Regulatory Power, & Role of College of Registered Nurses of Nova Scotia Michele Brennan January 20, 2010

St. FX Presentation - January 20, Presentation Outline Self-Regulation Self-Regulation Registered Nurses Act Registered Nurses Act Role of Council Role of Council Mission, vision and Ends Mission, vision and Ends Association vs College Association vs College Programs and services Programs and services Role of members Role of members

St. FX Presentation - January 20, Self-regulation is the relative autonomy by which a profession is practised in a public interest -Not a right or entitlement... but privilege granted by government to the profession What is Self-Regulation?

St. FX Presentation - January 20, Self-Regulation As registered nurses we establish: Who can practice Who can practice  must have a license & only RNs & LPNs can use the designation “nurse” What can be practised What can be practised  defined in the RN Act as “the practice of nursing” How nursing can be practised How nursing can be practised  Entry level competencies, Standards of Practice & a Code of Ethics, define & act upon unacceptable practice

St. FX Presentation - January 20, Public Accountability Self-regulation does not assume exclusive control by a profession Self-regulation does not assume exclusive control by a profession Legislation requires public participation in the process Legislation requires public participation in the process Open, transparent, dynamic processes Open, transparent, dynamic processes Government oversight Government oversight

St. FX Presentation - January 20, Principles of Self Regulation Promoting good practice Promoting good practice Preventing poor practice Preventing poor practice Intervening when practice is unacceptable Intervening when practice is unacceptable

St. FX Presentation - January 20, College of Registered Nurses of Nova Scotia Regulatory body authorized by legislation to regulate the practice of nursing in Nova Scotia Regulatory body authorized by legislation to regulate the practice of nursing in Nova Scotia Members of the nursing profession, working with the public to serve and protect the public interest by regulating the practice of nursing Members of the nursing profession, working with the public to serve and protect the public interest by regulating the practice of nursing Council comprised of 12 elected RNs and 6 public representatives for total of 18. Council comprised of 12 elected RNs and 6 public representatives for total of 18.

St. FX Presentation - January 20, Governing Framework COLLEGE OBJECTS (RN Act) Policy Statements (Council Ends) Strategic Priorities Programs & Services Outcomes / Results Interpretation by ED Consultation/ Stakeholder Linkages

St. FX Presentation - January 20, Legislative Framework for Regulation Registered Nurses Act (2006) Registered Nurses Act (2006)  Government statute  Sets out areas of jurisdiction/authority  Approved by government  Nova Scotia first province in Canada to enact legislation in 1910

St. FX Presentation - January 20, Regulations (2009) Regulations (2009)  Approved by Governor-in-Council (Cabinet)  Expands on matters set out in the RN Act -defines the “how” specified in the Act  College By-Laws  Administrative functions of College’s Council Legislative Framework for Regulation

St. FX Presentation - January 20, Objects of College in RN Act(2006) In order to: In order to: a)serve and protect the public interest b)preserve the integrity of the nursing profession c)maintain public confidence in the ability of the nursing profession to regulate itself

St. FX Presentation - January 20, Objects of College in RN Act(2006) The College shall: The College shall:  d) Regulate the practice of nursing and the practice of an NP through:  Registration, licensing,professional conduct and other processes  The approval and promotion of a code of ethics

St. FX Presentation - January 20, Objects of College in RN Act(2006)  The development, approval and promotion of standards for nursing practice, standards for nurse practitioner, entry level competencies, nurse practitioner competencies and the continuing competence program  Subject to clause (d),and in the public interest, advance and promote the practice of nursing and the practice of an NP

St. FX Presentation - January 20, Objects of College in RN Act(2006) Encourage members to participate in affairs promoting the practice of nursing and the practice of an NP,in the best interest of the public Encourage members to participate in affairs promoting the practice of nursing and the practice of an NP,in the best interest of the public

St. FX Presentation - January 20, Vision Our vision of success is a future where the College…   Empowers nurses to recognize and realize their contribution to the health of the public and healthcare system and advance their professional development,   Implements innovative regulation that enables the profession to shape the future healthcare system,

St. FX Presentation - January 20, Vision   Inspires nurses to be leading contributors to public safety,   Enhances nurses’ capacity to meet increased demand and higher expectations of RN/NPs,   Has a wealth of evidence to set public policy directions,   Is making connections, building coalitions and influencing change.

St. FX Presentation - January 20, Mission Registered nurses regulating their profession to promote excellence in nursing practice

St. FX Presentation - January 20, Ends Mega-END The public is well served by a dynamic, responsive, and forward-looking nursing profession. The public is well served by a dynamic, responsive, and forward-looking nursing profession.

St. FX Presentation - January 20, END A (Priority #1) The public receives safe and ethical care from competent registered nurses.   A-1 Beginning practitioners are competent to practice in an evolving health system.   A-1.1Begining practitioners are competent to practice in collaborative teams.   A-2 RNs participate in continued competence development in an evolving health system.   A-3 RNs understand the process of self- regulation and the role of the College as a regulatory body

St. FX Presentation - January 20, END B (Priority #2) The health system is strengthened by registered nurses working to their optimum scope of practice. B-1 Nursing practice environments exemplify best practice. B-2 Health policy supports registered nurses practice as knowledge workers. B 2-1 Registered nurses understand their role in knowledge generation, acquisition, translation and /or dissemination. B-3 Registered nurses use evidence to guide the plan of care and evaluation of outcomes.

St. FX Presentation - January 20,   A-4 RNs access information and consultation resources to address issues that impact professional practice.

St. FX Presentation - January 20, END C (Priority #3) Registered nurses provide leadership in advancing person centered practice within an evolving health system.   C-1 Registered nurses articulate their diverse contributions to outcomes.   C-2 Registered nurses articulate and demonstrate an understanding of person- centered practice.   C-3 Registered nurses articulate and enact their roles within new models of practice

St. FX Presentation - January 20, END D (Priority #3) Collaborative practice supports person- centered care. Collaborative practice supports person- centered care.  Registered nurse practice supports shared decision-making and an accountability framework for outcomes.  Team members describe the scope of practice, and accountability and contributions of collaborative team members to outcomes.  A regulatory framework supports collaborative person center practice.

St. FX Presentation - January 20, END E (Priority #4) The informed public is confident in the practice of registered nurses.   B-1 The informed public is aware of the College’s role.   B-2 The informed public is aware of the diverse roles of the registered nurse.   B-3 The informed public values RN’s diverse contributions to outcomes.

Programs and Services of the College The ED and College staff develop the Programs and Services to meet the defined Council Ends: Operational Plan The ED and College staff develop the Programs and Services to meet the defined Council Ends: Operational Plan Report at every Council meeting on the achievement of the Ends via Monitoring reports Report at every Council meeting on the achievement of the Ends via Monitoring reports St. FX Presentation - January 20,

College Committees Statutory, Standing and Ad hoc Committees Statutory, Standing and Ad hoc Committees  Statutory: A committee is a statutory committee if its existence and charge comes from the RN Act and Regulations. The Council establishes the statutory committees- consists of members with staff support St. FX Presentation - January 20,

Statutory committees  Complaints Committee  Education Advisory Committee  Nurse Practitioner Committee  Professional Conduct Committee  Registration Appeal Committee  Reinstatement Committee  Fitness to practice Committee  Interdisciplinary nurse practitioner practice review Committee St. FX Presentation - January 20,

St. FX Presentation - January 20, Council Organization Structure

St. FX Presentation - January 20, Council Organization Structure

St. FX Presentation - January 20, Council Organization Structure

St. FX Presentation - January 20, Council Organization Structure

St. FX Presentation - January 20, Council Organization Structure

St. FX Presentation - January 20, Association vs. College Accountable to members Accountable to members Social and economic welfare of members Social and economic welfare of members Voluntary membership Voluntary membership Advocacy role Advocacy role Accountable to public Public safety and protection Authority through legislation - mandatory “membership” fee Regulatory role

St. FX Presentation - January 20, One of the Objects in the RN Act  In addition to strict regulatory processes within Registration and Professional Conduct, many of our Programs especially within Professional Practice and Policy services are oriented to assisting RNs and NPs meet competency and practice requirements.  Programs never conflict with meeting the public interest e.g. do not promote higher wages, advance personal interests of members, staff or Council etc

St. FX Presentation - January 20, Highlights of programs and services of the College College Facilitator Program Continuing Competence Program Policy development Review and provide feedback on reports, government and other stakeholder policy Standards for Nursing Practice (RN and NP)and Entry level competencies Education Programs Interdisciplinary practice work

St. FX Presentation - January 20, Projects Telehealth Education- mostly clinical education Guidelines for Problematic Substance Guidelines for Problematic Substance Mentorship Resource Guidelines in 2009 Mentorship Resource Guidelines in 2009 Emergency Response Plan and Business Contingency Plan Emergency Response Plan and Business Contingency Plan Pilot project on nursing student reps Pilot project on nursing student reps Leadership for nurse managers( new in 2009) Leadership for nurse managers( new in 2009) Integration of Internationally educated nurses Integration of Internationally educated nurses

St. FX Presentation - January 20, Policy initiatives by the College Policy priorities are determined by the provincial, national and international environmental trends and issues that impact on the regulation of nursing practice and the direction of healthcare delivery. Also identified through trends in the practice consultation and professional conduct process

St. FX Presentation - January 20, Policy initiatives by the College The College continues to participate in and contribute to a number of provincial and national policy initiatives The College continues to participate in and contribute to a number of provincial and national policy initiatives  Provincial Nursing Network  Health Regulatory Network  CLPNNS Board  CASN Accreditation Board  Mutual recognition agreement national committee

 Midwifery Regulatory Council  Entry level competencies national Committee  Standards for Nursing Practice national  Canadian Nurses Protective Society (CNPS)Board St. FX Presentation - January 20,

PP and P Programs focus on: Education (not clinical education except for Telehealth Programs) List of programs on our website Education (not clinical education except for Telehealth Programs) List of programs on our website Practice Support especially consultation services for both RNs and NPs Practice Support especially consultation services for both RNs and NPs Policy development Policy development St. FX Presentation - January 20,

Education Programs-list on our website College Facilitators College Facilitators  Standards for nursing practice  Code of ethics  Self-regulation  Building your profile (CCP)  Documentation  Entry-level competencies  Resolving professional practice issues St. FX Presentation - January 20,

Staff education sessions Professional conduct review process Professional conduct review process Negligence / malpractice Negligence / malpractice Problematic substance use Problematic substance use Professional boundaries Professional boundaries Leadership in professional practice Leadership in professional practice Determining individual scope of practice Determining individual scope of practice Duty to provide care Duty to provide care Respect in the workplace Respect in the workplace St. FX Presentation - January 20,

Collaborative Practice-role of RN and LPN ( with the CLPNNS) Collaborative Practice-role of RN and LPN ( with the CLPNNS) St. FX Presentation - January 20,

St. FX Presentation - January 20, How can nurses participate in College activities Statutory committees Statutory committees Working and ad hoc groups Working and ad hoc groups Annual general meeting Annual general meeting Council Council Announcements on website and in College publications Announcements on website and in College publications

Pilot Project Sept 2009 September 2009 new student member added to Council meetings as observer September 2009 new student member added to Council meetings as observer Rotate with the three university nursing programs Rotate with the three university nursing programs Dalhousie rep Dalhousie rep Purpose: Purpose:  To engage with the next generation of nurses St. FX Presentation - January 20,

Encourage other nursing students to pursue advanced majors in nursing regulation Encourage other nursing students to pursue advanced majors in nursing regulation St. FX Presentation - January 20,

St. FX Presentation - January 20, Website Addresses College of Registered Nurses of Nova Scotia

St. FX Presentation - January 20, Questions?