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3. The Public needs to ask “Why Can’t Skilled Professional Registered Nurses be Paid Appropriately!”

The current economy to reduce costs in hospital budgets has led to significant number of terminations of registered nurses from the hospitals. Testimony is the hospital that recently terminated 300 registered nurses. These terminated, highly skilled, experienced registered nurse professionals still want to do what they do best - look after the health care of people with continuous nursing health care in all aspects of the health care required.

But who will pay professional highly skilled Registered Nurses who are no longer part of the hospital employment group? Once RNs exit the public funded hospital system there is no other payment structure for RNs who perform health care work. These experienced front line nurses want to do hands on health care. To do this their only option is moving into the private sector health care. They choose not to move into the privately paid areas of teaching, academic management, government, research, or medical offices.

IPNIG asks - Why can’t highly skilled Registered Nurses be paid similar to the rest of the health care providers? For example; by Third Party Insurance providers? A registered nurse can provide to the insurance benefit claimant continuous skilled health care, substantive follow up, assurance the whole body needs are met and provision of on time health care. This timely health care provided by the registered nurse prevents the benefit claimant being left alone and unattended claimant allowing them to slip into failed health that ultimately costs the 3rd party insurance providers significantly more money.

Registered Nurses are diversified in their areas of expertise and have recognized transferable skills in various industries outside of the standard health care environments. In the insurance industry there are numerous opportunities for a registered nurse in areas such as: life underwriting, critical care, disability, Veterans Affairs, WSIB, auto insurance, legal nurse consultant, employee assistance programs, short and long term disability and many more.

The Registered Nurse has a vast range of diverse health care knowledge to enable nursing assessment of client, determination of nursing care plan, rehabilitation knowledge, supportive counseling, return to work interventions, nurse management consulting, case coordination and planning for catastrophic cases, medical/legal reviews and legal nurse consultations.

There is a myriad of insurance policies in place and types of insurance, which all spell out differently the job requirements, who performs, and who and what payment will be processed. In fact, every insurance carrier has their own requirements and payment processes with the exception of the auto insurance industry. Of significance note is the insurance form that requires a health professional [including an NP] to sign the completed form but the Registered Nurses can do all the Assessment for Care that the above person signs off on!

Recent changes were made in the Auto Insurance legislation, Statutory Accident Benefits Schedule (SABS) for Ontario September, 2010. Currently only Occupational Therapists and Registered Nurses are able to complete the Assessment of Attendant Care Needs [Form 1] for clients injured in vehicular accidents. Prior to this change, these forms have been completed by several various health care professionals [excluding a registered nurse]. The billing and payment for auto insurance health care provisions is completed through an electronic service HCAI (Health Claims for Auto Insurance) which is regulated through the Financial Services Commission of Ontario (FSCO).

Registered Nurses value the health care system that is available for all Canadians. It is timely for registered nurses, who are valid health care providers, to ask to be recognized in policy for 21st century scope of practice and with equitable funding along with the current health care professionals. In addition, there is a huge need for the education of the myriad of insurance providers to the extensive skills, knowledge and expertise that specialized registered nurses provide.

We ask IPNIG members their opinions relating to pursuing or not pursuing time and investment into research of 3rd party payers for Registered Nurses.

Please send your comments using the survey email on the IPNIG web Site.

 Ruth Volpato – RN Nurse Consultant/Case Manager in Rehabilitation Care
Jill King – Occupational Health and Environmental Safety Consultant
IPNIG Professional Practice and Political Action Committee