Today I found out that Steven Duckett, CEO of Alberta Health Services, had a meeting with nurse leaders from CARNA earlier this month. In CARNA’s post on the subject, I noticed a couple of alarming facts.
First, both Duckett and Alberta Health Services Senior Vice-President of Nursing Strategies Andrea Robertson have said that there will be significant changes coming to the role of the RN within Alberta’s hospitals. They spoke of a study done in Ontario on staffing roles – a study that has had its legitimacy rejected by many nursing researchers, including the Registered Nurses Association of Ontario. The largest concerns with this planned re-introduction of a previously rejected model of care is with regards to continuity of care. Under the proposed changes, this would be rejected in favour of a model of care that is based around the health care team, not the patient. (And, if I am understanding this correctly, it would result in more nursing being taken away from nursing care, and put into positions where they are simply approving procedures for other staff, like LPNs, to perform.) The presentation on the new model of care was “unclear”, but it is known that it is being evaluated by the University of Alberta Faculty of Business – which tells us a lot. It tells us that it is simply all about saving money, and not about patient safety. I recognise that Alberta Health Services is feeling short of money, but when looking at new model of care, that should absolutely involve nurses and physicians, not just the business aspect.
The other part of this discussion that struck me as being a huge concern regards future graduating nurses (myself included.)
Robertson confirmed what we’d already heard: over the next 12- 18 months, AHS intends to hire less than 40 per cent of nurse graduates, layoff RNs and offer voluntary retirement packages to others.
However, in the same breath, Alberta Health Services is admitting that there is a nursing shortage. So, then it seems like an easy solution to me – hire more of the thousands of nursing students graduating every year, instead of letting them slip away. We saw this happen before during the 90′s, and the system has only just started to recover from that – this takes us one (small) step forward, and ten steps back.
Lastly, and most revealingly, we are starting to get a picture of just how much respect the Alberta Government, and Alberta Health Services, has for the work of nurses, nursing leaders, and nursing researchers. Duckett’s remarked that “Nursing’s future is not in nursing’s hands.” There has been no clarification of this statement, but it seems clear to me that AHS has a ‘plan’ for nurses, and will see that plan through, regardless of what nurses have to say regarding their own profession. Or does AHS even see nursing as a profession? A profession is self-governing – that is what CARNA is. That is what CNA is. They are the regulatory bodies that define what nurses do, and liaison with the government to put these roles into the official health care acts. They do research, and talk to their members directly, to find out how best the professional roles can be defined so that patients can receive the best, and most timely, care possible. It seems like more and more the government has decided that nurses cannot be trusted to run their own profession, and are stepping in to define our role for us.
This is all hugely concerning to Albertan nurses, and Albertans in general – but it is also an issue for Canadians. Because nursing is not a small profession. We work around the world, and what changes in one province, could lead to changes nation-wide. And if these changes come, it will not be good for the future of patient-centred health care.