Differences between Canadian and USA nursing?

[Cinquefoil]

Considering working in both the USA *and* Canada.

Plenty of threads out there about the requirements for licensing etc in each place. But how about the differences and similarities in scope of practice? I read on one of the licensure threads that Canadian nurses have a broader scope of practice, and a greater focus on preventative care.

Really? Well, ya got me wildly curious.....how? What can Canadian nurses do that US ones can't and vice versa? Who spends more time on paperwork? What are the headaches of pt. advocacy/HR and which ones are different depending on side of the border????

Looking for a few donations

Thank you!

[Cinquefoil]

THANK YOU THANK YOU THANK YOU! VERY useful!:redbeathe:D:)

dishes said:

cinquefoil

The difference between Canadian and USA nursing has more to do with competencies than with scope of practice. Competencies are the physical and intellectual knowledge that are required for entry level practice. The Canadian nursing exam tests knowledge of competencies, the US exam does not. The Canadian exam tests knowledge of community health nursing theory, the US exam does not. For more information on the differences between US and Canadian licensure and community health nursing competencies see http://www.registered-nurse-canada.com/NCLEX.html

and http://www.registered-nurse-canada.com/community_health_nursing.html

dishes

[Cinquefoil]

LaughingRN said:

I'm a dual citizen nurse:)

I think one of the biggest differences off the top of my head is that you HAVE to have your BSN in Canada in order to write the CRNE (Canadian licensing exam)

oh, and as someone also mentioned, In my experience (which is brief in Canada) you, the RN, typically does total care...all the bed baths, vitals, meds, ect. This is my experience from 2 provinces ?

Good thing I'm getting BSN, and like doing bed baths then, eh?

[itsmejuli]

Many people asked me why on earth I'd leave sunny, warm Florida for chilly Calgary. I simply told them that I was tired of being a nurse without my own health insurance. Most people were quite shocked to hear of a nurse without health insurance. Of course there are far more reasons than that for leaving FL.

I have my provisional license in Alberta and will be writing the CPNRE in May. I'll also be attending the CLPNA conference in Calgary in April. :) I'm looking forward to it :)

Its great to be back in Canada :)

[Fiona59]

@itsmejuli:

Convention always has recruiters there. Good place to network.

[Nurserandy]

I have worked in two different provinces and know many nurses who worked in the USA and came back for a variety of reasons.

Your scope of practice will be the same. Unless you decide to do outpost nursing in northern ontario/manitoba/nanavut/northwest territories where there is no doctor so you perform physician duties with awesome pay.

The main difference is the system you work for. Depending on the province, you will work for an agency of the government. I.e. in BC you work for a health authority. in Ontario you work for the hospital which in and of itself is not a government agency.

Healthcare professionals do not get sued nearly as much as in the US. Because it is universal healthcare EVERYONE gets treated.

we have wait times here which can be frustrating, however the government is trying to bring the wait times down (how well they are doing is another story).

Healthcare in Canada is a universal right, and Canadians are proud of it (including myself).

I have never had someone say they pay my wages and most people are patient with wait times ( I have worked in many ED's) in BC and ON

As with all healthcare, it can be frustrating...the system fails, patients don't listen etc... I think if you are patient, you will be fine.

And we have MUCH better labour laws.

[Nurserandy]

Cinquefoil said:

Good thing I'm getting BSN, and like doing bed baths then, eh?

I don't know of very many hospitals where the RN does total care accept critical care areas. Most places have gone to RPN/LPN and nurses aides.

[Cinquefoil]

@ Nurserandy: thank you so much for your thoughtful and detailed answers! I'll probably work for a while in the USA before trying to cross up to Canada, but I want to start the process of orienting myself to Canadian health care as early as possible.

The wait times....how are these decided? I imagine it's some sort of triage process, but what kind? And how would a Canadian appeal a wait time that seems to be too long?

[Nurserandy]

appeal what? our system is universal, everyone is the same... it depends on the urgency of it, generally people are referred by their GP and wait to see the specialist, then once they have seen the specialist they wait for the procedure. . My mother needed a knee replacement. it tool a month to get the appointment and a month and a half to get the surgery. some people wait 6 months... depends on the area of the country you live in and the availability of the service. i.e. people in the rural areas wait much longer than big cities. If it is not emergent, then people generally wait. I am sure there is a standard triage process for surgeries etc... I.e. Patient in hospital with urgent cardiac issues get their CABG done in hospital but others may wait months until a Cardiac surgeon is available if it can wait. We don't have private hospitals, so some people go to the states to get it done, but most wait.

[Cinquefoil]

I guess I was picturing myself in a situation where a patient (IMHO) has a higher acuity than that assigned to them by the system, and therefore needs surgery or a procedure sooner than the time assigned to them. What would I do, as a nurse, to address this and advocate for my patient?

Does this ever happen?

[Nurserandy]

Cinquefoil said:

I guess I was picturing myself in a situation where a patient (IMHO) has a higher acuity than that assigned to them by the system, and therefore needs surgery or a procedure sooner than the time assigned to them. What would I do, as a nurse, to address this and advocate for my patient?

Does this ever happen?

no, because EVERYONE is equal and treated under the same plan. EVERYONE is under the provincial healthplan. All essential services are covered under this plan. Their is no HMO, no varying degrees of coverage. Many Americans have problems understanding this. The only people who do not fall into this category are travellers who have travel insurance or who Don;t have travel insurance.

[joanna73, BSN, RN]

Should it happen where someone does not want to wait for a procedure or service AND they have the means and the money to pay, they often go to the US. Otherwise, they wait their turn. Yes, we can have high wait times. But I like the fact that everyone is entitled to a decent standard of health care here. That makes me proud to be Canadian. IMO, the system in the US is very cold. Health care is a right, not a privilege. Furthermore, because of our system, we can take comfort in the fact that we, as nurses, are not faced with the threat of a lawsuit on a regular basis.

[Cinquefoil]

So are you saying a patient is NEVER, under the Canadian plan, made to wait if a procedure or surgery is essential to their health?

Or are you saying that EVERYONE with the same health condition has to wait the same amount of time?

And if you're saying that, I'm just asking what happens if the emergent nature of their health concern increases during their wait period? Do they just get seen again and then get their wait time adjusted? Who adjusts their wait time? Do you have to fill out paperwork or just advocate to the doctor?

I guess overall I'm asking what the procedures for patient advocacy are like? And how do you apply to get a second opinion if you think it's warranted? Or do you have to go to the USA and pay for that?