Although the Ontario government funds our health care system and passes important laws and regulations that impact nursing practice and patient care, it doesn’t hire nurses directly (in most cases), doesn’t determine the nursing skill mix in our workplaces, and doesn’t set nursing practice standards or determine the workplace policies that guide nursing professional practice and patient care. But beyond its legislative, regulatory and financing functions, the provincial government does have an important role to play in supporting nursing workplace practice and creating healthier work environments for Ontario’s nurses.
As your professional association, it’s our job to advocate on your behalf with the government to make sure the public programs and funding initiatives designed to enhance nursing practice and patient care meet your needs, the needs of your nursing colleagues, and the needs of the people you care for. So we’d like to take a moment to tell you about four of the most important government-funded nursing programs in Ontario and give you some information about how we’re working with the Ministry of Health and Long-Term Care to ensure that these programs continue supporting Ontario’s nurses and their patients.
The Nursing Education Initiative (NEI)
Perhaps the best-known and most popular government nursing program in Ontario is the Nursing Education Initiative, which is administered by RPNAO for Ontario’s RPNs on behalf of the Ministry of Health and Long-Term Care. The Nursing Education Initiative (NEI) is a grant program that supports nurses who are taking continuing education courses. Ontario nurses registered with the College of Nurses of Ontario may be eligible for up to $1,500 per year in tuition reimbursement. Since its inception in 1999, NEI has provided education grants to thousands of RPNs and RNs across the province to enhance their knowledge and professional skills for the purpose of enhancing nursing practice and patient care in Ontario.
Given the importance of ensuring that Ontario’s nurses stay current in their clinical knowledge and skills, and the growth in the popularity of the program over the past few years, RPNAO has met with the Minister of Health and Long-Term Care and other government representatives to advocate that the NEI be renewed for the coming years. RPNAO also supports expanding the NEI program to create a special continuing education fund for rural and remote nurses, which is one of the policy recommendations made in the final report of the Registered Nurses’ Association of Ontario’s (RNAO) Rural , Remote and Northern Area Nursing Task Force of which RPNAO was a member.
The Late Career Nurse Initiative (LCNI)
As a member of the Joint Provincial Nursing Committee, RPNAO advises the Ontario government on important nursing initiatives aimed at improving nurses’ working environments, patient care, and the recruitment and retention of nurses in Ontario, including the Late Career Nursing Initiative and the New Graduate Guarantee.
The Late Career Nurse Initiative provides opportunities for Late Career Nurses (LCNs) – both RPNs and RNs – to utilize their knowledge, skills and expertise in less physically-demanding alternate roles. Over the years the LCNI has resulted in a number of improvements that benefit nurses and their patients, including decreased sick time, decreased stress, increased patient satisfaction, increased patient contact hours, and improved clinical outcomes.
LCNI funding is awarded to hospital, long-term care, and homecare organizations through an annual application process for projects involving LCNs (55 years of age or older) that improve patient care and/or the quality of the work environment. These projects, which require approximately 16 weeks to complete, must impact strategic retention and health care priority areas such as improving access to education and training, implementing best practices, collaborating to improve care outcomes, collaborating to improve patient transitions, and supporting mentorship and knowledge transfer.
The New Graduate Guarantee (NGG)
The purpose of the New Graduate Guarantee (NGG) is to give every new graduate RPN and RN the opportunity to work full-time in supernumerary positions for up to six months in order to integrate them seamlessly into Ontario’s nursing workforce. The NGG is especially important for Ontario’s RPNs, whose rate of full-time employment is well below the provincial target of 70.0 percent. In 2014 only 55.9 percent of RPNs employed in nursing in Ontario worked on a full-time basis, which marks a decrease of 5.0 percent since 2012. The problem is even worse for new graduate RPNs, who reported an overall full-time employment rate of just 26.1 percent in 2014, compared to 40.6 percent in 2009.
It takes a long time, on average, for an RPN to achieve full-time employment in nursing in Ontario, and it’s becoming harder and harder for our newest nurses to find stable employment and reliable hours. That’s not only bad for Ontario’s RPNs, but it’s bad for their patients as well, because the research demonstrates that a lower rate of full-time nursing employment results in fragmented care and lower patient health outcomes.
These are the reasons that it’s so important for the provincial government to work with Ontario’s nurses on improving the NGG to increase full-time nursing employment, not only for new graduates but for all nurses in Ontario, regardless of the year of their initial registration or current employment status. Building a culture of full-time nursing employment, for all Ontario’s nurses, begins with our new grads. We have to do more to help get them into full-time permanent nursing positions sooner and to develop a system that incentivizes employers to create more full-time nursing positions. Without a comprehensive strategy it will be difficult for our province to achieve and sustain the agreed upon target of 70.0 percent full-time nursing employment.
Leadership and Clinical Practice Fellowships (LCPFs)
The Ontario government also supports RPNAO’s Leadership and Clinical Practice Fellowships (LCPF), which give Ontario’s RPNs the opportunity to undertake fully-funded mentor-based internships at their workplaces. This program, which is the first of its kind for RPNs in Ontario, requires selected applicants to develop a learning plan and budget in collaboration with a mentor to address an identified gap in the workplace. The themes of past fellowships have included: building healthier workplaces; preventing and managing chronic diseases, such as diabetes; contributing to the development of Ontario’s eHealth strategy; improving mental health care and addictions services; and implementing interprofessional care plans.
Ontario’s nurses depend on the LCPF and the other government-funded programs to optimize nursing practice and enhance patient outcomes. As your professional association, we look forward to working closely with our elected representatives and other government decision-makers to ensure the success and longevity of these important public programs that impact nursing professional practice every single day. If you haven’t benefited from any of these programs already, we encourage you to find about more about how they can help you and your patients.
For more information about the Nursing Education Initiative (NEI) and the RPNAO Leadership and Clinical Practice Fellowships visit www.rpnao.org. To learn more about the New Graduate Guarantee and the Late Career Nurse Initiative, please visit the website of the Ministry of Health and Long-Term Care at www.health.gov.on.ca and the HealthForceOntario website at www.healthforceontario.ca. If you have any questions or comments about these programs, you can contact Searle Schonewille, RPNAO Director of Government Relations, at any time.
Director, Policy Development and Government Relations