In September 2023, the Government of BC announced a refreshed approach to the Primary Care Network (PCN) governance model. This refresh included a long-term goal of shifting the Longitudinal Family Physician Payment Model to enable the direct hiring of Registered Nurses (RN) and Licensed Practical Nurses (LPN) into primary care settings, as well as a short-term goal of expanding the Nurse in Practice model to enable hiring of RN and LPN team members into PCNs immediately. This welcome change enables family physicians and nurse practitioners to independently choose to include nursing more fulsomely in the delivery of team-based primary care, to meet the complex and evolving care needs of British Columbians.
The Gap
Nurses are self-regulating, autonomous care providers whose practices can meaningfully expand and extend not only the capacity, but also the quality of care delivered by primary care teams. While nurses employed by large health organizations are enabled through a variety of practice programs and peer networks, nurses employed independently in PCNs do not have access to similar enablers. Expansion of the Nurse in Practice model requires a concurrent investment in such enablers.
NNPBC Nursing Initiatives for Primary Care (NIPC)
As the professional association for nursing in BC, NNPBC has a proven track record of enabling Nurse Practitioner practice in PCNs via the NP Provincial Initiatives and Programs (NP PIP). NNPBC is thus well positioned to bridge the practice enabler gap for nurses employed through the Nurse in Practice model. To do so, NNPBC is partnering with the Ministry of Health to
deliver the new Nursing Initiatives for Primary Care (NIPC), comprised of a Nursing Practice Support Program and a Primary Care Nursing Network.
- The Nursing Practice Support Program will meet the needs of RN and LPNs hired directly into PCN settings. This program will include a variety of resources to support nurses, including in-person workshops and in-services, virtual learning, professional practice consultation, primary care specific competency resources, and quality improvement and assurance resources.
- The Primary Care Nursing Network builds on NNPBC success in connecting NPs across the province by building a similar yet unique peer connection network for RNs and LPNs. The Network sets into action a community of practice for RNs and LPNs across the province, enabling mentorship and coaching, providing the opportunity to share practice excellence, and opening opportunities for data collection on nursing specific KPIs. The Network will also support practice guidance dissemination and nursing specific communications pathways across BC.
Anticipated Outcomes
- All eligible nurses employed in Primary Care Networks have access to a provincial Practice Support Program enabling optimal primary nursing care for British Columbians.
- All eligible nurses have access to development and quality improvement opportunities ensuring continued competency and public safety.
- All eligible nurses are supported through a nursing network of practice coaching and mentorship.
Employer Level Responsibilities
While the NNPBC Nursing Initiatives for Primary Care will support nurses directly, this program cannot replace the activities required by employers to meet their responsibilities in fostering optimal working conditions for nurses. These responsibilities include:
- A fulsome and accurate understanding of nursing scope of practice;
- Thoughtful onboarding processes that support nurses entering this new model;
- Adequate space and equipment to practice nursing;
- Working collaboratively with nurses to enable practice at top of scope;
- Employer level controls on practice where and if appropriate;
- Socializing the unique nursing role within primary care teams; and,
- Enabling continuous professional development and education to maintain and enhance competency.
NNPBC recognizes these responsibilities may be new to some employers as employment of self-regulating professionals is unique. It is therefore imperative that employers fully understand their responsibilities to create the quality practice environments and conditions under which nursing excellence can flourish. The NNPBC NIPC complements employer excellence through the provision of direct programs and services to RNs and LPNs in primary care.