the operations roomAsk aPracticeConsultantThe following arefrequently asked questions toCLPNA’s Practice Consultants byour members, managers,educators, or the general publicthat could provide valuableinformation for you in yourpractice environment.Q.What do newly graduated LPNs know aboutimmunization?There have been recent changes to the practical nurse curriculumin Alberta to accommodate a new standard for the national exam.The Canadian <strong>Practical</strong> Nurse Registration Examination (CPNRE)now tests some core components related to immunizations.Newly graduated LPNs who wrote the CPNRE in January 2012or later are prepared with knowledge in the following areasrelated to immunization principles and implications for the client:• the mechanics around safely giving an immunization (e.g.,aspiration, etc…), and• common contraindications (e.g., not giving the rubellainoculation to a person who may be pregnant) or commonside effects.Additionally, basic LPN education teaches communicable diseaseand communicable disease control.The following areas related to immunization are NOT included inthe basic practical nurse program:• Population and community health strategies aroundimmunization programs• Storage or transportation <strong>of</strong> immunological agents• Immunization schedules and best practices for newbornsand infants• Rare or uncommon immunizations that are specific tospecialty areas such as travel clinicsQ.Can newly graduated LPNs administer vaccineswithout additional education?No, any LPN wishing to provide immunizations in Alberta mustcomplete the Immunization Certificate Course. This may change inthe future with Regulation changes. The Immunization CertificateCourse is available online via Bow Valley <strong>College</strong>. See the linkat www.clpna.com under Members/Continuing Education/Post-Basic Modules. Education grant funding is available through theFredrickson-McGregor Education Foundation for LPNs for thisprogram at http://foundation.clpna.com, foundation@clpna.comor 780-484-8886.Contact our Practice Consultants atpractice@clpna.com or 780.484.888636 care | VOLUME 26 ISSUE 2
the operations roomMATTERSCONDUCTAGREEMENT AND UNDERTAKINGMargaret Lee*, LPN, works full time at a long term care facility. Over a course <strong>of</strong>time, management started receiving complaints from staff regarding Margaret’swork ethic. <strong>On</strong> a regular basis, Margaret was coming in late, leaving early ornot showing up for her scheduled shifts. In addition, it was reported that Margarethad left a shift without notifying the care manager, giving a shift report, and notconducting a narcotic count.This was a big concern for management; they considered leaving her shift ‘abandonment<strong>of</strong> care’, which could potentially place clients at risk. Management probed into thematter more thoroughly and discovered she was not reliable nor was she consistentlyfollowing proper medication administration procedures. Management met withMargaret regarding their concerns. A learning plan was developed with Margaret andexpectations were clearly stated. Eventually Margaret’s time management improved,however she continued to make medication errors. It was reported by a co-workerthat Margaret had administered a dose <strong>of</strong> Morphine to a client who had an order forDemerol. Even though Margaret was aware <strong>of</strong> her mistake she did not follow unitpolicy. She failed to report the medication error to the care manager, notify the client’sphysician, properly monitor the client for adverse affects, and fill out an incidentreport. Although the patient was unharmed, the care manager decided that Margaretwas not meeting employment expectations. Margaret was given a two-day unpaidsuspension for unpr<strong>of</strong>essional conduct.As mandated under the Health Pr<strong>of</strong>essions Act, the care manager is obligated to reportMargaret’s suspension to CLPNA. This employer notification <strong>of</strong> suspension wastreated as a complaint and investigated accordingly. During CLPNA’s investigation,Margaret was cooperative and demonstrated remorse for her actions. She agreed herconduct was unpr<strong>of</strong>essional and expressed a willingness to improve her practice.Margaret met with the Complaints Director and agreed to complete a MedicationAdministration Course, write a reflective paper on Pr<strong>of</strong>essional Responsibility andAccountability, and read and reflect on the CLPNA Standard <strong>of</strong> Practice and Code<strong>of</strong> Ethics, and the CLPNA Practice Statement: Abandonment <strong>of</strong> Care. The employerwas satisfied with the end result. Margaret completed the requirements set forth byCLPNA and feels capable and competent in her practice.*This feature is intended toenlighten LPNs in conductrelatedconcerns throughfictionalized case studies.Any information associatedto real people or actualevents has been changed,however the context <strong>of</strong> thecase study representsreal life situations.The above fictionalized story highlights another route for processing complaints <strong>of</strong>unpr<strong>of</strong>essional conduct, an “Agreement and Undertaking”. The Complaint Director may,with consent <strong>of</strong> the complainant (employer) and the investigated person, attempt toresolve the complaint without going to formal disciplinary hearing. After reviewing allthe pertinent facts, the Complaints Director determined the best method to resolve thiscomplaint by using a method referred to as “Agreement and Undertaking”. This form <strong>of</strong>resolution is appropriate because the member showed insight into her conduct, agreed thebehavior was unpr<strong>of</strong>essional, was disciplined by her employer, and the client experiencedno adverse effects.CLPNA prefers, when possible, to work with the LPN to identify the issues and to worktowards a solution. An “Agreement and Undertaking” generally takes a few weeks toprocess, quickly giving the member the necessary information or education to ensure theirfuture practice is improved. The CLPNA believes that this approach creates a positivechange in LPN’s behavior.In future fictionalized stories, we’ll share other common examples <strong>of</strong> the wide range <strong>of</strong>behaviours and situations which may be reported to CLPNA’s Conduct Department.care | SUMMER 2012 37