Proposed changes to Licensed Practical Nurses Profession Regulation

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LPN Restricted Activities are under review and changes are proposed to:

  • LPN specializations (immunization, foot care, renal dialysis)
  • Bladder scanning
  • Fetal heart monitoring
  • Administering blood and blood products
  • Administering parenteral nutrition
  • and many more…

A first look is now available at the College of Licensed Practical Nurses of Alberta’s (CLPNA) proposed changes to the Licensed Practical Nurses Profession Regulation (LPN Regulation) and Standards of Practice for LPNs on the Performance of Restricted Activities (Standards of Practice), along with an opportunity to provide feedback.

In the thirteen years since the LPN Regulation was proclaimed, LPN education, practice and roles in Alberta’s health system have evolved considerably. Due to the restrictive wording in the LPN Regulation, there have been interpretation issues within the existing restricted activities for LPNs. This has resulted in the need to amend the LPN restricted activities provisions in the LPN Regulation.

These amendments are required to utilize LPNs to the fullest of their education and competence, to maximize the contribution LPNs make in health care, to support a sustainable health system, and to minimize the risk of error that currently exists in care transitions when the LPN must hand off care they are fully competent, but not currently authorized to perform.

Stakeholders such as employers, managers, educators, and members of other health professions may submit feedback using the survey below. The CLPNA is gathering Licensed Practical Nurse feedback separately through a member survey.

Next steps include: CLPNA drafting new wording in the LPN Regulation with Alberta Health; CLPNA Council approval of the final draft; and Alberta Health submitting the revised Regulation and the Standards to the Lieutenant Governor for government approval.

EXECUTIVE SUMMARY

The proposed LPN Regulation amendments outlines current and proposed restricted activities that, once approved by government, LPNs would be able to perform once they have met the parameters outlined in the Standards of Practice for LPNs on the Performance of Restricted Activities.

What are Restricted Activities?

Restricted activities are regulated health services that by law can only be performed by individuals who are authorized to perform them.

Restricted activities are listed in Schedule 7.1 of the Government Organization Act. Restricted Activities include procedures such as, but not limited to, surgery, assisting in childbirth, performing injections, prescribing medication, entering into one or more body cavities, and setting fractures.

Professions do not own or have exclusive rights to perform restricted activities. Practitioners must be authorized by statute or regulation. (Health Professions Act Employer’s Handbook, p7)

Proposed addition of four restricted activities that LPNs would be able to perform:

  • dispense, compound, provide for selling or sell a Schedule 1 drug or Schedule 2 drug (preparing ‘to go’ and ‘bridge medications)’;
  • apply non-ionizing radiation in the form of ultrasound imaging, including any application of ultrasound to a fetus (bladder scanning, fetal heart monitoring);
  • administer parenteral nutrition; and
  • administer blood or blood products.

Proposed changes to current practice limitations:

  • Supervision requirements to be removed from inserting liquid into the ear canal, administering imaging contrast agents, administering nitrous oxide.

Proposed changes to specializations:

  • Two LPN specialties will be maintained: Perioperative and Orthopaedic practical nursing. These two specialties will continue to require completion of a Council-approved education program and approval by the Registrar will be noted on the practice permit.
  • Renal Dialysis, Immunization and Advanced Foot Care will be self-managed by the LPN by completing advanced education.

Proposed new Standards of Practice for LPN Performance of Restricted Activities

  • New standards for 13 restricted activities that set practice requirements.

Proposed Amended Documents

Use the links below to download the full documents:

(These draft documents are no longer current.)

DOWNLOAD Proposed Amendments to LPN Regulation 

DOWNLOAD Draft Standards of Practice

LPN Feedback Survey

LPNs, please check your email for a link to the CLPNA member feedback survey to complete on these amendments.

Didn’t receive an email on June 29? Contact CLPNA at info@clpna.com, 780-484-8886 or 1-800-661-5877 (toll free in Alberta) to receive the link.

Stakeholder Feedback Survey

Stakeholders (employers, managers, educators, and non-LPN health professionals) with a comment regarding any part of the proposed amendments may submit feedback using the survey.

(SURVEY CLOSED) STAKEHOLDER (non-LPN) FEEDBACK 

The Survey will close on July 31, 2016.

The CLPNA will consider all feedback while working with Alberta Health to finalize these policy changes.

 

Comments are reviewed by a moderator before publication.  

55 Responses to “Proposed changes to Licensed Practical Nurses Profession Regulation”

  1. The changes are great, my only concern which will now concern the union is as our scope increases our pay stays the same. An area that all lpns will need to discuss.

  2. As an LPN who needs to do fetal heart rates and bladder scans constantly during a shift, I am looking forward to being able to do all those things again hopefully. It’s a struggle and almost an insult to the profession for LPn who have been doing the skills for years and now that’s taken away from us.

  3. I’m very excited about these changes. This opens up our opportunities as nurses in the work force. Thank you!!

  4. I agree that these changes are long overdue! It’s very frustrating to not be able to do some tasks for your patient. I think it also makes the family/patient wonder if you are not competent to provide the care.

  5. These changes are overdue and would allow the LPN’S to work to full scope and not looking for an RN to bladder scan or hang blood for them when we are capable and have the knowledge to do.

  6. This is a step in the right direction! These changes allow the LPN to be more independent and allow for less opportunity for mistakes as we won’t have to be switching between two people! I just hope that our wages change accordingly as well. It’s not fair to be giving LPNs more responsibility and not increasing our wage! Just the same as any other job force.

  7. I have been doing years almost every shift for bladder scan and fetal heart rates, it is very difficult to find an Rn to do those tasks for your patient that you were caring the entire shift , it makes you feel incompetent and it is insult to our profession. If we can insert a catheter within our scope of practice it is insult not to do a bladder scan.

  8. I am very excited for our profession, this is a step in the right direction. I wish the public was more informed on our scope, seems as though as soon as some client’s hear, LPN, they say I didn’t realize you could do these things. I’m in the dermatology field, all the Tasks I preform is not offered in RN or Bscn training, it’s learned on the job. I honestly had a very good friend of mine, who is a Bscn, ask me if I gave up my nursing license to work in dermatology, I said no, if anything I have increased my scope. Unreal how some people think.

    • i have one client who keeps asking for the RN, finally one day i told him there are no RN’s anymore they were replaced by LPN’s like me ( off corse he doesn’t recognize LPN, he was a Doctor 40 years ago). I am joking.

  9. I have always been frustrated by bladder scanning not being in our scope of practice. I look forward to the addition as do my RN colleagues.

  10. I agree cost of living goes up and so does our workload but we never get the wage we deserve!!

  11. Are you kidding? Are you trying to turn the LPNs into RNS? Never any recognition in pay! I don’t know what your thinking. Encourage the young LPNs to further there education into becoming an RNS. Then they will be paid what they deserve. alberta needs a bridging program. And making sure the LPNs get there full 2 years credit, then you’ll be doing something.

  12. Bring it on! Team LPN! Education is lifelong, our scopes and roles are evolving, it’s great to see the college listening to our concern and trying to increase our scope. I agree the wage could go up accordingly, but that’s a union fight not a college fight! Thanks CLPNA for being such a positive college that we LPN’s can be proud of! The hard work you all do for us LPN’s makes me so proud of our profession!

    • It’s about time, considering legally to already be in a professional occupation and regulated under the Health Professions Act, because in Alberta as a profession LPNs are expected to meet the same requirements for governance, registration and discipline anyway.

  13. I do agree these changes are long overdue. My only issue is that as our scope increases our wages should reflex this. I have been doing bladder scanning for years as per inservice on the job. I am truly excited.

  14. This is awesome to hear and a great step towards the LPN profession, I’m very proud to represent our profession! This is exciting news and something I greatly look forward to. However, I just hope to see that we also see an increase in wage to reflect these changes.

  15. Would be absolutely fabulous additions to our scope of practice! If only a wage increase came with it.

  16. Re-Advanced Foot Care
    Please post where Advanced Foot care courses are available in Calgary. Last time I looked Bow Valley only offers Basic Foot Care. Given your definition of Advanced training it would be a benefit to offer a segment specific to caring for the diabetic foot.

  17. The Government, Health Sector and Alberta Health Services/Covenant Health do not recognize our scope of practice with financial parity with our RN co workers. The more we, as LPN’s, do on any unit the less the RN will do. It noticeable that they do not pick up our assigned duties. Increasing our scope is wonderful as recognized nurses but UNA must also recognize our skills

  18. I am absolutely all for the changes. However with more responsibility should go along with high Lpn rates!

  19. yes it is a great Idea, we can do it all, but increasing work load should compensate for increase wage as well don’t you think? LPN’s and RN’s are two different things. LPN’s are still being stared down unless the pay rises just as the work load.

  20. that is great only problem is the pay is still the same, the only thing that helps LPN is that it saves time finding an RN to spike a bag for you, or to slide a scanner,and you are left to document the whole procedure.lol

  21. its the end of my career, thru the years I have seen many changes, the role of the LPN to most people eyes are those of “not a nurse, only a assistant attitude”, it still is there today, many RNs who talk still insist they are the only ones with the right to call themselves a ‘nurse”,,,define a nurse,,, my moto is if I can do it I will,,,if you need to teach me how, then do it,,

  22. The regulating body should by any means make all these changes and detailed scope of practice be known to the public and the employers. We, LPNs deserve to be recognized for all the work we do.

  23. I am happy to see an increase in our scope of practice. I would like to see CLPNA do more to educate the general public that we are trained, competent nurses. I’ve been nursing for 31 years and still have to explain that LPNs are nurses.

  24. Finally!!!! Able to do vaccines and syringe ears in Ontario, why not here? Good move in the right direction. Also agree with a pay increase needed way too much of a gap between LPN and RN, ridiculous actually. We need our own union, not to be lumped in with all others. Seriously! Why do RNs have their own that actually fight for them and we do not?

  25. I have been doing bladder scanning , which is needful on the stroke unit yrs ago . This unit has more LPN’s than RN’s and I am sure it is a strain on the RN when you have to keep clling them for bladder scannin and PVR. I also work at anothe facility where it is needed and not enough RN to do it . I would be glad to continue this skill

  26. I’m very excited about these changes. This opens up our opportunities as nurses in the work force. Thank you!!

  27. It looks very amazing and it is certainly nice to have such big scope of practice. however, I am afraid, if it only leads to their workload and they will do all the work as RNs and will be paid very differently. This will help the system to ease the workload by making more employees to do maximum work, but the benefit to employees will be limited, except to feel good in the beginning and then feel that they are victimized in some ways.

    This is what I am afraid of, but there may be other benefits that I may not be aware of.

    thanks

  28. I agree these are way overdue
    I wellcome these changes. We have been waiting so long way to go all lpns were ever you are

  29. I am relieved that finally all these little things will be officially added to our scope of practice. I prefer to continue care for my patients myself and not have to hunt down another busy colleague to perform those tasks. Soon I hope that the union gets strong enough to recognize how much our workload and skills have increased and DEMAND a wage closer to the RN wage to finally pay us more appropriately.

  30. I am very with the changes in the LPN scope of practice this will allow us to utilize or education and training that we have worked so hard for.

  31. Long over due. LPN’s across the boarder in most of the states have been doing all these things why not us here in Alberta. Great news for us. I hope the wages will go up too.
    Well done CLPNA.

  32. These changes are long overdue. Working as an LPN for a long time,now, I find it insulting to my intellegence, experience and education that we could not perform these tasks when I am perfectly capable of performing them. People need to understand and accept that LPNs are fully educated and competent to provide care.

  33. I would like to see Mental Health be a specialty as it is very different from most types of nursing. I would like to see the Mental Health Certificate for LPN’s returned to LPN’s as a choice of further education.

  34. Many LPN’s have been doing bladder scans for patients many years already at the hospital I worked at and since I graduated nursing 12 years
    . I was unaware majority of places it was not allowed. It is an insult to us as nurses not being able to practice and perform our skills .
    Some skills have been taken away in other areas as well such as admits into homecare done by LPN’s for years is now been reviewed and taken away as apparently we do not have the skill level or critical thinking skills to do an admission and only case managers are to do this now…(.though we do case manage and use criyical thinking skills everyday).
    It can be frustrating but theses sound like positive changes

    • Totally agree with Mental Health being a specialty area. Education is important so as to work on acute units. I have a certificate from Ontario as a “psychiatric nursing assistant”! It took me time and money for this program. I came out west with a full knowledge base and 7 years experience. Thank goodness the management now see the value my input is as part of a team. Glad to see the other areas acknowledged and our how our contribution is reconized. Thank you.

  35. These changes are great! allow the LPN’s to work full scope and capable to have those knowledge to do it and could increase our wage according to our workload.

  36. Our scope keeps expanding, which is fantastic, but our wages don’t reflect these changes. I think LPNs as a whole are taken advantage of for this reason. We’re highly trained, highly knowledgable, and only see a fraction of what the RNs get paid.

      • Our role expands…… why is it not reflected on our pay? With other professionals and or medical professionals, wages are based on their increase skills and education. Why is this not the case for LPN’S? It’s a shame and an insult to all caring and hard working LPN’s

  37. FB says:
    I am glad to see our scope of practice expanding, perioperative scope of practice should expand more as well,

  38. Our scope is always growing which is great, I always thought it was strange that we could insert a FC but couldn’t provide the bladder scan prior.

  39. We are always known to be Low Paid Nurses aka LPN. We do our job and widening our scope of practice is great but never get paid properly. We dont compare ourselves with RN’s but we do as much work as they do. We dont even demand to be paid as RN but the rate being and LPN and RN has huge difference. They get paid bonuses and has salary increase but LPN’s does not.

  40. Yes it is a wonderful step in the right direction, AND worthy of more pay, but I have been in the situation many years ago where there was only $1.00 an hour difference in pay between RN and LPN and the LPN was the one without a job. Be very careful of what your demands are.