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1Practical Nursing | July 2013 | College of Licensed Practical Nurses of Manitoba

practical nursingcommitted to excellence

July 2013

CLPNM President Christy Froese visited Jocelyn House Hospice during National Nursing Week in May.

(Left to right: Christy Froese, Rose Marie Reimer, Mariane Riding, and Michelle Emms).

Practical Nursing | July 2013 | College of Licensed Practical Nurses of Manitoba2

Office Closure Dates

Please note that the CLPNM office will be closed on the following dates:

College of Licensed Practical Nurses of Manitoba

463 St. Anne’s Road Winnipeg, MB R2M 3C9 Telephone: (204) 663-1212 Toll Free: 1-877-663-1212 Fax: (204) 663-1207 Email: [email protected]

table of contentspresident Christy Froese LPN

board of directors

District I – Patricia Rotzien LPN District II – Cheryl Geisel LPN District III – Rodney Hintz LPN District IV – Lindsay Maryniuk LPN District V – Jodi La France LPN District VI – Vacant Public Members – Darlene Barbe

– Tricia Conroy – Judy Harapiak – Diwa Marcelino – Susan Swan

executive director

Jennifer Breton LPN, RN, BN

clpnm staff Consultant, Registration & Conduct – Janice Benson LPN

Senior Consultant, Professional Nursing Practice – Tracy Olson LPN

Consultant, Education & Program Evaluation – Michael Roach BScN (Hons)

Consultant, Policy Process & Communication – Erik Isford BA, MA

Business Manager – Barbara Palz HB Com, CGA

Executive Assistant – Vicky Bering

Coordinator of Administrative Services – Jodie Levesque

Administrative Coordinator – Brenda Reid

advertising To advertise in the Practical Nursing Journal, please contact:

McCrone Publications Inc. Email: [email protected] Toll Free: 1-800-727-0782 Fax: 1-866-413-9328

August 5, 2013 – August Civic Holiday September 2, 2013 – Labour Day October 14, 2013 – Thanksgiving Monday

November 11, 2013 – Remembrance Day December 23, 2013 (2 pm) to January 2, 2014 – Christmas Break

President’s Message 3

Executive Director’s Message 6

A Matter of Conduct 8

Ask a Practice Consultant 10

2012 Continuing Competency Program Audit Report 11

CCP Audit Quick Facts 16

International Day of the World’s Indigenous People 17

2014 Registration Renewal 18

2015 Preauthorized Payment Plan 19

2014 Fee Schedule 20

Jocelyn House Hospice 21

Meet Melanie Mason LPN and Deanna Miller LPN 22

Facts

mailto:[email protected]



CLPNM’s Vision

Lead, innovate and promote professional excellence of the licensed practical nurse in Manitoba and collaborate with our stakeholders in a changing health care environment to serve and protect the public.

president’s message

CLPNM’s Mission

We are dedicated to protecting and serving Manitobans through effective, transparent, objective, and supportive nursing regulation.

This end is further interpreted to include:

• The College speaks with a unified voice in all regulatory matters for the licensed practical nurses of Manitoba.

• The College establishes the regulatory framework for the licensed practical nurses in Manitoba (Scope of practice, Standards of practice, Code of ethics).

• The College endorses professional development and life-long learning and ensures compliance with the continuing competency program.

• The College establishes mechanisms for hearing and investigating complaints against licensed practical nurses and sets out the disciplinary processes as defined in legislation.

• The College establishes robust mechanisms for registration as per legislation, including registration exams, initial enrollment, and renewal of student practical nurses, graduate practical nurses, and licensed practical nurses.

• The College is informed of evidence-based nursing practice and disseminates this information to all licensed practical nurses.

• The College enforces the standards of education, monitors practical nursing programs, and approves new programs.

I am excited to share with you that the Board of Directors has approved the new College of Licensed Practical Nurses of Manitoba (CLPNM) Vision, Mission and Values statements. These statements were approved at the June 3, 2013 board meeting. The timing couldn’t have been better as I was able to share these new statements with registrants at the annual general meeting (AGM). Our new statements are as follows:

CLPNM’s Values Description of Values We Believe In…

RespectCreating a culture of equity, inclusiveness, and diversity within our organization, with membership, and with our external stakeholders.

Integrity Being honest, fair, consistent, and objective in our deliberations, transactions, and relationships.

CollaborationEngaging licensed practical nurses and other stakeholders in a cooperative spirit to build strong professional and public relationships.

QualityPromoting excellence through the integration of emerging public policy and the consistent application of professional nursing regulation.

Professionalism

Providing nursing regulation that will support individual nurses to continuously improve their skills, knowledge, and expertise to offer the highest quality and exemplary professional services to those they serve.

Facts


The Board had a lot of discussion over the Vision that they had for CLPNM in the future. As a result of these discussions, the Board has set three goals for the future:

president’s message continued...

Priority #1:

Increase the visibility of the College of Licensed Practical Nurses of Manitoba with all stakeholders.

• Develop and establish programs that provide information about the health profession

Priority #2:

Increase collaborations with external stakeholders.

• Promote and enhance the College’s relations with its members, other colleges, key stakeholders, and the public

• Promote inter-professional collaboration with other colleges

Priority #3:

Facilitate Board development.

• Provide ongoing educational sessions so that Board members can competently administer the College’s affairs and perform its duties

67th AGM

This year’s AGM was held at the Viscount Gort Hotel on June 3, 2013.

The rules of procedure were presented and approved. Vera Chernecki was the parliamentarian for the proceedings.

The Credentials Report was:

Voting – 26 Non-Voting – 32

I would like to thank all guests who attended, and would like to invite you all to attend next year’s AGM on June 2, 2014 in Steinbach, Manitoba.

Annual Report

Tony Gauthier CA, from Craig & Ross Chartered Accountants, presented the 2012 audit statement. The 2012 auditors report was adopted as printed.

Ratification of Active-Practising Registration Fees

The Motion was adopted that the

active-practising registration renewal

fee be increased to $370 plus GST from

$350 plus GST effective for the 2014

registration year.

College Excellence Awards

2013 Nursing Preceptor/Mentor Award

Joann Semenek was awarded the 2013 Nursing Preceptor/Mentor Award. Joann graduated from the St. Boniface School of Nursing in 1970. Joann has spent most of her nursing career working at Seven Oaks General Hospital in both surgery and medicine. She has inspired countless students and new graduates in her years of nursing. She has provided students with a warm welcome, imparting advice, counsel, support, and valuable feedback. It is evident to her mentees that nursing is truly a vocation for Joann, not just a job. Joann teaches by example devoting her time to unhurried care. She is approachable, compassionate and warm. One of Joann’s mentees said this: “What makes Joann excel as a mentor lies not only in her skills and expertise, but in her genuine and innate kindness, her caring attitude that rubs into everyone she works with or mentors. Every moment is an opportunity, a learning experience for both skills and virtues development.” Joann is an excellent role model and embodies what nursing is all about.

2013 Nursing Practice Award

Pamela Stanton was awarded the 2013 Nursing Practice Award. Pamela graduated from the St. Boniface School of Nursing in 1992. She is currently employed at the Royal Canadian Mint as a full-time nurse in the Health and Safety Department. As the only nurse in a manufacturing setting, priorities are constantly changing. Last year Pamela had 4500 nursing consultations and was responsible for providing emergency first aid, disability management and wellness programs. She offers vaccinations and wellness clinics throughout the year and wants all employees to know their numbers: blood pressure, cholesterol and blood glucose levels. Pamela also actively serves on various committees including the Royal Canadian Mint’s Corporate Social Responsibility Team, the Wellness Subcommittee for Winnipeg’s Annual Excellence Conference, the Education Committee for the Manitoba Occupational Health Nurses Interest Group, the Credential Assessment Committee for the CLPNM and as an auditor for the Continuing Competency Committee at the CLPNM. In all she does, Pamela demonstrates outstanding caring, commitment and competence.

These goals won’t be achieved overnight, and the Board will need to put thought into how to implement these goals and make them a reality.


president’s message continued...

Award Winner - Joann Semenek (with Christy Froese).

Award Winner - Pamela Stanton (with Christy Froese).

2013 Leadership Award

Brenda Olson was awarded the 2013 Leadership Award. Brenda graduated from Red River Community College in 1974. Since then she has worked in numerous practice settings including medicine, surgery, emergency, rehabilitation, maternity, geriatrics and palliative care as well as having instructed practical nursing education. Brenda has worked all over Manitoba including Winnipeg, Northern Manitoba and in rural Manitoba. Currently Brenda is working at the Ste. Anne Hospital where she provides compassionate care to the clients she serves. In Ste. Anne she has had the opportunity to mentor student nurses, seeking out learning opportunities for them whenever possible. It is evident to all that she comes into contact with that nursing is a career that she loves. When working as a practical nursing instructor for Assiniboine Community College Brenda inspired and mentored her students, leaving a lasting impact on them. Brenda also serves on the Education Approval Committee at the CLPNM. Her background knowledge as an educator makes her a valuable asset to this committee. Brenda is a role model for the profession; she inspires others and is a true leader.

Licensed Practical Nurses Foundation of Manitoba (LPNFM) Scholarship Award

The LPNFM awarded a $1000 scholarship to Ann Hoeppner. The LPNFM invited all practical nursing students to submit an essay describing why they chose to enter into the nursing profession. Ann was chosen to be the recipient of this award. She is currently in her first year of nursing with Assiniboine Community College in Cypress River, Manitoba. Congratulations Ann!

Farewell

I would like to thank the following past Board members for their service and dedication to the CLPNM:

Elisa Wiebe LPN Marlene Ritchie LPN

Thank you to all nurses who will be putting in long hours during the busy summer months. I wish you all a wonderful and safe summer, and hope that you are able to take some time to spend with friends and family.

Award Winner - Brenda Olson (with Christy Froese).

Scholarship Award Winner Ann Hoeppner, with LPNFM Trustees, Leslie Olson and Janice Cournoyer


At the Annual General Meeting (AGM) on June 3, 2013, I had the pleasure of meeting licensed practical nurses (LPNs), student practical nurses, new Board members and several guests. Knowing that the nature of nursing involves shift work and schedule juggling, I can appreciate that many LPNs were not able to attend the AGM. I would like to take this opportunity to share my communications of that day with registrants unable to attend.

Two thousand and twelve has proved to be another busy year, and the College continues to work diligently within its legislated mandate of protecting the public through the regulation of LPNs.

The College closed the 2012 registration year with 3261 LPNs renewing onto the active practising register. That is 294 more than the previous year. In an effort to offer more effective and efficient registration renewal processes, the College made the renewal process 100% online in 2012. The change from paper to digital went very well with 99% of registrants applying for renewal before the November 30 deadline.

This change supports the College’s online public registry and employer verification system. With the ability to offer real-time verifications of the registration status of all LPNs and graduate practical nurses (GPNs) in the Province, the College is enhancing transparency and protection of the public by ensuring only nurses with current registrations are able to practice in Manitoba.

The online system also assists the College to be compliant with annual mandatory reporting, including complex reports such as those required by the Canadian Institute for Health Information (CIHI), Manitoba Health and the Office of the Manitoba Fairness Commissioner (OMFC).

As most regulated health professionals know, compliance with a Continuing Competency Program (CCP) is a requirement for ongoing registration. It is through the CCP audit that the College can assure the public that all active-practising LPNs have taken measures to maintain and increase their nursing knowledge over the last year. This year 723 registrants were randomly selected for the CCP audit; 67% met the requirements of the CCP during Phase One of the audit, while 95% met the requirements by the end of Phase Two. One hundred per cent of audited LPNs met the CCP requirements by the end of the third and final phase.

The College received valuable feedback from registrants regarding audit processes. This feedback was presented to the CCP Committee for consideration and as a result, in 2013 the College will focus on increased communication and education regarding the link between registration and the CCP audit, audit dates and schedules as well

executive director’s message

as the responsibilities of the LPN undergoing an audit. Fact sheets for LPNs and employers have been updated and will be sent out to all LPNs and employers. Free CCP education sessions will remain available throughout the year. Also new for 2013, the College will increase communications with audited registrants by utilizing email along with Canada Post. This allows registrants to receive vital, time sensitive information in more than one manner. To allow registrants more time to respond to CCP auditor recommendations, timelines between notification and submission deadlines will be increased for 2013. And, in order to keep the audit sustainable, the Board has directed that the annual audit will be made up of 10% of randomly selected LPNs each year. The four-year audit cycle will continue.

In keeping with the mandate, the College works to ensure that those applying for initial registration are equipped with the knowledge, skills and judgment required to provide safe, competent and ethical care. To that end, the College continues to review and evaluate all Practical Nursing (PN) education programs and grants recognition to those who meet the rigorous standards required to effectively train and prepare students for a career as an LPN.

In 2012 the College worked closely and collaboratively with all PN education programs including Assiniboine Community College (ACC), University College of the North (UCN), CDI College and Université de Saint-Boniface (USB).

http://www.ustboniface.mb.ca/

http://www.ustboniface.mb.ca/


The Government of Manitoba recently announced support for ACC to operate a third rural rotating site in the Province. ACC will take in 25 students at the newly announced Dauphin site beginning in September 2013.

The College continues to work closely with ACC and Manitoba Health on the Practical Nurse Qualification Recognition (PNQR) pilot program that assists internationally educated nurses to bridge into the Canadian nursing culture.

After almost a year of review, the College has granted ACC full approval status for its Diploma PN program. The Education Approval Committee remains active and is reviewing the remaining PN schools. With at least 10 student intakes and approximately 300 students on the College’s student register, the education programs department remains very active.

In 2012, the OMFC conducted a review of the College’s registration practices. The Fairness Commissioner commended many of the College’s registration practices stating that the College has “been active participants in several positive, joint initiatives with the Province and continue to be willing, open, and collaborative to better the system.” The findings of this review can be found on the OMFC website.

As the regulatory body for the LPN profession in Manitoba, a large part of our role is to consult and collaborate with various organizations and groups within the Province and jurisdictions across the country. It is through this consultation and collaboration that the College maintains and enhances excellence in its regulatory processes and supports LPNs in the provision of safe, quality health care.

Provincially, the College continues its work to move forward with the new Regulated Health Professions Act

(RHPA), and is an active member of the Manitoba Alliance of Health Regulators. To inform of this important work, in the past year, the College has held focused consultations with LPNs, employers and educators across Manitoba regarding current LPN practice, standards, education and expectations.

Surveys and focus groups were held to begin the validation process for the newly drafted Standards of Practice and Code of Ethics. The results thus far have been very positive. The College continues to work on the revised Competency Profile for LPNs in Manitoba. LPN feedback remains a vital component of this project. All registrants are encouraged to participate in future surveys and focus groups.

The College is also collaborating with Manitoba’s nursing regulators to develop a series of documents that describe the education and practice of the three regulated nursing professions in the Province. The first installment of this series has been released and the second document, focusing on the education foundations of the three nursing groups is nearing completion.

On a national level, the College continues to participate with other nursing regulators in the establishment of the National Nursing Assessment Service (NNAS). The intent of the NNAS is to diminish barriers and increase the ease in which internationally educated nurses’ credentials are assessed, and to provide a quicker pathway to recognition for those candidates who meet the qualifications for licensure. College staff are active members of the NNAS working group.

Continuing our harmonization efforts that began several years ago, the College worked closely with other LPN regulatory bodies to create consistent practice requirements for LPNs across Canada. In the summer of 2012, several Manitoba LPNs and educators attended focus groups to validate national documents including “Requisite Skills and Abilities” and “Entry to Practice Competencies.”

These two documents consist of global statements that speak broadly to the basic common requirements of LPNs across all Canadian jurisdictions. These two documents have been adopted by the College, and once they are released nationally will be available on the College website.

I would like to take this opportunity to acknowledge the individuals and organizations that assist the College in fulfilling its mandate. We are fortunate to have access to the incredible knowledge and experience of our various stakeholders, including LPNs, government representatives and other health regulators on the local, provincial and national level.

The College is fortunate to be directed by exceptionally dedicated and engaged Board members who are committed to serving the citizens of Manitoba. These individuals whether public, LPN, elected or appointed, uphold the values of knowledge, collaboration, respect, professionalism, organizational integrity and continuous quality.

Finally I must acknowledge the daily commitment of the College staff. These highly competent and ethical individuals work tirelessly to ensure the College upholds its mandate every single day.

In closing, I would like to say that in the midst of these dynamic times the College looks forward to working closely with our owners (the public), and our stakeholders as we continue to protect the public through fair, consistent and effective nursing regulation.


Fred’s employer contacted the College of Licensed Practical Nurses of Manitoba (the College) requesting some direction related to Fred’s nursing practice. The Practice Consultant asked the employer to elaborate on the issues that led to the phone call. The employer explained that Fred appeared to be having difficulty safely preparing and administering medications to the clients of the care home. It was at this point that the Practice Consultant asked the employer if he was interested in providing support for Fred or if he wanted to lodge a complaint. The employer said that at this point in time, he would like to offer Fred some support.

The employer and the Practice Consultant scheduled an audit of Fred’s practice at the facility. The College sent an LPN auditor to assess Fred in the workplace. The auditor developed and submitted a report based on the assessment with recommendations to the College. The Practice Consultant then discussed the audit report with the employer and together, a plan was developed to assist Fred with his nursing practice. Three months later the employer contacted the College again; however this time, it was to submit a complaint.

a matter of conduct

The complaint alleged that although Fred was receptive to working with the facility educator to improve his skills, he could not seem to grasp the importance of safe administration of medications. The employer believed that Fred had breached the profession’s standards by not applying critical thinking and problem-solving processes in his decision making, resulting in a risk to the safety of the clients of the care home. As a result, an investigation into Fred’s practice was conducted. A review of his personnel file disclosed a history of occurrence reports citing multiple medication errors. There was documentation that showed the facility educator worked with Fred to develop tools to improve his medication administration skills. It appeared that when the educator worked with Fred there was improvement; however, when he was left to work independently, errors occurred. The investigation also included interviews with Fred’s previous employers, which revealed a pattern of similar practice concerns that seemed to date back several years.

The College’s Investigation Committee decided to invite Fred to speak with them so they could gain a better understanding of the issues surrounding his nursing practice.

He was asked to bring his professional nursing portfolio to the meeting. When Fred appeared at the next scheduled committee meeting, he was asked about the education he took part in to enhance his nursing practice. He explained that he usually attended the educational in-services provided by the facility. He submitted to the committee proof of attendance at various facility in-services. He did admit to only attending education offered while he was working. When asked about educational opportunities outside of the facility, Fred stated that he took a physical assessment course in 1999. It was established that Fred had not continually assessed his own competence to identify his learning needs or opportunities for growth and development. He was asked if he believed that had breached his standards by not engaging in continual post-basic education. Fred admitted that he had.

Consequently, the Investigation Committee agreed that Fred had breached his professional standards. This included Standard II: Application of Knowledge, Skills and Judgement, which states; “The licensed practical nurse assesses the clients’ actual or potential strengths and limitations and plans interventions and evaluates outcomes.” Indicator 4 states that “The LPN determines client status and responds to actual or potential health problems, by planning nursing interventions, performing planned interventions, evaluating client outcomes and revising care

Fred* graduated from a Practical Nursing (PN) program in 1988 and had worked in long-term care for the majority of those 25 years as an LPN. In 1999 Fred successfully completed the mandatory upgrade in the areas of physical health assessment, urinary catheterization and intramuscular injection.


as necessary.” The occurrence reports discovered during the investigation cited several incidents of Fred failing to assess his clients both before and after administering medications. Fred also failed to maintain documentation of client care and observations that were chronological, legible, clear, timely, accurate and concise.

It was also found that Fred breached Standard VI: Continuing Competence, which states that “The licensed practical nurse assumes responsibility for attaining and maintaining competence relevant to his own practice.” In the aforementioned case, Fred did not demonstrate appropriate knowledge, skills and judgment related to his own practice, nor did he demonstrate awareness of the changing trends in nursing, health and society that impact practice.

The Investigation Committee, in accordance with The Licensed Practical Nurses Act (2001) made the decision to offer Fred a two-year voluntary undertaking, which included an educational session on the profession’s Standards of Practice and Code of Ethics. The undertaking also included remedial education in the area of medication administration and documentation as well as the

submission of scheduled employer practice reports. A condition of supervised practice was placed on Fred’s registration. Fred was ordered to maintain monthly contact with the College’s Conduct Consultant in which he was to provide evidence that he was upholding his professional obligations as an LPN.

*This article is a compilation of real conduct issues brought to the attention of the College, but does not reflect any particular case.


asK a practice consultant

Q: My employer has asked me to work overtime but I’m far too tired and I don’t feel safe to stay. What is my obligation?

A: During periods of staffing shortages, an LPN may experience an ethical dilemma in meeting an obligation to provide care if the employer needs extended hours of work from an LPN after his or her assigned period of time. LPNs can accept or decline additional shifts or overtime employment hours based on their fitness to practice, but must balance the duty to care for clients with the equal duty to ensure their fitness to practice competently does not threaten client safety.

It does not constitute abandonment of care on the part of the LPN to decline to accept extended hours of work directed from the employer – if, and only if, leaving does not terminate client care and the established therapeutic relationship before the transferring of client care occurs. Transferring of client care occurs when the LPN reports on the clients’ health condition, circumstances, and needs under his or her care in oral or written form directly to another nurse or appropriate health care provider who has the authority to assume the clients’ care; who then acknowledges receipt of the clients’ care.

LPNs have an obligation to provide safe, competent, and ethical care to their clients and to maintain commitments to the clients for whom they are responsible. Once the LPN has entered into the therapeutic

relationship with their client(s) by accepting the assignment of care, they have accepted the legal and ethical responsibility to provide care to the client(s) for that assigned period of time.

In the event that an adequate health care provider, as determined by the employer, is not available, the LPN must continue to maintain the therapeutic relationship and the provision of care, as failing to do so places client safety at risk and constitutes abandonment of care.

Employers share responsibility along with the health care team to ensure there are safe staffing levels appropriate to the practice environment and the client population within, and that effective communication is maintained between staff and management when issues arise. Employers are responsible to provide necessary resources and support to enable LPNs to meet their standards of practice. In addition, employers must ensure that clear policies and procedures are in place to support, direct, and guide LPNs in all practice areas.

When LPNs are required to extend their hours of work due to short staffing, they may collaborate with the employer regarding a limit to the number of extended hours they can reasonably work. For example, they may agree together that the LPN will work four (4) hours as opposed to the entire shift. In addition, the LPN may discuss the option of modifying the client assignment for the LPN, along with discussing reprioritizing delivery of client care. For example, the LPN could accept a

smaller client assignment and/or re-assign the responsibility for medication administration to another nurse in the practice area in the event the LPN feels too fatigued to do so safely.

LPNs have the professional responsibility to reasonably limit employment hours to maintain safe and effective nursing practice and to maintain their fitness to practice. Fitness to practice is based on an LPN’s ability to provide safe and effective nursing care with an appropriate level of physical and mental acuity.

LPNs are accountable to the Standards of Practice and the Code of Ethics of their profession at all times. During periods of inadequate staffing it is essential that LPNs collaborate professionally with their employers and other staff in order to maintain the provision of safe, competent and ethical care to all clients.


2012 continuing competency program audit report

The College of Licensed Practical Nurses of Manitoba (the College) is accountable through legislation, The Licensed Practical Nurses Act (the Act), to ensure nurses provide safe, competent and ethical nursing care. Robust and active practice of every member’s participation in the Continuing Competence Program (CCP) contributes directly to the College’s mandate of public protection, as it ensures that practice remains up to date, knowledge remains strong, and the overall quality of care remains high and only improves over time. As a result, the CCP audit is conducted each year to assure the College, the public, and registrants that CCP practice is being followed in a reasonable, quality manner, and the outcomes of each registrant’s CCP can support and improve practice.

This report contains the results of the 2012 CCP audit. The 2012 annual CCP audit process was conducted in three phases: Phase One in January 2013; Phase Two in February 2013; and Phase Three in April 2013. The auditor group was comprised of eight active practising LPNs from various practice areas who were appointed by the CCP Committee. Auditors worked in groups of two and audits were divided between the four pairs of auditors, ensuring that each CCP audit submission was independently evaluated by two separate individuals.

To ensure consistency and objectivity, auditors were provided with evaluation tools to use as a guideline to assess whether learning plans contained the mandatory components of the CCP and if a registrant’s practice was impacted. Once an audit was reviewed and scored, auditors then determined the

results of each individual audit. If it was determined that the registrant had not successfully met the requirements for the CCP, the auditors communicated the gaps by completing an audit discrepancy form.

Registrants who were selected to participate in the CCP audit were required to submit the following materials:

• The CCP Audit Questionnaire (Form A).

• The previous year’s completed learning plans (2012).

• The current year’s projected learning plans (2013), which only required having Steps One and Two complete – as Steps Three and Four may be completed during the remainder of the year.

New for 2012 was the additional requirement for independent practising LPNs to submit the following items, in addition to the materials previously stated:

• The CCP Independent Practice Audit Questionnaire (Form B).

• A copy of the Table of Contents of the independent practitioner’s policy manual(s).

• A copy of at least one of the independent practitioner’s policies that pertains to specific nursing care provided by the LPN in independent practice.

• A copy of at least one of the independent practitioner’s billing policies.

• A copy of at least one of the independent practitioner’s documentation/record keeping policies regarding the storage, retention and destruction of health records.

• A copy of at least one of the independent practitioner’s policies outlining infection control practices.

• A copy or template of documents and/or tools used to assist the independent practitioner in the provision of nursing care, including but not limited to:

• a nursing care plan

• assessment/care flow record

• nurse’s notes


2012 CCP Audit Phase One

There were 793 active practising LPNs randomly selected to participate in the 2012 CCP audit. Out of the 793 selected, 6 changed their registration to associate, 34 resigned their active practising registration, 24 were cancelled on December 15, 2012 per regulation, and 6 met the criteria for exemption from participating in the 2012 audit, as determined by the Executive Director.

This left a total of 723 active- practising registrants, of whom 32 were independent practitioners, required to participate in Phase One of the 2012 audit. Phase 0ne of the audit occurred in January of 2013.

The 2012 CCP audit results were divided into three categories:

1. Successfully met CCP requirements. These registrants received a letter from the College Practice Consultant via regular mail indicating the successful completion of their audits.

2. Successfully met CCP requirements with recommendations. These registrants received a letter from the College Practice Consultant via regular mail, indicating the successful completion of their audit along with auditor recommendations for improvements. These recommendations were a way for auditors to communicate with the registrants and offer peer feedback to assist with ongoing success with the requirements of the CCP.

3. Have not met CCP requirements. These registrants received a letter from the College Practice Consultant via registered mail, indicating they did not meet CCP requirements. Along with the letter, these registrants received a photocopy of the audit discrepancy form outlining what follow-up information was required before they could be considered having met the requirements of the CCP. This correspondence also informed registrants of the timeframe in which to submit this follow-up information and reminded registrants the CCP was a mandatory component of ongoing licensure and required their participation.

2012 CCP Audit Phase One Results:

Number Required to Participate in Phase One 723

Number of Registrants Who Successfully Met CCP Requirements 484

Number of Registrants Who Did Not Meet CCP Requirements 239

2012 continuing competency program audit report continued...

CCP Audit Phase One

Total number audited in Phase One: 723

Successfully Met - 67%

Did Not Meet - 33%


2012 CCP Audit Phase Two Results:

Number Required to Participate in Phase Two 215



2012 CCP Audit Phase Two

Registrants who did not meet the requirements of the CCP during the first phase of the audit were provided a second opportunity to successfully complete the audit. The second audit phase was conducted in February 2013. During this phase, the auditors were again required to determine if registrants had met the requirements of the CCP, or if further follow-up was required.

There were a total of 239 registrants required to participate in the second audit phase. Twenty-four registrants who were required to participate in the second phase of the audit failed to meet the deadline for submission and as a result, their active practising registration was cancelled.

Of the remaining 215 registrants, 24 were independent practicing LPNs.

The 2012 CCP audit Phase Two results were divided into two categories:

1. Successfully met CCP requirements. These registrants received a letter from the College Practice Consultant via regular mail indicating the successful completion of their audits.

2. Have not met CCP requirements. These registrants received a letter from the Executive Director via registered mail, indicating they did not meet CCP requirements. This correspondence also informed registrants of the timeframe in which to attend mandatory, free of charge CCP education delivered by the College. This correspondence also reminded registrants that CCP was a mandatory component of ongoing licensure, and as such required their participation.

Audited LPNs who continued to comply with the requirements of the CCP continued with conditional registration status. Per 7(3) of the Act, information regarding conditions, suspensions and cancellations of registration is accessible to any person, and per 4(2) of the Act, the College must carry out its duties in a manner that serves and protects the public. As a result, any registrant who has not met the requirements for the CCP is in jeopardy of having his or her registration cancelled and it is therefore the obligation of the College to ensure the registrant’s employer(s) are informed. Because of this, registrants were required to forward employer confirmation form(s) to their current employer(s) for the employer(s) to complete and return to the College.


CCP Audit Phase Two

Total number audited in Phase Two: 215


Did Not Meet - 16%


2012 CCP Audit Phase Three Results:

Number Required to Participate in Phase Three 35



2012 CCP Audit Phase Three

Registrants who did not meet the requirements of the CCP during the second phase of the audit were required to attend, within a specific timeframe, a CCP education session delivered by the College. This education was delivered by a College Practice Consultant at the College office, and via webinar/teleconference for registrants who were unable to attend in person. After registrants attended the education session, they were given a copy of their Phase Two audit discrepancy form, which outlined what follow-up information was required by the auditors. The follow-up information was to be submitted to the College within a specific timeframe in order for the auditors to conduct the third and final phase of the CCP audit in April 2013.

There were a total of 38 registrants required to participate in the third and final CCP audit phase. Four additional registrants were added to this list after completing reinstatement of registration, as their registration had been cancelled either during Phase One or Phase Two of the audit. Two registrants resigned their active practising registration, and one registrant met the criteria for exemption from the audit, as determined by the Executive Director. Therefore, 35 registrants were audited during this final phase; three of whom were independent practising LPNs.

CCP Audit Phase Three



Did Not Meet - 0%

Total number audited in Phase Three: 35


Conclusion

The expectation for all active practising LPNs in Manitoba is that they meet all requirements of registration in accordance with legislation, which includes meeting the requirements of the College’s CCP. The audit conducted to review the 2012 CCP year has informed the College, the public, and registrants that CCP practice is being followed in a reasonable, quality manner, and the outcomes of each registrant’s CCP do support and improve practice.

During the audit cycle, the College received valuable feedback from registrants regarding audit processes. This feedback was presented to the CCP committee for consideration and as a result, in 2013 the College will focus on increased communication and education regarding the link between registration and the CCP audit, audit dates and schedules as well as the responsibilities of the LPN undergoing an audit. Fact sheets for LPNs and employers have been updated and will be sent out to all LPNs and employers. Free CCP education sessions will remain available throughout the year. Also new for 2013, the College will increase communications with audited registrants by utilizing email along with Canada Post. This allows registrants to receive vital, time-sensitive information in more than one manner. To allow registrants more time to respond to CCP auditor recommendations, timelines between notification and submission deadlines will be increased for 2013. And, in order to keep the audit sustainable, the Board has directed that the annual audit will be made up of 10% of randomly selected LPNs each year. The four-year audit cycle will continue.

Lifelong learning is essential to a nurse’s continuing competence. The College is confident that with each year, successful participation in the CCP will continue to improve. Through cognizant and consistent self-reflection of nursing practice and a continued commitment to increase one’s knowledge, undoubtedly the LPNs of Manitoba will continue to be recognized as strong and competent members of the health care team. The CCP and its audit is an opportunity to reflect on practice, review accomplishments, and plan learning goals for the future. LPNs serve the public, and the public deserves safe, competent, and ethical nursing care.


CCP auditors are active practising LPNs. All auditors are compensated for their time spent auditing CCP materials. The College is asking our registrants for assistance in the auditing process. If you would like to become more involved with the College, why not start by participating as a CCP auditor?

If you are interested in serving as a CCP auditor, please submit your name and resume by mail to the College of Licensed Practical Nurses of Manitoba at 463 St. Anne’s Road Winnipeg, MB R2M 3C9 or by email to [email protected].

For further information, please contact the College at (204) 663-1212.

Wanted: 2014 ccp auditors

Annually, the College of

Licensed Practical Nurses

of Manitoba (the College)

facilitates the Continuing

Competency Program (CCP)

audit. The audit takes place

in three phases. Phase one

begins in January with

subsequent phases occurring

in February and April.



Purpose

The purpose of the Continuing Competency Program (CCP) audit is to allow the College of Licensed Practical Nurses of Manitoba (CLPNM) to ensure the continual, lifelong learning of practising licensed practical nurse (LPNs) in Manitoba.

The purpose of this article is to provide employers and registrants with important dates and considerations regarding the CCP audit.

Important dates

August 15 Annual registration renewal opens each year at the CLPNM.

November 30 Active-practising registration expires each year.

Mid-February Notification of Audit Phase One results are sent out.

Early March Notification of Audit Phase Two results are sent out.

Early May Notification of Audit Phase Three results are sent out.

Registration Renewal

The CCP is a requirement outlined in The Licensed Practical Nurses Act, Part 5, Section 15. As a result, registrants selected to participate in the annual CCP audit are required to submit their CCP materials to the CLPNM within the registration renewal deadline. Failure to do so shall result in the individuals’ inability to renew their active practising registration.

Registrants selected for the CCP audit, who have met all other requirements for registration renewal, shall be subject to a conditional license. The audited individual’s ability to practice fully as a LPN will not be hampered by the condition. Upon successful completion of the CCP audit, the condition may be removed.

About the CCP audit

The annual CCP audit process is conducted through three (3) phases. After each audit phase, the CLPNM contacts audited registrants to inform them of the audit outcome.

Audit One

The first phase of the CCP audit takes place in January, and registrants are notified of the results in mid-February.

Audit Two

The second phase of the CCP audit takes place at the end of February, and registrants are notified of the results in early March.

Audit Three

The third and final phase of the CCP audit takes place at the end of April, and registrants are notified of the results in early May.

After each audit phase, results are sent to registrants via email, and by regular or registered mail. If a registrant has not met the requirements of the CCP at any point during the audit phases, there are time-sensitive, follow-up requirements imposed on the registrant and there is a requirement for the registrant to forward an employer(s) verification form to his or her current employer(s). The employer(s) is required to complete this form and forward it to the CLPNM. Employer

ccp audit QuicK facts

confirmation forms are not accepted if submitted by the registrant.

If a registrant has not met the CCP requirements during any phase of the audit, and fails to comply with directions provided by the CCP auditors and/or the Executive Director within the deadline imposed, the registrant’s active practising registration may be cancelled. This means the registration will no longer be valid, and the registrant will not be authorized to practice as an LPN in Manitoba.

It is the responsibility of registrants to ensure their registrations are active and in good standing in order to practice as LPNs. Therefore, if a registrant has not received notification from the CLPNM with regard to the results of the CCP audit, and/or if the registrant is expected to be away from his or her place of residence (mailing address) for an extended period at any time during the audit phases, the registrant is responsible to contact the CLPNM for verification of the audit results.

Once a registrant has successfully completed the CCP requirements during any point of the audit phases, the CLPNM notifies the registrant and the employer(s) as listed on the registrant’s file at the CLPNM that the LPN’s registration status is no longer conditional and the registrant has now met all of the CCP requirements.

For further information regarding registration renewal and the CCP, visit the CLPNM website at www.clpnm.ca or contact the CLPNM office at (204) 663-1212 or 1-877-633-1212.

www.clpnm.ca


In 1994 the United Nations General Assembly decided that the International Day of the World’s Indigenous People (IDWIP) shall be observed annually on August 9th during the International Decade of the World’s Indigenous People. The goal of the First International Decade was to strengthen international cooperation for solving problems faced by indigenous people in such areas as human rights, the environment, development, education and health. The Second International Decade of the World’s Indigenous People, begun in 2005, is to further strengthen international cooperation for solving problems faced by indigenous peoples in areas that include culture, education, health, human rights, the environment, and social and economic development. Each annual observance of the IDWIP also recognizes the achievements and contributions that indigenous people make to improve world issues such as environmental protection.

international day of the World’s indigenous people

According to Marv Bernstein at UNICEF Canada, the proclamation of IDWIP sends a clear message that indigenous peoples’ human rights must be recognized and respected. This day every year provides an opportunity to raise awareness of indigenous peoples’ cultures and the great diversity that they represent. It is also an occasion to reflect on the importance of respecting and promoting the rights of indigenous children and young persons across Canada.

In Canada, the proposed Nunavut Representative for Children and Youth Act will ensure that the rights and interests of children and youth are recognized and protected, and that their views are heard and considered in government. The newly proposed Act recognizes that Inuit societal values will inform a holistic understanding of the best interests of children and youth within healthy families and build on the strengths of Inuit families and communities.

The framework of the proposed legislation reflects a level of comprehensiveness, internal cohesion, and rights-based integrity that will benefit the children and youth of Nunavut in a sustainable manner. In many respects, it could serve as a model for other jurisdictions in Canada and worldwide. A generation of children has grown to adulthood since the first IDWIP, nineteen years ago. On the IDWIP this year, we have reason to believe that the next generation of children in Nunavut will be supported in their rights, their culture, and their well-being.

For more information on the Nunavut Child and Youth Representative Act, go to: www.eia.gov.nu.ca/PDF/NuCYR%20Act.pdf

(Source: World Health Organization, 2013, and UNICEF Canada, 2013)

http://www.un.org/en/events/indigenousday/second.shtml

http://www.un.org/en/events/indigenousday/second.shtml

http://www.eia.gov.nu.ca/PDF/NuCYR%20Act.pdf

http://www.eia.gov.nu.ca/PDF/NuCYR%20Act.pdf


It is time once again for registration renewal with the College of Licensed Practical Nurses of Manitoba (the College). The 2014 online renewal season opens August 15, 2013, and the administrative deadline for registration renewal is October 15, 2013. To avoid a late fee of $100 plus GST, an accurate and complete registration renewal application must be received by the College by October 15, 2013. Late fees are in addition to the registration renewal fee and are not part of Preauthorized Payment Plan (PPP) withdrawals. Renewal applications cannot be processed until all fees are paid.

2014 registration reneWal

A completed registration renewal application includes:

• An accurate and completed renewal application via the College’s online registration system.

• A declaration of participation in the CCP.

• CCP materials (if selected to participate in the CCP audit).

• Submission of verification of hours if requested by the College at the time of renewal.

• Full payment of all applicable fees.

• Full payment of any outstanding amounts owed to the College.

It is important to note that all current active practising registrations expire on November 30, 2013.

Registrants who have not completed the renewal process in its entirety by November 30, 2013, as per LPN Regulation 22(1), are considered to be in default and must pay the administrative late fee as well as the default reactivation fee. While in default, registration will no longer be valid, nor will practising as an LPN be authorized. Individuals who practice

without current registration will be subject to a $500 plus GST unauthorized practice penalty fee. The privilege of using the title Licensed Practical Nurse is sanctioned and as such, only those who hold current active practising registration are permitted to use it or work in that capacity.

After December 15, 2013, registrants who have not completed the renewal process in its entirety are automatically cancelled. If a registrant wishes to regain active practising status, application must be made directly to the College for assessment of reinstatement. A reinstatement fee of $150 plus GST, the default reactivation fee and the administrative late fee will be added to the registration renewal fee.

Payment Options

Acceptable methods of payment are Visa, MasterCard, money order or debit (in person at the College office).

Registration renewal applications will not be approved until the required funds have been received by the College. Any dishonored payments will be subject to an administrative fee.

If you are enrolled in the PPP, are in good standing and renew your registration online before October 15, 2013, further payment will not be required.

How to Access the Online Registration Renewal System

• To begin, go to the College website at www.clpnm.ca. The College will have a step-by-step guide available at the time of online renewal under “Quick Links” on the homepage.

• Your username is your registration number. Your password remains the same unless you have changed it.

• If you have been selected for the CCP audit, you will be notified when you sign in to the online registration renewal system.

Renew Early

All renewal applications must be assessed and processed by the College. Early renewal will allow the College time to contact you should there be an issue with your application.

Calculate Nursing Practice Hours

Ensure you have projected your practice hours for the period from December 1, 2012 to November 30, 2013.

to avoid a late fee of $100 plus gst, an

accurate and complete registration renewal application must be

received by the college by october 15, 2013.

http://www.clpnm.ca


CCP & CCP Audit

All registrants applying to renew their registration must comply with the CCP requirements. Information regarding the CCP is available on the College website.

If selected for the CCP audit, you must ensure all CCP documents required for the audit are received in the College office by October 15, 2013. Your registration renewal will not be processed until these documents are submitted.

Associate Registration

Registrants who are not actively practising and/or do not plan to actively practice in the immediate future may opt to seek associate registration. This can be done through the online registration system. Those currently holding associate status, but who decide to actively practice as an LPN during the registration year must first apply to reinstate their registration. Please contact the College to begin the process.

Verification of Registration Renewal

Registrants can verify their registration status by viewing the Public Register on the College website. Employers can verify registrant status by accessing the College’s Employer Verification System.

Receipt Information

Once the College has approved your registration renewal application, an email will be sent to you with instructions on how to retrieve your receipt online.

*All fees are subject to GST

early bird draW! Win 1 of 2 ipads!

you will be automatically entered to win 1 of 2 ipads when you

renew your registration online on or before september 30, 2013.

Winners will be notified by october 31, 2013.

Pay your 2015 fees in advance through the College of Licensed Practical Nurses of Manitoba’s (the College) Preauthorized Payment Plan (PPP). This option is available to active practising registrants who wish to pay for upcoming registration fees through automatic bank debit.

Automatic withdrawals for 2015 fees will be 10 equal payments of $38.85 based on the current annual fee. The payments will begin November 15, 2013 and are withdrawn monthly up to and including August 15, 2014.

If you are already enrolled in the plan and wish to continue, there is nothing you need to do.

If you wish to join, a PPP application

2015 preauthorized payment plan

must be completed and submitted to the College office in person, by mail to 463 St. Anne’s Rd, Winnipeg, MB R2M 3C9 or by fax (204) 663-1207. The completed application may also be emailed to [email protected].

Application forms are available under Quick Links on the College website home page at www.clpnm.ca.

If you have any questions regarding the PPP, please contact Barbara Palz, Business Manager at [email protected] or (204) 663-1212.


http://www.clpnm.ca


Amount GST Total

Active Registration Fee (Renewal - by Oct 15) $370.00 $18.50 $388.50

Oct 16 - Nov 30 (add late-filing administration fee $100.00) $470.00 $23.50 $493.50

Dec 1 - Dec 15 (add default reactivation fee $125.00) $595.00 $29.75 $624.75

After December 15 Cancelled (add reinstatement fee $150.00) $745.00 $37.25 $782.25

Application for Enrollment, Active Practising Registration $470.00 $23.50 $493.50

Includes Practising Fee of $370.00 and Initial Enrollment of $100.00

Graduate Registration Fee $100.00 $5.00 $105.00 Student Registration Fee $50.00 $2.50 $52.50 Student Renewal Fee (2nd year) $50.00 $2.50 $52.50

Late-Filing Administrative Fee - Grad and Student $50.00 $2.50 $52.50

Exam Fee (CPNRE) $400.00 $20.00 $420.00

Late-Filing Administrative Fee - Exam $50.00 $2.50 $52.50

DNW - Did Not Write $75.00 $3.75 $78.75 Re-scoring Exam Fee $75.00 $3.75 $78.75

Working Without a Current Registration $500.00 $25.00 $525.00

Associate Non-Practising $100.00 $5.00 $105.00

Temporary Registration $50.00 $2.50 $52.50

Non-Negotiable Transaction Fee $50.00 $0.00 $50.00

Credential Assessment $420.00 $21.00 $441.00

Re-assessment $150.00 $7.50 $157.50

Endorsements $300.00 $15.00 $315.00

Educational Session (required by order of Investigation/Discipline) $300.00 $15.00 $315.00

Administrative Fees

General Administration Fee $75.00 $3.75 $78.75

Verifications $75.00 $3.75 $78.75

Appeal of Registration Decision $200.00 $10.00 $210.00

Payment options: Visa, MasterCard, Debit, Money OrderPre-authorized Payment Plan (PPP) 10 payments of $38.85 on the 15th of each month from Nov/13 - Aug/14


2014 fee schedule


Jocelyn house hospice

When you step into Jocelyn House Hospice, nestled within the trees and the solitude of the riverbed, you’re greeted by smiling faces and the smell of a home-cooked meal. On May 9, 2013 the College of Licensed Practical Nurses of Manitoba (the College) visited Jocelyn House Hospice during National Nursing Week and was greeted in just that way. Although a palliative hospice, the atmosphere was anything but somber. From the beautiful foliage that surrounds the house to the lazy Seine River meandering past, Jocelyn House Hospice exudes warmth and feelings of peace and tranquility.

Jocelyn Hutton, who passed away in 1985, is the inspiration behind the hospice. Jocelyn’s desire was to live each day fully and to die supported by family, friends and her community. After her death, Jocelyn’s parents, Bill and Miriam Hutton founded Jocelyn House Hospice with the intent that their family home be used as a hospice. The hospice has four private bedrooms, each with a ceiling lift, a bed, a dresser and a television. The residents are encouraged to bring in their own items to make the room as personalized as they wish during their stay.

A resident of the hospice has described the experience by saying that the nursing staff is wonderful and becomes an extended family. “You can tell that they really care about you and that they want to make you feel comfortable.”

Another resident expressed, “There are volunteers to fix things for us, to clean things for us, to talk to us, to cook for us, musicians who play music for us and the

list goes on. I am overwhelmed by these people who only want to give something back. We have volunteer chefs who come to serve meals they have planned for days before. These volunteer cooks are people like you and me who just love preparing good food and sharing good times. All these volunteers help to create the wonderful atmosphere in Jocelyn House, which you can feel as soon as you walk in.”

Staff at the hospice includes licensed practical nurses (LPNs), health care aides (HCA), a registered nurse (RN) who is the Charge Nurse weekdays until noon, a Volunteer/Spiritual Care Coordinator and physicians who visit weekly. Nurses with the WRHA’s Palliative Care Program are also a resource available to the staff at the hospice. Recently, the hospice hired nine LPNs to meet the changing needs of the clients. Six of these are permanent positions while three are casual.

Mariane Riding, who has been an LPN for 25 years, began working at the hospice

in April, 2013. She spent 15 years working in long-term care and the last 10 years in the community. “I have had experience with palliative care through previous employment in long-term facilities but what attracted me to Jocelyn House was the environment,” Riding says. “Most people I have had as patients during end-of-life care would prefer not to be in a hospital or nursing home. They would like to spend their last days at home. Jocelyn House offers a feeling of being at home; it is a quiet, peaceful and welcoming place.” She adds, “Jocelyn House allows nurses to provide holistic care in a unique way.”

At Jocelyn House, residents enjoy the freedom to make their own decisions; a dignified gift for people on precious time. “We try our best to accommodate any request,” says an HCA at the hospice. “You want ice cream for dinner? Let’s do it.” Together, staff, volunteers, families and residents at Jocelyn House Hospice create and foster an environment of trust, respect, support and acceptance. (This article was developed in conjunction with Jocelyn House Publication, 2013).

For more information on Jocelyn House Hospice go to www.jocelynhouse.ca

http://www.jocelynhouse.ca


Hearing Melanie Mason talk of her work within the Island Lake Regional Renal Health Program, you come to understand her deep roots within the community. Originally from St. Theresa Point, Manitoba, Melanie found herself aspiring to become a nurse by the time she finished high school in 2001. Unable to accomplish her goal at that time, a few years later Melanie enrolled in a computer business course in St. Theresa Point. While there, Melanie heard about Assiniboine Community College’s (ACC) Practical Nursing (PN) program coming to St. Theresa Point in 2007. A young wife and mom to a four-year-old son, Melanie was eager to become a licensed practical nurse (LPN) and entered into ACC’s PN program in 2008.

meet melanie mason lpn and deanna miller lpn

Towards the end of Melanie’s PN education, she learned her family would soon expand; shortly after Melanie graduated from ACC’s PN program, she and her husband welcomed their second son in 2009. In 2010, Melanie and her young family decided to move to Winnipeg, and she took an LPN position at Deer Lodge Centre for about one year. During that time, Melanie found herself missing her extended family and the community she knew to be home.

In 2011, Melanie, her husband, and their young boys moved back to St. Theresa Point where she took an LPN position as a renal nurse assistant within the Island Lake Regional Renal Health Program in Garden Hill, Manitoba. In June of 2012, when the time was right for Melanie and her young family, she decided to take advantage of the opportunity provided to her and returned to Winnipeg to take the Manitoba Nephrology Nursing Course (MNNC). After successfully completing the nine-week course, Melanie returned

home and accepted a full-time renal nurse position with the Island Lake Regional Renal Health Program.

Deanna Miller, originally from Three Hills, Alberta, knew she wanted to become a nurse since high school. In 2008, Deanna graduated from the Bow Valley College PN program delivered through the Prairie Bible Institute in Three Hills. Soon after becoming an LPN, Deanna began working in long-term care and acute care while also working as an educator; teaching both in the health care aide and PN programs in clinical and labs settings until 2011.

It was at that time in 2011 that Deanna and her husband Alex, who is also a LPN, decided to move to Manitoba where they both took the MNNC. They then headed north to settle into the community of Garden Hill, Manitoba. They both took full-time positions with the Island Lake Regional Renal Health Program.

In the summer of 2012, Deanna accepted the position of Clinical Resource Nurse (CRN) with the Island Lake Regional Renal Health Program. In addition to working full time in this role, Deanna is also currently enrolled in the Health Administrator degree program through Athabasca University in Alberta. Deanna states that this educational program is assisting her to enhance her leadership role within her CRN position and she expects to complete the program by the fall of 2014.

In November of 2012, Deanna and Alex welcomed their first child. Deanna took five months of maternity leave with their son, returning back to her full-time CRN position in April 2013. Deanna, Alex and their infant son reside Deanna Miller LPN and her husband Alex Miller LPN

with June Gray LPN at the Canadian Association of Nephrology Nurses and Technologists conference


in the nursing residence in Garden Hill. Deanna admits she felt uncertain when they first decided to relocate to Garden Hill and that having no family within the community is difficult at times, but she states the community has been a welcoming one. Deanna remarks that some of the community members, whom she has come to respect and admire, have affectionately stated they would gladly teach her son the Oji-Cree language and culture.

The Island Lake Regional Renal Health Program serves a cluster of four remote First Nations communities with a combined population of less than 6,000 in northeastern Manitoba. The unit, located in Garden Hill First Nation, is located 610 kilometers northeast of Winnipeg and 350 air kilometers southeast of Thompson. The communities – Garden Hill, Red Sucker Lake, St. Theresa Point, and Wasagamack – are accessible only by air or winter road. The much-needed and provincially funded renal health program opened in August of 2004 and is managed by the University of Manitoba’s Northern Medical Unit. The unit provides for six dialysis treatment stations and is funded for a total of 16 hemodialysis patients and 6.5 dialysis nurses, with a nurse to patient ratio of 1:3. The dialysis patients each receive treatment three times per week. The unit schedules their treatments in three sets, six patients in the mornings, four patients in the afternoons on Monday, Wednesday and Friday, and six patients on Tuesday, Thursday and Saturday of each week.

The renal health program provides a model of care aimed at reducing the number of cases of diabetes and its devastating effects on entire communities through its outreach component. In addition to the dialysis unit, this program

offers the utilization of a telehealth room, and staff and renal health education and prevention outreach offices. The establishment of this program means that hemodialysis patients are able to return to their home communities after being forced to relocate to Winnipeg; in some cases, after being separated from family and friends for as long as a decade. Uprooting patients and their families from their cultural homes and social networks so they can access treatment has serious health and social consequences; to have access to care at the Island Lake Regional Renal Health Program within reach of family and community is vastly important.

In order to travel between the communities of St. Theresa Point, Red Sucker Lake and Wasagamack, depending on the season, staff and patients must travel by boat, helicopter, or by ground on a winter road in order to reach the health unit in Garden Hill. For Melanie, this proves to be quite challenging with a husband who is also employed full-time as a teacher’s assistant while raising two young boys. During times of poor weather, Melanie stays at the nurse’s residence close by the Garden Hill Renal Health Unit and is thankful for the support of family members in the area for their help in caring for her boys.

Melanie Mason LPN and Deanna Miller LPN


All supplies required to run the renal program in Island Lake are ordered once a year and can only be delivered when the ice road is passable; usually in February. All supplies utilized, including all of the hazardous waste from the program, must be carefully stored until it can be shipped out via the ice roads.

As one can imagine, the unpredictable and extreme weather conditions of the area are challenging for members of these communities, especially for patients who rely on regular dialysis treatments to stay alive. Nonetheless, this is home. The establishment of a renal dialysis unit has made a substantial improvement in the quality of life for these patients, who are united with their friends, support networks and the culture of their communities. As the renal program proceeds with the continued education and prevention work with these communities, there is hope that future generations will enjoy better health.

Melanie and Deanna are two of only three full-time nurses currently employed there. At the time of publication, the unit was experiencing a staff shortage as there were no health care aides or registered nurses (RNs) currently employed in the program; however, in August of 2013, two additional LPNs (another husband and wife team, relocating from Alberta) will be joining the renal health program as well. An RN is set to start in November 2013. The program is managed out of the University of Manitoba and the nursing staff reports daily to another CRN in the Health Science Centre’s renal program. This CRN and the program manager are available as resources to contact if needed; in addition, the unit relies on agencies for casual relief when available. The renal health unit is attached to the local nursing station, which houses a physician from Monday through Thursday, as well as additional nursing staff who provide additional resources for the dialysis team.

There are many other tasks above and beyond the nursing care Deanna, Melanie and the other staff provide. These include making arrangements for transportation for their patients, dealing with residence housing, communicating with various nursing stations regarding patients’ appointments in Winnipeg, which includes making transportation and dialysis-treatment arrangements while there, covering for maintenance and housekeeping on occasion, and transporting of blood work – just to name a few. The unit also provides onsite blood analyzing through the utilization of an i-STAT® System to check patients’ potassium levels, which supports the decision-making process at the point of care. In addition, they are able to spin and separate other blood samples pulled before sending them on to St. Boniface General Hospital in Winnipeg.

Deanna describes care delivery within the unit as holistic, “Patients come with multiple health issues such as diabetes and other chronic renal diseases that often accompany impaired skin integrity – often with complex wounds, cardiac issues, nutritional implications, and amputations just to name a few.”

meet melanie mason lpn and deanna miller lpn continued...

Listening to Melanie and Deanna speak of their patients, their co-workers, the community, and its culture, you understand the respect and admiration they have for those around them and for the area in which they live. They understand the value they, as licensed practical nurses, bring to the health care team and to the communities they serve.

References:

(n.d.). Northern Health Programs. Umanitoba.ca. Retrieved June 24, 2013 from, http://umanitoba.ca/faculties/medicine/units/northern_medical_unit/programs/ilrrh.shtml

November 11, 2012. Garden Hill Renal Health Unit. Patientcommando.com. Retrieved June 24, 2013 from, http://patientcommando.com/stories/garden-hill-renal-health-unit/

Abbott Point, O. C. I. (2008-2013). The i-Stat® System: Advanced handheld and test cartridge blood analysis system that delivers lab-quality results. Retrieved from http://www.abbottpointofcare.com/Products-and-Services.aspx

Garden Hill Renal Health Unit. Photo by David Campion

Umanitoba.ca

http://umanitoba.ca/faculties/medicine/units/northern_medical_unit/programs/ilrrh.shtml



http://patientcommando.com/stories/garden-hill-renal-health-unit/

http://patientcommando.com/stories/garden-hill-renal-health-unit/

http://www.abbottpointofcare.com/Products-and-Services.aspx

http://www.abbottpointofcare.com/Products-and-Services.aspx


Helping Communities and Organizations with Issues of Crisis and Trauma

2013-2014 FALL AND WINTER WORKSHOPS COMING TO MANITOBA

TO REGISTER OR FOR MORE INFORMATION:

www.ctrinstitute.com 204.452.9199 [email protected]

GENDER AND SEXUAL IDENTITY IN YOUTH Winnipeg: October 16, 2013

MINDFULNESS COUNSELLING STRATEGIES - Activating Compassion and RegulationWinnipeg: October 17-18, 2013

DE-ESCALATING POTENTIALLY VIOLENT SITUATIONS™ Winnipeg: October 31, 2013

ANXIETY - Practical Intervention Strategies Winnipeg: November 6, 2013; Brandon: November 13, 2013

TRAUMA - Strategies for Resolving the Impact of Post Traumatic StressWinnipeg: November 7-8, 2013

STALKING - Assessment and ManagementWinnipeg: November 20, 2013

MOTIVATING CHANGE - Strategies for Approaching ResistanceWinnipeg: December 5-6, 2013UNDERSTANDING MENTAL ILLNESSWinnipeg: December 16, 2013

DSM 5-What’s New...What’s DifferentWinnipeg: December 17, 2013 (9 am to 12 pm)

SUICIDE PREVENTION, INTERVENTION AND POSTVENTION STRATEGIESWinnipeg: January 30-31, 2014

Please visit our website for details about more workshops coming to Manitoba in Winter/Spring 2014.

WEBINARSNo matter where you live, you can easily access some of CTRI’s workshops right from your desk. Our one-hour webinars offer you the opportunity to hear, view and engage with our trainers.

Visit our website for details.

Promoting Leadership and Organizational Performance

To register or for more informationplease contact us at:

www.achievecentre.com 204.452.0180 [email protected]

ASSERTIVE COMMUNICATION Winnipeg: October 24, 2013

LEADERSHIP AND MANAGEMENT - The Essential FoundationsWinnipeg: October 29, 2013

INNOVATION - A Workplace EssentialWinnipeg: October 30, 2013 (9 am - 12 pm)

PERSONALITY DIFFERENCES - Myers Briggs for Conflict PreventionWinnipeg: November 13, 2013

DEALING WITH DIFFICULT PEOPLEWinnipeg: November 14, 2013

COACHING STRATEGIES FOR LEADERS- Conflict, Performance, ChangeWinnipeg: November 28, 2013

CONFLICT RESOLUTION SKILLSWinnipeg: December 9, 2013

MEDIATION - An Informal Process for Conflict ResolutionWinnipeg: December 10-11, 2013

INTERGENERATIONAL COMMUNICATION IN THE WORKPLACEWinnipeg: December 18 (9 am - 12 pm)

RESPECTFUL WORKPLACE - Strategies for a Healthy EnvironmentWinnipeg: February 5, 2014

LEADING IN A UNIONIZED ENVIRONMENTWinnipeg: February 20, 2014

EMOTIONAL INTELLIGENCE - Value in the WorkplaceWinnipeg: March 5, 2014

STRESS MANAGEMENT - Increasing Workplace ProductivityWinnipeg: March 19, 2014

MANAGING PERSONALITIES - Myers Briggs for LeadersWinnipeg: March 20, 2014

2013-2014 FALL/WINTER WORKSHOPS COMING TO MANITOBA

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WEBINARSNo matter where you live, you can easily access some of ACHIEVE’s workshops right from your desk. Our one-hour webinars offer you the opportunity to hear, view and engage with our trainers.

Please visit our website for details.

Please visit our website for information on

Spring 2014 workshops coming to Manitoba


live the life you always wanteddiscover nursing opportunities right here in manitoba

For more information, please visit our website at www.manitoba.ca/health/nurses In Winnipeg: 204-788-6668 Toll Free in Canada: 1-877-681-4983 Email us at: [email protected]

Live the life you always wanted, at home, in Manitoba.

You’ll earn a competitive salary and enjoy an incredibly affordable quality of life. Stay close to family and friends while enjoying friendly communities, a thriving arts and cultural scene plus access to beaches, lakes and parkland and enjoy a healthier balance between your work as a nurse and your personal life.

Make your plans now and you may qualify to receive:

•$4,000inconditionalgrantfundingfornewgraduateswhochoose to work in a rural area

•$2,000ingrantmoneyifyouchoosetoworkinapersonalcarehome

•$2,000ingrantmoneyifyouchoosetoworkinapositionwhere bilingualism/French language is a hiring requirement

•Continuingeducationfunding

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