Policy and Political Action

Policy & Political Action

Representation of NPs in Ontario

Dear RNAO Members,

We are writing about an urgent development that has the potential to detrimentally affect all nurse practitioners in Ontario and their clients. On September 6, 2011, leadership of the RNAO and the Nurse Practitioners Association of Ontario (NPAO), an expert interest group of RNAO, met with representatives of a new group calling itself the Academy of Nurse Practitioners Association (ANPA). We convened this meeting to better understand the objectives of ANPA and the reasons for its formation.

During the meeting, it became clear that there is substantial overlap related to NP
representation, between ANPA’s objects and the long-standing goals of RNAO and its expert interest group NPAO, namely to promote the NP role to health care organizations, government and the public, support professional development of NPs, and unite members of the NP profession. RNAO and NPAO adds the goals of leading legislative, regulatory and policy change enabling NPs to transform health care delivery, and strengthening the role of NPs as leaders within the health care system. In addition, together RNAO and NPAO include the goal to address social, political, environmental and economic issues related to health, health care and the delivery of NP services in Ontario.

Supporters of the ANPA acknowledge the remarkable achievements of RNAO and NPAO in advocating on behalf of nurse practitioners, but they claim that neither the NPAO nor RNAO has the legal mandate to negotiate or represent the economic interests of NPs. It is primarily for this narrow purpose – negotiating economic interests for NPs, particularly for those who work as independent contractors – that the ANPA claims as its reason for formation.

Legal council has confirmed that ANPA is wrong when they suggest that the RNAO, and the NPAO as an expert interest group of the RNAO, do not have the legal ability to address and champion the economic interests of NPs or negotiate on their behalf. As a legal opinion from our lawyers confirms, the ANPA does not have an exclusive right to negotiate economic interests on behalf of NPs, nor is it true that the RNAO does not have that right. RNAO’s legal mandate, from its Supplementary Letters Patent, gives the RNAO a broad mandate to represent RNs, including NPs, in the province of Ontario including “to represent and assist employed registered nurses in their relations with employers.”

In other words, there is nothing in the proposed objects of the ANPA that is not already within the legal mandate of the RNAO and NPAO. Nor is there anything in the ANPA’s goals that is not already being performed admirably by the existing associations.

Nurses, like all Ontarians, have the right to choose individuals or an organization to act as their bargaining agent or representative for any purpose they choose. We do not question the right of the ANPA to exist. RNAO’s is gravely concerned however, that NPs already have an association that is both capable of representing and advocating for NP economic interests, and to lead what has become an extraordinarily dynamic and successful expert interest group. Thus, it is not clear what is to be gained with an additional professional association for nurse practitioners in Ontario, to the contrary, there is much at risk. Our success owes a great deal to our unity and strength. We are over 32,000 RNs together with over 1,700 NPs speaking with one voice. How else could we have transformed NP roles, expanded their scope of practice, gained the ability to admit and discharge hospital in-patients, pioneered nurse practitioner-led clinics, and permanently inserted Chief Nurse Executives as hospital board members and quality drivers and Chief Nurse Officers in all Public Health Units , to name just a few RNAO/NPAO successes! Whether it is social, political, environmental or economic issues, the RNAO and its expert interest group NPAO, have been at the forefront of change that is having a positive impact on our clients and communities every day. And there should be no doubt that the above achievements have had a profoundly positive influence on the future and strength of NPs, including economically, witnessed by the exponential growth in the numbers of NPs graduating from our faculties and finding good positions in our communities. Simply, the RNAO and NPAO have been and will continue to be the strongest voices for nurse practitioners, economically and otherwise.

This can only happen, though, if we remain united and speak with one voice. Multiple and fragmented voices threaten to undermine all that we have achieved together. That is why RNAO’s Board of Directors passed on September 24 a unanimous motion that the only group RNAO will work with when dealing with any NP issues, is NPAO.

The RNAO cannot support the ANPA or the establishment of any new NP association at this crucial time, as it will only serve to split our strength and weaken our voice.

Nurses must stand united, we owe it to the communities and clients we serve.

With warmest regards,

Doris Grinspun, RN, MSN, PhD, LLD(hon), O.ONT.
Executive Director, RNAO

David McNeil, RN, BScN, MHA, CHE
RNAO President

Cc: Debra Bournes, RN, PhD - Provincial Chief Nursing Officer

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