CNA Activities Related to 2013 Resolutions Proposed by Members and Agreed to by the CNA Board of Directors in November 2013 Resolutions are a method of providing advice to CNA s board of directors and receiving direct input from members. Eight resolutions were received at the annual general meeting (AGM) in June 2013. Due to time none were reviewed during the AGM and all were received to be discussed and approved by the board of directors. This report presents work undertaken by CNA related to the resolutions as approved by the board in November 2013. 1. CNA Governance, Member Engagement BE IT RESOLVED THAT as the Canadian Nurses Association (CNA) restructures its governance process it adopts a policy of well-defined and accountable linkages with its membership for the purpose of engaging nurses. The linkage policy will have features of accountability and transparency. The processes will include face-to-face meetings, workshops, the use of technology and any other processes deemed appropriate to fully engage nurses from across Canada in nursing issues, contributing to health policy development and advocacy. Linkage activity and outcomes will be part of the annual report to membership. In a survey of its members in 2013, CNA systematically analyzed members advocacy needs to assess our existing advocacy efforts and policy support tools and to make recommendations on member-engagement strategies. In 2013 CNA began developing a policy framework that could serve as a tool to guide CNA staff and representatives involved in policy work on behalf of the association. A new process has been implemented for network nursing groups to lead revisions on a CNA position statement related to their practice. The Canadian Hospice Palliative Care Association nurses group, with guidance by CNA staff, is revising CNA s end-of-life position statement: Providing Nursing Care at the End of Life. In 2013, CNA s CEO began sending monthly communiqués to our jurisdictional executive directors (EDs). CNA invited input from the EDs on its government relations submissions. CNA invited feedback/input from our network members on several submissions: o Employment and Social Development Labour Mobility Questionnaire o Bill C-17 Protecting Canadians from Unsafe Drugs Act (Vanessa s Law) o Bill C-2 An Act to amend the Controlled Drugs and Substances Act (Respect for Communities Act) governing exemptions for supervised injection services o Bill S-202 An Act to establish and maintain a national registry of medical devices (Medical Devices Registry Act). CNA was invited to present to the standing Senate on committee social affairs, science and technology. Sandra Lauck, a clinical nurse specialist and executive committee member of the Canadian Council 1
of Cardiovascular Nurses, worked with CNA staff and travelled to Ottawa to present at the committee hearing. o CNA was invited to a symposium on marijuana use by youth hosted by Health Minister Ambrose. o CNA was invited to a symposium on prescription drug abuse hosted by Health Minister Ambrose. o CNA worked with Health Canada on the Controlled Drugs and Substances Act consultation. CNA and the Canadian Association of Advanced Practice Nurses cosubmitted recommendations. o 2015 election platform issues CNA communicated and engaged with nurses by implementing a number of new processes (many of which will continue in 2014), including: o New section on the CNA website dedicated to the Canadian Network of Nursing Specialties (www.cna-aiic.ca/en/network-of-specialties) o Communities of Practice on NurseONE.ca for network business information specific to the Canadian Network of Nursing Specialties o Bi-monthly Spotlight on Specialties article in the CNA Now e-update o Let s Talk Specialties 5 articles in Canadian Nurse for 2014 o Regular quarterly teleconferences with network members o Hosting a breakfast for network members on June 15 in Winnipeg (54 network members will be attending) o Inclusion of linkage activities and outcomes in the 2013 annual report for the 44 member groups belonging to the Canadian Network of Nursing Specialties o CNA s webinar series, Progress in Practice: Participation increased by 41 per cent in 2013 (2212 total participants in 22 webinars), as compared with 2012 (1565 total in 22 webinars). o Webinar participation increased by 30 per cent from January to April 2014 (1448 total in 10 webinars) as compared to the same time frame in 2013, due to higher than average participation rates for the three January webinars (on public health nursing in schools, home care nursing and certification preparation). o WebEx technology was used to provide just-in-time access to members for new bylaws in 2013. o Hosting of several webinars for members on new bylaws ahead of the January 2014 special meeting and 2014 annual meeting o Special January 2014 electronic meeting broke new ground in engaging members. o Dozens of visits by CNA officers to events across the country o CNA presence at numerous specialty group conferences including booths, etc. 2. Medicare for Today and the Next Generation BE IT RESOLVED THAT the Canadian Nurses Association urge the prime minister to engage the premiers in dialogue to renew the Health Accord, and remind the federal government that in addition to providing health transfers, it has a central role in leading national programs such as pharmacare, as well as protecting and strengthening medicare by enforcing the principles and spirit of the Canada Health Act. 2
As a member of the Health Action Lobby (HEAL), CNA participated in the development and release of a report calling for federal leadership in health and health care and encouraging public discussion and engagement on this issue. CNA ran an obituary ad in the parliamentary paper, The Hill Times, to mark the end of the health accord and encourage federal leadership for a strong publicly funded, not-forprofit health system. Letters to the prime minister, health minister, premiers and provincial/territorial health ministers are being considered as part of CNA s federal election and federal budget 2015 priority recommendations and strategic planning. CNA has ongoing participation with the Council of the Federation s health-care innovation working group, convened by the premiers specifically to address gaps related to the demise of the health accord by (1) pursuing health-care transformation that addresses the growing number of older Canadians, (2) successfully managing team-delivered and evidence-based care, (3) reducing the cost of pharmaceutical procurement, and (4) enhancing appropriateness of care. This participation has had measureable outcomes including clinical best practice guidelines, the identification of innovative models and initiatives on aging in place and dementia care/support, and an inventory of innovative team-based care models. 3. Support the Development of a Credible Plan for Clean-energy Transition and Efficiency Programs and Oppose the Expansion of the Tar Sands BE IT RESOLVED THAT the Canadian Nurses Association oppose the expansion of the oil sands and support development of a credible plan for clean-energy transition and efficiency programs that include creation of educational sessions on this topic. CNA staff followed up with the Canadian Nurses for Health and the Environment to explore meaningful approaches to support their efforts on this issue. Subsequently, CNA provided communications assistance to the Canadian Nurses for Health and the Environment in the preparation of news releases on tar sands and pipeline projects. CNA provided space in the April 2014 CNA Now section of Canadian Nurse to highlight environmental priorities in conjunction with Earth Day. The Canadian Nurses for Health and the Environment has posted extensive information on these issues on their website, including an educational module, government relations activities, etc. 4. Promoting the Dissemination and Uptake of the National Standard of Canada Psychological Health and Safety in the Workplace BE IT RESOLVED THAT the Canadian Nurses Association and its members work collaboratively to promote the dissemination and uptake by employers of Registered Nurses of the recommendations outlined in the new National Standard of Canada Psychological Health and Safety in the Workplace (January 2013). This voluntary standard was developed by the 3
Mental Health Commission of Canada, the Bureau de normalisation du Quebec and the Canadian Standards Association. CNA became an early adopter of the standard, taking on the role as a leading employer, especially since burnout is a serious problem among Canadian RNs. In 2013, CEO Rachel Bard committed to its adoption for CNA s internal operations, e.g., reviewed personal policies, provided mental health first-aid awareness training and made our staff aware of the extended health benefits website, Mental Health in the Workplace. CNA, as a member of the Canadian Alliance on Mental Illness and Mental Health (CAMIMH), met with Treasury Board president, Tony Clement, to advocate for increased dissemination of the standard and adoption by the federal government as an employer of RNs and other Canadians. CNA staff sat on the Bell mental health advisory committee for Clara s Big Ride to build awareness of the workplace mental health standard among employers. CNA, as a partner of the Canadian Healthcare Association, worked on the development of their policy statement Psychological Health and Safety in Canadian Healthcare Settings (November 2013). CNA issued a media release to announce its work with the Partners for Mental Health s Not Myself Today campaign and promote its June 2013 commitment to implementing the standard. 5. Amend Bill C-54, the Not Criminally Responsible Reform Act, to Avoid Harm BE IT RESOLVED THAT the Canadian Nurses Association (CNA) join community mental health groups, health-care providers, and legal experts in urging the federal government to amend Bill C-54, the Not Criminally Responsible (NCR) Reform Act, to address substantive concerns that, as introduced, it is not evidence-based and will cause harm to individuals and the public. CNA joined with 10 national professional health organizations to advocate for amendments to the NCR Reform Act that would strengthen the societal goals of recovery and better support for victims, without negatively effecting the ability of those found not criminally responsible to access appropriate treatment and support. The coalition emphasized concerns about the likelihood that the high-risk accused category would unnecessarily stigmatize already vulnerable persons living with complex mental illness and prevent them from accessing appropriate treatment. This effort included letters to the minister of justice and the minister of health. CNA is a member of CAMIMH, who presented to the Senate s standing committee on legal and constitutional affairs, advocating for amendments in the NCR Reform Act, to reduce barriers to treatment for those found not criminally responsible and lessen the burden on the forensic mental health system that this legislation would set in motion. In October 2013, the house passed Bill C-54, the NCR Reform Act, without the amendments sought. CNA participated in a joint media release and statement expressing our disappointment in a legislative process that allowed a bill to pass that could jeopardize public safety, limit recovery for victims and cause harm to people living with a mental illness. We also emphasized our commitment to continue advocating for 4
evidence-based changes to the forensic mental health and criminal systems that will enhance access to appropriate treatment, reduce stigma and assist victims in their healing and recovery. 6. Responsibility and Accountability as it Relates to Professional Conduct Amongst Peers. BE IT RESOLVED THAT there be a zero tolerance policy of unprofessional conduct towards fellow peers. Nurses need to be accountable for all their actions and have an ethical responsibility to create, contribute and promote a professional work environment. CNA continues to strongly support zero tolerance for any violence in the workplace. CNA has two joint position statements on this issue with the Canadian Federation of Nurses Unions. The first, called Practice Environments: Maximizing Client, Nurse and System Outcomes, speaks to responsibility and accountability in connection with quality practice environments; the second, Workplace Violence, speaks to the role of the nurse in promoting and maintaining a violence-free workplace. CNA, in collaboration with the Canadian Federation of Nurses Unions and the support of Accreditation Canada, the Academy of Canadian Executive Nurses and the Canadian Patient Safety Institute, hosted a pan-canadian roundtable to discuss quality and safety in the Canadian health-care system. Given the important link between quality of worklife and quality of care and patient safety, CNA and its partners are proposing to develop an evidence-informed safe nurse staffing toolkit, which will include concepts of positive practice environments, violence in the workplace, whistleblower protection, etc. 7. Reject Inbound Medical Tourism to Safeguard Medicare BE IT RESOLVED THAT the Canadian Nurses Association advocate against initiatives to market Canada as a destination for medical tourism in order to safeguard Canada s publicly funded, not-for-profit health-care system. CNA staff will collaborate with CNA members to further explore this issue and determine the most effective approach to advocacy. 8. Complementary Nature of the Regulatory and Association Roles BE IT RESOLVED THAT the Canadian Nurses Association develop a position statement that supports an approach to professional governance that reflects the synergy and complementary nature of the regulatory and association roles in serving the public interest. Given its vision, mission and goals, the advancement of our mandate as an association is a CNA priority. 5
CNA has worked with the College of Registered Nurses of Manitoba to address the province s Regulated Health Professions Act and has succeeded in signing a memorandum of understanding. The result is a reinvented relationship that ensures Manitoba RNs will remain a part of CNA and continue to have a national voice. CNA has been focusing its efforts to be compliant with the new Canada Not-for-profit Corporations Act. The work has resulted in the creation of new membership classes and a full new set of bylaws that will support CNA s continued mission to contribute to the health of Canadians and the advancement of nursing and enable us to be inclusive of all the voices of the profession. CNA members will vote on the bylaws at the June 2014 AGM. CNA, informed by the approval of its articles and bylaws (anticipated in 2014, under the new act), will complete scanning and engagement with its jurisdictional members and other stakeholders to complete a position statement about the complementary nature of the regulatory and association roles. 6