QEH emergency room closes door on licensed practical nurses

Nigel Armstrong
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Queen Elizabeth Hospital's emergency department.

Only registered nurses will staff Queen Elizabeth Hospital emergency department starting this April

Staffing changes are underway in the emergency department of the Queen Elizabeth Hospital.

It is part of a move in health care all across P.E.I. that began with a report in 2009, a process known as the collaborative model of care.

Hospital management met Thursday with staff of the emergency department to announce that licensed practical nurses will no longer be part of that unit as of April.

It amounts to about eight full-time positions, but the exact number of staff varies, since not every position is filled by just one person, The Guardian was told.

"The hospital is going with an all-RN model for the emergency department," said Karen Jackson, president of the P.E.I. Union of Public Sector Employees, which represents LPNs employed by Health P.E.I.

Jackson and Health P.E.I. both told The Guardian that the LPNs will transfer to jobs in other parts of the hospital.

She did say, however, that the union is disappointed by the move.

"I feel that the LPNs are a valuable resource in that area," she said. "They are competent and skilled professionals."

For its part, the P.E.I. Nurses' Union applauds the move.

"In the emergency department, you have a very critically ill and unpredictable patient population, and nurses need to have excellent assessment skills, critical thinking skills and to be very knowledgable," said Mona O'Shea, president of the nurses' union.

She said patients will get good care as the changes take place and more registered nurses are added to emergency department staffing.

The Health P.E.I. website makes note of staff increases resulting from this process since it began in 2010.

"As of summer 2015, more than 75 full-time equivalent positions have been added throughout the province as a direct result of the collaborative model of care, which has led to an increase of more than 150,000 patient care hours," says Health P.E.I.

Organizations: Queen Elizabeth Hospital, The Health P.E.I., The Guardian P.E.I. Union of Public Sector Employees

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Recent comments

    January 25, 2016 - 17:42

    I believe there is a huge misunderstanding on the education requirements to be an LPN. We have required critical thinking courses, adult physical assessment equivalent to that offered to the BN students and we are trained in med administration from PO to IV. We listen to bowel sounds , lung sounds. We auscultate the heart. We interpret vital signs and are able to give insight to the team on the status of the patient. LPNs have a vital role to play in the ER in patient care. We are team players and work together with doctors, RNs , NPs, RTs , SWs and other disciplines to provide the best care for the patient. We are licensed. In order to be licensed our requirement is to have a 75 in every subject in a challenging two year program. Much of the LPN skill set overlaps greatly with the RN skill mix. That should not cause division or competition amongst nursing colleagues but create collaboration and partnership to give the best patient care. It is incredibly disappointing that a provincial Union would resort to diminishing a profession that plays an integral role in our ERs across this country. It appears by the statement of the nurses's Union and by those that believe that we are "Kias". That you need an education about our education and skills. There are thousands and thousands of us ready to have a conversation with you. Sorry PEI. You have definitely gotten this wrong.

  • RNlovesLPNs
    January 25, 2016 - 09:19

    SHAME ON YOU, PEI government!!!! Very disappointed with your step backwards!!!!

  • An RN
    January 24, 2016 - 10:56

    Just a reminder, not every RN applauds this decision, and not every RN wanted this to happen. We can't be assuming that all of our RNs out there feel threatening by LPNs and want them gone, when in reality, most RNs appreciate the hard work that LPNs do. As an RN working on Prince Edward Island, this decision may not have been the best (we don't know yet), but the RNs working on the floor didn't ask for this either.

    • hard work
      January 24, 2016 - 18:47

      Well I should say that most RNs will miss the LPN role in emergency...because they do alot of minor procedures now ...that the RN doesn't have to do ...and now there be no time for socializing looking at face book and selling Avon and epicure

  • Jackiemoon
    January 23, 2016 - 22:11

    Time for upse to start challenging the peinu on their comments and absolute disrespect for other health care professionals time and time again.

  • LPN from NB
    January 23, 2016 - 16:26

    Many professions have varied educational levels and skills within their portfolio - accountants (CA, CMA, CGA) physicians (surgeons, family physicians, specialists) nursing (LPN, RN, NP) each studying from the same body of knowledge but to varying levels of depth. Each have vital roles to play within their field - one that is educated less or differently is not 1/2 of the other. Each level exists for a purpose. Collaboratively we take the best of each level within their field to meet the needs of the client. Respecting each others roles and contribution allows success regardless of the discipline. Disrespect and disparaging comments only fuel the fire - ultimately this accomplishes nothing. Licensed Practical Nurses are trained professionals, regulated and write a national exam. They study from the same body of knowledge as Registered Nurses are are certainly capable of critical thinking as it is one of their core competencies! It's sad that in this article no voice for the LPN was heard... generally both sides to a story allow us to gain perspective. This article is clearly one sided and hurtful to the LPN's that most assuredly have provided excellent nursing care in the past in the very Emergency Room they are referring to. Does it make sense to say all physicians in every environment must be specialists and educated to the highest level within their field? Of course not. Registered Nurses certainly have a key role to play in an Emergency Room - but as clients present on a varying level of acuity in the ER, the LPN's have a role to play. Many LPN's in NB have active and vital roles in our emergency rooms... they cast, perform phlebotomy, vital signs, initiate IV's, perform ongoing assessments, provide care and the list goes on. I would urge this publication to speak to someone in defense of the LPN and their role as a follow up to this article as the comments in this article regarding LPN's capabilities are misrepresented.

    • Christa
      January 25, 2016 - 20:45

      Very well said! I hope more nursing professionals show support for a collaborative nursing team ...even in the ER

  • Allied Professional
    January 23, 2016 - 13:15

    So it's 2016 and much like any Government or Industry, there is essentially no wiggle room for budget increases or expansion. So all this being said, all professions are being expected to work within all of the capacities of their scope of practice to provide the most effective care possible so budgets are maintained. This is why they introduced the LPN/RN collaborative care model in the ER, which was a wise cost efficient budget model. Now, they are reverting back to an all RN model which is going to drive costs up majorly. I would love to see statistics of how many "true" emergencies are within the ER at any given time of day. I suspect it would be low compared to the non-emergent illnesses that walk through the doors of the ER, that probably could have been treated in a walk-in clinic. The other statistic that I would love to see is the number of times there was an adverse events in the ER that was caused by the RN/LPN model. You would think that something had to happen to drive this recent decision other than some manager's personal opinion on how the model should look. You don't see every ambulance staffed with 2 Advanced Care Paramedics. They are typically made up of 1 Advanced Care Paramedic and 1 Primary Care Paramedic (less scope of practice). I am all about improvement and best practice but it needs to make sense and be backed up by Clinical Best Practice Guidelines and Evidence Based Practice. My 2 cents on a Saturday afternoon!

  • Politics
    January 23, 2016 - 11:59

    If this is a indication of the new appointed Health Ministers critical thinking ..so far in a week ..? ESPECIALLY WITH AN RN Shortage As well to" hahas comment ..just to let you know a relative was triaged by an RN and sent home few hours later found unconscious on floor at home ..Lpns never work in triage that is not their scope in emerge it always an RN i belive as far as Ive ever seen ..any time Ive had to go to emergency dept . There many stories similar heard everyday so even RN skills are not triaged appropriately ..some new grads may have title BNsc but not have experiance of assessment skills to be in emergency department either btw ..

  • Care
    January 23, 2016 - 10:11

    This is just one of the bully type scenarios that the model of care created ..Lpns were supposed to take some of the work to free up RNs. All it did was create divisions ..and poor morale ..fueled by management in a divide and conquer atmosphere which upper management likes ..it not like all RNs want to even work in emerge and there is a shortage of RNS as they say .. All medical staff have a job to do with in a defined scope of practise ..Lpns had to take the extra courses required one being health assessment to be Liscenced by a governing body provincially . I also know some very good LPNS who were bullied right out of QEH .simply because they were not a fit in the boys and girls club and life long careers ruined .. I can hardly wait to see how the public complain about wait times at ER in the future . Obviously Mona Shea is not a team player her comments are ignorant. abusive and disrespectful .. Morale due to this attitudes overall only ones that suffer are the patients ..because it affects safety when there is disgruntled staff .. Lpns do alot of the tasks to assist or facilitate RNs so they can do theirs ..to eliminate numbers of staff overall is not patient safety ..

  • Unknown
    January 23, 2016 - 09:36

    Let's make it clear who made this decision. It wasn't the RN nursing Union. Look no further than our lovely government and their thirst for saving the almighty dollar. As an RN I too feel the incredible loss of the LPN's in the ER. Health has become a business, how to run the system with paying out the least amount of dollars.

  • Moved away
    January 23, 2016 - 08:46

    Typical. While EVERY other province uses LPNs MORE.... the protectionist RN has WAY too much political power in Canada's most political province.

  • Concerned Islander
    January 23, 2016 - 08:38

    Rediculous! A terrible idea! Mona isn't making sense. I hope to see the ER staff stand up to this. Be a voice to your department and protest. What would happen if they all threatened to walk out?? It's happened in other provinces.

  • To Mona O'Shea
    January 23, 2016 - 06:52

    I think you should publicly make an apology to the lpn's. Hate to see karma work their magic on you

  • whynot
    January 23, 2016 - 00:26

    The PEI nurses union has a history of not wanting LPN's in their care areas. I guess they feel threatened. Thankfully the Nova Scotia Nurses Union considers LPN's a valuable asset in the care they provide. Looks like the public is on the loosing end of this decision. Shame on you PEI Nurses Union

  • whynot
    January 23, 2016 - 00:14

    The PEI nurses union has a history of not wanting LPN's in their care areas. I guess they feel threatened. Thankfully the Nova Scotia Nurses Union considers LPN's a valuable asset in the care they provide. Looks like the public is on the loosing end of this decision. Shame on you PEI Nurses Union

  • RCW
    January 22, 2016 - 23:33

    A big step backwards and insult to the LPN's on PEI. One week the nurses union is on TV whining about the shortage of nurses (RN's) and how they're burnt out because of no time off now they want them out of the ER. Well prepare for more whining now because your even shorter staffed. It's never been a secret the RN's have felt threatened by the implementation of LPN's being trained to do more advanced nursing and this move validates that. This is a shame and a step backwards. Keep your chins up LPN's. You do great work and they'll realize that after they're burnt out due to massive ego's........

  • Llj
    January 22, 2016 - 21:06

    It's ridiculous stuff like this why I left PEI and am never going back like I'm sure there's way more important and pressing matters to address then removing important valuable lpns from the emergency dep also i don't care how educated you are I'd rather be treated by a happy LPN that actually takes the time then a cranky rn going on their last hour of a tweleve hour shift way to go qeh when will the rest of the lpns get the boot from the hospital? What's the since mise well speed up the inedible and get rid of the LPN course all together yes it is an emergency room but if that's the case dont all people deserve the best of care that are sick!

  • Mark
    January 22, 2016 - 19:05

    Incredibly disrespectful quote from the PEI Nurses Union. Health Care should be a team approach focused on the patient. Heath care on PEI took a step backwards today.

    • peigirl
      January 22, 2016 - 23:01

      appalling remark from PEI NU. shame on you!

  • dawn
    January 22, 2016 - 15:15

    I feel that there will be less care for the patients in emg now, anytime I've being in emg it was the LPN that got me a warm blanket or a drink when I was there, the RN'S where busy taking care of the more important things like keeping people alive!! Dump idea liberal party!

    • TS
      January 22, 2016 - 16:06

      No offence intended, but isn't that the job of the RN's in the emerg department, to keep people alive? Just as you stated? When a person is experiencing a heart attack or a stroke, the last thing they're thinking about is a warm blanket or a drink. It's not a flight service. I never comment on these things, but honestly, I would prefer quality over quantity when it comes to my nursing care.

  • Paul
    January 22, 2016 - 13:19

    Sounds like another RN Management decision to degrade LPNs even more. Most RNs feel they are better than LPNs and that LPNs dont deserve to be called a nurse, when in fact the LPNs and other staff do all the dirty work the RNs feel is not their job

  • Connie Bryanton LPN
    January 22, 2016 - 12:33

    This is really a sad day for health care on PEI. You are removing skilled professionals from a busy ER. Shame on Health PEI and shame on PEINU for applauding this.

  • Ezmerelda
    January 22, 2016 - 12:22

    With 37.2% of visits being mental health related, where is the social worker's union? When I lived in Ontario they were an invaluable resource. Overworked nurses don't have even close to the same skills and without social workers taking the time to listen and coordinate, mh problems get blown out of control.

  • Pat McGowan
    January 22, 2016 - 11:01

    This is a good move.Well trained RN's are necessary in such an acute care area. It's like comparing doctors vrs.EMT's.They both are knowledgeable,but you can't expect an EMT to perform emergency surgery.LNA's are trained in a specific area,and don't require the time and study needed to become an RN.

    • Scott
      January 22, 2016 - 14:14

      So the hospitals that have EMTs working in their ERs should have them removed as well then? Or could each profession not bring the benefits of their own training on the table to help provide a well rounded patient care plan?

    • Wanda
      January 22, 2016 - 16:13

      It isn't lna it is Lpn

    • Stacey Melvin
      January 22, 2016 - 17:35

      The course that the Lpn's do now is the old RN program, so your telling me the old RN's are not trained well enough? Because you sure are saying the LPN's are not

    • tanya
      January 22, 2016 - 20:08

      Get it right Pat..we are not LNAs...haven't been for years. Its LPN

  • Trevor Smith
    January 22, 2016 - 10:11

    Wow! Way to take a huge step back in time! LPN's are the back bone of our hospitals!

  • don
    January 22, 2016 - 09:45

    to me the so called Hospital management of the qeh is bias of lpn and to me it is a plain suit of Discrimination plain and simple. the old style management and staff is scared of lpn and the number one item should be the best care that they can give patients. but again the brains at the qeh cares less and to me they have shown it here.

  • Louann
    January 22, 2016 - 09:43

    In my career as a RN in a hospital setting I have worked with numerous LPN's /CNA 's, and found them to be valuable in acute wards including the emerg Dept. what a loss of knowledgeable resources !!!

  • UpsetLPN
    January 22, 2016 - 09:17

    This is absurd. Collaborative care should involve staff from different denominations, not just RNs. LPNs are trained well to work under the direction of an RN. Other provinces have a much more broadened scope of practice for LPNs than we do here and it wouldn't put a doubt in my mind that some LPNs would be willing to go work off island if they aren't going to be able to do what they are trained to do. PCWs are also utilized very well in the hospital and could have been used as well.

  • Pissed off islander
    January 22, 2016 - 07:56

    I find what Mona o'shea said is rather ignorant to say the least. Very Unclassy of her go passive aggressively say that basically lpn's aren't knowledgable, is incompetent to take care of patients and cannot assess patients in a critical care setting. Needless to say this island does not promote rn's working together with lpn's but rather seeing this as a totem pole. Way to go Mona !!

  • Patty
    January 22, 2016 - 07:33

    How disappointing. Absolutely my favourite place to have worked. Seems like a move backwards. Sorry for those talented LPNs who have lost their positions in ER

  • Just sayin
    January 22, 2016 - 07:05

    Be careful what you say Mrs O'shea.... Not only is the department filled with "critically ill" patients..... There are common colds, sore ears, throats, back pain, knee pains etc. things that can be taken care of by an LPN, not a highly trained "critical thinker, exceptional assessment skilled, very knowledgable, RN". And when the RN is too busy in this department to get your family Member a glass of water, or change their sheets or attend to lighter duties the patient requires.... Call on the LPN. Those things will be very last on the list of things the RN will need to do, especially on a busy day, with sick patients. No applause here.

  • Get Real
    January 22, 2016 - 05:25

    Great... so now instead of having LPNs sitting in the tirage room, laughing and giggling while they ignore the needs of everyone in the waiting room, it will be RNs. How is that an improvement?

    • HAHA
      January 22, 2016 - 22:53

      Just a correction, LPN's are not "qualified" to be working at TRIAGE... therefore you would not have seen them there. Those are skilled RN's sitting there waiting to asssess your EMERGENCY.... just waiting for people to come and verbally assault them about the wait time for their sore ear.. The CRITICALLY ILL people are in back, getting the treatment they need from the other RN's... you may not have to wait so long if there were more LPN's to help with your common cold, or sore knee for a week. If your able to complain in the waiting room about how long its taking, your not in need of the EMERGENCY department. Also, its not the RN's problem about the wait time... its the physicans who need to see all these people... for their EMERGENCY and there are much less doctors on then nurses.... Seek a clinic or your family doctor, less wait times, and you WILL be seen. Have a nice day.

    • Agree With Haha
      January 23, 2016 - 08:11

      It is RN's at the triage desk not LPN's. If you can complain about your waiting times and actually have time to observe and comment on the triage desk, then take a deep breath and give thanks. Behind those doors the team may be busy saving the life of an urgent Emergency. If you have time to stop for your coffee, use the vending machine for snacks or walk outside to puff on your cigarette, then you should be at a walk in clinic. Once people get an understanding of "EMERGENCY" the wait times will decrease. Oh, and have a nice day.

  • david
    January 22, 2016 - 03:53

    If LPN's are such a valuable resource than why are there positions called RN's. Having half a registered nurse which is what a LPN is hardly wise. I would rather be cared for by a real nurse than a part nurse. LPNs are fine for some duties and places but not everywhere if they are so valuable then why does even need to be RNs. This is like replacing a Lexus with a Kia sure the Kia will get you from point A to point B but it will rattle you around much more. I would rather be cared for by the real thing that being the RN the by the cheaper model that being the LPN. LPN's have some roles just not everywhere.

    • Sheila Eisnor
      January 22, 2016 - 20:10

      The letters RN--LPN are just that letters. Because you have RN and I have LPN after my name does not mean I do not have excellent assessment skills critical thinking skills and am knowledgeable. I am now retired however I contributed my skills many times over to the ER in the hospital I worked at never once considering myself a half RN I am not sure what you mean by the real thing we are all nurses in different roles.

    • tanya
      January 22, 2016 - 20:13

      Wow!!!! I hope someday u get care from an LPN and they have an enema with a rectal tube attached with your name on it!!!!

    • LPNProud
      January 23, 2016 - 18:14

      That has to be the most ignorant comment on here! I am a LPN and I am a different level of "Real" nursing care. I wish this hatefulness would stop already. PEI has taken a real step backwards.

    • LPNProud
      January 23, 2016 - 18:16

      That has to be the most ignorant comment on here! I am a LPN and I am a different level of "Real" nursing care. I wish this hatefulness would stop already. PEI has taken a real step backwards.

  • justanotherislander
    January 22, 2016 - 00:45

    I applaud this move. Patients, and not just in ER, need to have more RN's available. The LPN's simply do not have the training, knowledge, or skills of an RN. The prior duties of an LPN were appropriate. Hopefully this might improve patient care.

    • Caringgal
      January 23, 2016 - 11:46

      If the LPN's feel slighted,why don't they go back to school and take the RN exams?? They certainly fill an imp. role in a hospital setting,working under the supervision of an RN.I think some hospitals allow them more freeway to save money,and that isn't fair to the LPN or the patient.They don't have the training !!

  • Jim Smith
    January 21, 2016 - 22:43

    Very very poor move LPN,S RE A VALUABLE RESOURSE IN ER . This will cost MORE on the Health Care Budget. Maybe thats why I had to wait about two months to have a small procedure done

    • Anonymous
      January 21, 2016 - 23:27

      Very poor decision Lpn are just as valuable as RN's it's degrading LPN in a sense