Documentation Guidelines Documentation Guidelines by gjjur4356

VIEWS: 346 PAGES: 20


                                               I N   T H I S   I S S U E

                                          5    Connecting RNs with
                                          6    Impact of Continuing
                                               Competence on Practice
                                          7    2006 Registration Statistics
                                          10   Review of Consultations
                                          14   Discipline Decisions
                                          17   Notice Board

J A N U A RY 20 07 V O L U M E 63 N O 1

                                                                              Members Renew Online
Documentation                                                                 in Record Numbers

Guidelines                                                                    More than 50 per cent of CARNA
                                                                              members applied online for their
                                                                              2007 practice permit. The number
                                                                              of RNs increased from slightly more
PAGE 12                                                                       than 12,000 renewing online in the
                                                                              previous year to more than 15,000.
                                                                              This increase in online renewals
                                                                              translated into significant savings
                                                                              for printing and postage of renewal
                                                                              Online renewal is now available
                                                                              throughout the year for members
                                                                              returning to practice and is part
                                                                              of CARNA’s ongoing commitment
                                                                              to manage resources wisely and
                                                                              add value to member services.
                                                                              A summary of member registration
                                                                              data compiled by CARNA for the
                                                                              practice year ending Sept. 30, 2006
                                                                              is reported on page 7. The report
                                                                              includes highlights of voluntary
                                                                              responses to additional questions
                                                                              included in last year’s renewal
                                                                              form related to projected year
                                                                              of retirement and continuing
                                                                              competence activity.
CARNA Provincial Council
PRESIDENT                                   CENTRAL REGION                                 PUBLIC
Sheila A. McKay, RN, MN                     Evelyn Kraft, RN, RPN, BN                      R E P R E S E N T AT I V E S
Red Deer                                    Ferintosh                                      Maggie Fulford, BSc, DC
403.346.1994                                780.608.8601                                   Edmonton                                     780.412.8741
                                                                                                                          Next CARNA
                                            Joan Petruk, RN, MHS
P R E S I D E N T- E L E C T
Margaret Hadley, RN, MN                     Camrose
                                                                                           Margaret Hunziker, BA, MA
                                                                                                                          Provincial Council
780.466.6566                                               403.932.2069
                                                                                                                          Meeting                        CALGARY/WEST REGION
NORTHWEST REGION                            Shirley Chandler, RN, BTSN
                                                                                           Christopher Sheard, BA, LLB
                                                                                                                          March 1-2, 2007
Ellen Jones, RN                                                                            780.424.5560
Grimshaw                                    403.258.3237
                                         All CARNA members are welcome
780.332.4938                             Brenda Huff, RN, MN                            Mark Tims, QC                  to attend.
                                            Calgary                                        Westlock
Debra Ransom, RN, BN
                                            403.241.2226                                   780.349.5366
                                                                                                                          For more information contact:
Lac La Biche
                                            Maureen Jamison, RN, BScN                      Rene Weber, DVM
                                                                                           Red Deer
                                                                                                                          Wendy Buckley
780.623.2473                                                                               403.346.5956
                                                                                                                             453.0510 in Edmonton or
                                            SOUTH REGION
                                                                                                                             toll free 1.800.252.9392 ext. 510
Cheryl Deckert, RN, BN
                                            Heidi Watters, RN, BN, MEd, GNC(C)                                     
Debbie Elliott, RN, M.Ed.
Jane Walker, RN, BScN
                                                                                                                           Alberta RN is published
Edmonton                                                                                                                   nine times a year by:
780.438.1492                                                                                                           College and Association of
                                                                                                                           Registered Nurses of Alberta
                                                                                                                           11620-168 Street

CARNA Staff Directory                                                                                                      Edmonton, AB T5M 4A6
                                                                                                                           Phone: 780.451.0043
ALL STAFF CAN BE REACHED BY CALLING:                                                                                       Toll free in Canada: 1.800.252.9392
780.451.0043 or toll free 1.800.252.9392                                                                                   Fax: 780.452.3276
E-mail addresses are listed on our website at under Contact Us.                                 
Executive Director: Mary-Anne Robinson                                                                                     Managing Editor: Margaret Ward-Jack
Director of Communications: Margaret Ward-Jack                                                                             Editor: Rachel Champagne
Director of Corporate Services: Jeanette Machtemes                                                                         Assistant Editor: Carla Howatt
Director of Policy and Practice: Lynn Redfern                                                                              Designer: Julie Wons
Director of Regulatory Services: Kim Campbell
                                                                                                                           Advertising Representative:
Registrar: Rita Wright
                                                                                                                           Jan Henry, McCrone Publications
Assistant Registrar/Continuing Competence: Terry Gushuliak
                                                                                                                           Phone: 800.727.0782 Fax: 866.413.9328
Assistant Registrar/Registration: Shirley Meyer
Complaints Director: Sue Chandler
Conduct Counsel: Gwendolyn Parsons                                                                                         Please note CARNA does not endorse advertised services,
                                                                                                                           products or opinions.
Nursing Consultants – Policy and Practice: Debra Allen, Marie-Andrée Chassé,
     Donna Hogg, Debbie Phillipchuk                                                                                        US Postmaster: Alberta RN (USPS #009-624) is published
Librarian and Archivist: Lorraine Mychajlunow                                                                              monthly except June, August and December by the College and
                                                                                                                           Association of Registered Nurses of Alberta. c/o U.S. Agent:
NEPAB Consultant: Lori Kashuba
                                                                                                                           Transborder Mail, 4708 Caldwell Rd E, Edgewood, WA 98372-9221.
Alberta Registered Nurses Educational Trust: Margaret Nolan                                                                Alberta RN is published at a rate of $40 per year. Periodicals
Regional Coordinators:         Northwest:                 Kathleen Waterhouse       780.539.9470                           postage paid at Puyallup, WA and at additional mailing offices.
                                                                                                                           US Postmaster: Send address changes (covers only) to Alberta RN,
                               Northeast:                 Barb Diepold              780.826.5383                           c/o Transborder Mail, PO Box 6016, Federal Way, WA 98063-6016.
                               Edmonton/West:             Barbara Perry             780.461.8127
                                                                                                                           ISSN 1481-9988
                                                          Joan Rooke                780.416.4613
                                                                                                                           Canadian Publications Mail Agreement No. 40062713
                               Central:                   Heather Wasylenki         403.782.2024
                                                                                                                           Return Undeliverable Canadian Addresses to:
                               Calgary/West:              Christine Davies          403.932.7243                           Circulation Dept., 11620-168 Street, Edmonton, AB T5M 4A6.
                                                          Beverlie Johnson          403.625.3260                           E-mail:
                               South:                     Maralon Bevans            403.653.4032                           Alberta RN is printed on recycled paper.
                                                          Dalyce Burgess            403.504.5603

   2        Alberta RN January 2007 Volume 63 No 1            

President’s Update
Change and Renewal
                                       elcome to 2007! I am always     a tool you can use to ensure that you continue to grow as

                             W         exhilarated at the start of a
                                       new year. I enjoy the magic
                               and bustle of the holiday season –
                                                                       an RN. I hope that you view the program as an opportunity
                                                                       to enhance your nursing practice and your role.
                                                                           We know that the shortage of RNs, and other health
                               the visits with families and friends,   providers, is having a profound impact on work environments.
                               revisiting special memories and         CARNA’s Quality Practice Environment Consultation Program
                               making new ones – but I also prize      (formerly called the Practice Setting Consultation Program)
                               the feeling of renewed purpose that     and nursing practice consultants are resources to support
                               starts on New Year’s Day. My new        your practice. CARNA is working with government, nursing
year’s resolutions, like those of many people, are generally           faculties and employers to increase capacity to educate RNs,
forgotten by February. But there is a big difference between           to develop strategies to retain the current nursing workforce
making a casual new year’s resolution and making a genuine             and to create mechanisms to address the workplace issues
commitment to move forward towards goals that are challenging          that are leading to burn-out and early retirements.
and substantive.                                                           I truly believe in the ability of RNs, both individually
    There is new leadership in our province after 14 years, and        and collectively, to make a profound impact on the health
there will be new opportunities for registered nurses (RNs)            of Albertans. Research has confirmed what we already know –
                                 to influence health policy in the                                    the care provided by RNs makes
We need to continually           best interest of all Albertans.       … the care provided by         a difference to patient outcomes,
challenge ourselves to           As president of your regulatory       RNs makes a difference         to the health-care experience for
improve as RNs, to be            college and professional associa-     to patient outcomes, to the clients and their families, and to
                                 tion, I am committed to making                                       public satisfaction with the health-
more effective leaders                                                 health-care experience for
                                 sure that the voice of registered                                    care system.
and client advocates.            nursing is heard effectively at       clients and their families,        As we enter 2007, CARNA
                                 the decision-making table.            and to public satisfaction remains committed to ensuring
    The College and Association of Registered Nurses of                with the health-care system. that Albertans continue to receive
Alberta (CARNA) represents the collective power of RNs but                                            safe, competent and ethical nursing
I also believe in the power of individual leadership to effect         care. We are also committed to advocating for RNs as profes-
change. Our ability to be effective leaders is dependent on            sionals who make an essential contribution to the health system
our personal commitment to professional development.                   today and should play an integral role in shaping the system
We need to continually challenge ourselves to improve as RNs,          of the future. It is a privilege to be an RN and we should take
to be more effective leaders and client advocates. As former           pride in the contribution we make. I urge you to recognize
U.S. President John F. Kennedy said, leadership and learning           and acknowledge the excellent work your colleagues do each
are indispensable to each other. Lack of knowledge leads to            and every day. Supporting each other can help mitigate the
lack of confidence. It is easy to feel defeated in the face of the     stresses and pressures of the work environment.
complex if you are unsure of the first steps towards a solution.           On behalf of your provincial councillors and CARNA staff
We need to learn the skills required to be credible leaders at         members, I wish each of you the very best in the New Year. RN
the unit level, the facility level and the health system level.
    CARNA’s Continuing Competence Program is one tool                     S h e i l a A . M c K a y, RN, MN
that can help you acquire the skills you need. It is not only             E-mail:
a legislated requirement under the Health Professions Act but             Phone: 403.346.1994

                                CARNA will be reviewing its regulations with members and other
                                stakeholders as to possible changes to restricted activities authorizations.
                                If you have ideas or suggestions or want to be involved in the consultation,
       NOTICE                   please contact CARNA at 780.451.0043 or toll free 1.800.252.9392 and
                                ask to speak with one of the CARNA nursing policy and practice consultants
                                or e-mail

                                                                          January 2007 Volume 63 No 1 Alberta RN   3
Letters to the Editor
RNs and Patient Simulation                         reflect an increased number of complaints       Health First Strathcona
                                                   referred to hearings following investigation.
I read with interest the article on                                                                I enjoyed reading the article in the
                                                   In the year ending Sept. 30, 2006, CARNA
simulation featured in the September                                                               October 2006 issue on the integration
                                                   conducted 55 hearings compared to 27 in
2006 issue of Alberta RN. I must say we                                                            of nurse practitioners into the primary
                                                   2004-2005 and 29 in 2003-2004.
were a little disappointed that the work                                                           care team at Health First Strathcona.
                                                       CARNA began publishing discipline
we have been doing at Grant MacEwan                                                                This is a clear example of how health-
                                                   decisions in Alberta RN in 1996 and
in establishing a simulation centre                                                                care reform through scope of practice
                                                   non-publication of discipline decisions is
(first for a nursing program in Alberta)                                                           review can result in nursing best practice
                                                   now the exception rather than the rule.
and integrating simulation within our                                                              and improved client care. Capital Health
                                                   The courses in professional responsibilities
nursing curricula didn’t receive much                                                              needs to be congratulated on moving
                                                   or ethics which some members are ordered to
attention. MacEwan is the site of several                                                          ahead in February 2004 with this
                                                   complete are offered by Athabasca University
exciting developments worth noting.                                                                initiative. As we all know, this reform
                                                   and MacEwan.
We recently received approval to initiate                                                          was supported with the passing of the
a bachelor of science in nursing in                                                                Health Professions Act (HPA) in the fall
September 2007 and we are currently                Generation Gap                                  of 2005. Now that registered nurses in
in the midst of construction of the                I work in a busy oncology unit. In the          Alberta as well as other health profes-
new Robbins Health Learning Centre,                last few years, our unit has expanded           sionals are working under HPA, the
a 280,000 sq. ft. facility that is scheduled       and therefore the need for new staff is         stage is set for increasing dialogue with
to open in fall 2007.                              essential. Our quick growth has brought         the focus on improving client care.
    Sharon Bookhalter                              both experienced and new staff to our               No doubt news such as CARNA
    Dean, Faculty of Health and                    unit. I have found that the blend of            participating in the first tri-profession
    Community Studies                              new and senior staff works well in our          conference in 2007 only gives further
    MacEwan                                        area. The new staff bring with them             credence to the value of cross health
                                                   a youthful exuberance, willingness to           professional collaboration in health
Discipline Decisions                               learn, and a knowledge base geared              reform and improving client care. This
                                                   to new technology. The senior staff             also provides an excellent platform for
Each time my Alberta RN magazine
                                                   provide stability and experience for the        organizations of health professionals
comes, I read the discipline decisions
                                                   new staff to draw on and learn from.            to put forward a common front in
with more apprehension. Is it my
                                                   Our hospital is a teaching hospital,            negotiating with the Alberta govern-
imagination, or are these decisions
                                                   and therefore it is understood that it          ment. This is truly a time for innovative
becoming more frequent and are
                                                   is part of your job to teach as part of         change led by a nursing association
the incidents becoming worse? The
                                                   the hospital team.                              with a vision – nursing professional
incidents described in the September
                                                       In any work environment there may be        development and public interest.
2006 edition were appalling.
   Have events such as this been                   problems with personality conflicts, or             Chris Lemphers, BN, M.Ed.
happening for many years and were                  conflicts between independent learners              Edmonton
just not revealed? Are courses in nursing          and team players, causing problems
ethics not taught any more? Who is                 within a unit. These people can be
providing the ethics courses (Professional         assisted to change or encouraged to
Responsibilities courses) that some of             move to a more appropriate position
the offenders are ordered to complete?             or unit that would enrich their style
                                                                                                   Alberta RN welcomes your letters on
   Are these incidents related to                  of learning or teaching.
                                                       Remember that these new nurses              any nursing or health-care issues. Please
burnout in nurses? I hope there are
                                                   will be the ones with the experience            e-mail letters to
some answers.
                                                   when we are retired and requiring access        or fax to 780.452.3276. Please include
   Marvel Miller Evelyn, RN (Ret.) BN
                                                   to the health-care system. So let’s get         your name and city. Letters should be
                                                   together and educate each other!                a maximum of 250 words and may be
EDITOR’S NOTE: The number of discipline                Elaine Millard, RN                          edited for length and clarity.
decisions published in Alberta RN does                 Edmonton

4   Alberta RN January 2007 Volume 63 No 1
           RN to RN
New Column Launched to
Connect RNs Through Story-telling
Every RN has a story to tell. You’ve probably shared many of your favorite nursing stories over the years with
your nursing colleagues. Some are funny, some are sad and there are those stories that, for some reason,
leave a lasting impression on the way you see yourself as an RN or your profession.
    CARNA’s regional coordinators want you to share these         she said. “Stories are the key to creating communities.”
special stories with RNs across the province in a new column          A story has the power to reach each one of us, to touch our
called RN to RN. One story will appear each month in the          emotions and give us a sense of feeling connected to each other
Take Note newsletters distributed by regional coordinators        in its own special kind of way. It has the power to transport
every month to RNs in their respective CARNA regions. Each        us through time and provides access to all areas of nursing
one-page issue will feature a short story (about 200 words)       practice. A story can help describe who we are and define
provided by an RN in Alberta. January’s story is featured         our nursing practice.
below.                                                                RNs in Alberta work in a broad variety of practice environ-
    Regional coordinators were inspired to create the column      ments and stories are one way of sharing our nursing experience.
by keynote speaker Sister Elizabeth Davis who, at the 2006        Stories connect us to each other and link past, present, and
Canadian Nurses Association biennium, spoke eloquently            future by passing on accumulated wisdom to help us grow
about maintaining core values in times of uncertainty and         as individuals and as a profession. They give us the chance to
about leadership now and in the future. “…Leaders must find       show our understanding and support for each other, reflect
the essence (of nursing) and know how to relate that essence,’’   on our practice and describe the spirit and core of who we are.

An RN shares a memorable moment
from her long nursing career in Alberta
On the last night of my father’s life, he lay at home dying in his own bed. I sat by his bed holding his hand,
trying to make him comfortable, trying to make the last few hours of his year-long fight with cancer easier.
    I had time to reflect and realize that after all these years of nursing, it had come down to the true basics
and nursing care that had made him most happy and comfortable for those last few hours and months.
    That had to be what nursing was all about, and how I paid him back for my career in nursing and his
patience and support over all those years.

 If you have a story to share about a memorable or meaningful moment in your nursing practice or would like to
 receive a copy of Take Note, please contact your regional coordinator. Phone numbers for regional coordinators
 are listed on page 2 of Alberta RN.

                                                                    January 2007 Volume 63 No 1 Alberta RN   5
                                                  10,000 Members Report on Impact
                                                  of Continuing Competence Program
                                                  on Practice
By Oct. 1, 2006, more than 99 per cent            they did not. The Continuing Competence                         RNs/CGNs/NPs
                                                                                                                conditions imposed
of the CARNA members applying for a               Committee is looking forward to an analysis                           1%
2007 practice permit reported a CARNA             of member feedback which will help the
Nursing Practice Standard indicator as            Committee fulfill its mandate to provide
their professional development focus for          member support, guidance and teaching
the 2007 practice year. For the first time        to assist members with meeting program
in Alberta, all RNs were required to meet         requirements.
the requirements of the CARNA Continuing          Telehealth Sessions
Competence Program to qualify for a practice
                                                  Reach 3,500 RNs
permit to comply with the Registered Nurses
                                                  In March 2006, CARNA reached an agreement                       RNs/CGNs/NPs
Profession Regulation proclaimed on Nov.
                                                  with Capital Health to deliver education                          compliant
30, 2005 under the Health Professions Act.                                                                            99%
                                                  sessions to RNs in their workplaces via
                                                  the regional telehealth network. More than
For the 2006 practice year, member reporting
                                                  3,500 RNs attended one of the 596 continuing
was mandatory for nurse practitioners (NPs)
                                                  competence education sessions at 110 tele-           Rate of Continuing Competence
only and CARNA invited registered nurses
                                                  health sites throughout the province between         Compliance – 2007 Practice Year
(RNs) to become familiar with the program
                                                  March and September 2006.                                  (as of Dec. 8, 2006)
requirements by participating on a voluntary
                                                      The majority of respondents agreed or
basis. As a result, more than 80 per cent of
                                                  strongly agreed with the following evaluation     NP Audits in 2007
the 22,479 members reported one or more
indicators from the CARNA Nursing Practice                                                          In the 2006 practice year, all NPs were
                                                      telehealth is a satisfactory way to receive
Standards for which they would develop and                                                          required to meet the requirements of the
                                                      educational information from CARNA
implement a learning plan during the 2006                                                           CARNA Continuing Competence Program to
                                                      the presentation enlightened members          qualify for an NP permit. Of the 157 members
practice year. Of these voluntary participants,
                                                      about the CARNA Continuing Competence         listed on CARNA’s register of NPs at the end
more than 16,000 reported that they had
                                                      requirements                                  of 2005, 147 renewed their practice permits
implemented learning plans during the
2006 practice year. Of those, more than               examples used in the presentation helped      as NPs for 2006. During 2006, CARNA added
10,000 described the impact that this                 members understand the requirements           43 new members to the NP register and
had on their nursing practice. For example,       Members also reported that telehealth             all of them met the continuing competence
members wrote:                                    provided an opportunity for nurses across         requirements. For the 2007 practice year, all
    “This helped me to be more proactive          the province to connect on a topic of common      NPs renewing practice permits were required
    about providing a safer environment           interest; facilitated knowledge exchange and      to report on implementation of learning plans
    for patients/colleagues.”                     skill development related to this new regula-     related to their priority indicators throughout
    “I reassessed current drug protocol           tory requirement, provided more convenient        the 2006 practice year and 167 renewed
    at our clinic and was involved in             access to CARNA, provided timely access to        their permits as NPs.
    implementing new procedures.”                 educational sessions and offered significant          In November 2006, letters were sent
                                                  financial savings to members.                     to a random sample of 50 NPs selected for
    “I am able to counsel clients on tobacco          In October 2006, CARNA and Capital            completion of the continuing competence
    cessation more effectively.”                  Health co-delivered an oral presentation          questionnaire and document audit. Completed
    “I searched out evidence-based rationale      at the 9 th Annual Meeting of the Canadian        questionnaires are due January 2007. A
    and developed a new procedure.”               Society of Telehealth called Logistics of         similar process will be introduced for RNs
Members who did not implement learning            a Large Scale Telehealth Rollout. The joint       for the 2008 practice year. Your learning
plans were asked to identify why they did not.    education program is believed to be the           plan and evaluation documents must be
Members who did not meet their learning           largest telehealth program of its kind            kept in written form for five years to submit
goal(s) were also asked to identify why           undertaken in Western Canada.                     to CARNA if requested.

6    Alberta RN January 2007 Volume 63 No 1
 Alberta RN Statistics
 A summary of data reported by members for the 2006 registration year ending Sept. 30, 2006.

Initial 1 and Renewal of Registrations

                                                     2005                 2006                                           R9
Initial Registrations
 Alberta Graduates                                     903 * (63%)        1,282 * (66%)
 Other Canadian Registrants                            387       (27%)     521    (27%)
 Non-Canadian Registrants                                  141   (10%)     133 ** (7%)
Renewals                                           26,407                26,884
Number of Regulated RNs                            27,838                28,820
Initial Registration of Alberta Graduates
by Type of Education Program                                                                                                R6        R5
                                                     2005                 2006
Diploma                                                262 (29%)           248    (19%)                                      R4
Baccalaureate                                              641   (71%)    1,034   (81%)
Total Alberta Graduates                                903 *             1,282                                             R3           R2
Other Registration Services
                                                     2005                 2006
Canadian Applications Initiated***                         551             757
International Applications Initiated***                    378             498            Distribution of Regulated Registered Nurse Members
                                                                                          by Health Region
Verifications                                        1,750                1,671
Permits (Limited, Special, Temporary)                1,642                1,980                                                All Regulated RNs      NPs Only
Examination Applications                             1,207                1,401           R1 Chinook Regional Health Authority              1,385              3
                                                                                          R2 Palliser Health Region                           800              0
  * These numbers reflect a delay in obtaining the results of the CRNE exam
    administered in June 2005. As a result, CARNA was unable to finalize the              R3 Calgary Health Region                         10,354             55
    RN registrations of a substantial number of new graduates until October 2005
                                                                                          R4 David Thompson
    and these graduates are included in the 2006 figures.
 ** The decline in the number of Non-Canadian registrations reflects the implementation       Regional Health Authority                     2,452              4
    of substantially equivalent competence assessments which introduced changes to
    assessing eligibility for registration.                                               R5 East Central Health                                77             1
*** These numbers reflect incomplete applications submitted to CARNA and assessments      R6 Capital Health                                10,311             99
    pending receipt of additional documents.
                                                                                          R7 Aspen Regional Health Authority                  913              5
  1 Initial refers to first-time registrants in Alberta.
                                                                                          R8 Peace Country Health                             894              5
                                                                                          R9 Northern Lights Health Region                    432              9
                                                                                          Other Canadian                                      390              7
                                                                                          United States                                         55             1
                                                                                          Other                                                 60             1
                                                                                          TOTAL                                           28,820              190

                                                                                           January 2007 Volume 63 No 1 Alberta RN     7
Employment Status                                                                    Hours Worked per Week
of Regulated RNs                                                                     by Regulated RNs

    94.1%             93.6%        Employed in nursing Remainder are
                                                          employed in other
                                                          industries and seeking
                                                          employment in nursing,
    37.1%             37.3%        Employed full-time     employed in other and          45.4%       46.6%      30-40 hours per week
                                                          not seeking employ-
                                                          ment in nursing, not
                                                          employed and seeking
                                                          employment in nursing,
                                                          not employed and not
                                                          seeking employment
                                                          in nursing, did not
    42.1%             42.0%        Employed part-time     respond or are on leave.       33.5%       32.4%      16-29 hours per week

                                                                                         10.3%        9.9%      0-15 hours per week
    14.9%             14.3%                                                              8.0%         8.4%      Over 41 hours per week
                                   Employed casual                                       3.0%         2.8%      RNs did not respond

    2005            2006                                                                2005         2006
Top Three Places of Employment                                                       Top Three Position Types
for Regulated RNs                                                                    for Regulated RNs

    61.6%             61.5%        Hospital                                              78.2%       77.8%      Staff or community health nurses

     7.7%             7.3%
                                   Nursing home or in long-term care                     5.7%         6.0%      Other
     8.0%             7.3%         Community health agency                               4.7%         4.9%      Managers or assistant managers

    2005            2006                                                                2005         2006
Education of                                                                         Age of
Regulated RNs                                                                        Regulated RNs

    57.6%             55.5%        Nursing diploma

                                                                                         61.5%       60.9%      41 or older

    39.4%             41.4%        Baccalaureate degree                                  24.1%       23.7%      31 to 40

                                   Master’s                                              14.3%       15.4%      Under 30
     2.7%             2.7%         Doctorate = Less than 1.0%                                                   Unknown = Less than 0.1%

    2005            2006                                                                2005         2006

8   Alberta RN January 2007 Volume 63 No 1
Projected                                  Voluntary Reporting
RN Retirement                              of Continuing Competence
RNs 50 and older were asked to             For the 2006 practice year, CARNA invited registered nurses (RNs) to become
indicate their projected year of           familiar with the Continuing Competence Program requirements by participating
retirement on their 2006 registration      on a voluntary basis. As a result, more than 80 per cent of all members reported
renewal form. Of the 8,233 RNs who         one or more indicators from the CARNA Nursing Practice Standards on which
were 50 years or older, 57.5 per cent      they developed and implemented a learning plan during the 2006 practice year.
responded and provided their projected
year of retirement.
                                           NPS Indicators             Number of RNs/CGNs Selected

If you are more than 50 years of age,            1.1
what is your planned year of retirement?         1.2
Retirement         Total Responses               1.4
   2007                   578                    1.5
   2008                   581                    1.6
   2009                   363                    1.7
   2010                   928                    1.8
   2011                   308                    2.1
   2012                   396                    2.2
   2013                   243                    2.3
   2014                   202                    2.4
   2015                   489                    2.5
   2016                   123                    2.6
   2017                   146                    2.7
   2018                   131                    2.8
   2019                     79                   3.1
   2020                   125                    3.2
   2021                       6                  3.3
   2022                       5                  3.4
   2023                       1                  3.5
   2024                       2                  4.1
   2025                     16                   4.2
   2026                       4                  4.3
   2027                       0                  4.4
                                                                  0      1000       2000        3000        4000         5000        6000        7000
   2028                       2
   2029                       1
   2030                       5             Top 5 Nursing Practice Standard Indicators Selected by RNs and CGNs:
                        4,734               1.7: “I regularly assess my practice and take the necessary steps to improve personal competence.”

                                            2.2: “I use appropriate information and resources that enhance patient care and achievement of desired

                                                  patient outcomes.”

                                            1.5: “I participate in quality improvement activities.”

                                            4.2: “I use communication and team building skills to enhance client care.”

                                            1.4: “I follow current legislation, standards and policies relevant to my profession and my practice setting.”

                                                                             January 2007 Volume 63 No 1 Alberta RN           9
                                                                 Phoning-in of Prescriptions
                                                                 CARNA consultants received many requests for assistance to
                                                                 determine best practice regarding the phoning-in of prescrip-
                                                                 tions and refills on behalf of a prescriber. CARNA’s guidelines
                                                                 are clear on this subject:
                                                                    RNs are not authorized to phone in medication prescriptions
                                                                    to a pharmacy on behalf of physicians or other regulated health
                                                                    professionals who are authorized to prescribe medication.
                                                                   (Medication Administration: Guidelines for Registered Nurses,
                                                                   CARNA 2006, p.3)
                                                                 In response to the need for more information on this topic,
                                                                 CARNA published a summary article on the above document in
                                                                 the September 2006 issue of Alberta RN. The complete document
 REVIEW OF CARNA CONSULTATIONS                                   is available on the CARNA website
 O C T. 1, 2 0 0 5 – S EPT. 3 0, 20 0 6                          Best Practice in Influenza Clinics
                                                                 RNs have made numerous inquiries related to best practice
                                                                 for participating in, or being in charge of, influenza clinics.
                                                                 There were questions related to the involvement in this activity
 Scope of Practice and                                           as an employee versus providing these services by contract.
                                                                 Regardless of how a service for immunizations is provided by
 Nursing Practice Standards                                      an RN, the following components are necessary for a quality
 Dominate List of Concerns                                       • program policies
 BY DEBRA ALLEN, MARIE-ANDRÉE CHASSÉ,                            • order by an authorized prescriber
 DONNA HOGG, DEBBIE PHILLIPCHUK                                  • practice standards
 NURSING CONSULTANTS – POLICY AND PRACTICE                       • vaccine management
                                                                 • documentation
 The latest review of consultations by the College and           • education and promotion
 Association of Registered Nurses of Alberta (CARNA)             • occupational health and safety (prevention, management
 indicates that concerns related to scope of practice and            and monitoring of sharp injuries)
 nursing practice standards are on the rise.                     The article Injecting Quality into your Immunization Program by
     Consultations were initiated by phone, fax, e-mail          Honish, Loewen and Perrin is an excellent resource for RNs.
 or in person by registered nurses (RNs), employers, or          The article, published in Alberta RN in April 2002 is available
 others who sought assistance with issues that directly          through CARNA library services.
 or indirectly affected the delivery of safe, competent
 and ethical nursing care.
                                                                 Development and Use of Protocols in Practice
                                                                 RNs sought information about the development and use of
     The latest review is based on 862 consultations
                                                                 protocols to support nursing practice. For example, RNs working
 conducted between Oct. 1, 2005 and Sept. 30, 2006.
                                                                 in an anti-coagulant clinic would need to utilize a protocol
 The comparison is made from the previous year reviewed
                                                                 to support the practice of adjusting therapy based on the
 (Oct. 1, 2004-Sept. 30, 2005) consisting of a total of          laboratory results of individual clients and evidence-based
 917 calls.                                                      best practice. RN practice is influenced by who their clients
                                                                 are and the nursing care expected in the area of practice in
 NURSING PRACTICE STANDARDS                                      addition to a complex mixture of norms, values, policies and
 The majority of consultations (29 per cent) were about the      protocols utilized in their specific work environment. For that
 application of nursing practice standards in the following      reason, the responsibility for developing and implementing
 main topic areas:                                               evidence-based policies and protocols is shared among RNs,
 • phoning-in of prescriptions and refills for prescribers       employers, and other team members who participate in
                                                                 decisions related to client care.
 • best practice related to influenza clinics
 • development and use of protocols in practice                  Supervision of Health-Care Aides
 • supervision of health-care aides                              Consultations in this area have included general inquiries
 • fitness to practice                                           about the RN’s role in the supervision and assignment of care

10   Alberta RN January 2007 Volume 63 No 1
to health-care aides. The decision-making tree in the CARNA            against engaging in this activity.
document Decision-making Standards for Nurses in the Supervision           In all situations, members are encouraged to consider
of Health Care Aides: Restricted Activities and Activities for Daily   the following:
Living (2003) is particularly useful to RNs who have questions         • the blurring of professional and personal boundaries
in this area of practice. The decision-making tree helps RNs
                                                                       • the liability of RN practice outside an employee-employer
determine whether or not a restricted activity for a particular            situation or in a contracted position
client is an activity of daily living and whether or not it is
appropriate to assign this specific care to a health-care aide.        • the source of the order for the injection – RNs are not
                                                                           currently authorized by regulations to prescribe
The complete document is available on the CARNA website                                                      • risk management for potential of adverse event and source
                                                                           of direction for implementing interventions if required
Fitness to Practice                                                    • documentation of activity, ownership and maintenance
RNs wanted more information about fitness to practice as it                of documentation
related to both their colleagues and themselves. The review of
                                                                       RNs also had many questions related to documentation.
consultations identified a trend in concerns related to fatigue,
                                                                       Please refer to the article, Documentation Guidelines, on page 12
stress and unskilled or unprofessional practice. The CARNA
                                                                       of this issue.
Nursing Practice Standards provide guidance for RNs in addressing
their concerns related to unsafe practice and support them in
                                                                       Confidential Consultations (Individual Calls) by Category
making sound decisions so that quality care can be provided.
                                                                       Between October 2004 and September 2006
Resources for RNs are available at and include:
• Nursing Practice Standards                                                                                   Oct. 1, 2005 to   Oct. 1, 2004 to
• Working Extra Hours: Guidelines for Registered Nurses                 Category                               Sept. 30, 2006    Sept. 30, 2005
    on Fitness to Practice and the Provision of Safe, Competent,        Safety                                  107 (12%)         112 (12%)
    Ethical Nursing Care
                                                                        Nursing Practice Standards              251 (29%)        208 (22%)
• Guidelines for Assignment of Client Care and Staffing Decisions
                                                                        Legal/Ethical                           159 (18%)        133 (14%)
SCOPE OF PRACTICE                                                       Health Care Reform                        44    (5%)       87    (9%)
Scope of practice calls rose from 16 per cent of all calls received     Scope of Practice                       182 (21%)        146 (16%)
in the previous year to 21 per cent of calls in this current review.
A large portion of those calls related to both the overlapping          Relationships                             23    (3%)       41    (4%)
scope of practice and the differences in the scope of practice          Transitions/Independent Practice          11    (1%)       36    (4%)
for each of the regulated nursing groups. Members also sought
clarification about scope of practice for the various categories        Education                                 18    (2%)       21    (2%)
of RNs (graduate nurses, students, internationally educated             Information/Networking                    67    (8%)     133 (14%)
nurses) and sought advice about integrating new interventions
                                                                        TOTAL*                                  862              917
into the RN scope of practice. CARNA is encouraging RNs to
engage in discussion about their practice. Members are invited         * Totals may not equal 100% due to rounding.
to participate in this dialogue by going to
and completing the scope of practice feedback form. CARNA              The increase in consultations related to the application of
will report back to members in a future edition of Alberta RN.         nursing standards and the scope of practice may be linked
                                                                       to the implementation of the Health Professions Act and the
LEGAL/ETHICAL ISSUES                                                   Registered Nurses Profession Regulation in November 2005.
The number of consultations requested on legal and ethical             This has provided a lens through which RNs, employers
issues rose from 14 per cent of all calls received between             and others have viewed the entire spectrum of the registered
October 2004 and September 2005 to 18 per cent of all calls            nurse’s contribution in the provision of safe, competent and
between the period of October 2005 and September 2006.                 ethical care for the health of Albertans.
    Many of these consultations focused on the following               Resources
three areas:                                                           If you require more information on a specific topic related
• volunteering in the community, church/parish, at camps               to nursing policy and practice, call the provincial office at
• administering IM injections to a friend or family member             780.451.0043 or toll free 1.800.252.9392 and ask to
• acting as an ‘agent for’ another health-care professional            speak with one of the CARNA nursing policy and practice
Administering IM injections to a friend or family member               consultants or e-mail RN
is a particularly high-risk activity and members are advised

                                                                            January 2007 Volume 63 No 1 Alberta RN       11
                                                                                                WHAT TO DOCUMENT
                                                                                                Quality documentation provides specific
                                                                                                information – who, what, how and why
                                                                                                about the actual care the RN provided
                                                                                                and a record of the client’s response to
                                                                                                that care. It assists others in confirming
                                                                                                that the RN’s care was competent and
                                                                                                safe, met acceptable standards and
                                                                                                procedures, was provided in a timely
                                                                                                manner and was consistent with organi-
                                                                                                zational policies. When determining if
                                                                                                certain information should be included
                                                                                                within a health-care record, applicable
                                                                                                practice setting policy should be consulted
                                                                                                (CARNA, 2006). Additionally, documenta-
                                                                                                tion provides a chronological record of
                                                                                                the many events involving a client from
                                                                                                admission to discharge and may be used

 Documentation                                                                                  to refresh the RN’s memory if required
                                                                                                to give evidence in court (CNPS, 1992).

 for Registered Nurses                                                                          HOW FREQUENTLY
                                                                                                TO DOCUMENT
                                                                                                The frequency of documentation and
                                                                                                the amount of detail are dictated by
 Documentation can sometimes seem like a tiresome chore.                                        a number of factors including:
 Have you ever thought that if you spent less time doing the paperwork,                            the policies and procedures of the
 you would have more time for client care? However, our clients need us                            practice setting
 to document their care. Documentation is not separate from care and it is                         the complexity of the health problem
                                                                                                   degree to which the client’s condition
 not optional (CARNA, 2006). High quality documentation helps registered
                                                                                                   puts them at risk
 nurses (RNs) provide skilled and safe care wherever they practice. RNs                            degree of risk involved in the treatment
 in Alberta have a legal and professional accountability for care provided                         or care
 and, through documentation, we track changes in client status, make                            According to the Canadian Nurses
 decisions about client needs and enable continuity of care (CARNA, 2003).                      Protective Society (CNPS), the recording
                                                                                                of nursing care provided should be more
                                                                                                comprehensive, in-depth and frequent if
 Comprehensive and accurate documen-                  Over the past year, members from a
                                                                                                the client is very ill, has unstable health-
 tation shares astute nursing insights,           variety of practice settings have indicated
                                                                                                care needs and unpredictable outcomes.
 reflects the excellence of holistic nursing      a need for guidelines to support them
                                                                                                (CNPS, 1992).
 and provides a record of the professional        in providing safe and effective documen-
 and personal support that RNs provide            tation of care processes. In September        DOCUMENTING FOR
 every day to clients and their families.         2006, Provincial Council approved the         SOMEONE ELSE
 Documentation provides evidence that             document Documentation Guidelines for
                                                                                                RNs are accountable for their own
 RNs competently utilize their knowledge          Registered Nurses. This policy document
                                                                                                nursing practice and documentation
 to assess, plan, implement and evaluate          provides direction and supports RNs
                                                                                                is part of that responsibility. Because
 required client care and outcomes of the         in all practice settings. Common issues
                                                                                                health-care records reflect accountability
 interventions. In other words, documen-          raised by RNs include:
                                                                                                for the care provided, RNs should only
 tation demonstrates the visible and                  what to document                          document their own observations and
 invisible work that RNs do for each of               how frequently to document                actions.
 their clients. It is a communication tool            documenting for someone else                  In some emergency situations (e.g.,
 for all health-care professionals involved
                                                      entering a late entry                     during a cardiac arrest), documentation
 in client care.
                                                      using flow sheets for documentation       may be done by a designated recorder.

12   Alberta RN January 2007 Volume 63 No 1
When acting as a designated recorder,           No area should be left blank.
the recorder identifies the persons             RNs must use narrative notes when                  Provincial
involved and the care they provided.
The policies of the practice setting
                                                needed to record nursing care provided.
                                                Narrative notes should be more
should provide guidance and support
for how a designated recorder should
                                                comprehensive, in depth and frequent
                                                if the client is very ill, has unstable
                                                                                                   on Disclosure
document and identify the forms that            health-care needs and unpredictable
are to be used (CARNA, 2006).                   outcomes (CNPS, 1992).                             Disclosure of Harm to Patients
    If documentation is used for legal                                                             and Families, a guideline for
purposes, CNPS notes that the courts         SAFE DOCUMENTATION                                    sharing information with patients
have stated that one nurse documenting       PRACTICE
for another destroys the accuracy of the                                                           and families when a patient
                                             Documentation of care is an integral
notation and diminishes the credibility      part of providing care. Regardless of                 experiences unanticipated
of the witness relying on the record.        the method used to document, RNs                      harm, is now available at
Pooling observations or recording            are responsible and accountable for
information for a colleague undermines
                                             documenting client care including
the validity of the health-care record.                                                               The guideline was developed
                                             assessments, interventions performed
It is therefore very important that the      and results of the interventions on                   by the Health Quality Council
RN who has first-hand knowledge of           client outcomes (CARNA, 2006).                        of Alberta, which consists of
the events or who performed the action       Documentation must be:
documents the activities (CNPS, 1992).                                                             representatives from health-care
                                                                                                   organizations including the College
ENTERING A LATE ENTRY                            chronological
                                                 written from personal knowledge                   and Association of Registered
Completion of the health-care record
notes should be done as close to the             properly identified                               Nurses of Alberta.
time of care as possible (also known             accurate, true and concise
as contemporaneous documentation)            In all instances, confidentiality must
to enhance the credibility and accuracy      be respected for legal, professional and
of health-care records (CARNA, 2006).        ethical reasons.
Documentation in chronological succes-
sion assists in revealing a change pattern
                                                 The document Documentation                           Let’s Talk…
                                             Guidelines for Registered Nurses is available
in a client’s health status. However,        online at RN                           Scope of Practice
information must be entered in the
health-care record even if it is out of
chronological order (Phillips, as cited in
CRNNS, 2005). In the practice setting,
                                             Canadian Registered Nurses Protective                 Alberta RN will continue to publish
                                             Society. (1992). Quality documentation:
policies will guide the RN in how late       Your best defence. Ottawa, ON: Author.
                                                                                                   articles exploring the scope of
entries should be documented.                College and Association of Registered                 practice of registered nurses like
USING FLOW SHEETS                            Nurses of Alberta (2003). Nursing practice            those published in the three previous
                                             standards. Edmonton, AB: Author.
FOR DOCUMENTATION                                                                                  issues. RNs are encouraged to parti-
                                             College and Association of Registered
If documenting on a flow sheet               Nurses of Alberta (2006). Documentation               cipate in the dialogue by submitting
or checklist, CARNA endorses the             guidelines for registered nurses. Edmonton,           comments on scope of practice
following guidelines:                        AB: Author.
                                                                                                   on the feedback form posted on
                                             College of Registered Nurses of Nova
    Checkmarks may be used as long                                                       
                                             Scotia. (2005). Documentation guidelines
    as it is clear who performed the         for registered nurses. Halifax, NS: Author.               Let us know what you see as
    assessment or intervention.
    The meaning of a checkmark or
                                                                                                   the future of the health system and
                                             OTHER RESOURCES:
    symbol used must be identified                                                                 the practice of registered nursing in
                                             Canadian Nurses Protective Society (CNPS).
    by the practice setting’s policy.                                         Alberta, changes you think need to be
    The use of n/a should be used to         Personal Information Protection and                   made and some of the solutions to the
    indicate an intervention listed on       Electronic Documents Act.                             problems we face in the health system
    the flow sheet that is not applicable
    in the care provided for the client.        258031.html                                        and in RN practice.

                                                                           January 2007 Volume 63 No 1 Alberta RN   13
     D iscipline Decisions
     CARNA Member                                                                  cheated on random drug screening. The Tribunal ordered that the
     The Hearing Tribunal made a finding of professional misconduct                member be suspended for a minimum of 12 months and thereafter
     against a member arising from a complaint under the Nursing                   not be allowed to work as a registered nurse until she has completed
     Profession Act. The Tribunal found that the member had crossed                a residential treatment program and provided comprehensive medical
     professional boundaries when she befriended a client of a transplant          reports from physicians and a report from an addictions counsellor, all
     program; was prepared to donate an organ to the client; and continued         indicating that her illness is in remission and she is safe to practice as
     to be involved in the client’s care after she had withdrawn as his            a registered nurse, and proof that she has complied and is complying
     nurse and after she had been warned by her employer. The Tribunal             with the treatment recommendations of her physicians, addictions
     issued a reprimand and ordered the member to write a comprehensive            counsellor, and the residential treatment program aftercare. There-
     paper on professional boundaries by a deadline. Failure to comply with        after, she has the option of: 1. working in a setting with no access
     the order will result in suspension of CARNA practice permit with full        to narcotics and undergoing drug screening and providing medical
     publication at that time.                                                     reports and ongoing proof from the employer that in the setting
                                                                                   there is no access to narcotics; or 2. doing 1350 hours of supervised
     CARNA Member                                                                  practice where administration of narcotics is one of her duties with
     The Hearing Tribunal made a finding of professional misconduct                drug screening, performance evaluations and another twelve months
     against a member who appeared at work with what her co-workers                of random drug screens, and further medical reports. The member
     reported as a smell of alcohol on her breath, despite being warned            cannot have her licence restored unrestricted until she has successfully
     by her employer on numerous occasions that this was unacceptable.             completed the 1350 hours of supervised practice. Failure to comply
     The Hearing Tribunal gave the member a reprimand, and ordered                 with the order shall result in suspension of CARNA practice permit.
     that she be assessed by a physician with an expertise in addictions.          NOTE: Nursing Profession Act discipline conditions do not appear on
     If the physician is of the opinion that she has a diagnosis that requires     the practice permit.
     treatment for alcohol use she is to reappear before a Hearing Tribunal
     to determine if further sanctions are to be ordered. Failure to comply with   CARNA Member
     the order will result in the suspension of her CARNA practice permit.         Registration number:        62,328
                                                                                   The Hearing Tribunal made a finding of unskilled practice and
     CARNA Member                                                                  professional misconduct against member number 62,328 arising
     The Hearing Tribunal made a finding of professional misconduct                from a complaint lodged under the Nursing Profession Act, for the
     against a member who breached nursing practice standard 3.1 when              following errors: administration of glyburide to NPO patient with
     working on the ward while teaching students in the same facility for          resultant hypoglycemia; failure to titrate insulin as per physician’s
     two different employers and violated her employer’s policy regarding          order; removal of the G-tube in error instead of a JP drain with resultant
     meal break allotments for being absent from her unit in excess of the         harm to the patient; failure to unclamp NG tube with resultant
     allowable amount of time. The member was an instructing nurse who             discomfort to the patient; going on coffee break leaving patient in
     was overseeing nursing students on one unit while working a shift on          respiratory distress; failure to take appropriate nursing measures
     another unit at the same time. The Hearing Tribunal gave the member           to attend to patient’s respiratory distress; failure to chart nursing
     a reprimand, and ordered that she take a professional responsibilities        care including dressing change and arterial line tubing change.
     course. Failure to comply with the order will result in the suspension        The Hearing Tribunal issued a reprimand; ordered the member to take
     of her CARNA practice permit.                                                 courses in charting, basic medication administration, arithmetic skills,
     CARNA Member                                                                  responsible nursing, clinical nursing skills (assessment) by a deadline.
     Registration number:        59,102                                            In addition, the Hearing Tribunal ordered the member to undergo a
                                                                                   comprehensive assessment by her current employer after eight shifts,
     The Hearing Tribunal made a finding of professional misconduct
                                                                                   and if that is satisfactory, the member would be permitted to work with
     pursuant to the Nursing Profession Act against member number 59,102
                                                                                   that employer and be required to provide comprehensive performance
     who, while under AARN imposed supervised practice for previous theft
                                                                                   evaluations to the Hearing Tribunal every three months for a year.
     and use of narcotics, did the following: pilfered narcotics from her
                                                                                   The member is restricted to working only in the setting approved by
     employer for self injection while on duty; altered and destroyed narcotic
                                                                                   a Hearing Tribunal until the member has fully complied with the order.
     records to cover the theft; without permission accessed the code to
                                                                                   Failure to comply with the order shall result in suspension of CARNA
     the narcotic lock box; maintained a clean supply of urine and thereby
                                                                                   practice permit.

14      Alberta RN January 2007 Volume 63 No 1
NOTE: Conditions arising from a complaint lodged under the Nursing                        ALBERTA REGISTERED NURSES
Profession Act do not appear on the member’s practice permit.                             EDUCATIONAL TRUST
                                                                                          Promoting Nursing Excellence
CARNA Member
The Hearing Tribunal made a finding of professional misconduct
against a member who performed a procedure on a co-worker without          Applications for the Annual Scholarships of
obtaining written consent from the patient or performing a test dose to    the Alberta Registered Nurses Educational Trust
determine sensitivity to the solution. The Hearing Tribunal reprimanded    (ARNET) are now being accepted.
the member.                                                                Scholarships are available exclusively to registered nurse
                                                                           (RN) members of CARNA who are completing post-basic
CARNA Member                                                               baccalaureate, masters or doctoral nursing studies. More
The Hearing Tribunal made a finding of unskilled practice against          than $62,000 in educational support will be awarded
a member. The member failed to renew or facilitate the renewal             through this scholarship competition. Each application
of patients’ prescriptions on two separate occasions, and failed           will be considered for all scholarship reviews where the
to facilitate a referral to a specialist for another patient in a timely   applicant meets the donor criterion.
manner. The member received a reprimand, and was ordered to                Application Deadline: March 1, 2007
provide a letter from her family doctor confirming that she is fit to      RNs pursuing other educational programs or activities
practice. In addition, the member was ordered to complete a course         may be eligible for alternate educational funding support
in time management, on or before Jan. 1, 2007. She was also required       from ARNET. Due to the generosity of donors and the
to submit a copy of a performance appraisal from her current employer.     development of new funding partnerships, ARNET has
Failure to comply with the order will result in the suspension of her      significantly expanded the educational funding supports
CARNA practice permit.                                                     available to CARNA members. ARNET estimates that
                                                                           more than $640,000 in educational funding supports
CARNA Member
                                                                           will be distributed to Alberta RNs during the fiscal year
Registration number:       71,032
                                                                           Oct. 1, 2006 to Sept. 30, 2007.
The Hearing Tribunal, presiding at the matter of two separate
complaints commenced under the Nursing Profession Act, made                More Information
findings of professional misconduct against member number 71,032           For more information on ARNET’s educational funding
for failing to follow appropriate procedure when hanging fresh frozen      opportunities or to access application forms, visit the ARNET
plasma, failing to follow appropriate procedure when giving blood to       links on the CARNA website at or contact
a patient, co-signing for insulin at an incorrect time, administering      the ARNET office at 1.800.252.9392 ext. 427.
medication without a doctor’s order, failing to process a doctor’s order
                                                                           Nurses supporting Nursing
correctly, failing to change an incontinent patient, failing to deal
                                                                           Please consider ARNET in your charitable giving plans.
with a patient who had a low oxygenation level appropriately, signing
                                                                           Donations to ARNET support continuing nursing education
for medication and then failing to provide it, and failing to create
                                                                           in Alberta and are eligible for a charitable tax receipt.
adequate chart entries for five patients. The Hearing Tribunal gave
                                                                               For more information please contact the ARNET office at
the member a reprimand and ordered that she complete a course
                                                                           1.800.252.9392 ext. 523 or
in nursing 326, a pharmacology course of three credits, a basic
medication administration course, a blood administration course and
a charting course. In addition, she was required to complete 480 hours     IN MEMORIAM
of supervised practice and was forbidden from working in any other         Our deepest sympathy is extended to the family and friends of:
nursing setting during her supervised practice. Failure to comply with
                                                                           Katzell, Sonja, a 1961 graduate of the University of
the order shall result in suspension of the member’s CARNA practice
                                                                           Alberta Hospital school of nursing, who passed away
                                                                           on Oct. 6, 2006.
NOTE: Conditions arising from a complaint lodged under the Nursing
                                                                           Pedlar, Nettie, a 1938 graduate of the University of
Profession Act do not appear on the member’s practice permit.
                                                                           Alberta Hospital school of nursing, who passed away
                                                                           in Calgary on Nov. 8, 2006.

                                                                            January 2007 Volume 63 No 1 Alberta RN   15
                                                            NOMINATION DEADLINE:
                                                                April 2, 2007

 CARNA Election 2007: Make a Difference
                                                          development of health policy for
 President-Elect and                                      Albertans
                                                                                                         registered nurse
 Provincial Council members                               lead national nursing policy through           resident of the CARNA region in which
 You can make a difference in the lives                   membership on the board of the                 you are nominated
 of Alberta’s RNs today and for the future.               Canadian Nurses Association
 We want your ideas, commitment and                       expand networks with provincial             Take the Next Steps
 enthusiasm to shape the future of                        and national nurse leaders
                                                                                                      1. Obtain a nomination form by:
 registered nursing in this province.                 QUALIFICATIONS                                  • calling the CARNA provincial office
 The Elections and Resolutions Committee                 registered nurse                                at 1.800.252.9392 ext 525 or
 is seeking candidates for president-elect               resident of Alberta                             780.453.0525
 and provincial council. One member is                                                                • contacting the chair of the Elections
 needed from each of the following CARNA              Provincial Council Member                          and Resolutions Committee,
 regions to serve for a three-year term:              If you care about the profession of                Joan Petruk, at 780.672.8361
                                                      registered nursing, you have what it               or
     •   Northwest
                                                      takes to be a provincial councillor. You        • downloading the nomination
     •   Edmonton/West
                                                      can make a difference and know that your           form at
     •   Central
                                                      vision will be reflected in the decisions of
     •   Calgary/West                                 your professional body.
                                                                                                      2. Complete the nomination form
                                                                                                      3. Submit the nomination form
 What’s involved?                                     OPPORTUNITIES
                                                         work collaboratively to find solutions
                                                                                                         by April 2, 2007 by mail
                                                                                                         or courier to:
 President-Elect                                         to nursing issues
                                                                                                         CARNA Elections and Resolutions
 The president-elect position is a four-year             meet nursing colleagues who share
                                                         your passion for nursing at the                 Committee
 term. The first two-year term will be served                                                            11620-168 St.
 as president-elect and the second two-year              provincial and national levels
                                                                                                         Edmonton AB T5M 4A6
 term as president.                                      develop and expand your leadership
                                                         abilities as you help govern the nursing     While a copy of the form may
 OPPORTUNITIES                                           profession in Alberta                        be faxed to 780.452.3276,
    represent the registered nursing                     work with leaders who are shaping            the completed originals must be
    profession to government, the public                 nursing in Alberta                           received by the CARNA provincial
    and other stake holders                              learn from the knowledge and nursing         office by April 2, 2007.
    incorporate RN perspective in the                    experience of colleagues on council

 Play it Safe with Medications
 If you asked Albertans if they thought they were safety conscious                 There are many things Albertans could and should be doing
 when it came to their medications, what would the answer be?                  when it comes to medication safety. To help Albertans take a
 Probably a resounding yes. After all, it should be relatively simple          more active role, the Health Quality Council of Alberta (HQCA)
 to be safe when you only take something once in a while for the               has produced its third Health Report to Albertans. This time the
 odd headache or sore throat. But is it? We’re surrounded by an                focus is on giving Albertans information and tools they can use
 overwhelming number of medications, some prescribed by health                 to help play it safe with the medications they use: The tabloid
 professionals, other known as non-prescription medications and                publication will be available online at in late
 still others in the form of herbal and nutritional supplements.               January. If you would like additional copies for distribution,
 Often it can be confusing.                                                    please contact HQCA at 403.297.8162 or

16       Alberta RN January 2007 Volume 63 No 1
                                                      Besner, J. (2005). A systematic approach to maxi-        International Council of Nurses. (2006). Safe
                                                      mizing nursing scopes of practice. Edmonton, AB:         staffing saves lives: Information and action
                                                      Alberta Association of Registered Nurses.                tool kit. Geneva: Author. [WY16.I6 2006]
                                                      [WY16.B555 2005]                                         Messele, T. & Hawley, G. (2006). Propositions on
The latest books, documents and audio-visual
titles acquired by the CARNA Library. To reserve      Borkowski, N. (Ed.). (2005). Organizational behavior     the general nursing and physician labour forces.
these and other titles, CARNA members can contact     in health care. Sudbury, MA: Jones and Bartlett.         Ottawa, ON: Health Canada. [WY29.M574 2006]
the library Monday through Friday, 9 a.m. to 4 p.m.   [WY16.O6814 2005]                                        Redmond, K. (2004). Rules of engagement for
at 1.800.252.9392 extension 533, or visit             Canadian Federation of Nurses Unions. (2005).            communicating at work: 5 strategies for decreasing any time to access the library       Enhancement of patient safety through formal             conflict and increasing collaboration. Toronto, ON:
catalogue and CINAHL (Cumulative Index to Nursing     nurse-patient ratios: A discussion paper. Ottawa,        Engagement. [WY87.R319 2004]
and Allied Health Literature database).               ON: Author. [WY16.C2165 2005]                            Report of key findings of RCN’s survey of the
American Council of Critical Care Nurses. (2005).     Caulfield, H. (2005). Accountability. Oxford:            information needs of nurses, health care assistants,
AACN standards for establishing and sustaining        Blackwell. [WY44.C368 2005]                              midwives and health visitors. (2004). [London]:
healthy work environments. Aliso Viejo, CA: Author.   Cryderman, P. (1999). Customized manuals for chang-      Royal College of Nursing. [W84.R4145 2004]
[WY154.A51 2005]                                      ing times. Ottawa, ON: CHA Press. [WY105.C958 1999]      Studer, Q. (2005). Hardwiring excellence: Purpose,
Besner, J. (2005). Optimizing RN scope of practice    Forman, C. (2006). The orientation of nurses in          worthwhile work, making a difference. Gulf Breeze,
within a PHC context: Linking role accountability     new work settings. Geneva, ICN. [WY18.F724 2006]         FL: Fire Starter Publishing. [WY105.S9323 2003]
to nursing outcomes. Halifax, NS: Registered                                                                   Sutherland, J. (2005). Worldview skills: Transforming
                                                      Hirst, L. J. & Hirst, S. P. (2005). A review of entry-
Nurses of Nova Scotia. [WY16.B555 2005]                                                                        conflict from the inside out. Vancouver, BC:
                                                      to-practice education credentials within the
                                                      registered nurse profession. [S.l.]: Knowledge           Worldview Strategies. [WY85.S9655 2005]
                                                      Transfer Network. [WY18.H667 2004]
                                  Closing Perspectives
                                  Stepping Outside the Comfort Zone

 In late November, I had a remarkable             it comes to improving patient care.           to increase understanding of the valuable
 opportunity to reflect on the beliefs                When we discuss health-care reform,       contributions of RNs to the lives of
 I hold about the profession of registered        the nursing shortage or workload, the         patients, and of patients to the lives of
 nursing and on my personal values.               focus on accountability is usually on         nurses. CARNA regional coordinators are
 I attended a leadership development              government, on employers and sometimes        also soliciting your stories of meaningful
 program quite different than any other           even on patients. Health-care reform does     nursing practice experiences for their
 program I’ve attended and which most             have to occur in those areas, but I believe   regional newsletters. In both cases, your
 definitely nudged me outside my comfort          all RNs need to look inward and focus         stories provide powerful examples of
 zone in several ways.                            on our individual accountability.             nursing core values and beliefs in action
     I was the only registered nurse (RN)             I know each of you has suggestions        and help to engage others, both within and
 among a group of government bureau-              for improvements in your practice setting     outside the profession, in the dialogue.
 crats, business executives from large            that would affect the nursing care provided       In the new year, CARNA will be
 and small firms, community leaders,              to clients. Those ideas often surface when    reviewing suggested changes to the list
 independent entrepreneurs and other              you tell your stories over coffee, while      of restricted activities which RNs are
 self-described leaders attending Exploring       discussing a patient at shift change          currently authorized to perform under
 Inspired Leadership. As a group, in pairs                                                      current regulations. Many of these changes
 and individually, we explored various art        Nobody made a greater                         were generated from stories told to us by
 forms with master artists to gain insight                                                      RNs who suggested ways to assist them to
                                                  mistake than he who
 into an array of organizational challenges,                                                    work to full scope of practice, to improve
 to define the personal values that influence     did nothing because                           access to care and to keep pace with the
 both our personal and professional lives,        he could do only a little.                    evolution of RN expertise.
 and to exchange stories about the leader-        EDMUND BURKE, IRISH ORATOR, PHILOSOPHER
                                                                                                    Like all RNs, I think of myself as a
 ship challenges we face in our areas of          AND POLITICIAN, 1729 -1797                    life-long learner. I attended the leader-
 interest. At one point in the program,                                                         ship program to develop my capacity
 we were each given an assignment to              during report or when you come home           to imagine new things and see existing
 meet with a local personality. Mine was          after work. This tradition of story-telling   things in new ways. Some approaches
 a prominent environmental activist who           is increasingly gaining acceptance in         to learning are more conventional than
 provided me with a unique mirror to              corporations and other organizations          others and using stories to describe
 reexamine the values I hold and the              as a powerful communication tool and          RN practice might seem like an uncon-
 stories I told.                                  an alternative approach to successfully       ventional approach. However, sharing
     He told me he believed that “the worst       teaching and disseminating information.       your stories is one “something” you can
 is to do nothing.” I wasn’t surprised by             Nurses are natural story tellers. So      do to contribute to the discussion aimed
 his statement, but I was surprised at how        much happens during a shift and nursing       at improving patient care and creating
 loudly it resonated with me as an RN.            stories never lack for drama. Much of         quality work environments for all RNs. RN
 Like the problems facing the environ-            the feedback submitted by RNs to our
 ment, the challenges faced by registered         website in response to recent articles        M a ry- A n n e R o b i n s o n , RN, BN, MSA
 nursing and our health-care system can           in Alberta RN about RN scope of practice      Executive Director
 seem insurmountable. Sometimes it                is in the form of a story. This feedback      Phone: 780.453.0509 or
 seems like the small choices you and             is helping CARNA to articulate to others              1.800.252.9392 ext. 509
 I can make won’t amount to much when             what it means to practice as an RN and        E-mail:

30   Alberta RN January 2007 Volume 63 No 1
                                                   w w w.nurses.a

Online Help
for RNs
Check the online library tutorial

You’ll find:
• instructions on how to search the CARNA Library
  Catalogue and CINAHL*
• a glossary of Internet-related terminology
• tips on searching the Internet and World Wide Web

Access the CARNA Library on Your Time
• Browse through the catalogue and borrow from
  CARNA’s extensive collection of books, videos, journals,
  government documents, newsletters and more.
• Access the CINAHL database, an index of more than
  1200 nursing and allied health journals and publications
  from 1982 to the present for articles on various topics.

Get the professional resources you need.
Go to

* Cumulative Index to Nursing and Allied Health Literature Database
excellence in nursing
          The 2007 CARNA Awards recognize registered nurses who
          have dedicated themselves to providing a level of care, compassion
          and expertise that sets a standard for others in our profession.
          We invite you to nominate an individual that you feel exemplifies
          qualities all members of the nursing profession should aspire
          to emulate. Nominations of registered nurses will be accepted
          in the following categories:
          > Nursing Excellence in:
              Clinical Practice
          > Lifetime Achievement
          > Rising Star
          Nurses are also invited to nominate members of the public for:
          > Partner in Health Award
            This award recognizes outstanding members of the public
            who have provided a significant contribution to the community
            or who have partnered with nurses in supporting public health
            and well-being.
          For more information on the criteria for each award, or to request
          a nomination form, please call us at 1.800.252.9392 or e-mail us
          at or go to
          Deadline for nominations: Feb. 1, 2007
          All nominees will be listed in the April 2007 issue of Alberta RN and
          the 2007 CARNA award recipients will be honoured at a Gala Dinner
          on Thursday, May 10, 2007 at The Westin Edmonton.


To top