Bachelor degrees may be mandatory for nurses in Quebec one day, but not yet, says the ministry of health. Quebec’s nursing order asked the government in June 2012 to set bachelor degrees as the educational requirement for registered nurses — a level of education that has been in place in the rest of Canada since 1996.
Quebec’s health minister, Réjean Hébert, said the government committee reviewing the request from the Ordre des infirmières et des infirmiers du Québec could not come to a consensus, so for the time being, there will be no change. A three-year college program will remain sufficient to practise nursing in Quebec, Hébert announced Jan. 8.
Despite the government’s decision, Lucie Tremblay, president of the nursing order, says they remain convinced that making bachelor degrees mandatory is the best way to ensure patient safety and the province’s ability to adequately provide care for the next 30 years as the complexity of care increases with advances in technology.
Hélène Ezer, director of the Ingram School of Nursing at McGill University in Montréal, Quebec, agrees that a degree should be necessary. She says the critical thinking skills required by nurses are better taught at the university level. Nurses are independent professionals responsible for their own decisions, she points out. “A lot of people think that doctors are there to review every decision. That’s not the case. Nurses are the front line and need to be able to make decisions in complex situations.”
The government’s decision not to mandate a university degree for nursing was an unfounded political decision, says Ezer. The colleges in Quebec are often the centre of a community, in terms of employment and education, especially outside the major urban centres. “They get tons of funding for their nursing programs. More than universities do,” she says. “When the colleges want something, it puts a lot of pressure on the government.”
Politics played a major role, agrees Patricia O’Connor, director of nursing and chief nursing officer at the McGill University Health Centre (MUHC) in Montréal. “A majority of the nurses in the province believe that the minimum of a baccalaureate degree is required,” says O’Connor. “The ministry of health is very much in support of the idea, but there is too much political pressure.” The issue has been on the table for a number of decades.
Given the government’s plan to emphasize prevention, university education for nurses is vital, says O’Connor. “If you can work with people to prevent the high rates of diabetes, hypertension and cardiac disease, then you will not need as much money in the acute care sector,” says O’Connor. However, primary care is taught exclusively at the university level.
At MUHC, 53% of nurses have baccalaureate degrees; the percentage province wide is only 35%.
The federation of colleges in Quebec, a major proponent of college education, declined an interview request.
Tyler Lorenz, who is studying in the baccalaureate program at McGill, is in favour of having a college program. “In terms of the economic situation, it’s better. There’s actually a nursing shortage and nurses with baccalaureates are more expensive.” For him, it’s worthwhile having a bachelor degree because the beginning wage for university graduates is $5–$6 dollars more per hour than for nurses with a college degree, and there is more opportunity for advancement.
Although Tyler feels he has the necessary knowledge to be a nurse, he wishes he had more hands-on experience. He feels that the college program is better at getting nurses practical experience in the hospital.
Rafaëlle Dubreuil, a nursing student at Cégep André-Laurendeau in LaSalle, Que., confirms that she gets ample practical experience. “You learn a lot of techniques right away and you spend a lot of time in the hospital.”
In Quebec, both degree and college programs for nursing last three years. Given this, Mélissa Alfaro, a second-year nursing student at Dawson College in Montréal, argues that the nursing order’s position doesn’t make sense. The order’s proposal was to maintain the three-year college program, and then require those graduates to do two additional years at university to earn a bachelor’s degree. That would mean students going through the college program would get five years of nursing-specific education, compared to three years for university-only graduates.
“It makes sense to make changes to the nursing programs in Quebec,” says Alfaro, “only because we’re behind the rest of Canada.” However, she added, changes need to be made to both the university and college programs.
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