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Resolving professional practice problems

Using a collaborative approach

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.

Resources

  • Collaborating in resolving professional practice problems tutorial

 Need help?

​​​For further information on the Standards of Practice or professional practice matters, contact us:

  • Email practice@bccnm.ca
  • 604.742.6200 x8803 (Metro Vancouver)
  • Toll-free 1.866.880.7101 x8803 (within Canada only)