Guest Post: The Leadership of Nurses in Manitoba

Esther Max

International Nurse Day is celebrated May 12th, where we share appreciation for all our nurses, so we have invited one of our patient safety partners to be our guest on the blog today, Deb Elias.

When asked to write about my role as a nurse leader for WHO  Year of the Nurse & Midwife, I was honored and excited to share about my work as a registered nurse leader in regulation at the College of Registered Nurses of Manitoba.

As a regulator, our mission is to protect and serve the public interest through quality registered nursing regulation. Our focus is on the public and we work with registered nurses to achieve this. As the Chief of Quality Practice, I lead a team that is responsible for education program review, continuing competence, scope of practice and development and implementation of standards of practice/practice expectations to achieve this mission. My role as a leader is twofold: seeking opportunities for improvements and coaching my team towards this vision and establishing and enhancing collaborative relationships with external groups.

The need for a collective approach to health care provision has never been more essential.  

The current pandemic has brought about unique challenges, but the work we've done prior has helped. I have had the pleasure of working with various health care regulators in the province to develop shared approaches on internal processes and to establish expectations for our registrants. This sets a consistent standard and approach for health care teams and guidance for the public. An example is the Practice Direction on Interprofessional Collaborative Care that was developed jointly and has been adopted by the majority of health care regulators in the province. Another example is our collaboration with other healthcare regulators in setting expectations for virtual care that healthcare providers have adapted to in recent months.

The pandemic has also highlighted the need for practitioners to work to full scope of practice in order to maximize the potential of the health care team. Registered nurses (including nurse practitioners) provide care to meet the needs of their populations and clients and should be working to their full scope of practice in order to do so.

An emerging expansion of the scope of practice for registered nurses is the RN authorized prescriber, RN(AP). This role was introduced in regulation in 2018 and is in its infancy. RN(AP)s are registered nurses with additional education who have the authority to prescribe medications for three populations, travel health, reproductive, sexually transmitted infections and blood borne pathogens and diabetes health. The role was developed to enhance client’s access to care and enhance the capacity of the system. It maximizes the RN(AP)s contribution to the health care system and providing care to clients at the earliest point.

Often conversations about scope of practice and collaborative care include questions about the differences between the 3 nursing professions in Manitoba: Licensed Practical Nurses, Registered Nurses and Registered Psychiatric Nurses. To address this, the three nursing colleges developed a document “Nursing in a Team Environment”. This document provides a framework for the discussion of the roles of the 3 nursing groups in Manitoba with a shared lens. Collaboration between health care professionals including the client is expected and necessary in all practice settings. Utilizing all health care providers allows each practitioner to participate fully.

I am very fortunate to have excellent working relationships with engaged, highly responsive and accountable regulatory, nursing education and practice leaders. These ongoing relationships provide much personal and professional satisfaction while ensuring the public receives safe and competent care.