In N.L., the nurse education landscape is unique, and that needs to change, reports find

With two of three nursing schools operated by health authorities instead of a post-secondary institution,the nursing education landscape in Newfoundland and Labrador is unique to anywhere else in Canada.

But two recent high-profile reports are recommending that the faculty and staff of all three of the schools that train registered nursesbe consolidated into Memorial University.

"I actually think that this is very doable and I think it should happen soon," Alice Gaudine, dean of Memorial's faculty of nursing,said recently.

The body that regulates the nursing profession also supports consolidation.

"We've been on record for 16 years saying that this is the right thing," said Lynn Power, executive director of the College of Registered Nurses of Newfoundland and Labrador.

'Reduce operational costs'

Last month's report from the premier's economic recovery team,authored by former Royal Mail chief executive Moya Greene, recommendsthe schools be combined to reduce operational costs, increase efficiency and standardize quality.

Just weeks prior to that, a review of thepost-secondary education systemcalledfor a consolidation of the nursing program under the governance and administration of Memorial University.

"The delivery of nursing education outside of a post-secondary institution is unique in Canada," the post-secondary report stated.

It's just the latest report to make such a recommendation, with the first coming in 2005. But despite some movement about a decade ago, the transition stalled because of the costs involved.

High retention rate

Now the issue has resurfaced, and that has Gaudine hopeful that consolidation will move forward.

"It's the sensible thing. It's the way forward," she said. "It'sa small province andit makes sense to have one faculty of nursing with two sites."

"It is the opportunity to be one team; leverage expertise," said Power, adding that a single faculty would provide improved opportunities for research and innovation andallow for greater flexibility in deploying educators.

However, despite the unusual structure, theprovince graduates about 250 registered nurses every year, with nearly 80 per cent finding work in Newfoundland and Labrador. The success of the program may be one of the factors that has stymied previous calls for change.

"We know how to make things work, and the success of our programs is second to none," said Power.

In an earlier era, all nurse training was hospital-based. But as the standards for health care improved, the educational requirements for nurses also advanced.

Less than 30 years ago, there were five nursing schools in the province: four hospital-based diploma programsand Memorial's baccalaureate program, which was established in the 1960s.

In 1996, it was decided that registered nurses must have a university degree.

That resulted in a consortium agreement between Memorial and health authorities based in St. John's and Corner Brook.

A complex labour environment

It led to the creation of a three-school landscape, whereby the students at all three schools are Memorial University students, follow largely the same curriculumand work toward a Memorial nursing degree.The first graduates received their degrees in 2000.

But the faculty and staff have three different employers, and there are a handful of collective agreements and compensation plans, including pensions.

For example, nursing faculty at Memorial are members of the university'sfaculty association, known as MUNFA, while faculty at the other two schools are members of the registered nurses' union.

A consolidation like the one proposed in the reports would likely require those in the nurses' union to join MUNFA.

Aspokesperson for the nurses' union said "we're still trying to get more insight into this proposal and what it would all mean."

With public consultations now underway into the recommendations of the Greene report, the Health and Education departments are reluctant to weigh in, with an official in the Education Department saying it would be "premature and would distract from the important discussions that need to take place."

A unique three-school landscape

The Centre for Nursing Studies in St. John's the province's largest nursing school with some 1,000 students across all programs is operated by Eastern Health, a regional health authority whose primary mandate is the delivery of health care services.

The school is attached to the Miller Centre, a centre for continuing care in St. John's.

The Western Regional School of Nursing in Corner Brook in operation for half a century is operated by Western Health, with an enrolment of 250 nursing students.

The school is located inside Western Memorial Regional Hospital in Corner Brookbut its future is uncertain with the hospital set to close and a new one to openin a few years.

A spokesperson for Western Health said the health authority is exploring options, such asleasingspace for the nursing school.

Memorial's own faculty of nursing is located in the Health Sciences Complex, and is projectedto have440 students enrolled this fall.

Seeking efficiencies

With the province in the midst of a fiscal crisis, the search is on to find efficiencies and streamline public services.

And since more than 50 per cent of public spending goes to health and education, it's not surprising that a sharp lens is focused directly in those areas.

Gaudine envisions a scenario with a single nursing faculty and staff, delivering the baccalaureate program from sites located on Memorial campuses in St. John's and Corner Brook.

Right now, infrastructure required for such a vision does not exist, and the prospect of securing funding for new buildings must be considered a long shot.But Gaudine doesn't see that as a showstopper.

"I think we really should be prioritized among university students to have the space that helps us work with the next generation of registered nurses."

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