Changes to legislation that govern regulated health professionals in Ontario open the door to improvements in patient care but stop short of the kind of change that would further reduce wait times and improve access for the public, according to the top professional nursing organization.
Members of the Registered Nurses' Association of Ontario (RNAO) have spent months advocating for changes to legislation and regulations that oversee the practice of registered nurses and nurse practitioners (NPs).
A series of amendments to Bill 179 passed Monday at Queen's Park. Among the changes, registered nurses will now be allowed to dispense drugs. Previously, nurses could only dispense drugs if delegated or directed by a physician or nurse practitioner.
RNAO is also pleased with language in the amended legislation that paves the way for nurse practitioners to one day openly prescribe drugs. "While this is a welcome beginning, we're not there yet. There is an opportunity to remove restrictions so that NPs can better serve their patients," says RNAO president Wendy Fucile. Unlike most jurisdictions across Canada and around the world, NPs in Ontario are currently forced to prescribe medications from a limited list of drugs. RNAO would like to see the province adopt a model of open prescribing. Fucile says the association will continue to push for this vital change so NPs aren't unnecessarily hampered in their practice and patients receive timely treatment.
RNAO says a key limitation that wasn't addressed is the ability for nurse practitioners to admit, treat and discharge patients in Ontario hospitals. RNAO says that this must be addressed in regulation if the province is to further improve access and reduce wait times. "NPs face discriminatory practice privileges and that is affecting patient care," Fucile adds.
RNAO says it will also continue to push for a recommendation to amend the Public Hospitals Act. "We have written to the Premier and will continue to demand that Medical Advisory Committees (MACs) be replaced with Interprofessional Advisory Committees (IPACs)," says Doris Grinspun, executive director of RNAO, adding that "MACs are barriers to collaborative practice that reinforce inequitable power relations between physicians and other health professionals, including nurses, midwives, physiotherapists, and pharmacists. The government's objective of improved interprofessional collaboration won't happen if you maintain archaic organizational structures that focus power in only one profession. It's time to move into the 21st century and replace MACs with Interprofessional Advisory Committees," she states.
"Patients in Ontario can rely on the fact that RNs and NPs are expert professionals who are highly educated. The changes we are asking for will remove the artificial barriers that prevent them from fully serving Ontarians," adds Grinspun.
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