MacLeod Martha L P, Stewart Norma J, Kosteniuk Julie G, Penz Kelly L, Olynick Janna, Karunanayake Chandima P, Banner Davina, Wilson Erin, Kulig Judith C, Labrecque Mary Ellen, Moffitt Pertice, Jahner Sharleen, Garraway Leana
Professor and Northern Health - UNBC Knowledge Mobilization Research Chair, School of Nursing, University of Northern British Columbia, Prince George, BC.
Professor Emerita, College of Nursing, University of Saskatchewan, Saskatoon, SK.
Nurs Leadersh (Tor Ont). 2019 Mar;32(1):8-19. doi: 10.12927/cjnl.2019.25852.
Over the past two decades in Canada, licensed or registered practical nurses (LPNs) have experienced an extension of their educational preparation and scope of practice. Simultaneously, there has been an increase in the number of LPNs employed in rural and remote communities. These changes have influenced the practice environment and LPNs' perceptions of their work. The aim of this article is to examine what factors predict rural and remote LPNs' perceptions of working below their legislated scope of practice and to explore their perceptions of working below scope. The findings arise from a national survey of rural and remote regulated nurses, in which 77.3% and 17.6% of the LPNs reported their practice as within and as below their legislated scope of practice, respectively. Three factors, age, stage of career and job-resources related to autonomy and control, predicted that LPNs would perceive themselves to be working below their scope of practice. These results suggest that new ways to communicate nurses' scope of practice are needed, along with supports to help rural and remote LPNs more consistently practice to their legislated scope of practice. Without such changes, the LPN role cannot be optimized and disharmony within rural and remote settings may be exacerbated.
在过去二十年里，加拿大的执业或注册执业护士（LPN）经历了教育准备和执业范围的扩展。与此同时，受雇于农村和偏远社区的LPN数量有所增加。这些变化影响了执业环境以及LPN对其工作的看法。本文旨在探讨哪些因素可预测农村和偏远地区LPN对在法定执业范围以下工作的看法，并探究他们对在范围以下工作的看法。这些发现来自一项针对农村和偏远地区注册护士的全国性调查，其中分别有77.3%和17.6%的LPN报告其执业处于法定执业范围内和以下。年龄、职业阶段以及与自主权和控制权相关的工作资源这三个因素预测，LPN会认为自己的工作超出了执业范围。这些结果表明，需要新的方式来传达护士的执业范围，同时需要提供支持，以帮助农村和偏远地区的LPN更始终如一地按照法定执业范围开展工作。如果不做出这些改变，LPN的角色就无法得到优化，农村和偏远地区的不和谐状况可能会加剧。
