The Northwest Territories government plans to change how nurses are regulated, bringing them under one regulatory framework for the first time.
In a discussion paper, a working group of the territory’s health department and registered nurses’ association propose all nursing professions be regulated by the nurses’ association.
Currently, only registered nurses and nurse practitioners are regulated by the association. Licensed practical nurses are registered by the NWT government. Registered psychiatric nurses in the territory are unregulated.
Creating one regulatory framework under the Nursing Profession Act would simplify the process, the territory said, and a single code of ethics and standards of practice would be applied to all nurses.
“Having uniform standards of practice and a code of conduct for all nurses will ensure that residents of the NWT can expect to receive the same standard of care regardless of who is caring for them,” one licensed practical nurse was quoted as saying.
“With all nursing professionals adhering to the same continuing competence guidelines and annual practice hours, residents can take comfort in the fact that their nurse is participating in ongoing education to ensure they remain competent in their roles.”
The discussion paper notes there is “broad consensus” that licensed practical nurses are underutilized in the NWT. Several of those nurses said they hope legislative amendments will help address that issue.
“This will only serve to benefit our underserviced and often understaffed healthcare system,” one stated.
While there was “almost universal support” for the regulatory changes, the paper said there is concern that registration renewal fees for licensed practical nurses could “increase dramatically.” Currently those fees total $54 as the territorial government absorbs most of the cost to assess and process applications.
The discussion paper proposes other changes to territorial nursing legislation that it states would benefit both nurses and the public.
That includes the creation of a new nursing designation called Registered Nurse Prescriber that would allow registered nurses with additional certification to prescribe a limited range of medications and order certain screening diagnostic tests.
The paper also proposes updating the complaints and discipline section of the act. That includes the addition of a complaints officer who could order alternative dispute resolution, and a requirement that employers notify the nursing association if an employee has resigned, been terminated, or been sanctioned for unprofessional conduct.
The paper notes it is “highly unusual” for a nurse to be terminated or sanctioned for unprofessional conduct, but cases have involved “very troubling” sexual misconduct, abuse, theft, and fraud. In some cases, the paper says, nurses have gone on to jobs in other jurisdictions. In a recent case, it continues without providing specifics, a nurse “went on to commit the most serious of crimes.”
Finally, the paper recommends the nurses’ association be given the authority to make bylaws on telehealth and virtual care. It says there is a need for a regulatory and legal framework for telehealth that addresses the use of virtual technology as consultation versus treatment, documentation, policy for remote prescribing, and privacy implications.
The territorial health department is developing a proposal for legislative changes based on this feedback.
The department could not give a timeline for when it expects changes to be made to the Nursing Profession Act, but said changes will be implemented before the next territorial election anticipated in 2023.