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AlbertaRN
SUM MER 2019 VOLUME 75 NO 2
It’s time to
RENEW
your
registration
PAGE 5
Seeing the stigma
behind the headlines
PAGE 26
Breaking barriers to
medical supports for
Indigenous children
PAGE 30
Climate change:
a nursing concern
PAGE 32
nurses.ab.ca
CONTACT US AlbertaRN
SUM MER 2019
VOLUME 75 NO 2
CARNA Provincial Council CARNA Alberta RN ISSN 1481-9988
2018–2019 Staff Directory Published four times per year
by the College and Association
of Registered Nurses of Alberta
PRESIDENT CALGARY/WEST REGION General inquiries or to contact
11120-178 Street NW
Dennie Hycha Tyler Burley any member of CARNA staff:
Edmonton, AB T5S 1P2
MN, BScN, RN MN, BScN, RN carna@nurses.ab.ca
PHONE: 780.451.0043
Ponoka Calgary 780.451.0043
TF IN CANADA: 1.800.252.9392
president@nurses.ab.ca tburley@nurses.ab.ca Toll-free in Canada:
FAX : 780.452.3276
Pritma Dhillon-Chattha 1.800.252.9392
PRESIDENT-ELECT carna@nurses.ab.ca
DNP(c), MHA, RN Registration services
Nicole Letourneau nurses.ab.ca
Calgary registration@nurses.ab.ca
PhD, RN, FCAHS facebook.com/AlbertaRNs
pchattha@nurses.ab.ca Practice consultations
Calgary twitter.com/AlbertaRNs
nletourneau@nurses.ab.ca Bronwyn White practice@nurses.ab.ca
Alberta RN is © Copyright 2019
MN, RN Conduct and complaints by the College and Association
NORTHWEST REGION Calgary procond@nurses.ab.ca of Registered Nurses of Alberta,
Tracy King bwhite@nurses.ab.ca Communications and also reserves copyright
MN, RN communications@nurses.ab.ca for all articles. Reproduction
SOUTH REGION
Grande Prairie Privacy Officer without written permission from
tking@nurses.ab.ca Lisa Zubach
privacy@nurses.ab.ca the publisher is not allowed.
MSN, RN
NORTHEAST REGION Lethbridge STAFF Subscription is automatic for CARNA
Jeannie Hare lzubach@nurses.ab.ca members. Rate for non-members
Chief Executive Officer is $ 42 CAD per year plus GST.
RN
PUBLIC REPRESENTATIVES and Registrar
Redwater EDITORIAL STAFF
Steven Armstrong Joy Peacock, BSN, M.Sc., RN
jhare@nurses.ab.ca Managing Editor: Alan Clay
OStJ, CD, MSc jpeacock@nurses.ab.ca
Editor: Alex Boyd
EDMONTON/WEST REGION Calgary Chief Operating Officer Designer: Julie Wons
Sherri Di Lallo sarmstrong@nurses.ab.ca Damon Mayes, M.Sc., PStat, CStat albertarn@nurses.ab.ca
MN, BScN, RN Janet Blayone dmayes@nurses.ab.ca
Millet BA ADVERTISING REPRESENTATIVE
sdilallo@nurses.ab.ca Chief Professional Jan Henry, McCrone Publications
Peace River
Practice Officer PHONE: 1.800.727.0782
Alycia Lobay jblayone@nurses.ab.ca
Debra Allen, MN, RN FAX: 1.866.413.9328
MN, BScN, RN Phyllis Bohachyk dallen@nurses.ab.ca mccrone@interbaun.com
Edmonton Edmonton
alobay@nurses.ab.ca pbohachyk@nurses.ab.ca Chief Registration Officer For advertising rates, please
Janelle Ostby and Deputy Registrar visit nurses.ab.ca/advertising.
Frank Work
BScN, RN QC
Shelley MacGregor, BN, MBA, RN ADVERTISING SUBMISSION DEADLINES
Spruce Grove Spruce Grove smacgregor@nurses.ab.ca
Fall 2019 | Sept. 9, 2019
jostby@nurses.ab.ca fwork@nurses.ab.ca Acting Chief Conduct Officer Please note CARNA does not endorse
CENTRAL REGION David Kay, MHA, CHE, FACHE advertised services, products or opinions.
dkay@nurses.ab.ca
Ashna Rawji Canadian Publications Mail
MN, RN Complaints Director Agreement No. 40062713
Red Deer Rachelle Roberts, LLB, BScN, CTAJ Return undeliverable
arawji@nurses.ab.ca rroberts@nurses.ab.ca Canadian addresses to:
Alberta RN magazine
11120-178 Street NW
Edmonton, AB T5S 1P2
nurses.ab.ca
2 ALBERTA RN SUMMER 2019 VOLUME 75 NO 2 | nurses.ab.ca
CONTENTS
PRESIDENT’S UPDATE
26
4 Nursing leadership around the globe
REGULATION
5 Time to renew your practice permit
7 Five steps to a great learning plan
9 Changes coming to the continuing
competence program
10 Provincial council election
12 Reporting adverse events following
an immunization
13 Publications ordered by
hearing tribunals
Why nurses
15 Provincial council highlights need to see the
PROFESSIONAL PRACTICE
20 YOU ASKED US:
stigma behind
What is RN prescribing? the headlines
23 CASE STUDY:
Sexual abuse and sexual misconduct
FEATURE
30 Breaking barriers to medical supports
for Indigenous children
34 Changing pain management for
children
NURSING RESEARCH
climate
37 Healthy aging in Edmonton’s change –
Muslim immigrant communities
CELEBRATING NURSING
a nursing
40 Leadership in action concern
42 Leadership pledge gallery
44 Nursing excellence gala
EDUCATIONAL OPPORTUNITIES
32
45 Noticeboard, In memoriam
ARNET
14 Class of 2019 ARNET academic
scholarships
25 Meet ARNET’s new executive director
CLOSING PERSPECTIVES
46 What’s in a title? On the cover: Ashna Rawji, RN
COVER PHOTO: WILLIAM AU PHOTOGRAPHY
COURTESY CATIE (PG. 26)
OSTILL IS FRANCK CAMHI/SHUTTERSTOCK.COM (PG. 32)
nurses.ab.ca | SUMMER 2019 VOLUME 75 NO 2 ALBERTA RN 3
PRESIDENT’S UPDATE
Nursing leadership around the globe
The last several months have provided governments to provide strategic and technical health policy
the opportunity to listen, learn and advice.
meet with registered nurses, nurse To celebrate 2020 as the Year of the Nurse and the Midwife,
practitioners and the public. I have Nursing Now has also launched the Nightingale Challenge
had incredible experiences meeting which asks health employers around the world to provide
with nurses and discussing important leadership and development training for a group of young
nursing and health issues at the nurses and midwives.
provincial, national and international
level. International
I have just returned from the International Council of Nurses
Provincial Congress in Singapore, where again, encouraging nursing
I embarked on a President’s tour in May, starting in Calgary and leadership took the spotlight.
Lethbridge. It was important to me that this tour had a focus on I was so proud to see many
listening. CARNA plays an essential role in influencing health Canadian nursing leaders sharing
issues and public policy and I wanted to hear your perspectives While we face their knowledge on the global stage
on key health issues and the delivery of health services. Common many of the same in areas such as rural recruitment
themes you brought forward included Alberta’s new government, challenges globally, and retention, safe work places,
the opioid crisis, the future of nursing regulation and the newly- nurses are strategic, nursing’s role in food security
revised RN regulations, in particular RNs applying for prescribing and enhancing quality of life in
innovative, and we
authority. continuing care.
I look forward to hearing more of what you have to say as have the knowledge While speaking with nurses
I continue touring throughout the year. Watch for more dates and power to from other countries, it is clear we
and locations being announced soon. influence signif icant have much in common. Several
change and create speakers presented about changes
National solutions. around the world including global-
In early June, I attended the Canadian Nurses Association’s ization, migration, aging, climate
annual general meeting in Vancouver where I had the oppor- change, urbanization, innovation
tunity to meet inspiring nurse leaders from across the country and increasing citizen’s voice. While we face many of the same
and learn from excellent keynote speakers. Six resolutions challenges globally, nurses are strategic, innovative, and we
were presented at the meeting on issues like climate change have the knowledge and power to influence significant change
and Indigenous rights, themes you will also see throughout and create solutions.
the pages of this magazine. Three non-nurse world leaders, Singapore President Halimah
I was privileged to be present as Canada joined the Yacob, former Korean Prime Minister Kim Hwang-sik, and
Nursing Now movement. This global movement aims to WHO Director-General Dr. Tedros Adhanom, called on the over
show the integral role nursing and nurses have to improve 20 million nurses globally to lead the world beyond health care
health through influencing policymakers and advocating for to health for all. It was clear that nursing is not only an art and
more nurses in leadership positions. The Canadian Nurses science but also a human, social and political imperative. Nursing
Association, Canadian Indigenous Nurses Association and is well-placed and has a responsibility to move from discussion
Indigenous Services Canada developed a strong action plan to impact. WHO Chief Nursing Officer Elizabeth Iro indicated
with the following areas of focus. that, “We need to get our voices heard. We need to roar!”
First, the nursing leadership pillar will establish a compre- Alberta registered nurses and nurse practitioners are
hensive Canadian hub of leadership development to educate, 38,000 strong and continue to lead in the workplace, in
empower and support nurses to advocate, innovate, influence communities and with your families – let us move our voices
public policy and create sustainable change. to impact! RN
Second, the Indigenous pillar will support current and future
nurses to provide culturally safe care across Canada. De n n i e Hych a , MN, BSCN, RN
And finally, the chief nursing officers pillar will establish President
federal, provincial and territorial chief nursing officers reporting 403.783.1504
to the Deputy Minister of Health in each of their respective president@nurses.ab.ca
4 ALBERTA RN SUMMER 2019 VOLUME 75 NO 2 | nurses.ab.ca
REGULATION
time to
RENEW
your practice permit
THE RENEWAL DEADLINE IS SEPT. 1, 2019.
Streamline the renewal process
by having these pieces handy:
WE’RE HERE TO HELP!
Your MyCARNA user ID (usually your registration
Give us a call at 1.800.252.9392, ext. 348.
number) and password.
July 22 – August 16:
A record of your learning activities from the past year.
Monday – Friday: 8:30 a.m. – 4:30 p.m.
Think about what you’d like to accomplish for your
August 19 – September 1:
2020 learning plan. See what makes a great learning
Monday – Friday: 8:30 a.m. – 7 p.m.
plan on page 7.
Your practice hours from Oct. 1, 2018 – Sept. 30, 2019. Visit nurses.ab.ca for frequently asked questions,
If you are unsure of your hours, contact your employer. video tutorials and other resources.
Estimate your hours to September 30. If they end up
being different than your estimate, you can contact us
in October to adjust them.
Renewal fees
Your current employer information including supervisor’s Registered nurse: $656.80
name and phone number, and the address of your Nurse practitioner: $773.87
work site. Associate/retired member: $ 42.00
If you have been registered in another jurisdiction in the
ZMSHV/SHUTTERSTOCK.COM
See fee breakdown at nurses.ab.ca/fees.
past registration year, your registration number there.
Applications will not be processed until full payment
is received.
A late fee of $100 will be applied to renewal applications
received after September 1.
nurses.ab.ca | SUMMER 2019 VOLUME 75 NO 2 ALBERTA RN 5
what to do when you RENEW
Whether you are planning to practise next year or not,
here are the steps you need to take.
Do you have a 2019 practice permit?
NO YES
Will you practise between Will you practise between
Oct. 1, 2019 and Sept. 30, 2020? Oct. 1, 2019 and Sept. 30, 2020?
NO YES NO YES
To keep receiving CARNA Apply to return to Whether you are To renew your permit:
emails and Alberta RN, practice eight weeks taking a leave, retiring, 1. Sign in to MyCARNA.
submit an application before you start work or relocating to another
for retired/associate or orientation. Learn province, it’s important 2. Finish your 2019
membership. more at nurses.ab.ca/ to let us know you won’t MyCCP record.
If you no longer wish return-to-practice. be practising in Alberta. 3. Begin your 2020
to receive CARNA news, 1. Sign in to MyCARNA. practice reflection
submit an application in MyCCP.
2. Finish your 2019
for former membership. MyCCP record. 4. Submit your application
form and payment.
3. Submit an application
for former membership We will review your
ZMSHV/SHUTTERSTOCK.COM
(free) or retired/ application and email
Going on parental leave? associate membership you when your renewal
There are a number of different options depending on ($42) if you would like is approved or if we need
when you will be on leave. to receive CARNA more information.
View your options at: nurses.ab.ca/parental-leave. emails and Alberta RN.
6 ALBERTA RN SUMMER 2019 VOLUME 75 NO 2 | nurses.ab.ca
REGULATION
steps to a great
LEARNING PLAN
Every year, nurses must develop, record and submit
a completed learning plan, including feedback,
as part of renewing their practice permit for the
upcoming year.
Nurses engage in learning and professional
development all year long. CARNA provides the ASSESSMENT
online MyCCP record to support members in giving
us a snapshot of how they have maintained their ASSESS your performance against CARNA’s practice standards
competence and enhanced their nursing practice to determine your learning needs. Ask yourself how each
practice standard and indicator relates to your specific role and
during the year. Your learning plan should be
practice setting. Determine if there are aspects of an indicator
individualized to your specific nursing role and you would like to work on.
practice setting. The more details you include in your TIP: Refer to the Stand Up for Standards
>
learning plan, the easier it is to select appropriate learning module in My Learning Space.
learning activities, describe what you learned and FEEDBACK from your supervisor, colleague, mentor or
explain how you implemented the new information. another health professional who is familiar with your role and
Have you ever noticed that the five steps of the responsibilities can provide valuable insights into your actions
nursing process of assessing a patient are similar to and the way your behaviour is perceived. Feedback can help
to validate or stimulate your own self-assessment and support
the steps of meeting CCP requirements? Try applying
your professional growth.
these familiar steps when you complete your plan.
Use the feedback you received to help identify a strength or
an area to work on in your practice.
nurses.ab.ca | SUMMER 2019 VOLUME 75 NO 2 ALBERTA RN 7
DIAGNOSIS INTERVENTION
Address your learning need by specifically describing what
Identify your learning need and develop an objective. Narrow new knowledge, skill or understanding you learned after
down the focus as much as you can by asking yourself what you completed your learning activities.
specific knowledge, skill or understanding you hope to gain.
When you write your learning objective, ensure that it:
> Relates to your chosen standard/indicator
> Relates to your specific nursing role and practice setting
> Begins with an intention such as “I want to learn…”
>
EVALUATION
Represents a goal that is:
> SPECIFIC: Does your learning objective clearly state
what you want to learn?
Evaluate your learning. Clearly describe how your practice
> MEASURABLE: How will you know if you achieved your changed or improved as a result of completing the learning
objective?
activities and achieving your learning objective.
> ATTAINABLE: Is it reasonable to think that you can
Your evaluation should clearly relate to your learning objective,
accomplish this objective?
learning activities and your specific nursing role and practice
> RELEVANT: Is this objective meaningful to your specific setting. Focus on your own professional development and avoid
role and practice setting? documenting a broad and generalized statement.
> TIMELY: Do the completion dates for your learning
activities fall within the practice year?
Avoid:
> Restating your chosen standard/indicator as your learning Just as with assessing a patient, what counts in a
objective learning plan is specificity and a logical flow – from
> Focusing on the learning of others rather than on enhancing assessment to diagnosis, to intervention to evaluation.
your own knowledge (e.g., “I will teach my colleagues to…”)
Keep your competence in good health by completing
> Identifying the learning activities you want to complete
your MyCCP record early. RN
> Describing how you will demonstrate your chosen standard/
indicator in your practice
For more information or to contact
CARNA Competence and Learning
staff, visit nurses.ab.ca or email
ccompetence@nurses.ab.ca.
PLAN
Use your learning objective as a guide to picking appropriate
learning activities. The activity must be something that:
> Helps you meet your objective
> Is relevant to your role and practice setting but not
a professional expectation of your role
> Can be completed within the practice year
8 ALBERTA RN SUMMER 2019 VOLUME 75 NO 2 | nurses.ab.ca
REGULATION
Changes coming to the
continuing competence program (CCP)
THESE CHANGES WILL NOT AFFECT THE CURRENT RENEWAL PERIOD,
THEY WILL BE IMPLEMENTED NEXT YEAR. CONNECT WITH US AT
CCOMPETENCE@NURSES.AB.CA AND LET US KNOW WHAT YOU THINK.
MYCCP UPGRADES REQUIREMENT CHANGES
You talked, we listened. For the Under the new RN regulations,
past several years you’ve provided members are required to make a
feedback about your renewal few small changes when completing
experience. We’re putting your feedback their CCP learning plan. When recording
to work as we explore enhancements and feedback, you must include the feedback in
upgrades for the online MyCCP system. the planning process of your practice reflection.
CARNA is committed to creating an online Feedback must connect to your learning objective
platform for MyCCP that is meaningful for you. and identify an area of improvement.
We’ll keep you posted about the upgrades, Additionally, the new requirements allow
including previews and implementation dates, you to choose any practice indicator within
through our website, social media, emails and the standards to complete and document
publications. your self-assessment. In order to monitor the
effectiveness of the program, the competence
committee may require a member to complete
a competence assessment, which is based upon
previous evidence.
We understand change can be stressful.
We will provide tools to navigate
this change and keep you informed
of updates. RN
nurses.ab.ca | SUMMER 2019 VOLUME 75 NO 2 ALBERTA RN 9
REGULATION
The polls are open for CARNA’s
Provincial council makes important MEET THE CANDIDAT
decisions that protect the public and
guide the evolution of your profession. CALGARY/WEST
HOW TO VOTE
> Get to know the candidates
running in your region
at nurses.ab.ca/elections.
> Sign in to MyCARNA
and click “vote now”.
> Cast your vote!
Polls close at 11:59 p.m. on Aug. 31, 2019. Justin Burkett Dory Glaser Watson
BN, RN BScN, RN, PNC(C), PANC(C),
If you have questions about the election legal nurse consultant
process, please contact Barbara-Ann
Sheppard at 1.800.252.9392, ext. 531
or bsheppard@nurses.ab.ca.
VOTE
lections
nurses.ab.ca/e Leona Liski Bronwyn White
RN MN, RN
NOW!
Paul Wright
BScN, RN, CNN(C)
10 ALBERTA RN SUMMER 2019 VOLUME 75 NO 2 | nurses.ab.caprovincial council election.
ES
CENTRAL EDMONTON/WEST NORTHWEST
Amy Deagle Glennie Aromin Derrick Cleaver Thomas Berry
MScN, BN, RN (acclaimed) BScN, RN BScN, MPH, RN BScN, BA, RN
Ashna Rawji Caitlin Fenton Loretta Lee Liz Winnicky
MScN, BN, RN (acclaimed) BSc, BScN, RN BScN, MN, RN BScN
Katelyn Lindstrand Jessica Muller Ashley Woytuik
BScN, RN, ENC(C) MN, RN BSc, BScN, RN
nurses.ab.ca | SUMMER 2019 VOLUME 75 NO 2 ALBERTA RN 11REGULATION
REPORTING ADVERSE EVENTS
FOLLOWING AN IMMUNIZATION
On Dec. 17, 2018,
the Immunization Regulation
in the Public Health Act came
into effect with changes to
the requirements of reporting
adverse events following
immunization (AEFI).
Under the new regulation,
health-care practitioners
must report an AEFI to the
Alberta Health Services
AEFI team within three
days of becoming aware of AEFI team members Donna Meyer, BScN, RN, CCHN(C), Ruth Farley, BScN, RN, CCHN(C),
and Karen Bochar, BScN, RN .
the event. AEFI reporting is
required regardless of who
An AEFI is an unfavourable health recommendations according to the
administered the vaccine
occurrence following an immunization Alberta Health Immunization Policy.
and whether the vaccine that cannot be attributed to a pre-existing AEFI investigations that meet reporting
was provincially-funded condition and meets one or more of the criteria are submitted to Alberta Health
following: and subsequently to Health Canada.
or privately-purchased.
> a life-threatening health occurrence The AEFI team is contributing to
that requires hospitalization or urgent a safe immunization program in Alberta,
medical attention leading to improved immunization rates
> an unusual or unexpected health and decreased vaccine-preventable
occurrence that: disease incidence. By reporting all AEFIs
and providing best practice recommen-
> has not previously been identified
dations for future immunizations after
> has been previously identified experiencing an AEFI, public confidence
but has increased frequency in vaccine safety is improved. RN
> a health occurrence that cannot
be explained by the patient’s medical For more information on reporting an
AEFI , visit ahs.ca/info/page16187.aspx.
history, recent disease or illness, or
consumption of medication
Once they receive a report, the AEFI team
will communicate with the client, the
reporter and the immunizer to investigate
the event. The AEFI team confirms the
client is seeking appropriate care as needed
and, in consultation with the Medical
Officer of Health, provides immunization
12 ALBERTA RN SUMMER 2019 VOLUME 75 NO 2 | nurses.ab.caREGULATION
PUBLICATIONS ordered by Hearing Tribunals
Publications are submitted to Alberta RN by the Hearing Tribunal as a brief description to members and the public of members’
unprofessional behaviour and the sanctions ordered by the Hearing Tribunal. Publications are not intended to provide
comprehensive information about the complaint, findings of an investigation or information presented at the hearing.
To find out more, go to nurses.ab.ca/sanctions.
CARNA MEMBER ordered a performance evaluation. Failure to comply with the
REGISTRATION NUMBER: #47,997 Order may result in suspension of CARNA practice permit.
A hearing tribunal made a finding of unprofessional conduct
CARNA MEMBER
against member #47,997 who asked health-care aides to admin-
REGISTRATION NUMBER: #84,704
ister high-alert medications which the member had prepared
A hearing tribunal made a finding of unprofessional conduct
and which the member knew the health-care aides were not
against member #84,704 who pilfered from her employer
authorized to administer on three shifts. The hearing tribunal
remifentanyl and propofol on several occasions, which she
issued a reprimand and directed the member to pass courses
administered to herself on duty. She also pilfered clonazepam
in both medication management and responsible nursing and
from ward stock. The hearing tribunal issued a reprimand and
to complete e-modules on the Code of Ethics. A condition shall
accepted the member’s undertaking not to practise pending
appear on the member’s practice permit. Failure to comply with
satisfactory reports from a physician and counselors confirming
the Order may result in suspension of CARNA practice permit.
the member’s fitness to practise. At that time, the member
CARNA MEMBER may return to a setting where there are no medications, or
REGISTRATION NUMBER: #65,918 may do a supervised practice where controlled substances are
A hearing tribunal made a finding of unprofessional conduct available. The member is required to continue drug screening
against member #65,918 who failed to assess a patient when and submit medical reports to CARNA for a period of two
requested to do so by other staff. The member also failed to years after successful completion of the supervised practice.
communicate to other nursing staff the fact that there had Conditions shall appear on the member’s practice permit.
been concern expressed about the patient’s status and that the Failure to comply with the Order may result in suspension
member had not seen the patient, so she needed to be assessed of CARNA practice permit.
immediately. The member breached patient confidentiality when
CARNA MEMBER
she requested and received a photo of a patient’s leg wound on
REGISTRATION NUMBER: #88,107
her personal cell phone. The member failed to communicate
A hearing tribunal made a finding of unprofessional conduct
with a patient the reason she was withholding his medication.
against member #88,107 who administered a dose of insulin
The hearing tribunal issued a reprimand and ordered the
to a post-surgical patient while waiting for the results of the
member to pass two courses in responsible nursing and inter-
patient’s blood glucose level, rather than obtaining the results
personal aspects of nursing. The conditions shall appear on
first so the member could determine whether it was safe to
the member’s practice permit. Failure to comply with the Order
administer the insulin. The tribunal issued a reprimand.
may result in suspension of CARNA practice permit.
CARNA MEMBER
CARNA MEMBER
REGISTRATION NUMBER: #98,837
REGISTRATION NUMBER: #74,884
A hearing tribunal made a finding of unprofessional conduct
A hearing tribunal made a finding of unprofessional conduct
against member #98,837 who failed to initiate CPR, call a
against member #74,884 who, while working as a registered
code blue or comply with the Alberta Health Services policy
nurse, failed to appropriately complete a pre-operative shave,
“Code Blue – Adult Acute Care Sites”, after finding a patient
failed to complete and document a patient assessment, docu-
unresponsive and not breathing. The member also failed to
mented activities prior to the activity, failed to check and carry
document ongoing assessments of the patient. For this finding
out a patient’s pre-operative orders which almost resulted in the
of unprofessional conduct, the hearing tribunal issued a
patient being given the wrong medication, and failed to follow
reprimand, ordered coursework to be completed, ordered a
instructions from mentors to gain access to a required system.
followup assessment for CPR knowledge and skills and ordered
For these findings of unprofessional conduct, the hearing tribunal
a performance evaluation. Failure to comply with the Order
issued a reprimand, ordered coursework to be completed and
may result in suspension of CARNA practice permit. RN
nurses.ab.ca | SUMMER 2019 VOLUME 75 NO 2 ALBERTA RN 13ARNET
CLASS OF 2019 ACADEMIC SCHOLARS
CARNA TD INSURANCE KAREN POLOWICK CALGARY FOUNDATION – CALGARY HEALTH TRUST –
MELOCHE MONNEX SCHOLARSHIP FOR JIM & DORIS GARNER FLORENCE & LLOYD COOPER SCHOLARSHIP
SCHOLARSHIP NURSING LEADERSHIP NURSING SCHOLARSHIP FOR NURSING LEADERSHIP
Katherine Webber Mary Zhang Shakhawat Hossain Caralyn Bencsik Amelia Potter
MASTERS, NURSING MASTERS, MASTERS, SCIENCE/
MASTERS, MASTERS, NURSING
University of Calgary PUBLIC HEALTH NEUROSCIENCE
NURSE PRACTITIONER University of Calgary
University of Alberta University of Lethbridge
CARNA TD INSURANCE University of Calgary
MELOCHE MONNEX KAREN POLOWICK ELIZABETH (LIZ) LEMIRE Amanda Robinson
SCHOLARSHIP SCHOLARSHIP FOR MEMORIAL SCHOLARSHIP Sherry Gauthier MASTERS,
Mikelle Djkowich NURSING LEADERSHIP
Reanne Booker MASTERS, NURSE PRACTITIONER
MASTERS, NURSING Kairos Wong DOCTORAL, NURSING
TRAUMA SCIENCES University of Alberta
Queen Mary University
University of Alberta MASTERS,
NURSE PRACTITIONER
University of Victoria
of London Vanessa Sheane
CATHERINE DIANNE LETHBRIDGE LEGACY OF DOCTORAL, NURSING
DAVIDSON MEMORIAL
University of Alberta
NURSING SCHOLARSHIP Raelene Marceau University of Victoria
TRUST SCHOLARSHIP CHRIS LAMBERT
Jeanine Sklarenko DOCTORAL, NURSING
Sarah Weisbeck
Dominique MEMORIAL SCHOLARSHIP
MASTERS, NURSING
University of Alberta
Denis-Lalonde Katherine Wong University of Lethbridge Brittany Orr
MASTERS, NURSING
MASTERS, NURSING
University of Calgary
MASTERS, NURSING MASTERS, NURSING
MCKAY GREEN
University of Calgary University of Calgary
SCHOLARSHIP University of Lethbridge Sarah Yip
SISTERS OF SERVICE
SASKATOON CITY HOSPITAL
Maria Clonfero Tammy Patel
MASTERS, NURSING
ALBERTA CENTENNIAL
ALUMNAE SCHOLARSHIP University of Calgary
MASTERS, NURSING
SCHOLARSHIP Jennifer Dorman University of Alberta
MASTERS, NURSING
University of Calgary
Jennifer Plaquin MASTERS, NURSING
University of Calgary TERRILL MARGARET
MASTERS, NURSING
BONNAH MEMORIAL
University of Alberta GAYLE HISSETT SCHOLARSHIP
PATRICIA WALKER
MEMORIAL SCHOLARSHIP
Marci
FOUNDATION SCHOLARSHIP Chentel Neher-Schwengler
IN SUPPORT OF
CHILDBIRTH EDUCATION
Cunningham MASTERS, NURSING
AND MATERNAL & CHILD
DOCTORAL, NURSING University of Lethbridge
HEALTH NURSING STUDIES University of Alberta
YVONNE CHAPMAN
Sarah Smith MEMORIAL SCHOLARSHIP
MASTERS, NURSING Upinder Sarker ARN E T.CA
University of Calgary DOCTORAL, NURSING
University of Alberta
14 ALBERTA RN SUMMER 2019 VOLUME 75 NO 2 | nurses.ab.caREGULATION
PROVINCIAL
COUNCIL
HIGHLIGHTS
Meeting of JUNE 6–7, 2019 Help ensure CARNA’s documents are current and relevant
to registered nurse practice. Find documents that need your
input at nurses.ab.ca/practice-and-learning/document-library.
Proposed bylaw changes
Council approved draft revisions to CARNA’s Bylaws related Councillors recognized
to recent amendments to the Health Professions Act and for outstanding leadership
Registered Nurses Profession Regulation. The revisions are
necessary for CARNA to meet expectations to publish decisions
of unprofessional conduct. The draft bylaws were then posted
for member and stakeholder feedback. At the September meeting,
council will vote on whether or not to approve the final draft.
New use of title document
Council approved the new document, Use of Title “Doctor”
and “Dr.”: Practice Advice. This document provides clarity
on restrictions for using the title “Doctor” or “Dr.” and outlines
the accountabilities for regulated members authorized to use
this title. For more information, contact practice@nurses.ab.ca Congratulations to Tracy King on receiving the Vogel Award
or 1.800.252.9392, ext. 504. and Steven Armstrong for receiving the Public Member Award
for their contributions to Council. When selecting the recipients
Self-employment document withdrawn of these annual awards, Council considers several criteria
Council withdrew the document, Self-Employment for Nurses: including constructive debate and the initiation of new
Position Statement and Guidelines. Withdrawing the document approaches and ideas. RN
resolves inconsistencies with current processes and aligns
CARNA with other Canadian nursing regulatory colleges.
UPCOMING Provincial
To replace this document, there is now information and self-
directed checklists on CARNA’s website. For more information, Council meeting:
contact practice@nurses.ab.ca or 1.800.252.9392, ext. 504.
Sept. 19–20, 2019
Draft nursing documents
Council approved the following draft documents for the next stage
of development, consultation with members and stakeholders:
WILLIAM AU PHOTOGRAPHY
● Determining Appropriate Scope of Practice Guidelines
● Medication Management Standards
● Professional Boundaries for Registered Nurses: Guidelines
for the Nurse-Client Relationship
● Incorporating Primary Health Care Into Nursing Practice
nurses.ab.ca | SUMMER 2019 VOLUME 75 NO 2 ALBERTA RN 15Finding Balance: Tools to Help Nurses Prevent Falls
For older adults, Find out more about preventing a fall
falls are the leading at findingbalancealberta.ca.
Are you at risk
cause of injury. of falling? risk
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developed and promoted by the Injury
Prevention Centre.
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Injury Prevention Centre
780.492.6019 • ipc@ualberta.ca
Build @findingbalancealberta • @StopFalls
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Source of checklist:
To re s of falling
Rubenstein LZ, Vivrette R, Harker JO,
Stevens JA, Kramer BJ. Validating
an evidence-based, selfrated fall risk
questionnaire (FRQ) for older adults.
J Safety Res 2011;42(6):493-499.
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Funding provided, in whole or in part
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A Big Problem that is Getting Bigger Access Finding Balance materials,
Every day, 92 Alberta seniors are treated in emergency departments for injuries due including:
to a fall and 25 need to be admitted to hospital for treatment. With the population » Exercises to improve balance
of seniors expected to double by 2040, this problem will get bigger, unless we teach and strengthen muscles
older adults that falls can be prevented. » Tools and challenges to motivate
seniors to stay physically active
Nurses are Part of the Solution Remind your patients that falls are
Depending on your practice, you will have policies or guidelines to direct you not an inevitable part of aging:
in preventing falls. Both the Alberta Health Services Falls Risk Management » Balance can be improved
Recommendations for Adults and Older Adults and the RNAO Preventing Falls with practice
and Reducing Injury from Falls can assist in determining when it is appropriate » Strength can be improved
to use Finding Balance materials. at any age
» Being active improves balance
Use Finding Balance in Your Practice and strength
Finding Balance falls prevention materials cover a range of topics and are designed
Provide information about reducing
to encourage community-dwelling older adults to manage their risk of falling by
risks specific to the individual.
maintaining or improving their balance and strength. Whether you work with older
» Share Finding Balance
adults in the community or are preparing them to return home following a stay in
information sheets with patients
acute care, Finding Balance resources can help:
and their families
Start a conversation about the risk of falling.
Nurses have a valuable role to play
» Use the Are You at Risk of Falling? quiz with your patients
in preventing falls among older
Familiarize patients with the impact falls can have on independence and health. adults and Finding Balance can help.
» Discuss the Can a fall change your lifestyle? brochure Finding Balance is an initiative of
Share this message about how to prevent a fall. the Injury Prevention Centre. Visit
» Challenge Your Balance, Build Strength, Be Active findingbalancealberta.ca for more.PROFESSIONAL PRACTICE
YOU
ASKED
US
What is RN prescribing?
BY PAM MANGOLD, MN, RN, CARNA POLICY AND PRACTICE CONSULTANT
Registered nurses who meet certain require- While nurse practitioners in Alberta have had the autonomous
authority to prescribe since 1996, RN prescribers do not have
ments can now apply to become authorized to the same broad prescribing authority.
prescribe Schedule 1 drugs and order common
diagnostic tests within a specific clinical IS RN PRESCRIBING RIGHT
FOR MY PRACTICE SETTING?
practice setting. This new authority supports
In some practice areas, RN prescribing can support quality
access to care, system efficiency and cost- client care through increased access and system efficiencies.
effectiveness. It optimizes the RN scope However, RN prescribing may not be appropriate or relevant
of practice and provides new opportunities to all RNs in all practice settings.
RN prescribing is intended to safely address client health
for developing innovative practice models needs within a specific clinical practice area. The employer
in a variety of practice settings. must determine there is a unique client need for accessibility
RNs practise in areas where prescribing and administering to medication and diagnostic tests. When deciding if RN
Schedule 1 drugs to underserved populations can be time- prescribing is appropriate for your practice setting consider:
sensitive. Often, underserved populations are not well-connected > If you have the necessary knowledge, skill and support
with the health-care system and RN prescribing supports “just to make safe and appropriate prescribing decisions.
STEVE DEBENPORT/ISTOCKPHOTO.COM
in time” care. This can include prescribing anti-infective drugs > If client health-care needs are based on assessment of acuity
to treat infections, vaccines for preventing diseases and birth and predictability of client condition and health outcomes.
control. In these situations, instead of requiring a client-specific
> If the specific medications and diagnostic tests you anticipate
order from a physician or nurse practitioner, an authorized
prescribing can be clearly identified in a clinical support
RN prescriber could carry out standardized care that includes
tool. RN
a Schedule 1 drug when supported by a clinical support tool.
RNs are not authorized to prescribe controlled drugs and When you have decided that RN prescribing is right for you
substances or cannabis for medical purposes. Both of these and your practice area, please visit nurses.ab.ca/rnprescribing
are regulated by federal legislation. to find the requirements and application process.
20 ALBERTA RN SUMMER 2019 VOLUME 75 NO 2 | nurses.ab.ca›››
NURSES.
AB.CA
nurses.ab.ca | SUMMER 2019 VOLUME 75 NO 2 ALBERTA RN 21PROFESSIONAL PRACTICE
CASE
STUDY
Sexual abuse and sexual misconduct
Marie is a registered nurse who lives and works in a rural town in Alberta. While at a local coffee
shop, Marie spots Eric, a post-op patient she cared for around 10 months ago. Eric also recognizes
her and they start talking. An hour and a half passes by quickly and Marie and Eric are getting
along quite well. Before leaving, Eric asks Marie for her phone number and she gladly gives it to him.
The next day, Marie goes for brunch with for Eric, CARNA’s standards state that > Self-reporting any finding of profes-
her friend who is also a nurse. Although an individual is considered to be a patient sional conduct against them to all
Marie and Eric have not entered into a for one year after the last clinical encounter. regulatory bodies they are associated
sexual relationship at this point, she’s Even after one year, there may be with, as soon as reasonably possible
excited about Eric’s interest in her and circumstances where it is still considered > Reporting the conduct of a member
shares the details with her friend. Marie’s inappropriate for a nurse and patient to to the complaints director of the
friend asks if she received a letter from have a sexual relationship. The Policy appropriate college if a nurse has
CARNA about the new Protection of and Practice Consultant explains that reasonable grounds to believe that
Patients from Sexual Abuse and Sexual this is due to the power imbalance that the conduct of any regulated member
Misconduct Standards. Marie says, exists between a nurse and a patient, and of any regulated profession constitutes
“I think so, but I didn’t really pay much the vulnerability that exists in a patient. sexual abuse or sexual misconduct
attention to it.” Her friend responds, Marie learns about other important Marie is reminded that the obligation
“Well, you should really read it. Starting changes, including when an individual to maintain professional boundaries
a relationship with a patient or former is considered a patient or former patient, always lies with her, as a nurse, not Eric,
patient could mean having your practice considerations for nurses providing the patient. Upon learning about these
permit cancelled. You should call CARNA episodic care, and when a sexual new expectations, Marie decides to take
before seeing Eric again.” relationship with a former patient steps to maintain professional boundaries
After brunch, Marie calls a CARNA is never appropriate. The Policy and with Eric. RN
Policy and Practice Consultant to clarify Practice Consultant also outlines the
Disclaimer: Our case studies are fictional
her professional responsibilities and new standards and expectations of educational resources. While we strive to
accountabilities. They tell Marie there CARNA registrants, including: make the scenarios as realistic as possible,
any resemblance to actual people or events
are now mandatory penalties for sexual > Maintaining professional boundaries is coincidental.
abuse and sexual misconduct by all in all interactions with the patient in
regulated health professionals. She also the provision of professional services
learns that although she is no longer caring
nurses.ab.ca | SUMMER 2019 VOLUME 75 NO 2 ALBERTA RN 23ARNET
ANNOUNCEMENT
Nursing is changing.
A RN E T
is changing with it.
Planned 2020 changes to
ARNET’s funding supports for conference,
specialty nursing and degree studies include:
Changing to a Implementing
single application a charitable grant
form with two funding format Marilyn Wacko
reviews per year The Alberta Registered Nurses
Educational Trust is pleased
to announce the appointment
of Marilyn Wacko, MN, RN,
Receipts will as the charity’s next executive
Proof of
director effective July 15, 2019.
no longer be part completion will This appointment is in preparation
of the application be requried at time for the late summer retirement of
Margaret Nolan, who has provided
process of application leadership, direction and creative
inspiration to ARNET for
over 21 years.
Marilyn has extensive experience
For details and applications, visit arnet.ca in delivering innovative and collab
orative strategies and programs
NOTE: ARNET’s Annual Scholarship competition is not changing
that achieve positive organizational
growth. With a diverse background
Your charity. Our health. in public and not-for-profit sectors
at the national, provincial and local
Dedicated to quality health care by supporting levels, Marilyn is well-positioned to
lifelong learning for Alberta RNs.
TYLER OLSON/SHUTTERSTOCK.COM
champion and advance the charity
to meet the evolving needs of
Please Give. arnet.ca Alberta’s registered nurses.
Your charity. Our health.
Alberta Registered Nurses
Educational Trust
Dedicated to quality health care by
supporting lifelong learning for Alberta RNs.
ARN E T.CA
nurses.ab.ca | SUMMER 2019 VOLUME 75 NO 2 ALBERTA RN 25jane
cecilia
peggy violet
26 ALBERTA RN SUMMER 2019 VOLUME 75 NO 2 | nurses.ab.caFEATURE
Why nurses need to see
the stigma behind the headlines
BY TAMMY TROUTE-WOOD, MN, RN
“Alarming rates of syphilis “Alberta opioid overdose “Alberta transgender
and gonorrhea continue in fatalities hit record levels youth concerned about
Alberta. Number of cases last year, data show.” safety, violence and
of syphilis almost 10 times The Globe and Mail, Feb. 3, 2019 discrimination: survey.”
what they were in 2014.” Global News, Oct. 11, 2017
CBC News, May 3, 2019
How are these headlines related? Stigma.
THE IMPACT OF STIGMA ON WHAT IS STIGMA? their ability to secure resources, seek
services and participate in health-
HEALTH IS SEEN IN SEVERAL Stigma has been described as a process of
promoting behaviours, or weaken
AREAS INCLUDING RISING diminishing the worth of people. Negative
resiliency needed for self-advocacy.
societal attitudes, fear of discrimination
SEXUALLY TRANSMITTED AND and feelings of shame interact in complex
The Canadian Public Health Association
BLOOD BORNE INFECTIONS (CPHA) advocates that health and service
ways to produce poor health. Stigma
providers have an important opportunity
(STBBIS), THE OPIOID OVERDOSE creates barriers between patients and
to address stigma. As nurses, we can raise
health-care providers. This can look like
CRISIS AND IN THE HEALTH our awareness and knowledge, reflect on
lack of engagement between providers and
OUTCOMES OF SEXUAL AND people at risk, distrust, patient fears to
our values and develop skills to create
safer, welcoming and inclusive care for
GENDER MINORITY PEOPLE. disclose important information or nurse’s
all people.
fears to ask questions based on social
I’M SURE NURSES CAN THINK Stigma can be real or perceived.
taboos such as sexuality or substance use.
OF MANY OTHER EXAMPLES. Stigma can also undermine a patient’s
A person who has experienced enacted
stigma such as labelling, stereotyping or
agency by inhibiting social relationships,
The Body Maps series was originally published by CATIE, Canada’s source for HIV and hepatitis C information. These images were
created by women living with HIV in Tanzania and Zambia. In a five-day workshop, women outlined their bodies on paper and added
words, quotes and images to express their life journey with HIV. Learn more about the images at catie.ca.
nurses.ab.ca | SUMMER 2019 VOLUME 75 NO 2 ALBERTA RN 27INCLUSIVE AND PEOPLE-FIRST LANGUAGE STIGMATIZED LANGUAGE
Patient not in agreement with treatment Noncompliant patient
Person with diverse abilities Disabled person
Person experiencing a substance use disorder Addict
Person living with HIV HIV patient
Person experiencing mental health issues Mentally-ill person
Sex without a condom Risky sex
Sexual orientation Sexual preference
Assigned male at birth; assigned female at birth Born a man; born a woman
Person who is a survivor of sexual assault Rape victim
feeling judged, might anticipate stigma- that promotes health equity includes to care today? How might your thoughts
tized care in the future. This contributes low-barrier access STBBI testing and and reactions impact what health details
to a perception of stigma resulting in treatment. A person can come to any are shared?
people being less likely to ask for help, Alberta Health Services STI or Sexual
engage in care or seeking health care and Reproductive Health Clinic and get WHAT CAN WE DO?
only when very ill. free STBBI testing and treatment, even As nurses, we always try to put our
Health inequities are compounded if they don’t have Alberta health-care patients first. In trauma-informed care,
when multiple stigmatized factors intersect. insurance. if a person seems to be on edge, think
Consider how income, gender, race, culture, However, many people don’t get tested; about perceived stigma and how we might
education and social connectiveness why not? help neutralize it. Trauma-informed
impact our opportunities to be healthy. According to the CPHA , it’s a complex practices encourage us to approach
The Government of Canada (2018) report brew between heightened patient desire the situation with a spirit of ‘what has
of key health inequalities notes that for privacy and confidentiality and stigma, happened to you?’ rather than ‘what is
significant inequities are found for people including the patient’s right to control wrong with you?’ Patients need to feel
living with mental or physical functional how personal information is handled, safe, non-judged and assured that their
limitations, low socio-economic status, even by health and service providers. privacy and confidentiality are protected.
sexual and racial/ethnic minorities People are sharing intimate details and Language is powerful and can create
and immigrants. A report titled Social need to do so without the fear of losing either a safer and non-judgmental
isolation of seniors: A focus on LGBTQ control of their personal information experience or reinforce stigmatization.
seniors in Canada (2018) demonstrates which could result in stigma or discrimi- Use inclusive, non-judgmental language
the effects of compounded stigma. The nation. As nurses, we have an obligation that puts people first. Mindfully come
health inequities experienced by this to collect the least amount of information to each interaction without assumptions,
specific population includes increased required, ensure that patients know why asking open-ended questions that invites
risk for depression, suicidal ideation and information is being collected, and who the patient to tell their story.
other mental health problems, substance else might have access to it. There is always space to learn
use, increased stress and physical health I encourage you to think about it. more. RN
problems such as cardiovascular disease Would you want your health-care provider
and stroke. to know that you had chlamydia, ended Find CPHA stigma resources at: cpha.ca.
Policy can promote equity or produce a pregnancy or experienced an assault in
structural stigma. In Alberta, good policy your past? Why or why not? Is it relevant
28 ALBERTA RN SUMMER 2019 VOLUME 75 NO 2 | nurses.ab.caStigma defined
POUNDED STIGMA
COM
IONAL STIG
NSTITUT MA
I
CTED STIGMA
INTERSECTING ENA
SOURCES OF STIGMA LEVELS AT
ED STIG
HETERONORMATIVITY/ CEIV M WHICH STIGMA
ER MAY EXIST AND
CISNORMATIVITY
A
P
BE CONFRONTED:
SOCIAL TABOOS
INTERNALIZED POLICY/LEGAL
RELATED TO SEXUALITY
AND SUBSTANCE USE STIGMA INSTITUTIONAL
SEXISM/GENDER COMMUNITY
INEQUITIES
INTERPERSONAL
CLASSISM
INDIVIDUAL
RACISM
Potential impacts of stigma related to sexually transmitted and blood borne infections:
adoption of unhealthy behaviours
fear of disclosure
limited uptake of available STBBI-related services
inappropriate planning and implementation of STBBI prevention and support programs
ADAPTED FROM: Canadian Public Health Association, 2017. Exploring STBBIs and stigma: An introductory workshop for health and social
service providers (participant workbook). Available from cpha.ca/sexually-transmitted-and-blood-borne-infections-and-related-stigma.
REFERENCES: • Employment and Social Development Canada (2018). Social
• Canadian Public Health Association (2017). Discussing sexual isolation of seniors: A focus on LGBTQ seniors in Canada.
health, harm reduction and STBBIs: A guide for service providers. Retrieved June 2, 2019 from open.alberta.ca/dataset/0432e7da-
Retrieved June 2, 2019, from cpha.ca/sites/default/files/uploads/ 2884-4a39-8b17-6199cadd4b7b/resource/5aeb5c77-bd1f-4963-
resources/stbbi/discussionguide_e.pdf ae4c-893e7c738340/download/social-isolation-lgbtq-seniors.pdf
• Canadian Public Health Association (2017). Reducing stigma • Government of Canada (2018). Understanding the report on key
and discrimination through the protection of privacy and health inequalities in Canada. Retrieved May 30, 2019, from
confidentiality. Retrieved May 30, 2019, from cpha.ca/sites/ canada.ca/en/public-health/services/publications/science-research-
default/files/uploads/resources/stbbi/confidentialitystigma_e.pdf data/understanding-report-key-health-inequalities-canada.html
nurses.ab.ca | SUMMER 2019 VOLUME 75 NO 2 ALBERTA RN 29FEATURE
BREAKING
BARRIERS
TO MEDICAL
SUPPORTS FOR
INDIGENOUS
CHILDREN
BY MARY DOUGLAS, CARNA COMMUNICATIONS COORDINATOR
PATIENTS COME FROM DIVERSE BACKGROUNDS,
CULTURES, EXPERIENCES AND GEOGRAPHIC LOCATIONS. THESE BACKGROUNDS CAN MEAN SOME
CANADIANS ENDURE POTENTIALLY DISPARATE ACCESS TO HEALTH CARE.
INDIGENOUS GROUPS ACROSS CANADA EXPERIENCE CHALLENGES IN HEALTH EQUITY AND
INDIGENOUS CHILDREN ARE IMPACTED DRASTICALLY. INDIGENOUS CHILDREN ARE MORE LIKELY TO
HAVE PHYSICAL AND MENTAL DISABILITIES AND THEIR TREATMENT CAN BE FURTHER COMPLICATED
BY INADEQUATE CHILD AND WELFARE SERVICES. FEDERAL AND PROVINCIAL GOVERNMENTS
FUND DIFFERENT SERVICES FOR INDIGENOUS CHILDREN, ESPECIALLY THOSE LIVING ON-RESERVE.
AS A RESULT, IT CAN BE DIFFICULT TO DETERMINE HOW TO ACCESS SUPPORTS AND HAS OFTEN LED
TO DISPUTES BETWEEN GOVERNMENTS ABOUT WHO SHOULD PAY FOR WHICH SERVICES.
30 ALBERTA RN SUMMER 2019 VOLUME 75 NO 2 | nurses.ab.caJordan River Anderson’s life magnified the gaps within the
health-care system. Jordan, who was from the Norway House
Cree Nation in Manitoba, was born with complex medical needs
that could not be treated on-reserve. After spending more than
two years in hospital for treatment, Jordan’s doctors decided he
could leave the hospital and return home for care. The federal
and provincial governments had a jurisdictional dispute which
resulted in Jordan staying in hospital for an additional two years
unnecessarily. Jordan was five years old when he passed away
JORDAN WAS
in hospital and never spent a day in his family home. His story
was the inspiration for Jordan’s Principle, a child-first principle
developed to ensure all First Nations children can access the FIVE YEARS OLD
services and supports they need when they need them. WHEN HE PASSED
Jordan’s Principle is a legal order. In January 2016, after AWAY IN HOSPITAL
the Canadian Human Rights Tribunal found the federal AND NEVER SPENT
government failed to fully implement Jordan’s Principle, there
A DAY IN HIS
have been seven subsequent non-compliance orders since, most
recently in February 2019. Jordan’s Principle aims to ensure
FAMILY HOME.
First Nations children can access all public services in a way
that is reflective of their distinct cultural needs, takes full ACCESSING JORDAN’S PRINCIPLE
account of the historical disadvantage linked to colonization, Jordan’s Principle applies to all First Nations children ages
and without experiencing any service denials, delays or 0-18 years in Alberta who are living on or off reserve. If a child’s
disruptions because they are First Nations. needs are not being met, they are eligible to be referred to the
Under the principle, whichever governmental and depart- principle. Since July 2016, more than 218,000 requests were
mental jurisdiction encounters the child first is required approved under Jordan’s Principle giving children access to
to provide services to the child whether on or off reserve, speech therapy, educational supports, medical equipment,
minimizing disputes between jurisdictions. Jordan’s Principle mental health services and more.
is based upon the needs of each particular child, meaning it Individual (for a child or children in the same family or with
must take into account the distinct needs, circumstances and the same guardian) and group requests (for a whole community)
contexts of that child. The principle is also linked to substantive can be submitted by:
equality which means true equality in outcomes; for example
parents or guardians caring for a dependent First Nations
when some children need additional supports to achieve the same
child under the age of majority in the child’s province/
outcomes as children who are not similarly disadvantaged.
territory of residence
The government must make a decision regarding most cases
a First Nations child above 16 years of age
within 48 hours. Through Jordan’s Principle, families can also
learn about the help available for their child, be supported in an authorized representative of the child, parent or guardian
coordinating access to services and access funding when needed. with written or verbal consent provided by the parent or
As a major milestone in reconciliation, Alberta was the first guardian RN
province to sign a memorandum of understanding adopting For more information about accessing Jordan’s Principle,
Jordan’s Principle in November 2018. The First Nations Health please contact the 24-hour toll-free line at 1.855.572.4453.
Consortium and federal and provincial governments agreed to
coordinate services and address gaps in the health-care system REFERENCES:
unique to Indigenous people. • Canadian Paediatric Society. Jordan’s Principle. Retrieved from
Jordan’s Principle aids nurses in their commitment to cps.ca/en/status-report/jordans-principle.
provide safe, compassionate, competent and ethical care. • First Nations Child and Family Caring Society. Jordan’s Principle.
The Code of Ethics for Registered Nurses addresses nurses Retrieved from fncaringsociety.com/jordans-principle.
partaking in various aspects of social justice related to health • Government of Canada. Jordan’s Principle. Retrieved from
and well-being. Whether nurses witness a Jordan’s Principle canada.ca/jordans-principle.
case firsthand or they are aware of the potential for a Jordan’s • Jordan’s Principle Working Group (2015). Without denial, delay,
Principle case, it is vital for nurses to be aware of the supports or disruption: Ensuring First Nations children’s access to equitable
in place that contribute to health equity for Indigenous children services through Jordan’s Principle. Ottawa, ON: Assembly of
First Nations.
in Canada.
nurses.ab.ca | SUMMER 2019 VOLUME 75 NO 2 ALBERTA RN 31You can also read
