Introducing the recipients of ARNNL s 2016 Awards for Excellence and Honorary Members NCLEX REGULATION CHANGES PENDING PAGE 20 IN THIS ISSUE

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1 Vol. XXXVIII No. 3 September 2016 The Magazine of the Association of Registered Nurses of Newfoundland and Labrador Introducing the recipients of ARNNL s 2016 Awards for Excellence and Honorary Members NCLEX REGULATION CHANGES PENDING PAGE 20 IN THIS ISSUE View of a Student Workplace Representative Page 24 A Note From The New Editor - Page 15 See photos of Memorial Day and National Nursing Week Page 6

2 CONTENTS Message from the President...3 From the Executive Director s Desk...4 ARNNL Council Matters 5-6 Registration Update...7 WWI Spotlight Nurses of Note...10 ARNNL Continuing Education Teleconference Sessions...11 Q & A: You Asked...12 Advanced Practice View 13 From Hospital to Home: Supporting Implementation of Infant Sleep-Safe Guidelines...14 A Note from the New Editor 15 Goings On Volunteer Spotlight...18 CCP: Tips for Success 19 Regulatory Notes...20 Discipline Decisions 21 Ask a CNPS Lawyer...22 Clinical Corner...23 The View of a Nursing Student Representative...24 Congratulations, Nursing Graduates...25 Trust News...26 ARNNL COUNCIL Julie Nicholas President Elaine Warren President-Elect Patricia Rodgers Eastern Region Tracy MacDonald Central Region Lacey Sparkes Western Region Beverly Pittman Labrador/Grenfell Region Valda Duke Advanced Practice Megan Hudson Practice Alexia Barnable Education/Research Tonya Ryan Administration Carmel Doyle Public Representative Ray Frew Public Representative Irene Baird Public Representative Walter Arnold Public Representative Lynn Power Executive Director Representatives from nursing student societies (observers) Advertise in the next issue of ACCESS gcostello@arnnl.ca or call ARNNL STAFF Lynn Power, Executive Director I lpower@arnnl.ca Michelle Osmond, Director of Regulatory Services I mosmond@arnnl.ca Lana Littlejohn, Director of Corporate Services I llittlejohn@arnnl.ca Trudy L. Button, Legal Counsel I tbutton@arnnl.ca Gillian Costello, Communications Officer I gcostello@arnnl.ca Siobhainn Lewis, Nursing Consultant, Policy & Practice I slewis@arnnl.ca Pamela King-Jesso, Nursing Consultant, Policy & Practice I pkingjesso@arnnl.ca Michelle Carpenter, Nursing Consultant, Policy & Practice I mcarpenter@arnnl.ca Bradley Walsh, Regulatory Officer I bwalsh@arnnl.ca Rolanda Lavallee, Regulatory Officer I rlavallee@arnnl.ca Julie Wells, Research & Policy Officer and ARNNL Trust Coordinator I jwells@arnnl.ca Christine Fitzgerald, Administrative Assistant, Executive Director & Council I cfitzgerald@arnnl.ca Jeanette Gosse, Administrative Assistant, Policy & Practice and Regulatory Officer I jgosse@arnnl.ca Michelle Nawfal, Legal Assistant, Director of Regulatory Services & Legal Counsel I mnawfal@arnnl.ca Jennifer Lynch, Administrative Assistant, Policy & Practice I jlynch@arnnl.ca Carolyn Rose, Administrative Assistant, Registration I crose@arnnl.ca Jessica Howell, Administrative Assistant, Registration I jhowell@arnnl.ca Cover Photo: ARNNL Awards for Excellence Gala (June 2016). Left to right: Julie Nicholas, ARNNL President; Donnie Sampson, Award for Excellence in Nursing Administration; Brittany Abbott, Elizabeth Summers Novice Nurse Award; Cathy Murphy, Award for Excellence in Nursing Practice; Lorna Walsh, Award for Excellence in Nursing Education; Margaret (Pegi) Duff Earle, ARNNL Honourary Membership Award. Editor Gillian Costello Creative Design Brenda Andrews, Image 4 Contributing Editor Danielle Devereaux ACCESS is the official publication of the Association of Registered Nurses of Newfoundland and Labrador. ACCESS is published three times a year in January, May and September. Subscriptions are available to non-members for $25 per year. Association of Registered Nurses of Newfoundland and Labrador (ARNNL). All rights reserved. For editorial matters, please contact the editor. The views and opinions expressed in the articles and advertisements are those of the authors or advertisers and do not necessarily represent the policies of ARNNL.

3 MESSAGE FROM THE PRESIDENT This is an exciting time for me as I assume the role of ARNNL President. The past two years as President-Elect have been a great learning experience and enlightening as to the degree of dedication of ARNNL Council and staff as they work on your behalf to maintain standards and advance the nursing profession in the interest of the public. Being part of Council is both rewarding and challenging. It is professional volunteerism at its finest and direct engagement in the privilege of self-regulation. Julie Nicholas, RN, BN, MN president@arnnl.ca My term as president began with honouring fellow nurses who received awards at our June AGM to recognize their outstanding contributions to our profession. Listening to the achievements of these nurses was inspiring. I encourage all nurses to review the award categories and take time to recognize deserving peers by submitting a nomination (see back cover for categories). I also had the pleasure of interacting with nurses from across the country at the recent Canadian A THEME RUNNING THROUGHOUT THE CONFERENCE WAS THE HIGH REGARD FOR CANADIAN NURSES BOTH IN OUR COUNTRY AND INTERNATIONALLY, AND THE POWER OF OUR NURSES TO INFLUENCE POSITIVE CHANGE. Nurses Association (CNA) convention in New Brunswick, where we heard a commitment from the the Honourable Jane Philpott, Minister of Health, for a renewed health care system, listened to stories from Canadian and international nurses who are engaged in primary health care in their communities (including our own Bev White from Central Health!) and heard about progress towards improving the health of indigenous Canadians. A theme running throughout the conference was the high regard for Canadian nurses both in our country and internationally, and the power of our nurses to influence positive change. I intend to bring issues of interest forward while representing ARNNL and provincial registered nurses (RNs) on the board of CNA. A personal highlight for me so far has been representing you along with a parade of uniformed nurses during the Beaumont Hamel 100th Memorial Day Ceremonies at the St. John s War Memorial and The Rooms. How proud I was to have our province s wartime nurses recognized as the heroes they were. It was indeed a humbling experience to lay a wreath in honour of our fallen soldiers and to remember those who sacrificed so much in wartime, including nurses. I find myself reflecting on the next two years and what we as Council will accomplish within that timeframe. I think about opportunities for RNs and nurse practitioners (NPs) to expand their scopes and about the implications of RN prescribing. Other issues at the forefront for our profession include our roles in medically assisted dying, leadership opportunities afforded by a shift in health care delivery to a primary health care focus and the positive influences we may have in support of health equity and health partnerships for indigenous populations. Over the next two years it is my commitment to facilitate the work of Council on your behalf. I follow in Regina Coady s footsteps. Her mentorship over the past two years reminds me of the importance of nurses supporting each other throughout our careers whether a young nurse just starting out, or a more seasoned nurse taking on new roles. Many thanks, Regina. Congratulations to Elaine Warren as she takes on her role as President-Elect and welcome to new Council members, Megan Hudson, Valda Duke and Tonya Ryan. Thank you to our outgoing board members, Dena King and Lisa Jesso, you have been great colleagues and will be missed. And lastly, thanks to past and present Council members for your interest in professional volunteerism. I hope you all had an enjoyable summer; as we now prepare for the business of fall, I encourage you to be active in your Association and tune-in for the President s teleconference coming soon! The Magazine of the Association of Registered Nurses of Newfoundland and Labrador 3

4 FROM THE EXECUTIVE DIRECTOR S DESK Compassion fatigue, post-traumatic stress, physical harm versus compassionate, lifesaving, injury prevention how are these two sets of words linked? All are used in the literature to describe nursing. Lynn Power, RN, MN lpower@arnnl.ca Taking care of self while staying focused on patient-centered care is something that all nurses must balance. At the June 2016 Annual General Meeting (AGM) of the Canadian Nurses Association (CNA), a motion was passed by the assembly that CNA advocate to various authorities for recognition that registered nurses (RNs) are at high risk for developing Post Traumatic Stress Disorder (PTSD). The motion speaks specifically to worker s compensation legislation in each jurisdiction, led by the Manitoba Nurses Union, but I beleive that it speaks to a bigger matter that we need to give a voice to collectively. The ARNNL also raised the issue of demanding work environments for RNs at an education session ahead of the AGM to address topics such as drug misuse and addictions, and the lasting impact caring for clients in these situations can have on the nurse. RESEARCH VALIDATES THAT RNs ARE COMPASSIONATE AND THAT THEIR SKILLS DO MAKE A DIFFERENCE IN ALL SETTINGS AND ACROSS ALL DOMAINS OF PRACTICE. Stressful situations are routinely part of a nurse s workday. A nurse who shared a personal story with me recently said that while working one night a team of ambulance attendants and police officers arrived with a patient from an accident. Before they left, they commented that the images they had seen would haunt them for a long time. This nurse politely replied, We see images of that magnitude every day. A recent article posted by CBC News details a disturbing trend of violence in health care settings, citing the use of furniture as weapons and cases of nurses being repeatedly punched. In a quick look on Medscape, compassion fatigue was linked to a number of factors, of particular note was the link to another alarming situation: nurses believing that their actions would not make a difference or never seemed to be enough. Flip to the other side of the issue and there are countless articles, research and stories that attribute nurses actions to positive patient outcomes, like reduced rates of infection, falls and post-op complications, improved quality of life and increased knowledge. Even after 30 plus years of nursing, I still recall the very first time that my novice assessment skills helped raise alarms that a client s abdominal wound was dehiscing and needed immediate attention. I am sure you each have similar stories. Research validates that RNs are compassionate and that their skills do make a difference in all settings and across all domains of practice. So how do we create a balance between these apparently conflicting descriptors of nursing? The ARNNL Standards and the Code of Ethics offers some ideas. Think holistically about each situation, critically analyze what you know and do not know, incorporate self-reflection into your daily routine, know your policies both for servicing clients and for workplace safety, establish therapeutic relationships and open communications with your team, participate in continuing education and incident debriefing sessions, get involved on committees and provide input into policies. In essence, be engaged within your practice setting. But you also need to care for yourselves, inform yourself about the impact the intensity of what you experience can have upon you, read up on PTSD and compassion fatigue, learn coping skills and where to find resources, appreciate your family, and most importantly, acknowledge that these two sides of nursing are unfortunately a part of the profession. I welcome hearing your solutions and in particular if there are any regulatory tools ARNNL can develop to help you continue to practice safely and compassionately in your profession. 4

5 ARNNL COUNCIL MATTERS Welcome New Council Members and Council Executive Council welcomes new faces to the board: Valda Duke, Nursing Domain Representative - Advanced Practice, and Megan Hudson, Nursing Domain Representative - Practice. Valda is a nurse educator at the Centre for Nursing Studies, Memorial University and a nurse practitioner with Churchill Square Medical Centre. Megan is an RN with the Dialysis Program at Eastern Health. Tonya Ryan, RN, was the successful candidate out of the by-election held this summer to fill the vacant seat for the Nursing Domain Councillor - Administration position on Council. Tonya is currently a Change Manager (temp) with Central Health in Grand Falls-Windsor. A call for nominations was posted on ARNNL s website on August 1 and closed on August 29. In addition to welcoming three new faces, this year saw the installation of Council President Julie Nicholas and President-Elect Elaine Warren. Elaine left the Administration Councillor position to take on this new role. Welcome and congratulations, everyone! ARNNL is pleased to have you on-board. Megan Hudson, RN Valda Duke, NP Council Bestows 52nd Honourary Membership Margaret (Pegi) Duff Earle was awarded Honourary ARNNL Membership on June 6 at ARNNL s Awards for Excellence Gala at the Greenwood Inn and Suites in Corner Brook. Pegi has been involved with ARNNL for over 30 years, including serving for six years at the helm as Executive Director ( ). Pegi worked to help establish the organization s Education and Research Trust (a charitable foundation to support basic and continuing nursing education) and contributed greatly to ARNNL s Workplace Representative Program. She also worked to build consensus to achieve a Bachelor of Nursing Degree as the entry to practice requirement for RNs in Newfoundland and Labrador. Honourary Membership, which has been conferred to 52 nurses since 1954, is bestowed upon individuals who have helped advance the nursing profession and/or the Association. Tonya Ryan, RN Canadian Nurses Association (CNA) Fee Update At their June 20 Annual General Meeting, the CNA approved a pre-tax fee increase of $2.75 for 2018, $2.90 for 2019 and $3.05 for In anticipation of the potential changes, ARNNL Council authorized at their June meeting that from 2017 onwards ARNNL will automatically change member fees in direct correlation with any approved CNA fee decisions. ARNNL will initiate a communications process in conjunction with the CNA on the rationale, timelines and other related implications. Annual Report Available ARNNL s Annual Report is available on our website arnnl.ca/annual-report. The report details the organization s accomplishments, such as formalization of the Interim Licence II, as well as introducing new registration procedures with the Canadian Nurses Protection Society (CNPS). For a printed copy, please contact ARNNL House at info@arnnl.ca. Next ARNNL Council Meeting! The next in-house Council meeting will take place October at ARNNL House in St. John s. Contact Christine Fitzgerald, Executive Assistant, at (709) or cfitzgerald@arnnl.ca for more details. *More details about ARNNL Council, as well as ARNNL news and events, are available in UPDATE, ARNNL s e-newsletter. jlynch@arnnl.ca to subscribe today! The Magazine of the Association of Registered Nurses of Newfoundland and Labrador 5

6 ARNNL COUNCIL MATTERS Memorial Day: 100th Anniversary of Beaumont Hamel This year marked the 100th Anniversary of Beaumont Hamel and ARNNL was proud to represent RNs and NPs in this province at the special ceremonies at both the War Memorial and The Rooms. ARNNL President Julie Nicholas laid a wreath at the War Memorial as a member of the Uniformed Services Group, and attended the Official Commemoration Ceremonies at The Rooms along with ARNNL Executive Director Lynn Power. Both members were honoured to represent the profession and pay respects to those that served. A large contingent of registered and retired nurses also marched as part of the uniformed military parade from the Sergent s Memorial to the War Memorial just ahead of the official start of the ceremonies (picture below). Contingent of registered and retired nurses getting ready to march in the July 1 Memorial Day parade. Annual General Meeting (AGM) Motion Follow-up ARNNL s AGM was held at Corner Brook s Greenwood Inn and Suites on June 6. A motion was put forth that ARNNL develop a discussion document in consultation with key stakeholders, including nursing educators, students, administrators, researchers and practicing nurses to provide background information and analysis of ongoing issues associated with the NCLEX-RN exam to be used as a guide for future action for supporting students in the successful writing of the exam. This motion was passed and Council supported the intent. Work will commence over the coming months. Council Meeting Update ARNNL Council met on June 5. A series of motions were passed, including proposed changes to registration requirements related to the NCLEX-RN exam. For more information on recent Council activities, please see Update at For more information around proposed NCLEX-RN changes, please see page 20. Beaumont Hamel Freedom 100 Tour Retired NL Nurses proudly laid a wreath at the Caribou Memorial Ceremony in Masnieres, France, on July 2, Sheila Hickman, Debbie L. (Taylor) Pike, Sharon Meehan and Beverley (Hillier) Mulholland. Council was pleased to meet with the dean and directors of the Schools of Nursing. Their input and point of view regarding graduates entering the profession was very valuable. 6

7 REGISTRATION UPDATE Licensure Conditions & Reminders By: Bradley Walsh, RN, MN, Regulatory Officer Licensure conditions are set out in Section 11 of the RN Regulations (2013) Ensure address is up-to-date. Notify ARNNL of a change in name, address or employer information no later than 30 days from the effective date of the change. You can update your address and employer information via MyARNNL. Change in name requires legal documentation. Identify all your nursing employers, including self-employment, to ARNNL. Watch your throughout the year for important regulatory notifications. Immediately notify ARNNL of a criminal conviction. If employed outside a Regional Health Authority, ensure a letter confirming your hours of practice for the licensure year is forwarded to ARNNL. Nurse Practitioners must immediately notify ARNNL of a change in the physician collaborative arrangement. Fee Schedule Update Please see the ARNNL fee schedule at The required HST sales tax increases were effective July 1, Sketch of an ARNNL Learning Tool: How Do I use the YouTube Resource? ARNNL s YouTube Channel was created as an area for members to gain access to important, relevant practice information on a variety of topics. Listen to past teleconferences lead by ARNNL Consultants and guest speakers as they walk you through topics such social media, scope of practice for RNs, preparing for licensure, and also how-to sessions such as the Celebrating Excellence in Nursing teleconference which explained how to nominate a colleague for an Award for Excellence. Viewing archived teleconferences can be counted towards your self-directed learning hours for the Continuing Competence Program (CCP). To access archived teleconferences simply click the YouTube Channel icon next to the Search box on the homepage of arnnl. ca. Having trouble viewing it? We have also uploaded all past teleconferences from the YouTube Channel onto our website, visit arnnl.ca/archived-education-sessions to view. The Magazine of the Association of Registered Nurses of Newfoundland and Labrador 7

8 THE SISTERHOOD OF NEWFOUNDLAND GENERAL HOSPITAL GRADUATE NURSES IN WWI By: Sandra MacDonald R.N., Ph.D.; April Manuel R.N., Ph.D.; Marcia Porter B.A., B.J.; Jennifer Guy B.Sc. Memorial University of Newfoundland, School of Nursing Isabelle May Simms St. John s 1907 Graduate Served: Granville Orthopedic Hospital, Ramsgate, England Royal Military Hospital, Shorncliffe Camp, England Canadian General Hospitals, Bramshott, England Canadian Stationary Hospitals, Arques and Outeau, France British Red Cross Hospital, Sheffield, England Medals British War Medal Victory Medal Canadian War Service Badge Isabelle Simms was born in St. John s on April 1, 1885 and graduated from the General Hospital School of Nursing in On February 18, 1917 she signed the Officer s Declaration Papers for the Canadian Expeditionary Forces to serve overseas in the Canadian Army Military Corp (CAMC). On May 18, 1917 she officially enlisted with the CAMC at Victoria, British Columbia for service overseas in Britain and France. Lieutenant Simms began her service at the Granville Special Orthopaedic Hospital in Ramsgate, England on July 23, 1917 and then on to the Royal Military Hospital, at Shorncliffe Camp on September 3, She was then posted to the Canadian General Hospital, originally the Moore Barracks Military Hospital, at Bramshott, England on October 1, According to the war diaries for the Moore Barracks Hospital, on the evening Isabelle arrived they were ordered to take air raid action from 18:55 to 23:00. Lights were dimmed and observers mobilized as the nurses remained in the hospital. A year later, on October 28, 1918, Isabelle was transferred to the Canadian General Hospital in Arques, France. She also served at the British Red Cross Hospital in Sheffield, England. The strain of nursing in WWI took a toll on the health of many nurses, including Isabelle. On August 16, 1918, three months before the war Photo Courtesy Royal NL Regiment Museum ended, she was admitted to the Canadian General Hospital in Le Treport, France for gastritis and haemorrhages and was given 14 days leave, but resumed her duties within a week at the Canadian Stationary Hospital in Outeau, France. Isabelle stayed in France six months after the war ended, caring for wounded and dying Canadian soldiers. Her last post was with the Canadian Stationary Hospital in Arques before being discharged on May 13, Isabelle sailed to Canada aboard the S.S. Northlandon and arrived in Halifax on May 23, She received the British War Medal, the Allied Victory Medal and the Canadian War Service Badge Class A for her service overseas in WWI. 8

9 WWI SPOTLIGHTcontinued... As ACCESS readers learned in the January 2016 issue, from now until January 2017, ARNNL ACCESS is pleased to feature a series of articles that will explore the military service of 10 General Hospital School of Nursing graduate nurses. This research was supported by a grant from the Memorial University of Newfoundland WW100 Living Memorial Commemorative Fund. Mary McGrath St. John s 1912 Graduate Served Canadian Stationary Hospitals, France Bramshott Military Hospital, England His Majesty s Hospital Ship, Arguaya Canadian General Hospital, Liverpool, Red Cross Hospital, Taplow, England Medals British War Medal Victory Medal Canadian War Service Badge Mary McGrath was born in St. John s on August 29, 1890 and graduated from the General Hospital School of Nursing in On April 3, 1916 she signed the Officers Declaration Papers to enlist as a Lieutenant with the Canadian Expeditionary Forces in the Canadian Army Military Corp (CAMC). Lieutenant McGrath served overseas in both England and France during WWI. On July 8, 1916 she reported for duty at the Canadian Stationary Hospital, in Outeau, France. Shortly after that, on October 8, she was transferred to the Canadian Stationary Bramshott Military Hospital in England. On October 11, Mary learned that her brother, Private Thomas McGrath of the Royal Newfoundland Regiment was killed in action in France. Thomas received the Military Medal for conspicuous gallantry when under heavy shell and machine gun fire he brought in eight wounded men from no mans land at Beaumont Hamel. Mary contracted influenza while she was serving at the Bramshott Hospital in England and was hospitalized for ten days in December until she was declared fit to resume her duties on December 21, On May 11, 1917 she was transferred to the Canadian General Hospital located in Troyes, France. She also served on the hospital ship the Arguaya from February 2, 1918 to September 18, The Arguaya had 57 cots and 460 berths and made twenty trans-atlantic voyages from England to Canada during the war, carrying 15,324 wounded soldiers. Photo Courtesy Royal NL Regiment Museum On March 24, 1919 Mary left the Arguaya and was posted to the Canadian General Hospital in Liverpool, England. On May 28, 1919, she was posted to the Canadian General Hospital in Taplow, originally the Duchess of Connaught s Canadian Red Cross Hospital. That June she was transferred to the CEF headquarters in Liverpool and was granted one-week leave before she sailed to Canada on June 12, 1919 aboard the R.M.S. Scotian. Lieutenant McGrath served with the CAMC from April 3, 1916 to June 30, 1919 and received the British War Medal, the Victory Medal and the Canadian War Service Badge, Class A. Lte. McGrath was one of the twelve Newfoundland born, General Hospital graduate nurses who served her country overseas during WWI. The Magazine of the Association of Registered Nurses of Newfoundland and Labrador 9

10 NURSES OF NOTE By Gillian Costello, BA, GradDip P.R., MA, Communications Officer ARNNL s Awards for Excellence gala was held in Corner Brook at the Greenwood Inn and Suites on June 6. We wish to congratulate all of our winners and honour their commitment to Excellence in Nursing in their roles. Brittany Abbott James Paton Memorial Hospital, Central Health, Gander, NL Award for Excellence in Nursing The Elizabeth Summers Novice Nurse Award Originally from Aspen Cove, Brittany graduated from the Centre for Nursing Studies with her Bachelor of Nursing Degree in She currently practices at James Paton Memorial Hospital in Gander on the general surgery/pediatrics unit. Her colleagues make note of her leadership skills, reliability, helpfulness and competence. It is these skills, as well as her caring and positive attitude towards her patients, their families and her co-workers, that made her an ideal fit for the 2016 Elizabeth Summers Novice Nurse Award. Lorna Walsh Nurse Educator and Year One and Two Coordinator, Centre for Nursing Studies, Eastern Health, St. John s, NL Award for Excellence in Nursing Education Described by her colleagues as a conscientious, reliable, hard-working educator, Lorna graduated from Memorial University School of Nursing with a Bachelor of Nursing Degree in 1985, followed by a Master s Degree in Education in Lorna currently holds the position of Nurse Educator and Year One and Two Coordinator at the Centre for Nursing Studies, Eastern Health, in St. John s. She has participated in provincial, national and international initiatives and demonstrates excellence in education through her dedication to her students, creative approach to problem-solving and her active role in the classroom, clinical and laboratory settings. Lorna is a positive role model for students, faculty, nurses and community members. Cathy Murphy CEO Psychological Health and Safety at Work Ltd, Ottawa, Ontario Award for Excellence in Nursing Practice Cathy graduated from the Grace General Hospital School of Nursing in Her career in nursing practice has spanned the globe and includes Qatar, Ottawa and St. John s. Her passion for health and wellness has remained consistent over her 34-year career, and includes roles as a mental health nurse with a community-based crisis centre, a health educator with Heath and Community Services, and Respectful Workplace Coordinator with the Public Service Commission in Newfoundland and Labrador. Cathy currently lives in Ottawa and has combined her work experience and approach to wellness in her practice, Psychological Health and Safety at Work. Donnie Sampson Vice-President of Nursing and Chief Nurse for Labrador-Grenfell Health, Happy Valley-Goose Bay, NL Award for Excellence in Nursing Administration Donnie, Vice-President of Nursing and Chief Nurse for Labrador-Grenfell Health, was educated in Port Hope Simpson, and is a graduate of the Western Memorial School of Nursing in Corner Brook. Following graduation, Donnie continued her education completing the Nurse Practitioner Primary Health Care Certificate program at the Centre for Nursing Studies in Ms. Sampson also attained her Bachelor of Nursing from Athabasca University and earned her Masters of Nursing Advanced Nursing Practice Degree in She will complete her Master of Health Studies with Athabasca in August Ms. Sampson has held a number of positions with Labrador-Grenfell Health. Her colleagues credit her with restructuring the nursing department and standardizing nursing care, enhancing staff education and communication, and putting processes in place to increase the monitoring and measuring of accessibility of services to clients and overall performance of program areas. Recent initiatives include spearheading a new Model of Nursing Clinical Practice and working towards achieving Baby Friendly Designation for Labrador-Grenfell Health. 10

11 ARNNL CONTINUING EDUCATION TELECONFERENCE SESSIONS Fall 2016, Tuesdays h (Island Time) SEPTEMBER 27 Evolving Perspectives on Addiction Trena Snook, RN, NP, GNC(C), Mental Health & Addictions, Eastern Health OCTOBER 11 Professional Conduct Review: Lessons Learned Michelle Osmond, RN, MS(N), Director of Regulatory Services, ARNNL Trudy Button, Legal Counsel, ARNNL OCTOBER 25 ARNNL 101: Linking New Grads with Practice Resources Michelle Carpenter, RN, BN, MEd., Nursing Consultant Policy & Practice, ARNNL Pam King-Jesso, RN, BN, MN, Nursing Consultant Policy & Practice, ARNNL Siobhainn Lewis, RN, BN, MN, Nursing Consultant Policy & Practice, ARNNL NOVEMBER 8 Medical Assistance in Dying (MAID) Pam King-Jesso, RN, BN, MN, Nursing Consultant Policy & Practice, ARNNL Trudy Button, Legal Counsel, ARNNL Michelle Carpenter, RN, BN, MEd., Nursing Consultant Policy & Practice, ARNNL NOVEMBER 15 Let s Talk Lean: A Provincial Round-Up with RHA Chief Nurses Katherine Chubbs, RN, BN, MHS, CHE, Vice-President & Chief Nursing Officer, Eastern Health Donnie Sampson, RN, BN, NP-PHC, MN, MHST(C), Vice- President Nursing & Chief Nurse, Labrador Grenfell Health Trudy Stuckless, RN, Vice-President, Professional Standards & Chief Nursing Officer, Central Health DECEMBER 6 Preceptorship: Supporting our Future Colleagues Glenys Moran RN, BN, MN, Nurse Educator, Centre for Nursing Studies These sessions will be audio recorded and available online after the event. To access archived teleconference sessions, visit HOW TO ATTEND A LIVE TELECONFERENCE SESSION 1. Access is provided five minutes prior to start time. 2. Dial When prompted, enter the Participant Passcode # 4. If you experience technical difficulties, press *0 (star-zero). 5. All participant lines will be muted during the presentation. To mute your line during Q & A, press *4 to mute and *4 to turn off mute REGISTRATION To register go to under News & Events. If you need assistance with registration, contact Jennifer Lynch at jlynch@arnnl.ca, or MISSED A PAST EDUCATION EVENT? Check out ARNNL s Archived Education Sessions at CCP Attendance at live teleconference events = formal continuous learning hours. Viewing archived teleconference sessions = self-directed continuous learning hours. The Magazine of the Association of Registered Nurses of Newfoundland and Labrador 11

12 Q & A: YOU ASKED By: ARNNL Nursing Consultants, Policy and Practice Q: A: What do I do if Medical Assistance in Dying (MAID) is in conflict with my personal beliefs and values? ARNNL recognizes an RN s or NP s freedom of conscience. RNs and NPs practice in accordance with the Canadian Nurses Association (CNA) Code of Ethics (2008), which serves as the foundation for nurses ethical practice. When faced with a situation where an RN or NP experiences a conflict with one s conscience, they reflect on their ethical responsibilities: If nursing care is requested that is in conflict with the nurse s moral beliefs and values but in keeping with professional practice, the nurse provides safe, compassionate, competent and ethical care until alternate care arrangements are in place to meet the person s needs or desires. If nurses can anticipate a conflict with their conscience, they have an obligation to notify their employers or, if the nurse is self-employed, persons receiving care in advance so that alternate care arrangements can be made. (CNA Code of Ethics, 2008, p. 19) RNs and NPs may have beliefs and values that differ from those of a client and may not be comfortable aiding in MAID. The law does not compel an RN or NP to aid in MAID. RNs and NPs whose practice environments include aiding in MAID, and who determine that MAID is in conflict with their beliefs and values, must inform their employer of their conscientious objection. Nurses can work with their employers to identify an appropriate, alternative care provider. RNs or NPs who conscientiously object should transfer the care of a client to another RN, NP or other health care provider who can address the client s needs. Until a replacement caregiver is found, an RN or NP must continue to provide safe, competent, compassionate and ethical care that is not related to activities associated with MAID, in accordance with the client s care plan. In addition, conscientious objection must not be directly conveyed to the client/family and no personal moral judgments about the beliefs, lifestyle, identity or characteristics of the client should be expressed. Further guidance on raising a conscientious objection can be found in the Canadian Nurses Association Code of Ethics (2008), Section G7, and Appendix D: Ethical Considerations in Addressing Expectations that are in Conflict with One s Conscience. ARNNL is available to assist RNs and NPs in relation to regulatory requirements related to MAID. ARNNL can provide information on the Standards of Practice, the Code of Ethics and Scope of Practice to assist RNs and NPs with issues related to their practice. Additional resources related to MAID are also available at RNs and NPs should refer to the new ARNNL regulatory document REGISTERED NURSES AND NURSE PRACTITIONERS - AIDING IN MEDICAL ASSISTANCE IN DYING which outlines their regulatory responsibilities in MAID. Q & A: YOU ASKED reflects member questions frequently asked about general topics. Members can access confidential practice consultation with ARNNL Nursing Staff. Visit under Contact for ways to get in touch. 12

13 ADVANCED PRACTICE VIEW By: Valda Duke MN NP and Wanda Emberley-Burke MEd, NP Exploring the Need for an E- Mentorship Program for Novice Nurse Practitioners in Newfoundland and Labrador The first year of practice as a new nurse practitioner (NP) is a challenging and important time of transition. While some NPs are experts in their field as registered nurses (RNs) and transition to NPs in the same clinical area, others embark on an entirely new clinical role as an NP. Similarly, new NP graduates move from a structured learning program with faculty and peer support to a collaborative but independent practice, often in remote rural settings with little support. All novice NPs, whether new graduates or expert RNs evolving into NPs, undergo transition. Novice NPs report this time as stressful, overwhelming and frustrating (Gerhart, 2011; Hill & Sawatzky, 2011; Poronsky, 2012; Sullivan-Bentz et. al., 2010; Yeager, 2010). These reported feelings can be decreased with support and mentoring by an experienced NP. Such support could be implemented as an e- mentorship program. Failing to address adjustment to the new NP role can affect the quality of care received by patients, confidence and competence of the novice NP entering into practice, as well as the job satisfaction and retention of the new NP (Steiner, et. al., 2008; Yeager, 2010). Equally, ensuring a smooth transition to the new role is essential to the long term success of the novice NP (Gerhart, 2011; Harrington, 2011; Sullivan-Bentz et. al., 2010). Research has shown that novice NPs lack support as they transition to new NP roles (Sullivan-Bentz et. al, 2010; Yeager, S., 2010). A mentorship program which allows adequate support of novice NPs entering new roles in the workplace is a way to reduce this repositioning (Brown & Olshansky, 1997; CNA, 2011; Hill & Sawatzky, 2011; Poronsky, 2012; Sullivan-Bentz et. al., 2010). Mentorship with an expert NP plays a valuable role in gelling learned theory for the novice NP, with knowledge gained through experience. Benner s Novice to Expert theory suggests that expert nurses develop skills over time based on a solid knowledge base as well as through clinical experience. Benner (1982) proposes five levels of nursing experience: novice, advanced beginner, competent, proficient and expert. Similarly, Brown and Olshansky s (1997) theoretical model, From Limbo to Legitimacy, represents categories of transition into the primary care NP role: Laying the Foundation, Launching, Meeting the Challenge and Broadening the Perspective. There is no formal mentorship program in this province for NPs. An e-mentorship program would provide support through electronic means ( , telephone) to the novice NP, during the first year of independent clinical practice. This delivery format is realistic and accessible to all areas of Newfoundland and Labrador both rural and urban. Mentors and mentees would be identified by a mentorship program coordinator and mentorship details would be outlined in an orientation package. Participants would connect online and by telephone, allowing both the novice NP and mentor to clearly communicate questions/concerns and counsel during this important transitional year. The program would be evaluated for effectiveness at six and 12-month intervals. Acknowledgements: Beverley McIsaac *References are available upon request. For a list, please contact Gillian at gcostello@arnnl.ca Did you Know? ARNNL recognizes Special Interest Groups (SIGs) as valuable to the promotion of the profession, from enhancing quality of care and standards of practice, to developing knowledge and competency through sharing amongst peers. SIGs are comprised of registered nurses who have a common interest for professional development in a defined area of nursing practice, education, administration or research. To learn more about the process or to review our Guidelines for ARNNL Special Interest Groups please visit arnnl.ca/special-interest-groups. The Magazine of the Association of Registered Nurses of Newfoundland and Labrador 13

14 FROM HOSPITAL TO HOME: Supporting Implementation of Infant Safe-Sleep Guidelines By: Michelle Earle-Crane MN, RN, Michele Power, MN, RN and Kathleen Stevens PhD(c), RN The Joint Statement on Safe Sleep: Preventing Sudden Infant Deaths in Canada provides health care professionals with evidence-based guidelines for preventing sudden infant death syndrome (SIDS) and unsafe sleep practices. These guidelines developed by the Canadian Pediatric Society, Canadian Foundation of Child Health, Health Canada and Public Health Agency of Canada (PHAC) are used to educate parents regarding how to provide a safe sleep environment for infants. PHAC also provides online resources that outline the steps parents can take to provide a safe sleep environment for their infant, such as: avoiding exposure to smoke pre and postnatally; breastfeeding; placing infants supine on a firm, flat surface for sleep at all times, without quilts, pillows, comforters or bumper pads; and placing the infant to sleep in a crib, cradle or bassinet next to an adult s bed. Since the start of the 1999 Back to Sleep Campaign, the number of parents who place infants on their backs has greatly increased and the rate of SIDS has decreased more than 50%. THE STUDY EXAMINED CHANGES IN PARENTAL KNOWLEDGE, ANXIETY, CONFIDENCE AND UTILIZATION REGARDING SAFE SLEEP PRACTICES AFTER POLICY IMPLEMENTATION. Safe sleep guidelines should be implemented before the infant is discharged from hospital. However, sometimes newborns need support to transition to extrauterine life. For example, swaddling is sometimes necessary to maintain temperature and/or positioning aids to assure optimal positioning. After this initial period of adjustment, it is important to implement safe sleep guidelines. Inconsistent implementation of these guidelines during hospitalization has been associated with increased caregiver anxiety and decreased knowledge and confidence regarding safe sleep practices at home. Therefore, within Eastern Health, a Safe Sleeping Practices for Newborn Infants policy was developed. The intent of this policy is to demonstrate consistent implementation of safe sleep guidelines in the hospital. Through teaching and modeling by nurses to parents, the goal is to promote these practices in the home environment. To determine the impact of this policy, a descriptive-comparative study was undertaken in the Neonatal Intensive Care Unit (NICU), Janeway Children s Health and Rehabilitation Centre. The study examined changes in parental knowledge, anxiety, confidence and utilization regarding safe sleep practices after policy implementation. Ethical approval was obtained and 62 mothers and two fathers completed the pre-policy questionnaire and 66 mothers completed the postpolicy questionnaire. After policy implementation, parents reported the following in relation to safe sleep practices: increased knowledge; increased understanding of discharge instructions; increased confidence and decreased anxiety at time of discharge and arriving home; increased consistency between what was taught and what was seen in the NICU; and increased utilization at home. These research findings have implications for nursing. Content in nursing curriculum should reinforce the importance of consistency between discharge teaching and nursing behaviors in all practice settings. A policy for safe sleep progression is important in any practice setting where nurses provide care to newborns and their families. Furthermore, consistency between discharge teaching and modeling of safe sleep practices impacts parental behavior at home. Research in other clinical settings will further determine the impact of such a policy and promote understanding of parental choices regarding safe sleep practices. 14

15 A NOTE FROM THE NEW EDITOR: We Want to Hear From You! By Gillian Costello, BA, GradDip P.R., MA As the new Communications Officer with the ARNNL, one of my responsibilities is managing the organization s magazine, ACCESS. Flipping through the past newsletter editions, which span 50 plus years, I was able to witness both the historical significance of the publication (and the organization), and the evolution of the magazine. Many of you have expressed source of information as one of the main benefits of membership with ARNNL, and it is the main goal of ACCESS to share relevant, timely information with our membership. While updates from us at ARNNL to you are important, contributions from members are critical to help create a forum for learning and information-sharing. What would we like to hear about? Well, we want to hear stories you think would interest your RN and NP peers, as well as health-related news that may interest the public who have access to our magazine on our website and from ARNNL House. Gillian Costello gcostello@arnnl.ca I want to take this opportunity to share some helpful tips when considering an article for ACCESS below: Tips When Submitting to ACCESS: What kinds of things are we looking for in ACCESS? Please keep text to 500 words. Pictures are always welcome to accompany a story. ACCESS publishes three times per year: September, January and May. Remember you can view past editions of ACCESS on our website to get an idea of the type of articles that have been submitted and published. While the public are indeed an audience, the main readership of ACCESS are RNs, NPs and other health professionals. Are you wondering if your news is appropriate for publication in ACCESS? Here are some ideas: Upcoming conferences or events that would interest your peers. An RN or NP who has received an honour or award for their work. Articles around academic studies or research in which you may have taken part. If you are unsure about an item for ACCESS, I am happy to discuss it with you. Another important note is regarding timelines. ACCESS deadlines are about two months ahead of the publish date, so ensure you contact me to get the exact dates for submission if you are interested in a certain annual issue to give yourself lots of lead time. To submit an article for consideration in ACCESS, or discuss an idea you may have, please me at gcostello@arnnl.ca. I look forward to hearing from you! The Magazine of the Association of Registered Nurses of Newfoundland and Labrador 15

16 GOINGS ON ARNNL Education Session Raised Awareness of Addictions Issues and Nursing ARNNL s most recent education sessions focused on societal drug use and its impact on nursing practice. The Royal Newfoundland Constabulary brought to light the types of drugs that are available in this province. An expert panel discussed the changing practice landscape, highlighting clients clinical presentation when drug use is an issue, safety concerns for nurses and the importance of non-stigmatized care. Provincial treatment options were also discussed. A lunchtime presentation by the Canadian Patient Safety Institute provided reflection on the importance of listening to our clients. Thanks to all those that were able to attend! CCP Audit The CCP Audit for the licensure year was conducted in May. Thank you to all RNs and NPs who participated in the audit process. Stay tuned for the results in January s ACCESS. Nursing Achievements and Honours National Honour A contingent of RNs from Newfoundland and Labrador attended the IPAC Canada 2016 National Education Conference in Niagara Falls May 15-18, where Marion Yetman was the recipient of the prestigious Honorary Member Award. Congratulations Marion! Recognition for Recent Graduate Jennifer Hiscock, RN, Central Health, was awarded the University Medal of Academic Excellence in Nursing (Post RN-BN) at Memorial University of Newfoundland s May 2016 Convocation. Congratulations Jennifer! National Orthopedic Award for RN in Central In May in Edmonton Janice Young, RN, Central Health, received the Canadian Orthopedic Nurses Association s Excellence in Orthopedic Practice Award. There is only one national recipient per year. Back row: Michelle Carpenter, Edmund Walsh, Regina Walsh, Brenda Hayter, Lisa Hussey, Patricia Grainger, Beverly Simms, and Joanna Baird. Front: Rosemarie Woods, Marie Clarke, Rhonda McDonald, Myrna Pardy, and Pam King-Jesso. For more information about the NLNPA Conference, please contact Wanda Emberley Burke at web714@mun.ca. Sovereign s Medal for Volunteers Dr. Lan Gien, Professor Emerita from the School of Nursing, Memorial University, was honoured with the Sovereign s Medal for Volunteers by the Governor General of Canada, his excellency the Right Honourable David Johnston, at an award presentation held in Halifax, Nova Scotia, in July This award recognized a person who has made significant, sustained and unpaid contributions to their community in Canada or abroad. 16

17 National Nurses Week 2016 ARNNL and the College of Licensed Practical Nurses of Newfoundland and Labrador (CLPNNL) joined their counterparts across Canada from May 9-15 to recognize National Nursing Week (NNW) and its theme, Nurses: With you every step of the way. Throughout the week, nurses and employers recognized RNs, NPs and LPNs and their role effecting change in the delivery of quality health care. Pictures of Labrador- Grenfell are provided. Celebrating NNW in Goose Bay. Celebrating NNW in Forteau. Celebrating NNW in Churchill Falls. MUNSON is turning 50! Memorial University School of Nursing (MUNSON) are calling on alumni to celebrate this special milestone. For more information about the celebrations, or to register for the gala event on October 14, please visit: Celebrating NNW in St. Anthony. Fall Conferences and Events Solution Focused Brief Therapy Association 2016 Conference This North American non-profit association is dedicated to the advancement of solution-focused training and networking. Its annual conference is hosted in a different North American city each year and this year will be held in Halifax, NS. The conference is open to clinicians and may be of particular interest to mental health nurses. November 2-5, 2016 Marriott Harbourfront Hotel, Halifax, NS To register or for more information please visit Canadian Association of Practical Nurse Educators (CAPNE) Conference The Centre for Nursing Studies will be hosting the Canadian Association of Practical Nurse Educators (CAPNE) 2016 conference in St. John s October 11-13, October 11-13, 2016 Delta St. John s Hotel and Conference Centre, NL For more information, please visit www. Legal Risks for New Grads This Canadian Nurses Protective Society (CNPS) webinar discusses legal issues of interest to newly graduated nurses. A CNPS lawyer will present various issues, with the opportunity for participants to ask questions. September 14, :30-2:30 pm To register visit and click the education tab on the left Janeway Kids Rock Pediatric Emergency Conference & Webinar September 30 - October 2, 2016 Health Science Centre Main Auditorium & Foyer St. John s, NL For more information about this event, please contact Jackie or Tracy , or kidsrock@hotmail.com. The Magazine of the Association of Registered Nurses of Newfoundland and Labrador 17

18 VOLUNTEER SPOTLIGHT: NEW ARNNL WORKPLACE REPRESENTATIVES Terri-Lyn Coade, RN, BN, Fonemed, Corner Brook Terri-Lyn graduated with a Bachelor of Nursing degree in Her nursing practice has taken her to acute care, medical surgical areas, continuing care, discharge planning, and to her current role with the Newfoundland and Labrador Healthline based in Corner Brook. There are 18 RNs in my workplace, Terri-Lyn says. We service the whole population of Newfoundland and Labrador and have the opportunity to educate and support individuals in their homes and to offer access to health care to all, whether in urban, rural or remote areas. Terri-Lyn describes herself as a true nurse generalist, providing nursing information, advice and support to all ages and for a variety of health issues. Heather Taylor, RN, BN, Orthopedics, Health Science Centre, St. John s Heather graduated from the Centre for Nursing Studies in 2014 with a Bachelor of Nursing degree, having maintained the Dean s list academic standing throughout her program. She has practiced on the adult orthopedic unit at the Health Science Centre since graduation. Heather loves acute care surgery and says that her high energy level is a good fit for this fast paced environment. I love providing quality care in an efficient manner to a very diverse group of patients and I love learning about new or unfamiliar diseases or diagnoses, she says. Although the workplace representative role is new to Heather, volunteerism is not. She is a member of her workplace s quality improvement team and participates in community activities in Goulds and surrounding areas. Mary Beresford-Osborne, RN, BN, MN, St. John s Long Term Care Home Mary graduated from Western Regional School of Nursing with a Bachelor s degree in Nursing in 2002, a Master s degree in Nursing from MUN in 2007, and completed the International Interprofessional Wound Care Course from the University of Toronto in She is currently Clinical Educator at St. John s Long Term Care Home (Pleasantview Towers), St. John s. Mary describes her work environment as home to 450 residents ranging in age from mid-20s to late 90s and beyond, where care is provided in a skill mix team approach of RNs, LPNs and PCAs, and her role is to support care providers in achieving professional, accountable and evidence informed practice. Mary has received the Eastern Health CEO Award of Excellence for Connectedness, and cites professional and personal fulfillment when supporting and assisting individuals during some of the most challenging times in their lives, adding that this sense of fulfillment is enhanced when I can support and/or provide care with a friendly smile, compassionate touch and sense of humour. Lindsay Dawe, RN, BN, Carbonear General Hospital Lindsay graduated from the Centre for Nursing Studies in 2007 with a Bachelor of Nursing degree and currently practices on the surgery unit at Carbonear General Hospital, where she has worked for eight years. Our 16-bed surgical unit also houses obstetrics, gynecology and the Case Room, Lindsay notes, and while she recognizes that nursing practice can be challenging, at the end of the day, knowing you have made a difference in someone else s life makes it all worthwhile. Lindsay remains active with volunteerism through her daughter s school, and will begin the Masters of Nursing Program at MUN in September. If you would like to volunteer with ARNNL, visit 18

19 CONTINUING COMPETENCE PROGRAM (CCP) Tips for Success By: Advisory Committee on Continuing Competence 1 When RNs and NPs declare on their license renewal application that they have completed all requirements of the continuing competence program in the April 1- March 31 licensure year it means that the member has completed all aspects of the CCP for the preceding licensure year. This declaration indicates that the member has: completed the selfassessment; developed a learning plan; implemented a learning plan; completed a minimum of 14 continuous learning hours (at least seven of which must be formal learning); and evaluated the impact of their learning plan on their nursing practice. Members are reminded that in order to verify completion of formal hours, verification is required (e.g., conference/teleconference registration, CCP tracking form, certificates, etc.). If you do not submit documentation confirming completion of CCP, your status will be changed to non-practicing and will display accordingly on the annual register and ARNNL s online RN and NP Member Search and you cannot practice as an RN or NP. Your employer will also be notified. Documentation can be submitted in the form of a letter or to ARNNL Registration. If you declare on the licence renewal application that you have not completed all CCP requirements, you will be issued a 90-day conditional license. This conditional license does not impact your ability to practice to your full scope. However, those members are required to submit documentation to ARNNL confirming successful completion of all components of the CCP within 90 days of the effective date of the licence. Have questions about CCP? Want to know the differences between Formal and Self-Directed Learning hours? Visit files/ccp_continuous_learning_ Activities.pdf Review the Continuing Competence Program Framework at CCP_Framework.pdf Please connect with ARNNL s Nursing Consultant, Michelle Carpenter, at or mcarpenter@arnnl.ca Learning Tips Ensure your learning activities (conferences, educational events, etc.) fall within the licensure year, April 1 March 31. Ensure your learning goals have an action verb and indicate WHAT you are going to learn (e.g., to increase my knowledge of palliative care nursing, including dealing with family members ). Ensure that you include the number of hours for each learning activity that you completed (e.g., my seminar was two hours in length ). Review your target dates to ensure they include a month/year that falls within the ARNNL licencure year. Review your CCP forms to ensure all sections are completed accurately and in their entirety. For example, ensure completion of standard number, indicator and personal reflection on your learning plan. If you have been on extended leave (e.g., maternity or disability), or currently hold a non-practicing membership and are applying for renewal of your practicing license, you are required to meet CCP requirements for the preceding licensure year. 1 Joanne Baird, Cathy Burke, Patricia Grainger, Marcy Greene-Feder, Heather Hunt-Smith, Pamela King-Jesso, Michelle Carpenter, Tracy MacDonald, Anne Rowsell, Rhonda McDonald, Cynthia Davis and Lisa Hussey The Magazine of the Association of Registered Nurses of Newfoundland and Labrador 19

20 REGULATORY NOTES By: Michelle Osmond, RN, MS(N), Director of Regulatory Services and Professional Conduct Review Amendments Proposed to the Registered Nurses Regulations: Future Changes in Registration and Licensing Requirements At its June meeting Council deliberated and approved proposed changes to requirements related to RN Registration and licensure. Council s decisions were informed by a thorough analysis of legal, psychometric, and public protection principles related to the number of attempts an applicant should be granted to pass the NCLEX-RN exam (the RN registration exam approved by Council), as well as research literature and evidence related to maintenance of competency as it related to completion of entry level education and time to enter into nursing practice. As these changes require amendments to the Registered Nurses Regulations, and as required under the RN Act approval of the Minister of Health and Community Services, ARNNL was active during the summer months as drafts of the amended legislation were prepared and reviewed. Following validation by Council the amended legislation will be forwarded to the Minister. Although not yet in effect, when approved by the Minister and following government notice to the public 1, the finalized changes to the RN Regulations will become law. The proposed changes include: Registration: Lengthening the duration of provisional registration to three years (i.e. the time period, currently two years) that an applicant for RN registration is provided to meet all registration requirements including successful completion of the RN registration exam and professional reference (where required); Removing the specified number of attempts on the RN registration exam (i.e. currently three attempts with a fourth in exceptional circumstances) to an unspecified number that may be attempted within the period of provisional registration; and Licensure: Standardizing the length of time that completion of a BN program provides eligibility for initial RN licensure and RN licensure renewal with competency of knowledge evidence. Council also approved that the proposed changes to be retroactive to align with the proposed revisions proposed to the provisional registration period. Upon approval of the amended regulations ARNNL will communicate with applicants, both current and previous (where applicable), as it relates to the approved changes and individual circumstances. Removing the mandatory requirement for remedial education prior to a third attempt on the RN registration exam. Stay tuned to our website for updates as the proposed changes are anticipated to come into effect this fall. A link to the Registered Nurses Regulations (2013) is available at ARNNL s website. You may also contact ARNNL s Director of Regulatory Services or a Regulatory Officer for more information. 1 NL Gazette publication of the Queen s Printer that includes Public Notices and Regulations which fall under Provincial or Federal 1 Legislation pertaining to the province. 20

21 DISCIPLINE DECISIONS Michelle Osmond, RN MS(N) Director of Professional Conduct Review Pauline Hollett Newfoundland and Labrador Registration No In the matter of a Complaint against Pauline Hollett, Association of Registered Nurses of Newfoundland and Labrador, Registration #14033 (the Registrant ), a registered nurse whose license to practice nursing had been suspended by Council on May 6, 2015 pending a hearing of the Complaint. The Adjudication Tribunal accepted an Agreed Statement of Facts in which the Respondent admitted that she had engaged in conduct deserving of sanction under the Registered Nurses Act, 2008, sections 18(c)(i) professional misconduct; 18(c)(ii) professional incompetence; and 18(c)(v) acting in breach of the Code of Ethics. The Adjudication Tribunal determined that the Respondent engaged in conduct deserving of sanction, which conduct included: errors and omissions in client documentation; breach of client confidentiality; and failing to: demonstrate therapeutic and effective communications in her nursing practice; prioritize or plan client interventions in a timely or organized manner; demonstrate safe nursing practice in relation to sterile technique and infection control; demonstrate knowledge of basic nursing interventions and risk factors for client health or safety; demonstrate knowledge and accuracy in medication administration; and demonstrate nursing leadership and accountability. Pursuant to section 28(3) of the Registered Nurses Act, 2008, the Adjudication Tribunal accepted a Joint Submission on Penalty and in a Decision dated May 4, 2016, ordered: 1. The Registrant s license to practice nursing shall be suspended pending her successful completion of specified nursing education. 2. Upon the return of the Registrant s license her nursing practice shall be subject to securing a nursing employer who will monitor her practice for a period of 12 months. 3. The Registrant shall pay the ARNNL $1, towards its costs incurred in the investigation and hearing of the Complaint. The conduct deserving of sanction occurred from or about January 2010 to or about October 2013 while the Registrant practiced as a registered nurse at the Glenbrook Lodge. The Complainant was Eastern Health. Matthew Crawford Newfoundland and Labrador, Registration No In the matter of a Complaint against Matthew Crawford, Association of Registered Nurses of Newfoundland and Labrador, Registration #20353 (the Registrant ), an Adjudication Tribunal found the Registrant guilty of conduct deserving of sanction under the Registered Nurses Act (2008), section 18(c)(i) professional misconduct, in that the Registrant: breached an agreement (the Agreement ) he entered into to resolve an allegation filed against him by his nursing employer; and failed to respond to communications from the Director of Professional Conduct Review regarding his compliance with the Agreement. Pursuant to section 28(3) of the Registered Nurses Act (2008) on March 29, 2016 the Adjudication Tribunal accepted an Agreed Statement of Facts and a Joint Submission on Penalty and in a Decision dated April 13, 2016 ordered: Pursuant to section 28(3) of the Registered Nurses Act (2008) the Adjudication Tribunal ordered: 1. The Registrant s license to practice nursing shall be suspended pending his successful completion of the following: a. Learning Modules: i. The Profession of Nursing in Canada; ii. Therapeutic and Professional Communication; iii. Jurisprudence: The Legislation and Rules Governing the Practice of Nursing in NL RN; b. A meeting with a Nursing Consultant Policy and Practice Consultant, ARNNL c. All other requirements for licensure as set out in the Registered Nurses Act (2008) and the Registered Nurses Regulations (2013). 2. The Registrant shall pay the ARNNL $1,250 towards its costs incurred. The conduct deserving of sanction occurred on or about August 19, 2015, October 2, 2015, and October 9, 2015 while the Registrant was working out of province. The Complainant was the Director of Professional Conduct Review. Lori O Reilly Newfoundland and Labrador, Registrant No In the matter of a Complaint against Lori O Reilly, Association of Registered Nurses of Newfoundland and Labrador, Registrant #16771 (the Registrant ) an Adjudication Tribunal, in a Decision dated July 15, 2016, found the Registrant guilty of conduct deserving of sanction under the Registered Nurses Act, (2008), sections 18(c)(i) professional misconduct; and 18(c)(v) acting in breach of the Code of Ethics in that the Registrant failed to demonstrate accountability for her work assignment in that she left the hospital during an assigned shift and did not notify staff that she had left the building and failed to return to complete her shift. Pursuant to section 28(3) of the Registered Nurses Act, (2008) the Adjudication Tribunal ordered that the Registrant s license to practice nursing be suspended pending her successful completion of specified nursing education; a reflective paper to include specified content on the importance of ethical responsibilities and standards in nursing practice; and a meeting with a Nursing Consultant Policy and Practice Consultant, ARNNL to reflect on her conduct and learning. The Adjudication Tribunal further ordered that the Registrant shall pay ARNNL 50% of costs incurred in the investigation and hearing of the Complaint. The conduct deserving of sanction occurred on or about November 15, 2014 while the Registrant practiced as a registered nurse at the Dr. G.B. Cross Memorial Hospital, Clarenville. The Complainant was Eastern Health. The Magazine of the Association of Registered Nurses of Newfoundland and Labrador 21

22 Ask a CNPS Lawyer Working with Unregulated Care Providers by Canadian Nurses Protective Society Canadian Nurses Protective Society Q. What are the liability risks for nurses when working with unregulated care providers ( UCPs ) in collaborative care teams? A. New and evolving models for health-care delivery have increased the opportunity for collaborative practice between physicians, nurses and other health-care providers, some of whom may not be regulated. Unlike regulated health-care professionals, unregulated care providers are not governed by legislation, have no legallydefined scope of practice, and are not answerable to an external regulatory body that sets standards of practice and monitors the quality of the care they provide. Typically, UCPs have a scope of employment defined by their job description and are accountable to their employer. UCPs include, but are not limited to, nursing aides or assistants, personal support workers and home support workers. While health-care professionals are generally entitled to assume the competence of other regulated health-care professionals in the team, with respect to matters that fall within their scope of practice and area of competence, the same cannot be said about working with UCPs. Indeed, nurses who work with UCPs are often expected to delegate tasks to them and supervise the assigned tasks. The delegating nurse should be confident that the UCP is competent to perform the task safely, prior to assigning the particular task. It is recommended that the delegating nurse turn to the employer for information about the list of tasks that the UCP already has adequate training to perform and be familiar with employer policies regarding delegation to UCPs. Even when delegation is expressly authorized by the employer, the delegating nurse is expected to appropriately monitor and supervise the specific activities assigned to the UCP. Supervision involves initial direction, periodic inspection and corrective action when needed. Various regulatory bodies have developed practice standards or guidelines for nurses working with UCPs. 1 In Newfoundland and Labrador, registered nurses and nurse practitioners should be familiar with the document Scope of Nursing Practice: Definition, Decision-making and Delegation published by the Association of Registered Nurses of Newfoundland and Labrador (ARNNL). Nurses may also consult the CNPS infolaw on Delegation to Other Health Care Workers. To date, the CNPS is not aware of any case law that has addressed the liability of UCPs in the context of a collaborative care team. That being said, in the event of litigation, the supervising nurse, the UCP and the employer can all be held liable for any harm caused by the UCP to the patient. In this regard, the supervising nurse could be held liable if they inappropriately delegated the task or did not properly supervise the UCP. The UCP may be liable for accepting delegation for an act they are not competent to perform, unsafely carrying out a task or failing to report important information to the supervising nurse. In addition to vicarious liability, the employer may be directly liable for the failure to ensure adequate education, training, assessment and supervision of the competence of the UCP. Safe patient care is the common goal of all care providers, whether regulated or unregulated. Proper assessment of the care needs, effective care planning and implementation, and good communication between all members of the care team are keys to achieving this common goal. If you have questions about this article or wish to discuss legal issues when working with UCPs, please call us at to speak with a CNPS legal advisor. 1. For example, College of Registered Nurses of Nova Scotia s Assignment and Delegation Guidelines; College of Nurses of Ontario Practice Guideline on Working with Unregulated Care Providers; College of Registered Nurses of British Columbia Practice Standard on Delegating Tasks to Unregulated Care Providers. CNPS. More than liability protection MY-CNPS ( ) CNPS.ca About CNPS The Canadian Nurses Protective Society (CNPS ) is a not-for-profit society that offers legal advice, risk-management services, legal assistance and professional liability protection related to nursing practice in Canada to eligible registered nurses and nurse practitioners. For more information about CNPS services and benefits, contact CNPS at MY-CNPS ( ) or visit ARNNL Note : Also see ARNNL documents: Professional Responsibilities When Working with Institutionally Based Unregulated Care Providers (2009) and Performance of Nursing Tasks by Support Workers in Community Settings (2003). These are available at 22

23 CLINICAL CORNER Mental Health Resources for Youth and Adults Niki Legge, RSW, MSW, BSW, BA, Consultant, Mental Health and Addictions Division, Department of Health and Community Services, Government of Newfoundland and Labrador Bridge the gapp is an online resource designed to support mental wellness and can be accessed from a computer, tablet or cell phone. Content includes information that can provide advice, inspiration, assurance or direction for finding additional supports when you need it the most. Bridge the gapp services are available to both youth (13-18) and adults (18+) through two separate age-appropriate platforms. Individuals can visit or download the apps from Google Play or the Apple Store. The Breathing Room Program is an online self-management program which assists people between the ages of 13 and 24 to manage stress, depression and anxiety. BreathingRoom is a clinically proven awardwinning program which is now available through the youth and adult Bridge the gapp websites and apps. The Strongest Families Program provides care to families by teaching skills through a distance coaching approach over the phone and online. The award-winning program supports children and youth (ages 3-17) with behavioural difficulties, anxiety, attention deficit hyperactivity disorder, bullying behaviours and other disruptive behaviours that can cause stress at school or at home. Referrals to this program can be made by mental health and addiction services, child youth and family services and by teachers and guidance counsellors. The program is expected to be available to primary health care providers in Hot News! Kathleen Stevens RN, BN, MN, PhD(c), Nurse Educator, Centre for Nursing Studies An inexpensive hardware store infrared thermometer can be used to prevent diabetic foot ulcers. It s simple to use point, zig-zag, then read the temperature. Detecting a temperature difference of four degrees Fahrenheit between your patient s two feet and encouraging them to use this tool as part of foot self-assessment will provide an early warning sign that an inflammatory response is occurring. This information directs the patient to rest until the inflammation decreases, thus preventing skin breakdown and most likely a diabetic foot ulcer. Call the Midwife Midwifery practice is not new, but regulation of it in Newfoundland and Labrador is. These regulations (April 28, 2016) under the Health Professions Act come into force on September 30, The activities to regulate the profession of midwifery, including education and licensure requirements, will be carried out through the Newfoundland and Labrador Council of Health Professionals (NLCHP). Information about the registration of midwives can be found on the NLCHP website ca. Learn more about midwifery practice from the Association of Midwives of Newfoundland and Labrador at Dialing Down the Addiction Karen Whitehorne RN, MN, CPMHN(C) Nurse Therapist, Eastern Health Studies suggest that most of us are rarely ever more than five feet from our smartphones. Smartphones, tablets and computers can be a hugely productive part of our lives. Yet compulsive use, or smartphone addiction (also referred to as nomophobia: fear or being without a mobile phone), can interfere with the activities of daily living. Smartphone addiction can encompass a variety of impulse-control problems, including virtual relationships, online compulsions and information overload. To understand the effects, warning signs and selfhelp tips for smartphone addiction visit under topics addictions and recovery. For up-to-date information on Zika Virus, connect with the Health Canada website at and search Zika Virus. Are you Self-Employed, or thinking about it? Join ARNNL practice consultants for an education session for Self-Employed RNs on Wednesday, September 21st, 2:00 4:00 pm via teleconference and in person. To register, contact Jennifer Lynch at jlynch@arnnl.ca. Self-Employed RNs Network The Canadian Association of Self-Employed Registered Nurses is a network of self-employed RNs, supported to work and grow in business. Information about this network and about membership is available at The Magazine of the Association of Registered Nurses of Newfoundland and Labrador 23

24 THE VIEW OF A NURSING STUDENT REPRESENTATIVE By Elizabeth Eberendu, Student Representative Imagine the feeling of anticipation of a fresh-out-of-the-oven family thanksgiving dinner with all the positive experiences that accompany it catching up with friends and family, wonderful conversations, etc. In a nutshell, this is how I would summarize my time with the ARNNL office for the past calendar year, minus the wine. As a second year student representative from the Centre for Nursing Studies, I was afforded the honour of attending regular meetings with incredible and knowledgeable nursing consultants. I was also able to meet with the ever-friendly ARNNL staff, which was a truly fantastic experience, and as a nursing student access to various educational seminars was one of many benefits. Meetings with the consultants and other professionals were always informative, engaging and truly empowering. These meetings helped me to reflect regularly and put into perspective the wonderful and prestigious career path that I am following. What I appreciated most about the meetings was the potential to engage students and how receptive the consultants were to student representatives, not to mention very understanding. Opinions and suggestions were constantly sought from students as the Association treated me as part of their professional community. The atmosphere was always welcoming and positive. When at meetings, you get the sense of she knows what it s like and things are explained simply. Important and diverse issues ranging from nursing student affairs to registered nursing practices in the workplace were discussed, inadvertently preparing me for life as a registered nurse in Newfoundland and Labrador. WHAT I APPRECIATED MOST ABOUT THE MEETINGS WAS THE POTENTIAL TO ENGAGE STUDENTS AND HOW RECEPTIVE THE CONSULTANTS WERE TO STUDENT REPRESENTATIVES, NOT TO MENTION VERY UNDERSTANDING. Additionally, the historic building on Military Road, home to the Association, also comes with its charm and fond stories - ghost tales and all. During my first visit, I was given the customary tour of the building, which left me feeling a sense of being part of history. Although I was responsible for deciding to pursue the field of nursing as a vocation, I would also like to think that nursing chose me for a reason. My experience as a student representative has reaffirmed this notion, and having met the team at ARNNL House, I am reassured that I am indeed lucky to have found an amazing profession and community of which to be a part. I sincerely believe that nursing students looking to be involved in an enriching nursing experience will appreciate this volunteer activity, and I encourage them to take part in this invaluable programme. Accolades to Anne Marie Tracey (CNS), Lynn Cooze (MUNSON) and Peggy Hancock (WRSON) who are the lead contacts for the ARNNL Student Representative Program at their respective sites. 24

25 CONGRATULATIONS, NURSING GRADUATES of the Bachelor of Nursing (Collaborative) Program Abbott, Jessica Aeckerle, Nikita Amanfo, Ikenna Ash, Shannon Aubert, Rebecca Baggs, Jessica Baggs, Terri-Lynn Baker, Lucas Bartlett, Rebecca Batt, Stephanie Belzevick, Brittany Bennett, Jenna Blanchard, Michelle Boland, Kathryn Boone, Christine Broderick Fitzpatrick, Erin Bromley, Natasha Burton, Jodi Burry, Jenna Bursey, Alicia Caines, Laura Cave, Katie Chapman, Jordan Chaulk, Brittany Chaulk, Shawna Childs, Jacinta Clarke, Ashley Clarke, Jayna Coates, Leah Collins, Melissa Cook, Tiffany Conrod, Jessica Critch, Alyssa Critchley, Ryan Croucher, Jessica Crowe, Andrea Davies, Leah Dawe, Alexandra Dawe, Stephanie Dawson, Michelle Day, Katie Decker, Stephanie Devereaux, Emily Diaz Armas, Rosa Doucette, Amanda Dodge, Kayleigh Donagher, Miquela Doyle, Kaitlyn Doyle, Cindy Dyke, Amber Earle, Adrian Earle, Bradley Edmunds, Brittany Evans, Jeannie Farrell, Marissa Farrell, Taylor Fitzgerald, Samantha Fleming, Alyssa Foley, Brittany Foley, Maria Freake,Julia French, Robyn Furey, Natalie Genge, Danielle Genschorek, Robyn Glover, Samantha Gosse, Victoria Grant, Shana Greeley, Emily Greene, Ashley Greene, Serina Griffiths, Joseph Grinham, Stephanie Guy, Jennifer Halfyard, Erica Hamlyn, Allison Harding, Melanie Hayes, Morgan Hillier, Alice Houlihan, Nadine House, Angelina House, Kaitlan Howell, Leah Hudson, Abigail Hughes, Josephine Hutchings, Katherine Hyatt, Karli Hynes, Mallory Jewer, Jennifer Jingfors, Sarah Jones, Lynette King, Nicole Kean, Chelsea Kean, Martin Kelly, Holly Kennedy, Amber Kieswetter, Wayne Kowalchyk, Alyssa Laite, Sarah Langdon, Marissa Lee, MacKenzie LeFrense, Jenna Lieb, Moira Loveless, Andrea Lowe, Chelsea Luther, Kathryn MacDougall, Lauren MacIsaac, Hilliary Maloney, Amy Maloney, Dariann Martin, Brittany McCarthy, Kate McDonald, Dana McFarlane, Kelsi McKeever, Cecily McNeil, Ashley Meaney, Kristen Melanson, Emily Mitchell, Jacqueline Moriarity, Jessica Morris, Kayla Moss, April Mullins, Shelby Murrin, Ryan Newhook, Katie Newman, Chelsea Noel, Kaitlyn Noseworthy, Liam Noseworthy, Lisa Nyambane, Evangeline O Gorman, Alannah O Quinn, Caitlin O Brien, Brittany Oliver, Christina O Neill, Chelsea O Rielly, Jane O Toole, Samantha Park, Geoffrey Parsons, Jennifer Parsons, Lindsay Parsons, Tracy Peddle, Angela Pickett, Jillian Pike, Steve Pinto, Maria Pitcher, Nicole Pope, Tiffany Power, Joleen Pretty, Lindsay Queripel, Kaleigh Reid, Darlene Reid, Megan Rodriguez, Jade Rose, Brittany Rose, Kimberly Rothwell, Ashley Ryan, Cassandra Ryland, Tasha Saunders, Carly Scott, Alicia Scott, Kendra Scott, Sherry Lynn Sears, Elizabeth Sheppard, Sarah Simms, Jonathan Slaney, Lisa Slaney, Stephanie Snavely, William Snow, Stephanie Sparkes, Victoria Sprague, Angela Steele, Megan Stuckless, Kena Swan, Emilie Sweetland, Jamie Tarrant-Fudge, Paula Taylor, Amy Taylor, Jonathan Taylor, Lindsay Thompson, Megan Thorne, Meghan Tobin, Stacey Tremblett, Victoria van der Baaren, Kelsey Veysey, Jessica Vincent, Melissa Walsh, Jessica Warford, Laura Way, Jessica Webber, Janice Whelan, Benjamin White, Danielle White, Jennifer Whitten, Melissa Wilkins, Janelle Wiseman, Brooklyn Young, Courtney The Magazine of the Association of Registered Nurses of Newfoundland and Labrador 25

26 TRUST NEWS By: Julie Wells, BSc, MSc, Trust Coordinator Call for Applications Applications are now being accepted for awards in the following categories: Continuing Education Awards Bursaries for Conferences & Post Basic Courses (up to $1,000) Kay Daley Scholarship for Nursing Leadership ($1,000) NL Gerontological Nurses Association Bursary ($500) Nursing Leadership Awards ($500 - $3,000) Violet Ruelokke Primary Health Care Award (up to $1,000) Bachelor of Nursing Scholarships ($1,000 each) BN Years 2, 3, 4 BN Fast Track Year 2 Flo Hillyard Memorial Scholarship Post Basic Bachelor of Nursing Scholarships ($750 - $1,500) BN Post RN Scholarship St. Clare s Alumni Association Scholarship ARNNL Bay St. George Chapter Scholarship Available to RNs from the Bay St. George area Graduate Scholarships ($1,000- $2,000) ARNNL 50 th Anniversary Scholarship Masters or PhD Scholarships (Nursing & Non-Nursing) Marcella Linehan Scholarship NL Nurses Respiratory Society Legacy Scholarship RN Re-Entry Scholarship ($500) Nursing Research Awards (up to $2,500 each) Criteria and application forms are available at: Deadline for applications is Oct. 15. Late or incomplete applications can not be considered. Volunteer Opportunity: Research Awards Committee The Trust is seeking two graduate-prepared RNs to join the Research Awards Committee. This committee is responsible for the annual review of research applications and selection of award recipients. Committee members serve a term of three years. RNs interested in joining the committee are asked to contact the Trust Coordinator at trust@arnnl.ca before October 1, As per the committee terms of reference, preference will be given to RNs whose graduate program included completion of a thesis and who have a current record of research. Trust Elects New Board of Directors Members of the Trust elected a new Board of Directors at the annual meeting in June. Congratulations to the members of the Board: Janet Templeton, President Sara Seymour, President-Elect VACANT, Eastern Urban Regional Director Wayne Smith, Eastern Rural Regional Director Tina Drainville, Central Regional Director Erica Hurley, Western Regional Director Brenda Whyatt, Northern Regional Director Paulette Roberts, Labrador Regional Director Joan Whelan, Director-at-Large Tina Edwards, Director-at-Large Lynn Power, Secretary-Treasurer (non-voting) Julie Wells, Coordinator (non-voting) The Board extends their sincere appreciation to out-going President Penny Grant and Western Regional Director Anna Marie Alteen. It is through the willingness of members to dedicate their time and expertise that the Trust is able to achieve its goals. ARNNL Education & Research Trust 25th Anniversary Scholarship The Trust is delighted to announce that Renee Crossman has been selected as the recipient of the 2016 ARNNL Education & Research Trust 25th Anniversary Scholarship. The scholarship, valued at $4,500, is awarded to a registered nurse from Newfoundland and Labrador who is enrolled in a doctoral program and has demonstrated academic excellence during undergraduate and graduate studies, and leadership in the nursing profession and/or community service. Congratulations Renee! For more information about the scholarship, please visit the Canadian Nurses Foundation website ( 26

27 Get more out of your ARNNL membership. Get preferred insurance rates today! Take advantage of your group privileges: You could save $415 * or more when you combine your home and auto insurance with us. An affinity program with Because you ve earned it. At TD Insurance we believe your efforts should be recognized. That s why, as a member of the Association of Registered Nurses of Newfoundland and Labrador, you have access to the TD Insurance Meloche Monnex program, which offers you preferred insurance rates and highly personalized service, along with additional discounts. Request a quote and find out how much you could save! Our extended business hours make it easy. Monday to Friday: 8 a.m. to 8 p.m. (ET) Saturday: 9 a.m. to 4 p.m. (ET) HOME AUTO or visit melochemonnex.com/arnnl The TD Insurance Meloche Monnex program is underwritten by SECURITY NATIONAL INSURANCE COMPANY. It is distributed by Meloche Monnex Insurance and Financial Services Inc. in Quebec, by Meloche Monnex Financial Services Inc. in Ontario, and by TD Insurance Direct Agency Inc. in the rest of Canada. Our address: 50 Place Crémazie, Montreal (Quebec) H2P 1B6. Due to provincial legislation, our auto and recreational vehicle insurance program is not offered in British Columbia, Manitoba or Saskatchewan. *Nationally, 90% of all of our clients who belong to a professional or an alumni group (underwritten by SECURITY NATIONAL INSURANCE COMPANY) or an employer group (underwritten by PRIMMUM INSURANCE COMPANY) that have an agreement with us and who insure a home (excluding rentals and condos) and a car on July 31, 2015 saved $415 when compared to the premiums they would have paid with the same insurer without the preferred insurance rate for groups and the multi-product discount. Savings are not guaranteed and may vary based on the client s profile. The TD logo and other TD trade-marks are the property of the Toronto-Dominion Bank. The Magazine of the Association of Registered Nurses of Newfoundland and Labrador

28 PRACTICE ADMINISTRATION RESEARCH EDUCATION CALL FOR NOMINATIONS Nominate an RN or NP for an ARNNL Award for Excellence in Nursing! Nomination deadline is December 9, The Awards for Excellence have five categories: Nursing Practice Nursing Education Nursing Administration Nursing Research Elizabeth Summers Novice Nurse Award Visit Please view our Celebrating Excellence in Nursing: The Nomination Process teleconference at for more information about the awards and how to nominate. NOVICE PM Military Road St. John s NL A1C2C5 Tel Toll Free (NL only) Fax info@arnnl.ca ARNNL.CA The Association of Registered Nurses of Newfoundland and Labrador (ARNNL) is the regulatory body and professional organization representing all registered nurses and nurse practitioners in the province. In pursuit of its mission, Nursing Excellence for the Health of the Population, ARNNL exists so there will be accountability for self-regulation, professionalism, quality professional practice environments, and healthy public policy.