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Expanding health care options

Nurse practitioners help fill MD shortage void
web1_Kathy-Lepp
Barry Gerding/Black Press Vernon Jubilee Hospital nurse practitioner Kathy Lepp.

Nurses are trained to care for their patients, but not to encroach within a doctor香蕉视频直播檚 realm of making a diagnosis or deciding treatment options.

But with the introductory regulation of Nurse Practitioners in B.C. back in 2005, the scope of nursing has evolved.

Like all registered nurses, Dana Jones was ingrained with the traditional role of a nurse in her university training, and carried that forward working at a Downtown Eastside clinic in Vancouver and then enhancing her primary and acute care skills working at Vancouver General Hospital香蕉视频直播檚 emergency department.

香蕉视频直播淚 just found that kind of nursing wasn香蕉视频直播檛 my thing. During my emergency hospital training, I always wanted to follow up with patients admitted to the hospital. I like that care aspect of relationship building,香蕉视频直播 Jones recalled.

She took on an opportunity to work in clinics at Inuvik in the Northwest Territories and remote aboriginal communities in northern B.C., where a nurse香蕉视频直播檚 traditional scope of care was expanded.

香蕉视频直播淵ou would follow set algorithms of what medications someone with certain symptoms can be prescribed, but you made the decision whether it was needed or not,香蕉视频直播 Jones said.

香蕉视频直播淚t opened up a whole new world of learning for me. When training as a nurse, it is drilled into you that you don香蕉视频直播檛 make a diagnostic assessment, that is the role of a physician and outside of your scope.

香蕉视频直播淪o after that experience, coming back home to work in primary care and not being able to give out Tylenol without a doctor香蕉视频直播檚 approval became challenging for me.香蕉视频直播

Today, Jones is part of a fraternity of 66 nurse practitioners (NPs) working within Interior Health operating a health care practice in Kelowna香蕉视频直播攖he Rutland Aurora Health Centre香蕉视频直播攁s a family MP with her clinic partner Pamela Klassen.

Since moving to Kelowna in 2013, she has built up a patient roster of 600, largely based on health care service referrals, but is now taking on self-referred patients who qualify for NP care.

Currently, it is estimated some 30,000 people in Kelowna don香蕉视频直播檛 have a family doctor.

To book an appointment with Jones, a patient can香蕉视频直播檛 already have a family doctor, must live in the Central Okanagan area (Peachland to Lake Country), and face chronic or long-term care issues such as high blood pressure, diabetes, drug addiction, mental health concerns or infectious diseases such as hepatitis.

Kathy Lepp began as an NP in several resident care facilities in the North Okanagan, before taking on a new role as a hospitalist NP at Vernon Jubilee Hospital last year.

Unlike Jones, Lepp works within the confines of the hospital. Her involvement with patients begins and ends at the VJH.

Her role is partly a reflection of an increasing number of family physicians withdrawing from their hospital privileges to focus their attention on their medical practice.

香蕉视频直播淲hen patients leave, I sometimes get asked if I can see them on an ongoing basis but that香蕉视频直播檚 not my role here,香蕉视频直播 Lepp said.

All NPs are trained to provide clinical care that includes diagnosis and management of disease/illness, prescribe medications, order/interpret laboratory/diagnostic tests and initiate referrals to specialists.

Within that context, the ministry of health describes NPs as embracing a holistic view of health care, addressing the physical, emotional and social aspects of a patient香蕉视频直播檚 health care needs.

香蕉视频直播淵ou see health care from both the perspective of a nurse and a doctor in this role which offers a challenge to enlarge my knowledge to a fuller capacity,香蕉视频直播 Lepp said.

And working in a hospital environment, she adds, offers access to a wide range of health care experts, further enhancing a collaborative process of delivering health care.

香蕉视频直播淭he ultimate goal for me is to provide good quality patient care, to optimize their rate of recovery and either see them released and back home or transition into residential care,香蕉视频直播 Lepp said.

Jones says the traditional paradigm of training doctors to identify and treat diseases is changing as new physicians today are being taught to build a rapport with patients and understand how economic, social and lifestyle background issues can contribute to a person香蕉视频直播檚 health outlook.

香蕉视频直播淚t takes time to build a trusting relationship and educate someone on how to control their diet or address lifestyle issues that are contributing to their health issues, and NPs are in a position to do that.

香蕉视频直播淢y goal for someone with diabetes is not to manage your diabetes but for you to manage your diabetes. I can provide the information you need to know and guide you through the health care system, but I can香蕉视频直播檛 make decisions for you.

香蕉视频直播淚f you need to quit smoking or change your diet, it香蕉视频直播檚 ultimately up to you to accept and make those changes in your life, and that often takes time and numerous visits to get that win.香蕉视频直播

Story of interest:

Donna Mendel, director, advanced nursing practice for IH, says with NPs now being in B.C.香蕉视频直播檚 health care system for more than a decade, the benefits are starting to become more evident both by overworked GPs and patients.

香蕉视频直播淲e are pleased to see that happening,香蕉视频直播 Mendel said. 香蕉视频直播淭he demands of the health care system ask us to look at all service providers and find new ways to optimize the scope of what they can do, whether they be physicians, NPs, social workers, therapists or registered nurses.

香蕉视频直播淲e are seeing that right now in terms of improving primary care outcomes.香蕉视频直播

Dr. Alan Ruddiman, president of the Doctors of BC association, said doctors value the role and contribution of NPs, but don香蕉视频直播檛 believe they are the answer to the doctor shortage in B.C.

香蕉视频直播淲e train about 288 doctors a year in B.C. but research tells us we need that to be about 450 physicians a year to replace doctors who retire or move elsewhere,香蕉视频直播 Ruddiman said.

He said his association believes the highest quality of care for patients is derived from various health care service providers working in a collaborative team effort with medical doctors.

Story of interest:

Jones also acknowledges that NPs are not the solution to the current shortfall of access to family physicians in this province, saying the current health care system is broken and needs to transition into new ways of delivering services and educating the public to better look after themselves.

香蕉视频直播淚f you promote a healthier lifestyle香蕉视频直播攕top smoking, alcohol consumption and get more exercise香蕉视频直播攜ou get better health outcomes. But to do that requires time and intense rapport-building and coaching with patients, and our health care system doesn香蕉视频直播檛 do that.

香蕉视频直播淚f people quit smoking and exercised regularly, it would reduce acute care admissions by half to most hospitals.香蕉视频直播



Barry Gerding

About the Author: Barry Gerding

Senior regional reporter for Black Press Media in the Okanagan. I have been a journalist in the B.C. community newspaper field for 37 years...
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