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VOLUME 35 ISSUE 1 • SPRING/SUMMER 2021 ISSN 1920-6348 CARE
Caregiver
Centered Connecting
Regulation to
Care
Practice
Mandatory Module
on Restricted
Activities
2 care | VOLUME 35 ISSUE 1
contents SPRING/SUMMER 2021
4 | REGULATORY SPOTLIGHT
How Healthcare Regulation Connects
to Professional Practice
8 6 | REGULATORY SPOTLIGHT
Mandatory Module on Restricted
Activities
8 | COVER STORY
Vital Support: Caregiver-Centered Care
Supporting family caregivers can have incredible
system impact. New CLPNA-supported research
recognizes the value of LPNs including caregivers
in their patients' circle of care. The Caregiver-
Centered Care learning module helps build and
reinforce this competency.
15 | PRACTICE
24 Alberta’s Opioid Crisis:
An Ongoing Public Health Concern
17 | WEBside Manner
15 Virtual Care Resources for Healthcare Providers
and Healthcare Leaders
18 | CLPNA 2020 Year in Numbers
Copyright © 2021 College of Licensed Practical 20 | PRACTICE
Nurses of Alberta Building Resilience Will Serve Us Well
CARE is the official publication of the College of
22 |
Licensed Practical Nurses of Alberta (CLPNA),
published on a bi-annual basis beginning in 2021. Nursing with Heart:
Reprint or copy of any content in whole or in Talking to a Leader in Harm Reduction
part requires consent from the CLPNA
Communications Department.
Editorial services provided by:
24 | How to Manage Anxiety
Bird Communications.
During COVID-19
Graphic Design by: A Guide for Frontline Workers
Tim Abel, Graphic Overload.
Signed articles represent the views of the author
and not necessarily those of the CLPNA.
27 | Alberta LPN News
20
Protecting the Public Interest
The CLPNA has final discretion regarding the
acceptance of notices, courses or articles and
the right to edit any material. Publication does not
constitute CLPNA endorsement of, or assumption
of liability for, any claims made in advertisements.
Annual Subscription: Complimentary for CLPNA
members, $21.00 for non-members.
care | SPRING/SUMMER 2021 3
Regulatory Spotlight
How Healthcare Regulation
Connects to Professional Practice
An important part of professional practice for licensed
practical nurses (LPNs) is to fully understand the
requirements, accountabilities, and professional
expectations of the profession as defined by governing
legislation.
Albertans expect their healthcare system to support them to
be as healthy as possible and that requires knowledge and
accountability on the part of those providing care. Meeting
this expectation requires that LPNs understand the connection
between regulation and practice to provide safe, competent,
and ethical nursing care.
Understanding regulatory responsibility can be broken into two
major components. Part 1 captures the legislative context and Job Description,
provides structure for how the College of Licensed Practical
Nurses of Alberta (CLPNA) fits into health profession regulation.
Part 2 explains how LPN practice fits into this legislative context,
which can be explained via three core components of regulatory
functions: registration, competence, and conduct.
Part Setting the Environment for
1 Regulatory Responsibility
The environment for regulatory responsibility is demonstrated requirements are found in regulation. Each health profession
in the graphic and includes the following key components: has their own professional regulation. There are also other
supporting regulations under the HPA.
• Legislation
• Regulation At the time of writing, the most important regulation for LPNs
• The Regulatory College is the Licensed Practical Nurses Profession Regulation. It
• The Employer provides more specific details for the licensed practical nursing
• The LPN profession in Alberta and details authorized restricted activities.
• The Public
The Regulatory College
Protection of the public is the foundation for the LPN The CLPNA is the regulatory college for LPNs established
regulatory framework in Alberta. All components of the under the HPA. The CLPNA exists within the regulatory
regulatory framework and every action taken within each framework to protect Albertans. The mandate of public
component work together to serve this purpose. protection underpins the core and supporting functions of the
CLPNA. The CLPNA is committed to public protection by
Legislation establishing:
In Alberta, the Health Professions Act (HPA) is the major piece • Minimum entrance requirements for registration
of legislation that underpins all health professions. The HPA (education)
outlines requirements for health professions to be regulated • Continuing competence requirements
by regulatory colleges. It sets rules for registration, continuing • Disciplinary and conduct functions
competence, and professional conduct. Additionally, the HPA
outlines the responsibilities and boundaries of regulatory The CLPNA also establishes practice standards, a code
colleges. Schedule 10 of the HPA is specific to the LPN of ethics, policies, and guidelines to inform LPNs of their
profession. professional responsibilities. All standards and policy
documents can be found on the CLPNA website.
Regulation
Broad parameters and common provisions for regulating The Employer
health professions are established in various pieces of Employers of LPNs play an important role in building and
legislation, including the HPA. More specific details and maintaining quality workplaces and ensuring the public’s
4 care | VOLUME 35 ISSUE 1
right to safe and ethical nursing care. As regulated health Registration
professionals, LPNs practice independently and as part To be eligible for registration as an LPN in Alberta, practical
of a team, working within their scope of practice and job nurse applicants must have a practical nursing diploma
description. approved by the CLPNA’s Council, registration in another
Canadian jurisdiction as an LPN, or the equivalent knowledge
The LPN and experience. To practice as an LPN in Alberta, individuals
This component of the regulatory framework focuses on must be registered and have a valid Practice Permit from the
the LPN. As regulated health professionals, LPNs meet CLPNA.
registration, competence, and conduct requirements outlined
by legislation, regulation, the regulatory college, and Regulated members must participate in the Continuing
the employer. For more detailed information about LPN Competence Program on an annual basis and complete an
professional practice in the regulatory framework, please annual renewal application by December 31st to practice in
see part 2 below. the upcoming registration year.
The Public Competence
The public is at the core of the regulatory framework because The Competency Profile for LPNs defines the knowledge,
all other components work together to ensure the protection of skills, attitudes, and judgements expected of LPNs in Alberta.
the public. Additionally, the public acts as a quality assurance The Competency Profile is also a guide to determine learning
mechanism for any actions or changes made to other levels as part of LPNs' continuing competence requirements.
of the regulatory framework. Members of the public can
provide feedback directly to the LPN, the employer, the LPNs in Alberta have full responsibility and accountability
regulatory college, or the government to offer guidance on for their own practice and are expected to practice within
protection of the public. Health profession regulation focuses their own level of professional competence, refining their
on the responsibilities of both institutions and individuals knowledge, skill and ability through additional education,
which demonstrates a shared responsibility to provide quality certification, and experience.
healthcare for all Albertans.
Conduct
LPNs have the professional responsibility to practice in
Part Understanding LPN Professional accordance with the Standards of Practice and Code of Ethics.
2 Practice in the Regulatory Framework When an LPN's nursing practice falls below professional
standards, it may constitute unprofessional conduct.
As noted above, LPNs are a key player in the regulatory
framework. Part 2 of this article focuses on how LPNs interact Under the authority of the Health Professions Act, the CLPNA
with the other components through the lens of professional is responsible for protecting the public from unethical,
practice. Specifically, we will talk about 3 components of LPN unskilled, and unsafe nursing practice of LPNs. As such, there
professional practice: registration, competence, and conduct. is a formal process to manage complaints of unprofessional
conduct against LPNs.
As discussed, registration, competence, and conduct functions
are intended to fulfill the CLPNA’s mandate “To regulate and
lead the profession in a manner that protects and serves the
public through excellence in practical nursing.”
The CLPNA has a diverse role in regulating the LPN
profession. It is important for LPNs to understand and connect
their regulatory responsibility to their nursing practice.
Professionalism requires that LPNs demonstrate professional
standards when providing nursing care and collaborate with
patients, colleagues, and other members of the healthcare
LPN team.
PROFESSIONAL
PRACTICE The many components of LPN regulation examined through
the CLPNA’s regulatory framework and by connecting
regulation to practice underpins the commitment and integrity
required to ensure public safety.
Numerous resources to support LPNs in meeting their
regulatory responsibility and accountability can be found on
the CLPNA website: clpna.com. n
care | SPRING/SUMMER 2021 5
Regulatory Spotlight
Mandatory Module
on Restricted Activities
According to Alberta’s Government Organization Act,
restricted activities are considered high-risk health
services that require additional education, skills, and,
at times, supervision requirements. This can also be an
area of confusion for healthcare providers.
The College of Licensed Practical Nurses of Alberta (CLPNA)
released a mandatory education module in February 2020,
“Understanding Restricted Activities”, to explain restricted
activities in general and, specifically, the restricted activities
that LPNs are authorized to perform.
All CLPNA members must take the module by June 1, 2022,
as per the Standards of Practice on Restricted Activities
and Advanced Practice. Similar content is incorporated in
CLPNA’s Learning Modules
Alberta’s approved practical nurse programs so that all new
Completed in 2020 Total
graduates will have learned the material by the same deadline.
Understanding Restricted
The module thoroughly unpacks the details needed to Activities (mandatory) 6,008
understand that, before performing any restricted activity, Administering Medications via CVC,
the LPN must ensure: PICC, and IVAD 6,606
1. The restricted activity is authorized by the LPN Administering Parenteral Nutrition 5,240
Regulation and standards of practice; Ear Syringing 3,786
Administering Blood and Blood Products:
2. The restricted activity is appropriate within the Transfusion 4,627
context of the practice of practical nursing;
Dispensing of Medications 3,526
3. They have the competence and competencies needed Administration of Nitrous Oxide 1,854
to perform the restricted activity from their entry- Immunization 3,416
level practical nursing education or from advanced Fetal Heart Monitoring 1,333
education or training;
Non-Ionizing Radiation 2,872
4. Advanced authorization is obtained (if required); Administering Diagnostic Imaging
Contrast Agents 1,162
5. The LPN’s employer supports the LPN performing
Protecting Patients from Sexual Abuse
the restricted activity; and Sexual Misconduct 953
6. Other required supports and/or resources are PTSD Awareness & Mental Health
available to perform the restricted activity safely in and Wellness for LPNs 578
that specific practice setting; and Caregiver-Centered Care 46
7. They are demonstrating evidence-informed clinical Total Modules Completed 42,007
judgement and decision making.
The CLPNA launched a new learning management system
For questions related to the LPN Profession
to provide member-only access to free, online education to
Regulation and resulting LPN practice changes,
support practice competence. Fourteen learning modules, please contact the CLPNA’s Professional Practice
including “Understanding Restricted Activities”, were released Team at practice@clpna.com, 780-484-8886 or
in 2020. By year’s end, LPNs completed 42,000 learning 1-800-661-5877 (toll-free in Alberta).
modules. LPNs can access all modules through their
myCLPNA.com account. n
6 care | VOLUME 35 ISSUE 1
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Licensed Practical Nurses
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a permanent, valid practice permit with the College of
Licensed Practical Nurses of Alberta in good standing.
Successful candidate will need to work with EMR Advantage
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needed. Remuneration shall be 25 to 30 dollars an hour.
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Please send your resume/CV to gpmci2015@gmail.com
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care | SPRING/SUMMER 2021 7
VITAL SUPPORT:
Caregiver-
Centered Care By Kristin Baker
8 care | VOLUME 35 ISSUE 1
Cover Story
Lacey Shontreau is worried, stressed, and exhausted.
She works full time while studying to write the practical nurse
registration exam. On top of these demands, she’s the family
caregiver to her mom, who was recently diagnosed with early
onset dementia.
“I haven’t sorted out everything she needs yet and I’m feeling
very overwhelmed,” she says. “I care for patients all day and then
I go home to care for my mom at night. I don’t have enough time
to study, and I’m stressed out all the time. I didn’t think it would be
this hard.”
Shontreau coordinates her mom’s medical appointments,
administers her medication, and helps with her household chores,
all while figuring out how to work with the many healthcare
professionals involved in her mom’s care. She feels her opinion
sometimes isn’t heard when decisions regarding her mom’s care
are made; she worries about the potential consequences.
It’s been a challenging time for her, but Shontreau has the
support of her coworkers. Some of them are family caregivers,
too. They’ve made suggestions about how she can be involved
in care decisions, advocate for her mom, and navigate the
healthcare system. This has helped her to take the first steps
alongside her mom on her healthcare journey. But it’s also made
her reflect on encounters with her own patients’ family caregivers.
Shontreau’s experience as both a healthcare provider and a family
caregiver form the main story line in a series of videos featured in the
College of Licensed Practical Nurses of Alberta’s (CLPNA) Caregiver-
Centered Care self-study module. The recently launched module
explores the challenges faced by family caregivers and the role that
healthcare providers can play in supporting them. While Shontreau’s
character is fictional, the issues she faces as both a healthcare provider
and a family caregiver are real.
One in four Canadians currently provides care for a member of their
family. It could be caring for a parent who has dementia, a child with a
disability, a brother with a mental illness, a close friend with a broken
leg or a spouse with a chronic condition. It can be short- or long-term
care or, in some cases, lifelong care. These unpaid family caregivers are
the backbone of the healthcare system.
“First and foremost, family caregivers help to sustain care in the
community,” says Dr. Jasneet Parmar, associate professor in the
Department of Family Medicine at the University of Alberta and
the medical lead of Home Living and Transitions for Alberta Health
Services Edmonton Zone. >
care | SPRING/SUMMER 2021 9
“The kind of care they provide, if they research around caregiver support. She “At that conference we realized there
were not available – the healthcare has also been a caregiver for an ailing are a lot of grievances that family
system could not go on. Think of all the parent and found it to be a stressful caregivers suffer when interacting with
care-related activities family caregivers situation. us,” recalls Parmar. “Their voices were
provide!” very loud and heartbreaking.”
“That’s what took me down that path.
A family caregiver is any person who As a physician who cares for the elderly, Sharon Anderson, MEd, MSc, PhD,
takes on a generally unpaid caring I needed the family caregivers to take attended that first conference. She later
role and provides emotional, physical, care of the seniors that I was seeing,” became the research coordinator for
or practical support in response to says Parmar. “But what I was not doing Parmar. Anderson also has a personal
physical and/or mental illnesses, was looking out for the caregivers’ connection to caregiver research – her
disabilities, or age-related needs. needs and how I could support them. husband had a stroke in 1997 and she
All I was doing was giving direction became his family caregiver.
iStock.com/SDI Productions
This can include a range of support and advice. And then I became a family “Our healthcare trajectories are getting
such as performing clinical services, caregiver myself.” longer,” says Anderson. “People are
medical monitoring, rehabilitation, living longer, and they provide care for
transportation, financial assistance, This experience showed her what it longer. On average, somebody is caring
housework, picking up medications, was like to be on the other side of for 6.1 years now, when it used to just
arranging appointments and navigating caregiving. be a couple of years.”
the healthcare system.
“That’s what got me thinking, do we That unpaid labour is worth a
People often become a family caregiver have a role to play with these people staggering $66.5 billion per year
out of love, respect, and responsibility who are supporting the system and are (source: Caregivercare.ca). The
for the care receiver, but it can also be a very stressed out? What are we doing? healthcare system is not sustainable
very demanding and challenging role. And that’s when we started to explore.” without the help of family caregivers.
“Caregiving, as much as it can be The initial plan was that Parmar and “We really weren’t recognizing family
fulfilling and satisfying, we recognize her team would research the topic. caregivers. There’s nothing in our
that it can be stressful,” says Parmar. They began talking to other healthcare policies that recognizes them in the
professionals, including the CLPNA’s [healthcare] system,” Parmar says. “So
She knows this from both professional representatives. In 2014, the research instead of looking to the government or
and personal experience. Parmar has team held their first stakeholder a community organization, we started
served in a variety of ways to lead the conference to establish priorities. to look into it ourselves.”
10 care | VOLUME 35 ISSUE 1Parmar found that there was very little caregivers,” says Anderson. “What since its inception. They helped the
research into the topic of caregiver care we’re doing is a cultural shift. We’re researchers understand the LPN scope
and support. It became obvious that trying to change things and the CLPNA of practice and how integral LPNs can
something needed to be done to help has been with us making that change be to a paradigm shift of this nature.
the caregivers themselves. Anderson from the very beginning.”
recalls that point being made very clear “Collaboration between family
when a man stood up at one of the The research team worked closely with caregivers and healthcare professionals
research sessions and said, “Stop trying the CLPNA and other stakeholders is becoming even more important in
to build a better caregiver! You keep to determine the best way to educate our healthcare environment,” says
educating us to be better caregivers, but and train healthcare providers about Standing. “That’s what motivated the
what we need is your support!” caregiver-centered care. It was decided CLPNA’s Caregiver-Centered Care
that evidence-informed competencies learning module that includes the
“We talk about patient- and family- should form the foundation of that Foundational Level Caregiver-Centered
iStock.com/jarenwicklund
iStock.com/FatCamera
centered care, but what we mean by knowledge. Six core competency Care Course. It focuses on assisting
that is how can families look after the domains applicable to all healthcare LPNs in expanding their knowledge
patients? What can we do to educate providers were established. and competencies in this area.”
the caregiver? An ‘aha’ moment for me
is that family caregivers throughout the “We recognize that healthcare providers The LPN competency profile includes
care trajectory are actually interacting have their own stresses and challenges,” knowledge of person-centered care. In
with healthcare staff on a regular says Anderson. “But if you are engaged this way, every LPN already possesses
basis,” says Parmar. with family caregivers and recognize the foundation necessary to incorporate
them, communicate with them, partner caregiver-centered care competencies
Recognizing that healthcare workers with them, it supports the health and into their practice.
at all levels and in all sectors have an wellbeing of the caregiver. It makes
important role to play in the support of your work easier and improves your “The basis of caregiver-centered care
family caregivers helped shape the focus relationship, and staff benefit from that is woven within the LPN Competency
of the research. It became more about relationship.” Profile which outlines LPN scope of
supporting the family caregiver in their practice, and a distinct module like
caregiving efforts rather than simply Glenda Tarnowski, the CLPNA’s Caregiver-Centered Care builds on
assigning them caregiving tasks. Director of Professional Practice that base,” says Tarnowski. “There’s
and Sharlene Standing, the CLPNA’s a foundational understanding that
“Caregiver-centered care is about Director of Professional Development, LPNs should be looking at who’s in
person-centered care for family have been involved in the research the person’s circle of care, and >
care | SPRING/SUMMER 2021 11Continued from page 11
whether those caregivers are included Tarnowski. “It completes the puzzle. “For example, a six-week ‘lunch
in the decision making for that When that individual is not included and learn’ could be a way to support
individual.” in the caregiving paradigm, there’s a staff in taking the learning journey
wealth of information about the person together,” says Tarnowski. “When staff
Recognizing the caregiver role is the [in care] that’s lost.” have an opportunity to learn together,
first of the six competency domains the collective learning can positively
identified through the research. The She also notes that even seemingly small impact changed behaviours across a
other domains include: actions on the part of an LPN can make care setting.”
• communicating with family a caregiver feel they – and their efforts
members – are recognized and supported. Taking She also points out that the
the moment to explain something to a responsibility of an LPN is to provide
• partnering with family caregivers
family caregiver or saying, “How are safe care to the public. Safe care
• fostering resilience in family you doing today?” are steps that can includes understanding the needs of the
caregivers easily be incorporated into transactions care recipient while also considering
• navigating health and social systems with family caregivers. those of the individuals that make up
and accessing resources their circle of care. The inclusion of
• enhancing the culture and context family caregivers is an important aspect
of care of providing safe care.
Each domain contains a set of Including a At the end of the Caregiver-Centered
competency indicators that highlight family caregiver’s Care module’s video series, Shontreau
is feeling more supported in the care
the knowledge, skills, attitudes and
values that shape caregiver-centered knowledge of the of her mom. Using communication,
care practice. care recipient in respect, and empathy, she is better able
to support the family caregivers she
“It’s applicable for all LPNs in all assessments and encounters in her own work.
healthcare settings,” says Tarnowski.
“By changing their own individual
care planning “LPNs who complete the module will
practice, LPNs can have an incredible establishes a also benefit from the learning as they
incorporate the caregiver-centered care
system impact. The CLPNA appreciated
that right from the start and felt we collaborative competencies into their practice,” says
could contribute to this important work relationship Tarnowski.
at that level.”
and approach For Anderson and Parmar, the ideal
Family caregivers often have a lot of
knowledge about the person in care.
to care. outcome of the caregiver-centered care
research and education would be a
Their familiarity with the patient is a healthcare system where caregivers are
critical piece to providing respectful supported throughout their caregiving
person-centered care. For example, a journey and patients have better care
woman with dementia might refuse “Often it’s due to multitasking and the because of it.
to eat her meals. Her care team may demands of the day that those moments
not know how to solve this problem are missed,” says Tarnowski. “The “If everyone does a little bit, all family
until a family caregiver tells them the modules reinforce that it’s important to caregivers can be supported in the
patient’s preference is to eat her meals take time to connect with the caregiver way they need to be supported,” says
from a bowl rather than a plate. This because in the long run it will be a Anderson.
slight change in meal presentation is better experience for everyone.”
important information the care team Feedback received from LPNs who
would not have had otherwise. The Caregiver-Centered Care module have completed the online learning
includes a series of six short videos that module to date has been very positive.
Including a family caregiver’s illustrate how each of the competencies
knowledge of the care recipient might be incorporated into an LPN’s “The CLPNA’s goal is to see as many
in assessments and care planning practice. The entire module takes LPNs as possible complete this learning
establishes a collaborative relationship approximately three hours to complete. to expand their knowledge and
and approach to care. The learning can be done individually competence,” says Standing. “It will
or in a group setting such as a long- positively impact the health journey of
“It’s important to include family term care facility (when supported by Albertans.” n
caregivers at all stages of care,” says the employer).
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care | SPRING/SUMMER 2021 13CHANGING
The language we use has a direct and profound
impact on those around us. The negative
impacts of stigma can be reduced by changing
HOW WE
the language we use about substance use.
TWO KEY PRINCIPLES INCLUDE:
TALK ABOUT • Using neutral, medically accurate
terminology when describing substance use
SUBSTANCE
• Using “people-first” language, that focuses
first on the individual or individuals, not the
action (e.g. “people who use drugs”)
USE*
It is also important to make sure that the
language we use to talk about substance use is
respectful and compassionate.
TOPIC INSTEAD OF USE
People who Addicts People who use drugs
use drugs Junkies People with a substance use disorder
Users People with lived/living experience
Drug abusers People who occasionally use drugs
Recreational drug user
People who have Former drug addict People who have used drugs
used drugs Referring to a person as People with lived/living experience
being “clean” People in recovery
Drug use Substance/drug abuse Substance/drug use
Substance/drug misuse Substance use disorder/opioid
use disorder
Problematic [drug] use
[Drug] dependence
* This document was created in discussion with people with lived and living experience, through existing research and documentation from other
organizations trying to address stigma. This is not an exhaustive list. Furthermore, as a result of the evolving discussion around the best language
to use to accurately discuss substance use, this list will likely be revised.
Cat.: HP5-132/2018E-PDF | ISSN: 978-0-660-27219-1 | Pub.: 180182
14 care | VOLUME 35 ISSUE 1Practice
Alberta’s Opioid Crisis:
An Ongoing Public Health Concern
Throughout 2020, the public health emergency individual may be using an opioid for the first time and
related to the COVID-19 pandemic was at the experience an overdose. Therefore, it is always important
to be respectful, professional, and aware of personal
forefront of most of our minds and continues to be
biases when someone is seeking more information about
of concern in 2021. However, COVID-19 is not the the opioid crisis and available resources from healthcare
only public health emergency Albertans are facing. providers.
Alberta is still confronted with an ongoing opioid
crisis impacting thousands of Albertans. When providing health teaching and coaching to
individuals about opioids, adopt a harm reduction
Opioid or any substance use may lead to a substance approach by withholding judgement, providing a safe
use disorder. As healthcare providers, it is important to space for individuals to make their own decisions, and
not stigmatize people facing addictions and ensure the supporting access to resources, while respecting the
language we use is respectful and compassionate. Mental individual’s right to make behaviour changes when
health is a core component to a person’s wellbeing they are ready. By remaining committed to supporting
and problematic drug use is just like any other health patient rights, health, and wellbeing, LPNs can better
condition that a person may be dealing with. support them.
At the same time, not everyone who uses opioids may LPNs are encouraged to refresh their knowledge about
have an opioid use disorder. In some instances, an signs and symptoms of opioid overdose, how to educate >
care | SPRING/SUMMER 2021 15Continued from page 15
others about substance use, and how interactions with those who use This resource contains information
to administer Naloxone. Taking these opioids, to recognize the signs and about take home Naloxone kits, the
actions will support Alberta’s response symptoms of an opioid overdose, LPN’s role in educating patients and
to the opioid crisis. and how to properly administer families, and administering Naloxone.
Naloxone to someone experiencing an You can find this Info Sheet here:
Some signs and symptoms of an opioid opioid overdose. You can access this https://www.clpna.com/wp-content/
overdose include: training on the AHS website: https:// uploads/2018/02/doc_Info_Sheet_
www.albertahealthservices.ca/info/ Naloxone.pdf.
• Decreased level of consciousness page13663.aspx.
• Irregular, slow, or absent Many Albertans have been affected
breathing (respiratory distress) Alberta Health Services has also by the opioid crisis. We can all work
created a knowledge checklist together to support the response to this
• Skin or nail
to guide healthcare providers on ongoing public health emergency by
discolouration (cyanosis)
recognizing an opioid overdose, providing non-judgemental, quality,
• Cold or clammy to touch administering Naloxone, and person-centred care. n
(diaphoretic) ensuring the appropriate emergency
• Choking, snoring, or gurgling medical services are contacted. This
For more nursing guidance, please
noises (agonal breathing) is a helpful resource for LPNs when
contact the CLPNA’s Practice
• Nausea or vomiting educating patients and families about
Team at practice@clpna.com,
Naloxone. You can find this checklist
• Seizure-like movements 780-484-8886 or 1-800-661-5877
at: https://www.albertahealthservices.
(tonic-clonic) (toll-free in Alberta).
ca/assets/healthinfo/mh/hi-amh-thn-
• Pinpoint or tiny pupils (myosis) participant-knowledge-checklist.pdf.
Alberta Health Services (AHS) The CLPNA recently updated the
provides free online training for Naloxone and the Role of the Licensed
health professionals to help guide Practical Nurse in Alberta Info Sheet.
2 ANNUAL Wednesday,
May 5, 2021
0 GENERAL
2
Register at
www.CLPNA.com
1 MEETING
Featured Presentations:
Valerie Paice, President
Jeanne Weis, CEO
and the 2020 Annual Report
16 care | VOLUME 35 ISSUE 1WEBside
Manner
Virtual Care Resources for
Healthcare Providers and
Healthcare Leaders
of Canadians have of Canadians would like to have
experience with virtual visits with their
The way you care for patients is changing. virtual healthcare. healthcare provider.
Check out these valuable resources to help
you and your colleagues improve virtual care
appointments.
© 2020 Canadian Medical Association. Reproduced by the Canadian Patient Safety Institute and shared with the CLPNA with permission.
care | SPRING/SUMMER 2021 17CLPNA 2020 YEAR IN NUMBERS
806
Alberta graduate
401
Out of Province
75
IEN* registrations
registrations registrations 2019 - 139
2019 - 1171 2019 - 391
17,656 total LPN registrations
2.3%growth in
registration
152complaints
27
hearings
38
average age
received completed of LPNs
*Internationally educated nurse
18 care | VOLUME 35 ISSUE 1Top Places of Employment
90%
H H H
of Alberta
candidates passed Hospital Continuing Care* Community Care**
CPNRE Exam
on 1st write 36% 29% 27%
5277 4244 3939
Employment Practice
Consultations
41%
Full-time
40%
Part-time
19%
Casual 2578
inquiry responses
5998 5828 2768
Learning Modules
Completed 32 Webinars Self-Study Courses
Completed
42,007 7056 attendees
21,560
*Continuing Care includes Nursing Home / Long Term Care, and Rehabilitation / Convalescent Centre.
**Community Care includes Community Health / Health Centre, Home Care Agency, and Physician’s Office / Family Practice Unit.
care | SPRING/SUMMER 2021 19Practice
Building Resilience Will
Serve Us Well
By Michelle O’Rourke, RN, MA
Experiencing personal health and wellness can seem has firm roots and is grounded in solid ground, it not only
like an elusive dream in these chaotic times. There recovers but grows stronger. Our lives are much the same.
seem to be many stresses to tend to - family, home, Building good habits and strategies for staying healthy
amidst our everyday challenges serves us well – particularly
finances, time management – on top of the pressures
when a crisis arises, and we attempt to weather the storm
we may experience at work. Anxiety around tensions
without becoming depleted. As nurses, avoiding the pitfalls
in our world, coupled with the fears and sense of of compassion fatigue and burnout can be accomplished by
collective grief with COVID-19, all add to the strain ensuring we are caring for ourselves now and not putting it
we feel on any given day. off until we have more time!
Learning and applying strategies to maintain our wellness is There are three main areas that can help build resilience: 1)
important. Nurses are encouraged to focus on their overall attention to self-care; 2) raising our self-awareness through
wellbeing as part of their responsibility for maintaining their self-reflection, and 3) decreasing stress. One way to bring
fitness to practice. One way to do this is to focus on building down our stress level is to exercise mindfulness. Mindfulness
resilience. Resilience refers to the ability to adapt and thrive is the practice of having an awareness and acceptance of the
when faced with adversity. The good news is that resilience present moment without judgement. When taking a moment
can be developed and strengthened. for a few deep breaths and focusing on the present, instead
of focusing on the past or worries of the future, we are being
Imagine for a moment a tall, beautiful tree. When a storm mindful.
comes along, the tree bends and sways, almost to its
breaking point. Once the winds die down, the tree stands People that care for others sometimes find it difficult to
strong again. Its strength is tested in the storm, but if it prioritize caring for themselves. Self-care is an intentional
20 care | VOLUME 35 ISSUE 1way of living – where our values, attitudes, and
actions are integrated into our daily routines. The way
you care for yourself is unique, and you determine
what works best for you.
As nurses, building helpful strategies into your routine
is a good first step! This can include:
• Taking stock of your responsibilities: prioritize
and delegate
• Finding some time for yourself every day – quiet
and unplugged
We’re Hiring!
• Identifying what refreshes you and building it
into your schedule
• Enjoying nature, the arts, music, or hobbies
Licensed Practical Nurses (LPNs)
• Spending time with family and friends
• Maintaining a personal life outside of work SE Health is a Canadian not-for-profit home
• Taking time to exercise, sleep, and eat well - care organization. Named one of Canada’s
remember to play! Most Admired Corporate Cultures
(Waterstone, 2018), we’re committed to
• Seeking support – at home and work
supporting our staff and recognizing their
• Tending to your own spiritual needs unique needs. Join our team today for the
• Setting healthy personal boundaries opportunity to learn, grow and bring hope
• Engaging in self-reflective practice
and happiness.
• Practicing self-compassion Employee Perks and Benefits:
• Our ‘Total Rewards and Recognition’
To learn more about building resilience, watch the
Resilience: A Mindset for Wellness presentation on program that includes health insurance
the CLPNA’s YouTube Channel, and complete the • Comprehensive paid training
online Resilience learning module available through
myCLPNA.com. Take good care of yourself – there is and orientation
only one you! n • Tuition Assistance Program and bursaries
• Flexible work hours
Michelle O’Rourke, RN, MA, is a registered nurse
with a background in Emergency Nursing, Parish
Nursing, and Hospice Palliative Care. She has also
studied theology and spirituality, and was instrumental Apply to an LPN role today at one of our
in helping to design and build a 10-bed residential seniors living communities in Cochrane,
hospice. Michelle is the author of two books focused
on palliative care, and is excited about her new one,
Edmonton, Red Deer and Wetaskiwin.
titled Healthy Caregiving: Perspectives for Caring
Professionals. She is passionate about helping family
caregivers as well as professional caregivers learn the Apply now at jobs.sehc.com
importance of taking care of themselves while they care
for others. Michelle and her husband Tom reside in
Chatham, Ontario.
care | SPRING/SUMMER 2021 21Opioids and Harm Reduction
Nursing with Heart:
Talking to a Leader in Harm Reduction
By Shawna Dirksen
Compassionate and completely
an area that many nurses don’t have
committed to her profession, confidence in; there is often a lack of
Marliss Taylor has been a understanding or even fear. I think
registered nurse for well over three most healthcare professionals knew
decades. She has made countless opioids were a problem, but many had
contributions to the health and no idea of the magnitude. I think the
overdose crisis has led to uncertainty
medical field all while following a for many nurses. They aren’t sure how
career path that is anything but to approach people who use substances
conventional. or they react from fear.
Marliss is a program manager with What would you say to nurses
Streetworks, an inner city program about the stigma surrounding
that applies harm reduction principles substance users?
to help street-involved people who use
substances live safer, healthier lives. Marliss Taylor I think many people stigmatize without
In her role at Streetworks, she makes realizing it. A lot of it comes from
a difference each day, helping people media messaging and pop culture
who use substances access important things of people that they can’t do. - news stories and television shows
medical care and resources. We ensure people who use substances, showing people who use substances
and who are often involved in other at their absolute worst. This kind of
Marliss has contributed to harm risky activities like sex work, get the stigma prevents people from seeking
reduction initiatives not only care they need. We help them be as help when they need it. They are
provincially and nationally, but also healthy as possible by not putting them afraid of judgement or afraid that their
internationally in Guyana and Siberia. in a riskier environment than they are substance use will be put on record.
She has been recognized with both already in. This field lets me be the best Most nurses want to do their best, but
a Clinical Innovation Award and a nurse I can be. when some don’t, the message gets out
Leadership Award from the Nursing on the street. As a result, many people
Honour Society, and has received a You are clearly very passionate don’t receive care.
YMCA Woman of Distinction Award in about what you do. What keeps
Health and Medicine. that passion going? What advice do you have for
nurses to help them care for
Marliss talked to CARE Magazine I really love transcultural nursing. I get patients who use substances?
about her nursing career, opioids to come from a place where I look not
and harm reduction, and the stigma at what people can’t do, but at what Nurses are in an incredibly unique
surrounding substance users. people can do. Some of the stories I position to provide care and support
hear would break your heart or make to people who use substances, but the
You’ve been a program manager you angry, so it’s important to come judgement piece is a killer. We must
with Streetworks for more than at things in a positive way. This kind appreciate that people use substances
20 years. Why have you dedicated of nursing is relationship based. You for a reason. We need to treat people
your career to harm reduction? really need to let yourself care about like people and move away from that
people and let them get to know you as notion of “good” or “bad”. Often
For me, this is the way nursing a human being. people who use substances or who
makes the most sense. Abstinence or work in the sex trade are seen as one-
disease-based nursing is not the right What impact is the opioid crisis issue people, but they are folks who
solution for many. With people who having on nurses? also get appendicitis, or have babies,
use substances, there is often more or catch a cold. Everything in their
to the story. Using a harm reduction I think it has opened a door that health picture is not about the at-risk
approach means we do not demand many people don’t want open. It’s behaviour. These are just people. n
This article is a reprint from CARE Spring 2019 as opioid use in Alberta remains a crisis.
22 care | VOLUME 35 ISSUE 1An estimated
Hearing 19% of Canadian
adults have at least mild hearing
loss in the speech
frequency range.
Many of us take our ability to communicate for granted. Yet the ability
to speak, hear and be heard is much more vital to our everyday lives
than most of us realize. Each year, Speech-Language & Audiology
Canada dedicates the month of May to raising public awareness
TIPS for talking with
about communication disorders and the professionals who can help.
someone who has a
Common Hearing & Other Auditory Disorders:
hearing disorder:
Hearing Loss • Get the person’s attention by saying
Hearing loss is a partial or total inability to hear. The severity of the their name or touching their arm
hearing impairment can range from mild to profound and can be in before you start talking.
one or both ears. There are different types of hearing loss, which are
caused by problems in different parts of the outer, middle and inner • Speak clearly and loudly enough
ear as well as the hearing nerve. Hearing loss can be caused by the to be heard, but do NOT shout.
natural aging process, excessive exposure to noise, head trauma, a Shouting distorts the speech sounds.
history of ear infections or hereditary factors. • Be patient and provide the person
with some extra time to respond.
Auditory Processing Disorder Hearing and processing sounds may
Auditory processing disorder (or APD) is a disorder that affects the take a bit longer.
way the brain processes sound — in other words, what the brain
does with what the ear hears. Some symptoms of APD include poor • Avoid putting anything around
listening, trouble following directions, short attention span and your face and mouth when you are
difficulty reading. People with APD can have normal hearing and APD speaking (e.g., pens, phones, hands).
is not related to intelligence. People with hearing loss use visual
cues to help them understand the
Tinnitus message. People without hearing
Tinnitus (TIN-A-TUS) refers to “ringing in the ears” when no other loss also use visual cues!
sound is present. Tinnitus can sound like hissing, roaring, pulsing,
whooshing, chirping, whistling or clicking. Tinnitus can occur in one • Create an ideal listening
ear or both ears and while tinnitus is often associated with hearing environment: move away from noise
loss, people with normal hearing can also have it. Sometimes the sources and choose a place with
sounds are accompanied by pressure or pain in or around the ear or good lighting.
by a painful sensitivity to sounds. The impact of tinnitus ranges from
• Position yourself across from the
annoying to debilitating.
listener rather than beside. Look at
the person when talking.
Hyperacusis
Hyperacusis is a health condition characterized by an over-sensitivity • During group discussions only one
to certain sounds. A person with severe hyperacusis has difficulty person should speak at a time.
tolerating everyday sounds, some of which may seem unpleasantly
loud to that person but not to other people. Although all sounds may • Smaller group discussions are ideal.
be perceived as too loud, high frequency (pitch) sounds may be Listening in a large group setting can
particularly troublesome. be difficult.
www.sac-oac.ca AUDIOLOGISTS are highly-trained
hearing health professionals who
identify, assess and manage individuals
with hearing and balance disorders as
well as other auditory disorders.
care | SPRING/SUMMER 2021 23How to Manage Anxiety
During COVID-19
A Guide for Frontline Workers
By Elaine Conrad, Trainer (MEd, RP), Crisis & Trauma Resource Institute
“I just don’t want to do this anymore,” an exhausted
healthcare worker uttered as he hung his head against
his arms before heading off to visit the next anxious
patient. It’s a story that numerous frontline workers
are telling as they face the onslaught of frustrated
patients, family members, and coworkers who are
also facing the ever-changing landscape of the
“new normal.”
There’s a steep learning curve for frontline workers in all
fields as they try to keep up with the changing regulations,
angry clients, and extra demands of their jobs. Is it any
wonder that anxiety is climbing?
iStock.com/Tjaa
How can we manage anxiety before it manages us?
When I was working as a nurse, I remember times when
we faced extreme changes to protocol which required us
to quickly adapt and caused a huge amount of anxiety
among staff. One important thing I’ll never forget were the
sage words of one of my supervisors: “Cut yourself some Here are five ways frontline workers can reduce anxiety:
slack – this is new for all of us and we’re gonna have a little
anxiety about it. Take a deep breath, give yourself a moment EXERCISE
to digest it all, and then open the door and go to work.”
In other words, many of us will face anxiety – don’t beat Physical exercise during COVID-19 is still possible, even if
yourself up over it. you have limited space and time. With the weather changing
(for the better), take the opportunity to get out and grab
If you are feeling anxious and worried about everything some natural vitamin D as it’s been shown to reduce anxiety
that’s going on right now, give yourself a break! It’s likely and boost our immunity. Even taking ten minutes and
that your neighbour, partner, co-worker and even your walking around the building will do wonders for improving
employer are also feeling anxious. The first tip is to cut your mood. Allow your face to feel the sun, breathe in the
yourself some slack and realize that this is part of the air – really breathe it in, put on some excellent music if you
“new normal.” can, and enjoy the feel of the air on your skin. Do not think
about work, COVID-19, bills, or anything but the feel of the
Being slightly anxious is actually quite normal – being overly sun, the air, and how wonderful it feels to be outside.
anxious and letting it interfere with your sleep, thoughts,
and ability to work, play, or enjoy life is what’s harmful. PRACTICE POSITIVE MESSAGES
That’s when it manages us. Letting anxiety take control
of you is not only exhausting, but it can lead to physical Fill your breakroom, office, car, or wherever you spend your
problems such as a reduced immunity to disease. What downtime with pictures that bring you hope. I went through
better reason could you have during a pandemic to take my old photos on my phone and laptop and started pulling
steps to reduce risks? up pictures that bring me great joy – pictures of the ocean,
24 care | VOLUME 35 ISSUE 1SPRING-SUMMER 2021
sun, waves, my family, etc. Find whatever inspires you CRISIS & TRAUMA
LIVE VIRTUAL
and fill your space with those memories. If you have a RESOURCE INSTITUTE
WORKSHOPS
locker at work, put a positive message on the inside of
the door along with a picture that makes you smile. It’s
hard to be anxious when you are looking at a relaxing www.ctrinstitute.com
scene.
CHOOSE YOUR SOCIAL MEDIA Motivational Anxiety
AND NEWS WISELY Interviewing Practical Intervention
Strategies for Strategies
While social media can be our friend when we are Supporting Change May 18, 9 am-4 pm CT
socially isolated, it can also be a source of added stress May 11, 9 am-4 pm CT
and increase our anxiety. If you must check the news,
limit it to once a day and make sure it is a source that Depression The Ethics
is reliable. Remember, many news articles are written to Practical Intervention of Helping
draw you in with taglines that are often distressing. As Strategies Boundaries and
May 19, 9 am-4 pm CT Relationships
for social media, you may have to carefully choose which
friends you continue to follow during this time to protect June 3, 9 am-4 pm CT
your mental health.
De-escalating Walking With Grief
BE SELFISH ABOUT SELF-CARE Potentially Helping Others Deal
Violent SituationsTM With Loss
Set aside time for self-care. While you may want to rush June 8, 9 am-4 pm CT June 9-10, 9 am-4 pm CT
directly in the door to be with family, taking the time
after work to de-stress in your car by listening to calming Vicarious Trauma Critical Incident
music and practicing deep breathing will not only help
Strategies for Group Debriefing
with your anxiety, it will help lessen the overall stress Resilience July 6, 9 am-4 pm CT
levels for your loved ones as well. Ask those close to you June 29, 9 am-4 pm CT
to give you a set amount of time so that you can sit and
be quiet, grab a shower, a glass of water, a snack, and
relax before they ask about your day.
U N A B L E TO ATTEN D O N E O F
CONNECT WITH OTHER PEOPLE O U R L I VE VI RTUA L E VEN TS?
We are not meant to be alone. Humans are relational We offer many of our
workshops and webinars
beings and social distancing and self-isolation have as on-demand products.
made nurturing relationships difficult. When feeling
stressed, text a friend – a controlled vent is usually a
great way to express what you are feeling and let off
some steam. Video conference on your phone if you are
able – sometimes just seeing the face of someone you FREE RESO U RC ES
know cares about you can help reduce stress and reduce Webinars Assessment tools
anxiety. If you have time, play a virtual game, tell a few E-manuals COVID-19
resources
jokes, or read to a child to activate a different area of Handouts
your brain. Chat about something fun with one of your
coworkers between clients. Have a funny face contest,
and inject humour into the day as much as possible and is
NEW BOOK!
appropriate. Remember to connect with those you love as
often as possible. A Little Book About
Trauma-Informed
To all the frontline workers: the work you do is Workplaces
important and necessary. But to be helpful to others, you We envision a world where
must put on your own oxygen mask first. If your anxiety everyone is trauma-informed.
continues to manage you, please reach out to a helping
professional for support. n
Inspiring Learning. Improving Lives.
This article was originally published by Crisis & Trauma info@ctrinstitute.com www.ctrinstitute.com 877.353.3205
Resource Institute and is reprinted with their permission.
care | SPRING/SUMMER 2021 25Evaluating the Credibility of Health
Websites: Can You
Questions or comments Trust Dr. Google?
References
about CADTH or this tool? Aslani A, Pournik O, Abu-Hanna A, Eslami S. Web-site evaluation tools: a case study in
reproductive health information. Stud Health Technol Inform. 2014;205:895-9.
How to Tell if It’s Legit
Online:
cadth.ca
Chumber S, Huber J, Ghezzi P. A methodology to analyze the quality of health information on
the internet: the example of diabetic neuropathy. Diabetes Educ. 2015 Feb;41(1):95-105.
There are several tools available to evaluate health websites. Most
DISCERNofonline: Red
themquality criteria for consumer Flags
health information [Internet]. Oxford, UK:
list criteriaEmail:
that reliable websites should meet. Here is a summary of the
University
!
mainDivision of Public Health
of Oxford, and website
The Primary Health Care
relies on[cited 2016cases
single Jan 27].
requests@cadth.ca
criteria to look out for: Available from: www.discern.org.uk
or personal testimonials.
Golterman L, Banasiak NC. Evaluating web sites: reliable child health resources for parents.
2011 Mar-Apr;37(2):81-3. ! The information is presented in a
Twitter:
Author — The website should clearly identify the author, institution, and editorial
Pediatr Nurs.
@CADTH_ACMTS
board (the people responsible for the professional review of the content). sensational, overly emotional, or
HONcode: Principles – Quality and trustworthy health information [Internet]. Chene-Bourg,
alarmist way.
Switzerland: Health On the Net Foundation; 2013 Sep 19 [cited 2016 Jan 27]. Available from:
New at CADTH Newsletter:
Date — The website should contain current scientific information, and the
cadth.ca/subscribe www.healthonnet.org/HONcode/Conduct.html
! The website implies that a
content should be updated regularly. Khazaal Y, Chatton A, Cochand S, Coquard O,treatment
Fernandez S,affects
Khan R, eteveryone in the six
al. Brief DISCERN,
questions for the evaluation of evidence-based content
same way of health-related
(e.g., 100% websites.
successPatient
rate).
Objectivity — The website should be evidence-based and objective (factual)
Educ Couns. 2009 Oct;77(1):33-7.
in its content, listing benefits and risks (e.g., side effects). TheMonheit
website DF. should
! The website is trying to sell you
Evaluating health information web sites for credibility. J Hospital Librarianship.
mention other treatment options, if available, including no treatment, and it
2011 Feb 2;11(1):39-44. something.
Silberg WM, Lundberg GD, Musacchio RA. !Assessing,
should encourage patients to consult with a health care professional. It is notcontrolling,
clear who andthe author
assuring is or
the quality
what
of medical information on the Internet: Caveant qualifications
lector orreader
et viewor--Let the conflicts of
and viewer
Purpose — The website should state its purpose clearly. Any advertising
beware. JAMA.should
1997 Apr 16;277(15):1244-5.interest he or she has.
be clearly marked and separated from the site’s main content.Yaqub M, Ghezzi P. Adding dimensions to the analysis of the quality of health information of
! Studies
websites returned by Google: cluster analysis
are referenced, but they are
identifies patterns of websites according to their
Transparency — The website should identify its ownership, sources of funding,
classification old (from
and the type of intervention described. 10Public
Front yearsHealth.
ago or more)
2015 or the
Aug 25;3:204.
year of publication is not provided.
and explain how it collects and uses personal information.
! Links are broken — this could
Usability — The website should be easy to use, well-organized, and well- indicate that the site has not been
designed. It should provide a way of contacting the owner of the site. updated recently and that the health
information could be outdated.
There will be some credible websites that don’t meet all the criteria. Likewise,
there will be unreliable websites that look very slick and seem to meet all of
them. Ultimately, the only way to know if online health information is accurate is
to find the source and read the scientific study being referenced. Learning how
to evaluate for the credible criteria, however, will help you start filtering.
Tools for Evaluating
Health Websites
Examples of Credible Health Websites DISCERN
A validated instrument that enables patients and
The Medical Library Association has put together a list of pre-screened health
DISCLAIMER information providers to judge the quality of written
websites called consumer health information. It consists of 15
This material is the
made MLA Top Health
available Websites.purposes
for informational These websites
only and nocan be accessedor warranties
representations are made with respect to its fitness for any
questions and a rating scale.
onparticular
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— Consumer andshould notHealth
Patient be usedInformation
as a substitute for professional
Section — site: medical advice or for the application of professional judgment
in any decision-making process. Users may use this
www.mlanet.org/page/top-health-websites
www.mlanet.org/page/top-health-websites. . document at their own risk. The Canadian Agency for Drugs and Technologies in Health (CADTH)
HONcode
does not guarantee the accuracy, completeness, or currency of the contents of this document. CADTH is of
A set notprinciples
responsible for any errors
for evaluating or omissions,
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or injury, loss, or damage arising from or relating to the use of this document and is not responsiblecertification
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provincial or territorial governments, other CADTH funders, or any third-party supplier of information. This document is subject to copyright and other
JAMA Benchmarks
intellectual property rights and may only be used for non-commercial, personal use or private research and study.
Four criteria to score to a website
(0 to 4 points) based on authorship, attribution,
disclosure, and currency.
ABOUT CADTH
CADTH is
Evaluating anCredibility
the independent, not-for-profit
of Health Websites:organization responsible
Can You Trust for providing Canada’s
Dr. Google?
health care decision-makers with objective evidence to help make informed decisions
about the optimal use of drugs and medical devices in our health care system.
CADTH receives funding from Canada’s federal, provincial, and territorial governments, with the exception of Quebec.
March 2020 cadth.ca
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