Nurse practitioners (NPs) may soon be a familiar part of health care in New Brunswick — but not soon enough to meet existing needs, the New Brunswick Medical Society (NBMS) says.
Legislation due to be passed this fall will allow NPs to perform additional duties, including prescribing. The government hopes this will cut costs and improve retention of both physicians and nurses. The NPs will be authorized to diagnose common diseases and disorders, order some laboratory tests and diagnostic procedures, and prescribe certain drugs. “Until now these services have been outside the scope of practice for nurses,” says Premier Bernard Lord. The new legislation will allow NPs to work with FPs in a network of new community health centres. Fifteen NPs are expected to be hired this year.
That may be too little too late, says NBMS President Les Allaby. He says the society supports community health centres and the use of NPs in collaborative care settings, but it will take a long time for these initiatives to improve access to care. “We think RNs and registered nursing assistants could do [more] in physician offices that would result in more patients being seen.”
The society has proposed that nurses take on a larger role in physicians' offices by seeing patients who would otherwise be seen by the doctor. Funding would come from the $4.5 million earmarked for health care renewal initiatives in the recent provincial budget.
At present, if the physician does not see the patient, the service is not covered by medicare. The NBMS is recommending that nursing services be billed to the provincial health insurer so that both physicians and nurses could see patients. “This would allow FP practices to take on more patients and shorten waiting lists for specialists, and the structure exists to allow implementation of the new system quickly,” says Allaby.
NB will join Nova Scotia, Newfoundland, Ontario and Alberta in legislating the use of FPs. About 500 NPs work in Canada, compared with 70 000 in the US. — Donalee Moulton, Halifax