Alberta Physicians Supporting Alberta Nurse Practitioners
Background Information
Dear Alberta Physicians,
Alberta Nurse practitioners (NPs) are currently negotiating their first agreement with Alberta Health Services (AHS) and Covenant Health (CH), after nearly a decade of frozen wages. It is critical that NPs demonstrate the full value of their role within the healthcare system.
As a physician collaborating in a team with nurse practitioners, your support can highlight the role, responsibility and value NPs have within their respective practice settings. NPs are seeking an agreement that recognizes their professional abilities and aligns with their responsibilities and liability in provision of healthcare.
NPs have been a recognized profession for 50 years and are an integral part of our health care system providing services as autonomous advanced clinicians across multiple practice settings. Historically, NPs were initially considered part of the registered nurse (RN) group, as RNs with an extended class license, but have evolved to separate regulated practice under the Health Professions Act. Since 2003, when the Health Professions Act was moved into law, NPs have not been able to advocate for their own salaries or working conditions and have been financially disadvantaged over the almost 20 years since. The limited ability of NPs to negotiate for reasonable compensation is the culmination of multiple factors which have included the impact of Bill 27, exempting NPs from collective bargaining, a pay band based in senior RN classification pay rates, and organization and provincial wage freezes. This has led to reduced enrollment in NP programs, difficulty recruiting NPs into Alberta leaving significant NP vacancies, and NPs migrating to other provinces which have better remuneration.
In 2022, without any other feasible means to affect an agreement, NPs within AHS and CH formed a union, the Alberta Union of Nurse Practitioners, to advocate on their behalf and establish a contemporary agreement.
While NP roles continue to evolve to full scope of practice including high level healthcare services, compensation for the role and responsibilities has not been progressive. The Government of Canada, National Occupation Classification (NOC) 2011 include NPs within a Code 31 NOC Classification group with physicians, dentists, veterinarians, and optometrists as well as other primary care professionals - as separate and distinct from Code 30 NOC Nursing Classification group. The Ernst and Young report and the Blue Ribbon Panel Report 2019 recognize similar alignment of duties with physicians and acknowledge pay gaps experienced by NPs. In 2023 the Workers Compensation Board will renumerate NP services at 100% of physician rates.
Your support as physicians and leaders in Alberta healthcare is valuable as we progress through establishing an agreement with AHS/CH employers. Your unique perspectives on the benefits and value NPs add to the complex care delivered in clinical teams to Albertans could provide significant support towards a progressive agreement.
Below is a template letter of support that can be amended. It would be valuable for you to add your personal perspectives/experiences supporting the role and value of NP contributions to Albertan healthcare.
Please forward all signed letters to [email protected]. Our organization will gather responses and present them during negotiations and/or to an officially appointed mediator, should that be required. On behalf of your NP colleagues, thank you for your support.
Anne Summach
President, Alberta Union of Nurse Practitioners
Dear Ms. Summach,
I am writing you specifically in support of Alberta Health Services and Covenant Health nurse practitioners. It is my understanding that nurse practitioners are currently in the process of a negotiating an agreement after a decade of wage freezes, excepting a one-time small incremental advancement in 2022.
It is my intention to express support for nurse practitioners’ pursuit of an agreement that recognizes their professional abilities, scope of practice and aligns with their responsibilities and liability in provision of healthcare to Albertans.
Specifically, it is important to recognize and address the following:
- NPs are integral and indispensable care providers who have roles with significant clinical responsibility including:
- Complex tier-one level care provision which includes 24 hour/overnight coverage, often requiring independent, rapid, and critical treatment decisions.
- Provision of care as the most responsible health care provider in some settings.
- Autonomous practice with high levels of medicolegal liability.
- Engagement in education of medical/nurse practitioner learners.
- Performance of high-level care including physical assessments, order lab and diagnostic tests, diagnose, prescribe medications and treatments and performance of procedures within their authorized scope of practice.
- NPs contribute significantly to organizational programs through quality improvement, leadership, research, and educational contributions.
- Historic and current compensation bands do not reasonably reflect the level of responsibility, patient complexity/acuity and clinical roles undertaken by NPs.
- NPs to date, have not had any formal representation or means to negotiate wages, benefits or working conditions on their behalf, as other healthcare professionals have, due to multiple factors including Bill 27 and both organizational and provincial wage freezes. NP compensation has lagged significantly, relative to nursing, allied health and medical counterparts. Ernst & Young Report and the Blue Ribbon Panel Report reflects this as well.
- Many NPs currently provide clinical support or forms of clinical coverage for their physician colleagues, however again, current compensation does not recognise the expertise or education required to provide this service.
- NPs utilization can support healthcare gaps among many cohorts of Albertans.
As an Alberta physician, I am affirming the value NPs bring to the overall health of Albertans. It is imperative to have an agreement with terms and conditions of employment and compensation commensurate with the value of the services provided by nurse practitioners.