LPN’s in Mental Health too

Here is the letter we sent to BCNU regarding their recent E-Bulletin regarding Mental Health Strategy and workshops – advocating for LPN’s

Letter to BCNU from the LPNABC

Reply from BCNU:

Thank you for your letter. The eNews announcement was incorrect. LPNs, RNs and RPNs with mental health experience are all very welcome to apply to participate in the 16 workshops BCNU is hosting with a view to developing a position paper on the Mental Healthcare system in BC that is truly informed by the frontline nurse. BCNU values the work of LPNs in mental health and we would welcome their participation. A corrected version of this bulletin will be circulated as soon as possible. I apologise for any distress this may have caused.

Catherine Fast
Project Manager for Mental Health Strategy
BC Nurses’ Union

RPNAO Conference

Last week I had the opportunity to attend the RPNAO Conference and AGM in Ontario. As you may recall, Dianne Martin, ED of the RPNAO spoke at our LPNABC Conference in April.

Thursday morning there were a couple of workshops. I attended “Health Coaching”. The workshop was all about health coaching in relationship with the patient/client. This was interactive with scenarios and group work.They used a very good video

The focus was on the 4 C’s –
Climate Building – comfortable, safe, no distractions, prepared, familiar with client
Clarifying – why is this goal important to the client/pt (IE new dx of diabetes and support for at home monitoring or new medication regimen)
Collaborating – listening, feedback, observing body language
Closing – commitment from patient and follow up OR I am here when you are ready if they are not ready to move ahead (IE quitting smoking)

The idea is to provide the support & empower pts with chronic conditions before they become exacerbated, teach self management to cut down on those ER admits. Understanding that people are responsible for their own behaviors and they have to want to change – new behaviors with intention.

One of the things that really struck me was the range of places where the RPN is working here in Ontario – RPN case manager of forensics – managing crime and mental illness patients, clinics with Dr’s providing education/training, support to patients who have asthma, diabetes, COPD, CHF, hypertension for example, community health centres for the marginalized homeless, HIV, etc., working for the Red Cross, VON – I was just amazed at how widely the RPN/LPN is utilized in Ontario.

Wednesday afternoon was the RPNAO AGM with elections, business etc.
The membership of the RPNO Association has grown dramatically over 5 yrs by 146% as a result of the liability insurance. There is a choice of getting your insurance from the RPNAO or other carriers. The RPNAO is very comprehensive coverage. You also have the opportunity of getting discounts on home and auto insurance through RPNAO.

RPNAO growth over the last 5 years
5424
2009/10

6398
2010/11

6622
2011/12

7500
2012/13

13367
2013/14

REGULAR MEMBERSHIP, $226.89 + GST $29.50 = TOTAL $256.39/yr – provides you with:
– malpractice and legal defense insurance coverage as stipulated by RPNAO policy
– nominating and voting privileges
– membership card
– each issue of “The RPN Journal”

I also learned that all nurses (RN, RPN/LPN and NP) belong to the College of Nurses of Ontario. All nurses pay the same registration fee.

Friday I took part in an all day symposium elaborating on RPNAO All About Synergies Understanding the Role of the RPN in Ontario’s Health Care System. Dianne Martin introduced this in April when she was our guest. This symposium went into more details about how the report and study was done. They (RPNs) are facing many of the same issues we do in BC. There were many great discussions, including how to we make the team “seamless and integrated”. This included allowing the RPN/LPN to do the skills that both nurses share. Together we share approx 8-% of the skills.

Over lunch, a guest speaker, Dr. Sue Matthews, a nurse experienced breast cancer and her journey as a patient – it was very emotional and informative. She spoke of how those “small things” made a huge difference – the holding of a hand, the smile, the interest in family – all had an impact on her, the patient.

https://www.youtube.com/watch?v=JNC3mkVgOMo for example

The afternoon was more on Synergies – how some of the schools are putting pn’s & rn students in the same class so they know and share the same skills (0verlap in what we do). We did a circle example where understanding the RN circle/pie only has perhaps 20% of what we as RPNs/LPNs do not do. (imagine a circle with a 20% wedge coloured – that being what the RN can do that we can not – the rest is overlap) One person brought up the fact that the ingredients in the pie have changed so now you need to see what the new pie will be. Good point. Also that competencies need to be accepted over designation – example new grad working nights with an experienced and seasoned LPN but its the RN who is In charge.

We must stop the infighting and work together for the patient – patient centred care. RPNs are no more going to take the job of RN’s as RN’s are going to being doing the job of the NP. It’s a fact!

Ontario HPA(2002) Scope of practice is defined as healthcare professionals optimizing the full range of their roles, responsibilities, & functions that they are educated, competent & authorized ( legislated regulated) to perform.

Discussion around the skills needing to be assessed unit by unit based on the needs of the patients.It is not about the “skills” so much as about the role of the nurses for those patients. For example – if you are on a unit that uses the skill of IV initiation, then you would stay competent in that skill. If you do not have the need for that IV initiation on your unit, then you would not require the training for that skill.

Our closing speaker was Andre Picard. He is always good to hear – check out his website and free books www.andrepicard.com His books are free to d/l – his latest being “Path to Health Reform” He spoke about how the change CAN happen in healthcare but how govt won’t budge on creating community healthcare, keeping people in their homes and bringing supports to them. He said LPN’s/RPNs could be huge in this area. 85 is the new 65 – he went into a lot of history of medicare in the 50’s and how it has changed so much & that the system has never changed. Canada has put out lots of papers on HOW to fix they healthcare system but they don’t implement. The EU has taken our reports and used them to make their system very efficient and effective.

As nurses, regardless of our province, we all face challenges in doing what we do. Through discussion and conferences like this, we can continue to work and support each other and in the end, provide the best care possible for our patients!

Yours in nursing,
Teresa McFadyen, LPN
President of the LPNABC

Need for Education and Support

The LPNABC would like to share the following excerpt from CLPNBC in their response to our letter “There has been an increase in complaints to CLPNBC of over 1000% from 2000-2013. There were eight complaints in 2000 and 89 in 2013. Each complaint is thoroughly investigated.”

We would like to point out there there has also been a 500% increased in the # of registrants within the same time frame.

The LPNABC would also like to acknowledge the Mandate to work to our “Full Scope” in 2007, evolving & changing LPN practice based on the National Competencies and ever increasing in the health care needs.

The LPNABC continues to advocate for the need for education for LPNs as they are integrated into Leadership positions in Residential and Community Staffing Model changes. All of these dramatic changes could lead to the need for professional practice supports for LPNs.

The LPNABC would like to see the CLPNBC supporting the registrants with a Continuing Education program and funding as the other provinces do.

The LPNABC as the LPN professional advocate will be asking the college what are the top 5 practice issues for LPNs in BC and promote excellence in practice through continuing educational needs. With the dramatic increase and very changing LPN scope of practice, the CLPNBC should be supporting the registrants with a Continuing Education program and funding as the other provinces do.

The LPNABC will be asking for the college to set aside some of the funds acquired through the increase in fees for a “Continuing Education fund” this would be a welcomed support for registrants.

LPNABC Response to CLPNBC re: fee increase