Last week I had the opportunity to be interviewed by Karen Horsman of CBC radio on the topic of the government's decision not to regulate Personal Support Workers. Here's an overview of our discussion;
Karen asked me to speculate on the reasons that the decision was made not to regulate and why I thought it had turned out that way.
We know that regulation is seen as a positive measure to assure public safety and a high standard of practice from our health professionals. Nurses, dentists, doctors, physiotherapists are all regulated health care professionals. Personal Support Workers interact with a vulnerable sector of the public and it would stand to reason that their practice be regulated.
There are a couple of reasons that come to mind as possibly contributing to the decision not to regulate Personal Support Workers.
1. The sheer number. There are apparently 100,000 PSWs who have now graduated from either a College or vocational school program. To wrangle that many individuals and attempt to regulate their practice could prove to be a logistical nightmare.
2. There would be a large price tag attached to the creation of a new regulatory body, the development of a set of standards of practice and education, an enrollment procedure for the current practitioners and the development of leadership and committees to oversee the practice of current and future Personal Support Workers.
3. A lack of recognition for the value of the role. It may be that the decision makers undervalue the work of the Personal Support Worker. Certainly any one of us who has needed the care of a PSW for ourselves or for a loved one, can attest to the value of their work.
One comment made was that the Personal Support Worker does not have a distinct body of knowledge to call their own and therefore should not be recognized and regulated as a profession. However, Personal Support Workers have a valuable role in our health care system. They do graduate from a course of study set out by the Ministry of Education and they write a standardized exam in order to become "certified".
So, what to do?
We need to recognize the skills and contributions of the Personal Support Workers as a necessary part in the care of seniors. We already see the value of regulation for health care professionals and the PSW must be recognized as a valued newcomer to this group. All 100,000 existing title holders do not have to be regulated tomorrow. A 5 or 7 year plan to reach all existing practitioners is a realistic one. But for the very same reasons that we see value in the regulation of other health care practitioners; to set standards of practice; to protect the public; to standardize education; and to provide leadership and discipline even, we must begin the process of recognizing and regulating this group.
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Hi Lisa,
ReplyDeleteI so agree with you!!! It was only a few years that entry to practice for Registered Nurses required a BScN. This at the time looked like an overwhelming task, however it was phased in over a number of years and now is the norm. With this new legislation, and the entrance of Nurse Practitioners on the health care scene....everyone's role is changing.
The knowledge, skill base of Nurse Practitioners has permitted them to provide care for clients that once only physicians could provide. Areas of nursing care that at one time only Registered Nurses were able to provide, are now provided by Registered Practical Nurses. And of course now, the care that once only (regulated) Registered Practical Nurses could provide is carried out by PSW's.
Across the ages, "Nursing Care" was defined as the type of personal care provided to clients by PSW's. The advancement in knowledge, skill and technology over time has contributed to the change in the role of nursing. However, the direct patient care needs of frail/sick and dying patients are the same. This time spent assisting or completing activities of daily living for a client (bathing, feeding...)...has been a critical time for doing patient assessment. As a regulated health professional an RN or RPN is accountable and responsible for assessing client during this time for signs and symptom that might not otherwise be "picked up' at another point of care; (wincing on movement, guarding of a body part, an area of redness, tenderness, discoloration, skin breakdown, the list could go on and on...) Since regulated health professionals no longer are able to complete regular health assessment on such frail clients at this time...it is the unregulated PSW's who now must make these assessments and observations and report them to the regulated health professional for follow up.
If not regulated...just how accountable are PSW's for the care that they provide; care that at one time was considered "nursing care". I the governments lack of initiative in regulating this body of health care workers merely a way to, trim health care costs, at the expense of the frail elderly?; a marginalized and vulnerable segment of our society.