The anomaly of two-tier nurses

You don’t need a microscope to observe the strange anomaly in the training of nurses.

Posted at 5:00 a.m.

In Quebec, two very different paths lead to this profession: the DEC and the baccalaureate. However, they lead to exactly the same license to practice, despite the fact that CEGEP graduates have less of a background than university graduates.

Find the error !

We have been denouncing the situation for more than 20 years. The other provinces have all raised their requirements for a long time, as have the countries of the European Union where the baccalaureate has become the norm.

It is only in Quebec that we keep a two-tier system, with the risks that entails for the public.

States General studied the question from every angle in the spring of 2021. One hundred briefs, 500 comments and a citizen jury further, the conclusion of the commissioners is clear: all nurses should go through university.

This is what the Order of Nurses of Quebec claims in a memorandum filed to this effect with the Office des professions.

Come to think of it, the current situation doesn’t make sense…

Regardless of their diploma, graduates take the same exam to obtain their licence. In order not to disadvantage those who leave CEGEP, the law of the lowest common denominator is applied, which means that the more advanced concepts learned at university are never validated by the Order.

And regardless of their degree, all nurses have the right to practice the same reserved acts. Care institutions must therefore fill the gaps in the training of those who only have a DEC. But since they are at their wit’s end, many have eliminated mentoring for recruits.

As a result, novice nurses sometimes find themselves helpless in critical situations, without sufficient training and without help from their peers, as the coroner’s report on the death of Joyce Echaquan pointed out. Just before going to the resuscitation room, she had been left in the care of a nurse who had only four months’ experience and who received no support from the head nurse, despite her appeal to ugly.

The health of patients is at stake. We must take action. The concerns that have so far blocked the enhancement of nursing education must be overcome. Let’s review them…

First, some fear that by requiring a university degree, we will accentuate the shortage of nurses.

But the shortage is not so much due to a lack of nurses – there are 734 per 100,000 inhabitants in Quebec, compared to 688 in Canada – as to poor organization of their work.

Nurses occupy only half of their field of activity. They do administrative and procedural tasks that could be done by others and they ignore more complex acts that are at the heart of their profession.

Quebec does not have the luxury of depriving itself of the full potential of nurses. Better training must therefore be an integral part of Health Minister Christian Dubé’s plan to get the network back on its feet.

Second, some fear that the requirement of a bachelor’s degree will harm regional training, which is currently being deployed in 48 private CEGEPs and colleges across the province.

But the CEGEPs would continue to be put to contribution, since we would keep a DEC-bac course in parallel with the pure and simple baccalaureate.

And then, with their regional branches, the universities are present in almost all regions of Quebec.

Third, some fear that the cost of a university education of approximately $4,000 per year will put off female students who currently have access to free college education.

Except that we must not forget that Quebec launched in December a bursary program for essential workers, including nurses, which offers $ 15,000 over three years, in addition to the usual loans and bursaries.

Thus, it would be wrong to fear that the baccalaureate requirement would cause the number of graduates to fall. When Alberta and Ontario made this choice, it was rather the opposite that happened with an increase of 45% and 60% respectively.

By upgrading the profession, we could therefore attract more female candidates. And better equip them for the more complex tasks of the future, such as home care, which is not taught at CEGEP.

By moving up a gear, nurses would regain all the leadership they deserve within the health network.


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