On my first visit to Clinic Santé Kildare I was showered with welcoming smiles, the atmosphere of a friendly and reassuring environment, and enthusiastic promises of the opportunity to work at the Best GMF clinic in Montreal. Today, two weeks into working here in my “newfound home”, I am happy to admit that I am savoring each moment of being a part of such a cohesive and supportive multidisciplinary team. While holding a belief that many of us, primary care nurse practitioners (NP), have to deal with a range of fears and anxiety when first stepping into our field I cannot overemphasize the importance of the work environment.
As a relatively new profession in Quebec we face numerous challenges due to the lack of public awareness. While NPs have been successfully practicing in US for over 40 years in Canada there are few people that are familiar with our profession. All provinces and territories currently have legislation in place for the NP role however the level of autonomy of the nurse practitioner varies greatly province to province. Quebec was one of the last provinces to introduce NPs. It was not until 2003 that we had our official legislation. Is it any surprise then that the very first primary care NP graduates could be counted on the fingers of one hand – only 3 in 2007?! Meanwhile, in July 2010, Quebec announced it will spend $117 million to boost the number of nurse practitioners from 56 to 556 before 2018. In 2012 we almost made it to 100.
Increasing the numbers is great, but what about public awareness?! The media has dubbed our profession “super-nurse”. I do not know how that is helpful. Every time I introduce myself or mention my title to a patient or a health care professional it feels like one interaction is merely not enough to shed some light on the whole scope of our role and responsibilities. Some patients still think I am a doctor; I am not. Others believe that nurses and nurse practitioners are one and the same… yet another misunderstanding. Although we do start off as registered nurses, we have a minimum of two years of clinical experience in primary care, and receive graduate level education and training. To become a nurse practitioner upon successful completion of the Graduate Diploma Primary Care Nurse Practitioner program we are required to pass the advanced practice licensing exam of the Order of Nurse of Quebec. We work in collaboration with clients partnering physicians and other health-care providers in the provision of high-quality patient-centered care.
We are not there to replace nurses or doctors! We are there to integrate our in-depth knowledge of advanced nursing practice and theory, health management and health promotion, disease and injury prevention to provide comprehensive health services. The application of these equips us with necessary skills to
· make a diagnosis i.e. to identify a disease, disorder or condition;
· communicate the diagnosis to the client and other health-care professionals as appropriate;
· initiate, order or prescribe consultations and referrals (with some limitations);
· order and interpret screening and diagnostic tests (with some limitations);
· recommend, prescribe or reorder drugs (with some exceptions).
We can also help the residents who don’t have a family doctor to get primary care. As NPs we are trained to look at the person and his or her lifestyle and work together on a strategy that not only addresses the illness but also ensures illness maintenance and prevention.
You would certainly agree that for Canada’s health-care system, which faces long wait times and a shortage of doctors and money, this is a good thing. We all hope that spending health-care dollars on more nurse practitioners will help bridge the gaps in the system.