By Patricia Foster, RN
I have been privileged to work in a nurse led clinic for 17 years. The Comox Valley Nursing Centre began as a demonstration project, highlighting nurses working to the full scope of their practice, in partnership with the community. Chronic illnesses and in particular chronic pain were the primary needs.
Patients and colleagues have taught us much:
- Poverty undermines a person’s ability to pursue health. We must address the intersection between socioeconomic factors and illness. Cross ministerial planning is key to supporting those families most at risk.
- Partnership with patients is critical to the pursuit of health. Partnership means listening to what the patient’s goals are, not assuming we know based on a common diagnosis or standard care plan. Partnership means supporting patients to gain knowledge, recognize their own strengths. Partnership helps them navigate a complex health care system through nursing advocacy.
- Open referral policies to ambulatory community based programs (i.e. low barrier access to nursing) means patients are not waiting for doctor’s orders to access nursing.
- Nurse led clinics with access to interdisciplinary teams are effective for chronic disease management. Existing approaches to health care funding or delivery models that insist on MD leadership or provide funding only through physician or large corporate entities limit cost effective innovation. We need to take what we learn from successful projects and “grow it” — continue funding beyond the innovation stage.
Finally, what do we need from nurses, other health professionals, governments and the public to address the challenges? We need compassion, basic respect for humanity and a civil society that seeks to support all of its citizens.
Patricia Foster is a dynamic, passionate and articulate nurse with 37 years of experience in a variety of roles and settings: nurse practitioner in First Nations communities; continuing care case manager; clinical nurse specialist in geriatric rehab and private practice (continence speciality); educator; staff nurse and manager in primary health care setting.
Since 1998 Patricia has been the Manager of the Comox Valley Nursing Centre/North Island Regional Eating Disorder Program. She is a consultant for Community Living BC and a committee member for the Provincial Ethics Network, BC Ministry of Health.