P.E.I. Nurses' Union says no need for nurse practitioners to have their own union

As their role in health care continues to grow, nurse practitioners across Canada are looking to Alberta, where nurse practitioners recently formed their own union — but on P.E.I., the nurses' union that represents them says it's doing its job. 

During a recent Health P.E.I. meeting, Island nurse practitioner Darci Leggatt said compensation for nurse practitioners is "underwhelming" and "patchy," adding that she hopes a new contract will better reflect their increasingly important role in looking after Islanders. Currently, nurse practitioners are represented by the P.E.I. Nurses' Union.

Nurse practitioners are registered nurses with extra training, which lets them order tests, prescribe medication, manage chronic diseases and make referrals to specialists.

"They find themselves underrepresented, their priorities ignored, and [with] insufficient clout to make any change to their working conditions," said Anne Summach, the first president of the first standalone nurse practitioner union in Canada, the Alberta Union of Nurse Practitioners, in a recent interview with CBC Radio: Island Morning's Mitch Cormier. 

Summach said nurse practitioners from other provinces have been reaching out to her group, asking how to begin the process of organizing. 

'Their priorities are diluted'

A nurses' union is the wrong place for nurse practitioners, the Alberta union said, because it focuses on the needs of registered nurses, who perform a very different role in health care than nurse practitioners do.   

I think we have the capacity here to become the gold standard for nurse practitioners right across Canada.— Barbara Brookins, P.E.I. Nurses' Union

"They have a unique set of skills, responsibilities, a unique scope of practice," says David Froelich, the executive director of the Alberta union's bargaining unit.

"Their priorities are just diluted, if not lost, in the overall nurses' union." 

P.E.I. has about 100 nurse practitioners and more than 1,400 nurses. In Alberta, there are 500 to 600 nurse practitioners and a union representing 30,000 nurses. 

The P.E.I. Nurses' Union says it believes it is doing a good job representing the Island's nurse practitioners as well as its nurses, and there's no need for a separate union. 

"On P.E.I. we have a very specific local, or section of our union, that is all nurse practitioners, for the very reason that we wanted to ensure that they all had the capacity to collaborate amongst each other," said P.E.I. Nurses' Union president Barbara Brookins.

She added there are nurse practitioners at all levels of the union, including some involved in the collective bargaining process: "They are very much in position to be able to voice their issues and their concerns to both the union and the employer." 

Brookins said nurse practitioners on P.E.I.  also have the backing power of the other 1,440 nurses in the union. 

NPs taking over doctors' practices

Yet she acknowledges some P.E.I. nurse practitioners are frustrated because there is a lack of understanding of their value in the health-care system. 

"For years, we have not recognized that they are taking over physician practices, they are working autonomously in their own practice, they are working in clinics and covering for patients that don't have primary-care providers right now," Brookins said. "People don't realize that." 

The P.E.I. Nurses' Union is currently preparing a public awareness campaign to better explain nurse practitioners' role, as well as where they're working. 

Meanwhile, the union is preparing to go to the bargaining table with the province in the new year, since their current agreement ends in March. 

"We will certainly be going into our bargaining process looking for — call it pay equity, call it equal or comparable compensation for comparable work" for nurse practitioners, Brookins said. 

Separate union 'hard row to hoe'

"What happened in Alberta I think might be difficult to duplicate anywhere else," said Froelich. He notes nurse practitioners had been excluded from the province's labour act and thus were not represented as part of any union for the past 20 years. 

His advice to nurse practitioners in other provinces: Get legal help and a lobby group to advocate with local governments that have input with labour boards, and mount a public awareness campaign. 

The Alberta Union of Nurse Practitioners said that after organizing, there's now more legitimacy to their work and advocacy. 

"Previously, if anyone in government met with you, it was a favour, whereas now they're required to consider what your views are. You're a valued and legitimate member of the group which can inform policy at the upper government level," Summach said. 

"It's a hard row to hoe, but it's worth it," she said. 

Prince Edward Island nurse practitioners make about $58 to $68 an hour. In Alberta, they make a similar salary, but Summach said they believe the rate should be higher, to line up with nurse practitioners' responsibility in their increasingly key role. 

But Brookins said that to get what they want on P.E.I., "I don't think they need a lobbyist. They do have a union." 

She said they'll be looking to get nurse practitioners compensation packages that are better than elsewhere in Canada.

"I've yet to see one of them tell me Alberta is the gold standard. That's not coming forward to our office at all… I think we have the capacity here to become the gold standard for nurse practitioners right across Canada."