Common Questions on LPN Practice during COVID-19: Info Sheet

(UPDATED July 2 , 2020)

(The following is a plain text version of the CLPNA’s Info Sheet: Common Questions on LPN Practice during COVID-19. To download the PDF version, click below:)

DOWNLOAD: Info Sheet: Common Questions on LPN Practice during COVID-19

For current general CLPNA info about COVID-19, see:

RELATED – Alberta Health Updates for Regulated Health Professionals on Novel Coronavirus (COVID-19)

RELATED – Alberta Relaunch Guidelines for Self-Employed Nurses Released by Nursing Regulators


The legislative mandate of the College of Licensed Practical Nurses of Alberta (CLPNA) is to serve and protect the public by ensuring its members deliver safe, competent, and ethical nursing care. An Info Sheet informs membership on relevant nursing topics or the CLPNA’s processes.

INTRODUCTION

The College of Licensed Practical Nurses of Alberta (CLPNA) understands that licensed practical nurses (LPNs) are an integral part of the COVID-19 pandemic response and must be informed about how the pandemic might impact their practice. This document provides up-to-date information and will be updated weekly and as appropriate with the most accurate information.

The CLPNA recommends that LPNs remain alert and informed about COVID-19. It is important that LPNs continue to follow infection prevention and control (IPC) best practices and appropriately use personal protective equipment (PPE) to aid in protecting public health. The World Health Organization and the Public Health Agency of Canada provides information about IPC and use of PPE.

For information about COVID-19 more generally please see the COVID-19 FAQ Info Sheet:

https://www.clpna.com/2020/02/alberta-health-updates-for-regulated-health-professionals-on-novel-coronavirus-covid-19/

NEW! What do I need to know about Alberta’s relaunch strategy?

The Government of Alberta implemented a three-phase relaunch strategy for loosening restrictions put in place during the COVID-19 pandemic. This strategy allows for a phased re-opening of many areas of the economy and includes medical and healthcare procedures.

For information about the relaunch please see:
https://www.alberta.ca/external/covid19-alberta-relaunch-strategy.pdf

The CLPNA developed guidelines with the College and Association of Registered Nurses of Alberta (CARNA) and the College of Registered Psychiatric Nurses of Alberta (CRPNA) for self-employed nurses to use during Alberta’s Relaunch Strategy. Self-employed nurses can use these guidelines starting May 14, 2020 which aligns with stage one of Alberta’s Relaunch Strategy.

These guidelines can be found here: https://www.clpna.com/wp-content/uploads/2020/05/doc_Guidelines_Self-Employed_Nurses_AB_Relaunch_Strategy.pdf

UPDATED! What circumstances require me as an LPN to self-isolate? When can I return to work? What if I’m not exhibiting any symptoms?

Please use this Government of Alberta Self-Assessment tool to help determine whether you, as an LPN, should be tested for COVID-19:

https://www.alberta.ca/assets/documents/COVID-19-assessment-tool-for-health-care-workers-and-public-health-enforcement.pdf

The federal and provincial governments require that all travelers returning from travel outside of Canada self-isolate and monitor for symptoms. Please see https://www.alberta.ca/coronavirus-info-for-albertans.aspx for up-to-date information on self-isolation requirements.

AHS has also provided the following resources for healthcare providers.

The daily monitoring and screening of symptoms, if any, when reporting to work:

https://www.albertahealthservices.ca/assets/info/ppih/if-ppih-covid-19-daily-fitness-for-work-screening-protocols.pdf

The guidance related to the return to work, if required, as a result of self-isolation:

https://www.albertahealthservices.ca/assets/info/ppih/if-ppih-covid-19-return-to-work-guide-ahs-healthcare-worker.pdf

Please check with your own employer for their daily fitness to work requirements and return to work requirements.

The CLPNA appreciates that LPNs understand it is their professional responsibility to monitor their health and to self-isolate if required.

UPDATED! What do I, as an LPN, need to know about public health orders and guidance on working at multiple sites and public visits?

For all public health orders regarding COVID-19 from the Chief Medical Officer of Health, Dr. Deena Hinshaw please visit:

https://www.alberta.ca/covid-19-orders-and-legislation.aspx

Released as Alberta moved into Stage 2 of the Relaunch Strategy, Order 25 provides updated information on provincial expectations:

https://open.alberta.ca/publications/cmoh-order-25-2020-which-rescinds-cmoh-orders-01-02-07-15-16-17-18-19-20-24-2020-covid-19-response

Order 25 instructs Albertans to follow the guidance found on the Biz Connect webpage:

https://www.alberta.ca/biz-connect.aspx

AHS frequently updates guidance on visitation for inpatient and outpatient services in AHS facilities. Please find this information here:

https://www.albertahealthservices.ca/topics/Page17001.aspx

On May 5, 2020 Minister of Health Tyler Shandro released Ministerial Order 631. The accompanying news release indicates that LPNs may perform contact tracing after receiving training. The order and news release can be found here:

https://open.alberta.ca/publications/ministerial-order-631-2020-health

https://www.alberta.ca/release.cfm?xID=71274089430F9-9D0B-298D-C1FD6ADC622E7847

The Chief Medical Officer of Health, Dr. Deena Hinshaw issued public health Order 10 on April 10, 2020. The official order can be found here:

https://open.alberta.ca/publications/cmoh-order-10-2020-2020-covid-19-response

Part 2 of Order 10 was amended with Order 23 with the following on May 25, 2020:

https://open.alberta.ca/publications/cmoh-order-23-2020-2020-covid-19-response

For residential addictions treatment services facilities please see Order 13:

https://open.alberta.ca/publications/cmoh-order-13-2020-2020-covid-19-response

An updated Order 14 permits outdoor visits in licensed supportive living and long-term care facilities as outlined in Appendix A of the order:

https://open.alberta.ca/publications/cmoh-order-14-2020-2020-covid-19-response

Can I, as an LPN, collect a nasopharyngeal swab to test someone for COVID-19?

Collecting nasopharyngeal swabs is within LPN scope of practice, authorized under section 13(1)(a) of the Licensed Practical Nurses Profession Regulation. LPNs may insert or remove instruments, devices, fingers, or hands beyond the point in the nasal passages where they normally narrow. For questions related to LPN scope of practice please refer to the Competency Profile for Licensed Practical Nurses and the Standards of Practice on Restricted Activities and Advanced Practice.

Can I, as an LPN, refuse to work with a patient that has suspected or confirmed COVID-19?

Unless you are required to self-isolate as outlined by the Government of Alberta you are still expected to report to work. Please see https://www.alberta.ca/coronavirus-info-for-albertans.aspx   for up-to-date information on self-isolation requirements.

When there is a conflict between your professional obligation to a patient and your personal obligations you have the professional responsibility to ensure the patient receives the best care possible. The CLPNA encourages all LPNs to review the following documents to ensure you understand the professional expectations you have as an LPN:

If you are unable to care for your patient, you are required to transfer care of the patient to an appropriate provider. The CLPNA acknowledges that LPNs continue to support the safe and competent care of patients.

UPDATED! Where can I find information about personal protective equipment (PPE)?

The Chief Medical Officer of Health Order 23-2020 updates 10-2020 and states healthcare providers working in direct resident care or working in resident care areas are required to wear a mask at all times.

The Government of Alberta and Alberta Health Services recommends that all healthcare providers wear a surgical or procedural mask continuously in other healthcare settings.

The Government of Alberta provides the following guideline for care of individuals with suspected or confirmed COVID-19 in health care settings:

https://ppe.sp.alberta.ca/Shared%20Documents/PPE%20Guidelines.pdf

Alberta Health Services provides the following website which compiles the most up-to-date information about PPE and COVID-19, including a tool to direct use of appropriate PPE for Aerosol-Generating Medical Procedures:

https://www.albertahealthservices.ca/topics/Page17048.aspx

Can my employer extend my shift?

Healthcare providers may be asked to work extended hours to meet the demands of the healthcare system. If an LPN has any concerns or questions about extended hours, they are encouraged to have a discussion with their employer or contact their union.

Additionally, when working extended hours, it is part of the LPN’s professional responsibility to assess their fitness to practice.

What resources are available to me as an LPN if I’m redeployed to a different practice area?

During this time, you may be asked to work in an area of practice that you do not regularly work in. The CLPNA appreciates that as an LPN you are flexible in practice and understand you have the professional responsibility to provide care within your scope of practice.

Your employer may provide some additional training or orientation to equip you with the skills needed to perform tasks in that area.

Additionally, the CLPNA has learning modules available through your myCLPNA.com login that will support LPN knowledge, skills, and competence to prepare for possible redeployment.

If you feel you require additional training and education related to redeployment, please discuss with your employer or seek support from an experienced colleague.

UPDATED! As a self-employed LPN, what do I need to know?

The CLPNA developed guidelines with the College and Association of Registered Nurses of Alberta (CARNA) and the College of Registered Psychiatric Nurses of Alberta (CRPNA) for self-employed nurses to use during Alberta’s Relaunch Strategy. Self-employed nurse can use these guidelines starting May 14, 2020 which aligns with stage one of Alberta’s Relaunch Strategy.

These guidelines can be found here:

https://www.clpna.com/wp-content/uploads/2020/05/doc_Guidelines_Self-Employed_Nurses_AB_Relaunch_Strategy.pdf

Nurses in self-employed practice can find additional information about PPE, including obtaining of supplies for their business, on the Government of Alberta Biz Connect and Alberta Emergency management webpages:

https://www.alberta.ca/biz-connect.aspx

https://www.alberta.ca/alberta-emergency-management-agency.aspx

Do I, as an LPN, have any professional obligations to report unsafe practice?

LPNs have a professional obligation and duty to report unsafe practice or other unprofessional conduct under any circumstances in accordance with the Standards of Practice, Code of Ethics, the Health Professions Act, and other relevant legislation.

The CLPNA encourages all LPNs to review following documents to ensure you understand the professional expectations you have as an LPN:

Another Healthcare Provider

Under section 1.1(1) of the Health Professions Act (HPA) and standard 1.5 of the Standards of Practice for Licensed Practical Nurses in Canada, LPNs are expected to report unprofessional conduct considered dangerous to the health of the public. If you become aware of another healthcare provider not adhering to mandatory public health advisories, then you should consider informing a medical officer of health and the respective regulatory college.

A Patient

The CLPNA appreciates LPNs efforts in continuing to educate patients about COVID-19. If you become aware that a patient is not following mandatory public health advisories despite being educated about these advisories, then you should consider your professional obligations for reporting to a medical officer of health under section 1.1(1) of the HPA and standard 1.5 of the Standards of Practice for Licensed Practical Nurses in Canada.

NEW! As an LPN what do I need to know about virtual nursing care during COVID-19?

Virtual nursing care involves providing nursing services over the phone or other means that involve information technologies (e.g. Zoom or Skype).

The CLPNA supports LPNs in providing virtual nursing care to patients residing in Alberta or to a patient under the care of an Alberta physician. When providing practical nursing care virtually, LPNs are expected to follow all standards of practice and the Code of Ethics. If you are engaging in virtual nursing care during the COVID-19 pandemic, please also refer to and follow any additional employer requirements.

Additionally, LPNs must be familiar with the principles for appropriate use of social media and how they apply in the delivery of virtual nursing care. Please see the Social Media: e-Professionalism document for further details:

https://www.clpna.com/wp-content/uploads/2020/03/doc_Social_Media_E-Professionalism_Nurses.pdf

UPDATED! As an LPN, is there any information at the federal level that I need to be aware of?

The Government of Canada includes the followings webpages for information on COVID-19 generally and specifically for health professionals:

https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19.html

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals.html

Health Canada in partnership with Thrive Health has created the Canada COVID-19 app. You can find this app for iPhone, Android, or Web platforms at:

https://www.thrive.health/canada-covid19-app

This app is a central resource for accessing personalized, trusted, evidence-informed information about the COVID-19 pandemic.

On March 19, Health Canada issued several exemptions to the Controlled Drugs and Substances Act and its regulations. This change allows LPNs to receive telephone or verbal orders from physicians, pharmacists, or nurse practitioners to provide and deliver a controlled substance to a patient if required.  For further information please see:

https://abpharmacy.ca/sites/default/files/CDSA_Exemption_and_interpretive_guide_for_controlled_substances.pdf

CONCLUSION

Information about COVID-19 is evolving rapidly. The CLPNA is working with Alberta Health and other external stakeholders to communicate up-to-date information relevant for LPN practice. Your employer will provide additional information specific to your practice setting or facility. The CLPNA will update this document weekly and as appropriate.

The CLPNA appreciates that LPNs are committed to practicing in a manner that ensures public safety and quality of care.

Questions?

If you have further questions about LPN professional practice, please contact the Professional Practice Team at ASK CLPNApractice@clpna.com, 780-484- 8886 or 1-800-661-5877 (toll free in Alberta).