College of REgistered Nurses of Nova Scotia Annual Report 2014
Annual Report 2014
College of REgistered Nurses of Nova Scotia Annual Report 2014
2
Brooke, RN – Pediatrics
College of REgistered Nurses of Nova Scotia Annual Report 2014
Table of Contents
Protecting the Public Through Nursing Regulation . . . . . . . . 2
Mission, Vision and Mandate . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2012-2014 Strategic Ends . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Message from President and CEO . . . . . . . . . . . . . . . . . . . . . 5
Year in Review
Leadership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Our New Approach to Regulation . . . . . . . . . . . . . . . . . . . 7
Development of New Strategic Plan . . . . . . . . . . . . . . . . . 7
Registration Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
NPs Prescribe Controlled Drugs and Substances . . . . . 8
RN Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Continuing Competence Program Progress . . . . . . . . . 8
National Nursing Assessment Service . . . . . . . . . . . . . . . 8
Real eNgagement Community Sessions . . . . . . . . . . . . . 9
Nurse Practitioner Exam Approvals . . . . . . . . . . . . . . . . . 10
NP Practice Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Webinar Technology Keeps Education Accessible . . . . 10
Rising Star Award . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
2014 Annual General Meeting . . . . . . . . . . . . . . . . . . . . 11
Resources & Services
Registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Complaint Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Practice Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Learning & Development . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Publications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Quality Assurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Licence Status Check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Communications & IT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Awards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Where do your fees go? . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Council & Committee Reports
Council Members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Council President Profile . . . . . . . . . . . . . . . . . . . . . . . . . 23
Professional Conduct Statutory Committees
• Complaints Committee . . . . . . . . . . . . . . . . . . . . . . . . 24
• Professional Conduct Committee . . . . . . . . . . . . . . . 24
• Fitness to Practice Committee . . . . . . . . . . . . . . . . . . 25
• Reinstatement Committee . . . . . . . . . . . . . . . . . . . . . 25
Statutory Committee Reports
• Education Advisory Committee . . . . . . . . . . . . . . . . . 26
• Interdisciplinary Nurse Practitioner
Practice Review Committee . . . . . . . . . . . . . . . . . . . . 26
• Nurse Practitioner Committee . . . . . . . . . . . . . . . . . . 26
• Registration Appeal Committee . . . . . . . . . . . . . . . . . 27
Standing Committees:
• Awards Committee . . . . . . . . . . . . . . . . . . . . . . . . . . . .
• Committee on Appointments . . . . . . . . . . . . . . . . . . .
• Nominations Committee . . . . . . . . . . . . . . . . . . . . . . .
Financial Statements:
• Grant Thornton Auditor’s Report . . . . . . . . . . . . . . . .
• Audited Financials . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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27
27
28
29
Staff List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . outside back
The photos used throughout this report capture images of some of our members who are licensed to practice nursing in Nova Scotia. We would like to
acknowledge and thank all of the RNs and NPs who volunteered their time to help us demonstrate the unique contributions and value of the nursing profession.
Cover image: Tricia, NP – Pediatrics
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College of REgistered Nurses of Nova Scotia Annual Report 2014
Protecting the Public through
Nursing Regulation
The College of Registered Nurses of Nova Scotia (CRNNS) regulates registered nursing practise
in Nova Scotia in the best interests of the public.
As the regulatory body, we are responsible to:
• License registered nurses (RNs) and nurse practitioners (NPs) practising in Nova Scotia;
• Set the education requirements for those entering the nursing profession;
• Issue annual licences to qualified applicants to practice nursing;
• Establish and approve standards, competencies and guidelines for nurses’ practice;
• Support the continuing competence of nurses; and
• Review and take appropriate action on complaints about nurses’ practice or behavior.
We are committed to supporting RNs and NPs, as professionals, to uphold their standards of
practice and Code of Ethics in order to provide Nova Scotians with safe and quality nursing care.
Nursing has been a self-governing profession in Nova Scotia since 1910. This means that
government, through the Registered Nurses Act, has delegated the responsibility to oversee nursing
practice to registered nurses themselves. The public trusts that RNs and NPs practice with public
interest as their priority and it is the role of CRNNS to ensure that practice in the public interest
is maintained. It is a testament to the incredible work of RNs and NPs, and effective oversight on
the part of CRNNS, that the legacy of trust and self-regulation has been maintained for over
105 years.
Surveys will tell you that nurses are one of the most trusted professionals. Maintaining the trust
bestowed on the nursing profession is important to the public, RNs, NPs, other healthcare
providers, employers, educators, the unions, the government and CRNNS. The strong history of
nursing in Nova Scotia is something that we must all take pride in and cultivate for the generations
that follow. We look forward to a stronger future together.
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Susmy, RN – Geriatric/ Long Term Care
Meaghan, RN – Emergency Care
College of REgistered Nurses of Nova Scotia Annual Report 2014
Mission
Registered nurses regulating their profession to promote excellence in nursing practice.
Vision
Our vision of success is a future where CRNNS:
• Empowers nurses to recognize and realize their contribution to the health of the public and healthcare system and
advance their professional development;
• Implements innovative regulation that enables the profession to shape the future healthcare system;
• Inspires nurses to be leading contributors to public safety;
• Enhances nurses’ capacity to meet increased demand and higher expectations of registered nurses and nurse practitioners;
• Has a wealth of evidence to influence public policy directions;
• Is making connections, building coalitions and influencing change.
Mandate
CRNNS’ mandate is to regulate the practice of nursing in the public interest. CRNNS’ core regulatory functions are to:
• License registered nurses (RNs) and nurse practitioners (NPs) practising in Nova Scotia;
• Set the education requirements for those entering the nursing profession;
• Issue annual licences to qualified applicants to practice nursing;
• Establish and approve standards, competencies and guidelines for nurses’ practice;
• Support the continuing competence of nurses; and
• Review and take appropriate action on complaints about nurses’ practice or behavior.
3
College of REgistered Nurses of Nova Scotia Annual Report 2014
2012-2014 Strategic Ends
Ends (goals) and policies provide direction to the CRNNS’ CEO and staff.
They are established by Council in accordance with legislation.
Mega End
Excellence in RN self-regulation for the health of Nova Scotians.
Ends
A. Public receives safe, competent, ethical and compassionate care from
registered nurses and nurse practitioners.
B. Registered nurses and nurse practitioners work to their optimal scope of
practice in an evolving healthcare system.
B1. Clients receive coordinated care within and across the care continuum.
C. Registered nurses and nurse practitioners are competent to practise in
intra- and inter-professional collaborative teams.
D. Registered nurses and nurse practitioners practise self-regulation.
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Christine, RN – Psychiatric/Mental Health
College of REgistered Nurses of Nova Scotia Annual Report 2014
Message from President and CEO
Jacquelyn Garden-Jayasinghe,
MN, NP, RN, President
Sue Smith, RN, BN, MAOL
CEO & Registrar
In many ways, 2014 was a transformative year for
CRNNS. Yes, we have been in existence in Nova Scotia
for 105 years – that’s no small feat - and we are proud
of our history and our contributions to Nova Scotia’s
strong and vital nursing profession. Those registered
nurses who came before us have demonstrated
throughout the years that progress really happens when
we are aware of the environments in which we work and
adapt, evolve, and change. And we have been listening.
The past year was one of preparation, engagement, and
change as we worked towards a shared vision of the
future of CRNNS. With input from members of the
public as the ‘owners’ of CRNNS, Council developed
a new strategic plan that sets the direction for the
organization over the next three years. Underpinning
the plan is the understanding that enabling the provision
of safe, competent, ethical and compassionate nursing
care to Nova Scotians is at the heart of what we do.
We also wanted to have a candid conversation about
nursing in Nova Scotia, your relationship with us, and
what we can all be doing to contribute to the level of
nursing care provided to Nova Scotians. Many of you
took the time to share your insight in surveys and focus
groups, which has given us valuable information that we
will deliver on.
This year, CRNNS embraced a relational approach
to our work that will allow us to emphasize our
commitment to the safety and protection of the
public in a more targeted and transparent way. We
made decisions that would lay the groundwork leading
to enhanced customer service, more opportunity
for collaboration and engagement, and improving
relationships with our stakeholders. We also made
decisions that would see CRNNS focus on applying
‘right-touch’ regulation that will enable us to apply the
minimal amount of regulatory force required to achieve
appropriate outcomes. Key to our new strategic plan,
these are approaches to our work that you will continue
to hear more about and they will set a standard for what
you can expect from us in the future.
The Real eNgagement initiative has continued to create
a movement within the nursing community in Nova
Scotia and more of you joined us this past year to lend
your voice to help shape the future of the nursing
profession. In addition to Real eNgagement and our
core regulatory work, we undertook a number of key
initiatives in 2014 that we are excited to share with you.
Please read through this report and learn more about
how we spent our year together.
While we both have the honour and privilege of sharing
with you the accomplishments of CRNNS this past
year, we would be remiss if we did not acknowledge
the incredible wisdom, leadership and significant
contributions of Peter MacDougall as the past Council
President (2012-2014) and Donna Denney as the
preceding Executive Director of CRNNS (2009 –
2015). It is their commitment to the nursing profession
and their vision for the future of CRNNS that
continues to play an influential role not only for us but
also in the growth and development of CRNNS and the
nursing profession in Nova Scotia.
This past year was an exciting time of renewal and
engagement and we look forward to another successful
year of working together with all of our stakeholders
towards the ultimate vision of optimum health
for all Nova Scotians through excellence
in registered nursing practice
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College of REgistered Nurses of Nova Scotia Annual Report 2014
6
Hilary, RN – Cardiovascular
College of REgistered Nurses of Nova Scotia Annual Report 2014
Year in Review
Leadership
Our New Approach to Regulation
Peter MacDougall completed his term as Council
President in July 2014 following a successful
tenure with member engagement as one of his
CRNNS priorities. Peter was replaced by Jacquelyn
Garden-Jayasinghe who brings with her a wealth of
experience as an NP in Nova Scotia. Please see
page 23 to learn more about Jacquelyn and her
goals as President.
In 2014, Council supported the move to embrace a
relational approach to our regulatory work that allows
us to emphasize our commitment to the safety and
protection of the public. It will also enable us to find
new and innovative ways to build positive relationships
by being transparent, inclusive and available to our
stakeholders.
2014 was also a year in which we prepared for
the retirement of Donna Denney, Executive
Director & Registrar who retired early in 2015.
Council conducted a national search for Donna’s
replacement in the fall of 2014 and Sue Smith was
appointed CEO & Registrar effective February 2,
2015. Council also approved a title change from
Executive Director & Registrar to CEO & Registrar,
which is in keeping with comparable leadership
positions at our national counterparts.
Relational Regulation
As the regulatory body, we issue licences to qualified
RNs and NPs, set the nursing practice standards,
approve nursing education programs, support the
continuing competence of nurses, and address
complaints received about nursing practice. Our
new approach doesn’t change what we do as an
organization but it does change how we do it.
Right-Touch Regulation
As a ‘right-touch’ regulator, we will approach our
regulatory oversight by applying the minimal amount
of regulatory force needed to achieve appropriate
outcomes. This means that we will focus on the risks
we’re trying to regulate while regulating that risk and
creating the resources needed to promote safe and
quality nursing care. Through more engagement with
our stakeholders, we will look ahead enabling us to
better anticipate changes before they occur so that
we can respond to prevent and minimize risks.
Development of 2015-2017
Strategic Plan
This past year, with input from members of the
public as the ‘owners’ of CRNNS, Council developed
a strategic plan that sets the direction for the
organization over the next three years. Underpinning
the 2015-2017 plan is the understanding that
enabling the provision of safe, competent, ethical and
compassionate nursing care to Nova Scotians is at the
heart of what we do.
Registration Fee
In order to fulfill our obligation to protect the public,
we carry out foundational work related to registration
and renewal, standards of practice, supporting
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College of REgistered Nurses of Nova Scotia Annual Report 2014
registrants to meet standards, professional conduct,
and governance. Approximately 92% of our operating
budget required to support this work comes from
annual licensure fees. Last year, Council approved an
increase of $25.00 (+ HST) to licensure fees for RNs
and NPs for the 2016 licensure year, which opens in
July 2015.
NPs Prescribe Controlled Drugs
and Substances
In November 2014, the provincial government
announced changes to regulations that authorized
nurse practitioners to prescribe controlled drugs
and substances (CDS) to patients. CRNNS was
instrumental in working with government and
other stakeholders throughout this process and
implemented measures to ensure that all NPs had
access to resources and completed CDS education
as a requirement for licensure prior to assuming
this authority. This has been a positive move for
Nova Scotians as it leads to greater access to timely
healthcare within the range of services provided
by NPs.
8
RN Exam
The Canadian Registered Nurse Exam (CRNE) was
written by nursing graduates for the last time in 2014.
As of 2015, new graduates who wish to practice in
Nova Scotia will write the NCLEX-RN®. CRNNS
continued to work towards the transition to the new
exam and we published updates and Q&A resources
on our website, in our member-publications, and held
an Atlantic-wide workshop for educators in 2014.
Continuing Competence
Program Progress
Last year, Council approved revisions to the
Continuing Competence Program (CCP) that
included the verification of a random sample
of learning plans and mandatory education for
members when required. In 2014, the CRNNS
CCP Working Group continued its work on this
project, which included the development of new
policies, new and revised program tools and a threeyear implementation plan. The group also began its
stakeholder engagement by consulting with the Nova
Scotia Nurses Union and the Nova Scotia General
Employees Union.
Further consultations will occur in 2015 with both
members and other key stakeholders. The feedback
will be used to refine the CCP prior to finalizing the
program in the fall of 2015.
National Nursing
Assessment Service
On August 2014, CRNNS joined with 21 other
nursing regulatory bodies across Canada to launch
the National Nursing Assessment Service (NNAS).
All internationally educated nurses (IEN) applying for
a licence in Canada for the first time are now able to
apply to the centralized services of NNAS. We worked
with NNAS and other regulators to develop a system
to assess the IEN’s nursing program against Canadian
standards. Not only does the NNAS enhance our
ability to determine that the IENs we license are
competent to provide safe, ethical care to the public,
it also simplifies the application process for IENs
wishing to work in Canada.
College of REgistered Nurses of Nova Scotia Annual Report 2014
Real eNgagement
Community Sessions
Real eNgagement hit the road again in 2014
and hosted five sessions across the province in
Halifax, Antigonish, New Glasgow, Bridgewater
and Yarmouth. Hosted by CRNNS President
Jacquelyn Garden-Jayasinghe and/or Executive
Director Donney Denney, the sessions had
62 participants and together, they engaged in
storytelling through an interactive approach that
had participants creating solutions for a preferred
nursing future.
Gina, NP – Pediatrics
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College of REgistered Nurses of Nova Scotia Annual Report 2014
Nurse Practitioner Exam
Approvals
To ensure a standardized approach to NP licensure in
Nova Scotia, it was decided that NPs who graduated
from an NP program on or after January 1, 2007 and
are applying for initial licensure with CRNNS must
complete an NP exam in their focus of practice. Council
also approved two entry-level NP exams effective in
2014:
• American Academy of Nurse Practitioners
Certification Program’s (AANPCP) Primary Care
Adult-Gerontology NP Exam
• Pediatric Nursing Certification Board’s (PNCB)
Primary Care Pediatrics NP Exam
NP Practice Analysis
With the support of CRNNS and other nursing
regulators across the country, the Canadian Council
of Registered Nurse Regulators (CCRNR) continued
its work on the NP Practice Analysis.
In 2014, CRNNS supported the NP Practice Analysis
by facilitating the project’s national Working Group
under the direction of CCRNR. The NP Practice
Analysis made great strides in 2014 and some of its
accomplishments include: Pro-Exam was chosen as
the successful vendor to conduct the analysis, the
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Patrick, RN – Education
Research Advisory Committee and three subject
matter expert panels were formed to assist in the
analysis and survey development and in the fall 2014,
the NP Practice Analysis survey was finalized and
distributed to NPs across Canada.
The analysis results will be completed in May 2015
and will provide a complete description of entry-level
knowledge, skills and abilities that NPs will need to
practise in Canada. From that, it will inform a national
consensus on NP registration, licensure and exam
requirements. Finally, it will also provide a description
of the clinical services that NPs are currently
providing to clients.
Webinar Technology Keeps
Education Accessible
In partnership with the Canadian Nurses Protective
Society, the CRNNS hosted its first webinar in late
2014. The session was a hit and as a result, CRNNS
will continue to explore how webinar technology can
be used as an adjunct to the Continuing Nursing
Education Telehealth Program in 2015. This technology
creates more accessibility because it enables CRNNS
to engage presenters from outside of the province
and enables members to access education from their
personal computers rather than having to travel to a
Telehealth site.
College of REgistered Nurses of Nova Scotia Annual Report 2014
A New Rising Star Award
To recognize the achievements of recent nursing graduates, Council approved the addition of a fifth award category
called the Rising Star Award. The Rising Star Award recognizes RNs in Nova Scotia who are new to the nursing profession
and have exceeded professional expectations, demonstrated excellence in the application of the CRNNS standards for
nursing practice, and have shown great potential to become an exceptional member of the nursing profession. Approved
in 2014, the inaugural Rising Star Award(s) will be presented to award recipients at the 2015 Awards Banquet. 2014 Annual General Meeting
The 2014 Annual General Meeting (AGM)
was held on May 13, 2014 at the Holiday Inn
Harbourview in Dartmouth. A total of 109
RNs and NPs participated in the meeting,
which was an impressive 44% increase from
the previous year.
There were no motions from the floor on
the day of the AGM. The one resolution
presented and passed was the date for the
2015 election of councilors set as Friday,
April 10, 2015.
Susan, RN – Education
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College of REgistered Nurses of Nova Scotia Annual Report 2014
Resources & Services
Registration
One of the core services at CRNNS is the registration and licensure of
individuals to ensure that those wanting to practise as a registered nurse or
nurse practitioner are competent to do so.
Each year, we register and licence RNs and NPs of different ages, practice
settings, geography and job status to create a diverse and competent
nursing workforce in Nova Scotia. Within that, our role is to safeguard the
public by registering and licensing only those who meet our criteria set by
the Registered Nurses Act, regulation and registration best practice. As the
workforce needs evolve, so do we and our goal is to license every single
qualified individual in an efficient approach.
To become registered and licensed with CRNNS, an individual must
complete an approved nursing education program, pass the national nursing
registration exam and fulfill all other CRNNS registration requirements. In
2014, the CRNNS issued 529 first-time RN licences and 11 first-time NP
licences.
Each year, the CRNNS must also review, process and renew the licenses
of all current, qualified members who wish to continue practising nursing
in Nova Scotia. In 2014, the CRNNS renewed 9625 RN licences and 138
NP licences.
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Registration
2014
Information
% of total % change
licensed from 2013
First-Time RN Licences Issued
529
5.1%
-1.7%
First-Time NP Licences Issued
11
0.1%
+10.0%
Renewed RN Licences Issued
9,625
93.4%
+0.7%
Renewed NP Licences Issued
138
1.3%
-4.8%
Total Active-Practising
Licences Issued
10,303
100%
+0.5%
College of REgistered Nurses of Nova Scotia Annual Report 2014
ComplaintS
CRNNS exists to ensure that the public is safe and
protected when cared for by registered nurses and
nurse practitioners in Nova Scotia. One way we
do this is to review - and if required – investigate
all complaints we receive about the conduct and
competence of RNs and NPs licenced to practice
in our province. Some complaints may be resolved
informally while others require resolution through a
more formal process.
In 2014, 55 complaints were received, which
involved just .006% of our licenced members. This
is a slight increase from 2013 when we received
44 complaints and a decrease from the 73
complaints received in 2012.
In 2014, a total of 60 complaints were resolved.
57% (34) were resolved by CRNNS staff without
the need for disciplinary actions. The remaining
43% (26) complaints were resolved by one of the
four Professional Conduct Statutory Committees
involved with the professional conduct process.
Four statutory committees are involved in the
professional conduct process: the Complaints
Committee, the Professional Conduct Committee,
the Fitness to Practice Committee, and the
Reinstatement Committee. Each of these
Committees play a specific role in complaint
resolutions, which you can read more about on
page 24.
Practice Support
Two ways in which we support the practice of RNs
and NPs is through our practice consultations and
workshops. In 2014, CRNNS hosted 57 workshops
and responded to 757 practice consultation
requests.
In 2014, CRNNS Practice Consultants responded
to 735 requests for consultation from RNs and
NPs. The top consultation themes included
professional practice issues, RN and NP scope of
practice, policy, patient safety and violence in
the workplace.
Although the majority of CRNNS consultations
were with RNs and NPs, there were
approximately 22 consultations in 2014 with
non-RN administrators, private agencies, unions,
government, academic institutions, community/
home care services and members of the public.
The top public consultation themes included
professional practice issues, policy, RN scope of
practice and patient safety.
The most popular workshops last year were:
• Collaborative Practice
•Documentation
•Social Media
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College of REgistered Nurses of Nova Scotia Annual Report 2014
Learning & Development
CRNNS provides RNs and NPs with online learning
opportunities to support them in maintaining their
continuing competence.
In 2014, 1089 RNs and NPs participated in thirteen
e-learning modules offered through the CRNNS
website. The top three most popular e-learning
modules were “Assignment and Delegation Guidelines
for RNs and LPNs”, “Documentation Guidelines for
RNs” and “Social Media”, with over 33% of e-learning
participants accessing them.
Continuing Nursing Education via Telehealth was also a
popular method of learning and development. Over the
course of the year, 881 RNs and NPs attended 57 live
on-site sessions delivered through Telehealth. Feedback
from RN and NP participants showed that 84% felt
the sessions enhanced their learning, 85% thought
the sessions helped meet their professional learning
objectives and 87% felt the sessions were applicable to
their practice. Recorded Telehealth sessions available
on the CRNNS website were also frequently accessed,
receiving over 20,000 visits in 2014.
14
Joan, RN – Community Health
College of REgistered Nurses of Nova Scotia Annual Report 2014
Publications
We support RNs and NPs by producing publications relevant to nursing practice. CRNNS
regularly revises publications to maintain their relevance and develops new publications when
information through practice consultations, new legislation, environmental scans and/or
regulatory best practice is identified that may have an impact on nursing practice. In 2014,
CRNNS revised and produced 21 publications.
Policy Statements
• Nurse Practitioner Scope of Practice Related to
Cosmetic Procedures: BOTOX and
Dermal Fillers
• Nurse Practitioner Standards of Practice
Position Statements
• Advanced Nursing Practice
• Recommended and/or Publicly Funded
Vaccines for Immunizations of Staff and
Volunteers in Nova Scotia Health Agencies/
Facilities (in partnership with the Nova Scotia
Department of Health & Wellness)
Professional Practice Guidelines
•
•
•
•
•
Abandonment Guidelines
Duty to Provide Care Guidelines
A Guide for Self-Employed Registered Nurses
Medication Guidelines for Registered Nurses
Professional Presence and Registered Nurses in
Nova Scotia Practice Guideline
• Telenursing Practice Guidelines
• Treatment Agreements: Nurse Practitioner
Practice Guidelines
• When NPs Leave a Practice Temporarily or
Permanently Guidelines
Reports and Q&As
• Fair Registration Practice Act Review Report
• Licensure Requirements for Nurse Practitioners
Prescribing Controlled Drugs & Substances
• Nurse Practitioner Quality Monitoring &
Improvement Program First Five Year Cycle
Report
• Nurse Practitioner Sensitive Outcomes: A 2014
Summary Report
• Real eNgagement for Real Action Report
• Registered Nurse Sensitive Outcomes: A 2014
Summary Report
• Together We Can: College’s Response to Real
eNgagement for Real Action Report
• Registration Fees for 2016 Licensure Year Q&A
• Seasonal Vaccine Q&A
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College of REgistered Nurses of Nova Scotia Annual Report 2014
Quality Assurance
Communication & IT
As a nursing profession, we value continuing
competence and are dedicated to lifelong learning.
As a mechanism to support this, each year all RNs
and NPs must participate in the CRNNS Continuing
Competence Program (CCP) and NPs must also
participate in the CRNNS Nurse Practitioner Quality
Monitoring and Improvement Program (NP-QMP™)
once every five years. With client care always in mind,
the aim of both programs is to provide opportunities
for nurses to further develop their professional
practice.
Emails & Newsletters
Licence Status Check
The online Licence Status Check showing the
registration statuses of all CRNNS members
was visited 47,578 times and is the most accessed
webpage on crnns.ca. This is a slight increase over
the 45,300 visits this verification page had in 2013.
16
Embracing a relational regulator approach to our work
means that communications with all of our stakeholders
– including our members - is important to us. We are
committed to finding more and better opportunities
to engage with others and to improve our overall
communications. In surveys, members told us that
their preferred method of hearing from us is by email.
As a result, email continued to be our primary way of
communicating targeted information that is timely and
specific to the needs of our members. In addition to
the variety of emails sent to all CRNNS members, we
sent 10 NP Bulletins electronically to notify NPs about
matters unique to their practice.
Knowing emails are the preferred method of
communication for our members, we stopped
producing Nursing in Focus, in the spring of 2014, which
was printed and mailed to all members twice a
year. Instead, we focused our energy on finding new
ways of engaging members in two-way communication
and enhancing our e-newsletter, On-Line, and
increasing the frequency it was sent, from two to
four times a year. Stay tuned for our plans to create
an even more robust and favourable e-newsletter for
stakeholders in 2015.
We also introduced our new blog in 2014, which
provides another way for us to respond to issues,
support nursing practice, and for stakeholders to get to
know us better. We have plans to explore this more in
2015 as well.
Branding Re-fresh
We understand that strengthening the relationships
we have with members and other stakeholders starts
within. We also believe that enhancing collaboration
with others helps us to protect the public through
excellence in registered nursing regulation. Creating and
bringing the new CRNNS brand alive – both internally
and externally – was one of our main focuses in 2014.
We conducted surveys and focus groups with a variety
of stakeholders and used that feedback to inform the
CRNNS brand re-fresh that will launch in May 2015.
Amy, RN – Maternal/Newborn
Beverly, RN – Critical Care
College of REgistered Nurses of Nova Scotia Annual Report 2014
17
College of REgistered Nurses of Nova Scotia Annual Report 2014
Web Visitors
Our website had 675,129 visitors last year, which is an
increase of over 40% from 2013. The majority of our
traffic came from Canada but we had visitors from all
over the world who visited crnns.ca for information
about practising nursing in Nova Scotia.
Our international website traffic:
18
1. United States
2. Philippines
3. India
4. United Kingdom
5. Saudi Arabia
6. United Arab Emirates
7. Australia
8. Nigeria
9. Jamaica
Roger, RN – Geriatric/Long Term Care
Mariella, RN – Geriatric/Long Term Care
College of REgistered Nurses of Nova Scotia Annual Report 2014
How People Access crnns.ca
Technology is changing and it’s important for us to know how people are accessing
our website so we can work to maximize their user experience. In 2014, the majority
(74%) of website visitors still came to our site via desktop computers with 16%
accessing the site through mobile devices and 10% via tablet. We will continue to
watch for trends in the future and ensure our IT functionality evolves with the use
and preferences of our stakeholders.
Initial Assessment Portal
We are always looking for new ways to provide members with better customer
service and more timely results. As of the beginning of 2014, all applicants applying
for initial registration with CRNNS have improved access to information about the
progression of their application. New applicants can now view the status of their
application, submit documentation via email, print receipts, track received and
outstanding documents, and quickly access important memos from us about their
application.
New Website
In 2014, we began the foundational work that is required in order to build a
responsive new website that addressed the needs and wishes of our stakeholders.
Key to the project was the ability for enhanced engagement opportunities with
stakeholders, improved functionality through modern technology, and improving the
user’s overall experience on our site. Usability testing helped to direct website plans
and the new site, set to launch in May 2015, will feature the new look and feel – the
brand – of CRNNS.
19
College of REgistered Nurses of Nova Scotia Annual Report 2014
20
Sierra, RN – Psychiatric/Mental Health
Sheila, RN - Education
College of REgistered Nurses of Nova Scotia Annual Report 2014
Where do your fees go?
CRNNS celebrated the success of RNs and NPs at the 2014 Awards Banquet
where members were recognized for their contributions to nursing and for being
outstanding role models within the nursing profession.
Clockwise
9%
10%
i
i
6%
15%
10
%
i
i
The following individuals were presented with Awards of Excellence:
Excellence in Nursing Administration
i
Awards
7% 2%
i
i
6%
Keith Cockersell, Nurse Practitioner, North End Community Health Centre
Barbara Currie, Nurse Practitioner, QEII Health Sciences Centre
Eleanore Howard, Enterostomal Therapy Nurse, Annapolis Valley Health
Vicky Martin, Charge Nurse, Capital District Health Authority
i
Excellence in Nursing Clinical Practice
%
21
i
14 %
Sylvia Wist, Professional Practice Leader in Policy, Capital District Health Authority
9% Managing our registry
15% College oversight
14% Acting to uphold nursing standards
6% Operations
7% Infrastructure
2% Communicating with members and stakeholders
21% Setting and supporting nurses to meet standards
6% CNPS liability coverage for RNs and NPs
10% CNA membership fees paid on behalf of RNs and NPs
10% Meeting our members and stakeholders technology needs
i
Excellence in Nursing Research
Dr. Marsha Campbell-Yeo, Clinician Scientist, Dalhousie University School of
Nursing and the IWK Health Centre
Health Advocacy
Joanne Cumminger, Patient Navigator, Pictou County Health Authority
Honorary Life Membership
Edith Menzies, retired registered nurse, Annapolis Valley District Health Authority
21
College of REgistered Nurses of Nova Scotia Annual Report 2014
Council Members
The CRNNS Council is the governing body represented by registered nurses, nurse practitioners and members
of the public who are passionate about the provision of safe and quality nursing care in Nova Scotia.
July 1-December 31, 2014
Jacquelyn Garden-Jayasinghe, President – Peter MacDougall, President (Jan. 1-June 30, 2014)
Ruth Whelan, President-elect – Jacquelyn Garden-Jayasinghe, President-Elect (Jan. 1-June 30, 2014)
Cameron Boys, Councillor at Large – Ruth Whelan, Councillor at Large (Jan. 1-June 30, 2014)
Braden Davie, Councillor at Large – Rosalind Benoit, Councillor at Large (Jan. 1-June 30, 2014)
Amy MacDearmid, District Councillor-Annapolis – Tim Guest, District Councillor-Annapolis (Jan. 1-June 30, 2014)
Marlene Ash, District Councillor-Atlantic
Sheri Price, District Councillor-Atlantic – Kelly Ann Lackie, District Councillor-Atlantic (Jan. 1-June 30, 2014)
Clare Currie, District Councillor-Cape Breton
Cyndee MacPhee, District Councillor-Cape Breton
Kathy LeBlanc, District Councillor-Cobequid
Marian Mac Lellan, District Councillor-Highland
Angela Clifton, District Councillor, Western
Anne Bigelow, Public Representative
Carolyn Fowler, Public Representative
Michael Gillis, Public Representative – John Hudec, Public Representative (Jan. 1-June 30, 2014)
Dermot Jardine, Public Representative – Paulette Anderson, Public Representative (Jan. 1-June 30, 2014)
Colleen MacNeil, Public Representative
David Samson, Public Representative
Kendra MacCuspic, Nursing Student representative
22
“When I first met Jackie she was a nurse educator
with whom I shared an office. I was impressed with
her professionalism and caring attitude and I learned
a lot about best practice as I witnessed her caring for
patients and helping other nurses. Always committed
to learning, she went on to become an expert in
the care of hypertension sharing her knowledge
with patients, colleagues, students and health care
professionals around the world. I served on the
CRNNS Council with Jackie and am pleased to see
her use her diplomacy and passion for the profession
as she continues to guide and support registered
nurses throughout Nova Scotia.”
– Rosalind Benoit, nursing colleague
“I was referred to Jackie by my family physician for
complicated hypertension. I was immediately impressed
by the scope of her knowledge about conditions like
mine and her confidence put my mind at ease. She
knew exactly what tests needed to be ordered to begin
to put the puzzle together. She also tapped into her
connections within the healthcare community to help
diagnose me. Her care has made all the difference in my
life and I consider myself a healthier man today because
of her. As President of CRNNS, if she represents the
group of nurses who are licensed every year then we’re
all in good hands.”
– A Patient
College of REgistered Nurses of Nova Scotia Annual Report 2014
Jacquelyn Garden-Jayasinghe
Council President Profile
A graduate from the Dalhousie University School of
Nursing with both a Bachelor of Nursing and a Masters
of Nursing, Jacquelyn works as a nurse practitioner
specializing in the treatment of hypertension in addition
to being Council President of CRNNS.
“Getting involved with CRNNS has given me a
wonderful opportunity to feel connected to my
profession and my nursing colleagues in a new way,”
says Jacquelyn. “It’s shown me that we all play a role in
providing safe and quality nursing care to the public.
I’ve seen throughout my career how much more we
can accomplish as nurses when we get involved, work
together, and are united as one profession.”
Jacquelyn Garden-Jayasinghe joined CRNNS as
Council President in July 2014 upon being elected
into the position by her peers. With a nursing career
spanning 29 years, Jacquelyn has made significant
contributions not only to the nursing profession in Nova
Scotia but to the countless clients she has cared for
over the years.
A passionate advocate for the important role nurses play
in health care, Jacquelyn has always believed that she
could use her voice to contribute to sustain and advance
the role of registered nurses and nurse practitioners in
Nova Scotia. She learned early in her career that selfregulation supports the provision of safe, quality care
and that nurses have an opportunity to participate in a
self-regulated profession and to help contribute to a
strong and vibrant future.
“Most of us began our careers because we wanted to
help people and I find myself always returning to that
sentiment in my role as Council President,” she explains.
“The public are at the heart of CRNNS’ work and their
mandate is to ensure the public is protected. Their
needs and expectations are as essential to CRNNS as
they are to nurses and my goal is to strengthen that
relationship and connection with Nova Scotians.”
As President, Jacquelyn’s goal is to engage with RNs,
NPs, and the public at every opportunity. Positive about
the future of nursing, Jacquelyn has been instrumental
in work that supports re-igniting pride in the profession,
engaging nurses in solution-focused approaches, and
empowering her colleagues to be decision-makers in
health system change.
23
College of REgistered Nurses of Nova Scotia Annual Report 2014
Committee Reports
Professional Conduct Statutory Committees
Central to regulating registered nursing practice in
Nova Scotia with public protection as our top priority,
we receive, investigate, and dispose of complaints we
receive about the conduct, competence, health or
behaviour of an RN or an NP licenced to practice in
Nova Scotia.
Complaints are received and reviewed by the CEO
who forwards the complaint to the Professional
Conduct department for appropriate action. Four
statutory committees are involved in the professional
conduct process and work towards complaint
resolution:
• Complaints Committee
• Professional Conduct Committee
• Fitness to Practise Committee
• ReInstatement Committee
In 2014, 55 complaints were received by CRNNS,
which involveded just .006% of our licenced members.
This is a slight increase from 2013 when we received
44 complaints and a decrease from the 73 complaints
received in 2012.
Sources of complaints
• Employers/Managers: 33%
• CRNNS: 29%
• The Public: 24%
24
• Colleague: 9%
• Department of Health: 3%
• Self-report: 2%
Complaints Committee
Members: Lorna Khan (Chair), Charlene Murphy
(Vice-Chair), Valerie Banfield, Fred Beaton, Garland
Brooks, Douglas Bungay, Kimberly Clark, Daphne
Connolly, Dannie Currie, Melissa Currie, Valerie
Eden, Kim Fleming, Carolyn Fowler, Ethel Gunn,
Allison Hodder, Kristine Kempton, Sue Laroche, Bill
Lawlor, Deborah Linton, Emerson MacDonald, Ronald
MacPherson, Debora Mander, Maria Marshall, Jill
Morse, Kate Muir, Ken Nason, James Pritchett, Lora
Robers, Suzanne Sheppard-Jackman, Michele Steele,
Heather Wood.
The role of the Complaints Committee is to review all
complaints not resolved by the CEO and dispose of
them in accordance with the Regulations. A panel of
the Complaints Committee, made up of two nurses
and one public representative, acts as a screening
committee by resolving less serious complaints
and referring serious allegations of professional
misconduct, incompetence, incapacity, or conduct
unbecoming the profession to a Professional Conduct
Committee.
In 2014, this Committee met to consider 18
complaints against 16 nurses with the following results:
Dismissal1
Non Disciplinary Resolution (counsel,
caution, informal resolution)
12
Licensing Sanction (consent reprimand,
conditions and/or restrictions)
2
Approval of Request to Voluntarily Resign
1
Referral to a hearing before the PCC
2
Professional Conduct Committee
Members: W. Brian Smith (Chair), Sandra
MacPherson-Duncan (Vice-Chair), Camilla Benoit,
Kenneth Bowes, Barb Campbell, Ramon Cansanay,
Glenda Carson, Sharon Chafe, Jacklyn Clark, Jeanette
Combes, Barbara Darby, Susan Gouthro, Agnieszka
Grabowska-Comeau, Linda (Lyn) Hale, Kara Henman,
Christine Hines, William Hodder, Linda Hutchins,
Evelyn Kennedy, Sarah Leathley-Britain, James
Maclean, Wendy Miles, Deidre Mombourquette, Janet
Purvis, Jennifer Riis, Elaine Rivers, Erin Sarrazin, Paula
Wadden, Joanne Zevenhuizen.
The Professional Conduct Committee conducts
formal professional conduct hearings into the
allegations referred by the Complaints Committee. A
College of REgistered Nurses of Nova Scotia Annual Report 2014
panel of the Professional Conduct Committee hears
evidence to determine whether one or more of the
allegations against a nurse can be proven true, and
if so, whether such proof amounts to a finding of
professional misconduct, conduct unbecoming the
profession, incompetence and/or incapacity. If one
of these findings is determined then the Committee
must decide on the appropriate licensing sanction.
This committee resolved seven complaints against
four nurses, resulting in:
Reprimand and 6 month suspension
Reprimand and suspension until
re-entry program completed
Consent revocation of licence and registration
The Fitness-to-Practice Committee determines
whether a registered nurse is suffering from a
medical, physical, mental, or emotional condition,
disorder or addiction that is affecting, or could affect,
her or his practice. The committee also determines
what action may be necessary to protect the public.
In 2014, this committee approved one revised
Remedial Agreement permitting a nurse to return to
practice with conditions and restrictions.
Reinstatement Committee
1
2
1
Fitness-to-Practice Committee
Members: Cindy Cruikshank (Chair), Michele Steele
(Vice-Chair), Carol MacEachern, Lindsay Burke,
Heather Spencer-Benoit, Christina Vardy, Fred
Beaton, William Hodder.
Members: Cyndee MacPhee (Chair), Marian
MacLellan, Carolyn Fowler, Kelly Lackie.
The Reinstatement Committee hears applications
from individuals seeking reinstatement of their
registration or lience to practice nursing after
having their registration or licence revoked by
a Professional Conduct Committee.
The Committee did not receive any
applications for reinstatement in 2014.
25
College of REgistered Nurses of Nova Scotia Annual Report 2014
Committee Reports
Statutory Committees
Education Advisory Committee
Members: Jo-Anne MacDonald (Chair), Courtney
Breen, Garland Brooks, Duana d’Entremont, Anita
Ferguson, John McNeil , Willena Nemeth, Ruth
Martin-Misener, Kimberly Newton, Mary van Soeren,
Ruth Whelan, Audrey Watson.
The Education Advisory Committee (EAC) advises
and makes recommendations to Council on
establishing the standards for nursing education
programs; and approves, conditionally approves
or denies approval of baccalaureate, nurse
practitioner and nursing re-entry programs.
In 2014, Council approved the EAC recommendation
to approve the Cape Breton University Bachelor
of Science of Nursing BScN, 4-year Program
for five years until September 30, 2019 with
recommendations to be addressed in their annual
progress reports. EAC also reviewed the 2014
Annual Progress Reports from three Nova Scotia
baccalaureate, one nurse practitioner, and two nursing
re-entry programs.
Approval of university nursing education programs
supports the CRNNS mandate of public protection
26
by assuring that graduates of Nova Scotia nursing
education programs have the competencies to
practice nursing at an entry level.
Interdisciplinary Nurse
Practitioner Practice Review
Committee
Members: Keith Cockersell (Chair), Paulette
Anderson, Cindy Planetta, Sheila Higgins-McGray,
Lena MacDonald, Barbara Currie, Sandra Duke,
Darla MacPherson, Kim Hebert, Nancy Edgecombe,
Dermot Jardine, Douglas (Gus) Grant, Shelagh
Campbell-Palmer, Marsha Campbell-Yeo, Connie
Venedam Marchand.
The Interdisciplinary Nurse Practitioner Practice
Review Committee (IDPRC) reviews the
practice of NPs through a quality monitoring
and improvement program (NP-QMP). This
program supports NPs to improve their practice by
providing them with performance feedback from
health provider colleagues and clients.
In 2014, the IDPRC undertook a comprehensive
review of the first five year cycle of the NP–QMP,
including the program’s strengths and opportunities.
Based on survey and focus group feedback from NP
participants, program improvements were made to
the survey tools, methods and survey reports. The
past year, a new five year cycle of the program began
with 17 NP participants. The results of the 2014 NPQMP™ continued to demonstrate that 99.4% of the
NPs’ performance indicators were rated as meeting or
exceeding expectations.
The IDPRC supports the CRNNS mandate of
regulating NP practice in the public interest by
providing NPs with the information they need to
reflect on ways to improve their delivery of client care.
Nurse Practitioner Committee
Members: Ruth Martin-Misener (Chair), Marsha
Campbell-Yeo, Dawn Chubbs, Nancy Edgecombe,
Geralynn Hirsch, Debbie Roach.
The Nurse Practitioner Committee is established
by legislative authority to conduct competence
assessments for nurse practitioners when a nurse
practitioner has changed practice settings, or is
working with a different client population, or a
competence assessment is otherwise required by
the Act or Regulations.
College of REgistered Nurses of Nova Scotia Annual Report 2014
Standing
Committees
In the 2014, NP Committee members conducted
competence assessments of seven nurse practitioners who
were changing their patient populations and/or practice
settings. The results of these assessments are as follows:
• Three NPs met the required competencies without having
to complete a clinical practicum or case studies;
• Four NPs successfully completed a competence
assessment review by assessors.
Registration Appeal Committee
Members: Loretta Manning (Chair), Elizabeth Cooper,
Agnieszka Grabowska-Comeau, Daphne Connolly,
Trudy Campbell, Amy MacDearmid, Rosalind Benoit,
W. Brian Smith.
Committee Reports
Awards Selections Committee Members:
Marian Mac Lellan (Chair), Kathy LeBlanc,
Clare Currie, Angela Clifton & Colleen MacNeil,
Ruth Whalen, Kelly Lackie, Rebecca Dorey
Committee on Appointments Members:
David Samson (Chair), Ruth Whelan, Cameron Boys,
Tim Guest
Nominations Committee Members:
Peter MacDougall (Chair), Carolyn Power, Judy Bailey
Braden Davie
The Registration Appeal Committee, appointed by
Council, meets to consider requests from applicants
that request a review of CRNNS’ decision to deny
registration or licensure as a registered nurse or nurse
practitioner in Nova Scotia.
There were no registration appeals heard by the Committee
in 2014.
27
College of REgistered Nurses of Nova Scotia Annual Report 2014
Independent Auditor’s Report
Grant Thornton LLP
Suite 1100, 2000 Barrington Street
Halifax, NS B3J 3K1
T (902) 421-1734
F (902) 420-102648
www.GrantThornton.ca
To the members of the
College of Registered Nurses of Nova Scotia
We have audited the accompanying financial statements of the College of
Registered Nurses of Nova Scotia, which comprise the statement of financial
position as at December 31, 2014 and the statements of operations, changes in
net assets and cash flows for the year then ended, and a summary of significant
accounting policies and other explanatory information.
Management’s responsibility for the financial statements
Management is responsible for the preparation and fair presentation of these
financial statements in accordance with Canadian accounting standards for
not-for-profit organizations, and for such internal control as management
determines is necessary to enable the preparation of financial statements that
are free from material misstatement, whether due to fraud or error.
Auditor’s responsibility
Our responsibility is to express an opinion on these financial statements based
on our audit. We conducted our audit in accordance with Canadian generally
accepted auditing standards. Those standards require that we comply with ethical
requirements and plan and perform the audit to obtain reasonable assurance
about whether the financial statements are free from material misstatement.
An audit involves performing procedures to obtain audit evidence about the
amounts and disclosures in the financial statements. The procedures selected
depend on the auditor’s judgment, including the assessment of the risks of
material misstatement of the financial statements, whether due to fraud or error.
28
In making those risk assessments, the auditor considers internal control relevant
to the entity’s preparation and fair presentation of the financial statements in
order to design audit procedures that are appropriate in the circumstances,
but not for the purpose of expressing an opinion on the effectiveness of the
entity’s internal control. An audit also includes evaluating the appropriateness of
accounting policies used and the reasonableness of accounting estimates made
by management, as well as evaluating the overall presentation of the financial
statements.
We believe that the audit evidence we have obtained in our audits is sufficient
and appropriate to provide a basis for our audit opinion.
Opinion
In our opinion, the financial statements present fairly, in all material respects,
the financial position of the College of Registered Nurses of Nova Scotia as at
December 31, 2014, and the results of its operations and its cash flows for the
year then ended in accordance with Canadian accounting standards for not-forprofit organizations.
Halifax, Canada Chartered
Accountants
April 14, 2015
College of REgistered Nurses of Nova Scotia Annual Report 2014
Statement of Financial Position
Statement of Operations
College of Registered Nurses of Nova Scotia
College of Registered Nurses of Nova Scotia
Year ended December 31
2014
2013
Revenue
Membership $5,156,550 $4,258,681
Investment income
133,128 131,233
Other 293,814276,024
5,583,4924,665,938
Expenses
Administrative 276,148220,009
Interagency 547,965543,234
Legislated services
2,201,8312,212,223
Member services 2,084,7181,713,629
Premises 364,664353,380
Amortization of property and equipment
64,169 68,130
Loss on disposal of property and equipment 4,795
5,544,2905,110,605
Excess of revenues
over expenditures
(expenditures over revenues) $39,202 $(444,667)
December 31
2014
2013
Assets
Current
Cash and cash equivalents
$130,922$ 502,645
Short term investments (note 4) 4,914,1826,223,591
Receivables 100,726 110,103
Prepaids
24,397 30,801
5,170,2276,867,140
Long term investments (note 4)
Property and equipment (note 5)
3,368,5451,602,579
177,076 194,449
$8,715,848$ 8,664,168
Liabilities
Current
Payables and accruals (note 6)
$646,163$ 618,796
Deferred revenue 4,069,9434,086,856
4,716,1064,705,652
Deferred lease incentive
Retirement benefits (note 7)
11,860 14,706
305,234300,364
5,033,2005,020,722
Net assets
Net investment in property and equipment 177,076 194,449
Net investment in liquidity reserve
1,065,7721,019,859
Unrestricted
2,439,8002,429,138
3,682,6483,643,446
$8,715,848$ 8,664,168
Commitments (note 9)
On behalf of the Council
See accompanying notes to the financial statements.
29
Statement of Changes in Net Assets
College of Registered Nurses of Nova Scotia
Year ended December 31
Investment inInvestment
property and
in liquidity
2014
2013
equipment
reserveUnrestrictedTotalTotal
Net assets, beginning of year
30
$
194,449 $
Excess of revenues over expenditures
(expenditures over revenues)
Purchase of property and equipment,
net of disposals
Transfers (from) to liquidity reserve
Net assets, end of year
$
See accompanying notes to the financial statements.
$
2,429,138 $
(64,169)
-
46,796
-
-
1,019,859
45,913
$
4,088,113
103,371
39,202
(444,667)
(46,796)
-
-
(45,913)
-
-
3,643,446
177,076$ 1,065,772 $ 2,439,800$ 3,682,648 $ 3,643,446
College of REgistered Nurses of Nova Scotia Annual Report 2014
Statement of cash flows
Notes to the financial statements
College of Registered Nurses of Nova Scotia
Year ended December 31
College of Registered Nurses of Nova Scotia
December 31
2014
2013
Increase (decrease) in cash and cash equivalents
Operating
Net income (loss)
$39,202$(444,667)
Amortization
64,169 68,130
Amortization of deferred lease incentive
(2,846) (2,846)
Loss on disposal of property and equipment
4,795
Increase (decrease) in retirement benefits liability
4,870(64,940)
Change in non-cash operating working capital
(note 8)
110,190(444,323)
136,425449,534
26,235 893,857
Investing
Purchase of investments, net
(456,557) (53,155)
Purchase of property and equipment
(51,591) (37,733)
1. Nature of Operations
The College of Registered Nurses of Nova Scotia (the “College”) is the
professional regulatory body for registered nurses and nurse practitioners
licensed to practice in Nova Scotia. The College is a non-profit organization
exempt from tax under paragraph 149(1)(L) of the Income Tax Act and,
therefore, is not required to pay income taxes.
2. Change in Accounting Policies
In fiscal 2014, the College adopted the provisions of the CPA Handbook, Part
III – Accounting Standards for Not-for-profit organizations, Section 3463 Reporting employee future benefits by not-for-profit organizations.
The adoption of this section did not result in any adjustments to the previously
reported assets, liabilities, net assets, or revenues over expenditures of the
College. The transition did not result in any adjustments to the statement of
cash flows. (508,148)(90,888)
Net (decrease) increase in cash and
cash equivalents
(371,723) 358,646
Beginning of year
502,645 143,999
Cash and cash equivalents
End of year
See accompanying notes to the financial statements.
3. Summary of Significant Accounting Policies
These financial statements have been prepared in accordance with Canadian
accounting standards for not-for-profit organizations (“ASNPO”). The
significant accounting policies are detailed as follows:
$130,922$ 502,645
31
Notes to the Financial Statements
College of Registered Nurses of Nova Scotia
December 31
Fund accounting
The accounts are maintained in accordance with the principles of fund
accounting. This method ensures observance of restrictions, if any, on the use
of the resources by maintaining separate accounts for each fund. Funds that
have limitations placed on their use by internal or external parties are classified as
restricted.
The following provides a brief description of each fund group:
• The unrestricted fund is for general operating funds.
• The net investment in liquidity reserve represents an estimate of three months
of operating expenditures net of non-cash and externally funded expenditures
allocated to fund a future wind-down or contingencies.
• The net investment in property and equipment is the balance in capital assets
less associated amortization.
Financial instruments
Initial measurement
The College’s financial instruments are measured at fair value when issued or
acquired. For financial instruments subsequently measured at cost or amortized
cost, fair value is adjusted by the amount of the related financing fees and
transaction costs. Transaction costs and financing fees relating to financial
instruments that are measured subsequently at fair value are recognized in
operations in the year in which they are incurred. Financial instruments consist
of cash and cash equivalents, receivables, short term and long term investments,
payables and accruals and deferred revenue.
Subsequent measurement
At each reporting date, the College measures its financial assets and liabilities at
cost or amortized cost (less impairment in the case of financial assets), except
for investments held, which are measured at fair value. The financial instruments
measured at amortized cost are cash and cash equivalents, receivables, payables
and accruals and deferred revenue.
32
For financial assets measured at cost or amortized cost, the College regularly
assesses whether there are any indications of impairment. If there is an indication
of impairment, and the College determines that there is a significant adverse
change in the expected timing or amount of future cash flows from the financial
asset, it recognizes an impairment loss in the statement of operations. Any
reversals of previously recognized impairment losses are recognized in operations
in the year the reversal occurs.
The College’s main financial instrument risk exposure is detailed as follows:
Credit risk
Credit risk on financial instruments is the risk of financial loss occurring as a
result of default or insolvency of a counterparty on its obligations to the College.
The College’s credit risk is primarily attributable to receivables. Receivables are
managed by closely monitoring delinquent contributors and ensuring that any late
payments or deviations are investigated.
Liquidity risk
Liquidity risk is the risk that the College will not be able to pay financial
instrument liabilities as they come due. The College’s liquidity risk from financial
instruments is its need to meet operating requirements for payables and accruals.
The majority of assets held by the College are invested in securities that can be
readily disposed of as liquidity needs arise.
Market risk
Market risk is the risk that the fair value or future cash flows of a financial
instrument will fluctuate because of changes in market prices. For purposes
of this disclosure, the College segregates market risk into three categories:
interest rate risk, currency risk and other price risk. The College is not exposed to
significant currency or other price risk.
College of REgistered Nurses of Nova Scotia Annual Report 2014
Notes to the financial statements
College of Registered Nurses of Nova Scotia
December 31
Interest rate risk
• The College is exposed to interest rate risk through the cash and interest
bearing investments held. The College manages its portfolio investments
based on its cash flow needs and with a view to optimizing its interest income.
The investments held as of December 31, 2014 are invested in guaranteed
investment certificates, treasury bills, and mutual funds with fixed interest
rates ranging from 1.75% - 4.4% with maturity dates between February 2015
to October 2018. Sensitivity to a plus or minus 1% change in rates would not
have a significant effect on the College’s operations.
Cash and cash equivalents
Cash and cash equivalents include cash on hand and balances with banks.
Investments
Investments are carried at quoted market value. Gains or losses on sales of
investments are recognized as investment income in the year of disposal.
Property and equipment
Property and equipment is recorded at its original cost and subsequently
measured at cost less accumulated depreciation. Property and equipment is
depreciated over its estimated useful life. Management reviews estimates of
the useful lives of property and equipment and adjusts the estimates as required. Management regularly reviews assets for impairment and adjusts as necessary.
Property and equipment is depreciated over the estimated useful life of the asset
using the methods and rates as follows:
Computer software
and hardware
Office equipment
40% declining balance
20% declining balance
Leasehold improvements are being amortized using the straight-line method to
the end of the lease term.
Deferred revenue
All fees collected or receivable as at year end, which relate to future fiscal years,
are recorded as deferred revenue.
Deferred lease incentive
The deferred lease incentive is amortized on a straight-line basis over the term of
the lease.
Employee future benefits
The College has a number of defined benefit plans that provide benefits to
its employees. These include: the Post-retirement health subsidy benefit,
Retirement allowance and participation in Nova Scotia Health Employees’
Pension Plan.
The College accounts for the Post-retirement health subsidy benefit and the
Retirement allowance using the immediate recognition approach. These plans
are unfunded. The cost of pension benefits earned by employees are actuarially
determined using the projected benefit method.
The College accounts for participation in the multiemployer Nova Scotia Health
Employees’ Pension Plan as a defined contribution plan. The College is not
obligated for any unfunded liability, nor does the College have entitlement to any
surplus that may arise in the plan. Contributions to this plan are required by both
employees and the College. Total contributions made by the College during the
year were $225,697 (2013–$209,991) and are recognized as an expense in the
period.
33
Notes to the financial statements
College of Registered Nurses of Nova Scotia
December 31
Revenue
Membership fees
Revenue from membership fees are recognized on an accrual basis as the related
services are provided.
Investment income
Investment income consists of interest income and realized and unrealized gains
on investments. Interest income is recognized on an accrual basis.
Realized gains or losses on sale of investments are the difference between the
proceeds received and the cost of investments sold.
Unrealized gains or losses on investments represent the difference between
the carrying value at the year end and the carrying value at the previous year
end or purchase value during the year, less the reversal of previously recognized
unrealized gains and losses in respect of disposals during the year.
Other income
Income related to projects and professional development are recognized as the
related services are provided.
Use of estimates
The preparation of the financial statements in conformity with ASNPO requires
management to make estimates and assumptions that affect the reported
amounts of assets and liabilities at the date of the financial statements and the
reported amounts of revenues and expenses during the reporting period. By their
nature, these estimates are subject to measurement uncertainty and the effect
on the financial statements of changes in such estimates in future periods could
be significant. Items subject to significant management estimates include useful
lives of capital assets.
34
Allocation of expenses
The College allocates its general IT, finance and human resources support
expenses across administrative, legislative and member services. These allocations
are determined annually based on the estimated amount of time the individuals
within these support areas are working in each functional area. The amount
allocated to each functional area is listed in note 11.
4. Investments
20142013
Total investments
Less: Investments maturing
within the next year
$ 8,282,727
Long term investments
$ 3,368,545
$ 7,826,170
(4,914,182)(6,223,591)
$ 1,602,579
Total interest income earned during the year is $89,371 (2013 - $145,077).
5. Property and Equipment 20142013
AccumulatedNet bookNet book
Costdepreciation
value
value
Furniture and fixtures
$ 424,985
Leasehold improvements
75,457
Computer equipment
189,952
Computer software
21,130
$ 337,069
35,384
146,677
15,318
$ 534,448 $ 177,076 $ 194,449
$ 711,524
$ 87,916
40,073
43,275
5,812
$ 98,722
42,313
45,810
7,604
College of REgistered Nurses of Nova Scotia Annual Report 2014
Notes to the financial statements
College of Registered Nurses of Nova Scotia
December 31
6. Payables and Accruals
20142013
employed, the retiring allowance will be paid to the employee’s beneficiary or
estate. No allowance is paid to a member who terminates employment prior to
eligibility for benefits. The most recent actuarial valuation of this plan was as of
December 31, 2013. The next valuation will occur on December 31, 2015.
Trade
$ 250,003
$ 117,638
Information pertaining to the College’s defined benefit plans are as follows:
Miscellaneous
104,569156,104
Government remittances
291,591345,054
Defined benefit obligation
20142013
$ 646,163
$ 618,796
7. Retirement Benefits
Post-retirement health subsidy benefit
Employees are eligible for a post-retirement health subsidy program if the
employee retires directly from active status after age 60, has been employed by
the College for a minimum of ten continuous years and is enrolled in the Health
Association of Nova Scotia Health Plan. The benefit is equal to 65% of the
monthly premium of either single, couple or family coverage as charged by the
Health Association of Nova Scotia Retirement Health Plan. This subsidy ceases
upon the retiree reaching age 65. The most recent actuarial valuation of this plan
was as of December 31, 2013. The next valuation will occur on December 31,
2015.
Retirement allowance
Employees retiring after the age of 60 and who have been employed by the
College for a minimum of ten continuous years are eligible to receive a retirement
allowance. The allowance is equal to one weeks’ pay for each year of full-time
service, to a maximum of 30 weeks. If an eligible employee dies while actively
$
58,282
$ 65,469
246,952234,895
$ 305,234
$ 300,364
Post-retirement health subsidy benefit
Retirement Allowance
Total
The defined benefit costs recognized during the year are as follows:
Employer current
service cost
Finance cost
Defined benefit cost
Retirement AllowancePost Retirement
2014 201320142013
$ 27,125
9,371
$ 18,791
9,612
$ 5,548 $
2,170
4,832
2,523
$ 36,496
$ 28,403
$ 7,718 $
7,355
Remeasurements and
other items
$ 20,994
$
1,386
$ 4,613 $ (17,540)
35
Notes to the financial statements
College of Registered Nurses of Nova Scotia
December 31
Actuarial assumptions used in measuring the benefit cost and accrued benefit
obligations include the following:
Discount rate for
benefit expense
Rate of compensation
increase for benefit expense
Retirement AllowancePost Retirement
2014 201320142013
3.5%
3.5%
3.9%
3.5%
3.6%
3.5%
Change in non-cash operating working capital
Receivables
Prepaids
Payables and accruals
Deferred revenue
3.5%
20142013
$
9,377
$ (42,499)
6,404(3,130)
27,36734,913
(16,913)904,573
$ 26,235
$ 893,857
9. Commitments
The College has entered into various lease agreements for premises and
equipment. Minimum payments required over the next five years for the base
rent of the premises lease and equipment leases are as follows:
36
2015
$ 385,941
2016392,834
2017391,475
2018399,762
201965,923
4.1%
8. Supplemental cash flow information
10. Government Contributions
During the year, the College received government contributions as follows:
Nova Scotia Department of Health - Nursing School Transcripts
Nova Scotia Department of Health - Nova Scotia Telehealth
Nova Scotia Department of Health Controlled Drugs & Substances
NP Education
Deferred contributions, beginning of year
Deferred contributions, end of year
Government contributions earned
during the year
20142013
$ 14,400
$ 14,400
72,00072,000
28,000114,40086,400
93,60093,600
93,60093,600
$ 114,400
$ 86,400
Of the total government contributions earned during the year, $86,400 (2013 $86,400) is recognized in membership revenue while the remainder of $28,000
(2013 - $Nil) is recognized in other revenue.
College of REgistered Nurses of Nova Scotia Annual Report 2014
Notes to the financial statements
College of Registered Nurses of Nova Scotia
December 31
11. Allocation of administrative expenditures
MemberLegislatedTotalTotal
services
servicesAdministration
2014
2013
Finance and human resources
Information technology
$ 108,608
173,214
$ 108,608
173,214
$ 108,608
173,214
$ 325,824
519,642
$ 313,995
373,634
$ 281,822
$ 281,822
$ 281,822
$ 845,466
$ 687,629
12. Comparative figures
The financial statements have been reclassified to conform with the
financial statement presentation adopted for the current year.
37
CRNNS Staff
exeCuTiVe offiCe
Sue Smith, CEO & Registrar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
Shelley Farouse, executive assistant . . . . . . . . . . . . . . . . . . . . . . . [email protected]
hillary maceachern, communications consultant. . . . . . . . . [email protected]
Jane Wilson, communications consultant. . . . . . . . . . . . . . . . . . . . . . [email protected]
Corporate Services
Colleen Arnold, Director . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
Sheri MacLellan, Corporate Services Assistant . . . . . . . . . . . . . . . [email protected]
Karen Mahoney, Multimedia Designer . . . . . . . . . . . . . . . . . . . . . [email protected]
Susan Crowe, Finance Officer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
Song Peng, Technology Applications Specialist . . . . . . . . . . . . . . . . . . . [email protected]
Lee Whynot, Technology & Information Systems Officer . . . . . . . . [email protected]
Lidia Zykova, Records Management Analyst . . . . . . . . . . . . . . . . . . . . [email protected]
Policy, Practice & Legislative Services
Teri Crawford, Director . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
Jennifer Best, Practice Consultant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
Clare Brown, Practice Consultant . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
Darlene Martin, Administrative Assistant . . . . . . . . . . . . . . . . . . . . . [email protected]
Lynn Miller, Policy Consultant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
Crystal Morgan, Administrative Assistant . . . . . . . . . . . . . . . . . . . . [email protected]
Elizabeth Parenteau, Policy Consultant . . . . . . . . . . . . . . . . . . . . [email protected]
Paula Prendergast, Policy Consultant . . . . . . . . . . . . . . . . . . . . [email protected]
Professional Conduct & Registration Services
Heather Totton, Director . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
Karen Boutilier, Administrative Assistant . . . . . . . . . . . . . . . . . . . . [email protected]
Ann Marie Cameron, Registration Officer . . . . . . . . . . . . . . . . . [email protected]
Matthew Lafond, Professional Conduct Consultant . . . . . . . . . . . . [email protected]
Krista Mosher, Registration Services Assistant . . . . . . . . . . . . . . . . [email protected]
Darlene Mott, Professional Conduct Consultant . . . . . . . . . . . . . . . . . [email protected]
Elizabeth Parenteau, Professional Conduct Consultant . . . . . . [email protected]
Cathy Rose, Policy Consultant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [email protected]
Shelly Spears, Registration Services Assistant . . . . . . . . . . . . . . . . . . [email protected]
Haley Young, Administrative Assistant . . . . . . . . . . . . . . . . . . . . . . . [email protected]
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