celebrating the evolution of nursing regulation in british columbia 100 Years of Nursing Regulation 1912 - 2012

Professional Conduct Review

The privilege of a self-regulated profession that Helen Randal and her contemporaries fought so hard to establish was predicated on their belief it was the best way to protect the public. It was true 100 years ago and remains true today.

All registered nurses, nurse practitioners and licensed graduate nurses practising in British Columbia are required to adhere to a Code of Ethics that includes the assumption they will provide “safe, compassionate, competent and ethical care.”

In the 1970s, RNABC’s Committee on Social and Economic Welfare was responsible for much of what would become the domain of the Association’s Labour Relations Division and eventually the B.C. Nurses Union. Within that committee was a sub-committee, the Committee to Hear Appeals of Nurses Dismissed from Their Positions.

In the mid-1970s, a process was established for receiving complaints about nurses. When a complaint was received, the nurse in question was interviewed by RNABC’s employment referral director. A report was submitted to the Referral and Review Committee, which then made a recommendation to the Board of Directors. If the Board deemed it necessary, a hearing was ordered.

Writing about this new process in the 1975-76 annual report, Ann Sutherland, chairman of the Committee on Social and Economic Welfare, said: “I would like to assure you that the hearings have been very hard on all concerned. This is the first time that board members have had to face such a situation, assessment of peers. It is not an easy thing for any of us: ‘Who am I to be judging another nurse? Do I understand all the facts?’ The decisions are not taken lightly.”

In the 1990s, a comprehensive examination of the RNABC’s professional conduct review process was carried out, resulting in a number of recommendations to ensure the discipline process “continues to be fair, flexible and effective” and to make the process more participatory and less adversarial. Changes included the establishment of a staff position – the consumer relations representative – to handle complaints and, where possible, to resolve concerns through a consensual complaint resolution process without having to hold a formal discipline hearing.

Today’s Professional Conduct Review process ensures there is a venue in place for receiving, investigating and dealing with complaints about nurses. All complaints, from whatever source, are taken seriously and reviewed to determine if the continued practice of the nurse poses a danger to the public. Some complaints are handled informally – helping people to address their concern by referring them to the most appropriate resource or agency, for example – while others are resolved using a formal process, which may involve CRNBC’s Consensual Complaint Resolution Process.

The most recent change to the process came about with the implementation of the Health Professions Act. It provides for a Health Professions Review Board that functions somewhat as an ombudsman when a complainant or a nurse is not satisfied with CRNBC’s decision.