december 2016 practical nursing · tracy olson, lpn consultant, practice education and program...

PRACTICAL NURSINGCOMMITTED TO EXCELLENCE

December 2016

Lindsay Maryniuk, LPN is a member of My Health Team at the Portage Clinic in Portage La Prairie, Manitoba. Read about Lindsay on page 12.

2Practical Nursing | December 2016 | College of Licensed Practical Nurses of Manitoba


TABLE OF CONTENTS

College of Licensed Practical Nurses of Manitoba463 St. Anne’s RoadWinnipeg, MB R2M 3C9Telephone: (204) 663-1212Toll Free: 1-877-663-1212Fax: (204) 663-1207Email: [email protected]

Publications Agreement #40013238

Fragrance-Free NoticeIn response to health concerns, CLPNM has a Fragrance-Free Policy and is a scent-free environment. Please do not use scented products while on the CLPNM premises for work, education, appointments, or other business.

PRESIDENTCheryl Geisel LPN

BOARD OF DIRECTORSDistrict I – Elisa Wiebe LPNDistrict II – Camille Martyniw LPNDistrict III – Rodney Hintz LPNDistrict IV – Lindsay Maryniuk LPNDistrict V – Jodi La France LPNDistrict VI – Patricia Smythe LPNPublic Members – Darlene Barbe

– Tricia Conroy– Judy Harapiak– Diwa Marcelino– Susan Swan

EXECUTIVE DIRECTORJennifer Breton LPN, RN, BN

EXECUTIVE OFFICEVicky BeringExecutive Assistant

Buffi e Babb, B Comm (Hons), CPA, CGABusiness Manager

Renata Neufeld, BA (Hons), MPAConsultant, Policy, Governance and Communications

REGISTRATION DEPARTMENTCarrie Funk, LPNDeputy Registrar

Kathy Halligan, BA (Hons), CTESL, CACEConsultant, Credential Assessment

Dina BeringRegistration Coordinator

PROFESSIONAL CONDUCTDEPARTMENTJanice Benson, LPNConduct Case Manager

RECEPTION AND ADMINISTRATIVE SUPPORTKennedy GagawchukReceptionist

PROFESSIONAL NURSING PRACTICE DEPARTMENTTracy Olson, LPNConsultant, Practice

EDUCATION AND PROGRAM EVALUATION DEPARTMENTBrenda Wohlgemuth, LPN, BAConsultant, Education and Program Evaluation

ADVERTISINGTo advertise in the Practical Nursing Journal, please contact:

McCrone Publications Inc.Email: [email protected] Free: 1-800-727-0782Fax: 1-866-413-9328

2016 Offi ce Closure DatesOffi ce closed 1200hrs December 19.

Offi ce closed 1630hrs December 22, 2016 and re-opens 0930hrs January 3, 2017.

2017 Offi ce Closure DatesJanuary 30

February 20

April 14

April 17

May 22

June 5

June 22

July 3

August 7

September 4

October 9

November 13

Offi ce closed 1200hrs December 22, 2017 and re-opens at 0930hours January 2, 2018

President’s Message 4

Strong Board, Strong Profession 5

Changes to CLPNM’s Electoral Districts 6

Call for Nominations: Board of Directors 7

Nomination Rules 8

Working Together for all Nurses 9-10

My Health Team Member: Lindsay Maryniuk LPN 12-13

New Requirements for Criminal Record, Child Abuse Registry, and Adult Abuse Registry Checks 14-15

Help Inform the Future of Your Profession 17

Ask a PC: Quality Practice Environment 18-19

Ask a PC: CCP Audit 20

Important Information: 2016 CCP Audit 20New Regulatory Bulletin – Continuing Competence Program 21

Practical Nursing Student Scholarships 21

New Competency Documents for LPNs in Manitoba 22

January 2017 Student Registration Renewal 23-24

Can We Reach You? 24

Returning to LPN Practice 26-27

Practical Nursing | December 2016 | College of Licensed Practical Nurses of Manitoba4

PRESIDENT’S MESSAGE

Merry Christmas and Happy New Year to all of our registrants. For this

issue, I am going to veer away from the usual topics and dedicate this

message and journal to a very valuable colleague at the College of

Licensed Practical Nurses of Manitoba (CLPNM) who recently lost her

fi ght with cancer, Barb Palz.

answer anything I asked or thought I needed to know.

Barb became ill the summer of 2015, but did not fi nd out the source until November of that year. She remained resilient and steadfast in her work and interactions with her colleagues. Not once did she let her illness break her spirit. Barb had a positive attitude throughout her diagnosis and treatment, and this positivity remained until her fi nal days.

Barb’s presence at the CLPNM will be noticeably missed, but we will keep her spirit alive by remembering her work ethic, the personality she brought to the work environment, and the personal relationships she developed.

Barb acted in the role of the CLPNM’s Business Manager. She was knowledgeable, forthright, fair, approachable, kind, and had a great sense of humour. I am sure I am missing adjectives to describe her, but in the short time I knew her, these are the qualities I had the privilege to witness.

I fi rst met Barb in 2013 when I became a member of the CLPNM’s Board of Directors. Barb was always welcoming and willing to off er help and guidance. When I entered the position of President in June of 2015, Barb helped me acclimate to the new role. Often I would enter her offi ce with multiple questions, and she would calmly turn around, stop what she was doing, and

– Cheryl Geisel, LPN


Nominations for election to the College of Licensed Practical Nurses of Manitoba (CLPNM) Board of Directors

will be open from December 1, 2016 to February 24, 2017. Elections will be held in the spring, and new Board

members will be announced in June, 2017. You might be thinking about nominating a colleague, or even

putting your own name forward. As you do so, it may help to have some information about the role of the

Board of Directors.

Government of Manitoba through The Licensed Practical Nurses Act, which allows the LPN profession to regulate itself.

Along with the authority to self-regulate, the CLPNM is also vested with the duty to carry out all of its activities and govern its members in a manner that serves and protects the public interest. This means that, while six members of the Board are elected from amongst the LPN membership of the CLPNM, they are not elected to represent their colleagues; they are elected to

The Board is the governing body for the CLPNM. It sets strategic and policy direction, and approves professional standards. It provides oversight to the organization, ensures fi nancial accountability, and acts as the informed voice for those the CLPNM exists to serve: the public.

By participating on the Board, LPNs have an opportunity to directly contribute to the self-regulation of their profession. Self-regulation refers to the authority, responsibility and privilege, delegated by the

serve the public. On occasions when the interests of the public and the interests of one or more LPNs are in confl ict, the interests of the public must guide the Board’s decision. It can be a challenging role, but also a role that is rewarding and that contributes to the respect for and trust in the profession.

What mix of competencies, perspectives and experiences do you think will contribute to a strong Board? Do you know someone who might be ready for the challenge?

STRONG BOARD, STRONG PROFESSION


CHANGES TO CLPNM’S ELECTORAL DISTRICTS

The By-Laws of the College of Licensed Practical Nurses of Manitoba (CLPNM) were revised in June, 2016. The new By-Laws divide Manitoba into two districts for the purposes of elections to the CLPNM Board of Directors. These two districts are:

• within the Winnipeg City Limits, and

• outside of the Winnipeg City Limits.

Prior to June, the Province was divided into six electoral districts for the purpose of CLPNM elections. The new, smaller number of districts is intended

to increase the pool of eligible candidates in each district, thereby increasing choice for voting members. The smaller number of districts will also increase the likelihood that Board members will be elected in competitive elections instead of acclaimed or even appointed, as becomes necessary when there are no eligible candidates nominated. The move to fewer districts will also increase each LPN’s voice by increasing the number of positions on the Board for which they can vote. Maintaining two districts will ensure that the Board is inclusive of LPNs with practice experience from both inside and outside of Winnipeg.

The total number of elected LPN positions on the Board remains the same under the new By-Laws. The Board will continue to include seven LPNs in total: six elected from the districts, and one president elected by and from amongst the LPN Board members. Although the total number has not changed, the distribution of the positions has been adjusted, along with the realignment of the districts.

Here is how the former and the new districts line up:

If your former district was Your new district is Your new district will collectively vote for

Upcoming vacancies will be

• District 6: Winnipeg Region• District 1: The area

within the Winnipeg City Limits

• 2 positions on the CLPNM Board

• One in June, 2017

• One in June, 2018

• District 1: Churchill, Burntwood and Norman Regions

• District 2: Parkland and Interlake Regions

• District 3: Brandon and Assiniboine Regions

• District 4: South Westman and Central Regions, and

• District 5: South Eastman and North Eastman Regions

• District 2: The area outside the Winnipeg City Limits

• 4 positions on the CLPNM Board

• Two in June, 2017

• Two in June, 2018

The revised By-Laws also clarify and simplify eligibility to nominate, run, and vote in CLPNM elections. Prior to the revision, eligibility was in some cases tied to home address and in some cases tied to address of employment. Under the new By-Laws, eligibility to nominate, run and vote will all be tied to the LPN’s primary location of practice.

If you have questions about the new electoral districts and your eligibility to nominate, run for election, and vote, please review the nomination rules on page 8 of this edition of the Practical Nursing Journal, view the full CLPNM By-Laws at http://www.clpnm.ca/about-us/bylaws/ or contact the CLPNM at [email protected], at 204-663-1212, or toll free at 1-877-663-1212.


CALL FOR NOMINATIONS: BOARD OF DIRECTORS

In accordance with Article 5 of the CLPNM By-Laws, election of the Board of Directors shall be held by May 1 each year. The positions of the Directors stated below expire June 5, 2017, and are now open for nomination. All registrants on the active practicing register of the College of Licensed Practical Nurses of Manitoba, whose primary location of practice falls within the electoral District that is accepting nominations, are invited to submit names of nominees:

District 1 – (The area within the Winnipeg City Limits): One vacancy

District 2 – (The area outside the Winnipeg City Limits): Two vacancies

To view the area captured within the Winnipeg city limits, please see here.

Process:A current resume of the nominee must be submitted with the original nomination form by February 24, 2017, at 1630hrs. Forms that are not accurately completed will not be accepted. Please refer to the Nominations Rules for more information.

Nominator Information:We (1) Print: (full name) ____________________________________________________ , Registration Number _____________________

Signature: __________________________________________________________, Date ___________________________________,

(2) Print: (full name) ____________________________________________________ , Registration Number _____________________

Signature: __________________________________________________________, Date ___________________________________,

(3) Print: (full name) ____________________________________________________ , Registration Number _____________________

Signature: __________________________________________________________, Date ___________________________________,

Registrants in good standing on the active practicing register of the College of Licensed Practical Nurses of Manitoba, in accordance with approved Nomination Rules do hereby nominate

(print name) ________________________________________________to represent District _________ on the Board of Directors of CLPNM.

Nomination Acceptance:Note for Nominees: Regular attendance at board meetings is required of all board members. The board is expected to meet six to seven times per year. Future board meeting dates are available on the CLPNM website here. Please ensure that you review these dates prior to accepting a nomination.

I (print name),__________________________________________________, registration number _____________________, a registrant in good standing on the active practicing register of the CLPNM, whose primary location of practice falls within District _______ do hereby accept the nomination for election to the position of Director on the Board of the CLPNM. I declare that I have reviewed the Nomination Rules and I confi rm that I meet the criteria for nomination and for membership on the board, as described therein. I declare that if elected I do hereby consent to serve as a Board Director for the term 2017-2019.

Signed this ____________________________________ day of ______________________________, 20_______.

Signature: ___________________________________________________________________________ (nominee).

http://www.winnipeg.ca/ppd/pdf_files/WinnipegNeighbourhoodsMap.pdf

http://www.clpnm.ca/wp-content/uploads/CLPNMNominationRules.pdf

http://www.clpnm.ca/about-us/board-of-directors/

http://www.clpnm.ca/wp-content/uploads/CLPNMNominationRules.pdf


1. Nomination forms shall be submitted to the CLPNM by the deadline.

2. Each nominee is eligible to run in one electoral district per election.

3. To be eligible for nomination and for membership on the Board of Directors, a practicing registrant must:

a. be registered in good standing with the CLPNM

b. practice within the electoral district in which he or she is seeking nomination

c. not have any union affi liation other than that required for employment

d. not hold an employment position as a manager of LPNs with responsibility for hiring, evaluations, discipline or terminations of LPNs

e. not currently be a member of another regulated health profession

f. not be the subject of an ongoing CLPNM investigation or disciplinary proceeding

g. not have been the subject of a fi nding under The Licensed Practical Nurses Act, and

h. not have been convicted of an indictable off ence.

4. A valid nomination includes:

a. a complete CLPNM-approved nomination form,

b. the signature of at least three (3) CLPNM registrants who are in good standing on the active practicing register and whose primary location of practice falls within the electoral district in which the candidate is nominated,

c. the written consent of the nominee,

d. current resume of the nominee, and

e. a signed declaration of eligibility and consent from the nominee.

5. Nomination forms that have been altered or changed must be initialed by the nominee and by all three (3) nominators in order to be valid.

6. To be eligible, the College must receive all required documents on or before the established deadline date by email or regular mail.

7. If the number of eligible nominees in any electoral district does not exceed the number of vacancies in that district, the nominee shall be elected by acclamation.

NOMINATION RULES

Excerpt from: CLPNM Board Policy BG-4 Nominations and ElectionsPublished: December 1, 2016


The following is a joint article

written by Darlene O’Reilly RN,

Tracy Olson LPN and Ryan Shymko

RPN. This team of three leads the

nursing advisory group and each

works as a practice consultant with

their respective nursing college.

WORKING TOGETHER FOR ALL NURSES:

Manitoba’s Nursing Colleges Team Up to Take on New Legislation

Where We Started

Medical assistance in dying is changing the health-care landscape and we recognized long ago that the impact is broader than just one nursing regulatory body. With a goal to provide a consistent message to all nurses in Manitoba, we knew this was something we needed to work on together.

Before medical assistance in dying became legal in Canada, the three college’s came together to talk about how we collectively could approach this topic. From there, we established the advisory group that has grown

The medical assistance in dying nursing advisory group is made up of members from all three nursing

colleges in Manitoba: the College of Registered Nurses of Manitoba (CRNM), the College of Licensed Practical

Nurses of Manitoba (CLPNM) and the College of Registered Psychiatric Nurses of Manitoba (CRPNM). This

group works together to inform and develop education supports for nursing practice related to medical

assistance in dying.

to include members from all three colleges who work in a variety of practice areas and locations in the province. We respect our collective contribution to health care and are learning together as we guide Manitoba’s nurses through this new legislation.

We started our work in early 2016 and brought the whole advisory group together for our fi rst meeting in June 2016. During the early stages, we produced a joint statement between our three regulatory bodies that explains legislation on medical assistance in


dying and conscientious objection. This statement is still available on each of our college’s websites as an ongoing, up-to-date resource for nurses. Our early work also meant keeping pace with changes in legislation as it evolved, reviewing current literature and following provincial, national and international discussions and challenges that other groups are experiencing.

Where We’ve Been

This past fall, we presented at CRNM’s annual Education Day to share our history, what we’re currently working on and how we’re moving forward as an advisory group. At the event, we took time to explain what conscientious objection means and teamed up in groups to work through hypothetical scenarios where medical assistance in dying may come into play in a nurse’s practice. CRNM’s Education Day is traditionally only available to RNs, but we knew it was important to open this event to all nurses looking to learn more.

While we’re lucky to be a strong team, we’ve defi nitely faced some challenges such as getting everyone to the table for robust discussion and ensuring the messages we provide are applicable to all nurses in all practice areas. What’s been important to our success is having the nurses on the Medical Assistance in Dying Provincial Services Team participating in our meetings and sharing their direct care experiences. We’re also fortunate to have a representative from the Manitoba Provincial Health Ethics Network join our discussion to talk about ethical scenarios surrounding a medically assisted death.

While we can’t always predict what lies ahead, what we do know is that it’s crucial to share our resources, experiences, perspectives and knowledge as we navigate this major change in our health-care system. Working together helps us provide a unifi ed approach, avoids confusion and lowers the risk for miscommunication.

Where We’re Going

As the practice and discussions around medical assistance in dying evolve, we are constantly evaluating our work. We’ve taken feedback from members of the advisory group and are currently working on developing guidelines that nurses and employers can use this year.

Shifting our thinking from our individual silos to a more collective vision has helped us grow as individuals and professionals. Our work has also opened the door further for additional collaboration as we move forward with the Regulated Health Professions Act in the near future.

While it’s an excellent opportunity to come together at this time in history, we feel it makes sense too. Just as interprofessional collaboration improves client outcomes in direct care, we believe our collaborative eff ort will improve outcomes for all nurses and clients.

– Tracy Olson, LPN– Darlene O’Reilly, RN

– Ryan Shymko, RPN


Lindsay Maryniuk is a licensed practical nurse (LPN) who is blazing a trail for other LPNs by taking part in a new model of primary care delivery in the province – My Health Teams. She is part of the My Health Team that is housed at the Portage Clinic in Portage la Prairie, Manitoba. Manitoba’s My Health Team initiative was developed to address the needs of Manitobans by fi lling identifi ed gaps in health care and enhancing accessibility to health care providers. By bringing diff erent health care providers directly to communities, high quality primary care will be more accessible to those who are in need. According to the Government of Manitoba, each health care team has been created to address the needs of the community it serves by providing health care professionals who can support the community’s specifi c needs. As a result, each team will be unique. Their aim is to achieve a future model of primary care delivery that emphasizes accessible, coordinated, comprehensive, and ultimately, consistent quality of care (www.gov.mb.ca). Reducing health care costs and the need for hospital and emergency room visits are also goals of the initiative (Government of Manitoba, 2014).

MY HEALTH TEAM MEMBER: LINDSAY MARYNIUK LPN

Prior to establishing the My Health Team in Portage la Prairie, a steering committee was established to identify gaps and determine the needs of the population. From there, a plan was developed to decide what health care providers could best contribute to the team by meeting the needs of the community. “By doing this, the goal was to create and allow easier access to a family physician and to cut down on wait times (Maryniuk, 2016).

Unfortunately, many people in Portage la Prairie and throughout the Province do not have a family physician. Subsequently, areas of care were lacking. The steering committee in Portage, which includes family physicians from the Portage Clinic, established that prenatal care was a primary area of focus. With the development of the My Health Team, which includes physicians, nurses, dieticians, and social workers, together they are able to provide high-quality primary care for the community. The team off ers a Chronic Disease Education Nurse, a Child and Adolescent Shared Care Clinician, a Registered Dietitian, a Skin and Wound Care Coordinator and a Prenatal Nurse. Lindsay uses her expert knowledge and skills to provide the best possible care to her clients.

Following graduation from Assiniboine Community College in 2010, Lindsay worked at Southport Aerospace where she provided primary health care for the Royal Canadian Air Force pilots. This included physicals, immunizations and fl u clinics. She also practiced at the Portage District General Hospital (PDGH) on the surgical/post-partum unit and then in the labour and delivery department. It was at PDGH on Labour and Delivery that Lindsay gained the knowledge, skills and judgement to fulfi ll her current role as Prenatal Nurse.

Lindsay disclosed that on many occasions she witnessed laboring women transferred out of their community and into Winnipeg because of a lack of prenatal care. When staff at PDGH established that an actively laboring woman had not received any prenatal care, she was deemed to be high risk and transferred to Winnipeg for obstetrical care. She recalls thinking at that time, ‘…if she had prenatal care, we would not have to send her out.’ Lindsay states that pregnancy is not an unhealthy condition, so shared care between a family physician and a multidisciplinary team makes sense. Lindsay stresses that we want everyone in our community to have access to the best quality health care available. By creating the position of the Prenatal nurse and the other positions within


My Health Team, the goal is for the practitioners to have more vacancies to see other clients in the community, and so the community has more access to the physician when the physician really needs to be seen.

According to Lindsay, the clients she initially sees do not have a family physician; therefore, she is the initial contact for these pregnant women. She sees approximately 10-12 new patients each week for whom she conducts an initial comprehensive head-to-toe health assessment, draws blood samples, assesses fetal heart rate (after 12 weeks gestation), as well as provides ongoing prenatal care. She then makes arrangements with a family physician to share care of these clients throughout the pregnancy. She also sees her scheduled patients throughout the day whose care she shares with the physicians; this in turn establishes high quality continuity in care.

Lindsay disclosed that she schedules more time for the initial appointment, so she can sit with the client to provide education or to simply talk, which thereby helps to establish a trusting and therapeutic relationship. She admits that there are occasions when she has to track down her clients when they do not make it to their appointments; however, Lindsay feels it is all

worth it as this assists in building a trusting relationship. But more often than not, she receives calls from clients who specifi cally wish to see her. According to Lindsay, she has received phone calls from previous clients, who want to share with her the news of their newly delivered babies. She feels that there is nothing more rewarding than knowing you helped to get them there.

After the initial visit with a client, Lindsay provides scheduled prenatal care and refers the client to a physician for a medical assessment. If the client is unable to secure a family physician, she is seen by both the physician at the clinic and by Lindsay who coordinates the equal distribution of client referrals to the physicians in an eff ort to alleviate the physicians’ workload while ensuring that prenatal care continues. On occasion, a client will advise that she does not wish to deliver her child in Portage la Prairie and will then request an obstetrician in Winnipeg. Lindsay works with a physician in the clinic to then coordinate the referral to either a specifi c obstetrician, or she attempts to fi nd one who will accept the client and see to her needs. The family physicians and nursing staff at the Portage Clinic are extremely supportive of this newly created role and have made the transition smooth.

My Health Team builds on the strengths of the current health care system, standardizing and supporting further health system changes that enhance accessibility, coordination and quality of primary care (Manitoba Health, 2016). Another initiative being considered is the need for prenatal care in the remote and isolated communities north of Portage la Prairie. By providing members of the My Health Team to these remote areas, pregnant women can receive prenatal education, assessments and care, thereby reducing the number of negative outcomes for both mother and newborn. Thanks to the provincial support of My Health Team, and to nurses like Lindsay Maryniuk, people now have:

• quality, safety and enhanced access to primary care, and

• focused client-centred primary care.

My Health Team connects care providers across geographical boundaries and supports the sustainability of the heath system. “The end result is that we are now able to deliver more babies in Portage la Prairie, rather than transferring mothers to Winnipeg. This is because we have established solid prenatal care that is available in or close to the women of this community” (Maryniuk, 2016).


Confi rming that members of the profession do not have a history of conduct that places the public at risk will add to public protection and confi dence in the profession. It is also consistent with requirements implemented by other regulators in Manitoba and with existing legislative requirements.

The new process will position the CLPNM to meet more stringent legislative requirements, which are expected to come into eff ect in the near future.

What is the existing process?

Currently, CLPNM registrants are directed to provide criminal record checks, and adult and child abuse registry checks at the time of initial registration with the CLPNM. Registrants are also required to answer related self-disclosure questions each year when they renew their annual registration.

What will change?

Beginning in 2017, the CLPNM will verify self-disclosure responses by requiring that a portion of registrants supply updated criminal record, child abuse registry and

The College of Licensed Practical Nurses of Manitoba (CLPNM) will be implementing a new process in 2017 for confi rming that registrants do not have a criminal record, nor a child or adult abuse registry record, which places the public at risk.

adult abuse registry checks to the CLPNM. Those selected must provide the documents to the CLPNM by August 15, 2017 to be eligible to renew their registration for 2018.

Why is this new process being implemented?

The main reason is to strengthen public protection, and trust and confi dence in the profession. Regular checks will also likely be required by provincial legislation that will soon take eff ect. Implementing the process on a small scale in 2017 will allow us to get a head start and sort out any potential process related complications before regular checks are mandated on a broader scale.

Does the new process suggest there is a concern about practical nurses, in particular?

No. Several other Manitoba health professional regulators already require regular checks from their members. The CLPNM expects that regular checks will be mandated for all regulated health professionals with the implementation of new legislation.

NEW REQUIREMENTS FOR CRIMINAL RECORD, CHILD ABUSE REGISTRY, AND ADULT ABUSE REGISTRY CHECKS


Can the CLPNM require me to disclose a criminal record, or record on the adult or child abuse registry?

Being free of a criminal record that places the public at risk is a requirement for registration, as per section 6 of the Licensed Practical Nurses Regulation. The Regulation also requires registrants to provide evidence of all eligibility requirements.

The CLPNM By-Laws further state that registrants must report to the CLPNM, within 30 days, if they are under investigation or have been charged or convicted of any offence under federal law, or of any offence under provincial law (except for The Highway Traffic Act), or if their name has been entered on the adult abuse and/or child abuse registry.

The Executive Director of the CLPNM also has authority, under section 18 of the Licensed Practical Nurses Regulation, to require any information necessary to assess eligibility and suitability for membership in the profession before renewing a registration.

These requirements are in place to protect the public.

Will all LPNs have to submit a criminal record, child abuse registry, and adult abuse registry check?

Eventually, but not in the first year.

In 2017, the CLPNM will require checks from a small percentage (approximately 10%) of registrants, so that we can refine our processes before the requirement is mandated on a broader scale. In following years, it is expected that all registrants will be required to provide up-to-date criminal record, child abuse registry,

and adult abuse registry checks, approximately once every five years.

How will I know if I’ve been selected?

Those required to provide a new criminal record, child abuse registry, and adult abuse registry check in 2017 will be notified early in the year.

How much time will I be given to submit the documents if I am selected for 2017?

Those selected will be provided until August 15th of 2017 to submit the documents. Although this deadline has been set to provide registrants ample time to obtain the documents, the CLPNM strongly recommends applying for them as early as possible in 2017 to ensure backlogs do not impact your ability to meet the deadline, which in turn may affect your registration for 2018.

Those who are directed to submit the documents and do not do so by the deadline may face the following consequences:

• Subject to all late fees

• Referral to CLPNM’s Investigation Committee

• Inability to renew registration for 2018

What if I am selected and I recently provided a criminal record, child abuse registry, and adult abuse registry check to the CLPNM?

CLPNM policy states that these documents are considered valid for six months from the date they are issued. It is your responsibility to contact the CLPNM to confirm whether documents already on file with the CLPNM are still valid.

If I am selected, how do I apply for the documents?

See the CLPNM’s fact sheet on this topic, accessible at: http://www.clpnm.ca/resources-2/

How do I submit the documents?

Once you have applied for and received the documents from the appropriate authorities, you will need to either drop off the original copy (or a copy notarized by a Notary Public) in person at CLPNM, or submit the documents by mail. Please note that faxed, photocopied and scanned emailed copies will not be accepted.

What if I have a criminal record or child/adult abuse registry record that I have not disclosed to the CLPNM?

You will be held accountable for not disclosing it previously. That said, the CLPNM recognizes that having a record does not always mean that the public is at risk. When a criminal or child/adult abuse registry record is identified, the CLPNM carries out an assessment to determine the extent of the risk to the public before taking any further action. In some cases, such as when there has been an absolute discharge or a pardon, the CLPNM may determine that ongoing authorization to practice does not place the public at risk. The full circumstances surrounding each individual case will be considered, and each case may result in a different outcome.

If I have questions or concerns, who do I contact?

Contact us at [email protected], or by phone at 204-663-1212 or 1-877-663-1212 toll free.


Who

The CLPNM is seeking active practising LPNs in good standing with the CLPNM who are willing to volunteer a few hours a week to review and provide feedback on the CLPNM’s draft proposal to the Government of Manitoba, related to the “reserved acts” in the RHPA. Information about the reserved acts and the RHPA is available on the CLPNM website at clpnm.ca/rhpa.

Ideally, volunteer reviewers will include:

• those both new to and experienced in the profession;

• representation from diff erent practice environments (community, hospital, clinics), and

• representation from diff erent communities throughout Manitoba.

What

The role will include:

• reviewing draft documentation on LPN practice and commenting on whether it is consistent with your current practice in Manitoba;

• providing recommendations to enhance or clarify the documentation, or make it more refl ective of current practice, and

• identifying any questions or concerns that may require particular attention as the RHPA and reserved acts are implemented for the profession.

Please note that the role will not include proposing changes in or an expansion of current scope of practice.

Why

The documentation in question will be considered by the Government of Manitoba when it makes decisions about the health care activities it will authorize the practical nursing profession to perform in future, when the RHPA takes eff ect.

Each member of the profession has unique experience and knowledge about the realities and expectations of diff erent

practice environments. By sharing your advice, knowledge and expertise, you can help strengthen the documents that will inform Government decisions about your profession.

When

Over the winter of 2017, the CLPNM will be circulating documents for review and feedback. We estimate this work will be ongoing and sporadic until approximately fall of 2017.

No meetings or travel is expected. Documents will be distributed for review and feedback electronically.

If a need for meetings is later identifi ed, remote participation by teleconference or webinar will be possible.

The CLPNM is seeking members of the profession to provide detailed feedback on documentation about current

LPN practice in Manitoba. This documentation is being developed to support the profession’s transition to The

Regulated Health Professions Act (RHPA).

HELP INFORM THE FUTURE OF YOUR PROFESSION

If you are interested or have questions

Please contact the CLPNM at:[email protected] in Winnipeg1-877-663-1212 Toll Free

Or visit www.clpnm.ca/rhpa and fi ll out an online expression of interest.

www.clpnm.ca/rhpa

http://www.clpnm.ca/lpn-reviewers-wanted/


A: Nurses1 are key contributors to the delivery of quality health care in the ever-changing and demanding health care system. Maintaining quality client2 care and creating a work-life balance can be challenging.

A quality work environment is where goals and needs of both clients and care providers are met while collaborating to meet clients’ individual and optimal health objectives within legal, economical and quality frameworks mandated by the organization(s) and jurisdiction(s) in which care is provided.

The College of Licensed Practical Nurses of Manitoba’s (CLPNM) Code of Ethics (December 2014) serves as one of the foundations for the nurse’s professional practice. Further, the Code of Ethics:

• outlines the nursing profession’s commitment to respect, promote, protect, and uphold the fundamental rights of people who are both the recipients and the providers of health care;

ASK A PRACTICE CONSULTANT: QUALITY PRACTICE ENVIRONMENT

Q: “The morale at my workplace is at an all-time low. Many seem worried about being mandated to work overtime hours because of sick-time and the amount of recent staff turn-over. I am worried about the quality of client care and of our work environment. What can we do to improve our workplace?”

• describes the accepted standards for ethical decision-making, ethical practice, and the professional conduct expected of nurses, and

• provides a framework for professional integrity, accountability, and responsibility.

All nurses, in all roles and settings, are held accountable for understanding, upholding, and promoting the ethical standards of the profession.

The Code of Ethics articulates specifi c values that underpin the ethical standards of the profession. One of these values includes quality work environments.

Undoubtedly, a challenging work environment may have a negative eff ect on the therapeutic nurse-client relationship. Negative consequences of working in a dysfunctional atmosphere may have adverse eff ects on client care and on care providers’ physical and psychological health, which may increase clients’ uncertainties and fears for their well-being.

Safe, competent and ethical client care delivery is a responsibility shared

by nurses, employers, health authorities, regulatory bodies, unions, educational institutions, accreditation organizations, governments, communities and individuals. Leadership is also a shared responsibility and is an essential element for quality professional practice environments.

1 In this article, “nurse(s)” refers to the following CLPNM registrants: licensed practical nurses (LPNs), graduate practical nurses (GPNs), and student practical nurses (SPNs).

2 In this article, “client(s)” refers to the person with whom the nurse is engaged in a professional, therapeutic relationship. The client may also include the natural supports and/or substitute decision-makers for the individual client. The client may also be a family, group/aggregate, or a population residing in a specifi c community.


The public depends on nurses to practice leadership competence by advocating for their health care needs and well-being. An eff ective nurse leader is an individual who elicits input from others to formulate a clear vision of the preferred future, and collaborates with others to make that vision happen. All practitioners are expected to provide leadership in the identifi cation and resolution of professional practice issues. When issues arise, it is important to continue to communicate and work towards a common resolve by:

• clarifying the issue by identifying what type of violation it is (i.e. ethical, labour relations, work environment, etc.);

• using the professional Standards of Practice as a framework;

• being objective and by documenting concerns where appropriate;

• presenting concerns to the appropriate person(s), and

• continuing to work towards resolving the issue.

Nurses, as members of a self-regulating profession, are responsible for knowing the Code of Ethics, are accountable for their actions and decisions, and are answerable to the CLPNM for their practice. It is the expectation that the nurse will:

• participate in creating and maintaining safe and equitable social and economic working conditions in nursing;

• use resources eff ectively and effi ciently when providing nursing services;

• promote a practice environment that supports ethical behaviour and practice;

• advocate for developing, implementing, and evaluating best practice guidelines, and

• promote an environment in which the human rights, values, customs, and spiritual beliefs of the individual, family, and community are respected (CLPNM, Code of Ethics December 2014).

Building an organizational infrastructure that creates a climate that stresses a common mission and core values starts with explicitly stated expectations. These expectations, which may include the following list (but are not limited to it), are:

• eff ective communication and collaborative processes and systems

• health team members who participate in the development of policies, allocation of resources and provision of client care

• suffi cient staffi ng levels to support holistic therapeutic relationships for the delivery of safe, competent and ethical care in accordance with jurisdictional practice standards

• team members who participate in refl ective and professional development practices

Achieving quality and healthy work environments requires a willingness to change with interventions that target underlying workplace and organizational factors. Changes that involve current best practices can be successfully implemented only where there are adequate planning processes, resources, organizational and administrative supports, along with appropriate and shared facilitation. Implementing positive and eff ective changes will make a diff erence for safe, competent and eff ective client care delivery, and for a nurse’s work-life balance.

The CLPNM practice department provides consultation to registrants, employers and other stakeholders regarding LPN practice. The Practice Department may be reached by email at [email protected] or by phone at 204-663-1212 extension 110.


A: Yes. As per 4(2) of The Licensed Practical Nurses Act (the Act); the College of Licensed Practical Nurses of Manitoba (CLPNM) must carry out its duties in a manner that serves and protects the public. Further, section 15 of The Act requires that the CLPNM establish a continuing competence program that provides for the supervision of the practice of licensed practical nursing, and which includes but is not limited to: reviewing the professional competence of members, conducting practice audits in accordance with The Act, and requiring members to participate in programs for continuing competence.

ASK A PRACTICE CONSULTANT: CCP AUDIT

IMPORTANT INFORMATION IF YOU ARE PARTICIPATING IN THE 2016 CCP AUDIT!

Q: “Does the College of Licensed Practical Nurses of Manitoba (CLPNM) have the right to notify my employer if I have been unsuccessful with my Continuing Competence Program (CCP) audit?”

As continuing competence is a requirement for ongoing licensure, licensed practical nurses (LPNs) undergoing the CCP audit are granted provisional registration contingent upon successful completion of the audit. With that in mind, the CLPNM must provide employers with reasonable notice when an LPN in their employment is at risk of having his or her registration revoked as a result of not meeting audit requirements. This ensures employers are able to make any staffi ng adjustments necessary to ensure the public is not at risk. The CLPNM also notifi es employers when

an LPN’s provisional registration has been revoked. Information on CLPNM registration status is deemed public information, as per 7(3) of The Act.

Once the LPN has successfully completed all of the CCP requirements, the CLPNM notifi es the registrant and their employer(s) that the LPN’s registration status is no longer provisional as they have met all of the CCP requirements.

Direction and guidance regarding LPNs’ obligations as members of the profession may be found in the CLPNM’s Regulatory Bulletin: Continuing Competence Program.

The CLPNM will contact you by email to inform you of audit outcomes. It is essential that your email address, and all other contact information on fi le with the CLPNM remain accurate and up-to-date throughout the audit to ensure you do not miss time-sensitive communication that could aff ect your license.

Maintaining accurate contact information is a requirement of all CLPNM members as per the CLPNM By-Laws.

To review the CLPNM By-laws and the CLPNM Regulatory Bulletin: Continuing Competence Program, please visit the CLPNM website.

Information regarding CCP audit timelines can also be found on CLPNM’s website in the CCP Instruction Guide.

http://www.clpnm.ca/about-us/bylaws/

http://www.clpnm.ca/wp-content/uploads/Regulatory-Bulletin-CCP.pdf

http://www.clpnm.ca/wp-content/uploads/Regulatory-Bulletin-CCP.pdf

http://www.clpnm.ca/wp-content/uploads/CCP-Instruction-Guide.pdf


NEW REGULATORY BULLETIN – CONTINUING COMPETENCE PROGRAM

The College of Licensed Practical Nurses of Manitoba’s (CLPNM) Board of Directors has approved a Regulatory Bulletin on the requirements of the CLPNM’s Continuing Competence Program (CCP). The document has been prepared to help clarify the CLPNM’s obligation under legislation to ensure its members’ continuing competence, and LPNs’ corresponding obligation to participate in the program each year.

The requirements of the program have not changed.

All of Manitoba’s LPNs should review the document, which is available at: http://www.clpnm.ca/standards-guidelines/regulatory-bulletins/.

The Licensed Practical Nurses Foundation of Manitoba (LPNFM) will be awarding two $750 scholarships to fi rst year PN students and two $1500 scholarships to second year PN students for a total of $4500.

The scholarships will be presented at the College of Licensed Practical Nurses of Manitoba (CLPNM) annual CLPNM Excellence Awards and Recognition Luncheon on June 5, 2017. The luncheon will take place at the Canad Inns Fort Garry in Winnipeg, Manitoba.

Please be advised that all interested applicants must submit a maximum 1000 word essay on or before Friday, February 24, 2017, at 4:30pm describing why you chose to enter into the nursing profession.

All applications must include:

• Full name

• Address

• Phone number

• PN school name and site where you are enrolled

• Your program start date

• A summary of your recent volunteer and work experience

All applications should be emailed to [email protected] or mailed to:

ATTENTION: Vicky BeringCollege of Licensed Practical Nurses of Manitoba463 St. Anne’s RdWinnipeg MB R2M 3C9

ATTENTION ALL PRACTICAL NURSING STUDENTS

http://www.clpnm.ca/standards-guidelines/regulatory-bulletins/


NEW COMPETENCY DOCUMENTS FOR LPNS IN MANITOBA

The College of Licensed Practical Nurses of Manitoba (CLPNM) has published three documents to assist licensed practical nurses (LPNs), employers and other stakeholders in understanding the competencies of a Manitoba LPN.

Entry-Level Competencies for the Licensed Practical Nurse in Manitoba, 2016, sets out the competencies that today’s LPNs will have upon entry into professional practice in Manitoba. The revised entry-level competencies refl ect the theoretical and practical education, knowledge, skills, judgment, and attitudes required of beginning practitioners to provide safe, competent, and ethical nursing care in a variety of settings to clients across the lifespan.

Nursing Competencies for Licensed Practical Nurses in Manitoba, 2016, provides information about the competencies that fall within the full scope of the practical nursing profession in Manitoba. It replaces

the Competency Profi le for Licensed Practical Nurses in Manitoba, last revised in 2007. The revised nursing competencies for Manitoba LPNs include those that are demonstrated at entry-level, as well as others that may be developed throughout the career of an LPN. It is important to note that no individual LPN is expected to demonstrate all of the competencies set out in this document. Each LPN’s level of competence will be determined by their unique post-basic education, training and experience.

Both documents must also be interpreted in the context of others that guide and limit LPN practice in Manitoba, such as the Standards of Practice, the Code of Ethics and Regulatory Bulletins. For example, the Standards of Practice require that each LPN practice within his or her own level of competence. Therefore, before carrying out any nursing activity, LPNs must self-assess and accept responsibility for ensuring they have acquired the comprehensive

knowledge, judgment and skills needed to perform the activity safely, appropriately, and in the client’s best interest.

The competencies of an individual LPN are an important factor when determining appropriate LPN practice; however, they are not the only factor. For more detailed guidance on how to determine whether an activity or practice environment is appropriate for an LPN in Manitoba, please review the CLPNM’s guide to Determining Appropriate LPN Practice, 2016.

Please visit http://www.clpnm.ca/standards-guidelines/competencies/ to access these documents and for more information.

Please contact the CLPNM with questions at:204-663-1212 1-877-663-1212 toll [email protected]

COMPETENCIES OF THE PRACTICAL NURSING PROFESSION IN MANITOBA

Additional Nursing Competencies

Entry-Level Competencies

• Potential competencies that fall within the scope of the profession.

• Built upon the entry-level competencies.

• Specifi c to an individual LPN.

• Developed through additional education, training and experience.

• Carried out in accordance with professional Standards of Practice, Code of Ethics and Regulatory Bulletins.

• Expected competencies of all entry-level LPNs.

• Common to all beginning practitioners.

• Developed in entry-level education.

• Carried out in accordance with professional Standards of Practice, Code of Ethics and Regulatory Bulletins.

http://www.clpnm.ca/standards-guidelines/competencies/

http://www.clpnm.ca/standards-guidelines/competencies/


How do I know if it is time for me to renew?

The easiest way to confi rm your SPN expiry date is to search your name on the Public Register, which can be accessed by visiting the CLPNM website and clicking on “Find an LPN.” The Public Register will list your registration number, your name, the register you are currently on (student year 1 or student year 2) and your current expiry date.

It is important to note that SPN registration dates directly correspond to the cohort/intake date of your practical nurse education program, and registration is only valid for a maximum of twelve consecutive months. For example, if your classes begin January 4 but your SPN application is not approved until February, your SPN expiry date will be January 4 of the following year as that is when classes for that intake/cohort began. You must remember to renew your student registration yearly and be aware of all deadlines and expiry dates.

How do I renew?

By now you should have received an email from the CLPNM with information on how to renew your SPN registration online. If you have not received this email, please contact the CLPNM right away as it contains important information related to time sensitive deadlines and fees.

What do I need in order to complete my online renewal?

You must complete your SPN registration renewal before your current student registration expires. On the CLPNM website, in the top right hand side of the homepage, you must enter your CLPNM log-in credentials (which were provided to you when your student year 1 registration was approved). Once you have entered into your profi le, you will be able to access the online renewal system.

Additionally, you will need to supply the CLPNM with a notarized copy of your government-issued photo-identifi cation (valid Manitoba Driver’s license or valid Canadian Passport) as part of the renewal process. Your renewal will not be approved without your identifi cation on fi le, and it is your responsibility to ensure that is submitted to the CLPNM prior to the deadlines.

I completed my online renewal; how do I know if it was successful?

Once you have submitted all of the requirements for your student registration renewal, the quickest way to verify your status is to check the online Public Register. If your student registration has been approved by the CLPNM, the Public Register will now say “Student Year 2” with a new expiry date. Additionally, once

In accordance with The Licensed Practical Nurses Act and the Licensed Practical Nurses Regulations, student practical nurse (SPN) registration is mandatory for all individuals enrolled in a College of Licensed Practical Nurses of Manitoba (CLPNM) Board-approved practical nurse education program.

your SPN registration has been approved, which may take up to fi ve business days, you will receive an email from the CLPNM to the email address on fi le. The CLPNM communicates primarily through email correspondence and it is your responsibility to update that information as necessary.

What happens if I am late or do not renew?

The deadline to supply your renewal application, which includes your photo-identifi cation, is four (4) weeks from the date of re-entry into the program. If your completed application is received between four (4) and eight (8) weeks after re-entry, you will be responsible for all late fees in addition to the registration fee. Should your renewal application be received eight (8) weeks after classes have already begun, you will also be subject to an assessment by the CLPNM’s Executive Director and this assessment will cost you an additional assessment fee of $78.75, in addition to the registration fee and the late fee. It is in your best interested to renew early, so the CLPNM can contact you if there are any concerns with your application.

If you do not renew your registration before going out on your clinical practicum, you are not entitled to use the protected title of student practical nurse; any unauthorized

JANUARY 2017 STUDENT REGISTRATION RENEWAL


Keeping your personal contact information up-to-date with

the College of Licensed Practical Nurses of Manitoba (CLPNM)

will ensure you do not miss important information about your

profession, your practice and your license.

The CLPNM’s primary means of communicating with registrants is by email. By email, we send out information on new and revised practice requirements, registration deadlines and other matters that may aff ect your practice and registration. Many other important notices are sent to registrants by regular or registered mail, such as when a registration is at risk of being revoked, suspended or cancelled, or when a condition on a registration is being applied or lifted. The CLPNM also contacts registrants by phone, for example, to gather more information about an incomplete application or to remind applicants of certain time-sensitive requirements that may have been missed.

The CLPNM contacts registrants throughout the year, so it is important that your personal contact information is updated as soon as it changes, even outside of registration season. Under CLPNM By-Law, registrants have an obligation to notify the CLPNM of any changes to contact information throughout the year.

To update your contact information, or to check its accuracy, log into your online CLPNM registration profi le available from clpnm.ca. If you have forgotten your user ID or password for the registration system, fi nd out how to recover them by visiting www.clpnm.ca/about-us/faq/.

CAN WE REACH YOU?

use will be subject to all fees and penalties, which may include a referral to the CLPNM’s Investigation Committee. In addition, if you fail to renew your student registration, you will not be eligible to apply for graduate practical nurse (GPN) registration, nor be eligible to sit the Canadian Practical Nurse Registration Examination.

My registration says it expires at a later date; why do I have to renew now?

For the majority of students this is not the case; however, this happens to students who have left and rejoined a practical nursing program for any reason. All students who are in a practical nursing program in Manitoba have to be on the student register, and your student license has to refl ect your current program year (either year 1 or year 2). If you leave the program for any reason, your registration is immediately cancelled. If you then re-enter the program at another time, you would have to re-register with the CLPNM; when you rejoin a new cohort, you then follow your new cohort’s schedule. That means when your new cohort starts their second year you will too, and you will need a Student Year 2 registration. Renewing at this time is important as it allows you to remain on the register until you are eligible for your GPN registration.

Do you want more information about student registration? If Yes, please visit:

http://clpnm.ca/registration/students-and-graduates/.

http://clpnm.ca/registration/students-and-graduates/


RETURNING TO LPN PRACTICE

Former Manitoba licensed practical nurses (LPNs) who wish to return to practical nursing in Manitoba, must fi rst apply to have their eligibility for reinstatement assessed. A reinstatement assessment is used by the CLPNM to determine whether the length of time the applicant has been away from practice could impact the individual’s readiness to provide safe and competent nursing care.

If an applicant has unresolved issues with CLPNM’s Investigation Committee, Discipline Committee and/or the Board of Directors, these issues must be resolved before being considered eligible to open a reinstatement fi le with the CLPNM. Also, it is important to note that any conditions or restrictions associated with the applicant’s LPN registration prior to leaving the CLPNM register may need to be addressed prior to reinstating, or may be reapplied to the reinstated active practicing registration.

Pre-assessment

The fi rst step in the process is to submit the Reinstatement Pre-assessment Form, which is found on the CLPNM website’s registration page. Based on the information provided, the Registration Department will then email further information and/or the appropriate reinstatement application package to the email address provided by the applicant.

Opening a Reinstatement File

In order to open a reinstatement fi le with the CLPNM, applicants must submit the following items:

• Part 1 – CLPNM Reinstatement Assessment Application Form

• A non-refundable reinstatement assessment fee of $393.75 (includes GST)(Fees are subject to change.)

A reinstatement assessment fi le will not be opened until both the application form and fee have been received and processed by the CLPNM. Any documents received by the CLPNM prior to opening a reinstatement fi le will be held by the CLPNM for 30 days and then will be destroyed.

Required Documentation

Once a reinstatement fi le has been opened, the applicant will have up to six (6) months to ensure all of the following documentation is submitted to the CLPNM:

• Part 2 - Unauthorized Practice Declaration Form

• Part 3 – Verifi cation of Registration Form

o Applicants must provide this form to any regulatory authority that has licensed them to practise a profession in the past seven (7) years. This includes any authority with whom they are currently licensed, and authorities that regulate the practise of other professions in Manitoba or in any other jurisdiction.


• Part 4 - Verifi cation of Hours Form

o Applicants must provide this form to all employers with whom they have been employed as an LPN within the last four (4) years.

• A current Canada-wide Criminal Record Check with a Vulnerable Sector Search

• A current Manitoba-issued Child Abuse Registry Check

• A current Manitoba-issued Adult Abuse Registry Check

Please note that a reinstatement application will only be assessed when all documents have been received; furthermore, documents received by email or fax will not be accepted and all photocopies must be notarized by a Notary Public.

Assessment Process

Once the CLPNM receives all of the required documentation, the Registration Department will assess the fi le to determine the applicant’s eligibility to return to the active practicing register. The

CLPNM may request additional information or documents to assist with this assessment process. Once the assessment is complete, correspondence will be sent to the applicant to the address on fi le with the CLPNM.

Assessment Outcomes

Possible outcomes of the reinstatement assessment may include one (1) or more of the following:

• Notifi cation of eligibility to apply for active practising registration

o Based on the fi ndings of the assessment, if the CLPNM anticipates that conditions will be applied to the registration, the applicant will also be notifi ed at this time.

• A referral for a Clinical Competence Assessment (CCA)

• A referral to the Practical Nursing Refresher (PNR) program

• A referral to other remedial education

1 Offi cial registration decisions of the CLPNM will be communicated in writing. No verbal representations or warranties by any staff of the CLPNM will be binding on the CLPNM or relevant to the assessment process by the CLPNM or any subsequent appeal to the Board of the CLPNM.

• A decision that the applicant is not a suitable candidate for reinstatement

Costs associated with any assessment and/or education are the responsibility of the applicant and are not included in the CLPNM reinstatement fees.

Registration Decision1

Applicants will be notifi ed of all CLPNM registration decisions in writing, and should the reinstatement assessment provide evidence that the applicant is eligible for reinstatement, an enrolment application form will be provided at that time.

For further information regarding the reinstatement process, please visit CLPNM’s website at www.clpnm.ca, contact the CLPNM by email at [email protected], by phone at 204-663-1212 or toll free at 1-877-663-1212.


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