B R I T I S H C O LU M B I A C O L L E G E O F N U RS I N G P RO F E S S I O N A L S

NEW APPLICANTS

Committees are critically important to enable the British Columbia College of Nursing Professionals (BCCNP) fulfill its statutory mandate. BCCNP’s board strives to ensure committees benefit from a variety of skills and experience needed to make good decisions. Information collected from a completed Expression of Interest (EOI) form is used to support the board’s appointment of committee members.

The college functions with two kinds of committees: regulatory and board support. Some committees are composed of mostly board members. Visit the Committees web page to learn more about each specific committee. To be considered for appointment to a BCCNP committee you need to submit this EOI form. Thank you for your interest.

Privacy notice and consent to disclose personal information

Expression of Interest

Privacy

The British Columbia College of Nursing Professionals (“BCCNP”) collects, uses, discloses, stores and retains personal information in compliance with the Freedom of Information and Protection of Privacy Act (FIPPA).

The personal information you provide when submitting this EOI to BCCNP is being collected and will be used by BCCNP to assess your qualifications and suitability for the position(s) you apply for as a potential committee member. The collection of this personal information is permitted under section 26(c) and (e) of FIPPA. Your personal information will be retained in accordance with BCCNP’s Records Retention and Disposition Schedules.

The personal information you provide when submitting this EOI may be disclosed by BCCNP to others, but only in accordance with the consent to public disclosure that you give by complet-ing and submitting this EOI to BCCNP (see below for details) or as authorized or required by law.

Consent to disclose personal information

By completing and submitting this EOI, you are providing BCCNP with consent to disclose to the public, for transparency and accountability purposes, the following personal information

that BCCNP collects or has collected about you in this EOI or otherwise: name; place of residence (city, town or other munic-ipality); registration class or classes (current and historical), if applicable; committee/board service or experience; employment history, education credentials; and, any memberships or affilia-tions. Your consent for this public disclosure is effective on and from the date that BCCNP Board appoints you to a committee.

Please check this box to confirm that you have read and understood this privacy notice, and that you consent to the disclosure of your personal information as described above.

NOTE: If you do not check the box, your expression of interest will be deemed incomplete and will not be considered.

Choose one of two options to send in your completed EOI:

1. Type in your response directly into the fillable fields on the following EOI form using Adobe Acrobat.

a. Save and name your PDF document and email a copy as an attachment to governance@bccnp.ca

OR

2. Create a new WORD document and type out your responses to all the questions asked on the EOI into a new MS Word document

a. Save and name your WORD docu-ment and email a copy as an attach-ment to governance@bccnp.ca

After emailing your EOI

• You will receive an email confirming re-ceipt within 3-5 business days; contact governance@bccnp.ca if you have any concerns/questions

• Submitted EOI forms are retained on file

• If your interest changes, email governance@bccnp.ca to advise.

• All new appointees are notified by email when they are appointed

• New appointees are contacted by the committee liaison to coordinate orien-tation and onboarding

The Nominations Committee reviews EOIs received as part of the annual committee appointment process each Fall, with the Board confirming appoint-ments at its January board meeting. If a committee vacancy or urgent need occurs, your EOI may be reviewed before the annual appointment process.

Questions or concerns about BCCNP’s privacy practices? Please contact the BCCNP Privacy Officer:

Privacy OfficerBCCNP900 – 200 Granville Street, Vancouver, BC, Canada V6C 1S4Tel: 604-742-6200Email: privacy@bccnp.ca

For general information on BCCNP’s privacy policy, please consult the BCCNP Privacy web page.

Instructions

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Street address* City* Postal code*

Telephone* Primary email*

LPN NP RN RPN

Member of the public BCCNP registrant

First name* Last name*

Preferred first name

*REQUIRED

Committee Candidate Information Candidates are responsible for updating BCCNP staff as soon as any information provided below changes.

If a BCCNP registrant, provide your Registrant ID # and select all categories that apply to you:

Discipline

Education Program Review

Finance & Audit

Inquiry

Nominations

Nurse Practitioner Exam

Professional Practice & Standards

Quality Assurance

Registration

PERSONAL INFORMATION

CURRENT PLACE OF RESIDENCE

SELECT ONE OF THE FOLLOWING

PLEASE INDICATE WHAT REGULATORY COMMITTEES YOU HAVE PREVIOUSLY SERVED ON

PLEASE INDICATE ON WHICH COMMITTEES YOU WOULD LIKE TO SERVE

one year two years three years

Education credential(s)

Profesional designation(s)

Please indicate the duration of time that you would like to serve on the committee.

COMMITTEE TERM

ADDITIONAL INFORMATION

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Employer

Position (title)

Unit/facility/area (if you’re a registrant)

Please indicate any memberships or affiliations you hold with professional associations or organizations.

Name of association/organization Position

Name of association/organization Position

Are there any relationships or interests — paid or voluntary — that could compromise, or be perceived to compromise, your

ability to be appointed to a regulatory committee?

No Yes If yes, please describe below

Would need significant help and access to

technology

Would need help and access to technology

Would need some assistance but comfortable learning new

technology and using technolo-gy in my work and personal life

Comfortable working with and learning new technology.

Significant use in my work and personal life.

Able to work with and can teach/assist others

in using technology.

EMPLOYMENT

MEMBERSHIPS, AFFILIATIONS, CONFLICTS OF INTEREST

TECHNICAL COMPETENCIES

BCCNP committees meet in a variety of settings. Committee members will need to access our secure IT system to participate

fully in committee activities. Committee members should be prepared to have access to current technology and devices and

have a high degree of confidence in using technology or be willing to learn. Using the following scale, enter the number that

best describes your proficiency with technology

Why do you want to serve on a BCCNP Committee? Please limit your answer to 200 words.

INTENTION

1 2 3 4 5 Low Proficiency Somewhat Proficient Proficient Very Proficient Expert

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In April 2019, the BCCNP Board approved the Committee Composition Matrices upon the recommendation of the BCCNP Governance Committee. These composition matrices include values, core competencies, diverse perspectives, and specialized skills and experi-ences that will benefit the work of the committees in the context of the regulatory environment in which BCCNP currently operates.

The values articulated by the Board are critical in ensuring that committee members have a clear understanding of BCCNP’s public protection mandate, are willing and able to work in collaboration with others, and positioned to lean in to the opportunities and challenges the Board and college are facing.

Annually, the Board approves composition requirements for each of its committees and for the Board itself. Read the composition requirements.

The following values and attributes are articulated for the Board and all the committees:

PERSONAL VALUES AND ATTRIBUTES

Accountability, honesty, and integrityAct with integrity and speak the truth, be able and willing to take full responsibility for decisions, and follow through on commitments.

AdaptabilityAppreciate that, at times, plans will adjust to meet changing circumstances and needs.

CollaborationRecognize that, in a complex system, what can emerge as a result of meaningful engagement and dialogue will be stronger than what is created in isolation.

HumilityBe open to new ideas, new perspectives, and new ways of doing things, always bringing a learning mindset to decision-making.

Inclusivity Create an environment and culture that welcomes diverse per-spectives, new partners and new ideas.

Objectivity Be able to self-reflect and make decisions based on evidence and good information, to best fulfil the public mandate.

Public ServiceHave compassion for the public and their right to safe, ethical care, demonstrated by an understanding and appreciation of, and commitment to, the public protection mandate and the time required to execute the role diligently, recognizing that public interest will always be prioritized over personal or professional interests.

Respect Be able to work with others effectively, and appreciate different perspectives and opinions, while fostering and promoting, not impeding or stifling, robust dialogue.

Self-AwarenessHave a clear understanding of personal strengths, areas of development and potential biases, remaining open to reflection, feedback, continuous growth and improvement.

How do you embody these values in your work and personal life? Please limit your answer to 200 words.

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DIVERSE PERSPECTIVES

CultureA variety of cultural and historical backgrounds and experiences, that reflect the community the College serves and the cultural context within health care.

EducationA variety of educational backgrounds and experiences that re-flect the diverse public served by the College.

First NationsFirst Nations and Indigenous voices, embedded within the College’s governance structure, to ensure that deliberations are informed, and decisions include and respect First Nations per-spectives, that biases are identified and questioned, and that the College’s collective work continues to grow in its cultural safety and humility journey, contributing to positive systemic change.

Gender DiversityA variety of perspectives to support decisions that are balanced and relevant.

RegionRegional diversity, to reflect the reality that practice, access to healthcare, and the public’s expectations of the health care system varies throughout the province.

Registrant PracticeDiverse practice experiences, backgrounds and specialities that inform dialogue and decision-making, ensuring decisions meet in-tended objectives, are practical and, ultimately, protect the public.

SectorDiverse leadership experience in the public, private, healthcare, and not-for-profit sectors to promote knowledge and the sharing of best practices.

In order to support strong decision-making in the public interest, Committees will bring the following diverse experience, backgrounds and perspectives:

Please explain what diverse perspectives, experience and background you would bring to the committee? Please limit your answer to 200 words.

A variety of competencies and skills are required to make our committees function. A few examples include: past board or committee

experience, understanding of regulation, specialized practice, remote practice, accounting experience.

You can see the specific competencies required by each of the BCCNP committees by looking at our board-approved committee

composition matrices.

Please explain why you feel you can make a valuable contribution to BCCNP committees or the specific committee you are inter-

ested in. What specific experiences, skills and perspectives do you bring that will enhance BCCNP committees? Please limit your

answer to 200 words.

COMPE TENCIES & SKILLS

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SUBMIT TING FORM — Choose one of two options to send in your completed EOI:

I, (name) ____________________________________________________of (address) _____________________________________________________________

agree that by submitting this expression of interest form to BCCNP by email on (date) __________________________________________ that

I am electronically signing it.

DECL AR ATION

1. Save and name your PDF document and email a copy as anattachment to governance@bccnp.ca

2. Save and name your MS Word document and email a copyas an attachment to governance@bccnp.ca

Thank you for your expression of interest!