The anomaly of the two-tiered nurses

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

Posted at 5:00 am

In Quebec, two very different routes lead to this profession: the DEC and the Baccalaureate. However, they lead to exactly the same professional license, although CEGEP graduates have a lower background than university graduates.

Find the mistake!

We have denounced the situation for more than 20 years. The other federal states have all raised their requirements long ago, as have the countries of the European Union where the Abitur has become the norm.

Only in Quebec do we have a two tier system with the associated risks to the public.

The States General examined the question from all angles in the spring of 2021. One hundred pleadings, 500 comments and a citizen jury further, the conclusion of the commissioners is clear: All nurses should go through the university.

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

When I think about it, the current situation makes no sense…

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

And regardless of their degree, all nurses have the right to practice the same reserved activities. Nursing institutions therefore need to fill the gaps in the education of those who only have a DEC. But stumped, many have eliminated recruit mentoring.

As a result, as the coroner’s report on Joyce Echaquan’s death shows, inexperienced nurses are sometimes helpless in critical situations, without adequate training and without the help of their peers. Just before she went to the resuscitation room, she was in the care of a nurse who had only four months’ experience and, despite her appeal to ugly, received no support from the head nurse.

The health of patients is at stake, we must act. The concerns that have so far blocked the improvement of nursing education must be overcome. Let’s check them out…

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

But the shortage is less due to a shortage of caregivers — Quebec has 734 per 100,000 residents, compared to Canada’s 688 — and more to a poor organization of their work.

Nurses take up only half of their field of activity. They perform administrative and procedural tasks that could be performed by others and 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 requiring a bachelor’s degree will interfere with regional training, which is currently deployed at 48 private CEGEPs and colleges across the province.

But the CEGEPs would continue to be used, since we would run a DEC final course alongside the simple Abitur.

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

Third, some fear that the cost of college education, around $4,000 a year, will deter female students who currently have access to free college education.

That being said, let’s not forget that in December Quebec launched a grant program for essential workers, including nurses, that offers $15,000 over three years in addition to the usual loans and grants.

It would therefore be wrong to fear that the number of graduates would fall as a result of the compulsory Matura. When Alberta and Ontario made this choice, the opposite was true, with increases 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 stepping up a gear, nurses within the healthcare network would regain the leadership they deserve.

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