As a nurse, you may face problems that impact your practice. The focus of this resource is to present a process for addressing problems that cannot be resolved at the individual level and must be forwarded to the employer.
BCCNM encourages a collaborative approach to resolving professional practice problems. The goal is safe, competent and ethical care for clients.
What is a professional practice problem?
It’s any problem or situation that:
- puts clients at risk; and
- interferes with meeting BCCNM’s Standards of Practice, employer guidelines and policies, or other clinical standards.
What are your responsibilities?
Nurses and employers have responsibilities in the workplace.
Nurses
- meet Standards of Practice;
- take action when problems impact client care; and
- communicate and collaborate with employers to resolve problems.
Employers
- examine situations and work with nurses to resolve problems, once they have been informed about them; and
- provide resources and support so that nurses can meet the Standards of Practice.
Consider the problem
The first step to resolve a problem is to clarify the nature of the problem and how best to approach it.
Ask yourself:
- How does the problem put clients at risk? What specific examples can you give?
- How does the problem conflict with BCCNM's Standards of Practice and/or employer guidelines and policies?
Communicate the problem
Now that you have clarified the problem, it’s vital to communicate it. Start with verbal communication.
Verbal communication
- Ask your manager for a meeting to discuss the problem
- Explain how the problem puts clients at risk and conflicts with BCCNM’s Standards of Practice or employer guidelines and policies
- Be specific, factual, include all relevant information, and respect client confidentiality
- Listen with an open mind to your manager’s perspective and pay attention to any new information the manager provides
- Be prepared to work together to resolve the problem, recognizing that some negotiation and compromise may be necessary
- Work together to confirm the next steps
After your meeting, follow up in writing with your manager. Send your manager a summary of what was discussed, the response received, and the next steps you agreed upon.
Written communication
Clearly and concisely document your communication. Keep a record of all correspondence.
- Treat all documentation as confidential
- Use a workplace form, letter or, memo (see "Resources"), workplace form and send in a secure manner
- Include your manager’s name and title in this formal communication
- Start with a general opening statement such as: “This is a follow up to our discussion of ...”
- Describe the problem: date, time, place, who was involved (use initials for names), what happened, how it affected clients, what specific
- Standards were reviewed and referenced
- Include possible solutions
- Ask for confirmation that the correspondence has been received and request a response by a specific date, allowing a reasonable amount of time for progress to occur
Resolution is not always immediate
Continue to work within the system to improve client care.
- If you do not hear back by the specified date, follow up with your manager (“What is happening with the problem?”)
- If the problem has not been addressed, send a second memo or letter to the same person, re-state the problem, include any new information, attach the first correspondence, and request assurance that the problem will be addressed.
- Your manager may not be able to resolve the problem. Be prepared to take your concerns to the next level of management.
- You may work with your manager to take the problem to the next level or you may take the issue forward yourself, advising the manager of your plan.
- It is important to again ask for a meeting at the next level to communicate your concerns, and then to follow up with written documentation.
At any time in this process, you can contact a
BCCNM regulatory practice consultant.