We humans are creatures of habit. When something comes along that threatens to change our  customs and routines, it can be unsettling, even downright scary. Especially when that change  involves something as central to our identities as our jobs. Just because many of us tend to bristle  at the prospect of change, however, does not necessarily mean that keeping things the way they  are today is always for the best.

 Every week, it seems, there are new media reports about one category of health care workers being replaced by another. In response, there are the obligatory quotes, posts, letters and tweets from the various corners of the nursing world, parsing the numbers and extolling the virtues of one group, sometimes at the expense of another. The implied question seems to be, “Why can’t they just keep things the way they were?”

In the midst of this jockeying and messaging about the relative numbers of various types of care providers, shouldn’t our collective focus instead be on the lost levels of care? It would seem that some are far more interested in who is providing the care rather than the decreasing amount of care provided in today’s system care itself. Have we forgotten that there are real patients (and their families) at the other end of this?

Yes, the assignment of care providers always has, and will always, need to be done in a careful manner, matching patients to the skills of their nurses. And yes, care needs to be taken to ensure that we don’t end up with the wrong category of nurse/care provider. That is a real risk, one that needs to be carefully managed by health care leadership.

However, in a health care system in which few truly understand the role of the RPN (a fact made abundantly clear in our recent ‘Role Clarity’ research initiative), it does not make much sense for any of us to continue to insist on maintaining the status quo. Rather, we should be looking at the evolving roles of RPNs (which reflect the evolving education of all nurses) and then ensure that the health care organizations that don’t have RPNs in those roles today get them there.

To advocate for the status quo implies that we’ve already figured it out. That the system we have in place today is as good as it can be. And clearly, that’s not the case. As in any other industry, there’s room for improvement in health care. After all, there are such major differences in how nurses are being utilized throughout the system. If one organization uses nurses in one way and another organization uses them in an entirely different way, what’s to stop us from learning from one another?

If we truly believe that matching the right care provider with the right patient at the right time is the best approach to creating the best quality health care system, then all of us, RPNs included, need to be willing to give up the status quo. At the same time, however, we also need to demonstrate leadership in ensuring that we be recognized for the quality care we provide when assigned to the right patient populations and, by the same token, not allow research to be widely generalized to situations it was not initially meant to describe.

Nursing is one profession with two categories. And the diversity of nurses matches the extensive diversity of needs of our patients. As the education of each category grows, so should the roles of all nurses … RNs and RPNs alike.


Dianne Martin
Executive Director

Category: Messages from the Chief Executive OfficerDate: Monday, June 22, 2015