Regulating LPNs ensures ‘safe, ethical and quality care’
When it comes to the procedure of regulating the province’s Licensed Practical Nurses (LPNs), the Saskatchewan Association of Licensed Practical Nurses (SALPN) takes a great deal of care.
LPNs, one of three categories of professional nurses in Saskatchewan, work within their own scope of practice, standards or practice and code of ethics. They provide care in many areas of health care: acute care, long term care, community programs, primary care clinics, education, occupational health and safety, public health and leadership. There are around4000 practicing and non-practicing LPNs in the province.
The SALPN is given the authority and responsibility to regulate LPNs in Saskatchewan by the Licensed Practical Nurses Act 2000. The SALPN Council, consisting of seven elected LPNs, three government appointed public representatives and the councilappointed executive director, oversees the regulation.
“Like all regulators, we exist for the purpose of public protection, ensuring that LPNs give the residents of Saskatchewan safe, ethical and quality care,” says Lynsay Nair, LPN, executive director of SALPN. “We have a role in ensuring there’s a balance between public safety and the needs of the health care system.”
SALPN’s regulation process begins with the approval of the education program of prospective LPNs, who study from the same body of nursing knowledge as Registered Nurses and Registered Psychiatric Nurses with a focus on foundational knowledge, critical thinking and clinical judgment. LPNs have to enroll in a two-year diploma in practical nursing at an approved practical nursing program in Saskatchewan.
Nair says that the SALPN approves the education program to ensure that graduates of those programs are able to meet entry level LPN requirements and come to their specific profession with the necessary entry level competencies. SALPN also determines the requirements for initial LPN licensure. LPNs in Saskatchewan must complete their education and pass the Canadian Practical Nurse Registration Exam. LPNs also need to meet English language requirements and submit a criminal record check.
The regulation process doesn’t end when an LPN becomes licensed. Every year, LPNs have to seek out continuing education (anywhere from six to 24 hours based on total months licensed).
“The continuing education requirement is in place because the commitment to lifelong learning is required of an LPN in order to remain competent and grow with the changing times,” Nair says. “LPNs may engage in a variety of different learning. Some will choose a formalized approach and work through university and college classes. Others may choose to attend specific workshops or seek out online learning.”
Each year, SALPN audits 20 per cent of its membership through methods such as requesting another criminal record check, proof of their education or documentation of their claimed work hours.
“Our audit percentage may be higher than other regulators. We feel it’s important to ensure LPNs are as compliant as we assume them to be,” Nair says. “I think that we were one of the first in Saskatchewan to initiate the random criminal record check audit. That’s something we’re proud of, because people are in this profession for up to four decades, so it’s probably not enough to only ask for an initial criminal record check.”
SALPN also has a discipline component to its regulation process. When a complaint regarding an LPN is received, SALPN investigates and presents material to a committee consisting of both LPNs and a representative of the public. That committee’s job is to determine an appropriate form of remediation.
“It’s not about punishment; it truly is about remediation,” Nair says. “The question asked is, ‘What can be done to either correct behaviour or ensure it doesn’t happen again?’ This could involve additional education and assessments, but it could also result in restrictions or suspension of certain duties. Generally, they’re able to come to a mutual agreement to remediate this behaviour.”
Ultimately, Nair feels that SALPN’s regulation process is to assist in ensuring LPNs provide appropriate care to patients. She notes though that when it comes to regulation, it can be hard to establish measurable criteria.
“Some of our activities are proactive, such as the ones that are intended to prevent instances of unsafe practice and there’s reactive activities intended to remediate and prevent those instances from occurring again,” Nair says. “It is difficult to measure what has not occurred or has been prevented on account of regulation.
“Regulatory bodies set the minimum standards of the profession. We strive to regulate with excellence, but excellence in practice comes from the LPNs themselves.”