UPDATE, January 13, 2013: The discussion around nurse practitioners in B.C. continues to evolve on the Globe and Mail Website. On January 11, 2013, Dr. Ross submitted a Letter to the Editor [Click here to view] querying whether or not the 'numbers add up'. Subsequentlly, Rosemary Graham, BCNPA President, has shared the following message with ARNBC [Click here to view]. The BCNPA would like to hear the views of nurses, colleagues and the public about nurse practitioners in British Columbia. We welcome your thoughts and views in the comment section of this blog.
On January 5, 2013, the Globe & Mail published an excellent article by Rod Mickleburgh entitled “Are Nurse Practitioners the cure for B.C.'s family doctor shortage”. [Click here to view]
This timely and informative article included comments from Rosemary Graham, President of the BC Nurse Practitioner Association (BCNPA) as well as Shelley Ross, President of the British Columbia Medical Association (BCMA). In great part due to Dr. Ross' comments, the article has received more than 80 comments and sparked broad discussion in British Columbia and across Canada. ARNBC chose to write a Letter to the Editor to highlight our concerns over the comments attributed to Shelley Ross and the BCMA. To read ARNBC's Letter to the Editor, click here.
To further the discussion, on January 7, 2013, Rosemary Graham and Shelley Ross were interviewed on CKNW's Simi Sara Show. Click here to listen to the full audio of both interviews, and the comments made by callers. [Listen to mp3.]
ARNBC is proud to be a partner and friend of the BC Nurse Practitioner Association, and we encourage all nurses and all British Columbians to learn more about the important role nurse practitioners can play in improving the health of individuals and communities across the province. Recently ARNBC partnered with the BCNPA and the Canadian Nurses Association on the www.npnow.ca campaign to raise awareness of NPs in the province. Visit our NP Page to view materials and information from the campaign.
Visit the BCNPA website for more information on nurse practitioners, or to download their Position Statement on Nurse Practitioners in Primary Care.
ARNBC will continue to advocate in support of strong, collaborative healthcare teams that are led by the most appropriate healthcare professional - whether that is a nurse practitioner, a physician, a registered nurse, a physiotherapist, an LPN, a midwife or another health provider.
The Association of Registered Nurses of British Columbia (ARNBC) is a professional organization that provides a unified voice for registered nurses and nurse practitioners in the development of health, nursing and public policy that advances the health of British Columbians.
We welcome comments on this or any other blogpost!
I happened upon your blog when doing a search for NPs in BC. Really great to see all of this information and resources pooled in one place.
I would bet that half the patients who come to the doctor's office, clinic or hospital emergency are routine cases of sniffles, flu, hang-overs, minor aches and pains, etc ... If these people can be processed at lower costs and more efficiently then what are we waiting for? I am tired of the medical establishment assuming they are next to God in determining our well being. And a little competition would work wonders for a customer service attitude.
How can the BCMA still get away with such antiquated views of healthcare? It's offensive to anyone who works in healthcare and has a brain.
Good on the ARNBC and BCNPA for keeping the discussion relevant for those of us who work in healthcare but don't live in a physician-created make-believe world.
I'm not an NP (although I've thought about it a few times), but I am a proud RN, and I'm really glad to see us standing up for NPs.
Thank you for continuing to beat the "collaboration not domination" theme. I hold out little hope that doctors will ever understand how offensive they come off when they talk about being the only ones who can lead.
Some of the misinformed comments on the Globe article make me shake my head.
I wonder if people would rather see a nurse practitioner who has 20 years of experience and a Masters degree or a physician who graduated three years ago at the bottom of his class?
Thanks for helping to educate on the value of NPs to BC.
In all of this heated debate, I want us to also remember the tremendous vote of confidence and support that has been given to the very existence of NP programs in BC by hundreds of individual physicians. Although their bargaining organization (BCMA) may have consistently held with the antequated view that care teams require a hierarchical structure with the MD always on top, there are dozens and dozens of fine physicians all across this province who have proven how much more effective care can be when the disciplines truly collaborate.
In the early days of NP programs in BC, there were no practicing and qualified NPs to oversee the requisite student clinical practice. BC physicians stepped up to take on this role - and with no remuneration, since the ministry funding model prohibited nursing schools paying for clinical supervision! In other words, these individuals were forgoing the stipend that would have been offered had they accepted a medical student in order to support the cause.
That history, and the knowledge that many of these same physicians have remained huge champions of NPs and RNs, and are often the 'thought leaders' of care models in their regions, gives me real hope that we are on the brink of meaningful changes in how we work together. So as we challenge some of the unfortunate rhetoric out there, lets also remember to give a pat on the back to the enlightened physician colleagues who have really played a role in this facinating NP-evolution process. And someday their good sense will prevail!
Although I agree with you Sally, that there are some physicians who are supportive of NPs, I also think that those same physicians need to step up when it comes to this discussion. Why are they letting their own Association speak so strongly about NPs? Silence is compliance right?
It's all very well and good to 'know' you quietly support something, but when the people who represent you are saying ugly and wrongful things, then part of being a leader and being socially responsible, is to stand up and demand that at the very least, your opinion is recognized and registered and people (especially the media) are made to understand that not everyone shares the same perspective.
We need those quiet physicians to come forward because otherwise, the BCMA is the only voice anyone will hear. By not speaking up, their members are allowing them to be the only authority on this.
As president of BCNPA, I'd like people to remember that nurse practitioners are nurses first. While our culture and practice is a blend of nursing and medicine, we need to remain grounded by the caring principles of nursing. We are forging new ground in B.C. but are doing it with the support and experience of other nurses. Together we are connecting to patients and bringing care back to health.
All of us are busy with our daily lives. Finding time to respond to articles, participate in discussions and advocate for change in healthcare is a daunting job. But when the topic of nurse practitioners comes up - remember that we are all nurses, we are on the same team and we have the patient at the centre of care.
Please share your thoughts and your stories about the work of nurse practitioners.
(Revised from BCNPA Letter, January 13, 2013)
Thank you to everyone for your thoughtful comments on this blog post during the past week and to nurses who have been speaking out in the media. Please take a few minutes to read Rosemary Graham’s message, linked at the top of the post, reminding us that NPs are nurses first. Recent media attention provides a golden opportunity to use our collective nursing voice on these issues.
It is exciting that we are seeing such debate and discussion regarding the contributions and role of NPs in BC and indeed across the country. In reading all that has been offered here and on the links, I would like to thank the ARNBC for being such amazing partners. Additionally, all those that have contributed thoughts and arguments certainly increases the richness of the discussion.
Using discussion and debate is an important way to continue to move forward, in doing so being positive and providing education is really the key. As nurses, and of course the interested public, we know that the best way to acceptance is through knowledge and education. I personally have a large amount of support from my physician colleagues and I have also faced some resistance. What I have found is that resistance is seated in misunderstanding and mostly a well intentioned idea of protecting the public. It is on these fronts that we need to concentrate out efforts.
The BCNPA with Rosemary Graham as lead, has been actively seeking engagement with colleagues and stakeholders on all fronts, these efforts are the root of progress. I applaud the efforts of our and partner organizations and I encourage the continuation of a positive conversation about the role of all nurses in the future of healthcare for people in BC, especially for the approximately 400,000 people in this province who do not have a primary care provider. Is it a case of economics or of access to care for all? Please look to the BCNPA website for our recently published position statement on NPs in Primary Care!
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