Health Care Reform – How does it affect nurses?
As someone working in the Community Nursing Sector in Ontario we have been preparing for these reforms for several years through the development of care pathways. The provider I work for if a for profit company that strives to provide the best possible care and service to its clients. This is achievable more so when we remove the red tape and ‘middle man’ that so often slows the system to a halt. When providers are able to have clinicians use their knowledge skill and judgment to improve outcomes of our clients it not only makes financial sense but you see the ability to reward nurses for a job well done, putting the autonomy back into the profession. Both of these result in improved work environments and client outcomes.
Hi Katie. This sounds like an interesting approach. Although I don’t have experience working as a community nurse, I have participated in using community skills nursing without holding an official job as a community nurse through an agency. Some experiences have been very positive, stepping outside my traditional roles in LTC. It’s great to hear community nursing thriving in areas. I do feel working in the roles I have, the system is integrated at times and we do learn from one another, however, this seems more guarded. At my workplace, the use of community nurses and paramedics from the community, has really been an asset and great help at times when needed, as well as, when those opportunities have come to work with these individuals, the sharing of their knowledge base is invaluable, when facing an imbalance of supply and demand in the past few years.
As someone new to for-profit care I could not agree more with what you stated about this removing much of the ‘red tape barriers’ we see in the not-for-profit sector. Rather than relying on HCCSS many of our patients/caregivers choose to pay to have access to myself, an OT, a pharmacist and/or a social worker. We are able to see most patients within 48-72 hours of the initial call which is helping reduce families going into a crisis and therefore reducing the burden on our already stressed health care system.
The healthcare reform has affected nurses by creating opportunity for education, skill development and learning. Through different roles, integral for development of the health care field and integration of processes throughout the LHINs, it has been necessary to create diversity within each area to meet the needs of the population. Although the demands of the healthcare system have been taxing on nurses, over the years, as involvement of interdisciplinary teams’ members have lacked in certain areas, or where funding and/or staffing shortages have been a concern; the reform has allowed nurses to explore and expand his/her skills, offering opportunities for personal growth and career development. In LTC, a nurse must possess the ability to accurately assess, provide nursing care at the bedside, while also using counselling skills to meet the resident’s needs. Nurses are required to work as a team and communicate with residents, families, and the community, while relaying the appropriate information to the interdisciplinary team. LTC has become a diverse place for collaboration of skills and roles, working amongst workers, who also are employed within the community. LTC has expanded to provide more in-depth care, collaborating with the community to increase resources offered to residents within the home environment, while collaborating with other health care facilities to optimize care. Through this, the development of care has improved, allowing change and implementation of community trained health care professionals, as well. This has allowed diversity in care in the home, the needs of residents to be met much easier, and allowed time for skill development without and learning opportunities for RN’s and RPNs.
The same has been seen in the community sector. As RPN’s in the last 20years I have seen our role in community expand with our scope of practice in leaps and bounds. This has lead to an increase in professional development for all RPN’s within community nursing. Great pride and attention to detail is evident in our nurses. This in turn supports the clients in community and improves outcomes which is the intention of these reforms across the board. I would add that it is still an area that needs financial support, as RPN’s scope of practice has increased we need to continue to advocate to see that reflected in the rate of pay. Many of our RPN’s in community have identical job responsibilities to the RN’s they work with but that is not notable on the pay scale.
I have seen both positive and negative impacts of health care reform in my nursing career. In LTC, our leadership would often choose to admit those with conditions that would increase our funding which I feel doesn’t always equate to equal access to care. On the positive, in my role with the Memory Clinics, we would connect caregivers to the supports they need – whether this be PSW assistance, social work, OT assessments etc. Having the ability to request all these services through HCCSS and connect caregivers with a dedicated HCCSS team member significantly reduces the burdens placed on caregivers and therefore also helps nurses provide the support our patients / caregivers need.