[Sharon]

Key Findings of the Research- Review the key findings below and discuss in the forum if there is anything that you were expecting but is not listed

• The RPN role is viewed as a valuable member of the health care team in the provision of quality patient care.
• Although frequently used, the phrase scope of practice is not well understood, with most nurses describing scope of practice in terms of tasks or what they are allowed to do in their practice settings
• There continue to exist many misconceptions and old truths, held by both RPNs and RNs, regarding the RPN scope of practice, which contributes to role confusion and underutilization of RPNs (e.g. the misconception that RPNs must work under the direct supervision of RN).
• Leadership has a vital role in setting expectations regarding scope of practice, collaboration, and respect within the practice setting.
• Organizational practices (e.g., policies, procedures, role descriptions, models of care) play a key role in determining the appropriate utilization of RPNs.
• Given the significant degree of overlap between the RPN and RN roles, many nurses and nursing leaders are uncomfortable with the resulting ambiguity and would like a list of who can do what to cover all possible scenarios.

[Melanie]

I found this research article quite interesting and very informative. It gave me a little more understanding as to how the health care team views the different nursing roles and the knowledge about the difference in roles.

Discovering that “There is little /no opportunity for practicing nurses to be updated & informed regarding changes to roles” is a fact and not a myth makes me think there is room for improvement here. A definite opportunity to clear up role ambiguity. I feel this should be something the College of Nurses should publish or make readily available to HCP’s and the public.

The one thing I would have expected to see in the article is the ongoing wage gaps between the roles. Currently the wages between PSW and RPN’s are much closer in range than the RPN and RN. Considering the fact that RPN’s must be licensed to practice and we belong to the same regulatory body as RN’s and NP’s. Fair compensation should be a topic of review and given some serious consideration.

[Marion Catherine]

Hi Melanie, you make a valid point about wage disparity. And I wish to add to the disparity by stating that fiscal restraints are a valid concern but if something were to go awry with a resident/patient’s care the RPN is fully accountable under CNO and other governing authorities. Although we have professional insurance protection through registering with WeRPN, we are not compensated fairly given the level of accountability we are to uphold. Granted and respectfully considered, the extended years of education for the RN & NP does warrant its fiscal compensation, RPNs ought to be acknowledged for their level of accountability, too.

[Marion Catherine]

Interestingly, missing from key findings is the discrepancy between education in current trends and best practices and the realities of being on the job.
Although we are educated with current trends and best practices, the facilities we are hired into are still functioning with outmoded routines and there is strong resistance among the unit team members to update care practices and attitudes. Consequently, spending time on how to navigate staff and the system takes away from the focus of person centered care. The learning curve of how to navigate within an established unit is steep. Coming in as a newly registered PN, one’s enthusiasm & idealism is quickly curtailed.

[Adella]

I often find that organization do not want to upset the apple cart so they remain status quo working in silos and not allowing PNs to work to their full scope. They often stunt our growth and development rather than expecting more of the RNs.
Wage discrepancy has been and will likely always be a discussion point. Again we often hear senior management use terms like RPNs are cheaper. This could be phrased differently to allow respect for the profession.

[Daniela]

The key findings above are as expected and I do find that “scope of practice” is not well understood.

I found that an organization’s policies and procedures do play a large part in what the RPN role is and sometime does cause conflict and role ambiguity between RNs, RPNs and PSWs. In turn, as Melanie stated above, if often paves the way to wage disparity.

[Daniela]

Activity 1

[Sadie]

One thing I expected to see discussed more directly was how the ongoing push for the professionalization of nursing may have contributed to current perceptions of RN and RPN roles.

In my RN education, there was a strong emphasis on the significance of RNs moving to a degree requirement and what that meant for nursing being viewed as a profession. Reflecting on the readings, it made me wonder whether some of that messaging may have unintentionally shaped how the RPN role is understood or valued, particularly given the ongoing misconceptions and role confusion noted in the research.

[Author]

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