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!

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)

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.

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!

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.

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.

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 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.