This text is part of the special section Higher Education
We had a slogan in the 1990s: “The bac for all in the year 2000.” We are in 2022…” This reminder, Luc Mathieu, president of the Order of Nurses of Quebec (OIIQ) since 2018, evokes it to underline both how time flies… and that certain things move slowly. Because the wish of the OIIQ, of the leaders of the profession and among the nursing community has been the same for a long time: to ensure that the baccalaureate is the key to obtaining a license to practice the nursing profession.
Because unlike “the 46 professional orders in Quebec, the OIIQ is the only one with different paths to give access to the same permit”, affirms the one who is also professor of nursing sciences of the Faculty of medicine and health sciences of the University of Sherbrooke. At college, a student has the choice between the DEC in nursing, the pre-university DEC and the three-year bachelor’s degree in nursing, or the DEC-BAC for a graduate in nursing who can complete his bachelor’s degree in two years. “A very popular degree,” he says.
There is, in these multiple paths, a certain form of inequity, according to Luc Mathieu. “The OIIQ exam is designed on the basis of knowledge acquired in college, and not on that of university training,” says its president. Have two permits to settle the solution? Our colleagues in the health network do not want it, because it would further complicate the organization of work. And it is complex enough, according to a study by Roxane Borgès da Silva, professor at the School of Public Health at the University of Montreal, who had surveyed 33 players in the health system in the Montreal region in 2019. Among her Findings: the different categories of nurses mean that many are not employed for what they are supposed to be doing, which creates frustration and waste of expertise.
An analysis shared by Kathleen Lechasseur, professor of nursing at Laval University. According to her, the quality of college education is not called into question in this whole debate, quite the contrary, but “several aspects of practice are not covered [à ce niveau] and should be given priority. Whether it’s critical care, community health, or palliative care, all of this requires a university education. “At university, we talk about nursing sciences,” emphasizes Kathleen Lechasseur. We prepare future graduates technically, as we have excellent laboratories, but also in how to use research and demonstrate scientific rigor. All of this contributes to ensuring, and increasing, the quality of care. »
Enter through one door
In several places in Canada and around the world where the baccalaureate has become the exclusive gateway to the profession, the quantitative and qualitative effects have been felt, testify Luc Mathieu and Kathleen Lechasseur. “It is said that raising the requirements will lead to a labor shortage, but it is quite the opposite that we have seen in Ontario, British Columbia or in French-speaking Switzerland”, underlines the first. “Thus, 67 international studies present striking findings, for example a 4 to 14% reduction in the risk of mortality thanks to a 10% increase in nurses with a baccalaureate, not to mention a significant reduction in nosocomial infections in healthcare settings” , adds the one who is also president of the Canadian Association of Schools of Nursing in the Quebec City region.
Currently, 50% of the 80,000 nurses in Quebec have a bachelor’s degree. “We have never had so many nurses, admits Luc Mathieu, but the challenge is how we use them. The real shortage is that of healthcare professionals able to accommodate a greater number of patients. More baccalaureate nurses can improve efficiency. »
It is said that to raise the requirements [de la formation] will lead to a labor shortage, but it is quite the opposite that we have seen in Ontario, British Columbia or French-speaking Switzerland
“Imagine if these 80,000 nurses all had a bachelor’s degree and occupied 100% of their field of practice: we would no longer be talking about a shortage,” says Kathleen Lechasseur. And in the difficult context of the current pandemic, some of them, trained in infection prevention and control, could play a leading role. “We don’t hear them much, regrets the professor from Laval University. They are not very numerous, overwhelmed, but crucial in the current context. Their job requires a 2 degreeand cycle. So, if you want to train more in this sector, you need a baccalaureate. »