2002 Annual Report REGISTERED NURSES ASSOCIATION OF BRITISH COLUMBIA

Transcription

1 2002 Annual Report REGISTERED NURSES ASSOCIATION OF BRITISH COLUMBIA

2 Contents President s Message 3 RNABC 2002 Strategic Priorities 4 Education Quality Practice Environments Regulation Scope of Practice 2002 Report on Regulation 6 Board of Directors 8 Standing Committees 9 RNABC s Mission Our mission is safe and appropriate nursing practice, regulated by nurses in the public interest, and achieved by promoting good practice, preventing poor practice, and intervening when practice is unacceptable. Reports to Members 10 Statement of Revenue, Expenditure and Surplus 11 Financial Statements Annual Report

3 PRESIDENT S MESSAGE Opportunity and Uncertainty By Bonnie Lantz, RN, BSN, MEd, CPN(c) We are facing major changes to our health care system, and the difficulty we face today is that we don t know what the changes will be... those are the words I used to open my address to members at the 2002 Annual Meeting in April. As 2002 drew to a close, we knew little more about these changes than we knew nine months earlier. For example, the repeal of the Nurses (Registered) Act and the introduction of new legislation that would place registered nursing and all other health professions under the Health Professions Act was expected to occur in 2002, but didn t. We now anticipate this happening in The delay has created both opportunity and uncertainty. The opportunity has been that we have been able to push our case for maintaining self-regulation of the profession, including approving our own standards and codes of ethics. We believe government has heard us on this issue. The uncertainty is that, by year-end, we still do not know what the scope of practice for registered nurses will be after the legislation passes. It s safe to say that the dissolution of the Nurses (Registered) Act and implementation of the Health Professions Act will have an impact on the practice of B.C. s registered nurses. We anticipate there will be a lengthy transition period and RNABC will be providing resources to assist members in understanding the changes and the impact on their practice. Despite this uncertainty, 2002 was a productive year for the Association. Many of the activities undertaken during the year are reported elsewhere in this Annual Report. Other activities included: development of a resource, Implications of the Nurse Shortage: Questions and Answers for Nurses, to address concerns raised by registered nurses about the impact of staff shortages on patient care and to assist nurse leaders in developing strategies to reduce the impact of staff shortages; development of a question and answer handout for members regarding RNABC and the Health and Social Services Delivery Act (Bill 29); redesign of the RNABC Web site to improve access and increase communication with members; pilot testing of online registration renewal; and, most importantly, development of the Guidelines for a Quality Practice Environment for Registered Nurses in British Columbia. Among the key decisions made by your Board of Directors in 2002 were: revision of the policy on use of title by members to accurately reflect whether RNABC members have practicing or non-practicing membership; endorsement of the Canadian Nurses Association revised Code of Ethics for Registered Nurses (2002), which will be included in the 2003 revision of RNABC s Standards for Nursing Practice in British Columbia document; and approval of guiding principles to address the issue of assignment and delegation between nurses (registered nurses, licensed practical nurses and registered psychiatric nurses). We would not have achieved the accomplishments of the past year without the support and dedication of you, the members, our Board of Directors both elected and public representatives and our staff. I look forward to your continued support in 2003 as we address our key strategic priorities: self-regulation of registered nursing is maintained in the public interest; the public receives safe and ethical care from competent registered nurses; and practice environments retain registered nurses and enable them to practise in accordance with the Standards for Nursing Practice in British Columbia. Registered Nurses Association of British Columbia 3

4 RNABC 2002 Strategic Priorities A total of 1,099 candidates wrote the Canadian Registered Nurse Examination in British Columbia in The pass rate for graduates from B.C. schools of nursing was 97.3%. The pass rate for candidates who graduated outside B.C. was 84.3%. The number of RNABC workplace representatives increased from 430 to 447 in Workplace reps assist members to understand and use the RNABC Standards for Nursing Practice in British Columbia. Education Sufficient numbers of registered nurses are educated to meet the health care needs of the public. Graduates of all basic and refresher nursing education programs achieve the revised entry-level competencies. Registered nurse education seats increase to ensure adequate supply. RNABC continued to participate in a coalition with the Nursing Education Council of B.C. and the Health Care Leaders Association of B.C. to develop strategies to educate government and other key publics about entry-level nursing education. One of these strategies included having registered nurses throughout B.C. meet with MLAs to educate them about issues related to entry-level nursing education and RNABC s entry-level competencies. In September, the B.C. government announced its support for the transition of all entry-level nursing education in the province to baccalaureate programs. With the changes to be phased in over several years beginning in 2003, RNABC and other coalition members began developing strategies to support the government s transition plan, which includes not reducing the number of students who graduate each year. The relentless nature of the current nurse shortage, in conjunction with ongoing concerns expressed by employers, unions, schools of nursing, and new graduate registered nurses themselves about the issues facing new graduate registered nurses, prompted RNABC to conduct the New Graduate Registered Nurse Employment Project. The project included a mailed survey to, and telephone interviews with, registered nurses who graduated from B.C. nursing education programs in A report of the findings was published in the December issue of Nursing BC and on the RNABC Web site. In 2003, RNABC will conduct a similar survey of 2002 graduates to compare findings. Quality Practice Environments Practice environments support quality nursing practice. Practice environments support registered nurses to meet the RNABC Standards for Nursing Practice. Registered nurses use the RNABC Standards for Nursing Practice to advocate for changes in practice and policy. In September, the RNABC Board of Directors approved the Guidelines for a Quality Practice Environment for Registered Nurses in British Columbia. These guidelines, which build upon the RNABC policy statement, Nursing Practice Environments for Safe and Appropriate Care, were distributed to members in the December issue of Nursing BC and widely distributed to employers, government, other health regulatory organizations and stakeholders. These guidelines were developed to assist registered nurses and their employers to create practice environments that contribute to the health of nurses, the clients they serve and health care organizations. Following release of the Canadian Nursing Advisory Committee (CNAC) report in September, the President participated with other B.C. stakeholders in an advisory group of the B.C. Chief Nurse Executive to identify 10 of the 51 CNAC recommendations that should be given top priority by the B.C. government. The CNAC recommendations address key issues identified as barriers to a quality workplace for Canadian nurses. RNABC s top 10 recommendations were reported in the December issue of Nursing BC. In 2002, RNABC developed Tools for Resolving Professional Practice Problems to assist registered nurses to confirm, communicate, document and resolve professional practice problems. This four-step process assists registered nurses to meet the RNABC Standards for Nursing Practice, protect clients from harm and ensure clients receive safe and appropriate care. Education sessions on using the tools were provided to RNABC workplace representatives and BCNU stewards Annual Report

5 Regulation Legislation governing registered nurses provides for regulation of the profession by registered nurses. A proposal paper, released by the Minister of Health Planning in July, recommended repealing the current acts governing registered nurses, physicians, optometrists, dentists, podiatrists and chiropractors and introducing new legislation that would place these professions under the Health Professions Act. The new legislation will regulate health professionals through a system of overlapping scopes of practice, title protection and reserved actions (activities involving a significant risk of harm that may only be initiated and carried out by professions to whom they are assigned). It is anticipated that the name of the RNABC will be changed to the College of Registered Nurses of British Columbia. The draft legislation included many of the proposals recommended by the Health Professions Council, an independent agency established by the provincial government to provide advice to the Minister of Health Planning on the designation of new health professions pursuant to the Health Professions Act, and on matters relating to the regulation of health professions generally. The Council conducted an extensive review of the legislation and scopes of practice for health professions in B.C. and submitted its final report to government in In responding to the government s request for feedback on the July 2002 proposal paper, RNABC expressed a number of concerns, including the proposed degree of Cabinet and ministerial control over the self-regulatory function of a college. In addition, RNABC requested that there be legislative protection for a college to set standards for practice and codes of ethics without being subject to government approval, to independently set standards for educational achievement (e.g., entry-level competencies) and to approve nursing education programs preparatory to registration with RNABC. Scope of Practice Legislation governing registered nursing provides for registered nurses practising to full scope. Reserved acts for registered nurses reflect the reality of nursing practice. Reserved act regulatory mechanisms increase opportunities for registered nurses to practise to full scope. The brief Regulating Registered Nurses in the Public Interest, outlining RNABC s position on scope of practice for registered nurses, was submitted to government in December In 2002, meetings were held with representatives of the Ministry of Health Planning to further discuss RNABC s position. The Board of Directors also clarified its position on a number of reserved actions related to registered nurses scope of practice. RNABC has been working with government in a project to regulate, educate and deploy nurse practitioners in B.C. A major achievement for RNABC in 2002 was the development of the core Competencies Required for Nurse Practitioners in B.C. More than 200 nurses and other experts participated in the development of these competencies. The proposed new legislation for B.C. s health professions will also permit the regulation of nurse practitioners in British Columbia. Nurse practitioners are registered nurses who have achieved the competencies that will be required for registration as a nurse practitioner with RNABC. Such competencies are usually achieved through graduate nursing education and nursing practice experience. Following the Board s approval of the core competencies, policy work began on applying the core competencies to three streams of nurse practitioner practice. Once this work is approved by the Board, the Competencies Required for Nurse Practitioners in B.C. will be used for approval of education programs for nurse practitioners and for verification of competencies of nurse practitioners for registration. RNABC s practice support staff received 4,126 calls from members in 2002, the majority of whom were registered nurses in clinical practice settings. The most frequent calls related to concerns about not being able to meet the Standards for Nursing Practice, followed by scope of nursing practice, policies and procedures, and issues related to organizational restructuring such as number of staff and staff mix. Practice support staff provided 1,233 on-site consultations in 2002 to more than 11,200 RNABC members. Registered Nurses Association of British Columbia 5

6 2002 Report on Regulation The following information has been compiled in response to draft government regulations for the reporting of statistics of health care professions. Explanations of the various categories can be obtained from RNABC s Director of Regulatory Services. Note: Numbers from category to category may not balance because activity for one individual may span two years Number of registrants/members RNs practicing members 29,775 29,539 RNs non-practicing members 3,948 3,938 LGNs practicing members LGNs non-practicing members Student members 2,348 2,168 Total 36,259 35, Number of new registrants Graduates from within British Columbia Graduates from other provinces or territories Graduates from outside of Canada Total 1,330 1, Number of applications for registration refused Did not meet educational qualifications Did not meet practice requirements 0 0 Did not meet fitness and character requirements 0 0 Total Number of appeals on registration/ examination matters Allowed 4 6 Dismissed 0 0 Pending Number of nursing education programs reviewed Basic education programs 11 6 Refresher programs Number of complaints received with respect to: Sexual misconduct 4 3 Refusing access to patient records 0 0 Incompetence/negligence Unethical conduct Fitness/impairment Criminal convictions 6 3 Other Total Annual Report

7 2002 Report on Regulation Disposition of complaints Informal resolution Investigation continuing 0 1 Other (including no further action, dismissed, withdrawn or frivolous) 13 7 Citation issued 0 0 Consensual agreements (ADR) Suspended inquiry 4 5 Resolutions in progress Total Number of disciplinary hearings held Completed 0 0 In progress 0 0 Total Number of appeals on disciplinary matters Allowed 0 0 Dismissed/withdrawn 0 0 Pending Number of practice reviews or inspections undertaken Number of information requests received pursuant to the Freedom of Information and Protection of Privacy Act Number of criminal record checks completed pursuant to the Criminal Records Review Act 2,097 2, Disposition of matters after a hearing Dismissal of matter 0 0 Reprimand 0 0 Imposition of limits or conditions on practice 0 0 Suspension 0 0 Cancellation of registration/ resignation with prejudice 0 0 Assess costs of hearing 0 0 Fine 0 0 Registered Nurses Association of British Columbia 7

8 Board of Directors The following policy statements were revised by RNABC in 2002: Primary Health Care Nurse-client Relationships: Establishing Professional Relationships and Maintaining Appropriate Boundaries The following policy statements were rescinded by the Board of Directors in 2002: Aids for Independent Living Informed Consent President Bonnie Lantz Director, Health Services - New Westminster, Fraser Health Authority Vice-President Katie Hine Public Health Nurse, Upper Island Central Coast Community Health Services Society President-Elect Howard Searle Staff Nurse, Lions Gate Hospital Directors-At-Large Karen Irving Nursing Instructor, University College of the Cariboo/Staff Nurse (casual), Royal Inland Hospital Melissa Koehle Nurse Manager, Inpatient Surgery and Maternal Child Health, Vernon Jubilee Hospital/Consultant Executive Director Laurel Brunke Public Representatives Rina Berkshire - Campbell River Marilyn Clark - Sorrento Gwen McKay - Stewart Meg Shaw - Kelowna Lynn Braun - Richmond Nancy Macey - Delta Edith Nee - Vancouver Electoral District Directors Val Cartmel - District A: Mainland Coastal Regional Manager, Hospital Information Systems, Vancouver Coastal Health Authority, Louise Malysh - District B: Vancouver Metropolitan Clinical Nurse Leader, St. Paul s Hospital Catherine Clark - District C: North Vancouver Island Faculty Member, North Island College Margaret Gauthier - District D: Victoria-Gulf Islands Area Manager, Respiratory Care, South Vancouver Island Health Authority Jan Robertson - District E: Fraser Valley Nursing Instructor, Kwantlen University College/Staff Nurse, Royal Columbian Hospital Kelly Dillon-Hunt - District F: Northeast Clinical Coordinator, Deni House ECU Lynne Price - District G: Northwest Nurse Manager, Mills Memorial Hospital Linda King - District H: Kootenay Patient Care Manager, Renal Programs, East and West Kootenays Tracy Christianson - District I: Thompson-Columbia Public Health Nurse, Interior Health Authority Sharon Hodgson - District J: Okanagan Rural Nurse Educator, Penticton Regional Hospital Annual Report

9 Standing Committees Board of Examiners The Board of Examiners arranges for the examination of applicants for nurse registration, including the setting and marking of examinations. Marcia Carr, Chair Michal Adler Harold Faw Nancy Symmes Registration Committee Joan Belfry Beverly McNamara Donna Warrender The Registration Committee reports on, and recommends policies to the Board of Directors with respect to enrollment, licensure and registration of members, interim and special permits, renewal, conversion and reinstatement of membership. In situations involving membership or interim permits, the committee makes recommendations to the Board of Directors regarding eligibility of applicants. Melissa Koehle, Chair Rina Berkshire Jane Braun Shirley Clarke Rosemaree Gentles Judith Huska Marie Morris Sandra Nixon Meg Shaw Karen Steward Finance Committee The Finance Committee recommends policies to the Board of Directors with respect to the financial affairs of the Association. It also proposes the Association s annual budget. Karen Irving, Chair Katie Hine Lynne Price Geraldine Nicholson Ken Simpson Professional Conduct Committee The chair of the Professional Conduct Committee has authority under the Nurses (Registered) Act and Rules to enact a variety of responsibilities within the professional conduct review process. The members of the committee work in panels of three to conduct inquiries. After a hearing of the evidence, the panel makes decisions about a member s professional conduct. The panel has the authority to take disciplinary action. Janice Radford, Chair Melanie Basso, Deputy Chair Christine Ondrik, Deputy Chair Deborah Armstrong Janice Blaskovits Diane Campbell Brenda Canitz Barbara Cross Charlotte Miller Jean Nicolson-Church Jean Oland Elizabeth Peltzer Tanya Snow Beverly Wilden Roster of Advisors The advisors function in groups of two to advise the chair of the Professional Conduct Committee with respect to some decisions made within the Professional Conduct Review Program. This includes approving consensual agreements negotiated between the Association and a member to resolve a complaint. Jan Radford, Chair Melanie Basso, Deputy Chair Christine Ondrik, Deputy Chair Roy Craven Elizabeth Fleet Patricia Gibson Dorothy Hamilton Lee Houghton Leslie Peterson Janice Robinson Kathleen Yeulet Education Approval Committee The Education Approval Committee reviews education programs preparatory to nurse registration and makes recommendations to the Board of Directors about whether to approve such programs and the terms and conditions of approval. Lily Lee, Chair Pat May, Deputy Chair Trudy Freeman Patricia Hartley Marjorie MacDonald Kathy Quee Lynn Stevenson Paul Vermeulen Margaret Warcup Cathy Ulrich The RNABC Helen Randal Library received more than 9,700 enquiries and researched 1,281 practice information questions in More than 8,000 books, videos and journal articles were loaned out by the library. RNABC provided 168 continuing education workshops and teleconferences to nearly 3,400 members in Registered Nurses Association of British Columbia 9

10 Reports to Members Resolutions and Bylaws Committee Resolved clauses of five resolutions submitted to the 2002 Annual Meeting were published in the February 2002 issue of Nursing BC. Three resolutions were Bylaw amendments and two were general resolutions. The full text of each resolution with background information was mailed to chapter presidents for distribution to voting delegates prior to the Annual Meeting. One late resolution was presented at the Annual Meeting. Two Bylaw amendments were approved at the Annual Meeting one limited eligibility for elected office to registered nurses eligible for practicing membership, and one provided non-practicing members optional membership in the Canadian Nurses Association. One Bylaw resolution, related to eligibility for appointment to a standing committee, was defeated. One general resolution on certification standards for immunization in B.C. was defeated and a second resolution supporting fall and injury prevention initiatives for the older adult was accepted. The late resolution on funding for the Registered Nurses Foundation of B.C. was defeated. The call for resolutions for the 2003 Annual Meeting was published in the October 2002 issue of Nursing BC. Detailed information on how to choose between a resolution and an issue, and how to develop a resolution was mailed to all chapters and professional practice groups in August. Three general resolutions for debate at the 2003 Annual Meeting were submitted for review to the Resolutions and Bylaws Committee by the deadline of November 12, The Resolutions and Bylaws Committee held two meetings by teleconference to review and edit the general resolutions and make recommendations to submitters on matters of clarity, legality and format. All three resolutions submitted were approved for debate at the 2003 Annual Meeting. Two resolutions for amendments to Bylaws were prepared by the Board of Directors. Maureen Wood, Chair Nominations Committee At the deadline date of 1600 hours, January 14, 2002, extended by the Nominations Committee to 1200 hours, January 28, 2002, the Nominations Committee had received nominations for the following positions: president-elect, director-at-large and electoral district directors C, E and J. The Nominations Committee developed a strategy to identify candidates for the electoral district directors F and G. The 2002 ticket of nominations was presented to the President and the Executive Director of RNABC and approved on January 31, The positions of president-elect and director-at-large were contested and required a mail ballot. The positions of district director in electoral districts C, E, F, G, and J were elected by acclamation. The Nominations Committee contacted all chapter and professional practice group presidents, provided promotional posters and advertised in Nursing BC as part of the strategy to seek nominations. Linda Ferron, Chair Scrutineers Committee The Scrutineers Committee, made up of RNABC members appointed by the RNABC Board of Directors to supervise the counting of ballots for the 2002 RNABC Board of Directors election, met at the offices of the election trustee, BDO Dunwoody LLP, on June 14, Two positions, president-elect and director-at-large, were contested and required a mail ballot. The district directors positions for Electoral Districts C, E, F, G and J were elected by acclamation. Ballots for president-elect and director-at-large were mailed to all members. A total of 34,904 envelopes, representing 69,808 ballots, were mailed to members. BDO Dunwoody LLP received 7,391 ballot envelopes by the deadline date of June 12, A total of 203 envelopes and 28 ballots were declared invalid. At the request of one of the candidates for the position of director-at-large, a ballot recount was held at the offices of BDO Dunwoody LLP on July 17, One member of the Scrutineers Committee observed the ballot recount. The ballot recount for the director-atlarge position reconfirmed the total votes for the candidate with the highest number of votes and the candidate with the second highest number of votes. Janice Appleton, Chair Annual Report

11 Statement of Revenue, Expenditure and Surplus Actual Budget REVENUE Fees - Professional membership 8,815,447 8,926,211 - Other membership 96,652 80,817 Credentials processing 421, ,500 Examinations 330, ,830 Interest 402, ,581 Sundry 448, ,659 10,514,385 10,540,598 EXPENDITURE Executive Office Association governance 222, ,275 General management 124, ,942 Corporate relations 139, , , ,996 Administrative Services Financial services 383, ,196 Personnel services 369, ,046 Office support services 671, ,307 Building and grounds 257, ,378 1,682,065 1,584,927 Practice Support Practice standards 1,066,448 1,093,350 Legal standards & malpractice 307, ,110 Nursing education approval 320, ,192 Regional Services 509, ,113 2,203,885 2,263,765 Regulatory Services Registration 1,222,516 1,220,483 Professional conduct review 342, ,972 Registration examination 324, ,683 1,889,450 1,930, Actual Budget Policy Health policy 104, ,842 Nursing practice policy 481, ,559 Support systems policy 217, ,376 Annual meeting 221, ,933 Organizational activities 209, ,107 1,235,004 1,326,817 Resource Development & Communications Helen Randal Library 342, ,912 Continuing education 618, ,552 Leadership development 164, ,446 Internal communications 525, ,569 External communications 159, ,411 1,809,366 1,850,890 CNA Affiliation Fees 913, ,075 Contingency 0 25,000 Fixed Assest Purchase out of Operations 47,352 55,000 Capital Fund Contribution* 163,790 Dividend from Captive Insurance Corp. (53,000) Information Technology Implementation 486,684 Information Technology Grant (350,000) 1,208, ,075 SURPLUS (DEFICIT) (0) 105,990 * The Board decides on the contribution to this fund late in the year. Registered Nurses Association of British Columbia 11

12 Auditor s Report Annual Report

13 Consolidated Statement of Financial Position Approved by: President Chair, Committee on Finance Registered Nurses Association of British Columbia 13

14 Annual Report Consolidated Statement of Operations and Changes in Fund Balances

15 Consolidated Statement of Cash Flows Registered Nurses Association of British Columbia 15

16 Annual Report Summary of Significant Accounting Policies

17 Summary of Significant Accounting Policies Registered Nurses Association of British Columbia 17

18 Annual Report Notes to Consolidated Financial Statements

19 Notes to Consolidated Financial Statements Registered Nurses Association of British Columbia 19

20 Annual Report Notes to Consolidated Financial Statements

21 Registered Nurses Association of British Columbia 21

22 The Registered Nurses Association of British Columbia (RNABC) is the professional organization of registered nurses and licensed graduate nurses in British Columbia. RNABC is a self-regulating organization created by nurses as the means for establishing, monitoring and enforcing standards that assure the public of safe, competent nursing care. RNABC is empowered by the Nurses (Registered) Act. It is the duty of RNABC under this Act to serve and protect the public at all times. The Act requires RNABC to: establish, monitor and enforce standards of education and qualifications for registration; promote high practice standards; establish, monitor and enforce professional ethics; establish a continuing competence program; and reduce incompetent, impaired or unethical practice. The Association accomplishes its mandate by promoting good nursing practice, preventing poor practice, and intervening when practice is unacceptable. Through the energies of its Board of Directors, volunteers and staff, RNABC is dedicated to helping registered nurses and licensed graduate nurses carry out this mandate and, together with them, maintaining the public s trust in the profession. REGISTERED NURSES ASSOCIATION OF BRITISH COLUMBIA 2855 Arbutus St.,Vancouver, BC V6J 3Y or Copyright Registered Nurses Association of British Columbia/March 2003 Pub. No. 245