N.S. exploring whether to add psychiatric nurses to health-care system

Nova Scotia was part of a recent 12-month feasibility study aimed at determining if registered psychiatric nurses could help to improve health-care in the Maritimes.

These nurses already play a role in other provinces in Canada but can't practice in jurisdictions like the Maritimes where they aren't regulated.

The study was a collaboration between the Registered Psychiatric Nurse Regulators of Canada and provincial health bodies in Nova Scotia, New Brunswick and P.E.I.

Cindy MacQuarrie, the senior director of interprofessional practice and learning at Nova Scotia Health, spoke to CBC Radio's Information Morning Nova Scotia host Portia Clark about registered psychiatric nurses and the regulatory changes needed for them to play a role in Nova Scotia.

Their conversation has been edited for clarity and length.

What's the difference between a registered nurse and a registered psychiatric nurse?

Registered psychiatric nurses work side by side with other nurses — registered nurses, licensed practical nurses and nurse practitioners — in various practice settings and are especially concerned with individuals with mental health and addictions concerns.

It's really critical as well to understand that psychiatric nursing education is considered a specialty.

This type of program prepares graduates to meet national entry level competencies from a nursing perspective, but they have an in-depth and a much broader depth of knowledge that focuses on mental health, addictions and advanced therapeutic relationships and communications in psychiatric nursing education.

How did the study come about to explore whether they could be useful, and how they might be integrated into health care in Nova Scotia?

There was a pretty critical piece of work that happened around 2015. There was a mobility and assessment project that was undertaken at the time and there was a question as to where opportunities align across the country for the introduction of the registered psychiatric nurse role.

We're very privileged in the province of Nova Scotia to have the Nova Scotia Provincial Nursing Network. The intention of that network is really to support Nova Scotia's nursing strategy.

When the 2015 project concluded, there was an invitation for members of that team to come to our provincial nursing network and through conversations with the provincial nursing network, there was a decision for us to undertake the feasibility study.

What it found is that it is absolutely feasible for Nova Scotia to move forward with the introduction of the registered psychiatric nurse role.

What would have to change so that registered psychiatric nurses could work here in Nova Scotia?

I'm not speaking on behalf of government or the Nova Scotia College of Nursing. The things that we need to be considering would be in relation to the current legislation around the Nursing Act in our province and how that shows up in our Nova Scotia College of Nursing from a regulation standpoint.

What standards of practice would be required, and how might they be the same as the current standards or how might they be different?

What do our education programs and the province currently offer? And might that have to change going forward from an entry level competency perspective, but also from more experienced or advanced competency in mental health and addictions care in the province?

You mentioned labour-market issues. What do you mean by that?

The western provinces and territories have this role currently and we do not.

There would be a bit of a risk in saying  we're going to open up to this market that we haven't had in the past and what how would that have an impact on the workforce in other jurisdictions and in the country.

If we look to the West, have patients been better served by having registered psychiatric nurses?

I am a registered nurse and spent many years working in the western provinces.

In my nursing days, I worked alongside registered psychiatric nurses so I've seen great benefit in working with my colleagues that have this form of education.

We have complementary knowledge and we lean on each other.

For example, my undergraduate nursing education may prepare me much more in addressing more complex medical care needs or critical care needs and cardiac care, whereas the nurse that's educated as a registered psychiatric nurse would have very in depth knowledge of the mental health and addiction perspective.

We would lean on each other to bring all of our expertise and knowledge together to provide the best care possible.

From working with the regulator, they have seen benefits in other parts of the country.

It's going to be Nova Scotia's decision, specifically at the provincial nursing network, on where to go next in our province.

Would this potentially free up registered nurses to move elsewhere or to fill some of the gaps? We know there's a nursing shortage.

It's going to be interesting to see if we move forward and what that will look like. I think it will be an important part of our evaluation framework.

I would say that we have a lot to learn and it's going to be new territory for us. So I look forward to being able to have that conversation at the provincial nursing network in the near future.

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