regulatory power, & role of college of registered nurses of nova scotia michele brennan january...

Regulatory Power, & Role of College of Registered Nurses

of Nova ScotiaMichele BrennanMichele Brennan

January 20, 2010January 20, 2010

St. FX Presentation - January 20, 2010 2

Presentation Outline

Self-Regulation Self-Regulation Registered Nurses ActRegistered Nurses Act Role of Council Role of Council Mission, vision and EndsMission, vision and Ends Association vs College Association vs College Programs and services Programs and services Role of members Role of members


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?


Self-Regulation

As registered nurses we establish:As registered nurses we establish: Who can practice Who can practice

must have a license & only RNs & LPNs can use the must have a license & only RNs & LPNs can use the designation “nurse”designation “nurse”

What can be practised What can be practised defined in the RN Act as “the practice of nursing”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 Entry level competencies, Standards of Practice & a

Code of Ethics, define & act upon unacceptable Code of Ethics, define & act upon unacceptable practicepractice


Public Accountability

Self-regulation does not assume Self-regulation does not assume exclusive control by a professionexclusive control by a profession

Legislation requires public Legislation requires public participation in the processparticipation in the process

Open, transparent, dynamic processesOpen, transparent, dynamic processes

Government oversightGovernment oversight


Principles of Self Regulation

Promoting good practicePromoting good practice

Preventing poor practicePreventing poor practice

Intervening when practice is unacceptableIntervening when practice is unacceptable


College of Registered Nurses of Nova Scotia

Regulatory body authorized by legislation to Regulatory body authorized by legislation to regulate the practice of nursing in Nova Scotiaregulate the practice of nursing in Nova Scotia

Members of the nursing profession, working Members of the nursing profession, working with the public to serve and protect the public with the public to serve and protect the public interest by regulating the practice of nursinginterest by regulating the practice of nursing

Council comprised of 12 elected RNs and 6 Council comprised of 12 elected RNs and 6 public representatives for total of 18.public representatives for total of 18.


Governing Framework

COLLEGE OBJECTS (RN Act)

Policy Statements

(Council Ends)

Strategic

Priorities

Programs & Services

Outcomes / Results

Interpretation by ED

Consultation/

Stakeholder

Linkages


Legislative Framework for Regulation

Registered Nurses Act (2006)Registered Nurses Act (2006) Government statuteGovernment statute Sets out areas of Sets out areas of

jurisdiction/authorityjurisdiction/authority Approved by governmentApproved by government Nova Scotia first province in Nova Scotia first province in

Canada to enact legislation in 1910Canada to enact legislation in 1910


Regulations (2009)Regulations (2009) Approved by Governor-in-Council Approved by Governor-in-Council

(Cabinet)(Cabinet) Expands on matters set out in the RN Act Expands on matters set out in the RN Act

-defines the “how” specified in the Act-defines the “how” specified in the Act College By-LawsCollege By-Laws

Administrative functions of College’s Administrative functions of College’s CouncilCouncil

Legislative Framework for Regulation


Objects of College in RN Act(2006) In order to:In order to:

a)serve and protect the public interesta)serve and protect the public interest

b)preserve the integrity of the nursing b)preserve the integrity of the nursing professionprofession

c)maintain public confidence in the ability c)maintain public confidence in the ability of the nursing profession to regulate itselfof the nursing profession to regulate itself


Objects of College in RN Act(2006) The College shall:The College shall:

d) Regulate the practice of nursing and d) Regulate the practice of nursing and the practice of an NP through:the practice of an NP through:Registration, licensing,professional Registration, licensing,professional

conduct and other processesconduct and other processesThe approval and promotion of a code The approval and promotion of a code

of ethicsof ethics


Objects of College in RN Act(2006)

The development, approval and promotion The development, approval and promotion of standards for nursing practice, standards of standards for nursing practice, standards for nurse practitioner, entry level for nurse practitioner, entry level competencies, nurse practitioner competencies, nurse practitioner competencies and the continuing competencies and the continuing competence programcompetence program

Subject to clause (d),and in the public Subject to clause (d),and in the public interest, advance and promote the practice of interest, advance and promote the practice of nursing and the practice of an NPnursing and the practice of an NP


Objects of College in RN Act(2006) Encourage members to participate in affairs Encourage members to participate in affairs

promoting the practice of nursing and the promoting the practice of nursing and the practice of an NP ,in the best interest of the practice of an NP ,in the best interest of the publicpublic


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,


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.


Mission

Registered nurses regulating their profession to promote excellence in nursing practice


Ends 2009-2011

Mega-ENDMega-END The public is well served by a The public is well served by a

dynamic, responsive, and forward-dynamic, responsive, and forward-looking nursing profession.looking nursing profession.


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


END B (Priority #2)

The health system is strengthened byregistered 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.


A-4 RNs access information and consultation resources to address issues that impact professional practice.


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


END D (Priority #3) Collaborative practice supports person- Collaborative practice supports person-

centered care.centered care. Registered nurse practice supports shared Registered nurse practice supports shared

decision-making and an accountability decision-making and an accountability framework for outcomes.framework for outcomes.

Team members describe the scope of Team members describe the scope of practice, and accountability and practice, and accountability and contributions of collaborative team contributions of collaborative team members to outcomes.members to outcomes.

A regulatory framework supports A regulatory framework supports collaborative person center practice.collaborative person center practice.


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 The ED and College staff develop the

Programs and Services to meet the defined Programs and Services to meet the defined Council Ends: Operational PlanCouncil Ends: Operational Plan

Report at every Council meeting on the Report at every Council meeting on the achievement of the Ends via Monitoring achievement of the Ends via Monitoring reportsreports


College Committees

Statutory , Standing and Ad hoc Statutory , Standing and Ad hoc CommitteesCommittees Statutory: A committee is a statutory Statutory: A committee is a statutory

committee if its existence and charge committee if its existence and charge comes from the RN Act and Regulations. comes from the RN Act and Regulations. The Council establishes the statutory The Council establishes the statutory committees- consists of members with committees- consists of members with staff supportstaff support


Statutory committees

Complaints CommitteeComplaints Committee Education Advisory CommitteeEducation Advisory Committee Nurse Practitioner CommitteeNurse Practitioner Committee Professional Conduct CommitteeProfessional Conduct Committee Registration Appeal CommitteeRegistration Appeal Committee Reinstatement CommitteeReinstatement Committee Fitness to practice CommitteeFitness to practice Committee Interdisciplinary nurse practitioner practice review Interdisciplinary nurse practitioner practice review

CommitteeCommittee



Council

Organization Structure

Executive Assistant

Policy R esearch & D evelopm entU niversity N sg. Prog. R eview sStandardsPractice C onsults, P rogram s, ServicesC ollege Facilitator Pro jectEducationEntry Level C om petenceC ontinuing C om petence ProgramPractice Environm ent C ollaboration ProgramN urse Practitioner com petence & consultationTelehealth Program sLegislative R eview

Professional Practice & Policy

InvestigationsH earingsD ecisions Adm inistration

ProfessionalConduct

Prem ises R & M , SecurityF inancial ServicesB usiness ServicesC om m unications

R egistryAssessm entExam sN urse Practitioner licensing

R egistration Services

Corporate Services

In form ation TechnologyIT System s P lanning and SupportD atabase D evelopm ent,Integration, R eporting

IT S tandards, Policies & Security

Technology &Information Systems

Executive Director


Council


Policy R esearch & D evelopm entU niversity N sg. Prog. R eview sStandardsPractice C onsults, P rogram s, ServicesC ollege Facilitator Pro jectEducationEntry Level C om petenceC ontinuing C om petence ProgramPractice Environm ent C ollaboration ProgramN urse Practitioner com petence & consultationTelehealth Program sLegislative R eview

Professional Practice & Policy


Council



Council


Prem ises R & M , SecurityF inancial ServicesB usiness ServicesC om m unications

R egistryAssessm entExam sN urse Practitioner licensing

R egistration Services

Corporate Services


Council



Association vs. College

Accountable to Accountable to membersmembers

Social and economic Social and economic welfare of memberswelfare of members

Voluntary Voluntary membership membership

Advocacy role Advocacy role

Accountable to publicAccountable to public Public safety and Public safety and

protection protection Authority through Authority through

legislation - legislation - mandatory mandatory “membership” fee“membership” fee

Regulatory role Regulatory role


One of the Objects in the RN Act

In addition to strict regulatory processes In addition to strict regulatory processes within Registration and Professional Conduct, within Registration and Professional Conduct, many of our Programs especially within many of our Programs especially within Professional Practice and Policy services are Professional Practice and Policy services are oriented to assisting RNs and NPs meet oriented to assisting RNs and NPs meet competency and practice requirements.competency and practice requirements.

Programs never conflict with meeting the Programs never conflict with meeting the public interest e.g. do not promote higher public interest e.g. do not promote higher wages, advance personal interests of members, wages, advance personal interests of members, staff or Council etcstaff or Council etc


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


Projects

Telehealth Education- mostly clinical education Guidelines for Problematic SubstanceGuidelines for Problematic Substance Mentorship Resource Guidelines in 2009Mentorship Resource Guidelines in 2009 Emergency Response Plan and Business Emergency Response Plan and Business

Contingency PlanContingency Plan Pilot project on nursing student repsPilot 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


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


Policy initiatives by the College

The College continues to participate in and The College continues to participate in and contribute to a number of provincial and national contribute to a number of provincial and national policy initiativespolicy initiatives Provincial Nursing NetworkProvincial Nursing Network Health Regulatory NetworkHealth Regulatory Network CLPNNS BoardCLPNNS Board CASN Accreditation BoardCASN Accreditation Board Mutual recognition agreement national Mutual recognition agreement national

committeecommittee

Midwifery Regulatory CouncilMidwifery Regulatory Council Entry level competencies national CommitteeEntry level competencies national Committee Standards for Nursing Practice nationalStandards for Nursing Practice national Canadian Nurses Protective Society Canadian Nurses Protective Society

(CNPS)Board (CNPS)Board


PP and P Programs focus on:

Education (not clinical education except for Education (not clinical education except for Telehealth Programs) List of programs on Telehealth Programs) List of programs on our websiteour website

Practice Support especially consultation Practice Support especially consultation services for both RNs and NPsservices for both RNs and NPs

Policy developmentPolicy development


Education Programs-list on our website College FacilitatorsCollege Facilitators

Standards for nursing practiceStandards for nursing practice Code of ethicsCode of ethics Self-regulationSelf-regulation Building your profile (CCP)Building your profile (CCP) DocumentationDocumentation Entry-level competenciesEntry-level competencies Resolving professional practice issuesResolving professional practice issues


Staff education sessions

Professional conduct review processProfessional conduct review process Negligence / malpracticeNegligence / malpractice Problematic substance useProblematic substance use Professional boundariesProfessional boundaries Leadership in professional practiceLeadership in professional practice Determining individual scope of practiceDetermining individual scope of practice Duty to provide careDuty to provide care Respect in the workplaceRespect in the workplace

St. FX Presentation - January 20, 201042

Collaborative Practice-role of RN and LPN Collaborative Practice-role of RN and LPN ( with the CLPNNS)( with the CLPNNS)



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 Announcements on website and in College

publicationspublications

Pilot Project Sept 2009

September 2009 new student member added September 2009 new student member added to Council meetings as observerto Council meetings as observer

Rotate with the three university nursing Rotate with the three university nursing programsprograms

2009-2011 Dalhousie rep2009-2011 Dalhousie rep Purpose:Purpose:

To engage with the next generation of To engage with the next generation of nursesnurses


Encourage other nursing students to pursue Encourage other nursing students to pursue advanced majors in nursing regulation advanced majors in nursing regulation



Website Addresses

College of Registered Nurses of Nova ScotiaCollege of Registered Nurses of Nova Scotia www.crnns.ca


Questions?

regulatory power, & role of college of registered nurses of nova scotia michele brennan january...

Documents

fx presentation

public participation

public interestbpreserve

public representatives

public interestnot

practice of nursinghow

role of college

objects of college