COUNCIL

L. Haugh, Chair
J. Attwood
M. Bestwick
I. Bajnok
D. Barber
S. Burnell-Jones
K. Campbell
K. Cook
A. Cunningham
D. Dietrich
R. Graham
E. Greenwood

L. Hall
B. Hill
E. Howe
P. Howe
S. Ireland
S. Keating
V. Kerr
R. Kitson
K. Lawrence
L. Lillie
M. McGinn
M. A. Murray

B. Noble
D. Norling
S. Richardson
R. Rupert
J. Sanger
A. Taylor
M. Taylor
M. Ternovan
D. Trouten
B. Weichel
K. Wetherall
S. Young

D. Fox

C. Charlton

A. Coghlan
C. Campbell

H. Crawford
J. Hofbauer, Recorder

P. Reinhart
G. Siskind

WELCOME

L. Haugh welcomed R. Graham, a new public member. She informed Council that J. MacEachern has resigned as a public member.

AGENDA

L. Haugh identified a number of changes in the order of agenda items.

Motion 1

Moved by L. Lillie, seconded by L. Hall,

That the agenda for the Council meeting of December 11 and 12, 2002 be approved.

CARRIED

CLOSURE

The Executive recommended closure of the Council meeting to address recommendations of the Finance and Executive committees regarding staff salaries and Council stipends and expenses.

Motion 2

Moved by M. Ternovan, seconded by J. Attwood

That the Council meeting be closed at 9:00 a.m. on Thursday, December 12, 2002 to discuss personnel matters in accordance with Section 7(2)(d) of the Procedural Code.

CARRIED

MINUTES

Minutes of the Council meeting of October 2 and 3, 2002 had been distributed.

Motion 3

Moved by M. Taylor, seconded by K. Wetherall,

That the minutes of the Council meeting of October 2 and 3, 2002 be accepted as presented.

CARRIED

ELECTION BY-LAW

In October, Council had reviewed a number of proposed by-law revisions presented by the Elections Committee. While supporting the intent, Council had concerns that the proposed wording of Article 55.03.1 was not clear. A revision of the Article was presented. L. Haugh noted that the Executive had reviewed the new version and felt that the wording was clearer, while still reflecting the intent of the original proposal. The revision had been shared with the Elections Committee.

Motion 4

Moved by V. Kerr, seconded by B. Weichel,

That Article 55.03.1 of the Election Part of By-Law 1 be approved as follows:

CARRIED

EVALUATION OF OCTOBER COUNCIL MEETING

The Executive reviewed the evaluation of the October Council meeting. It was identified that most members found the rules of order session valuable. A review of rules of order at beginning of every Council year assists with efficient and effective Council operations.

MONITORING STRATEGIC OBJECTIVES

Council received a report on implementation of the strategic objectives including an action plan update, indicator report and report on the environment. This is the end of the first year of CNO’s three-year plan and the reporting framework provides a mechanism for Council to monitor the College’s success in progressing towards achievement of the strategic objectives.

It was noted that the indicators are not static. They will change over time as CNO improves its performance in some areas and identifies other areas that need to be monitored. There was discussion about the indicators related to the Regional Education Network and the verification of registration service provided to employers.

Council received an update on the action plan, highlighting the status of the activities to operationalize the strategic objectives. The following reports were provided to Council:

• An update on the initial initiatives aimed at improving the sharing of knowledge and information across CNO and with our members;
• An update on activities related to the development of a service delivery model for CNO; and
• An update on the activities accomplished to date to integrate knowledge, leadership and innovation throughout CNO.

B. Campbell highlighted the Environmental Report for August to December, 2002. The report included updates on The Kirby Report and the report of the Commission on the Future of Health Care in Canada (Romanow). The implications of the two reports for CNO were highlighted.

Council identified that the current focus on health care provides an opportunity for CNO to move forward its strategic objectives. Rather than realigning strategies to address the reports, CNO will use the recommendations that have a high profile to showcase CNO’s accomplishments and current initiatives. CNO is already proactive and addressing many of the issues that the reports are highlighting. For example, Council’s agenda for this meeting reflects CNO’s focus on scope of practice (RPN education, acute care/specialty nurse practitioner) and CNO is taking a leadership role in relation to the issue of nursing human resources by hosting a national forum to explore the impact of globalization on registration.

RPN PROGRAM APPROVAL

R. Rupert, Chair of the Registration Committee, highlighted the results of the consultation to identify a mechanism for review and approval of practical nursing programs. The Ministry of Training, Colleges and Universities has carried out an initial assessment and approval of these programs and the focus of the consultation was the ongoing review that needs to take place beginning in 2005.

R. Rupert highlighted the recommendations of the Registration Committee and its rationale.

Motion 5

Moved by R. Rupert, seconded by D. Norling

That Council accept the recommendations of the Registration Committee that:

It was clarified that "peers" in the recommendation are nursing educators.

Given the partnership between faculty and clinicians in providing the clinical aspect of nursing education, it was suggested that the review process include clinical practitioners.

Amendment to motion 5

Moved by M.A. Murray, seconded by K. Campbell,

That part 1 of motion 5 be amended to include "clinical partners".

DEFEATED

The amendment was defeated because it was felt that it was too broad and there was a need to specifically articulate the involvement of RPN practitioners. There was some concern that specifically including reference to RPNs in the team would be too prescriptive, and that a more broadly worded motion would give needed flexibility.

Amendment to Motion 5

Moved by A. Taylor, seconded by E. Howe,

That part 1 of motion 5 be amended by changing "peer review team" to "review group".

DEFEATED

There was concern about removal of the term "peer review" in the amendment. The concept of "peer review" for educational programs is clearly understood, and the amendment changes the meaning. It was noted that "peer review" in the educational sector has a different meaning from peer review at CNO.

Amendment to Motion 5

Moved by A. Cunningham, seconded by K Cook,

That part 1 of Motion 5 be amended to read "The body designated to approve practical nursing programs in Ontario shall comprise, but not necessarily be limited to, nursing educators, RPNs and CNO staff."

Amendment to amendment

Moved by E. Howe, seconded by S. Keating,

That the amendment to motion 5 be amended by removing the word "staff"

CARRIED

Amendment to Motion 5

The following amendment had been duly moved and seconded,

That Part 1 of Motion 5 be amended to read: "The body designated to approve practical nursing programs in Ontario shall comprise, but not necessarily be limited to, nursing educators, RPNs and CNO."

DEFEATED

The above amendment was defeated due to the continued exclusion of reference to "peer review". It was seen as important to include "peer review" to facilitate understanding in the educational sector.

Amendment to Motion 5

Moved by L. Lillie, seconded by I. Bajnok,

That Part 1 of Motion 5 be amended by adding after CNO "representatives including RPNs".

CARRIED

Amended Motion 5

The following motion was duly moved and seconded:

That Council accept the recommendations of the Registration Committee that:

CARRIED

MEDICATION STANDARDS

M. Cyr presented the draft revisions to the Medication Standards. A number of suggestions were made for clarification. It was suggested that the Standards be cross-referenced to Practice Expectations: A Guide for Utilization of RNs and RPNs. It was also suggested that a reference to documenting medication errors on the client’s chart be included.

It was suggested that the revised Medication Standard be shared with relevant stakeholders. Since the Standard is an excellent teaching tool, it was suggested that it be sent to nursing educators.

Motion 6

Moved by M. McGinn, seconded by S. Richardson,

That Council approve the revised Medication Standards.

CARRIED

The Standards will be revised, incorporating Council’s input, prior to publication.

EXECUTIVE DIRECTOR UPDATE

A. Coghlan presented a summary of the key 2002 operational accomplishments.

FEES BY-LAW

In June, Council approved revisions to the fees by-law, for publication. The proposals were published in the September Communiqué and there was minimal feedback.

Motion 7

Moved by A. Taylor, seconded by L. Hall,

That the proposed revisions to By-Law 2: Fees, as published in the September, 2002 Communiqué, be approved.

CARRIED

NOMINATING COMMITTEE

The Executive appoints the Nominating Committee, for ratification by Council.

Motion 8

Moved by V. Kerr, seconded by E. Greenwood,

That Kathy Cook, Denise Dietrich, Liz Haugh, Margaret McGinn, Mike Ternovan and Sophie Young be ratified as the 2003 Nominating Committee.

CARRIED

Thursday, December 12, 2002

CLOSED SESSION

A closed session of Council was held to discuss staff salaries and Council stipends and expenses. The minutes of the session are attached in the confidential appendix.

FINANCE REPORT

S. Keating presented the report of the Finance Committee.

Financial statements

The financial statements as at October 31, 2002 were highlighted. It was noted that a significant portion of the positive variance between actual expenditures and the budget is the result of increased revenues. The Finance Committee reported that the current financial results place CNO in a good position to meet its long-range financial and strategic goals.

2003 Operating and Capital Budget:

S. Keating highlighted the roles of staff, the Finance Committee, and Council in developing and reviewing the budget. Council has delegated the detailed review of the budget to the Finance Committee. This year, the Finance Committee specified the information provided to Council reflect Council’s broad governance role.

The Finance Committee discussed the process of approving a budget increase guideline in the fall. It was confirmed that the percentage budget guideline is not relevant and will no longer be included in the budget process.

S. Keating highlighted the proposed budget, and subsequent two-year projections.

There was considerable discussion about the amount of information provided by the Finance Committee. A number of Council members identified a discomfort with approving the budget based on the information submitted. Other members identified their belief that the information was appropriate given Council’s governance role and the involvement of the Finance Committee in the process.

A breakdown by type of expense was requested and provided. In reviewing the breakdown, concern was expressed about the amounts in some areas and clarification was provided.

Motion 9

Moved by S. Keating, seconded by M. McGinn,

That the 2003 Operating and Capital budgets be approved.

It was suggested that the motion to approve the budget include the specific amounts.

Amendment to Motion 9

Moved by D. Trouten, seconded by P. Howe,

That motion 9 be amended to include specific amounts of the operating budget (revenues, expenditures and surplus) and the capital budget.

CARRIED

Amended motion 9

The following motion was duly moved and seconded,

That Council approve the 2003 operating budget (revenues of $20,643,048, expenses of $18,804,117, surplus of $1,838,931) and capital budget ($1,323,620), as presented.

CARRIED

S. Keating informed Council that the Finance Committee will be undertaking a review regarding information for financial decision-making and will bring options to Council.

ACUTE CARE NURSE PRACTITIONER

R. Rupert highlighted the recommendation and rationale of the Registration Committee regarding Acute Care/Specialty Nurse Practitioners. He reviewed the options that were considered by the committee and its decision-making criteria. If Council approves the recommendation, a workplan will be developed.

Council confirmed that, given the existence and current practice of acute care/specialty nurse practitioners, it is in the public interest that CNO explore mechanisms to regulate their practice.

Motion 10

Moved by R. Rupert, seconded by B. Hill,

That CNO proceed to investigate the registration of the Acute Care/Specialty Nurse Practitioner as a member of the extended class.

CARRIED

REN SESSION

The Regional Education session on the revised Professional Standards was deferred to the March Council meeting.

EXECUTIVE COMMITTEE

L. Haugh briefly highlighted the notes of the Executive Committee meetings of October 16, 2002 and November 14, 2002. The November discussion of the differences in the roles of the Executive and Complaints committees was noted.

LIAISONS

L. Haugh reported on liaisons with the Ontario Nurses’ Association, the Registered Nurses Association of Ontario and the Registered Practical Nurses Association of Ontario. All three meetings were positive and collegial in tone. Issues of common interest were discussed, including how the nursing organizations can support CNO to build confidence in nursing self regulation.

L. Haugh reported on the retreat of the Joint Provincial Nursing Committee.

OTHER BUSINESS

R. Kitson reported that a representative from the Ministry of Health and Long-Term Care had attended a Regional Education Network presentation on restraints and was very impressed with the information CNO was providing.

CONCLUSION

At 4:00 p.m., it was,

Moved by P. Howe, seconded by J. Attwood,

That Council conclude.

Chair