The number of nurse practitioners (NPs) practicing within Interior Health (IH) continues to climb; and while there are no NPs currently scheduled to begin work at the Ashcroft Family Medical Clinic or the Ashcroft Hospital, they are the “first and most obvious part” in expanding the health care team in Ashcroft and making it work.
That is according to David Durksen, vice-chair of the Wellness and Health Action Coalition (WHAC). “Nurse practitioners, lab technicians, X-ray technicians, counsellors: all of that needs to be integrated into a central team. The Ministry of Health has mandated health authorities to deliver health care as close to home as possible, in a team-based, primary care setting.”
“Nurse practitioners are a primary care provider: we can diagnose, treat, prescribe, and refer to specialists,” says Dr. Louann Janicki, who was one of the first four nurse practitioners in IH in 2005, when the role of the NP was established there. “They’re an important access to primary care, especially for people who have no primary care provider.”
There are currently 51 NPs working in Interior Health, most in acute care areas, in special services such as cardiac, pediatric, and diabetic clinics, in residential care, and in rural and remote settings. Seven new NPs have been hired by IH since this summer.
They support Interior Health’s efforts to shift the focus of health care from hospital to community programs and services; a shift that is happening across the country as the population changes. People are living longer, often have more complex medical needs, and prefer to live at home from birth to death. Interior Health’s intent is to support people to live healthy at home and in their communities for as long as they can.
Nurse practitioners have sometimes been touted as a solution to staffing the emergency department (ED) at the Ashcroft Hospital, but Janiki says that while NPs can carry out many procedures, “We have not had nurse practitioners working exclusively in emergency departments.”
Durksen says that in the WHAC’s vision, “A nurse practitioner in our situation would not work exclusively in the emergency department, but would be working in the ED for certain parts of the week. It would make it easier to staff the ED and prevent doctors and other health care professionals from burning out because of emergency work.”
Janicki says that “An ounce of prevention is worth a pound of cure. NPs work with patients to make educated health care decisions and lead a healthy life. This prevents the need for acute care and emergency treatment. If we had more NPs in a community, the need would not be so great for an emergency department.”
She adds that “Nurse practitioners have the greatest impact when working with other members of a health care team, to provide patient-centric practices that keep people out of the emergency department. Improving patient care access is always important for nurse practitioners.”
Durksen agrees. “The focus is on wellness, rather than illness. We’re very keen on that piece of it. One thing that is really necessary in this process is for each of the professions to work in collaboration with the others, and do what they do best.
“Doctors have a particular knowledge and skill set, and it’s not a good use of their time to be doing certain procedures. It’s not the best use of their education. Being part of a team allows doctors to do what they do best, and do it with excellence.”
Durksen says that the WHAC is currently working on drafting its definition of what a team-based primary care clinic would look like.
“The committee has a shared vision on that, and we are doing background work to bring that forward in a way that can be embraced by Interior Health and our doctors and our catchment area.
“There are things nurse practitioners can’t do without a doctor being there, but there is lots they can do. They would be a key part of the team, but they are only one additional part. We’re looking at making the whole team work.”