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Open Letter to the Community

4/26/2013 12:00:00 AM

To our patients, communities, and partners,


We recognize that over the past week you may have read and heard some concerning statements about the care provided by Registered Practical Nurses (RPNs) in the pre-admission clinic at Orillia Soldiers' Memorial Hospital (OSMH).  We hold ourselves accountable for the care we provide and would therefore like to address these comments.


The Ontario Nurses Association (ONA) has called into question the use of RPNs in place of Registered Nurses (RNs) in the pre-admission clinic. We respect the mandate of the ONA to support their members, however their vested interest in this case is a labour issue.  Our priority is to ensure that our communities have access to the best possible care by the most appropriate provider.


We believe in this safe and proven model of care because: 

  • RPNs are regulated healthcare professionals who are part of an integrated inter-professional team of care at OSMH.
  • In the pre-surgery clinic RPNs work within their full scope of practice with access to resources that include a Registered Nurse (RN), the unit manager, an anaesthetist and other support staff.
  • The pre-admission RPN role is only one step in a complex pre-operative assessment that also includes the surgeon, family doctor and anaesthetist.
  • This nursing model has been successfully operating at OSMH since August 2010 and is also used in other hospitals across the province. We have consistently applied the College of Nurses of Ontario (CNO) three-factor framework to support our decisions around nursing model changes.
  • There is no data -- admission rates after surgery, surgical cancellations, etc. -- that points to or supports the idea that errors occur because an RPN is performing the pre-admission assessment. 

Dr. Nick Bauman, Surgeon and Program Medical Director for the Surgery, CCC/Rehab & Cancer Care program says, "Our RPNs and RNs work very hard and in many capacities within the organization. Their number one priority is always the provision of high quality care for our patients. As a surgeon I value their contribution in the preoperative and surgical setting."


That sentiment is echoed by Pat Campbell, President and CEO, Ontario Hospital Association, who says, "The health professionals who work in Ontario’s hospitals strive to provide excellent patient care.  An important part of this is ensuring that all health professionals have the opportunity to provide the kind of patient care they are educated, trained and qualified to. The Ontario Hospital Association fully supports hospitals in their efforts to meet patient care and organizational needs by deploying their staff in the most effective ways possible."


As a hospital our commitment is first and foremost to safe, high quality patient care.  Quality and safety is one of the strategic pillars of our organization and is considered in every decision that we make.  We do not compromise patient care for our budget.


In regards to the Independent Assessment Committee (IAC) which was convened by ONA, we would like to state clearly that their report did not recommend reverting to an all-RN staffing model in this department, despite ONA’s requests.


We are thankful for the strength and the support shown by our patients, our community and our partners. We will continue to work tirelessly to earn and deepen the trust you place in us as a provider of hospital services.


We look forward to continuing to serve you and the needs of our communities.




Elisabeth Riley

President and Chief Executive Officer

Orillia Soldiers' Memorial Hospital

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