Alberta Health Services

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OK, we've all heard that they are eliminating 100 managerial positions.

We got the OT ban announcement last week, followed by the "part timers should pick up shifts before OT is permitted" (well, duh, that's in the contracts, can't help it if the staffing office failed to follow the rules), followed by the those on OT will be floated off to units within their services that are short.

How about the wonderful pens for nursing week?

How is AHS affecting your work day?

Specializes in NICU, PICU, PCVICU and peds oncology.

Lately our unit has been handing out stats and ad hoc vacation like communion wafers, so maybe it's true... there is no nursing shortage. What's more likely is that our surgical programmes have slowed down and there are fewer RSV and flu cases than we expected for this time of year. We've only had one RSV to my knowledge so far.

Meanwhile, we were slammed over Christmas and there were people in on OT for just about every shift between the 23rd and the 28th. But even better, the people who worked OT on the named holidays have only been paid the OT and not the named holiday pay. One of our nurses worked OT nights the 24th, 25th and her regular day shift the 1st. The only holiday she was paid for was the 1st, although she should have been paid for 11.63 hours for the 24th-to-25th night and the first five hours of the 25th to 26th night, then another 6.38 hours for the early hours of the 26th. There were others who were done the same deal. There's a grievance in the works since payroll says they were given a directive that OT on a stat is only payable at OT rates. WRONG!

As far as Haiti goes, it's really horrible what's happening there, and the people of the First World are obliged to help however they can. I'm not sure that should mean that their needs be put before those who have been waiting months or years for care here, or that an NGO be given the authority to spend money that isn't theirs on relief efforts.

What I would REALLY like to see is for Haiti to get the restructuring it so desperately needed - even before this catastrophe. For the amount that would be spent to transport, care for, house, etc, these poor people and then to ship them back (or would they end up as refugees further indebted to the system?) we could begin to truly make a dent in the costs of setting up a system that would allow them to become more self-sufficient. The poverty there is beyond comprehension, but there ARE local organizations at the grass-roots levels that are working with the people in far more EFFICIENT ways than a big governmental organization could ever hope to achieve.

This is my hope for Haiti - that the eyes of the world would truly be opened to the needs there and that First World populations would have the attention span (Tiger Woods/____ hollywood actor/actress OD notwithstanding) to make a LASTING difference. God knows they need it, so lets help them get the tools.

As an aside: I'm in 1st year PN programme. The grads for this year have been told that the local AHS liason who usually comes in to try to recruit for this region will NOT be coming this spring. I don't think that bodes well for their ability to find employment post-grad, at least this year. Let's hope they can make some sense of this baloney by next spring when I graduate. What a sorry mess this is becoming.

Specializes in NICU, PICU, PCVICU and peds oncology.
As an aside: I'm in 1st year PN programme. The grads for this year have been told that the local AHS liason who usually comes in to try to recruit for this region will NOT be coming this spring. I don't think that bodes well for their ability to find employment post-grad, at least this year. Let's hope they can make some sense of this baloney by next spring when I graduate. What a sorry mess this is becoming.

Wow, that's very interesting... considering that AHS has made it a crusade to replace RNs or augment the staffing numbers with LPNs. If they're not planning to recruit PN students either, what do they plan to do?? Oh wait, they don't HAVE a plan!

At our unit staff meeting last week the manager told those in attendance that we RNs have to prove our scope and that our environment is not suitable for LPN involvement. Her idea is to have us devise committees that are purely staff-nurse-run that will focus on things like CQI, nursing research, family-centred care, pain management, blah blah blah. And she also said that she will not be involved in any way with any of these endeavors. Considering that we have about a 30% per annum turnover, we have no nurse educator and we have a vacant supervisor position that no one wants, I see bad things in our future.

You know Jan, I'm yet to work with an LPN that WANTS to work in the NICU or ICU. My co-workers are just plain fed up. Our scope keeps expanding yet we get no recognition of it. We are just expected by AHS to jump in wherever they want us.

When we deal with CLPNA their attitude is "we don't touch pay, that's the union". They just go to meeting with the govt. and expand our role. In the decade I've been working Alberta, not once has CLPNA said, "should we expand your scope to this level?" They should have concentrated on getting us the ability to use the skills we graduated with and then were facility restricted against practising.

Where is that poster called CLPNA when we want answers????

Specializes in NICU, PICU, PCVICU and peds oncology.

I hear you, Fiona. The level of responsibility that expanded scope of practice brings with it deserves recompense. I expect Guy Smith is already planning his attack on AHS when your contract comes due... "You want LPNs to take on more responsibility, then you're gonna have to pay 'em!"

There could be a role for LPNs in an ICU environment but without adequate examination of the actual work being done and a clearly defined set of expectations aimed at ALL staff members, it's not a good idea. The LPNs need to know exactly what they're there to do, the RNs need to know exactly what the LPNs are there to do and how to integrate them into the unit's workflow, and the NAs need to know exactly what everyone else is doing and what can be delegated to them by whom. Building such a system will take time that I know AHS won't want to take.

At ACH the respiratory techs are being given patient assignments with the RN at the next bedside responsible for administering all meds, doing dressing changes etc and the RT providing basic care. Now THAT's a slippery slope!!

Specializes in Geriatrics, Med-Surg..

I don't see how these nutty politicians figure LPN's will work in ICU if the LPN is only to be caring for the more stable patients with somewhat predicatable outcomes. I realize that often a stable patient can be unstable in an instant but really where does one draw the line. As an LPN, I would be very worried about being out of scope.

Also, I really can't see the RN being willing to oversee and be responsible for some crazy number of patients that someone else is taking care of.

Specializes in Geriatrics, Med-Surg..

I guess the Minister of Dance (sorry Health) has all the answers. He must be related our premier of Ontario.

Linzz, that's part of the problem. What is a stable patient in Active Treatment?

The assumption is if you are stable enough to discharged from ICU or the OBS unit you are stable enough for the floor. In my hospital the patient gets assigned to a room and the nurse with the empty bed assumes care. Doesn't matter how many tubes or lines are hanging out of the patient, what type of drains, dressings, etc. They are yours. They are stable and therefore are an LPNs responsibility.

The system sucks and management knows how to play it. Sure I've had patients that I've felt are too unstable to be cared for me and I've documented it, spoken to Charges, Bed Managers, called the Union and filed incident reports. My rather large backside has been covered. On my unit the LPNs have run themselves ragged caring for patients that should technically be an RNs but the patient is considered stable and as the managers have said you are an experienced LPN you are a better choice for this patient than X,RN because she's a new Grad with less than two years experience.

I give. I've tried. Hell even student RNs are allowed to access a central line and I can't but when they graduate and start work, I will still be taking the more complex patient because I'm "experienced".

Specializes in NICU, PICU, PCVICU and peds oncology.

It always comes down to a subjective definition, doesn't it? Stable is in the eye of the beholder. We have patients that our management consider to be stable sometimes, and they would be the "chronically critical" patients. They may have an assortment of issues, but with current management are holding their own. They are the patients that tend to be assigned to our green-as-grass new staff. The problem then becomes that things get missed, overlooked or downright ignored. Over time, the "little things" add up and the patient either is assigned to a senior nurse by default who then cleans everything up (as was the case over Christmas where I was assigned to one such patient and spent two days undoing a lot of the things that had been done by a string of very junior nurses) or s/he tips over. These are the patients that I could see being assigned to the LPN. Some of these patients have critical airways; some have complex metabolic and fluid balance issues, some have myopathy of critical illness and require long-term mechanical ventilation. They are fragile and unpredictable. And then we have the usual group of newish nurses who complain long and loud about being given these assignments... "I didn't come here to look after patients like this; I came here to look after the fill in the blank patients." My favourite is the new grad who wants to be a transport nurse. Sorry but you need at LEAST 2 years of progressively more complex experience before you can even take a patient off our unit for a test without a senior nurse accompanying you.

Fiona, you do the right thing when you document everything. You need to protect yourself when your assignments are inappropriate for your scope. But I don't think anything ever really happens after the documentation leaves our hands, do you? Unless a NetSafe indicates moderate harm or worse, it gets buried on the unit manager's desk to be "handled" at the unit level. (Oh, and your bum's not THAT big! :kiss )

Well, since the government has blinked on the Alberta Hospital bed closures, things may yet come back around for acute care too.

300 acute care beds are safe.

Hm, backpedalling anyone? Duckett seems to be losing his golden boy status.

Let me guess? He'll be getting a golden handshake, oh, by April 30.

Specializes in NICU, PICU, PCVICU and peds oncology.

The fiscal year ends March 31, doesn't it? And so does the UNA contract. We could be in for a perfect storm.

But we're still going to have to pay for four first-class air fares, plus all moving expenses to Australia. And a huge severance package.

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