The ideal health care model recommended by a national panel of nurses is already being practiced in many places in the North, according to Fort Smith nurse practitioner Julie Lys.
The Canadian Nurses Association’s National Expert Commission celebrated the completion of its one-year mandate last week by releasing a report of recommendations for a nurse-led, patient-centred model of primary health care that advocates bringing all sectors of government and society together to meet the health needs of individuals.
The report, titled A Nursing Call to Action, is based on a year of cross-Canada consultations with health care providers and the public. Though it makes recommendations to policy-makers, the report puts the onus on nurses to be leaders in their communities to make the changes required.
Lys, who was one of the commission’s experts, said the patient-centred, interdisciplinary health care model is more likely to be successful in small, Northern communities than in the south where the system is divided into isolated units that don’t communicate well, or at all.
“I think that it’s probably easier to do in the North than anywhere else because in every community, there’s limited clinicians and practitioners, so doctors, social workers, nurses – we all work closer together because we are the system. It’s not as siloed,” she said.
Lys said communities like Fort Smith, which have many types of health care professionals under one roof, can provide continuity of care that does not exist in larger centres.
“A patient goes into emerg in the south and that’s one encounter. They don’t connect that encounter to an office visit the next day. Whereas here at the (Fort Smith) health centre, if somebody comes in to out-patient at night, we follow them up the next day and we can say, ‘come back and see me in the morning,’ and you can actually see that person. The key to education and changing health is that continuity, seeing the patient again and (asking) ‘did that work for you?’ – really developing that relationship and understanding.”
The commission strongly recommends policy-makers recognize social determinants of health, such as housing, poverty, food security and safe drinking water, as connected. Lys said it’s vital for different departments to work together on these issues to ensure their population is healthy and successful.
“People tend to protect their roles, and their departments are the way they do things, whereas maybe we should just be looking at what’s really right for the patient, what’s going to make a difference in their health,” she said.
As well, she said, professionals should include clients in the policy-making process and familiarize themselves with the history of colonization to better understand the health of their Aboriginal patients. Lys said success will depend on different agencies stepping out of their comfort zones and cooperating.
“It’s going to take huge bureaucratic changes where we all work together. I think everybody has a role to play,” she said.