Advanced Practice Nurses
Where we’ve been, Where we are
now, Where we’re going.
Jan Currie Vice President and Chief
Nursing Officer
Winnipeg Regional Health Authority
November 2008
Workshop Objectives
• Provide a forum for networking and information
sharing
• Provide evidence of successful health care
outcomes in MB employing NPs and CNSs
• Clarify the differences in the roles of NP and CNS
• Provide an update about what employers now
know for successful implementation of NPs and
CNSs
Where We’ve Been
• Nurse Practitioners have been in Manitoba for
over 30 years, mainly in the North.
• Clinical Nurse Specialists have been practicing all
over Manitoba for many years.
• Both roles are well established in other countries
Where We’ve Been
• Position paper on Advanced Practice Nursing in
the WRHA (2001)
• 1999 introduction of new Registered Nurses Act
(proclaimed 2001) which provides new
opportunities for the RN to work beyond the
traditional scope of nursing practice
Position Paper Highlights
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•
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Support for NP and CNS roles
Educational Preparation of NPs and CNS
Remuneration and Union Status
Advocate for regulatory changes
Explore role development in a variety of health care
settings
• Seek new funding model and financial supports
Where We are Now
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•
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Regulations in place
Availability of educational programs
Liability issues resolved
NP title protection granted
The session from the CRNM this afternoon
will give you more information.
WRHA Positions in Place
Program
June 2006
June 2008
Cardiac Sciences
1
5
Child Health
2
3
Emergency
3
9
Family Medicine
2
2
Medicine
1
Home Care
1
PCH
2
2
Primary Care
10
19
Oncology
TOTAL
2
21
43
Where We’ve Been
• WRHA Nursing Leadership Council-provides regionwide leadership & direction to the practice of nursing
within the WRHA
• Advanced Nursing Practice Implementation Steering
Committee has been working since 2000
• Program specific implementation initiatives for APN
– ED
– Primary Care
– Acute care
Advanced Practice Nursing Steering
Committee
• Linkages with
– WRHA via NLC
– Manitoba Health
– College of Registered Nurses of Manitoba
– University of Manitoba Faculty of Nursing
– National efforts of Canadian Nurse Practitioner
Initiative
Advanced Practice Nursing
Implementation Steering Committee
• Job descriptions for CNS and NP implemented
• Tool Kits for CNS and NP developed and
implemented
• Facilitated implementation of NP regulations in
primary and acute care
• Provided forum for problem solving for NPs in new
roles
• Liaison role to ensure clinical placements for NP
students
A Guide to Implementation of the
Advanced Practice Nurse
http://www.wrha.mb.ca/professionals/nursing/apn06.php
Advanced Practice Nursing
Steering Committee
• Committee has focused to date on NP
introduction
• Next focus will be the Clinical Nurse
Specialist role
Where Are We Going?
Advanced Practice Nursing Steering
Committee
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•
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Further clarification of CNS role
Collaborative Practice model development
Integration Tools development
Evaluation plan
Lobby for more CNS and NP positions
Where are We Going?
Role Clarification Needs to Continue
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•
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Nurse Practitioner
Clinical Nurse Specialist
Primary Care Nurse
Clinical Assistant/Physician Assistant
Nurse Clinicians
Where Are We Going?
Recruitment
• Recruitment strategies in place in WRHA
• Links between WRHA and RHAs through
HPSEN.
• NLC linked with Program Liaison committee – U
of M Faculty of Nursing
• Conditional Grant (NRRF) applies if outside
Winnipeg and Brandon
• Relocation (NRRF) support available if moving to
Manitoba
Visions for the Future
• Villeneuve and MacDonald (2006) Toward 2020 Visions
for Nursing
• What will health and illness look like in 2020?
• What roles, scopes and practice settings?
A Sense of the Scenarios
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•
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Focus on health and communities
Enhanced roles for all providers
Integrated interprofessional education
Core competencies taught in schools
Targets for increasing diversity
• If we maintain current delivery models and levels
of demand, then the shortages of nurses,
physicians and other professionals being
experienced in 2006 are irresolvable. We can stay
on this course of another few years (more seats) or
we can change demand and delivery
We are not working in the health care
system we grew up in. Even if you
wanted to keep that, it’s too late, it’s
already gone.
Porter-O’Grady, 1998