Professional Practice Process – Tips & FAQsDecember 20, 2023
High staffing turnover, increased patient acuity, heavy workloads, and alarming rates of violence and burnout in healthcare – these factors contribute to challenging work environments and growing professional practice concerns.
It is critical to document situations when you feel unable to provide safe and quality care within your scope of practice. Documenting your concern is imperative to achieving change in your workplace.
Here are some frequently asked questions and important things to know about the professional practice process.
What is a professional practice concern?
It can be a concern related to patient care, workload, nursing practice, or safety of patients/registered nurses. A professional practice concern can be any situation in the workplace that:
- Has or could put patients or registered nurses at risk;
- Interferes with the RN’s/NP’s ability to practice in accordance with their Standards of Practice, Code of Ethics, the Registered Nurse Act, or other legislation, workplace policies, procedures, and relevant standards or guidelines; and,
- Is beyond the ability of an individual member to resolve.
What are some examples of professional practice concerns?
Staffing levels or needs are not the only cause for a professional practice concern. For example, not having access to the proper equipment like a blood pressure cuff or calibrated glucometer can also be a professional practice concern. Professional practice concerns may be caused by a number of factors:
- Staffing levels
- Lack of communication
- Insufficient education or orientation
- Work environment
- Inadequate equipment/supplies
- Unclear job description/duties
- Access to medications
- Non-nursing duties
What is a professional practice form?
The form is an advocacy tool that articulates and communicates a concern to the employer. In short, completing a professional practice form creates a paper trail of a concern that needs to be addressed.
What is the relationship between professional practice forms and my CRNNL professional license?
It is the RNs/NPs duty to identify and address concerns that compromise safety and/ or their ability to practice according to their standards. Completing a professional practice form provides proof that your employer was notified of your concern. This places the responsibility of addressing the concern with your employer.
Can I complete the professional practice form for another RN?
Each RN should complete their own form. However, it is acceptable for a group of RNs to complete the form on a collective issue, as outlined below.
Can a number of registered nurses fill out one professional practices form?
Yes. Getting a group together to include all names on one form can be a good strategy if everyone has experienced the same issue and are in agreement. On the other hand, submitting several individual forms can create an strong impression and sense of urgency with the employer. Use your professional judgement. Either way, documenting the concern is key.
Do I have to stay behind after a long shift to complete a professional practice form?
The quick answer is no. Documentation standards typically advise documenting right after the event when things are fresh in your mind, which helps capture the most accurate information. If you’re not able to complete the form after a shift, make a few jot notes. This will help you recall the facts when you complete the form, ideally within the first few days following the event.
However, remember that the first part of the professional practice process is to bring the matter to your immediate manager for low-level discussion. If the concern is not resolved to your satisfaction at this stage, the professional practice form must be completed and submitted within seven (7) calendar days of first identifying the concern as outlined in the collective agreement.
How should I focus my documentation?
Consider how the issue impacts workload, nursing practice, and patient/RN safety. Try to illustrate how the concern is compromising your Standards of Practice for Registered Nurses and Nurse Practitioners and specify how you are at risk for potentially/actually not meeting a certain standard. Stay objective and avoid placing blame. Always try to offer a solution of how the concern could be resolved and avoided from occurring again in the future.
Does RNU have a standardized professional practice form?
We are happy to say a standardized, provincial electronic form is finally in the process of being created.
For now, there are a number of different forms in circulation across the province. Most regional health zones have their own form which is agreed upon by the employer and members of the Professional Practice Committee. Check with an RNU volunteer to ensure you have the correct form.
Where can I find a professional practice form?
Forms vary by worksite but should be available on your unit/in your work area. Ask a RNU volunteer if you can’t find one. Make copies to ensure there is always some on hand.
Does the professional practice form replace incident reporting in my workplace?
No, it does not. This is a separate process and is not the same as filing a professional practice form. You may also have to document the concern using the incident reporting system, or according to employer policies and guidelines.
What if my concern is not resolved?
Often members fill out professional practice forms in good faith and do not hear back or see change. We know this is frustrating.
If you find yourself in this situation, there are some questions you should ask your manager:
- First, what happened to the form(s)?
- Was the form successfully submitted to your manager and did they go to the Professional Practice Committee (PPC) for discussion?
Remember, we suggest keeping a copy of the form for your own records.
Next, speak to a PPC representative and/or your Branch President about the lack of response you are experiencing.
If your concern is unresolvable at the committee level, was the CEO ever invited to a PPC meeting as Article 49 (i) of the CA allows for?
Similarly, was the issue(s) escalated by the PPC to the appropriate director and Chief Nursing Officer as Article 49 (h) allows for? If not, request that the Chief Nursing Officer attend the next PPC meeting.
RNU Labour Relations Officers (LROs) are available to support you and advocate on your behalf.
As well, PPCs can invite LROs and/or an RNU Board of Director’s member to attend a meeting. We suggest that the mechanisms identified in Article 49 (i) and (h) be exhausted first.
Could I be reprimanded for completing a professional practice form?
No. It is your right under the collective agreement and your professional obligation. The professional practice process is to be used as a collaborative problem-solving strategy.
What successes have been achieved through the professional practice process?
The professional practice process requires persistence. We know that it is not a perfect process and RNU is actively working on strengthening it to become a more powerful tool that can affect positive change in your workplaces.
However, we continue to see the professional practice process result in positive outcomes in member workplaces. We have seen:
- Increase in staffing levels;
- Safer work places;
- Improved communication with employers; and
- Improved equipment and supplies.
Please take a moment to read about the recent success in Branch 5 here!