COVID-19 resources for nurses

Messages from CARNA to nurses

Oct. 1, 2021 | COVID-19 vaccine exemption requests

CMOH Order 43-1021 allows NPs to complete the COVID-19 vaccine medical exemption letter. In partnership with the College of Physicians and Surgeons of Alberta, CARNA has developed the following a resource for the public on COVID-19 vaccine exemption requests. More information for NPs can be found under resources in their MyCARNA account.

May 13, 2021 | NPs able to sign off on mask exemption

CMOH Ministerial Order 22-2021 states that starting May 13, anyone wishing to verify that they have a medical condition that makes them unable to wear a mask will require a medical exception letter from a health professional. Nurse practitioners will now be able to verify these exemptions. Find out more.

April 27, 2021 | Changes to Alberta's Rapid Testing Program

Effective April 26, 2021, employers and service providers no longer require the oversight of a health care provider in order to use rapid test kits in their COVID-19 screening programs. Find out more from Alberta Health.

April 15, 2021 | Phase 2C Immunization Program

Alberta Health has provided a stakeholder update on the COVID-19 Immunization Program.

April 13, 2021 | Phase 2C COVID Vaccination Bookings Open for Eligible Health Care Workers

As of April 12, 2021, eligible health care workers may book their immunization appointments through Alberta Health or their local pharmacy.

This does not represent all of Group C. Those workers not included at this time will become eligible in the coming weeks.

Please check with Alberta Health for eligibility, booking links and the latest information on the immunization process, including what you will need to bring to your appointment. You can print your proof of registration by signing in to MyCARNA.

March 17, 2021 | Alberta nursing regulator's statement on high volume vaccination clinics

The Alberta Nursing Regulators: The College and Association of Registered Nurses, the College of Licensed Practical Nurses of Alberta and the College of Registered Psychiatric Nurses of Alberta recognize that the COVID-19 pandemic is a public health emergency and mass immunization clinics are being put in place to protect Albertans from COVID-19. As a result, Alberta Health Services (AHS) has put forward protocols for use in AHS COVID-19 High Volume Vaccination Clinics. These protocols apply to specific locations, for a specified time frame and will be reviewed periodically. The Nursing Regulators wish to provide the following information to their registrants.

All nurses are expected and required to abide by their Practice Standards. It is important to acknowledge that the Practice Standards of each regulatory college recognize the need for health care professionals to exercise their evidence-informed professional judgment given the circumstances.

The Colleges recognize that the first duty of health professionals is to their patients, and that in certain circumstances appropriate patient care involves exercising professional judgment as to the best means of protecting patients from risk of serious harm.

In addition, nurses should follow their employer requirements for administering medications within their competence and scope of practice, while at the same time adhering to their professional accountability and responsibility. COVID-19 has impacted how we work together as a greater community in addressing public health interests, directives, and mandates.

April 20, 2020 | Infection prevention and control

What better time to refresh your Infection Prevention and Control skills! Our Infection Prevention and Control – 2020 course is the newest version and includes the Alberta Health Reusable & Single-Use Medical Devices Standards, Infection Prevention and Control Standards, and Guidelines for Medication and Vaccine Injection Safety. Learn more by signing into MyCARNA and earn your certificate of completion today!

April 14, 2020

Dr. Deena Hinshaw announced that all workers in continuing care and designated supportive living facilities must only work at one site.

Any staff or residents who display any symptoms at continuing care facilities are being tested.

Staff in these facilities who need to be within two metres of others during their work are required to wear face masks during their shift.

Enhanced cleaning and disinfection requirements, and mandatory outbreak protocols have now been implemented to protect staff and residents at these facilities.

Answering your questions

Can I refuse to care for someone who may be infected if I feel I may be at risk?

During a pandemic, RNs and NPs provide care using appropriate safety precautions. They have a duty to provide care. A duty to provide care refers to a nurse’s professional obligation to provide clients receiving care with safe, competent, compassionate and ethical care. We know that nurses are experienced in dealing with challenging health issues, including infected patients, on a daily basis. A pandemic situation calls for extraordinary effort from all health-care personnel.

As part of planning preparations, it’s our responsibility to make sure you’re aware that the Canadian Nurses Association (CNA) Code of Ethics for Registered Nurses (2017) and CARNA’s Practice Standards for Regulated Members continue to apply. Pages 38-40 of the Code of Ethics explain what you should do to make sure people’s individual needs are recognized, assessed and responded to without undue delay.

It’s also important that you’re supported to take account of your own safety and wellbeing. Your employer is there to help by managing resources effectively and dealing with risk so that the quality of care or service you provide for people can be maintained.

I’m worried that my registration/license is at risk if I need to act outside my normal job. What should I do?

We recognize that in highly challenging circumstances you may need to depart from established procedures in order to care for patients and people using health-care services.

Our regulatory standards are designed to provide a framework for decision-making in a wide range of situations.

In line with the CNA Code of Ethics for Registered Nurses (2017 ) (pages 38-40), use your professional judgement, working with other colleagues across all disciplines to assess risk, find the best way to provide care for people while recognizing and working within the limits of your competence to ensure essential care is provided to clients.

What does the CNA Code of Ethics for Registered Nurses and the Practice Standards for Regulated Members tell me to do in this type of emergency situation?

Some professional standards and behaviours, as set out in the Code, that may be particularly helpful for RNs and NPs to bear in mind at this time include:

Acting in the best interests of people at all times within the limits of your knowledge and competence
Understanding you have a professional obligation to ensure that any actions they take do not compromise client safety
Supporting decisions with evidence-based rationale
As well as your own safety and fitness to practice, taking account of the safety of others and the availability of other options for providing care
Using appropriate information and resources that enhance client care and the achievement of desired client outcomes
Exercising reasonable judgement and setting justifiable priorities in practice
Integrating infection prevention and control principles, standards and guidelines in providing care and service to protect the health and well-being of clients, staff and the public

You will be expected to do what any reasonable, prudent nurse would do in this same situation and make informed and reasonable decisions based on the context, length and severity of the pandemic situation at this time.

What should I consider if I get re-deployed to an unfamiliar practice setting during the COVID-19 outbreak?

All RNs and NPs may be asked to work in an area that they are less familiar with during a pandemic. Temporary re-deployment is a legitimate employer practice to ensure they can meet the needs of the clients they serve every day. You and your employer have an accountability to ensure clients are receiving safe and competent care. It is also very important to note that a public health emergency, such as a pandemic, is not a usual circumstance. While in the midst of this pandemic; registered nurses, nurse practitioners and employers are accountable to work together to make the best decisions based on the information at hand, fully recognizing that the evolving situation may result in a different decision at a different time.

We expect that RNs and NPs are responsible and accountable for the care they provide and must practice to their level of competence. Although there are elements of nursing knowledge and entry-level competencies that cross all client groups and practice, the RN or NP may not be able to do all interventions or carry a full client assignment in the setting to which they will be re-deployed. The RN or NP need to assess and communicate the interventions that they can do competently. The discussion with the manager could include asking for an orientation to the new practice setting, asking questions to understand the expectations of them in this situation, and asking for an identified experienced staff member to be a buddy to answer questions when needed.

I am a former member of CARNA how can I help with the pandemic?

Former members who wish to assist with the COVID-19 pandemic are asked to contact their previous employer, or AHS at careers@ahs.ca, or Covenant at Careers@covenanthealth.ca to inform them of their availability. Employers will send a list of names to CARNA and we will reach out to those who are identified on the Alberta Health or the health care provider organizations list to begin the process of reinstating licenses for the pandemic response.

If you are contacted by CARNA you will be required to complete an application, and meet all eligibility requirements before being assessed.

In the meantime, please ensure that your contact information is updated in your MyCARNA profile.

Nurses like all individuals, can do their part to stop the spread of the virus. Nurses can direct clients and the public to reliable sources for information and must also take a leadership role in reminding others to prevent the spread of the virus by:

Self-isolating yourself or your family members if feeling sick
Washing your hands frequently
Covering coughs and sneezes
Avoid touching your face

Virtual Care during the COVID-19 pandemic

CARNA supports regulated members in having the capacity to provide quality client care through virtual care during this pandemic. Regulated members and their employer have an accountability to ensure clients are receiving safe and competent care. While in the midst of this pandemic regulated members and employers are accountable to work together to make the best decisions based on the information at hand, fully recognizing that the evolving situation may result in a different decision at a different time.

CARNA supports the use of virtual care platforms that are recommended and supported by the employer. We recognize that in highly challenging circumstances there may be a departure from established procedures in order to care for clients and people using health-care services. It is reasonable that if the employer is supporting temporary use of unregulated communication technologies based on the principle of matching intervention to need then CARNA would also support this use as the practice standards for regulated members state that the RN and NP follow policies relevant to their practice setting.

What are my responsibilities with sharing patient information during the COVID-19 pandemic?

Some regulated members are being asked to share information on COVID-19 testing and results.

Regulated members are responsible and accountable for ensuring they follow all relevant legislation, regulation, and policies, and understand the privacy requirements that apply to their nursing practice.

All information related to an individual who is or was infected with a communicable disease shall be treated as private and confidential, and no information shall be published, released or disclosed in any manner that would be detrimental to the personal interest, reputation or privacy of that individual. Regulated members must collect, use and disclose only health information that is essential for the intended purpose, and with the highest degree of confidentiality possible. Any inappropriate access or disclosure of personal or health information of an individual receiving care may constitute a privacy breach. Regulated members can seek guidance from their custodians of health information to ensure they know the policies and procedures regarding collection, use, disclosure and security of health information. In situations where regulated members are self-employed or employed to provide health services by other organizations such as private industry or clinics, corporations, and educational institutions, it is the regulated members who are the custodians of health information.

Information on regulated member responsibility can be found in the Privacy and Management of Health Information Standards (2020). Regulated members can also direct questions to the Office of Information and Privacy Commissioner at www.oipc.ab.ca

Practice advice

Nursing education programs

Guiding Principles: Effect of COVID-19 pandemic on nursing education programs, faculty members and students

CARNA is aware of and monitoring the impact on nursing education programs, faculty members and students. As the situation rapidly evolves, CARNA is in continuous contact with all RN, NP and re-entry program faculty members to discuss contingency plans for their curriculum.

This unprecedented time requires agility, creativity and innovative options for faculty members and students. Both CARNA and faculty members are committed and confident that together we will arrive at a plan in the best interest and safety for the public, students and faculty.

Considerations for nursing education program contingency plans include:

Student, patient and nursing faculty member safety is paramount. It is important to closely monitor and follow the Alberta's Chief Medical Officer of Health directions.
Students are informed of the post-secondary institution’s pandemic plans.
Alternate and innovative learning strategies may be used to support clinical experiences and student learning to achieve CARNA entry-level competencies.
Nursing education programs are responsible for documenting, tracking and reporting program modifications implemented during the pandemic to NEPAC.
Program modifications to address these extenuating circumstances are short term for the duration of the pandemic only and not precedent-setting. They are not to become permanent changes to the program.
In the event the pandemic continues long term, and students cannot achieve the entry-level competencies required for program completion, post-secondary institutions may need to delay student progression in, or graduation from, the nursing education program.
The expectation is that students have met CARNA entry-level competencies for entry to practice as an RN or NP at the time of program completion. Faculty members evaluate students to ensure they have the knowledge, skills and judgement required to practise safely and ethically.
Post-secondary institutions will continue to submit their confirmation of program completion list to CARNA. This list verifies that each named student has successfully completed all the requirements of the approved nursing education program. This requirement will not change.

COVID-19 vaccination and clinical placements guidance

Currently, approved nursing education programs are receiving requests from unvaccinated nursing students for alternate clinical placements when the health care organizations have made COVID-19 vaccination mandatory.

CARNA is aware of the Alberta Health Services (AHS) Immunization of Workers for COVID-19 policy that requires compliance of all AHS, Alberta Precision Laboratories, Carewest, CapitalCare, and Covenant Health employees, members of the medical and midwifery staffs, students and instructors, volunteers, and applicable contracted service providers to be fully immunized against COVID-19 by Nov 30, 2021.

Alberta approved nursing education programs must provide experiences in clinical, laboratory, and simulation environments for students to achieve course objectives, program outcomes, and CARNA entry-level competencies, and clinical placements are an integral part of nursing education. Refer to the Guiding Principles: Effect of COVID-19 Pandemic on Nursing Education Programs, Faculty Members, and Students.

Requests from unvaccinated nursing students for alternate clinical placements should be addressed by the nursing education program. CARNA does not regulate nursing students; all eligible nursing students are encouraged to get COVID-19 vaccination to participate in clinical placements.