Editorial: Is Collaboration Just Talk??

Linda Stanger, CLPNA Executive Director
Linda Stanger, CLPNA Executive Director

By Linda Stanger, CLPNA Executive Director.

I am a Registered Nurse. I graduated from the University of Calgary, and have practiced as an RN in a variety of clinical settings and leadership roles. Being a Registered Nurse does not diminish my belief in the high quality of LPN nursing care.

I am honoured to be the Executive Director of the College of Licensed Practical Nurses of Alberta. I believe passionately in the work of LPNs, who deliver excellent care to patients in Alberta and I attribute much of my successful transition as a novice nurse to the support I received from experienced LPNs.

As an RN, I am deeply disheartened by the recent “Expert Caring” public campaign launched by my own profession’s college. The campaign suggests that the only safe nursing care Albertans could expect to receive would come from only an RN. Yet, in an era of collaborative practice the scientific evidence indicates that quality care requires a team of providers! The literature is clear that when a profession holds itself sovereign, the situation is RIPE for patient safety to be compromised.

People will forget what you said.
People will forget what you did,
but people will never forget how you made them feel. – Maya Angelou

There is room and need for all types of nurses and other providers in our complex health system to promote quality care and patient safety. A campaign that minimizes other professions serves to evoke fear and distrust within patients and their families. It also serves to undermine the collaboration that currently exists within the system. Albertans can be assured that they receive safe, competent and ethical care from LPNs, and I expect every regulated health profession would say the same of their members.

One type of nurse does not trump another. In fact, the system needs to optimize the scope of practice for all health professionals to ensure patient safety and quality care in a sustainable system. Every person who works in health care is vital to the patient experience – food service workers, environmental services staff, receptionists and allied health professionals. We must treat each of our colleagues with respect and dignity, no matter their education, job title or status.

The theme of the Summer 2014 issue of CARE magazine is Interprofessional Practice (coming June 30). The feature story “Learn by Heart” showcases a collaborative best practice in clinical education with a team of LPNs and RNs. “From Strangers to Colleagues” outlines our involvement with the University of Alberta’s Interprofessional Pathway Launch. Cheryl Mahaffy’s story shows how collaborative practice leads to patient-centred care.

Here at CLPNA, our recent Strategic Plan identifies Collaborative Practice as a strategic focus area. We will continue our dedication to partnering with all our colleagues to model collaboration at the regulatory level. We will partner with government and employers to create a system where all nurses work to their full capacity in an environment of trust and respect.

RELATED – CLPNA’s Strategic Plan sets 10 year goals for Licensed Practical Nurse profession

To my LPN colleagues, I encourage you to continue to build your own collaboration skills. Embrace personal leadership opportunities. Demonstrate respect to all of your co-workers, and strive to build trusting relationships with them. Above all, keep making a positive difference for your patients through your own expert nursing care.


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14 Responses to “Editorial: Is Collaboration Just Talk??”

  1. Hi Linda,
    Thank you for your editorial. As an instructor of the Nursing Foundation course; Transition to Graduate Nursing at Norquest, the students are recognizing that the CARNA public campaign is doing them, as soon to be professional nurses, a dis-service. I must admit that I was not very familiar with the CARNA campaign until the students mentioned it & I saw your editorial piece. Upon further research from your link above, I find the campaign quite lacking in relevant and reachable facts. Many of the links that are being used to support the statements “reduce hospital infections, prevent hospital deaths & control health care costs” are not from Canadian resources or they simply are not available (links are broken). I am very proud to be an LPN as are my colleagues & students. I explain to the students that our role as LPNs is to educate the public about our profession and to eliminate fear mongering regarding safe quality care by all educated, competent nurses. I am wondering what, as a college & professional association, we & CLPNA can do to make the public understand that an LPN is an excellent choice & supporter in their care.
    Again thank you for your support & recognition of the fantastic care that LPNs in our province do!
    Ayshea Thornton

  2. Thank you for your stand on the professionalism and skills that LPN’s have, and for acknowledging that collaboration between classifications is key to provide quality person centered care that all persons are entitled to. It is disconcerting that a professional association would minimize the importance of one classification to ensure their own importance. I work with some wonderful RN’s and have great respect for them, as they do for me as well. It’s a shame that CARNA would suggest that the level of care an LPN provides might now be “quality care”. LPN’s are professional well trained team members and our level of competency is exceptional.

  3. Hi,

    I agree fully that the campaign from CARNA does not represent the dynamic nature of the nursing professions. If the focus for nurses is to ensure quality care, than the combined strength, education, and knowledge of all nursing classifications needs to be recognized and empowered.
    I have been an LPN for thirteen years, and during that time I have been blessed to work in acute care, rehab, LTC and supportive living. However, in each environment, I have also had to fight to be recognized as having a valid voice because of my label…..how many times I have been asked if I was a nurse, only to have my response to “yes, I am a LPN” be, “oh, I mean a real nurse.”
    I moved to Alberta in 2009, and have seen that the attitude towards my profession is much more positive than in the other three provinces that I have worked. I only hope that this campaign does not invalidate that positive attitude, and send the public mindset backwards.
    Pam Purdy

  4. Hi Linda,
    I believe ,we the LPN gained the trust of public being well educated , competent , and accountable ,delivering excellent services . CARNA restarts a negative campaign against colleagues ,part of interdisciplinary team, it
    is an unprofessional, disrespectful act ,confusing the public and sabotaging the health care system .
    Is CARNA lacking the confidence in their future ,and what is their role in promoting negative attitude? We are not competing , we work as a team to protect and serve the public. Thank you for your support and recognition of LPN,as self regulated professional .
    Livia Palosanu , LPN.

  5. Thank you Linda for your well spoken comments. Fortunately not all RN’s feel that way. The segment that I am privy to work with demonstrates perhaps the ultimate of collaboration in all areas of nursing. I am so very grateful for that cooperation. How should I be so fortunate? As it happens so often, a small cross section take the lead and the wheels of collaboration fall off. Although disheartening, we shall continue to take the high road, speak to those who make directional decisions in health care and we will always provide competent, safe and ethical care to our fellow Albertans.

  6. Thank you for your article!

    I’ve been a LPN for 5 years in Saskatoon, SK working in acute care. In the past year I have seen some changes in the RNs union as they have a new president. I have never personally felt a strain with my coworkers. I value all the RNs I work with. However the new president for the RNs has made some very bold statements. It’s unclear the purpose behind the campaigns. Perhaps there is some fear of replacement or because their contract is up and feel the need to make themselves irreplaceable. However they are definitely going about it the wrong way. It’s unprofessional, and ultimately makes them look bad by putting down their coworkers. Once again this is the president not coming from my coworkers.
    The care aides have a increased scope of practice in our Province as well. They can now do vital signs, blood sugars and intake and outputs. This is not currently being practiced as of yet but I for one would love for them to be able to work to their full scope. It is beneficial for all health care providers to do this. In a time of higher care needs and increasing demands for placement in long term care we need to work together now more than ever. I will continue to work collaboratively and support my colleagues to do the same.

  7. Well spoken words Linda. I have been an LPN for 14 years. I have seen many changes from our scope of practice and those of HCA’s. Medicine is an area of constant change, and being involved in the medical field I see it on a continuous basis. I support all changes in regards to helping our sick and vulnerable to achieve the best care possible. Which is utilizing every person involved; including all support workers such as house keeping, dietary, physio, and all others who are there in our time of need. I had worked at a College for 2.5 years along side of Rn’s who valued my input as a Lpn and worked with those who still seen Lpn’s as less than a Rn. I remember this one year in particular, when the Rn students and the Lpn students were almost in fisicuffs due to the attitude that Rn’s are better than Lpn’s! I was never so disgusted with that sort of attitude as I had been that day. The reason why? We still have the old mind frame that Lpn’s are not the same as Rn’s. I thank god every day for the Rn’s and the Lpn’s who have demonstrated collaborative care and taught me so much. It still saddens me to see how Rn’s and other therapists view Lpn’s as less educated. The one Rn I worked with at the College who taught in the Lpn program, stated it was the same program she had taken when she took her 2 year Rn program! Another Rn, who doesnt like Lpns, is a part of the re-vamping the Lpn program at the college. It also saddens me that the only bridging program, is still a 3 year bridging program. After the experience and knowledge and having been part of education, I dont see that as being a feasible bridging program, and hence still undermines us as Lpn’s. It took many years for me to educate my mom, when ever she asked me why I didnt go in for being a nurse! I said, “mom I am a nurse. There are only 3 governing bodies in Alberta that can be called nurses. Rn’s, lpn’s and Rpn’s. She has accepted me as a “nurse.” In the end, its about the care we give to our sick and vulnerable that matters, not initials. Its about care, compassion and empathy, which so few practice present days. I have been fortunate to be able to gain a position in a long term care facility as an educator. Im having to prove myself that Im good at what Im doing, it’s coming and I’m winning the Rn’s over, as well as other therapists, but in the end, its the mindfulness of the person itself. But let’s not start a campaign of ugliness, saying Rn’s are better than Lpn’s. It speaks of uneducated people not understanding the full scope of Lpns. So to the many Rn’s out there, we know that Carna doesnt speak for all of you, but it’s time you said to your president, enough! As what they are promoting is unfounded. There is no excuse for ignorance in this day and age.

    • Thankyou Kathy. Everything you have said is right and after hearing the ad on the Radio Stn Lite 95.9 over and over again, I can’t describe how offended I feel. This is a direct jab at LPN profession, who have the same education as a lot of the RN’s out there. It truly is sad and you can’t help but feel that this division will only get worse with this type of leadership. We know as LPN’s, that we are providing top level care and are working to our full potential. The ad misleads vulnerable populations and instills a fear that has no right to be there. All u need is to look within the units and see that the right nursing staff is put with the right pt’s. Whenever there is an unstable or critical pt, an RN is almost always on the job, so saying anything but that is just not the truth. We can only hope that this is not what are future is to be made of, but all we can do is keep providing the excellent care that has allowed our profession to flourish! Keep it up LPNS!

  8. Linda,

    I have been in a nursing contractor field for 10 plus years and did work in the hospital setting for a few years prior. The professional bulling that goes on in the RN fields in hospitals is disturbing. In the last 10 years of my contracting work I have worked mainly with Underwriting Companies and Occupational Health, I have owned and run 2 successful Occupational Health Companies and done consulting work in both underwriting and Occupational Health services. I am an LPN, who has had to fight long and hard to prove the merits of the LPN field.

    I also observedl that the union that the LPN is associated with is a reason for the lower opinion/attitude held by many in the field of medicine as a whole. There definitely needs to be a distinction among CLPNA that will elevate the LPN professional to what is is and can be.

    No mater what you do LPN, RN our calling is about the people and they are the primary reason for excellence.

    I know when I was working in the hospital patients noticed the tension between the nursing staff and that should never happen. I took my LPN when I was 40 so I was a little older and wiser when I 1st started working in the hospital setting and I remember once saying to myself, I went to high school once and it seemed I was there again.

    That being said I have also found working with RN’s who treat everyone as a team member and are professional beyond the call of duty. Leadership as a whole is so important.

    Lynmarie Neufeld, LPN

  9. This continued war between RNs and LPNs is perpetuated by both camps. RNs are continually threatened (and most recently, I believe, rightly so) by the threat of being replaced by less extensively trained professionals. LPNs, on the other hand, continue to face harsh skepticism and criticism of their abilities as the lesser trained nurses. RNs bully and greatly exaggerate the gap in competency, while LPNs let pride interfere with judgement and fallaciously insist they are equivalently competent (which has also opened the door to extended the scope of LPNs beyond what is reasonable to adequately teach in 16 month period.).

    I don’t think CARNAs campaign seeks to eliminate or devalue collaboration, but rather emphasizes the importance of having our most extensively trained nurses maintain a great presence in all healthcare settings, and unfortunately that highest level of nursing is being lost due to poor economic allocation. The “Us VS Them” attitude that ALL of us in the health care setting continue, is precisely what has bolstered this opinion that one or the other party seeks to minimize the other. The only way to gain any ground and truly become collaborative is to do what we do best and CARE. Care about other nurses and our clients, and care to rise above the aggressive, scared, “what about me?” way we have interacted in the past.

    I care about nurses. I care about health care. We all need to put care before judgement if we stand to move beyond this stymie of interdisciplinary politics.

  10. Hello. Any campaign that seeks to highlight the value of a specialized nurse- an RN that has sought a higher level of education, should be supported by all. My son does not hide his engineering ring when he is near the tech that now does the plans he USED to do. The legal assistant does not pretend to be the lawyer. The mall cop is valuable. So are LPNs. But bragging about much you are willing to do with how little education it takes compared to today’s RNs does you an even bigger disservice. Be proud of you. We are proud of our well earned and deserved psimons of RN .

  11. Thank you for the Editorial Linda and to all who have added such well thought out reply’s. Once again makes me very proud to be an LPN. I have worked in that same facility for 12 years and for the first 8-9 years was very fortunate to work with a group of individuals that has practiced a team approach and supported each other. I have though noticed a big change over the past few years as our scope of practice increases. There are still very remarkable RN’s that I am fortunate to work along side but, (I am hearing in our LPN support group) that there seems to be more and more that make it very difficult in many ways for many of us. Everyone is such an important part of any health care team and we could not do our jobs effectively with a missing link.
    Again, thank-you for opening up this needed discussion and your continued support.

  12. We’ll said Linda.
    I do work in a hospital setting and I am an LPN. I find we do work as a team and support each other until… public contraversy resurfaces. Public talk about cutbacks, public talk about which discipline is the better choice, public talk about union settlements. It is then that I see and hear RNs huddled chatter about how they should get or keep the jobs, how they are more qualified, more educated and on. As well I see and hear and contribute to the LPN huddled chatter of how we have increased our scope to manage more situations, how we deserve the jobs and on. It’s sad how we all work so hard together for our patients and care so much for people and then back talk each other… our colleagues and friends.
    RNs have sound knowledge for their scope of practise, and LPNs also have sound knowledge for their scope!