A rapprochement between nurses with diplomas and nurses with degrees

At Georgian College, like many other institutions, there are two tiers of nursing education. There is the 2½-year practical nursing diploma program that leads to a registered practical nurse, or RPN, and the four-year bachelor of science in nursing, which leads to a registered nurse, or RN. Those two worlds collide on campus and on the job, where practical nursing professors Kim Jagos and Jaqueline Limoges wondered if there was anything they could do about the simmering tension between the two. Pay-scale differences are part of the problem—RNs are paid more than RPNs—and when tasks overlap on the job, resentment can build. And that friction can affect patient care.

“Higher education has been used to convey higher standards of knowledge and legitimacy,” Limoges explained at the annual meeting of Colleges and Institutes Canada earlier this year, where the team received a research award for teaching, learning and student success. “We knew the students were having some tensions.” If the degree program was seen as more legitimate, then the RPNs might feel undervalued and disenfranchised. In a recent interview, Jagos said some students come into nursing programs with preconceived notions about RNs and RPNs. “We need to train them a little bit more about how they are socialized as two different professions and how they will work together.”

So the professors gathered interviews and reflective writing from 270 participants at two joint RN and RPN educational events. The students were nervous to come together, but there was a “very different flavour” among those who had participated.

The researchers continue to present their work at conferences, and it is evolving to encompass faculty at the school. Jagos hopes it will be used to improve the nursing curriculum. “How can we move forward to train our upcoming nurses differently so that maybe those problems don’t exist at the same level?” she said. The distrust needs to be addressed, “because you know it comes down to patient safety at the bedside.”

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