A change in how three levels of health care staff provide care at Nanaimo Regional General Hospital has the British Columbia Nurses’ Union worried about what future roles will be for nurses, and how patients will be affected.
Last week, the Vancouver Island Health Authority advised NRGH staff and physicians through a letter that ongoing care delivery model redesign, initiated in 2008, would be taking its next step, which includes changing the composition of care teams that serve patients in the medicine, surgery, rehabilitation and transition units at the hospital.
According to VIHA, out of the seven units at NRGH where changes are being made, three units will have more staff, two will remain the same and two units will have fewer staff. The nurses union, however, argues that there will be fewer registered and licensed practical nurses and more care aides.
“There will be no layoffs associated with these changes,” states a release from VIHA. “There is a shortage of trained health care professionals in VIHA and across the country, and every trained, skilled and dedicated nursing professional is needed to provide quality care.”
The release added that registered nurses, licensed practical nurses and care aides, as part of the changes, may end up in different roles that requires “their full scope of training and skills.”
Jo Taylor, regional chairwoman of the Pacific Rim region for BCNU, said nurses are concerned that the changes will have a negative effect on patients and will hinder their abilities to provide the best care possible. She said VIHA wants to replace registered nurses for some duties with care aides, who have significantly less training.
“For example, when a nurse walks somebody to the bathroom, an LPN or RN is doing an assessment of a whole multitude of things,” said Taylor. “What their gait is, can they walk on their own, do they need help, are they short of breath, do they get dizzy. There are so many facets to the job whereas VIHA is saying a care aide can toilet somebody. Well, sure they can, but they can’t do all of the other things.”
Taylor said the new model will result in RNs and LPNs becoming supervisors, which is not what they are trained to be. They will also have less time bedside.
The decision to implement the redesign was brought in at the same time that the Nurses Bargaining Association staff moved to a new 37.5-hour work week as part of the new collective agreement. Introducing the changes at the same time is expected to minimize the impact on staff.
The changes are effective in September, and individuals are expected to be notified of their new role, if any, by early June. Though NRGH is one of the first hospitals in the area to see the change, it is likely most hospitals throughout B.C. will see similar patient care models adopted.
“The changes will improve both patient care and health outcomes and are being made because the population has changed – today’s population has more complex needs and that means a different approach to care is needed,” said the release.
Taylor said she agrees that an increasing number of hospital patients are on average older, but moving to a senior’s care facility-type model won’t improve patient care and outcomes at hospitals.