The Honorable Pat Binns, Premier of Prince Edward Island today announced that new Nurse Practitioner regulations have been approved for the Registered Nurses Act. Proclamation of the Act is planned for February 25, 2006. This announcement opens the door for the development of Nurse Practitioner proposals to be developed for healthcare work sites on PEI.
Premier Binns noted, “The Nurse Practitioner role is becoming an important aspect to healthcare across the country and we are pleased to see this role added to the PEI health system. We hope that roles such as this one continue to enhance healthcare practice and improve health outcomes for Islanders.”
Now that there are regulations for practice in place, proposals can be developed for health sites on the Island which are considered good prospects for the Nurse Practitioner role. The role will work in collaboration with a medical practitioner(s) and teams of health professionals. A Nurse Practitioner Position Assessment Committee has been developed to oversee where these positions are best placed within the health system.
Chester Gillan, Minister of Health added, “We are pleased with the work that has been accomplished with the Association of Nurses of PEI and the Nurse Practitioner Position Assessment Committee. It is through this teamwork approach that we will see success in the Nurse Practitioner role on PEI.”
Sylvia Poirier, President of the Association of Nurses on PEI (ANPEI) said, “This effort helps broaden the focus of nursing on PEI and we are very pleased to have been part of the development of this legislation and associated regulations.”
In December of 2004, the new Registered Nurse Act received Royal Assent in the Legislature. The Act could not be proclaimed until all the accompanying sets of regulations were drafted and approved.
BACKGROUNDER
NURSE PRACTITIONER REGULATIONS / REGISTERED NURSES ACT
History of Government collaboration with the Association of Nurses of PEI (ANPEI):
Department began working with ANPEI in 2002 on new legislation to govern registered nursing in the province.
• New Registered Nurses Act received royal assent December 2004. One of the changes in the new Act caused much anticipation and excitement in the province – recognition of a new title and scope of advanced nursing practice in PEI – the Nurse Practitioner.
• ANPEI had several committees begin preliminary drafts of regulations under the new Act.
Since 2004, Department representatives have been working with ANPEI and their legal counsel to further develop the four sets of regulations: Registration and Licensing of Nurses, Schools of Nursing, Professional Conduct Review, and Nurse Practitioner regulations.
Summary of the Four Sets of New Regulations:
1) Nurse Practitioner Regulations – Highlights include one category of Nurse Practitioner endorsement on a RN licence; endorsement requirements; overview of scope of practice of the Nurse Practitioner; requirement for Nurse Practitioners to establish and maintain a collaborative working relationship with a physician; standards for consultation; application for authority to prescribe drugs; overview and composition of the Diagnostic and Therapeutics Committee; and a requirement for an annual declaration of how collaborative working relationship is being maintained.
2) Registration and Licensing of Nurses Regulations – Updated licensing rules including additional requirement of criminal record check for new applicants; continuing competence requirement and consequences of failure to comply; establishment of practice hour requirements and provisions for temporary permits.
3) Professional Conduct Review Regulations – Restructured, and some name changes including change from “discipline” to “professional conduct review”; mediation is introduced as an alternate dispute mechanism; the Committee acts in panels of four, with a different panel of the Committee handling each of the two stages of the process: (a) investigation stage and (b) formal inquiry stage; and a Committee appointed by Council will hear appeals. Currently Council hears appeals.
4) Schools of Nursing Regulations - Standards have been reformatted and streamlined, with qualifications of dean and teaching staff listed in schedules; provision is made for situations when the School is unable to recruit teaching staff with the qualifications outlined in the schedules; and the minimum number of years of nursing experience for teaching staff was increased from two to three years.
The Nurse Practitioner Role:
• The role is clinically focused and practiced in collaboration with physicians.
• The role involves diagnosing or assessing diseases, disorders or conditions, and communicating the diagnosis or assessment to the client.
• Ordering and interpreting reports of screening and other diagnostic tests.
• Selecting, prescribing and monitoring the effectiveness of drugs and therapeutics, as directed by legislation and schedules developed by the Diagnostic and Therapeutics Committee.
The ANPEI Consultation Process:
ANPEI had also undertaken to consult with other health professionals impacted by the introduction of nurse practitioners into the health system – primarily physicians and pharmacists. This consultation was carried out with the College of Physicians and Surgeons, the Medical Society, and the Pharmacy Board – drafts of the Nurse Practitioner regulations were provided to these groups and feedback was received and considered
Once the nurse practitioner regulations were nearing completion, the last few drafts were provided to nurse practitioner representatives for their feedback.
Before submitting all of the regulations to Executive Council for final approval, ANPEI called a general meeting of their members in order to take a ratification vote for the new regulations. At the meeting, all of the draft regulations were ratified.
Government Approval of the Regulations:
On February 14, 2006, Executive Council approved the four sets of regulations, as well as regulations that will revoke the existing regulations under the current Nurses Act. They also approved the department’s recommendation to proclaim the Registered Nurses Act – the new Act and regulations will be brought into force and effect on February 25. Once the new Act is in force, applicants can come forward and seek a Nurse Practitioner’s endorsement on their RN license from the Association of Registered Nurses of PEI.
Nurse Practitioner Position Assessment Committee:
In order to ensure nurse practitioners are brought into the health system in a manner that will add value, and will ensure the most effective placement of these advanced nurses, a Nurse Practitioner Position Assessment Committee has been established to evaluate proposals that come into the Department from any entity wanting to create a nurse practitioner position.
The committee includes representatives from the following (one representative for each category is required):
• Manager of Human Resources, Department of Health
• Senior Management - Director, Department of Health
• Chief Nursing Officer
• Finance, Department of Health
• Acute Care Director of Nursing
• Nurse Practitioner
• A Community Hospital Administrator
• PEI Nurses Union representative
• Medical Society of PEI representative
• Community Hospital Board Member
Salaries for Role:
This is an area which is still under discussion with the PEI Nurses Union. Salary ranges for NP positions will be negotiated through the collective agreement process. The average salary for NPs in other provinces ranges between 75 and 85 thousand dollars.
Potential Costs to the System:
Each NP proposal will be reviewed and critiqued by a Nurse Practitioner Assessment Committee. It is difficult to determine the number of Nurse Practitioners which will be hired on the Island until the process unfolds. There are no pre-established targets. However, once proposals are approved, funds will need to be allocated. Each NP position will be assessed individually and funding will be determined on a case-by-case basis.