April 10, 2013

On April 7, in accordance with the mandate given it by the Federal Council delegation, the FIQ publicly stated its concerns about the file on nurses’ initial training. In fact, an upgrade of the initial training, that is, the entrance standard to practice nursing in Québec, would certainly lead to a major reform in the Québec health network and the Federation cannot stay in the background.

The position of the OIIQ is very clear in its request to the Ministry of Health and Social Services (MSSS). The OIIQ has done its work and answered the questions covered by its mandate. However, what about the other stakeholders involved?

The role and responsibilities of each member on the care team will be affected by an upgrade in the initial training of their nurse colleagues. The care team involves a close collaboration and work performed as an interdisciplinary unit, where every member brings a specific and additional expertise to that of the other members. It is therefore unrealistic to think that a modification in one component of the care team can be done without any impact on the healthcare professionals and on the delivery of care to the patients.

The MSSS must tell us: when it intends to start discussions with the Ordre des infirmières et infirmiers auxiliaires (OIIAQ) and the Ordre professionnel des inhalothérapeutes du Québec (OPIQ) on the expected transformation of those professions and on the impact of potential changes to the entrance standards for these same professions. Note that neither the OIIAQ or the OPIQ were asked to participate in the work of the interministerial-partners working group and that they still remain silent on the issue.

Would a modification in the role of the licensed practical nurse have an impact on that of the beneficiary attendant? If yes, to what extent? Would the roles of other contributors in the health network be affected? We do not know.

The university network, that is currently struggling to meet the demand for nursing training, must indicate the measures that they intend to set up to welcome this stream of new students. Where will we find the teaching staff needed when we are already facing a shortage in this sector?

The Fédération des cégeps, who say they share the idea of an upgrade in the training of nurses, state however, that any questioning of the training model must be based on a strict analysis of the current and future needs of the Québec population and that this analysis must be done on all the staff on the care team. That analysis has not been carried out.

The OIIQ is trying to be reassuring by stating that the nurses with a college diploma at the time the reform is implemented will be recognized.  How will that recognition be applied by the MSSS? In the institutions in the health network? We do not know.

The nurses who would normally have received their college diploma will not be in place three years after the new entrance standard has been implemented. What effect will that have on the shortage that exists across the network? At best, they will be confined to a limited temporary status, requiring the supervision of experienced nurses. What will the parameters be to regulate this temporary status? We do not know.

What estimates will be applied to the enhancement measures required to compensate for the increase in the tasks and responsibilities for all the healthcare professionals? How high will the bill be for university education for all new nurses? How high for that of more advanced training that could be imposed on the licensed practical nurses? Can the Conseil du trésor guarantee that the government in power at the time that this new entrance standard goes into effect will have the necessary budgets needed by the education network and the health network?  We do not know… but, we can imagine the answer given the budget cuts presently being imposed on them.

The FIQ is not at war with the Ordre des infirmières. The OIIQ has clearly stated its position and we have taken note. However, the OIIQ cannot speak in the name of the MSSS, the Ministry of Education, the Conseil du trésor, the OIIAQ, the OPIQ and who knows how many more. It is these bodies who must now engage with the healthcare professionals in the FIQ and the population that they serve.

This is a major reform that is pending in the health and social services network. By setting its effective date for 2014, we are depriving ourselves of any manoeuvring room for the problems that are likely to arise. Can we allow ourselves to fall back into the usual pattern of the reforms over the last few years in Québec, a hit and miss approach? Are we in such an emergency situation that it is absolutely unthinkable to contemplate delaying for 3 years, even 5 years, applying the new entrance standard?

I am a nurse. My training allows me to assess the overall health of an individual and to apply preventive measures when required, in light of a precise scientific analysis, supported by the facts and not vague suppositions. The current situation calls for no less.