Nurse scope already wide, despite political promises
Regulations changed in February allowing NPs to practise in hospitals
CHARLOTTETOWN Three of P.E.I.'s main political parties say expanding the scope of practice of nurse practitioners could help fix some of the province's health-care woes.
The Liberals, PCs and Greens have all promised to expand the scope of practice for nurse practitioners while also allowing physician assistants to practise in the province. Party leaders have said this will ease some of the pressures on ER doctors and family physicians in the province.
But the CEO of P.E.I.'s College of Registered Nurses says P.E.I. nurse practitioners already have the ability to work independently in primary care clinics.
"We have one of the broadest scopes of practice for nurse practitioners in Canada," said college registrar Melissa Panton.
Panton also said a Feb. 25 change of regulations to the province's Hospital Management Act will allow NPs to have the ability to admit and discharge patients, allowing them to work in hospitals.
"It was one of our last hurdles for nurse practitioners to kind of work to their full scope," Panton said.
In an email, Health P.E.I. senior communications representative Everton McLean confirmed the changes will allow NPs, along with midwives, to work in hospitals. McLean also said the regulation changes, made with little fanfare by cabinet, have yet to be implemented.
Panton said the province's regulations still could be changed to allow better mechanisms for NPs to transfer patients to someone outside of their scope of practice.
Panton also said more work could be done to allow NPs to practise to the full range of their abilities.
“There's education programs out there and nurse practitioners are taking full advantage of them. It's just, is there a position available within the system that lines up with their independent knowledge and skill?" Panton said.
Barbara Brookins, president of the P.E.I. Nurses' Union, agreed the scope of practice for legislated nurse practitioners is wide. She welcomed the recent changes allowing practice in hospitals.
But Brookins said the change is not necessarily an easy fix to staffing shortages throughout the health system. Health P.E.I.'s website currently lists 156 nursing vacancies in the province.
“There's not a big resource of nurse practitioners out there, even more than there is a big resource of (licensed practical nurses) or (resident care workers),” Brookins said.
“The frustrating part is that when there is a shortage of one, they seem to think that by bringing in others, it's going to fix the problem. And it doesn't really fix the problem."
All four mainstream political parties – Green, Liberal, NDP and PC – have promised to allow physician assistants to practise within the system.
Physician assistants can diagnose and treat conditions but, in other jurisdictions, must only treat patients under the supervision of a physician.
In an email, McLean said Health P.E.I. had not, prior to the election, requested that cabinet change regulations to allow physician assistants to practise in the province.
“Physician assistants are valued professionals who work in locations across Canada and can have an important role to play in various health care settings,” McLean said in a March 17 email.
On March 15, the Medical Society of P.E.I., released its list of health-care policy recommendations. The list included more administrative support for family doctors but did not mention physician assistants.
In a March 16 interview, MSPEI president Krista Cassell said physician assistants could help alleviate some pressure in emergency rooms. But she said allowing this new health professional would not likely solve the province's staff shortages.
Cassell said political promises about nurse practitioners or physician assistants are part of larger discussions about clinicians working collaboratively in teams.
“Everyone's working to make this situation less scary,” Cassell said.
"I think that it's a reasonable approach to say 'how do we expand access for patients?' Because that's what our system needs."