Nurses pushing for bigger role in Canada

[regular]

It's happened in the US and looks like it's no different in Canada.

 

Put nurses in charge for better, cheaper health care

 

An expanded role for Canada's nurses would result in better care for more patients and significant cost savings for the health system, a report done for the Canadian Nursing Association and released today says.

 

The report, A nursing call to action, was prepared by the independent National Expert Commission in advance of the Canadian Nurses Association's National Biennial Convention in Ottawa, which begins today and lasts until June 20.

 

"We have had a physician-led model of health care . . . for the past 50 years that has focused on episodic acute care," the report argued, quoting research commissioned for the NEC by Browne, Birch and Thabane.

 

The research concluded it is time that Canada test a "nurse-led, proactive, targeted model of comprehensive chronic care with a physician as a member of the team," whereby the nurse, as opposed to the physician, would be in charge of enlisting the necessary health and social services based on an individual's treatment needs.

 

It cited examples such as a post-operative wellness model established by a clinical nurse specialist that helped Royal Columbian Hospital's cardiac surgery department to move from helping 300 patients to 800 patients per year.

 

The report stated that one of the things the model, established by Jocelyn Reimer-Kent, accomplished was to take a proactive stance to controlling pain, nausea and food intake, enabling post-operative patients to be discharged much more quickly without feeling they are being "pushed out" of hospital too soon.

 

Additionally, a complex chronic disease management clinic in Calgary where nurses were given a leadership role was cited in the report as reducing by a quarter the number of hospital admissions and by half the length of hospital stay of those who required admission.

 

The report also emphasized that research shows a link between higher nurse staffing levels and lives saved in hospitals. In particular, this meant "reduced hospital-related mortality, hospital-acquired pneumonia, unplanned extubation, failure to rescue, bloodstream infections acquired in the hospital, and length of stay."

 

Although the report stated "the human value [of these achievements] cannot be calculated," it estimated an average of $224,000 was added to the Canadian economy per life saved, based on the idea that individuals whose deaths were prevented by higher nurse staffing levels would go on to be productive members of society.

 

In addition to a leadership role for nurses, the report emphasized a rapid expansion in the use of technology by nurses and health professionals.

 

Technology such as smart-phones, email and Skype "hold the potential to change the face of health promotion, improve timely access to care, and put valid and reliable information and research into the hands of patients, families and providers," argued the report.

 

© Copyright © The Vancouver Sun

 

http://www.vancouversun.com/health/nurses+charge+better+cheaper+health+care+report/6800546/story.html#ixzz1yBkbf74D

 

All the multidisciplinary care in theory is good, but often is inefficient imo. Secondly, it leads to role creep as shown by this article.

[NLengr]

I'm not sure what this means exactly. I, and most of my fellow residents, give our nurses a fair amount of lee-way on managing pain, nausea and diet. Lots of times we pan order Tylenol, tramadol, dilaudid (po and sc for breakthrough), along with zofran and gravol, plus CF to DAT. The nurses then tailor to the patients needs. But we specifically know what we are authorizing. I have no problem with this.

 

If we are talking about getting nurses to start evaluating post op pain from scratch, ordering CT's, working up post op patients for irretractable nausea etc. then I am much less comfortable.

[jerkstore]

I'm not sure what this means exactly. I, and most of my fellow residents, give our nurses a fair amount of lee-way on managing pain, nausea and diet. Lots of times we pan order Tylenol, tramadol, dilaudid (po and sc for breakthrough), along with zofran and gravol, plus CF to DAT. The nurses then tailor to the patients needs. But we specifically know what we are authorizing. I have no problem with this.

 

If we are talking about getting nurses to start evaluating post op pain from scratch, ordering CT's, working up post op patients for irretractable nausea etc. then I am much less comfortable.

 

Women man, Women lobbyists. Scary.

 

I certainly hope they have some Physician panel in the government advising about this, and they aren't just asking Dalton McGuinty to give them more autonomy.

 

The answer is more PA's and NP's, not giving RN's (or RPN's from what I hear the trend is) more autonomy.

[Robin Hood]

These Nurses amaze me, they want to do everything to take the role of the physicians without having to go to med school.

[jerkstore]

They think they're so highly skilled but they don't know ****, and do nothing more than stick needles, apply bandages and clean ****.

 

Yeah let's hand over the reigns of the Canadian health care system to them, and become the laughing stock of the world.

 

Don't worry folks I wouldn't put much into this, even if there was a big movement - the Physicians have far too much pull.

 

This is just another amusing Nurse to laugh at. They got their nurse practitioners, their nurse anesthetists, their midwives, now apparently the RN's should be running things. There may be a day where they run their own departments with more autonomy, but they will never be "in charge".

 

The day I see an RN giving orders to a Surgeon with 13 years of education, the day I see "Becky" who graduated in 4 years from everest college giving orders, is the day I blow up parliament.

[holiday1001]

They think they're so highly skilled but they don't know ****, and do nothing more than stick needles, apply bandages and clean ****.

you're gonna do real well in med if you treat nurses like that ^^

[jerkstore]

you're gonna do real well in med if you treat nurses like that ^^

 

I wouldn't, I'm just pissed at these particular Nurses. Even though that particular quote is true, + monitor vitals. Not saying they aren't hugely important and useful, but in what upside down world would they ever be in charge? Let's just leave them to it and give all the Doctors a month off - see how they make out.

[NLengr]

These Nurses amaze me, they want to do everything to take the role of the physicians without having to go to med school.

 

I don't think this is what the article is advocating.

 

It seems like in Columbia, the nurses were coordinating getting PT/OT/SW involved, advancing diets etc. We already do this in Canda to a great extent. I don't think the point of the article was that nurses were going to start telling surgeons how to manage post op patients.

[jerkstore]

I don't think this is what the article is advocating.

 

It seems like in Columbia, the nurses were coordinating getting PT/OT/SW involved, advancing diets etc. We already do this in Canda to a great extent. I don't think the point of the article was that nurses were going to start telling surgeons how to manage post op patients.

 

All I'm getting from the article is that the more nurses you have, the more lives are saved...which is obvious. I don't know how the author managed to extrapolate that into putting nurses in charge, which is obviously impossible - unless your goal is to have all Doctors pack up and leave Canada.

[medisforme]

They think they're so highly skilled but they don't know ****, and do nothing more than stick needles, apply bandages and clean ****.

 

Ha ha, I can't tell if you are serious or just trolling. Though I can assure you that the only one who doesn't know **** Is you. Being an RN, I will tell you nurses do a lot more than that depending on what their specialty is.

[DeeDoc]

I am refraining very much from making a rude comment on this thread. Consider the following... (estimated from an article on student doctor network)

 

RN hours of clinical training - 1,000

Physician Assistant/Nurse Practitioner - 2,000

MD - over 10,000

 

NPs and PAs want more power? Sure, then they can accept the responsibility that comes with it. When it comes down to it, something goes bad? The nurse wants NOTHING to do with it. It's all the doctors fault. Nurses trash talk doctors behind their backs and how stupid they are ALL the time.

 

Try and tell me otherwise and I will call you a blatant outright liar. Or, you're just naive and have not actually worked in an acute care setting.

 

That's all.

[medisforme]

Nurses trash talk doctors behind their backs and how stupid they are ALL the time.

 

That's all.

 

I have been an RN for 7 years and this has never been my experience, so you can understand when I say that it is hard to take you seriously when you make generalizations like that. For the most part nurses and physicians do a great Job of working together to optimize patient care. They have different roles which complement each other to provide high quality care to patients.

[vancity88]

When it comes down to it, something goes bad? The nurse wants NOTHING to do with it. It's all the doctors fault. Nurses trash talk doctors behind their backs and how stupid they are ALL the time.

 

Try and tell me otherwise and I will call you a blatant outright liar. Or, you're just naive and have not actually worked in an acute care setting.

 

OK, call me a liar. And I'll tell you that your experience is limited. Maybe what you're describing is the case in some settings, but I would attribute that to a toxic work environment that could happen in any field. Moreover, my guess is that it's limited to one or two doctors who could very well be bad apples.

 

In my personal experience as a medical student/clinical clerk at various clinical sites, RNs and MDs get along just fine and there is plenty of mutual respect between the two groups (obviously and as with all things, I have observed some exceptions, but generally speaking, this is the case). Also, to suggest that nurses try to flee the scene when something goes wrong is just plain ignorant. Nurses are just as passionate about patients as doctors are, and they work just as hard to ensure a high standard of care.

 

Whether they should be accorded more responsibility is another story, but I would really, seriously encourage you to not be that med student who comes in with this sort of negative attitude about nurses. They are a valuable resource, and I promise you will come to understand that over the course of your medical education.

[DeeDoc]

OK, call me a liar. And I'll tell you that your experience is limited. Maybe what you're describing is the case in some settings, but I would attribute that to a toxic work environment that could happen in any field. Moreover, my guess is that it's limited to one or two doctors who could very well be bad apples.

 

In my personal experience as a medical student/clinical clerk at various clinical sites, RNs and MDs get along just fine and there is plenty of mutual respect between the two groups (obviously and as with all things, I have observed some exceptions, but generally speaking, this is the case). Also, to suggest that nurses try to flee the scene when something goes wrong is just plain ignorant. Nurses are just as passionate about patients as doctors are, and they work just as hard to ensure a high standard of care.

 

Whether they should be accorded more responsibility is another story, but I would really, seriously encourage you to not be that med student who comes in with this sort of negative attitude about nurses. They are a valuable resource, and I promise you will come to understand that over the course of your medical education.

 

Nowhere did I state that nurses are not a valuable resource. I do not have a negative attitude towards nurses. What I strongly dislike is nurses trying to tell doctors they aren't doing their job and that the nurses could do a better job of it.

 

The article states, "more nurses, equals more lives saved." Do you not think this is trashing physicians? If you do not see the blatant ad hominem attack on the profession as a whole, then you are ignoring some key points.

[DeeDoc]

I have been an RN for 7 years and this has never been my experience, so you can understand when I say that it is hard to take you seriously when you make generalizations like that. For the most part nurses and physicians do a great Job of working together to optimize patient care. They have different roles which complement each other to provide high quality care to patients.

 

Different roles you say? Yes, I completely agree. So if nurses want more responsibility they should attend medical school or a masters program in nursing.

 

You made a generalization by saying, for the most part... so you have seen instances where what I said is true? So then why are you saying you can't take me seriously? Your comment is equally as invalid then, is it not?

 

I love nurses. I really do. They do a ton of work. I appreciate this, I recognize this.

 

BUT, nurses are territorial when it comes to their jobs. They don't want anyone to infringe on their responsibilities, so why should they infringe on a physicians responsibilities?

[jerkstore]

Ha ha, I can't tell if you are serious or just trolling. Though I can assure you that the only one who doesn't know **** Is you. Being an RN, I will tell you nurses do a lot more than that depending on what their specialty is.

 

Nurses do more than administer medication, bandage, clean sh!t, monitor vitals, take charts, brief physicals, and the occasional nasogastric intubation? I suppose a surgical nurse does none of the above besides clean sh!t, bandage, and hand instruments to the surgeon - if that's what you meant by "depending on the specialty" aka. in which department does the nurse do up to everything I listed above.

[Robin Hood]

And now, we have nurses calling themeselves using the Doctor title. (DNP)

[jerkstore]

And now, we have nurses calling themeselves using the Doctor title. (DNP)

 

I'd rather a DNP call their self (is it theirselves, themselves? what is the singular?) a Doctor than an Optometrist or Chiropractor.

[Robin Hood]

I'd rather a DNP call their self (is it theirselves, themselves? what is the singular?) a Doctor than an Optometrist or Chiropractor.

 

What's wrong with ODs calling themeselves Doctor? They do a lot of medical stuff (a recent grad told me they do everything but complex cases and surgery).

Chiropraty is pseudo-scientific charlatanism.

DNPs calling themeselves Doctor is confusing, and it seems one of the reasons for setting this up is indeed calling themeselves Doctor.

Singular is: herself/himself.

[jerkstore]

What's wrong with ODs calling themeselves Doctor? They do a lot of medical stuff (a recent grad told me they do everything but complex cases and surgery).

Chiropraty is pseudo-scientific charlatanism.

DNPs calling themeselves Doctor is confusing, and it seems one of the reasons for setting this up is indeed calling themeselves Doctor.

Singular is: herself/himself.

 

One of those huge self-facepalm moments.

 

It's been a long day at work.

 

But what if you don't know the him or her? Like in my statement.

[drkwhy]

One of those huge self-facepalm moments.

 

It's been a long day at work.

 

But what if you don't know the him or her? Like in my statement.

 

Themself.

 

Pronoun:

Used instead of “himself” or “herself” to refer to a person of unspecified

[Robin Hood]

One of those huge self-facepalm moments.

 

It's been a long day at work.

 

But what if you don't know the him or her? Like in my statement.

 

I dunno, I'm French-educated.

But I know you can't use "it" for people.

[bloh]

This forum has really gone downhill.

[Med0123]

I have nothing against nurses taking minor cases in Family practice if they are supervised, a little bit like if they were medical clerks

 

It would speed up things greatly and improve primary care access

[bloh]

But medical clerks don't speed up things; if anything, they slow things down. On top of that, you'd be paying nurses while clerks go unpaid. It would actually cost the system more.