Mary I agree!

sorry for the rambling and disjointed post, but so many separate ideas came to mind reading all these comments.

I think we need to quickly move this conversation from the problems of how we got in this position to hammering home the reasons why nursing in it's full expression from (including NPs) is needed to improve health of british columbians. We need to think of this as a big tendering process. If nurses could spend the kind of time and money to put our agenda forth to the public that other groups do we might have a chance. Look at how much we hear from and about oil pipelines. If issues nurses know to be of crucial importance to british columbia had the same press we could get somewhere.

We need to show we are indispensible and make it clear that we will decide the future of our workforce rather than get slowly pushed aside and away from the bedside. The ARNBC likely does not have giant bank accounts to bankroll a big campaign but there are other things we can do. At this point strikes and removal of service will not help our cause. Instead I suggest we find some ways to get in front of those that need care and show them what RNs and NPs can do. Why not some free clinics in malls all across BC staffed by RNs and NPs and any other professions that want to do more to make BC healthier.

Lets get Brian Goldman from CBC radio to do an episode on the situation of NPs in BC? He has touched on it before.

I would like to say that something Rob mentioned was how we are not a united force and there is a lot of fractious relationships within nursing. Nurses are a large and varied group with many different political and social values, personal and professional goals and priorities. What can we all agree on? We need to figure that out.

I am an RN in Victoria and a NP student. I would say that a reason I went back to school to become an NP was to protect my time with patients. As an RN in VIHA I have seen the Care Delivery Model Re-design (CDMR) project moved ahead to the point where it is finally showing what the true end-point seems to be. I would say that the most basic value of nursing is how we do our work in relationship with our patients and families. This relationship is only possible when we spend time with our patients at the bedside giving direct care, doing our own physical assessments and asking our own questions. I am worried about how nurses are getting moved further away from this relationship because without it I do not see nursing having much special to offer patients.

I am heard from at least five nurses from different areas about how they feel they had their expertise and energy misappropriated by the CDMR consultations they went to. In the end, they were helping to dismantle their own jobs by creating the framework to change the staff mix and lose nurses and even worse nursing time with patients.

I could say that perhaps it was naive not to see this coming but it matters not now as the fight is upon us.

I am becoming and NP so that I can have more control over my time with my patients. I hope my concern for the direction of nursing can be proven unfounded with a renaissance for nurses in BC.

Thanks for these thoughts Maryanne,

I am an RN and NP student in Victoria. A agree that If NPs are going to be salaried health authority employees vs private contractors like MDs then we should be in the union.

As a practicing NP I am in full agreement with the sense of urgency around the future of NPs in BC. It has become clear that impementation and integration of NPs in primary care is messy and fraught with barriers. I worry that our BC MOH is losing interest and energy in this initiative that they started with good intentions - increasing access to primary care for the people of BC. I dont think even they realized how physian centric our health care system has become.

Nursing needs to get political. We not only need nurses in health authority leadership positions, we need them in government. I wish I knew how to achieve that?

As well as being seen by the public as a strong voice for health care policy in BC, I think we need to engage the public to advocate for their own health care which is so much more than surgical waitlists and the costs of medications. I agree with Hannah's comment that the public are not well informed re the health care system. Perhaps that could be one strategy in this nursing initiative.

Could it be the powerful lobby of the BC Medical Association and the collective de-valuing of nursing in general by our government?

I echo the comments posted by Natasha. Values and beliefs united nursing, no matter where we practice. Key among those values is the role we play as advocates for those we care for. As the government has removed the voice of nursing from the policy table and has failed to replace the nursing directorate, nursing voices get smaller and smaller and so do the voices of patients. We are bombarded daily by the lobby of the BCMA to further incentivize care through such programs as ‘GP for Me’, which is actually code for ‘money for me’. Such a program does little to actually improve care. Rather it is designed to sweeten the pot if a GP takes on even more patients. These fee structures create dependency and could significantly increase the cost to the taxpayer while cutting other highly educated and qualified health care providers from the work force. As the BCMA works behind the scene to silence and control scope of NP practice, patients continue to seek care that can be provided safely and efficiently by a NP. Nurse practitioners provide care to thousands of British Columbians every day in this province and many more NPs are waiting to do the same. Medicine continues to impede the full integration of NP into the health care system. It is time for government to provide a place for nursing at the policy table. Now is the time for an informed, transparent process that includes all stakeholders and gives voice to nursing and to the health care needs of the people of British Columbia. Continuing to protect the self-interests of a single interest group is hardly good for the health of our population.

I hope-and anticipate-that this group and your post will galvanize some concrete plans, actions, and results to improve the health of BC's population, through an increased profile and access to health policy decision makers in BC for nursing. Responses so far to your post offer additional perspectives and context.

There is so much more to nursing than "bed side". I'm proud that we have nurses representing us and leading health care. In fact we NEED them in leadership roles. I'd much rather have a nurse at the leadership helm than a CEO who knows little to nothing about actual nursing care/health care and is most focused on the business aspects. Kudos to nurses like Stan for speaking out and leading our profession.

If a bedside nurse were to take on this role - when do you think they would actually have time to be at the bed side?

Anne, It is unfortunate you do not know Rob Calnan. I have had the privilege of knowing and working with him. Yes, he was a bedside nurse for many years at Victoria General Hospital, and he has brought a voice to nursing concerns for many years. His fairness, compassion and persevering attitude are not to be underestimated. I'm encouraged because nurses like Rob "get" both sides (nursing and management) and can move forward from there. It is the antagonistic attitudes between employers, lobby groups and nurses that have prevented solution-oriented ideas for too long. This is a process.