lack of an intended medicine. Includes adverse drug reactions and harm from medication incidents. Adapted from Bates DW, Spell N, Cullen DJ, Burdick E, Laird N, Petersen LA, Small SD, Sweitzer BJ and Leape LL, The Costs of Adverse Drug Events in Hospitalized Patients. Adverse Drug Events Prevention Study Group, Journal of the American Medical Association 277, 4 (January 22, 1997): pp Source: checkitout! Consider these suggestions to help avoid errors with IV medications that have concentrations expressed as a dilution ratio or per cent. Ask pharmacy to create a dose conversion chart for all concentrations of epinephrine, lidocaine, calcium, magnesium sulphate, sodium bicarbonate and other emergency drugs with concentrations expressed as a dilution ratio or per cent. Post dose conversion charts on code carts and in other areas where emergency medications may be prepared and administered. Refer to the dose conversion chart before giving these products, since an independent double check may not be possible in emergencies. Review the dose conversion chart during CPR certification and discuss the potential for confusion with emergency drugs that have concentrations expressed as a dilution ratio or per cent. Store a single concentration of these drugs if possible (e.g., on a code cart, you may be able to store epinephrine in 1:10,000 prefilled 10 ml syringes only). Ask pharmacy to apply warning labels to alert staff to the different concentrations if more than one concentration is available. Ask pharmacy to affix bold warning labels on epinephrine 1:1,000 ampuls to alert nurses to dilute before IV use. Have a pharmacist attend all codes to help with medication preparation and dosing if needed. REFERENCES: 1) Rolfe S, Harper NJ. Ability of hospital doctors to calculate drug doses. BMJ 1995;310: ) Jones SJ, Cohen AM. Confusing drug concentrations. Anaesthesia 2001;56: ) Nelson LS, Gordon PE, Simmons MD, et al. The benefit of house officer education on proper medication dose calculation and ordering. Acad Emerg Med. 2000;7: Reprinted with permission from ISMP Medication Safety Alert! Nurse Advise-ERR (ISSN ) September 2003 Volume 1 Issue Institute for Safe Medication Practices (ISMP). Visit ismp-canada.org or ismp.org. July 2008 Volume 64 No 6 Alberta RN 19

20 CNA 100 IN 100 AWARD RECIPIENTS Alberta RN is proud to feature Alberta recipients of the Canadian Nurses Association (CNA) Centennial Awards. All recipients were also featured in a video shown during the Awards of Nursing Excellence Gala in May. Sheila A. McKay PRESENT OCCUPATION/POSITION Instructor, Red Deer College Faculty of Nursing MAJOR ACCOMPLISHMENTS Sheila A. McKay has made significant contributions to nursing by influencing decisions affecting the future of nursing and by promoting the value of registered nurses in the health-care system. Her career spans clinical practice, education and administration and she has worked in medicine, emergency, intensive care and public health nursing. McKay teaches at the Red Deer College faculty of nursing and has served as chair of nursing programs. Her professional leadership includes being a charter member of the Northwest Territories Registered Nurses Association and serving as president of the Yukon Nurses Society. She is also past-president of the College and Association of Registered Nurses of Alberta. Barbara Rocchio PRESENT OCCUPATION/POSITION Health Care Consultant, IBH Innovative Health Care Consulting Inc. MAJOR ACCOMPLISHMENTS Barbara Rocchio s contributions include creation of a provincial concerns resolutions framework and forming an advisory committee of chronically ill children to influence the design of the Stollery Children s Hospital. She developed many programs to address specific community and population health needs, worked on projects to improve practice readiness for new health professionals and spearheaded quality improvement processes to positively impact patient care and work environments. For more than 45 years, her innovative administrative leadership has improved the delivery of health-care services and created exceptional programs, including a child abuse prevention and support program, which has since been duplicated nationally. Rocchio was a CARNA Lifetime Award recipient in Alberta RN July 2008 Volume 64 No 6

21 RN Embraced Culture in her Role on First Nations Community The career of a community health nurse in a First Nations community is often short-lived. Most opt to practice elsewhere after only one to three years. Cultural differences, distance from major city centres and other factors often lead nurses to relocate. RN Pat Hogan is the exception. She s worked as a nurse in the Alexis First Nation for almost 15 years, says Paula Bailey a community health nurse with the Paul Band. She has been part of their lives, watching their children grow up and helping them along the way. Nurses in First Nations communities face unique challenges. Working within a distinctive cultural context, they practise in non-traditional settings, engage in community development and participate in a wide range of health programs. According to Health Canada Zone Nurse Manager Joyce Cardinal, the higher youth population rate calls for a focus on health prevention and promotion. Hogan understands these challenges well. Working in First Nations is different than working anywhere else. Residents want access to western medicine, but they also want to use their traditional medicine and ideas, says Hogan. She is not of aboriginal descent, but was willing to learn and embrace the culture. Hogan regularly participates in non-nursing related community events such as round dances, award ceremonies and retreats. According to colleague RN Jody Bonner, Hogan is valued and respected in the community as one of their own. She learned to march to the drum beat of the community without judgement, says Cardinal. She got to know the community and respected what they do and how they do it. In June, Pat Hogan retired after 37 years of nursing. During her career, she practised in diverse settings, including Saudi Arabia, remote communities in Canada s Northwest Territories, Edmonton and most recently at the Alexis First Nation, 85 km west of Edmonton. Hogan appreciates her experiences. She enjoyed working in a smaller community with a variety of people. It provided her with freedom and flexibility she feels could not be matched elsewhere. Each day presented new experiences she was eager to tackle. Nothing that happens around here is textbook, says Hogan. Technical knowledge is an asset, but you have to leave it at the edge and pack your flexibility. Over the years, Hogan has watched community initiatives lead to increased health. Smoking cessation and immunization rates have steadily improved during her time in Alexis First Nation. She credits the determination of the community and health promotion programs implemented, in part, by the residents. Hogan is unsure of how she will spend her retirement. Over the next few months, she will gear down and possibly travel. Life without the daily challenges and rewards of nursing will take some getting used to for Hogan. I ve never regretted a moment I ve spent nursing. RN First Nations Health Statistics When compared to the overall Canadian population, First Nations have a two times higher rate of pertussis, a seven times higher rate of rubella and a six times higher rate of tuberculosis. In 2000, the First Nations birth rate was 23.4 births per 1,000 population, more than twice the Canadian rate. Suicide and self-injury are the leading causes of death for youth and adults up to the age of 44, accounting for 22 per cent of deaths among First Nations youth. Suicide and self-injury account for 20.4 per cent of deaths in the overall Canadian youth population. According to the 2001 Census of Canada, on-reserve registered First Nations individuals rate lower than the general population on all educational attainment indicators. Hospitalization rates are higher among First Nations for all causes except circulatory diseases and cancers. In First Nations, potential years of life lost from injury is more than all other causes of death combined and is almost 3.5 times that of the Canadian rate. SOURCE: pubs/aborig-autoch/stats_profil-eng.php (accessed June 24, 2008) July 2008 Volume 64 No 6 Alberta RN 21

22 REMEMBERS RN RESCUE 22 Alberta RN July 2008 Volume 64 No 6 BY ROSE MARY PHILLIP In the summer of 1994, Rebecca Skinner (then known as Rebecca Mulcair) an RN working in Calgary, joined friends Yolanda Arambarri and Naomi Batiuk for a weekend of camping and hiking in Waterton Lakes National Park in southern Alberta. That same weekend, John Hill, a former addictions councillor, and his eight-year-old daughter Jennifer went hiking on the Crypt Lake Trail at Waterton National Park, a climb of over 2,300 feet. They would all soon meet on the hike back down through an unfortunate circumstance. Both groups hiked along the switchback, a set of zigzagged trails leading down the steep mountain. Hill and his daughter grew frustrated with the crowds of hikers on the trail. Peering down the side of the mountain, Hill could see a considerably less crowded trail just below. I know it wasn t a smart move, but I decided to leave the trail and cut through the scree slope. I accidentally tripped and landed on a glass bottle of orange juice I was carrying, says Hill. It shattered and severed my ulnar artery and nerve. Nearby hikers converged on Hill, trying to help as blood gushed from the split artery. Luckily for Hill, Skinner and her friends quickly joined the rescue effort. More than generalized pressure with gauze was required to stop the blood from pouring from his hand. I put my fingers directly in the wound to stop the rush of blood, says Skinner. Arambarri removed an extensive first aid kit from Skinner s hiking pack to assist with care. To the amusement of her friends, Skinner would pack the rather heavy first aid kit on every trip, complete with scissors, clamp, sutures, betadine and alcohol swabs,

23 instant ice packs, elasticized cling wrap, 2x2s, 4x4s, soaked 4x4s, tape, a sling, penknife, candle, matches and, of course, chocolate. Skinner wrapped Hill s hand tightly with elasticized cling wrap and the group began the long hike down the mountain Hill with his hand elevated as per Skinner s instructions. Ahead of them lay several hours of hiking before reaching the trailhead, followed by a half hour ferry ride across the lake and then an additional half hour of driving to the nearest hospital in Pincher Creek. If they arrived ahead of a scheduled arrival time, they would have to wait for the next ferry. Since cell phones had not yet gained popularity, the group had no way to communicate with the marina at the Waterton village site to send a boat urgently. Soon after leaving the accident scene and beginning the trek down the mountain side, the group spotted a grizzly bear in the distance. Nearby hikers warned one was in the area. A short time later, the trees began to move near the switchbacks just below. The bear was getting too close for comfort. From that point on, the group would speak loudly and make as much noise as possible to scare the animal away. Thankfully, the bear didn t make another appearance. She had a special comforting and reassuring manner about her that let me know I was in good hands, says Hill. We talked about every imaginable subject. As it turns out, I knew her cousin from back east and both our families had cottages in the Laurentian Mountains. Throughout the trek, Skinner assessed his dressing for bleeding, his mental state and his hand. Half way down the mountain his fingers became cold and white, says Skinner. There wasn t much circulation left in his hand. Hill was resilient, walking down the mountain side unaided. His sole concern was to ensure his daughter remained calm and unafraid. He would often repeat Honey, I m okay. It s just a small cut. He had his daughter walk ahead of him so he could keep an eye on her demeanour. Batiuk helped the effort to keep Jennifer calm by distracting her with stories and laughter as they hiked. By late afternoon, the group arrived at the trailhead to await the ferry that would bring them back to the marina and village. It was just as they feared. The dock was abandoned. The group, including the now pale and cold Hill, had to wait 30 minutes for the next ferry. The summer heat and exertion were beginning to take a toll on Hill. He took a turn for the worse. Citing pain and tightness, Hill asked to have the dressing loosened. Succumbing to dehydration and blood loss, he became light headed and needed to lie down. At long last, the ferry arrived. The captain sent a dispatch to the village to advise of the medical situation. Wanda Robinson received the emergency call and also happened to be an RN. She called for an ambulance to meet them at shore. When the ferry docked, the group faced yet another setback the ambulance had not yet arrived. [Rebecca] loaded me into her small car and was ready to drive me to the hospital herself, says Hill. Before the group could pull away, a Parks Canada ambulance arrived. Skinner accompanied Hill in the ambulance, while DID YOU KNOW With the exception of Québec, there is no legal obligation in Canada to assist the ill or injured. Alberta, British Columbia, Ontario and Nova Scotia have passed Good Samaritan laws to protect those who offer assistance to the ill or injured. Under Alberta s Emergency Medical Aid Act, registered nurses who offer assistance without the expectation of compensation at a location other than a medical facility are not liable for damages, injuries or death caused as a result of their help, unless the damages, injuries or death are as a result of gross negligence. SOURCES: (accessed June 24, 2008) Arambarri followed in Skinner s vehicle. Batiuk drove Hill s truck to his campsite with Jennifer to dismantle the site and pack everything in Hill s truck. After a 50-km ambulance ride, Hill finally arrived at the Pincher Creek Hospital, but his ordeal wasn t over yet. The damage was too severe. Doctors recommended he transfer to another facility for treatment. They cleaned the site, clamped the severed artery and wrapped his hand with sterile drapes, says Skinner. Arambarri drove Skinner and a now stable Hill to Lethbridge Regional Hospital for treatment. Following them was Batiuk and Jennifer with Hill s camping gear in tow. Upon arrival at the hospital, Hill was immediately attended by staff. Knowing Hill was in capable hands, the group drove Jennifer home. His wife gratefully greeted them on the front lawn. He had a lot of fortitude. It must have been awful to hike that distance while so injured, says Skinner. After returning Jennifer to her mother, Skinner, Arambarri and Batiuk made the two-hour drive back to their campsite, arriving shortly before midnight to resume their weekend camping trip. The following morning, Skinner called the hospital from a nearby payphone to check on Hill s condition. He underwent surgery and today has full use of his hand. She selflessly committed herself to my recovery, says Hill. She is an exceptional professional and a special human being. She is a tribute to the nursing profession. RN Rebecca Skinner is now married with two step-children and living in Winnipeg, Man. She is a nurse in the emergency room and intensive care unit and continues to stay active outdoors with cycling and hiking. John Hill remains active in his love of hiking and recently joined the Chinook Hiking Club. Since the accident, he has hiked on various mountains across Alberta and internationally. There were two other nurses present on the Crypt Lake Trail the day of Hill s accident. They too aided in the initial accident response, however their names are unknown. July 2008 Volume 64 No 6 Alberta RN 23

24 THE HOPELESSLY HUMAN NURSE Reprinted from Thoughts from the Teeter Totter, an e-newsletter published by Hopelessly Human Productions. One Thing Isn t So Hard We cannot achieve self-respect if we are afraid of self-knowledge. M. R. Cohen BY KATHY KNOWLES, RN AND LINDA BRIDGE, RN My lamp overhaul started with one thing. It wasn t a conscious beginning where I said ok, tomorrow I will start with strategy A, then B and so on. I simply woke up. It began one evening when I was dealing with a pediatric death in the emergency department where I worked. I was in charge that shift and responsible for family support and communication during the attempted resuscitation of the child. I was with the parents a long time in the quiet room and later as they held their dead daughter. In a consoling voice I said numerous times I m sorry. On that particular evening, what I heard myself saying was nothing. The I m sorrys felt meaningless. I had the road to myself, after midnight, as I drove the 40-minute commute home. In the quiet darkness, my inner voice spoke to me with a clarity I had never heard before. Or at least one that I had never bothered to recognize and hear. Each curve and mile that unfolded brought a startling thought to my mind. It was like rewinding a tape and playing it over and over. What I saw was myself as I repeatedly, and I must accent this word, said I m sorry. I realized that I m sorry was used in every other sentence of my vocabulary during an eight-hour shift. It was rampant in my talk with others in the world as well. I started to cry as I concluded that I said I was sorry for everything. In that instant, I felt I was sorry to be alive! I m sorry you have to wait. I m sorry you feel that way. I m sorry to bother you. I m sorry to call. I m sorry I have to give you this needle. I m sorry to ask you to move over but I need to get this medication from the refrigerator. Quick! I m sorry what I do is not good enough. I m sorry to have to ask you this. I m sorry you have pain. I m sorry you re having a bad day. I m sorry. I m sorry. I m sorry. How? I asked myself. How could I be responsible for all those people and the situations they were in? I had done nothing wrong and I did not need to take ownership of them or their complaints and problems. Whom did I think I was, believing I was responsible for others feelings? It wasn t my fault someone had to wait, nor was it my fault someone was sad. It was not my fault a physician was on call and I needed to talk with him about one of his patients. It was not my fault someone was in pain. I was not responsible for that child s death. What were all those apologies doing to me? Oh my, what had I been doing? What I thought was a nicety in my words was something very detrimental toward myself. I wanted the true meaning of I m sorry back. Nearing my home that night I decided to stop using it unless I truly needed to apologize for my actions. This first step in my lamp overhaul began the very next shift. I never told anyone what I had discovered about myself. I was ashamed and felt I was probably the only person doing this. Nor did I tell anyone what I was doing, as I deleted the I m sorrys from my vocabulary. Once I was aware, I saw how automatic the saying was. It slipped out of me often. Of course, I would chastise myself at first, then I realized that wasn t fair and would only make it worse. This belief of the need to say I m sorry was ingrained in me and it would take time to let go of it. I worked to be gentle with myself and at times I laughed as the old I m sorry would sneak out. Chuckling to myself was the key for me. It turned what I thought of as a weakness of character into a game. After each shift I would tally up my I m sorrys on my drive home. Slowly and steadily, and actually much easier and faster than I expected, I squashed them from my sentences. I began to feel better about myself and about work. A few simple words had held such power over me and their omission had a potent effect. I believe this effect, this energy, bolstered my self-respect. I started with one choice. One simple change. This one deletion of a few simple words carried me forward, curious to examine more of my vocabulary. I felt so much better and if words alone could affect that then I decided to search for others. My overhaul has become my life. I have fun with it. I gain power and energy (self-respect) each time I alter a previous thought, action, or word. Yes, I falter often and I smile to myself at the game I play to rid the unhealthy things in my life. Each falter is celebrated, a lesson learned. Each triumph is the same. I started with one thing and it grew from there. That one thing gave me the strength to try another and then another and so on. It started with an awareness an awakening. I believe if each nurse in Canada does one thing, for him or her self, to gain energy, self-respect, the health system will change. If every action causes a reaction, then every change in an action will cause a different reaction. A domino effect will take place. I know now that one thing isn t so hard. RN 2005 Kathy Knowles and Linda Bridge 24 Alberta RN July 2008 Volume 64 No 6

25 D iscipline Decisions Discipline summaries are submitted for publication in Alberta RN by the Hearing Tribunals as a brief description to members and the public of the member s unprofessional behaviour and of the sanction 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 used a patient s first name and posted personal health information about the patient on a co-worker s Facebook site, addressed to another RN on a different unit who had no professional reason to have the information. The member further used the Facebook site to communicate with other staff about personal issues during work hours, in violation of the employer s policy. The Tribunal issued a reprimand and ordered the member to write a paper on Electronic communications considerations in confidentiality for the practice of the Registered Nurse 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: 58,366 The Hearing Tribunal made a finding of unprofessional conduct against member #58,366 who stole narcotics from her employer; failed to follow the narcotic wastage protocols to obtain co-signatures so she could steal the drugs; and falsely documented narcotic wastage. The member admitted to the behaviour. The Tribunal gave the member a reprimand and accepted an undertaking to not practice as a registered nurse pending proof that she is safe to return to practice at which time the member has a choice to return to either a practice setting where there is no access to controlled medications or do a supervised practice in a setting where the member is expected to administer 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, addressing all diagnoses. 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: 62,727 The Hearing Tribunal made a finding of unprofessional conduct against member #62,727 who after resigning his position where he was responsible to supervise assisted living facilities stole Percocet on one occasion and Tylenol #3 on two occasions from the assisted living facilities that he had previously supervised; continued to visit the facilities for four months and looked through the medication cupboards and client medical records cupboard. Further, while registered, but employed in a non-nursing position, for a different employer, stole 10 Tylenol #3s on one occasion and signed them out to a patient on the medication administration record. The member admitted to the behaviour. The Tribunal gave the member a reprimand and accepted an undertaking to not practice as a registered nurse pending proof from a physician and counselor that he is safe to return to practice 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. RN IN MEMORIAM Our deepest sympathy is extended to the family and friends of: Delaney, Rita May, a graduate of the University Hospital school or nursing, who passed away on April 14, Hauck, Mary Lou, a graduate of the St. Mary s General Hospital school of nursing, who passed away on May 19, Visit July 2008 Volume 64 No 6 Alberta RN 25

26 update Continued from page 3 I want to point out that these trends are not necessarily bad. The focus on public safety is consistent with CARNA s mandate and CARNA supports principles of accountability, transparency, trust and privacy. At the end of the day, CARNA believes that there must be a balance between the need to be competitive in today s world economy and the need to ensure the safety and quality of patient care. In addition to these global regulatory trends, there are developments in Alberta that are affecting CARNA. Regulatory Environment CARNA operates within the legislative framework of the province s Health Professions Act (HPA). HPA is an example of meta-regulation since it is umbrella legislation which standardizes regulation of all health professions and clarifies government expectations of regulatory bodies. Provincial governments are also becoming more interested in pursuing Trade and Labour Mobility Agreements (TILMA), which eliminate barriers imposed by different regulatory standards, rather than traditional mutual recognition agreements. Alberta has entered into a TILMA agreement with British Columbia and CARNA is working with the College of Registered Nurses of British Columbia to resolve nursing issues. At the same time, there is a strong likelihood of expansion of the agreement to Saskatchewan and Manitoba. The work on TILMA has been affected by measures announced by British Columbia that have opened discussions with the Alberta government. The B.C. throne speech mentioned an enhanced scope of practice for RNs and creation of a new provisional registration category for nurses, among other things. Many details about these announcements in B.C. are still unknown. However, the enhanced scope of practice for registered nurses seems similar to changes CARNA is proposing to the Registered Nurses Profession Regulation under the Health Professions Act in Alberta. CARNA has already moved on the concept of a provisional or restricted licence for international applicants. In March, provincial council made a significant decision to approve development of a model for a restricted temporary permit for internationally educated nurses with deficits in defined areas. The new licence is intended to increase the potential international pool of applicants, but still requires the internationally educated nurse to write the Canadian Registered Nurses Exam within a specified time period. Information about the new licence will be available in early June. That brings us to Bill 41, the Health Professions Statutes Amendment Act passed by the Alberta government in December CARNA worked closely with other health professions to express serious concerns about Bill 41 s ability to erode selfgovernance for the health professions. As a result, government did agree to include a requirement for the Minister of Health and Wellness to consult with an affected college before making changes to the profession s bylaws, regulations or standards of practice. CARNA recently was given the opportunity to provide feedback on draft regulations outlining the requirements for the minister to consult with colleges. CARNA had serious concerns because the draft regulation did not meet the minister s obligation to consult with affected colleges. It is important to point out that CARNA s relationship with the provincial government is now conducted with an awareness that the provisions of Bill 41 exist. We are more CARNA BELIEVES THAT THERE MUST BE A BALANCE BETWEEN THE NEED TO BE COMPETITIVE IN TODAY S WORLD ECONOMY AND THE NEED TO ENSURE THE SAFETY AND QUALITY OF PATIENT CARE. acutely aware of the importance of working closely with government and anticipating directions in provincial public policy to ensure that we can respond appropriately within our own mandate to protect the public. Provincial Health Action Plan Now, I am going to take a few moments to comment on the provincial government s Health Action Plan which was released in April. Government has already acted on one of its immediate priorities with the creation of one provincial board to govern Alberta s health system. The impact of this step on front-line staff remains to be seen, but it does, at the very least, create a climate of uncertainty. Another immediate action in the plan is to increase nursing seats in order to graduate 2,000 nurses a year by This was actually announced last December and, while an important increase, won t be enough to address the nursing shortage. Looking at other parts of the action plan, the strategies related to recruiting more internationally educated nurses and other foreign-trained health professionals will have an impact on CARNA and registered nurses. The plan refers to government working with other western provinces on a recruitment strategy. CARNA is already working more closely with the western nursing jurisdictions from B.C., Saskatchewan, Manitoba and the Yukon to address licensure issues related to international applications. On another front, Provincial Council has already passed a motion strengthening CARNA s previous guidelines for reporting blood-borne pathogens. The decision elevates the reporting requirement for all RNs infected with a blood-borne pathogen to a mandatory standard of practice. 26 Alberta RN July 2008 Volume 64 No 6

27 update CARNA has major reservations about government plans to introduce more physician assistants. CARNA Executive Director Mary-Anne Robinson and I met with the minister to share our concerns about introducing another category of unregulated health professional and to promote the role of the nurse practitioner. Government intends to conduct a stakeholder consultation regarding the role of the physician assistant which will give CARNA an opportunity to provide feedback. Finally, we are not sure what government intends with the announcement regarding nursing education. When discussing nursing education, it can be a challenge to distinguish between practice readiness and job readiness. Registered nursing is a practice discipline which suggests that a key component for education is practice in a clinical setting. On the other hand, all new employees require an orientation period when they start a new job. It is important for nursing employers and educators to clarify the concepts of practice readiness and job readiness. That is why CARNA supports the work being done in this area by the Clinical Nurse Practice Leaders Network, consisting of the chief nursing leaders of Alberta s regional health authorities and the Alberta Nurse Educators Association. CARNA also holds the secretariat for the Nursing Advisory Council of Alberta s Knowledge and Education Project, which is expected to provide information that can help to inform government decisions regarding nursing education. Registered Nurse Leadership So far, I have discussed CARNA s role in terms of its regulatory mandate and the forces affecting achievement of that mandate. Now I want to speak about registered nurse leadership. I am convinced that now, more than ever, it is essential to focus on what we can achieve together as registered nurses and how we can support each other in our practice, rather than focus on the differences among us. The changes facing the health system in this province are immense. Yet the shortage of registered nurses and other health providers allows us to take a close look at what we are really doing in our practice settings. In February of this year, CARNA conducted a survey of its members and found that nearly two-thirds (65 per cent) of members currently spend between 10 per cent and 39 per cent ON AVERAGE, MEMBERS SPEND 27 PER CENT OF THEIR WORK DAY PERFORMING NON-REGISTERED NURSING ACTIVITIES THAT COULD BE HANDLED BY A SUPPORT WORKER. I AM IMPRESSED AND INSPIRED BY THE LEADER- SHIP, THE INNOVATION AND POSITIVE CONTRIBUTIONS REGISTERED NURSES ARE MAKING EVERY DAY IN THEIR PRACTICE SETTINGS. of their work day performing non-registered nursing activities that could be handled by a support worker. An additional 14 per cent spend between half and three-quarters (50 to 75 per cent) of their time on these types of activities. On average, members spend 27 per cent of their work day performing non-registered nursing activities that could be handled by a support worker. Just imagine what could be achieved for patient care and safety, for infection prevention and control and for health promotion if these registered nurses were able to focus on their nursing role. Results like these are the reason that CARNA is lobbying for more support workers in the health-care system. As I travel the province, I am impressed and inspired by the leadership, the innovations and positive contributions registered nurses are making every day in their practice settings. The majority of the RNs I meet are confident, flexible professionals who enjoy their nursing career. They are leaders at the direct care level, at the management table and as educators and researchers. Registered nurses are also the health professionals perfectly equipped to proactively move the health promotion and disease and injury prevention agenda forward in this province. That is because it is part of the role of the RN to consider the whole person and to understand the impact of injury and illness on their lives. Now is the time to address long-standing issues about service delivery and to maximize scopes of practice for all health providers. It is important for each of us, as individual RNs, to be confident that we can influence the change around us. Our ideas can improve patient care, create safer care environments and lead to a seamless continuum of care. We know that the health system is changing. Now is the time for registered nurses to exert the power inherent in our presence throughout all parts of the system, 24/7, and channel our knowledge, education and skills towards improved patient safety and care and a system that values our contributions as registered nurses. RN Margaret Hadley, RN, MN president@nurses.ab.ca Phone: July 2008 Volume 64 No 6 Alberta RN 27

28 The Health Quality Council of Alberta (HQCA) recently released the results of its first provincial survey of patient experience in Alberta s emergency departments. Overall, 90 per cent of rural and 84 per cent of urban respondents ranked their overall care as excellent, very good or good. Wait times in the emergency department, especially the time it took to see a doctor, clearly affected patients overall emergency department experience. However, what mattered most to patients, and what most influenced their overall rating, was the care and communication they ultimately received. On releasing the survey, Chief Executive Officer Dr. John Cowell said, This is the first provincial survey of its kind undertaken in Alberta and it establishes a baseline for measuring emergency department experience and provides health-care providers with information needed to improve the quality of emergency department patient care. Emergency Department survey finds Albertans highly rate the courtesy of triage nurses Highlights of the key findings: Staff care and communication Overall, 90 per cent of patients rated the courtesy of the triage nurse who first asked them about their health problem as excellent, very good or good. 72 per cent of urban and 80 per cent of rural respondents said they were treated with dignity and respect while in the emergency department. 30 per cent of urban and 24 per cent of rural respondents felt physicians and nurses did not always take the time to listen to what they had to say. Overall, 36 per cent reported their condition had either not been explained to them in an understandable way or was only to some extent. 43 per cent of urban and 33 per cent of rural respondents said they were not always involved as much as they wanted in decisions about their care and treatment or were only to some extent. On discharge, 64 per cent of urban and 55 per cent of rural respondents said they were not told or were only told to some extent when they could begin normal activities. 40 per cent overall said they were completely informed about what danger signals to watch for after they went home. Accessibility and reassessment Overall, people who waited longer or experienced extreme crowding were less happy with their emergency department experience. Wait time issues were more common and had the greatest impact on urban emergency departments. The time spent waiting to see a doctor was very important to people. The longer they waited, the more likely they were to be unhappy with their emergency department experience. The shorter the wait, the more likely they were to be happy with their emergency department experience. 82 per cent of urban and 92 per cent of rural respondents said the overall order in which patients were seen was fair. Overall, two per cent of patients identified that staff were not always checking on them while they waited. Overall, 41 per cent said they could not always find a staff member when they looked for help or could only some of the time. The survey showed patients were more likely to leave without being seen if staff were not regularly checking on them or if they could not get staff help when they needed it. Over the next weeks, we will meet with our stakeholders to discuss the findings and where to go from here, says Cowell. The survey results clearly show that regardless of overcrowding and wait-time issues, from the patient s perspective, health-care providers need to develop strategies that provide an optimal environment for communication so that patients can fully share information about their condition, have enough time to discuss their health concerns and receive information about treatments, test results and discharge instructions. The full report is available at: For more information about the HQCA s emergency department patient experience survey, please contact Pam Brandt at or pam.brandt@hqca.ca. 28 Alberta RN July 2008 Volume 64 No 6

29 BOOKMARKS A Handbook on Spirituality for Nurses and Caregivers Judith M. Campbell A caregiver s guide through the subject of spirituality, based on Campbell s two-year course A Journey With Your Spirit. This handbook will familiarize the reader with the elements of awareness and understanding needed to address the spiritual needs of patients, without crossing the religious boundary. Both I Brake for Butterflies: Finding Divinity in All That Is and energywellness.ca are suggested as companion reading pieces. I Brake for Butterflies challenges us to look for divine happenings in our lives and teaches how to find meaning by acknowledging such happenings. It suggests that all humanity is connected and that finding this spiritual connectedness replaces depression with excitement. energywellness.ca, based on the namesake website, offers methods to achieve balance of the mind, body and spirit through diet, meditation and communing with nature. ACCOLADES First Nations Nurse Receives National Honour Rocky Mountain House RN Joyce Ritchie is one of two First Nations nurses honoured with the National Award of Excellence in Nursing for First Nations and Inuit Communities. Federal Minister of Health Tony Clement presented Ritchie with the award for her work as a home care nurse at Kiska Wapton Bighorn First Nation, approximately 80 km west of Red Deer. Ritchie is currently enrolled in the University of Alberta post-rn bachelor of science in nursing program. She holds a speciality certificate in emergency and critical care nursing and teaches first aid and CPR. Ritchie also maintains her firefighter certification and Incident Command System (ICS 300) certification. The award was created to recognize nursing excellence and the key role nurses play in improving the health of Canada s aboriginal people. Recipients are nominated by their peers and receive $2,500 for professional development. RNLibrary The latest books, documents and audio-visual titles acquired by the CARNA Library. To reserve these and other titles, CARNA members can contact the library Monday through Friday, 9 a.m. to 4 p.m. at , ext. 533, or visit any time to access the library catalogue and CINAHL (Cumulative Index to Nursing and Allied Health Literature database). Anderson, E. T. & McFarlane, J. M. (Eds.). (2008). Community as partner: Theory and practice in nursing (5th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. [WY 106 C ] Campbell, A. (2006). The SARS Commission (Vols. 1-6). Toronto, ON: Publications Ontario. [WX 167 C ] Conference Board of Canada. (2007). Achieving public protection through collaborative self-regulation: Reflections for a new paradigm. Ottawa, ON: Author. [WY 21.1 A ] Decter, M. & Grosso, F. (2006). Navigating Canada s health care: A user guide to getting the care you need. Toronto, ON: Penguin Canada. [WH 84 D ] French-language primary health care in Alberta. (2006). Edmonton, AB: Réseau Santé Albertain. [WY 128 F ] Gill, M. D. (2005). Governing for results. A director s guide to good governance. Victoria, BC: Trafford. [WY 105 G ] Leddy, S. (2006). Integrative health promotion: Conceptual bases for nursing practice. Sudbury, MA: Jones and Bartlett. [WY 108 L ] Merson, M. H., Black, R. E., & Mills, A. J. (Eds.). (2006). International public health: Diseases, programs, systems, and policies (2nd ed.). Sudbury, MA: Jones and Bartlett. [WA I ] Perry, C. (2007). Infection prevention and control. Oxford: Blackwell. [WX 167 P ] Picard, E. I. & Robertson, G. B. (2007). Legal liability of doctors and hospitals in Canada (4th ed.). Toronto, ON: Thomson/Carswell. [W 32.1 P ] Shields, M. (2006). Findings from the 2005 national survey of the work and health of nurses. Ottawa, ON: Health Canada. [WY 31 S ] Sneiderman, B., Irvine, J. C., & Osborne, P. H. (2003). Canadian medical law: An introduction for physicians, nurses and other health care professionals (3rd ed.). Scarborough, ON: Thomson/Carswell. [W 32.5 S ] Stanhope, M. & Lancaster, J. (2006). Foundations of nursing in the community: Community oriented practice (2nd ed.). St. Louis, MO: Mosby Elsevier. [WY 106 F ] Torrisi, D. L. & Hansen-Turton, T. (2005). Community and nurse-managed heath centers: Getting them started and keeping them going. New York: Springer. [WY 128 T ] Yalnizyan, A. (2006). Getting better health care: Lessons from (and for) Canada. Ottawa, ON: Canadian Centre for Policy Alternatives. [WA Y ] July 2008 Volume 64 No 6 Alberta RN 29

30 NOTICEBoard calendar Holistic Nurses Seek Certification The Canadian Holistic Nurses Association (CHNA) is asking RNs who use one or more energy-based modalities to complete a short survey. Examples of energy-based modalities include therapeutic touch, healing touch, reiki, guided imagery, sound/music. CHNA is applying to the Canadian Nurses Association (CNA) for certification of holistic nurses and requires your assistance to obtain specific information about the use of energy-based modalities in nursing practice in Alberta. Current CHNA members, have already provided this information to CHNA, and do not need to resubmit the survey. A summary of the results will be submitted as part of CHNA s application to CNA for certification. To complete the survey: dlfreeman@shaw.ca and place CHNA Nursing Survey in the subject line to receive your three question survey, or phone Debbie Freeman at About CHNA: Organized in 1988, the objective of CHNA is to further the development of holistic nursing practice and to ensure that professional health maintenance and promotion services are made available to Canadians. CHNA supports the role of holistic nurses and sets standards for holistic nursing practice in Canada. For more information on CHNA, visit E D M O N T O N / W E S T BETWEEN A ROCK AND A HARD PLACE When Healthcare Providers Experience Moral Distress Hosted by CARNA and the Provincial Health Ethics Network Sept. 19, Edmonton CONTACT: TL2 Conference and Event Management, , events@tl2.ca, WOUND CARE: CHAMPIONS FOR CHANGE Oct. 6, Edmonton CONTACT: GRHEdServices@capitalhealth.ca BUILDING INTEGRATED HEALTH SYSTEMS A National Symposium Nov , Edmonton CONTACT: Buksa Conference Management, , ext. 229, ihs@buksa.com C A L G A R Y / W E S T THE FOURTH ANNUAL EDUCATION CONFERENCE Change, Chaos and Courage: Educating for Nursing Excellence Aug , Calgary CONTACT: CANADIAN HOLISTIC NURSES ASSOCIATION LEVEL I: INSTITUTE Sept , 2008 CONTACT: Debbie Freeman, DEPRESSION IN ADULTS How to Improve Prevention, Diagnosis and Treatment Oct , Calgary CONTACT: ALBERTA OPERATING ROOM NURSES CONFERENCE Continuing Surgical Innovations Oct , Red Deer CONTACT: Donna Wapple, donna.wapple@calgaryhealthregion.ca N A T I O N A L 5TH INP/APNN INTERNATIONAL CONFERENCE ON ADVANCED NURSING PRACTICE Sept , Toronto CONTACT: International Conference Services Ltd., , inpapnn2008@meet-ics.com HALIFAX 8: THE CANADIAN HEALTHCARE SAFETY SYMPOSIUM Oct , Winnipeg CONTACT: CANADIAN NETWORK OF NATIONAL ASSOCIATIONS OF REGULATORS CONFERENCE Ethical Regulation: Doing the right things for the right reason Nov. 3-4, Toronto CONTACT: N E T W O R K I N G O P P O R T U N I T I E S INTERESTED IN FORMING A NAVIGATOR/CARE COORDINATOR SPECIAL INTEREST GROUP? If you are a nurse navigator, patient navigator or care coordinator working in any clinical area and are interested in networking with colleagues in similar roles, contact Janet Bates, , janetb@cancerboard.ab.ca or Sally Turco, , sallyturco@caritas.cha.ab.ca CARNA SPECIALTY PRACTICE GROUPS Contact your CARNA regional coordinator or go to. Submission deadline for events listed in Alberta RN September 2008 is August 1. Go to for an up-to-date listing of events. 30 Alberta RN July 2008 Volume 64 No 6

31 Conference Coming to Edmonton A Joint Conference of: Sept. 19, 2008 Shaw Conference Centre All speakers except one are confirmed to return. Dr. Margaret Somerville will replace Ruth Purtillo in the speaker lineup. Dr. Margaret Somerville Margaret Somerville is the founding director of the Centre for Medicine, Ethics and Law at McGill University and is among Canada s most highly regarded, and sometimes controversial, medical ethicists. As a consultant to numerous government and non-governmental bodies, she has worked with the World Health Organization, the UN High Commissioner for Human Rights and UNESCO. For information on other speakers go to or consult the conference brochure inserted in the February 2008 issue of Alberta RN. Register Now Early-bird registration ends August 22. Use the registration form on the next page or register online at Don t Miss this One! Calgary conference sold out in May. AGENDA 8:15 am Continental Breakfast 8:45 am Opening Remarks and Introduction Wendy Austin, University of Alberta 8:55 am 9:15 am Catch-22: A Theatrical Presentation 9:15 am 10:05 am Telling Your Story: Its OK to Talk About It LIVE John Lantos, University of Chicago 10:05 am 10:25 am Break 10:25 am 11:15 am OK, I m Distressed. What Now? Dawn Oosterhoff, Ontario Medical Association 11:15 am 12:15 pm World Café NEW Using an exciting format to stimulate dialogue, the World Café draws on the wisdom and diversity of conference participants with the aim of helping each other see new ways to make a difference in their work and lives. 12:15 pm 1:15 pm Lunch NEW Global Mardi Party and Auction of Internationally Themed Gourmet Goodie Baskets. Fun and Games will be hosted by ARNET. 1:15 pm 2:30 pm Concurrent Sessions NEW 1. Bird on an Ethics Wire: The Lived Experience of Moral Distress An Open Conversation with Participants Margaret Somerville, Centre for Medicine, Ethics and Law, McGill University 2. Nurses Experience of Moral Distress: Surveying the Landscape Dawn Oosterhoff, Ontario Medical Association 3. Moral Distress Among Families & Caregivers: A Personal Account Barbara Farlow, Canadian Patient Safety Institute 4. The Flashlight & The Hammer: Tools & Metaphors for Grappling With Moral Tension Wendy Austin, University of Alberta 5. Interprofessional Angst: When Nurse and Physician Don t See Eye to Eye Daniel Garros, Stollery Children s Hospital and University of Alberta 6. Why Are We Doing This? Moral Distress and Futility Cynda Hylton Rushton, Johns Hopkins University 2:30 pm 2:45 pm Break 2:45 pm 3:40 pm Transforming Moral Distress into Healing Cynda Hylton Rushton, Johns Hopkins University 3:40 pm 4:30 pm A Vision for Morally Healthy Workspaces NEW Margaret Somerville, Samuel Gale Professor of Law; Professor Faculty of Medicine; Founding Director, Centre for Medicine, Ethics and Law, McGill University

32 Sept. 19, 2008 Shaw Conference Centre Registration form 32 Alberta RN July 2008 Volume 64 No 6

33 calendar Reunions Foothills Hospital School of Nursing Class of Year Reunion Oct. 3-5, Comox, B.C. CONTACT: Shirley Revitt ; Foothills Hospital School of Nursing Class of Year Reunion Oct. 4, 2008 CONTACT: Gena Hoffer, Holy Cross School of Nursing Class of Year Reunion Sept , 2008 CONTACT: Sharon Iversen, , Mount Royal College School of Nursing Class of Year Reunion Sept. 27, 2008 CONTACT: Viola Routly, , or , Red Deer College Class of Year Reunion Fall 2008 CONTACT: Sandy Bartoli, , Jacky McAfee, , Reunion organizers are requesting volunteer assistance with planning. Red Deer College Class of Year Reunion Spring 2009 CONTACT: Danielle Tkachenko, , Reunion organizers are requesting volunteers for planning and updated personal contact information. Royal Alexandra Hospital Class of Year Reunion Are you interested in having a reunion in fall 2008? CONTACT: Treva Schultz (Nordby), , tschultz@una.ab.ca University of Alberta Faculty of Nursing Class of Year Reunion Fall Edmonton CONTACT: Gwen Thompson, , gwenthompson@shaw.ca University of Alberta Faculty of Nursing Class of Year Reunion CONTACT: Cathy Loughlin, , rothbone@shaw.ca, or Susan Schafer, , susanschafer@shaw.ca. University of Alberta Hospital School of Nursing Class of Year Reunion Oct. 3-4, Edmonton CONTACT: Liz Bonneville, , rlbonn10@hotmail.com Submission deadline for reunions listed in Alberta RN September 2008 is August 1. Go to for an up-to-date listing of reunions under Member Info.

34 opportunities Coming this Summer Simpler, faster and always secure Renew Online by September 1 st at Update personal information at your convenience. All you need is Internet access and an address.

35 Closing Perspectives Working Towards Harmony in RN Regulation In the midst of an unprecedented nursing shortage, CARNA, educators, employers and registered nurses (RNs), are navigating through uncharted territory. As identified by President Hadley in her message, we are facing an increasingly complex regulatory environment and the growing emphasis by governments on global competitiveness and economic drivers. One of CARNA s most pressing regulatory challenges at the moment is meeting the Alberta government s target date of April 1, 2009 for full implementation of the Trade, Industry, and Labour Mobility Agreement (TILMA). This agreement between Alberta and British Columbia is designed to remove barriers to trade, investment and labour mobility including for RNs. Since B.C. and Alberta both belong to the national Mutual Recognition Agreement for RNs, there are relatively few issues related to RN mobility. However, reconciling registration and practice requirements for nurse practitioners (NPs) under TILMA presents greater challenges. The College of Registered Nurses of British Columbia (CRNBC) requires masters level preparation for NPs, successful completion of both a written examination and an objective structured clinical examination while CARNA currently does not. In February 2008, an external report commissioned by CARNA and CRNBC highlighted other areas of significant differences between the two provinces. These areas include the definition of the NP role, governing legislation, regulations and policies, core competencies, streams of nurse practitioner practice, continuing competence/quality assurance requirements, prior learning assessment, lapsed practice and re-entry processes. CARNA staff members are now undertaking the comprehensive review required to determine the appropriate steps for meeting the expectations outlined in TILMA by April Much work remains to be done. On the bright side, CARNA, through consultation, has established that the majority of its NP members, Alberta educators and employers support CARNA s proposed changes to registration requirements for NPs. In September 2007, CARNA Provincial Council approved changing the educational requirement for entry on the CARNA register of nurse practitioners from a baccalaureate degree in nursing to a master s degree in nursing or education and experience that is substantially equivalent. This decision is congruent with feedback received in stakeholder consultations coordinated by CARNA, with recommendations proposed by the Canadian Nurse Practitioner Initiative and with educational requirements in B.C. In May, during a meeting with President Hadley and I, the Minister of Health and Wellness Ron Liepert expressed his support for master s preparation as the entry to practice requirement for NPs in Alberta. Applicants without master s level education would still be considered eligible for NP registration under the substantially equivalent process if they provide evidence of competence to practice as an NP. Council s decision does not require changes to educational programs or additional funding for educational seats as all NP educational programs in Alberta are currently at the master s level. Having obtained this level of consensus among our stakeholders, CARNA anticipates that our request for the necessary revisions to the Registered Nurse Profession Regulation under the Health Professions Act will receive prompt attention from government. On the other hand, we are sensitive to B.C. government s recent introduction of Bill 25, the Health Professions (Regulatory Reform) Amendment Act 2008, which contains significant amendments which have implications for CRNBC and nursing in the province. It is too early to know what the impact will be for RNs in Alberta, but given the requirements under TILMA for Alberta and B.C. to harmonize standards related to RNs, B.C. s proposed amendments could impact measures being considered by the Alberta government. Given the degree of difference in NP requirements between the two jurisdictions, CARNA will face considerable challenges over the next nine months to realize the legislative, regulatory and operational changes required to meet the April 2009 deadline. However, CARNA is also aware of the agreement s significance for registered nursing across Canada. TILMA creates the second largest economic region in Canada and its progress toward implementation is being monitored by all sectors nationally. Our success in meeting the TILMA requirements may very well lead to reconciliation of regulatory requirements for NPs across the country. Alberta RNs can take pride in taking a leadership role in setting the direction for the future of NP practice in Canada. Collectively, we are adapting to the current economic and regulatory environment while maintaining a firm hold on the regulation of our profession to ensure Albertans continue to enjoy consistently competent, safe and ethical registered nursing care. RN Mary-Anne Robinson, RN, BN, MSA Executive Director Phone: or , ext mrobinson@nurses.ab.ca 54 Alberta RN July 2008 Volume 64 No 6

36 a century of leadership During 2008, Alberta RN will feature photos from the collection of the CARNA Museum and Archives to mark the 100th anniversary of the Canadian Nurses Association. Pediatric nurses dressing injuries, Royal Alexandra Hospital, c P-377 CARNA Museum and Archives The CARNA Museum and Archives collections are available for research and educational purposes. We maintain permanent and temporary exhibits including a lamp that was used by Florence Nightingale in the Crimean War as well as two online exhibitions at. LOCATION: CARNA Provincial Office, Street, Edmonton HOURS: Monday through Friday from 8:30 a.m. to 4:30 p.m.

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