Quality Practice - Summer 2010 Volume 9 Issue 2 Print
Online Renewal 2011: How employers can help
All nurses in Ontario will be required to go online when membership renewal for 2011 begins on Oct. 20. The paper renewal form will no longer be distributed. How can you, as an employer, help your nursing staff make the transition?
Time to renew
The College believes that most nurses can easily find a way to renew online. When online renewal was launched in 2006, we heard from nurses who wanted to try it, but didn’t own computers. These nurses renewed by borrowing a friend, family member or work colleague’s computer, or they visited their local library or an Internet café.
Another option is for employers to allow nursing staff to take some time to renew at work. You could even schedule a renewal day when all nurses at your facility can renew.
There are a couple of benefits to helping nurses renew online. First, by allowing nurses who don’t have a computer at home to use a computer at work, you will know that all nursing staff have renewed on time and aren’t at risk of being suspended. Second, by having groups of nurses come together to renew, those who are more familiar with online renewal can assist those who aren’t.
No more APC
Starting this year, the College will no longer be providing members with a printed Annual Payment Card (APC), which were evidence of payment of the annual fee. By not printing APCs, the College will reduce incidents of forged, lost and stolen cards. For 2011, nurses will receive an electronic confirmation of renewal receipt once they’ve completed their renewal. This electronic confirmation can be stored online in the nurse’s secure Members’ Area account.
Currently, many employers ask nursing staff to present the APC as proof of current registration. Now, however, you have to access the College’s online register, Find a Nurse, to check a nurse’s registration status with College. On the register, you will find profiles for all nurses in Ontario, including their registration status and information about any terms or conditions on their registration. If you’ve never visited Find a Nurse, you should familiarize yourself with this tool before online renewal opens. It will be an important resource for confirming that your nursing staff has valid registration for 2011.
In addition, the College’s Annual Automated Verification of Member Renewal (AAVR) service will continue to be available to employers for checking the renewal status of members. If you employ 50 or more nurses, the AAVR service may be very convenient for you; employers with smaller numbers of nurses on staff can access Find a Nurse.
Why this change?
The College made this change so the renewal process is easier and more convenient for nurses and to assist the provincial government in its HealthForceOntario strategy.
The College first launched online renewal in 2006. Since then, nurses have told us that online renewal is easy to use and very convenient. In addition, starting in 2010, the Ministry is requiring the College to collect more practice and employment-related information from nurses. This data will remain anonymous, and will be used for health human resource planning.
Lastly, the College has been researching nurses’ use of new technologies, and has seen a continuous increase in their use of online resources, including online renewal. Staying up-to-date with technology is an important part of maintaining competence in nursing.
For more information about online renewal, see the list of Frequently Asked Questions.
Promoting technology in the workplace
Today, changes in technology affect our lives continuously. This seems especially true in the health care sector. As an employer, what can you do to introduce new technologies into your workplace effectively?
Staff involvement
Nurses’ attitudes toward new technology, and whether they will accept or resist its introduction into the workplace, depend on a number of factors. In workplaces where nurses feel unsupported, they are more likely to resist change. Staffing issues, and lack of resources or time to do anything beyond direct care for clients, can also lead to resistance. Such challenges need to be addressed first.
Involving nurses in the introduction and appraisal of a new technology, especially if it is something that they will be required to use, increases the likelihood of a successful implementation.
If nurses are to embrace a new technology, they need to be shown how it will support them in providing better client care. At first, they may worry that a new technology will actually increase their workload, but open communication and opportunities for learning can decrease such fears.
Education and support
Providing practical hands-on training allows nurses to have their questions answered. Issues about lack of experience, incorrect assumptions about how complicated a technology is to use, or fear of making mistakes while using a technology, can be addressed through education. Pairing a nurse who may not be as comfortable with a new technology with another who is ‘tech-savvy’ is one strategy for advancing learning. Or, if the technology is going to be used widely across a facility, planning an education day for all staff might be a good approach.
Employers should also listen to nurses’ experiences about how a technology is affecting their practice. Such feedback can help employers develop policies around technology that promote best practices. For example, nurses working with a new technology may want to track its impact on performing procedures. Or, they could find that a newly introduced piece of technology isn’t compatible with existing technologies.
QA & technology
The College’s Quality Assurance Program requires nurses to stay up-to-date with technology and take opportunities to enhance their skills in this area. The College has many resources to assist nurses with integrating technology into practice. For example, the Documentation practice standard includes a list of resources about electronic documentation. For more information about nurses and technology, see the Summer issue of The Standard.
Employing nursing students
During the summer, many employers hire nursing students to cover for staff members who will be away on vacation. But, what should be considered before students are hired and assigned care tasks?
First, remember that nursing students are just that – students. They are still learning how to safely perform the controlled acts authorized to nursing. This means that, until their education is complete and they are registered members of the College, they cannot perform controlled acts.
A summer job is different than a clinical placement that takes place during the school term. For the purpose of education, the legislation allows students enrolled in a nursing education program to have access to controlled acts while being supervised by a member of the profession. Individuals hired for the summer, however, are acting as unregulated care providers (UCPs), not as students.
In addition, the term “nurse” can only be used by registered members of the profession. Individuals enrolled in a nursing education program should only use the title “nursing student” during the school year. In their position as a summer hire, refer to nursing students as UCPs or personal support workers (PSWs).
Students have much to gain by working as a UCP. The experience can help them develop confidence and organizational skills for their future nursing careers. It can enhance their ability to work collaboratively within a health care team and better their understanding of the health care system as a whole.
For more information, see the Supporting Learners and Authorizing Mechanisms practice guidelines.
National standards on the way
CNO and the College of Registered Nurses of Manitoba are leading a project to develop national professional regulatory standards for all nurses in Canada.
Nursing standards are authoritative statements that set out the legal and professional bases of nursing practice. They describe the behaviour required of every nurse and are used to evaluate individual performance.
Commissioned by the executive directors of nursing regulatory bodies across Canada, the project will set the stage for further collaboration between provincial nursing regulators.
While each province has its own legislative requirements and approach to nursing regulation, the basic practice expectations in the nursing profession are comparable. National standards will create similar expectations for the knowledge, skill and competencies nurses should have, regardless of the jurisdiction in which they practise. This will, in turn, facilitate safe labour mobility.
The project’s guiding principles require the national standards to be open and transparent, consistent, current, informed by evidence, impartial and respectful of jurisdictional differences.
Last year, representatives from nursing regulatory jurisdictions across Canada (except Quebec), and the Canadian Nursing Association, formed the National Standards Working Group.
Each provincial regulatory body, including CNO, is consulting with its members and stakeholders through a variety of means, including teleconferences, advisory groups and web-based strategies. The working group will then incorporate the feedback it receives into the national standards.
The final result will be shared professional regulatory nursing standards, which are in the public’s interest as it will help Canadians to be confident that no matter where they choose to reside, their nurses will meet the same high standards of professional practice.
Look for updates on the national standards at www.cno.org.
2009 Annual Report
The College recently released its 2009 Annual Report and online webcast, which is narrated by Anne Coghlan, the College’s Executive Director and CEO. These reports contain highlights of College initiatives from the past year and focus on the four components of self-regulation: entry to practice, standards, quality assurance and enforcement. The annual report and webcast are available at www.cno.org/annual_report.
Bedside confidentiality
I’m the manager of a telemetry unit in a large urban hospital. All of the clients on this unit are in ward rooms with four clients per room. At change-of-shift, the departing nurse provides an verbal report on each client to the incoming nurse at the bedside. Should we be concerned about breaching client confidentiality when giving bedside reports?
Yes, you should be concerned about breaching client confidentiality when giving a bedside report in this situation. While nurses are obligated to communicate client information to the health care team and involve clients in decisions about treatment, they also have ethical and legal responsibilities to maintain the confidentiality and privacy of client health information.
The Confidentiality and Privacy—Personal Health Information practice document states that nurses should not discuss client information with colleagues or the client in public places such as elevators, cafeterias and hallways. A telemetry unit is not a public place, but it is not a private room either. Discussions in shared settings such as ward rooms are likely to be overheard by other clients, family members, visitors or health care facility employees.
There are many benefits to giving verbal reports at the bedside. Face-to-face reports at the bedside facilitate information-sharing between the client and health care team. This provides the client with an increased opportunity to be involved in decisions about his or her care. It also provides nurses with opportunities to clarify information for the client.
If you choose to continue having the nurses provide each other with verbal reports at the bedside, you should have them discuss this with clients beforehand so they know this is how information will be shared. This will give them an opportunity to consent to this method of information-sharing. If there is a specific aspect of health information that a client does not want to have discussed, then the nurses should abide by this request. If discussions can be moved to a more private area while still including the client as a participant, then explore this option with the nurses, clients and other members of the health care team.