Editorial: Regulation Consultation – It’s Time for Change

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“For several months, CLPNA has been collaborating with Alberta Health to prepare our proposed Regulation amendments…”

To regulate and lead the profession in a manner that protects and serves the public: this is the mandate of the College of Licensed Practical Nurses of Alberta, and it’s not new to a self-governing profession like ours. In 2001, the Health Professions Act (HPA) brought about a new way of regulating health professions. The HPA introduced overlapping, non-exclusive scopes of practice and a system for managing high risk interventions (restricted activities) through authorizations for those professions appropriately educated and regulated. Additionally, a new way of thinking was introduced, focusing on the concept of competence (knowledge, skills, attitudes and judgment) and autonomy, rather than the previous focus on delegation of tasks.

RELATED – What are Restricted Activities?

Early adopters under the HPA

Adopting the HPA quickly, with the LPN Profession Regulation coming into force in 2003, was a strategic move for CLPNA. LPNs had just completed a mandatory education upgrade (1996-1999), our Competency Profile (1st Edition, 1998/2000) was adopted and for the first time, it clearly defined LPN competencies. Employers were eager for the new scope of practice that included intramuscular injections and administration of vaccines. But there was more. Our profession was ready for a Regulation that allowed LPNs to work more independently, with autonomy rather than ‘under the direction’ of registered nurses, psychiatric nurses or physicians (LPN Regulation, 1997).

Being an early adopter of change comes with opportunities and challenges. Our opportunities in the last 13 years have been vast and this is showcased in our newest version of the Competency Profile for LPNs (3rd Edition, 2015), along with the varied roles for LPNs throughout the health system, particularly in high acuity and leadership areas. The challenges have been ongoing related to the facilitation of a clear, concise and aligned understanding of restricted activities, specifically what they are and what interventions are included within each one. This challenge remains today, with heightened impact in the last few years through issues with bladder scanning and dispensing, motivating a strong need for changes to the 2003 LPN Profession Regulation.

RELATED – Alberta Regulations for Licensed Practical Nurses (2003) – Subordinate legislation that governs nursing practice in Alberta in more specific detail.

Preparing Regulation amendments

CLPNA initiated the process of updating the 2003 Regulation several years ago, starting with a consultation with employers related to the gaps in the Regulation. This process continued with ongoing policy work within the CLPNA and resulted in many proposed changes to LPN Regulation and specifically to the Restricted Activity authorizations for LPNs. Additionally, Council approved a draft ‘Standards of Practice for LPNs on the Performance of Restricted Activities (2016)’ to further clarify restricted activities authorized for the profession and outline specific parameters.

For several months CLPNA has been collaborating with Alberta Health to prepare our proposed Regulation amendments for the Alberta Health consultation process, which occurred over the summer. At the same time, CLPNA performed a member survey with rich feedback from LPNs related to the proposed changes. We have had great response from all parts of the system and have great support for many of our proposals, along with questions related to others, and through the fall, we will be reviewing and managing all consultation feedback in preparation for moving forward.

RELATED – Proposed changes to Licensed Practical Nurses Profession Regulation

Goal is public safety

Our goal remains to ensure LPNs have the education, competence and authorizations necessary to continue to perform safe care for the public and to advance in the various roles and activities demanded in an evolving health system. This truly is the essence of the Health Professions Act and is what self-regulation is all about.

Although Regulation change is a lengthy and arduous process, we see great value in consulting broadly with all our stakeholders. Consultation with our members is a fundamental principle under the HPA, and because practical nursing is a self-regulating profession, the profession needs to have a say and play an important role in changes to the Regulation. Thank you to all LPNs and stakeholders who participated so far. We appreciate your thoughtful consideration.

Valerie Paice, President and Linda Stanger, CEO CLPNA