Posted at 1:00 p.m.
In an editorial published on May 12, the editorialist Stéphanie Grammond directly takes up the essentials of the arguments deployed for several years by the Order of Nurses of Quebec (OIIQ) in its case against the DEC qualifying in Nursing , an argument repeated recently as part of the Estates General commissioned and orchestrated by the OIIQ. What seems particularly regrettable to us is that Ms.me Grammond does this while being careful not to encumber itself with nuances and even less with divergent opinions, which one should however take great care to put in the balance before taking a position within the framework of an enlightened debate.
The Fédération des cégeps and several of its partners have already responded to many of the arguments of the OIIQ to make the baccalaureate compulsory in order to practice the nursing profession, in particular in letters published in this same newspaper in May1 and in september2 2021. But, as repetition has its virtues, let’s resume the exercise here.
Mme Grammond is concerned from the outset that in Quebec, two different paths lead to the nursing profession, the DEC and the baccalaureate, on the pretext that graduates from CEGEP have less experience than those from university. In the process, she affirms that regardless of their diploma, all nurses have the right to practice the same reserved acts.
However, the reality is quite different. Of the 17 activities reserved for the nursing profession, 14 are common to nurses with a DEC or a baccalaureate, while the other three concern only clinical nurses who hold a baccalaureate in nursing science or a master’s degree. . Don’t compare apples to oranges.
where M.me Grammond and the OIIQ believe they are observing an anomaly; on the contrary, we see a good complementarity.
Similarly, the comparison between the specific training system in Quebec (composed of two higher education networks, CEGEPs and universities) with other systems is not very relevant. The CEGEP has no equivalent elsewhere. In the other provinces, for example, college does not offer a general education. Also, in Ontario, colleges are permitted to offer applied bachelor’s degrees without partnering with universities. This may be an avenue to explore for Quebec!
Elsewhere in his text, Mme Grammond makes a curious connection between the poor organization of work and the other shortcomings of our health network and the presence of nurses with a DEC.
This is all the more curious since the very recent report of the National Task Force on the Nursing Workforce published by the Ministry of Health and Human Services3 devotes a whole section to the organization of work in the health network and nowhere mentions the mandatory baccalaureate as part of the solutions to solve the problem. On the contrary, it is written in full that “too often, we do not take, or little, into account the skills, expertise and knowledge of the members of the team in place to decide on the distribution of patients [et] experts argue that 50% of procedural acts could be performed by auxiliary nursing staff and that office tasks could be carried out by administrative agents”.
In other words, the key lies in complementarity rather than wall-to-wall uniformity. Contrary to what M.me Grammond, CEGEP-graduated nurses are not part of the problem, but more than ever part of the solution.
Furthermore, the time could not be worse for proposing to make obtaining a university degree compulsory for the next generations of nurses, at a time when Quebec is experiencing major shortages of nursing personnel and is struggling to get out of a health crisis of unprecedented magnitude. The Fédération des cégeps recalls in this regard that no serious study, either before or during the pandemic, has confirmed the need to initiate such a shift or to support the claim of the OIIQ taken up by Ms.me Grammond, that increasing the duration of studies would make the profession more attractive.
One fact remains: the training offered in the DEC program in nursing, which is currently being updated, contributes to training effective and competent professionals, capable of intervening in different health settings and demonstrating clinical judgment.