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Registered nurse and Registered practical nurse should have individual regulatory body - Essay Example

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An individual regulatory body for registered nurses and registered practical nurses in Ontario is necessary considering the fact that the fundamental knowledge and theoretical background of RN’s and RPN’s differ. According to the professional standards of the College of…
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RPN and RN regulatory bodies An individual regulatory body for registered nurses and registered practical nurses in Ontario is necessary considering the fact that the fundamental knowledge and theoretical background of RN’s and RPN’s differ. According to the professional standards of the College of Nurses of Ontario (2002), registered practical nurses, registered nurses and nurse practioners each have rudimentary education and knowledge that is associated with their professional practice.

However, CNO (2002) also indicates that the knowledge of an RPN is considered more basic in comparison to their RN counterparts. As stated by Melrose and Wishart (2013), RN’s study for a longer period of time and have more in depth scope of practice and have greater knowledge in decision making, critical thinking, leadership, research utilization, resource management and healthcare delivery systems.An RN focuses on greater understanding of patient care and identifies the need for involvement of other health professionals (Melrose &Wishart, 2013).

RPN’s focus on collecting data such as vital signs, monitoring the progress of patients and reporting any adverse reactions. RN’s not only gather data, they incorporate the data in a more holistic approach for better patient care (Melrose &Wishart, 2013). Considering their educational background, RPN’s have been trained to care for stable patients, where there may not be medical interventions required. The autonomy of an RPN will depend on the complexity of their patient’s condition (RPNAO, 2012).

The RPNAO explains that when the care of a patient becomes more complex, there is a greater need for RN’s. This information would imply that RN’s have further educational training that allows them to care for patients with greater needs.On the other hand, one would argue that the nursing knowledge of an RPN is comparable with the educational knowledge of an RN and for this reason they should be regulated under the same body. Along with RN’s; following graduation, RPN’s take a national certificate examination that will allow them to obtain their license to practice.

RPN’s also study from the same body of knowledge as RN’s and have a more focused foundational knowledge. In addition, over the past 10 years, it is evident that the RPN program has started to lengthen and their scope of practice has become broader and comparable with RN’s (RPNAO, 2012). Martin and Weeres (2012) suggest that RPN’s are not working to their full scope of practice and are unable to utilize their knowledge, this in turn impedes on their ability to provide high-quality care.

This information puts forward the debate of whether RN’s and RPN’s truly differ in their fundamental knowledge.During their 4-year study period where they achieve a Bachelor of Science degree in Nursing, RN’s are taught the importance of critical thinking, scientific and theoretical background of the nursing profession. Boblin et al. (2008) conducted a study that concluded that RN’s reported greater frequency than RPN’s in decision making elements such as: identifying the problem, need or issue, alternative courses of action, risk and benefits to patients and selecting an intervention or action.

This study suggests that with the education, knowledge and critical thinking skills RN’s incorporate in their practice; this leads to higher quality care and better patient outcome. Thus, it is appropriate to implement individual regulatory bodies in Ontario for both RN’s and RPN’s based on their difference in fundamental knowledge.An individual regulatory body for registered nurses and registered practical nurses in Ontario is necessary considering the fact that the fundamental knowledge and theoretical background of RN’s and RPN’s differ.

According to the professional standards of the College of Nurses of Ontario (2002), registered practical nurses, registered nurses and nurse practioners each have rudimentary education and knowledge that is associated with their professional practice. However, CNO (2002) also indicates that the knowledge of an RPN is considered more basic in comparison to their RN counterparts. As stated by Melrose and Wishart (2013), RN’s study for a longer period of time and have more in depth scope of practice and have greater knowledge in decision making, critical thinking, leadership, research utilization, resource management and healthcare delivery systems.

An RN focuses on greater understanding of patient care and identifies the need for involvement of other health professionals (Melrose &Wishart, 2013). RPN’s focus on collecting data such as vital signs, monitoring the progress of patients and reporting any adverse reactions. RN’s not only gather data, they incorporate the data in a more holistic approach for better patient care (Melrose &Wishart, 2013). Considering their educational background, RPN’s have been trained to care for stable patients, where there may not be medical interventions required.

The autonomy of an RPN will depend on the complexity of their patient’s condition (RPNAO, 2012). The RPNAO explains that when the care of a patient becomes more complex, there is a greater need for RN’s. This information would imply that RN’s have further educational training that allows them to care for patients with greater needs.On the other hand, one would argue that the nursing knowledge of an RPN is comparable with the educational knowledge of an RN and for this reason they should be regulated under the same body.

Along with RN’s; following graduation, RPN’s take a national certificate examination that will allow them to obtain their license to practice. RPN’s also study from the same body of knowledge as RN’s and have a more focused foundational knowledge. In addition, over the past 10 years, it is evident that the RPN program has started to lengthen and their scope of practice has become broader and comparable with RN’s (RPNAO, 2012). Martin and Weeres (2012) suggest that RPN’s are not working to their full scope of practice and are unable to utilize their knowledge, this in turn impedes on their ability to provide high-quality care.

This information puts forward the debate of whether RN’s and RPN’s truly differ in their fundamental knowledge.During their 4-year study period where they achieve a Bachelor of Science degree in Nursing, RN’s are taught the importance of critical thinking, scientific and theoretical background of the nursing profession. Boblin et al. (2008) conducted a study that concluded that RN’s reported greater frequency than RPN’s in decision making elements such as: identifying the problem, need or issue, alternative courses of action, risk and benefits to patients and selecting an intervention or action.

This study suggests that with the education, knowledge and critical thinking skills RN’s incorporate in their practice; this leads to higher quality care and better patient outcome. Thus, it is appropriate to implement individual regulatory bodies in Ontario for both RN’s and RPN’s based on their difference in fundamental knowledge.A second reason why the RN regulatory body should be regulated independent of RPNs is that a generic encompassing regulation can limit RN’s autonomous and competency levels due to an ambiguous practice guideline.

The CNO (2011)’s guidelines divide RN and RPN by ambiguous factors. For example, depending on patient’s complexity, CNO states that both autonomous RPN and RN can have less complex patients, and autonomous RN can be involved with high-risk patients. Also, the role of the registered nurse has rapidly changed as many nurses take on an expanded role in both acute and primary settings by critical thinking (Bullough, 1976). Due to the fact that RPN and RN are under same regulatory body, it leads to RNs having a higher chance of having their competency downgraded compared to a regulatory body that does not include RPNs.

The College of Registered Nurses of British Columbia (CRNBC, 2014) nursing standard includes only RNs and nurse practitioners (NP). Due to the fact that British Columbia College’s minimum entry level is that of a registered nurse, their position is connected to a higher level of education and responsibility. Due to that, RNs in BC are more likely to have higher competency practice than those of Ontario.Another issue that arises with a single college representing different levels of the nursing practice is role confusion.

While the differences in educational standards seem to be known between the varying levels of practice, the specific roles that one can provide and another cannot are not always clear. When this lack of clarity exists then it leaves the possibility for overlaps or possible misconceptions of who is responsible for performing different tasks. Substantial role confusion was observed in the United Kingdom between nursing groups employed in acute care settings (Debbie et al., 2008). This is of particular note considering that the different levels of nursing are all regulated by one body, the Royal College of Nursing.

This can have a damaging effect on the workplace as documented in the literature. According to Baranek (2005), when an overlaps in roles is perceived, it leads to competition among providers, workplace tension, lack of trust, ineffective teamwork, diminished professional identity and possible under or overutilization of professionals.While the previously mentioned arguments are calls for individualized colleges for RPNs and RNs, it is worth acknowledging some possible repercussions of such an action.

Since the College of Nurses of Ontario is the governing body of all nurses of Ontario, they have a larger population from which they can collect the membership fees it requires to operate. When compared to other governing bodies of RNs there are some, at times substantial, differences between the annual memberships fee for RNs in Ontario and the rest of the country. The College of Nurses of Ontario charges both RNs and RPNs a renewal fee of $175.15 (CNO, 2013). This is fairly modest fee when compared to other provinces such as Alberta and Manitoba, which charge renewal fees of $555.

90 (CARNAV, 2014) and $442.49 (CRNM, 2014) respectively.Salary is a factor that needs to be taken into consideration while discussing the importance of acquiring two regulatory bodies for the nurses of Ontario. Throughout the discussion it was evident that RNs have responsibilities and a larger scope of practice while being compared to the RPN, and this lays the foundation as to why RNs have a higher wage. According to Robinson (2002) RNs starting salary was $17.07 and the RPNs salary was $11.92. The ‘Government of Canada’ (2013) showed that the starting pay for RNs in Ontario was approximately $23.

00 per hour, and for an RPN it was $19.50 per hour.The article by Walters, Eyles, Lenton, French and Beardwood (1998) was a primary research article that performed a study consisting of 1833 Registered Nurses (RNs) and Registered Practical Nurses (RPNs). They compared the professional responsibilities, and how it related to their difference in salary. RNs were considered to have greater autonomy, accountability, and more interactions with physicians. Whereas, RPNs were described as having less opportunities within their career, and less autonomy in their work.

This resulted in a lower pay than an RN. RNs were more likely to experience higher stress than the RPNs in relation to their higher responsibilities that are expected from them.The opposing argument states that role ambiguity should result in the same pay salary for both RNs and RPNs, since they are performing the same skills. However, Buerhaus (1994) stated that if wage reduction were to occur than less RNs would enter the nursing profession. This would lead to a detrimental deficit of highly valuable staff, which had encompassed a higher level of knowledge and scope of practice.

Eventually it would result in patients receiving quality of care, as RNs will be employed to work “harder and faster” causing them to provide inadequate treatment. If they were to reduce their wage they would also have to reduce the set of responsibilities and/or higher RPNs to perform skills. However, this would lead to less desired patient outcomes. They would be forced to provide the minimum amount of care that is required, as a means to avoid negative patient outcomes, and to prevent jeopardizing the hospitals reputation.

With little evidence to support the importance of the role of an RPN, it is odd that that they are considered a licensed nurse under the same pretenses as an RN, since RNs patients are having less mortality and morbidity rates. Therefore, by having two regulatory bodies it would distinguish the differences of the two roles, and that the salary difference between the two completely epitomizes the true difference of the RPN and the RN.ConclusionIt is therefore necessary to have different regulatory bodies to monitor the work of a RN and RPN .

Their education backgrounds differ in that an RN concentrates on patient care while an RPN is more concerned with the health of a patient and is also involved in taking part of critical decision making while ensuring proper health delivery to the patients (Buerhaus, 1994). Although it is argued that RPN and RN should have the same regulatory body, this should not be so because RPNS education is broader since they take a longer time to study and they are also more practical. It is therefore important to have different regulatory bodies for both the RPN and RNs because of the difference in the nature of their educational background.

Furthermore it can be seen that when both the RPN and RN work under the same regulatory body, then one of them may be downgraded and thus not put all the skills that he learned into action due to the set rules and regulations (Bullough, 1976). More over cases of role confusion may easily occur as there are possible misconceptions as to who is supposed to undertake a given task. This leads to competitions, tension, and lack of teamwork which leads to diminished levels of professionalism. However individual regulatory bodies can also have their repercussions as the bodies call for more collection of annual fees as compared to united regulatory bodies that charge lesser.

It can also be seen that the RN have greater responsibilities compared to that of RPNS and therefore the RN tend to get higher wages. This makes the RN to have greater accountability and contact with physicians which makes them to have greater autonomy compared to the RPNs who do don have autonomy (Bullough, 1976). Therefore in order to enhance efficiency in the health services, it is important to have separate regulatory bodies.ReferencesBaranek, P. M. (2005). A review of scopes of practice of health professions in Canada: A balancing act.

Toronto: Health Council of Canada. Retrieved from http://www.healthcouncilcanada.ca/rpt_det.php?id=133Bullough, B. (1976). The law and the expanding nursing role.American Journal of Public Health, 66(3), 249-254.College of registered nurses of British Columbia.(2014). Legislation relevant to nurses’practice.Retrieved from https://www.crnbc.ca/Standards/Lists/StandardResources/328LegRelevanttoNursesPractice.pdfCollege of nurses of Ontario. (2011). RN and RPN practice: The client, the nurse and the environment.

Retrieved from http://www.cno.org/Global/docs/prac/41062.pdfCollege of nurses of Ontario.(2013). Application & membership fees. Retrieved from http://www.cno.org/en/become-a-nurse/about-registration/application-membership-fees/College & association of registered nurses of Alberta.(2014). 2014 membership fees. Retrieved from https://www.nurses.ab.ca/carna/index.aspx?WebStructureID=5683College of registered nurses of Manitoba.(2014). Registration renewal. Retrieved from http://www.crnm.mb.ca/registration-renewal-faqs.

phpDebbie, W., Nelly, D. O., Jeanne, B., Diane, D., Linda, M. H., & Phyllis, G. (2008). Nursing scope of practice: Descriptions and challenges. Nursing leadership, 21(1), 44-57.Government of Ontario. (2014). Health Force Ontario: Nursing Roles. Retrieved from http://www.healthforceontario.ca/en/Home/Nurses/Training_%7C_Practising_Outside_Ontario/Nursing_Roles.Buerhaus, P. (1994). Price Controls, Health Care Reform, and New RN shortages.Nursing Economics.Vol.12/No.6Walters, V., Eyles, J., Lenton, R.

, French, S., and Beardwood,B. (1998).Work and Health: A Study of the Occupational and Domestic Roles of Women Registered Nurses and Registered Practical Nurses in Ontario, Canada.Gender, Work and Organization.Vol 5, issue 4. Retrieved from: https://slc.me/+CSCO+00756767633A2F2F6A726F2E6E2E726F667062756266672E70627A++/ehost/pdfviewer/pdfviewer?sid=fa897446-c823-44ff-a2ed-5daef4820af1%40sessionmgr4001&vid=2&hid=4106Robinson, E. S. (2002). Salary survey. Nursing, 32(4), 46.Government of Canada. (2013). Working in Canada: explore careers-job market report.

Retrieved by: http://www.workingincanada.gc.ca/report-eng.do?area=9193&lang=eng&noc=3233&action=final®ionKeyword=Perth%2COntario&s=1&source=2&titleKeyword=registered+practical+nurse+%28R.P.N.%29#report_tabs_container2CNO (2002)- Professional Standards-knowledgeBoblin, S., Baxter , P., Alvarado, K., Baumann, A., & Akhtar-Danesh, N. (2008). Registered nurses and licensed/registered practical nurses: a description and comparison of their decision-making process.Lankshear, A. J., Sheldon, T. A.

, & Maynard, A. (2005).Nursing staff and healthcare outcomes.a systematic review of the international research evidence. Advances in Nursing Science, 28(2), 163-174.Melrose, S., &Wishart, P. M. (2013). Resisting, Reaching Out and Re-imagining to Independence: LPNs Transitioning towards BNs and Beyond. International Journal Of Nursing Education Scholarship, 10(1), 1-7. doi:10.1515/ijnes-2012-0033RPNAO, 2012

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