Alberta hires cheaper nurses to tackle shortage

Alberta Health Services wants to hire more licensed practical nurses — rather than registered nurses, who are more expensive — to deal with a nursing shortage.

Alberta Health Services wants to hire more licensed practical nurses — rather than registered nurses, who are more expensive — to deal with a nursing shortage.

A study by Alberta Health and Wellness suggests 6,000 more nurses are needed.

A nurse walks down a hallway at Calgary's former Grace Hospital. ((Jeff McIntosh/Canadian Press))

Registered nurses go through a four-year university program while LPNs receive training in a two-year diploma program at a college. LPNs are paid $10 to $15 an hour less than RNs.

AHS is planning to hire 1,000 more licensed practical nurses in the next two years to work in clinics and hospitals, bringing the total of LPNs to just under 10,000.

To achieve this goal, AHS is creating more spots in colleges where LPNs get their training. As well, 200 Jamaicans are getting trained in Jamaica, using Alberta curricula for LPNs.

The first batch of Jamaican LPNs is already being recruited by Canadian health agencies, according to Colin Jarrett of Pre University School in Jamaica.

"Since there was a shortage of LPNs in Canada, [the plan is] to train them in Jamaica, with their curriculum, and then [have them] proceed to Canada," Jarrett said.

There is agreement that RNs are currently doing a lot of work below their training, and if they shift into the role of managing more complex nursing jobs and patients, then LPNs can fill in the gaps at a much cheaper cost.

The fear is that this shift will mean fewer RNs, and the nurses directly responsible for a patients' care may not be the most highly trained. Linda Stanger, executive director of the College of Licensed Practical Nurses of Alberta, says that fear is unfounded.

Role of LPNs has evolved

"Part of it could be that people hang on to old thinking, I mean we came from a time when we were a nursing assistant and there are many in the system who hang on to that, and so really struggle with the notion that we're educated now to take on more," Stanger said Wednesday.

"There's a huge overlap in the competencies that can be performed by both the registered nurse and the licensed practical nurse ... so if the LPN is doing the same thing as the RN, then there's a need for movement for both professions, and that's a challenging assignment," she said.

There's also a suggestion that if registered nurses were to stop doing the work that LPNs can do, perhaps the shortage of nurses wouldn't exist. That's the logic of Stephen Duckett, president and CEO of Alberta Health Services.

"If we continue doing things the way we've always done them, there'll be a shortage of 6,000 registered nurses, which to my mind immediately begs the question, 'Should we continue to do things the way we've always done them?' And I think we should be open to doing things differently," Duckett said.

"If I went to hospital, what I'd want a registered nurse to do is to make sure you know they've assessed me properly, identified what my nursing care needs [are]. Do I need a four-year trained person to help me have a shower?" he said.

"I never want to see the day where registered nurses are no longer laying hands on patients." said Bev Dick, an RN and first vice-president of the United Nurses of Alberta.

The union is among the most vocal opponents of the plan to hire significant numbers of LPNs.

"I've heard some people say, 'Well, registered nurses shouldn't have to go and bath a patient,' But people that say that don't understand that while I as a registered nurse am bathing that patient I'm doing a complete assessment of what's going on with them. I'm chatting with them, I may be chatting with their family," Dick said.

Dick agrees nurses are often not doing everything they're trained to do, and spend too much time portering patients around, getting medications and doing jobs that less trained staff could do.

Change should come, but it'll take time and in the end there should be plenty of work for everyone, she said.

"We need more of everybody. There is lots of care that needs to be given in a day-to-day basis and there's not enough people to do it," Dick said.