Nurse practitioners are part of the solution: ANPEI sets the record straight
CHARLOTTETOWN, July 4 /CNW Telbec/ - The recent suspension of the nurse
practitioner pilot project at the Beechwood Community Health Centre in O'Leary
has generated considerable debate on the role and responsibilities of the
nurse practitioner. The Association of Registered Nurses of Prince Edward
Island (ANPEI) welcomes this debate and says more work is needed to ensure the
successful integration of this university-educated professional in the health
system.
The Beechwood initiative has also raised the need to continue to explore
ways to address barriers to successfully integrating nurse practitioners (NP)
here in Prince Edward Island. While this project has been suspended, there are
lessons to be learned as we move forward. We can also look to other provinces
where nurse practitioners are working well in collaborative practice alongside
family physicians, pharmacists, nutritionists, social workers and other health
care providers.
However, it is evident that Islanders like other Canadians across this
country are losing patience with the health system. They are looking to
governments, policy makers, regulators, administrators and health
professionals to come up with solutions to address the pressing issues of
access and wait times. The results of a Decima poll, commissioned by the
Canadian Nurses Association in April, indicated that 90 per cent of Canadians
felt that nurse practitioners would speed up the time it takes for patients to
be diagnosed and treated.
ACCESS TO PRIMARY CARE PROVIDERS A CONCERN
Access to primary care providers is a problem in PEI. Given that many
Islanders go through a maze of walk-in clinics or physicians-on-call to deal
with day-to-day health problems. As a result, continuity of care and quality
of care can be negatively affected.
It is well accepted in jurisdictions that currently utilize nurse
practitioners that they increase access to care. In fact, an Ontario study
showed that nurse practitioners are capable of handling over 80% of patient
care with the remainder requiring referral to a physician. That same survey
also found that for those who had seen an NP in the past 12 months,
satisfaction rates were high.
We have heard testimonials from clients of the Beechwood Community Health
Centre who acknowledged the tremendous quality of care and satisfaction they
experienced from being cared for by nurse practitioners. Two of the physicians
who left Beechwood have indicated their support of the NP collaborative
practice concept.
Therefore, the nurse practitioner role is well-placed to resolve some of
the current pressures in the health system. The NP role complements other
health care professionals and should not be viewed as a substitute for any
health care provider.
SETTING THE RECORD STRAIGHT ABOUT NURSE PRACTITIONERS
There continues to be a misunderstanding among Islanders of what a nurse
practitioner is. A nurse practitioner (NP) is a registered nurse with
additional education in health assessment, diagnosis, treatment and management
of illnesses and injuries, including ordering of lab tests and prescribing
medications. They work within specific practice guidelines relating to the
health problems they may treat independently, and the tests, treatments, and
medications they may prescribe. Nurse practitioners are university-educated
and licensed to provide services within guidelines.
Examples include diagnosing and treating ear, throat or bladder
infections, common injuries such as ankle sprains, and management of early
prenatal or birth control needs. In cases were care needs extend beyond these
guidelines, such as in a case of abdominal pain suggestive of appendicitis,
nurse practitioners collaborate with the physician to address health needs via
a partnered approach. In this way, nurse practitioners carry the
responsibility and liability for their own decisions and actions.
BARRIERS TO INTEGRATION
We know that the issue of liability has caused considerable concern for
our physician colleagues. Both the Canadian Nurses Association and the
Canadian Medical Association believe in the value of the NP initiative and the
collaborative practice model. They have worked diligently for the past number
of years to address some of the impediments to implementation of this model,
including the issue of liability.
In a joint position statement released in March 2005, these national
bodies acknowledge and address the issue of liability for both physicians and
nurses. The same principles of liability apply in a collaborative practice
model as they do in any health team. Primarily, professionals are always
responsible for their own practice.
To provide coordinated, seamless, quality care each category of
practitioner must respect and rely on the assessment and interventions of
other practitioners on the team. In turn, each practitioner is held to the
practice standard of their profession, and is expected to act in accordance
with their defined scope of practice.
NATIONAL INITIATIVE SEEKS TO INTEGRATE NPS
A major initiative is now underway in Canada to develop a pan-Canadian
framework to promote the sustained integration of nurse practitioners in
Canada. This work is being led by the Canadian Nurses Association through the
Canadian Nurse Practitioner Initiative and is funded through Health Canada's
Primary Health Care Transition Fund. This initiative will be making
recommendations next spring, including recommending collaborative practice
guidelines, a common definition of the NP and ways to overcome barriers to
implementing the role. Work has already been completed on pan-Canadian core
competencies for NPs as well as a pan-Canadian examination.
LET'S WORK TOGETHER
ANPEI is committed to working with its colleagues in the health system as
well as the PEI government to find ways to improve access to health services
in this province. At ANPEI, we see nurse practitioners as one solution. That
is why we are currently working with the Department of Health and Social
Services on draft regulations that will formalize the work of nurse
practitioners. Once approved, ANPEI will assess qualifications of RNs who have
completed approved nurse practitioner programs and provide them with a license
to practice on Prince Edward Island.
For further information: contact: Tina Grznar, (613) 237-2159 ext. 283 |
