“Super nurses”: months of waiting before practicing

From 50 to 75 “super nurses” who have completed their training will have to wait at least until November before being able to practice independently because discussions persist about the final exam which, in principle, they must undergo.

The College of Nurses of Quebec (OIIQ) confirms that discussions are underway to “review the content” of the final exam. A proposal to this effect will be submitted to the College’s Board of Directors, which is expected to settle the matter by the end of April. If the proposal is endorsed, the new Specialist Nurse Practitioner (SPI) final exam will be rolled out in November,learned.

Claude Latulippe, who was a nurse in Quebec from 2002 to 2015, completed her IPS training in Ontario in 2015. She still lives in the west end of Montreal, but practices in a family medicine group in Hawkesbury. She now wants to continue her practice of IPS in Quebec, even if the salary is $ 20,000 less per year.

In 2018, she completed 210 hours of unpaid internship in Quebec in order to have her skills recognized, as required by the OIIQ. In May, she planned to take the final exam to finally obtain her right to practice in Quebec. “But here we wait … I’m floating,” she says.

An exam or not?

In December, the OIIQ announced its intention to eliminate the final exam, which is mandatory for all IPS who complete their university education. According to the Order, the skills of the IPS were already evaluated many times during the 950 hours of training they must spend during their training. The OIIQ wanted the IPS to obtain their specialist certificate at the same time as their diploma, without having to pass an exam.

President of the Association of Specialized Nurse Practitioners of Quebec, Christine Liberty believes that whereas the IPS of the province come, after years of waiting, to obtain the right to diagnose certain diseases, withdraw the examination “can send a funny message.

Ms. Latulippe works in the same clinic as her husband, general practitioner Jean-Claude Landa. The latter is more than satisfied with the presence of IPS in his clinic. “I just took in 900 patients from a colleague who leaves. I almost double my practice. Without the IPS, I could not have. They do many things that help me a lot, “he says.

“We are open to the format of the exam changes. But we want a specialist certificate. This is a form of recognition of the rigor of training. ”

– Christine Liberty, President of the Association of Specialized Nurse Practitioners of Quebec

The Order of Nurses of Quebec states that it has changed its position and wishes to maintain the final exam. But rather than reevaluating the skills of future IPSs, one would like to test their knowledge of professional dimensions, such as ethics.

By the time the new examination procedures are established, the 50 to 75 specialized nurse practitioners who were expected to attend the May exam will retain their “IPS candidate” status. As a trainee, an IPS candidate can practice in some settings, but not independently.

Spokesperson for the Department of Health and Social Services, Marie-Claude Lacasse said that the file is closely monitored “since it will determine the date of entry into function of the IPS.” However, it specifies that the MSSS is not concerned about the situation as IPS candidates will be able to join the health network and “exercise certain conditions”.

Jean-Guy Rochon consulted with Ms. Latulippe because he is struggling to control his sugar levels and has back pain. After prescribing medications and recommending physiotherapy for back pain, Ms. Latulippe consulted with Dr. Landa on what would be the best medication option to control this patient’s sugar.

“Like two separate countries”

For Ms. Latulippe, there is an urgent need to facilitate the certification process for SPIs, especially for Ontario SPIs that would like to come to work in Quebec. “It’s illogical that the requirements are so complicated,” she says. M me Latulippe particular that the IPS Ontario have far more autonomy and flexibility in their practice than in Quebec.

“Why are our skills not more easily recognized? If it were easier to return, other Quebec IPS, who came to work in Ontario in recent years, may want to come back to Quebec. Currently, it’s like two separate countries. ”

– Claude Latulippe, IPS

M me Lalibert√© also calls for the OIIQ “works to standardize practice” IPS across the country and to facilitate their mobility. “In Canada, we have the same title, but not the same rights,” she says. M me Lalibert√© stressed among others that all Canadian provinces except Quebec have the same standardized final exam. “We could go to that,” she says.

IPS Ontario-Quebec: some differences

In Quebec, since February, IPS can diagnose six chronic diseases (diabetes, hypertension, hypercholesterolemia, asthma, chronic obstructive pulmonary disease and hypothyroidism) as well as any current health problem related to their specialty. In Ontario, they can take care of patients and have no diagnostic limit.

Number of IPS:

Quebec: 500

Ontario: 3500

Ontario’s GPIs earn about $ 20,000 more per year than Quebec


SPIs in Quebec must obtain 75 credits at the master’s level. It takes two to three years. To qualify for this training, they must also have worked 3360 hours as a nurse. In Ontario, the master’s degree of an IPS lasts one year. Candidates must have previously worked at least two years as a nurse.

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