Nurse practitioners can help transform health-care system
NPS must be allowed to do more, Hazel Magnussen says.
EDMONTON The Alberta government spends more than 40 per cent of its budget on health care.
“A major reason why Alberta spends more per person on health care than comparable provinces without getting better results is that Ontario and British Columbia have made more progress in transforming their health care systems from a 20th to 21st century model.”
That was the conclusion of the recent Blue Ribbon Panel (Mackinnon) Report on Alberta’s finances. Compared to the “slash-andburn” Klein era of cuts in government spending and services in the 1990s, the Mackinnon Report recommends transformation of healthcare delivery to make it more accessible and sustainable.
Making similar suggestions, the Canadian Nurses Association’s 2012 report, A Nursing Call to Action, recommended that “informed, well-educated and committed nurses’ lead a shift in health care from its emphasis on acute care in hospitals to community primary-care teams focusing on prevention and management of chronic illness.”
The subsequent 2013 report, Registered Nurses: Stepping up to Transform Health Care, included this message: “Nursing interventions make it possible to design a cost-effective health system that is responsive to the evolving needs of the population.”
Effective use of nurse practitioners is part of that transformation. In 2018, the B.C. government announced the creation of 200 new nurse practitioner positions to support health care’s transition to include team-based primary-care teams. Additional funding was also allotted to increase the capacity for training 75 nurse practitioners each year.
In Ontario, nurse practitioners work in nurse practitioner-led clinics providing co-ordinated primary care services that “improve the quality of care through enhanced health promotion, disease prevention and chronic disease management, as well as improve care co-ordination
Nursing interventions make it possible to design a cost-effective health system that is responsive to the evolving needs of the population.
and navigation of the health-care system.”
Nurse practitioners are experienced registered nurses, educated at a master’s level and certified by their provincial/territorial regulatory authority for an expanded role in assessment and management of common health problems. They do not replace or compete with physicians; rather, their work complements medical care and increases public access to health care.
Nurse practitioner training programs were introduced in Canada in the late 1960s to upgrade nurses’ skills to work in remote communities. According to Health Canada, nurse practitioner initiatives ended in the 1980s due to lack of public awareness, lack of support from both medicine and nursing, lack of a remuneration mechanism and applicable legislation.
In the 1990s, with renewed interest in advanced practice, Alberta became the first province to pass legislation for registered nurses providing extensive services and enabled nurse practitioners to work in hospitals and community clinics. In 2006, the Canadian Nurse Practitioner initiative established a framework for the integration of nurse practitioners into the health-care system. The Nurse Practitioner Association of Alberta currently advocates for “a team-based sustainable funding model in Alberta that supports NP implementation in rural areas, community settings, hospitals, home and long-term care.”
In a Sept. 17 Edmonton Journal story, Janet French reported Alberta Health Minister Tyler Shandro’s announcement regarding government funding for 30 new nurse practitioners to increase the availability of nurse practitioners in clinics in underserved communities. This resets the balance since currently, nearly three-quarters of the 600 nurse practitioners in Alberta work in hospitals, acute-care centres and specialty clinics.
In keeping with Alberta’s visionary spirit, these developments respond to current needs and demonstrate willingness to embrace approaches that improve the quality of health care for all Albertans.
Hazel Magnussen is the author of The Moral Work of Nursing: Asking and Living with the Questions and a retired nurse. She lives in Edmonton.