Nurses across a wide range of service sectors contribute a major component of the spectrum of primary care – supporting patients, families and communities in a wide range of health promotion, disease prevention, and chronic illness management activities to name a few. However, wherever they work, nurses also witness the individual impacts of a troubled primary care system -- a system that does not yet guarantee access for all British Columbians, that remains strongly physician-centric at a time when physicians themselves are concerned about the serious scarcity of primary care providers within their own ranks, and whose funding and management systems operate in isolation from the rest of the publicly funded health care system. British Columbia lags behind most other provinces and many other nations in enacting a truly comprehensive and coordinated interprofessional system of care. And nurses see first hand how the gaps in primary care lead to unacceptable acute and chronic illness rates as well as preventable human suffering.
BC’s nurse practitioners have been fighting the fight to try to crack open the established systems for primary care management and reimbursement in order to ensure that more patients can access a primary care practitioner. Although everyone understands that making optimal use of BC’s expertly trained NPs makes good public health sense, and many members of the physician community have been strongly championing their cause, we have been lacking the collaborative political will necessary to put success within reach.
We think that this is a matter that all nurses ought to rally behind. We understand these primary care renewal challenges in BC as part of the global demand for primary health care renewal by such groups as the WHO and the CNA. Wherever we work, we understand how important a good system of primary care is, and we want our patients to have access to it. We all envision multidisciplinary teams, including MDs, NPs, RNs and many other members of the allied health team, working in close collaboration to offer best practice care. We can envision it, and we know it makes good economic sense. The evidence is absolutely clear.
So we encourage all RNs to think about how you can be champions for comprehensive multidisciplinary primary care practice in your communities. If we leave this matter for the NPs to argue on their own, solutions may take longer. The ARNBC sees this issue as a fundamental one that all nurses will want to rally around. British Columbians need all of us!
Read Natasha Prodan Bhalla’s June 14 letter to the Vancouver Sun on “What About Nurse Practitioners?” http://www.vancouversun.com/health/What+about+nurse+practitioners/4941992/story.html
ABOUT DR SALLY THORNE
Sally Thorne, RN is a Professor at the UBC School of Nursing, where she has been a faculty member for over 25 years. A nurse researcher and educator, she draws attention to the contribution of professional nursing to the lives of persons with cancer and chronic disease. She represents nursing as a board member in the non-profit and health sectors both in British Columbia as well as nationally.
I want to thank the ARNBC for these very thoughtful, and well stated remarks.
As a RN for almost 30 years, I have seen the erosion of BC's primary care system and the difficulties faced by families with children in finding appropriate primary care access and most importantly for children continuity of care.
The provision of practical, easily accessible yet comprehensive primary health care that meets the needs of all the citizens living in BC is doable. It is doable through the use of the many highly skilled health care providers available in our province working together to ensure that the patient has access to the right provider with the right skill set for the right problem at the right time. It will require collaboration, team work and effort, but it is doable.
As a one of the limited number of practicing Family Nurse Practitioners in BC, I am fortunate to be able to provide primary health care for a growing number of women and children in Vancouver. Unfortunately, there are many other families in our province without access to primary care and still in need. How sad, that our province remains stuck, when many effective solutions are within reach.
Lorine Scott MN NP(F)
Thoughtful commentary. We are overdue for a stronger nursing presence in BC's health care reform, ongoing tranformation. The nursing voice in the 1990's was strong in BC and we influenced many positive changes in health care. ARNBC can be that new voice!
Now so many of the MOH's changes and funding opportunities are being directed through the medical profession. Nurses understand collaborative interdisciplinary practice -- I hope the future will bring a stronger recognition of all that RN's and NP's can contribute.