Renewal is now closed. If you missed the December 1 deadline:

Click here to reinstate.

October 9, 2024

Uncategorized

Creation of the Undergraduate Nurse Employee Position: Benefits and Opportunities

Back in 2021, we worked together with the College of Registered Psychiatric Nurses of Manitoba (CRPNM), the provincial government, and health system employers to enable an opportunity to help put more qualified workers in healthcare, and let those training to become a registered nurses (RN) or a registered psychiatric nurse (RPN) to start working in their field. This culminated in the undergraduate nurse employee (UNE) role.

How UNEs came to be in Manitoba

During some of the height of COVID-19 and major burnout in the health system and many other sectors, the provincial government came to the College, looking to get qualified nursing students into the workforce to help bolster staffing. 

At the time, similar roles were already active in British Columbia, Alberta, and Ontario, providing a framework for what this could look like. 

The role originated in Alberta and had been in place for many years and was seen to have been an effective approach to integrating students into the system and to provide them with practical experience in a safe environment. 

On the College’s side, our team worked on regulation for supervision alongside CRPNM, including creating the Supervision of Undergraduate Nurse Employees resource. 

Our area of responsibility – alongside CRPNM – in the development of the UNE role was to determine how UNEs could perform reserved acts under the current legislation. Performance of a reserved act is restricted to the members of a regulated health profession who are authorized by regulation to perform specific reserved acts, or where it has been delegated to an individual who is being supervised by a member regulated health profession.  

In this case, our focus was on RNs, NPs, and RPNs who are qualified and competent to perform specific reserved acts. Our review indicated that changes to the Colleges’ general regulations were necessary to allow students enrolled in a program to be supervised. 

We also realized at this time that we had not defined supervision and what this would mean for the RNs, NPs and RPNs providing that supervision. Knowing this would be a key question, we developed a practice direction to provide guidance and clarity. 

The employers did the work of creating the job descriptions, pay scale, and supervision system, with input from both Colleges on entry level requirements.

“CRNM and CRPNM worked with employers and the legislative unit at Manitoba Health to ensure that the legislative framework allowed UNEs to practice under supervision. Through this consultation process, the Colleges identified many of the questions that would be asked of both managers and RNs and RPNs when implementing this role, and developed resources to address as many of those questions as possible,” said Deb Elias, CEO/Registrar of the College. “Evaluations of this role have been positive for both UNEs and employers. The role seems to be very popular among students and IENs.” 

The UNE role started with around 60 students but had a lot of room to grow. In 2022, the role was updated to include qualified IEN applicants enrolled in Nurse Re-Entry Program (NREP), helping to reduce financial barriers and providing an opportunity for further clinical experience. 

At the time of the UNE role implementation, Rhonda Cairns RN was the Chief Nursing Officer at Saint Boniface Hospital in Winnipeg. 

“An evaluation of the trial was completed with surveys and interviews of both the UNEs and nursing staff who mentored them. The trial was an overwhelming success and additional UNE positions were created and was later expanded to smaller hospitals throughout the province where the UNE role could be supported,” said Cairns, now Chief of Quality Practice and Deputy Registrar at the College. “The role continues to be popular and in demand across the province.”

The benefits

The UNE role gives employers an opportunity to provide future nurses with great working experiences and a taste of what they can expect. They can attract and retain Manitoba graduates in key areas of the system where they are needed. 

On the other side, UNEs can be paid for gaining hands-on experience in the system, helping to offset costs of tuition or other expenses. They also have a membership with the Manitoba Nurses Union, meaning their work hours count toward seniority.

Some of the feedback received after the role’s launch in Manitoba included: 

  • The UNE role provided additional clinical experience for the nursing student made them feel more prepared for independent practice upon graduation 
  • Students were paid at the LPN salary level, which was a substantial financial win for students, In the following months, there were hundreds of applicants for only a handful of UNE positions 
  • Budgetary concerns from management arose as UNE positions were essentially unfunded positions, so salary costs for certain employers were over budget 
  • Clinical units benefited from the additional hands-on help to assist in providing care to patients, particularly during the pandemic when staffing levels started to decrease

Role clarification

UNEs are third- and fourth-year nursing students and qualified IEN applicants who meet certain requirements. UNEs are unregulated and work under supervision. They are accountable to employers for their actions. 

There is no legislation defining their role, but legislation restricts their roles as some activities are only performed by certain regulated professionals. 

Student UNEs are not allowed to complete a senior clinical practicum on the same unit as they work as a UNE to avoid role confusion.

UNEs’ place in the current system

Implementation of the UNE role is an important part of the College’s collaborative engagement with its partners to help address ongoing health human resources (HHR) challenges in Manitoba. 

This alone won’t solve staffing issues, but as we move forward with our strategic plan and our HHR strategic imperative, we will continue to look for more opportunities like this one to collaborate and learn from our partners, our registrants and the public on how we can help implement meaningful registered nursing practice solutions for Manitoba healthcare.

Read more: