Mohawk College Professional Development - Fitness to Practice PDF

Week 12 Professional Development I Module 12: Fitness to Practice  Land Acknowledgement Mohawk College derives its name from the Mohawk Nation, one of the Six Nations of the Haudenosaunee Confederacy. The Confederacy marks a union of peace and friendship, and Mohawk College honours that union b...

Week 12 Professional Development I Module 12: Fitness to Practice  Land Acknowledgement Mohawk College derives its name from the Mohawk Nation, one of the Six Nations of the Haudenosaunee Confederacy. The Confederacy marks a union of peace and friendship, and Mohawk College honours that union by recognizing the Six Nations of the Grand River and the Mississauga’s of the Credit First Nation. We acknowledge that the territories on which Mohawk College and its campuses are situated are governed by the Between the Lakes Treaty, the Dish with One Spoon Wampum Agreement, and the Upper Canada Treaty Agreement. These agreements are binding to this day and represent our mutual commitment to maintain healthy, reciprocal and respectful relationships with the many Indigenous nations and peoples of this area. We acknowledge this and iterate our dedication to inclusivity, to friendship and to valuing the ongoing contributions of Indigenous peoples and communities. Agenda 01 02 03 Housekeeping Learning Understanding Outcomes Fitness to Practice 04 Maintaining 05 06 Fitness to Coming Up Questions? Practice  0 Week 12 1 Housekeeping Questions Week 11? Part C: Group Presentation on QI In Ontario, every nurse is required by the College of Nurses of Ontario to report professional practice and client care concerns and attempt to resolve them. One way to solve nursing practice issues is through quality improvement initiatives utilizing the Plan-Do-Study-Act (PDSA) cycle. In this assignment, students will theoretically attempt to manage a practice issue using the Plan-Do-Study-Act cycle. In your groups, you will analyze the practice issue within your assigned case scenario and generate solutions to manage or solve the problem. You will do this following the steps of the PDSA cycle. Assignment Learning Objectives: Engage in continuous quality improvement and risk management to promote quality practice environment Participate and engage in the quality improvement process by working through the Plan-Do- Study-Act Cycle (PDSA) Apply relevant nursing ethical and legal principles to enhance and support analysis Collaborate in the analysis, development, implementation, and evaluation of nursing practice issues Part C: Group Presentation on QI Plan: 1. Recall that in Part A of this assignment, you were asked: What is the key problem/issue in this scenario? Share how you answered this question with your team members. Come to a consensus as a group what the key problem/issue is within your scenario. 2. Identify resources that are relevant to the identified practice issue. For example: College of Nurses of Ontario (CNO) practice documents, Registered Nurses Association Ontario (RNAO) Best Practice Guidelines, WeRPN resources, Canadian Nurses Association (CNA) practice documents, textbook readings, journal articles etc. Ensure your chosen resources are relevant, current, and reputable. 3. Recall that in Part A of this assignment, you were asked: What potentially contributed to this problem/issue? Using the resources identified in step "2" above, analyze the practice issue in your case scenario. Consider: contributing factors, patient safety, ethical principles, legal implications, quality of care, social justice, etc. 4. Discuss how this practice issue impacts all stakeholders involved (clients, health care staff, families, communities etc.). Part C: Group Presentation on QI Do: 1. Create a list of strategies that could be used to manage or solve the practice issue. The suggested strategies cannot be your personal thoughts or opinions. They need to be based on best practice and supported by evidence. 2. Provide a rationale and evidence (in APA formatting) to support these strategies. Describe how you would go about implementing the identified strategies into practice. 3. Describe how you will know if your strategies have been successful. What outcomes would you expect to see? Study: 4. Create a list of potential problems or unexpected obstacles you would have to overcome while implementing the strategies listed above. 5. Generate some strategies to overcome the potential problems or unexpected obstacles identified in step "1". Again, provide rationale and evidence (in APA formatting) to support these strategies. Part C: Group Presentation on QI Act: 1. As a group, briefly summarize and reflect on what you have learned. Do you believe your chosen strategies would work to solve the problem? Be very realistic and consider the obstacles identified above. Would you implement the strategies, modify them, or abandon them completely? 2. Re-write your case scenario as if your chosen strategies have been implemented and what you expect the outcome to be. The outcome can be positive, negative, or neutral. 3. Students are responsible for ensuring Academic Honesty is maintained for all assignment submissions. Please refer to the Mohawk College policy on Academic Integrity  0 Week 12 Learning 2 Outcomes Learning Outcomes 1 2 Understand the Apply the concept of fitness concept of fitness to to nursing practice, self- practice regulation, and public protection 3 4 Recognize and assess Examine methods to symptoms, causes, and maintain fitness to effects of stressors that practice might impair nursing practice  0 Week 12 Understanding 3 Fitness to Practice Small Group Activity Fitness to Practice Time: 5 minutes What do you think “Fitness to Practice” means? Can you think of examples? Write down your answers Be ready to share in large group Fitness to Practice “All the qualities and capabilities of an individual relevant to his or her capacity to practice as a nurse, including, but not limited to freedom from any cognitive, physical, psychological, or emotional condition, or a dependance on alcohol or drugs, that impairs his or her ability to practice nursing” What does this mean? Under the Code of Ethics (Canadian Nurses Association) FTP means… ○ Nurses are responsible for maintaining their fitness to practice ○ If a nurse is aware they do not have physical, mental, or emotional capacity to practice safely and competently, they must withdraw from the provision of care ○ Nurses take responsibility for taking the necessary steps to regain their fitness to practice (NANB, 2022) Fitness to Practice A nurse may feel “unfit” to practice and not able to meet the Standards of Practice or values from the Code of Ethics Factors that may result in a nurse feeling unfit ○ Problematic substance use ○ Exacerbation of a mental health issue ○ Physical limitations and/or injury ○ Fatigue or other factors that negatively impact their practice (NANB, 2022) Fitness to Practice Nurses who experience a situation affecting their fitness to practice have a professional and ethical obligation to address the issue Until this issue is addressed the nurse shall not continue to practice If a nurse requires support to manage a situation, they should… ○ Speak with their employer ○ Seek advice from their primary health care provider ○ Access staff health programs or other support or treatments programs as required (NANB, 2022) Fitness to Practice Summary: Providing safe, competent, and ethical care to clients is the responsibility of every nurse Should there be an issue related to fitness to practice, a nurse must withdraw from client care so that there is no risk to the client Nurses are expected to report the issue whether it applies to themselves or another healthcare provider (NANB, 2022) CNO Fitness to Practice The Health Inquiry & Fitness to Practice Process CNO should receive a report from an employer that identifies concerns about a nurse’s ability to practice safely There is a 3-Stage process: 1. The Health Inquiry 2. The Fitness to Practice Committee 3. The Public Register (CNO, 2020) CNO Fitness to Practice 1. The Health Inquiry The employer must provide a written report to the CNO’s Executive Director within 30 days if there are concerns about a nurse’s ability to practice safely ○ Note: If there is serious concern for risk this must be reported immediately Executive Director reviews the report and the level of risk to the public is determined An appropriate regulatory response follows, which may include an additional inquiry into the concerns about the nurse’s health (CNO, 2020) CNO Fitness to Practice Inquiries, Complaints and Reports Committee (ICRC) conducts the inquiry The nurse may be directed to attend an independent health assessment The nurse always has the opportunity to respond to the inquiry Following the review, if the ICRC has concerns about the risk to the public, it will refer the nurse to the Fitness to Practice Committee If the committee has concerns that the nurse will likely cause harm to patients, the committee may restrict or suspend the nurse’s practice until the Fitness to Practice Committee concludes the matter (CNO, 2020) CNO Fitness to Practice 2. The Fitness to Practice Committee When a nurse has been referred to the ICRC, the CNO makes a notation in the nurse’s public record within the Find a Nurse profile An agreement or a formal hearing may resolve the issue To resolve by agreement, a nurse can volunteer to obtain treatment and restrict their nursing practice or voluntarily surrender their certificate of registration A nurse would not be able to return to practice until all applicable criteria from the agreement has been met and they are deemed to practice safely (CNO, 2020) CNO Fitness to Practice If the matter is not resolved by agreement… ○ Nurse will have a full, and fair, opportunity to participate in a formal hearing ○ The hearing is with the panel of the Fitness to Practice Committee FTPC may impose terms, conditions, and limitations, or suspend a nurse who does not voluntarily agree to obtain treatment FTPC may restrict a nurse’s practice or surrender their certificate of registration (CNO, 2020) CNO Fitness to Practice 3. The Public Register CNO will only post information about a nurse (Find a Nurse) that is reasonably necessary to protect the public Restrictions may be posted to which a nurse has voluntarily agreed Notification may be posted that a nurse has voluntarily surrendered their certificate of registration and are no longer entitled to practice CNO will remove any restrictions posted when there is no longer a threat to the protection of the public (CNO, 2020)  0 Week 12 4 Maintaining Fitness to Practice Mental Health at Work Silent Crisis: Across Canada, nurses are experiencing a silent mental health crisis (Since 2020) ○ Short staffing ○ Unrealistic workloads ○ Workplace violence (mental, physical, psychological from patients/patient families) Canadian Federation of Nurses Unions is attempting to give a voice to this crisis CFNU conducted a national study; Mental Disorder Symptoms Among Nurses in Canada (CFNU, 2021) Mental Health at Work Mental Disorder Symptoms Among Nurses in Canada Study Findings Nurses experience widespread and severe symptoms of... ○ Posttraumatic Stress Disorder (PTSD) ○ Anxiety & Depression ○ Burnout ○ Suicidal Behaviour Nurses’ rates of mental disorder are higher than the general population and often higher than other public personnel (firefighters and paramedics) (CFNU, 2021) Mental Health at Work In response to the crisis, CFNU partnered with Wellness Together Canada to share resources with health care workers, their families, and patients Wellness Together Canada is Canada’s first and only online platform offering immediate, 24/7 mental health and substance abuse support for all ages WTC is funded by the Government of Canada Platform offers a stepped care approach, where users choose the level and types of support, they are most comfortable with ○ Mental Health Assessments ○ Mindfulness Workshops ○ Live phone, video, or text counselling with a mental health professional or crisis responder (CFNU, 2021) Mental Health at Work Go to WellnessTogether.ca for free support, available 24/7. You can also access the service anonymously if you prefer. For immediate crisis support, front line workers are encouraged to text FRONTLINE to 741741. (CFNU, 2021) CNO Health Support A nurse’s health can affect the care they provide to their patients Research suggests that physical and emotional fatigue can reduce brain function and affect decision-making, memory, and attention Personal and professional lives have ups and downs and nurses may need to take a step back and reflect on whether they feel their health is impacting the care they provide (CNO, 2019) CNO Health Support (CNO, 2019) Small Group Activity Maintaining Fitness to Practice Time: 5 minutes Discuss some ways in which a nurse can maintain fitness to practice What are some strategies? Be prepared to share in large group CNO Health Support (CNO, 2019) Maintaining Fitness to Practice The Nurses’ Health Program (NHP) Voluntary bilingual program for Ontario nurses Designed to encourage nurses to seek treatment for substance use and/or mental health disorders that may affect their ability to practice safely Recognized as best-in-class approach that focuses on early identification and referral for treatment The program is modelled on similar ones used for other regulated health professions across the province (NHP, 2023) References Canadian Federation of Nurses Union. (2021). Mental health at work. https://nursesunions.ca/campaigns/mental-health College of Nurses of Ontario. (2020). Fact Sheet: the health inquiry and fitness to practice process. Retrieved from https://www.cno.org/globalassets/docs/ih/health- inquiry-and- fitness-to-practise-processes.pdf College of Nurses of Ontario. (2019). Your self-care matters. Retrieved from https://www.cno.org/globalassets/4- learnaboutstandardsandguidelines/ prac/learn/sap/self-care-fact-sheet-en.pdf Nurses Association of New Brunswick. (2022). Fitness to practice, what does it mean? https://www.nanb.nb.ca/wp-content/uploads/2022/11/NANB-FAQ-FitnessTo- Practice- 2019-Revised-March-2022-E.pdf  0 Week 12 5 Coming Up… Coming up… Ensure you have completed 1 hour of asynchronous work for Module 12 Prepare for Module 13 (Week 13) ○ Review module objectives ○ Begin required readings and activities and come prepared to engage in lecture Part C Assignment: Group Presentation ○ Refer to Canvas for Assignment Instructions ○ Due: December 6th Final Exam… Refer to Announcement for Information Refer to Module 14 Final Exam Information Monday December 9th at IAHS – No students writing at TW/WH 4:30pm 90 minute exam Covering Module 9-13 Worth 25% Arrive Early MUST have Mohawk OneCard NO belongings – please use lockers  0 Week 12 6 Questions Break Time… Please enjoy a 5-minute break  Week 12 Bonus Group Project Time Please use the remainder of class time to work on your group assignment