P.E.I. expanding nurse practitioners into hospital critical care, emergency departments

Nurse practitioners will begin caring for the most seriously ill patients at two Prince Edward Island hospitals as well as working in the emergency department of a third hospital, according to the nurse practitioner directorfor Health P.E.I.

P.E.I. is the last province to have nurse practitioners (NP) working in those roles, Ellen Christie said Fridayat a conference in Charlottetown organizedby the Prince Edward Island Nurse Practitioner Association (PEINPA).

But the expansion will help take the strain off the health-care system, she said.

"The health-care system is definitely going through a period of challenge, for sure. And we really just need all hands on deck," Christie said.

Four NP positions are being added to the critical care units at Charlottetown's Queen Elizabeth Hospital and Prince County Hospital in Summerside, P.E.I. The main role of these NPs will be with patients requiring the highest levels of care, but they may also work in the hospital emergency departments, Christie said.

Meanwhile, another nurse practitioner has started orientation in the emergency department at Western Hospital in Alberton, P.E.I.,and will start seeing patients shortly, she added.

Nurse practitioners are registered nurses with advanced education and specialized training.They diagnose,treat, prescribe medications, order tests and make referrals to other specialists.

Christie said nurse practitioners have been working in the province for 18 years. Over that time, the range of work they do has expanded.

"Nurse practitioners on P.E.I. have one of the broadest scopes of practice of anywhere in Canada, and we're really able to do a lot of things," Christie said.

"It's really kind of been an evolving role, and it's really wonderful to see that growth and development over time."

Jena McCarthy,a nurse practitioner from Nova Scotia, spoke at the conference about the role of nurse practitioners in that province.

"Change is hard. So there's varying reactions in responses," said McCarthy, who splits her work between the emergency department in Truro, N.S., and at the Millbrook First Nation just outside Truro.

"For the most part, in my experience, the physicians have been really open," she said. "They want to teach us, they want to collaborate with us, and they want the role to grow in a positive way in Nova Scotia."

McCarthy said she thinks it's definitely a good move to have nurse practitioners help out in P.E.I. emergency departments, adding that the best approach is a collaborative one.

"If we think we don't understand something, or there might be something missing, we are going to bring in our physician colleague to give us another opinion."

Dawn Holloway, aCharlottetown nurse practitioner who attended the conference, said there are a few challenges that might be preventingnurse practitioners from being used to their fullest capacity.

"There's a lot of, I guess, not so much 'red tape,' but just barriers to overcome," she said.

One option that could improve care is nurse practitioner-led clinics, as is being done elsewhere in the country,Holloway said.

WATCH | Nurse practitioners called beneficial for patients and the health-care system:

Nurse practitioner initiative tackles emergency department challenges in P.E.I.

4 months ago

Duration 4:31

But addressing gaps in the health-care system isn't as simple as just hiring a nurse practitioner, Holloway added.

"There has to be a lot of forethought about, you know, education of the public, education of health-care providers in the emergency department. How does that impact physician compensation, how do you educate the NP to take on that role?"

She suggested that a fee-for-service model, similar to the model used by P.E.I. physicians, might be a good option.