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"There's going to be an ebb and flow (in hiring) as programs come and go," he told reporters Wednesday. This wave of cuts to nursing positions is worrisome and "out of the norm" according to Doris Grinspun, CEO of the Registered Nurses' Association of Ontario. Grinspun says registered nurses have been among the hardest hit in the bout of cuts so far, but the cuts won't just affect nurses: she warns they could affect direct patient care. "The patients will suffer the consequences because some of these organizations - the terrible thing is not only are they replacing RNs, but they're moving into models of care delivery that we left in the '70s," Grinspun said, describing dwindling one-on-one time with more qualified nurses. The problem isn't only government funding, Grinspun insists."The RN hours of care is directly linked to health outcomes of patients and that if you want to have better outcome don't get rid of RNs," she said.

"People who come to Health Sciences North come from a lot of different areas. I can't jump on the subway and go down to the hospital to make my appointments. Some people come from Blind River, some come from Timmins, we're a referral hospital that's not funded properly and we can't provide the care we expect to be able to provide. We're very proud of what we do and people are struggling. People are going home sick. They're happy to get through a day, not happy to go to work and provide the care they want to provide. We don't think that's proper." According to CUPE, the hospital has cut beds, services and staff because of a five-year funding freeze imposed by the provincial Liberal government.

The union cited an Auditor General's report which estimated hospitals' costs increase by 5.8% annually, rising faster than inflation, because of the soaring costs of drugs provided free to inpatients and medical technologies, among other factors. Thibeault was at Queen's Park in Toronto on Thursday, but forwarded a statement through his communications staff. "I understand that Health Sciences North has made the decision to make changes in its nephrology department, shifting to a model of RNs working alongside renal aides, rather than RPNs," Thibeault said. "I have been assured by officials at Health Sciences North that this decision was made based on surveys of other nephrology departments in Ontario working successfully under similar models, and will not change the terms or quality of patient care.

"I understand that RPNs who choose to stay in nephrology will be re-assigned as renal aides, while those interested in pursuing RPN opportunities in other departments will be offered any additional training necessary. "I have been assured by officials at HSN that no layoffs are anticipated, and that vacancies for RPN positions in other departments are expected. I recognize, as does our government, that nurses are the backbone of our health-care system, and I will continue to advocate for health-care practitioners and patients in Sudbury."

The move to use renal aides alongside registered nurses, rather than the previous model of RPNs alongside RNs, was made to find efficiencies without affecting patient care, HSN spokesperson Dan Lessard said in a statement. "Nothing changes from a patient's standpoint, in terms of the care provided or quality of care," Lessard said. "The RNs assigned to the patient still oversee the process and their care."

The duties of the renal aide will include preparing, starting, and monitoring the dialysis machines, Lessard said. They'll also help transfer patients around the unit and help them with such things as going to the bathroom. "RPNs were doing these duties before, but these duties don't encompass the full scope of practice for RPNs. "For the RPNs affected by this, we're offered them an opportunity to let us know if they would be interested in receiving additional training in order to qualify for other RPN positions within HSN, where they would be working more fully within an RPN's scope of practice." Lessard confirmed that no layoffs are expected.

"In terms of their salaries, they don't get a pay cut," Lessard said. "They will have their salaries red-circled. That means their salaries will remain the same until the pay scale for renal aides catches up to their present salaries, and at that point they will follow the normal progression up the salary grid, but as renal aides, not RPNs." ben.leeson@sunmedia.ca Twitter: @ben_leeson

Registered practical nurses from Health Sciences North and their supporters hold a rally outside Sudbury MPP Glenn Thibeault's office in Sudbury on Thursday.

Blais said the staff mix in the continuing care program would be redesigned to include more regulated clinical staff caring for patients to deal with the "increased complexity of conditions in the patient population."

These two provinces were the only ones in the country where the number of LPNs over the five-year period actually went down. In contrast, LPN growth was a remarkable 52.2 per cent and 30 per cent in British Columbia and Alberta, while Saskatchewan and Ontario also recorded LPN growth rates above the national average of 20.7 per cent.

The number of RNs in Canada stood at 268,512 in 2010. This was a 5.8 per cent increase from 2006 (less than two per cent a year on average) and with a distinct east-west split.

the number of nurse practitioners has more than doubled to 2,486, with strong growth in most provinces (Newfoundland and Labrador and Manitoba being the exceptions and the numbers too small in PEI to report). Sixty per cent of NPs work in Ontario.

The RNAO has sent a letter to Premier Kathleen Wynne and urged its members to write to the premier to press for action.

Nice, an authoritative body whose recommendations are supposed to be implemented across the NHS, has spent months examining evidence on the impact staff numbers have on both the quality and the safety of the care patients receive.

Leng will also tell hospitals that nurses need to be constantly on the alert for "red flag events", such as patients not receiving help to go to the bathroom or not receiving pain medication, which can trigger an immediate need for more nurses on the wards.

"A 1:8 ratio still means that the nurse only has seven and a half minutes per patient per hour, which is too little. If it's more than eight then patients won't get fed, care plans won't get written, and nurses can't sit and talk to patients and reassure them about their condition. Care just won't be given to a proper standard, and patients can die," said Osborne, a former director of nursing at St Mary's hospital in west London.

Eight should be the absolute maximum number of patients a nurse should have to care for but "if you get to that level it's bordering on unsafe care", so ideally the ratio should be 1:4 or 1:6, she added.

They, along with RN’s will work together in a team model, looking after as many as 15 patients at one time.

An RN can make up to $43.50 an hour, an RPN about $28 an hour and a PSW makes up to $22 an hour.

A total of about 83 positions in total will be effected. The QHC board has anticipated a $12 million shortfall between expenses and funding (including inflation). QHC has also received verbal confirmation they will receive funding, likely in the $6 million range, from the Ministry of Health. There is also a concern that they will have to dip into their line of credit to make payroll.

(RNs), licensed practical nurses (LPN) and nurse practitioners (NPs).  T

Each year, the province spends $21.6 million for Nova Scotia’s three nursing schools and a total of 1,604 nursing seats. Given the pace at which the health system evolves, it’s critical that today’s students are offered every opportunity to be as “practice- ready” as possible when they graduate.

Paying for experienced nurses to spend dedicated time mentoring new nurses

Support professional development for RNs, LPNs and NPs, with targeted topics like improving practice environments, developing clinical leadership, developing strong teams and injury prevention

O'Shea says some of the Island's 1,100 registered nurses are facing burnout.

In addition, close to two thirds of respondents believed there is currently insufficient qualified staff available in both home care (68.4 per cent) and long-term care (63.7 per cent) settings.

An overwhelming 77.6 per cent of respondents identified a strong preference for home care over institutional care.

The highest rating in the survey, 96 per cent, was given to the importance of having a qualified nurse on duty.

the proposed new regulation does not reflect the full scope of current LPN practice and competencies, and could negatively impact LPN utilization

inevitably taken, minimal care is given and more family involvement is required for basic care. Staff shortages in all areas touching patient care contribute to errors, which directly impact patient care. Nicole Beggs retired RN, Ottawa

In the letter to Timmings, lawyer Michael Polvere of Siskinds wrote, "While we encourage all honest and fair debate on the issues, defamatory and untrue statements made of and concerning our client, the LHSC, will not be tolerated and will be met with swift action. The LHSC intends to hold both RNAO and yourself personally responsible for the conduct of this meeting." At the 6:30 p.m. meeting at Wolf Performance Hall in the Central Library, Timmings will lead discussion on a nurses' association report that claims cash-strapped hospitals are cutting registered nurses and replacing them with less qualified and lower-paid staff to the detriment of patients. "These (changes) are detrimental to Ontarians, to nurses, and to the future of health and health care in Ontario," conclude authors of the report Mind the Safety Gap in Health System Transformation: Reclaiming the Role of the RN. No one should be muzzled from discussing key health issues and LHSC's efforts should be addressed by Ontario Health Minister Eric Hoskins, Grinspun said. Hoskins couldn't be reached for comment Thursday. Nor could officials at LHSC. Earlier this year, Glendining refused to comment publicly on Burkoski's firing but defended the hospital in internal memos that insisted that the nurses' association had told a one-sided story and that safety was always a priority.