Proposed Nurses Regulation
The BC Nurses' Union Council has approved a submission to the Ministry of Health in response to the current proposed Nurses (Licensed Practical) Regulation. We will also be reviewing changes to both the Registered Nurse and Registered Psychiatric Nurse regulations and making a submission prior to the July deadline. The following will be submitted regarding the LPN Regulation:
As a union representing over 45,000 nurses, of which close to 9,000 are Licensed Practical Nurses, the BC Nurses' Union is pleased to submit our comments regarding the current proposed Nurses (Licensed Practical) Regulation. Much of what we submitted as comment on the first proposed changes in 2012 remains the same.
As a nurses' union we share the goal of protecting the public through safe care, advocating for:
- education that prepares nurses to work to their full scope
- system supports that enable safe practice, and
- safeguards that ensure that our members' licenses are not put at risk.
In general, BCNU views the proposed LPN Regulation as a positive step forward as it supports standardized, autonomous practice for LPNs. Nurses in BC have been working for a long time without role clarity and the enactment of this new regulation will be welcomed.
BCNU recognizes that the proposed regulation generally speaks to entry-level competencies for LPNs which will provide challenges for LPNs who have additional education and have been carrying out activities that will be viewed as beyond the scope of practice articulated in the regulation. Currently, LPN practice is uneven throughout the province. In our view, this is related to the fact that standardized, credentialed post-basic education for LPNs is sorely lacking in BC. Examples (but not an inclusive list) of needed education are mental health, LPN Orthopedic Technician, dialysis, peri-operative, peri-natal and learning related to expanded roles in community nursing. We strongly advocate for such education, as well as appropriate supports in the workplace to enable all nurses to work safely to their full potential. In addition, we hope that health authorities will embrace the new regulation and support LPNs to work to the new scope.
Regarding the issue of RNs/RPNs issuing orders for patients/clients/residents being cared for by LPNs, it is BCNU's expectation that the process will be identical to that of a physician issuing an order in that the RN/RPN will not be expected to assess an individual LPN's ability to carry out the order.
Since our original submission, we have had time to reflect on feedback from the many LPNs we have met with regarding nursing activities they are currently carrying out. We are therefore very pleased to see the expanded Section 6 list of activities that LPNs may carry out without an order.
In Section 7, we applaud the inclusion of (b) cast a fracture of a bone, which we called for in our previous submission.
The one activity we see missing from Section 7 is venipuncture for the purpose of establishing intravenous access, maintaining patency or managing hypovolemia. Theory to support this activity is included in the provincial PN curriculum. In addition, health authorities have created learning modules for establishing competency in this activity which are aimed at all regulated nurses. Therefore, it is puzzling that activity has not been included, especially when the CLPNBC will issue the appropriate limits and conditions.