The Nurse Practicioner Advantage

ABSTRACT

Canadians have seen a constant deterioration in the existing health care system. Current wait times have exceeded accepted limits and medical manpower has significantly decreased. In reaction to these growing problems Canada's health care officials have began implementing a relatively new role for nurses into the health care system. The nurse practitioner has a master's degree in nursing and additional education in medical care. By employing the nurse practitioner in many areas of health care there has been an increase in access to existing recourses, decreased wait times, improved health outcomes by early diagnosis and overall health education.

THE NURSE PRACTITIONER ADVANTAGE

Did you know that over 3.5 million Canadians are with out a family a doctor, or that average wait times to see a doctor range from 1-4 days to even 3-4 months? ("Change management," 2005, p.20). With our population increasing daily and a huge generation of that population growing older, our health care needs are greatly increasing. To further this problem less and less doctors are choosing primary health care as their specialty. This shortage of medical manpower has caused great reductions to the accessibility of our existing health care, wait times have significantly increased, and extra time spent educating people about their health regimen has become nearly impossible. However, Canada has been taking the necessary steps to mend the deteriorating health care system. A relatively new field of nursing that has been employed in other countries for more than a decade is now being implemented into Canada's undersupplied health care system. The new Ð''super' nurse, or, more formally, Nurse Practitioner, has been looked to, to fill this ever growing void. A nurse practitioner (NP) is a registered nurse with "further education in health assessment, diagnosis, treatment and management of illnesses and injuries" ("Integrating nurse practitioners," 2005). So, what does this mean? Well, an NP can diagnose and treat common illnesses, order and interpret tests, refer patients to other health care professionals such as physicians, nutritionists and therapists. They can also prescribe certain medications, such as birth control pills or blood pressure medication.

Nevertheless, implementing NPs into the current health care system is facing some difficulties. The biggest sets backs have been from the opposition of general practitioners (physicians). General practitioners are nervous that nurse practitioners will be taking employment opportunities away that were previously dedicated to only doctors. And some doctors are even going to the extreme as of saying that nurse practitioners are so under qualified that they are dangerous. One doctor, Dr. Scott Stern, was reported saying, "in most situations, patients are compromising their care and settling for less when they see someone other then a doctorÐ'.... To assume that somebody who has much less training is going to do as good a job just doesn't make any sense" (Perez, 2006). But, the role of the NP is not designed to replace any other member of the health care system, but rather is intended to work in relationships to improve timely access to care with a slightly different approach to care. Despite the concerns of some doctors, nurse practitioners are an essential element to solving some of Canada's growing health care needs.

NURSE PRACTITIONERS ARE CRUCIAL

A general poll conducted in the fall of 2004, revealed that Canadians number one concern in Canada was health care, and at the top of these concerns was timely access to service. The Canadian Medical Association took another more specific poll in February 2004, revealing that:

Only 14 percent of Canadians believe their country has a sufficient number of doctors. 49 percent of Canadians said either they or a member of their household had to wait "longer than you thought was reasonable" to see a medical specialist within the last year. 38 percent gave the same answer when asked about access to their family physician, and 31 percent said so about access to advanced diagnostic proceduresÐ'.... And a whopping 74 percent of Canadians were concerned about long waits for access to emergency room services (Ridenour, 2004).

With reaction to these types of concern every major health commission report in the last ten years has recommended an expanded scope of practice for nurses (Turris, Knoll, Hayhoe, Freeman, Wilson, Forster, Hornack, 2005, p. 21). The nurse practitioner's role is well designed to mend several of these present issues and ease some of these pressures.

NPs are unique in the their practice, which is derived from blending highly developed clinical diagnostic and therapeutic knowledge, skills and abilities within a nursing framework that emphasises holism, health promotion, and partnerships with individuals and families as well as populations and communities. This blending of nursing and medical knowledge and skills along with the bridging of clinical services that are qualitatively different from other health care providers (Robinson Vollman Inc., 2005, p. 19)

NPs have greatly increased the publics access to existing services, and NPs usually see their patients within 24 hours, whereas the current wait times in some areas are weeks to even months. Full integration of NPs into the healthcare system will also relieve some of the pressures in hospital emergency rooms, making sure that people with urgent needs are treated quickly. With an NP monitoring some of the patients who have chronic illnesses, such as diabetes, heart disease, or Alzheimer's, physicians can carry a larger caseload where their expertise is gravely needed . Also, areas where NPs have been implemented show a greater improvement of overall heath outcomes. Whether this was by early detection of illnesses, having more time to spend teaching patients about their health regimen and disease, or increasing awareness about health issues in the public, NPs have been able to fulfill patients needs that have previously been left unmet or were not available from physicians. In addition, physician organizations have had mediocre success in attracting physicians to family practice; it seems logical to look to the nursing profession to fill this void.

GENERAL PRACTITIONERS AND NURSE PRACTITIONERS WORKING TOGETHER

Some doctors and health care officials are seeing this expanding opportunity, and in the interests of quality care for their patients, are taking up the co-practices in family medicine. Lessening some of the workload, doctors are more