In early November, discussions held by Alberta Health Services (AHS) were reported in the press to reflect increased hiring of registered nurses, with no additional need for licensed practical nurses. Through a letter of clarity directed to CLPNA members, Deb Gordon, Senior Vice President and Chief Nursing Officer of AHS, reaffirmed the AHS commitment to hiring and utilizing all nurses including LPNs (see full letter).
This discussion unearths a longstanding issue with the interpretation of Who a nurse is, and Who is being referred to when the term Nurse is used.
In Alberta there are three types of professional nurses, all authorized to use the title Nurse. In fact, since the Health Professions Act was proclaimed in Alberta (2001), the title Nurse has been protected for use by licensed practical nurses (LPNs), registered nurses (RNs), and registered psychiatric nurses (RPNs) (Alberta Health & Wellness, 2004).
Licensed Practical Nurses have been practicing in Alberta since 1947. Initially trained as assistants, the LPN education and role has evolved to that of professional nurse. As graduates of a two year diploma program, the LPN has sound education in both the art and science of nursing. With comprehensive assessment and critical thinking skills, LPNs formulate nursing diagnoses, plan interventions, provide health education, and evaluate response to treatment in collaboration with patients, families, and the health care team.
LPNs who graduated prior to the diploma entry to practice standard have met education requirements through a mandatory upgrade and the continuing competence program of the profession. LPNs work within professional standards, competencies, and a code of ethics established by the College of Licensed Practical Nurses of Alberta (CLPNA).
LPNs work collaboratively within teams that may include registered nurses, registered psychiatric nurses, health care aides (HCAs), physicians, and other regulated and non-regulated providers. As autonomous professionals LPNs assume independent, interdependent, and often overlapping roles within these teams.
The LPN is a nurse. The RN is a nurse. The RPN is a nurse.
But who is called “nurse” remains an issue; one that is impacted by a variety of things including titles, roles, habits and collective agreements, each influencing language from the unit level employee through the system to management and human resources and outward to the media. LPNs encounter situations daily where the nursing team they are part of uses divisive language such as ‘the nurse and the LPN’ when describing an RN/LPN team.
In Alberta, government, employers, educators and regulators are collectively committed to developing collaborative inter-professional models of care and creating a healthy workplace. Using language that is inclusive – both in Word and Intent – is critical in building the trusting and respectful relationships so important in reaching these goals.
It costs nothing, takes no time, only a conscious commitment to respectful treatment of each other and our workforce. It’s time…
REFERENCES: Alberta Health & Wellness. (2004). Health Professions Act Employer’s Handbook: A guide for employers of regulated health professionals. Edmonton, AB.