[Sharon]

The study of Bachelor of Science in Nursing and Practical Nursing students explored how education constructs intraprofessional relations. The findings of the study revealed that the two education programs rarely discuss how to work with each other as there is generally segregated education. This often leads to role confusion and the students degenerating to describing each other’s roles negatively. Little education is provided to assist students to learn nurse-to-nurse collaboration. Thinking about the article that you read last week, what implications on communication can occur in practice when students are educated in segregated programs?

[Johanna]

When students are educated in segregated programs, there is a power imbalance that is set up. PN students automatically feel that they are less, compared to the BScN students. When asked about their delegation, many unconsciously reply, “I’m just an RPN”. When I first started working, I remember a manager who said, “You’re not JUST an RPN, you’re an RPN!” Since that moment, I have never forgotten to be proud of being an RPN.
I also suspect that there is a built-in bias in the university setting, that reinforces that students who have a degree are superior to those who do not. This may account for how new RNs may be unsure of how to communicate with RPNs. The RNs may not understand how well developed RPN assessment and nursing judgement skills are. This may lead to mistrust between the two classes of nurses. I have also experienced that some doctors have expressed that they “prefer” to communicate with RNs rather than with RPNs, which leads to the RPN having to depend on the RN, rather than the RPN being able to communicate their own observations to the doctor.
My experience has shown me that over time, RNs and RPNs personally develop working relationships and are able to develop trust. It would be much easier for both if this was set up in the educational programs.

[Jeanette]

Johana,
I do completely agree with you comment regarding the university bias. You do hear it even with other programs and careers. I do strongly believe that the working relationship does evolve over time between RN’s and RPN’s.

[Katie]

Agreed, I think its not until RNs have the opportunity to work along side of RPNs that they understand, we too are nurses!

[Jeanette]

Thinking about the article that was read last week and the implications on communication that can occur in practice when students are educated in segregated programs. An important finding was that little education was provided to assist students to learn nurse to nurse collaboration or how to address the hierarchies that create and sustain power relations between the groups. Stratification within nursing shows strong ties between university education, science and theory to the top of the hierarchy and nurses who complete traditional nursing tasks, such as those undertaken at the bedside in the lower tier.
I believe this to be true now a days. When I graduated from the PN program the both programs completed the first 2 semesters together and then divided. When we reconnected in the working world we would then use each others skills and knowledge to work together. I would use their theory and they would use my working experience this communication was so beneficial for the patient’s care.

[Maame]

When students are educated in segregated programs there isn’t role clarity for both designations which creates problems within practice. If there is an emphasis on teaching students about the roles of each designation it clears up role confusion . When the emphasis on collaboration and effective communication is taught in both programs the transition into practice is much smoother and easier for the students to adapt within their work environment.

[Katie]

One thing I have always thought community nursing has been good at is showing us is that yes a nurse is a nurse. We all come to the table with different strengths and weaknesses as new grads regardless of our designations.

It would be beneficial for the programs to intertwine clinical experiences that mimic the work place.
It is not until RNs and RPNs have real world experience working along side each other that they can truly develop and understanding and appreciation of the roles each other has and how that works together in an team approach.

[Author]

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