Why? Change: Nurse practitioners

This piece is part of Future Health Policy Network

At the Living Well Together conference at the University of Toronto last September we spoke to more than 200 registered nurses about changing attitudes in practice and community, and how things have changed in our industry over the past 15 years.

After four years of collaboration, this collection of shorter essays on things we know are important to caregiving in Ontario explores issues such as social supports and coping strategies, staffing, patients and disabled individuals, senior care, planning and case management.

Asking questions about the way nurses practise – like how we link into the community and what others in the profession can learn from our experiences – was part of the collaborative process.

While there are a range of diverse opinions, what the eight nurses below have in common is a strong sense of the need for more collaboration and more community-based services as a core part of improving services in care.

The health care sector presents a unique reality for caregiving. We have an intense bond with patients, employees and the community – we know firsthand what lives are impacted by illness or disability, we know about what is unique about each person, we work with clients and attend funerals. And because we are based within this environment, we have a relationship with all of these communities, and feel as though we have a responsibility to help and serve them.

Until 20 years ago we were also responsible for handling negative behaviours, so we often had a personal involvement with health professionals in interventions to prevent people from engaging in risky behaviour – for example, in our home care teams who can help identify why an individual’s behaviour is getting worse.

How do we learn from each other? Here’s what we learned from the speakers at the conference:

Health and social care providers need to make a commitment to attend social and prevention services in the community.

Social workers and nurses are the most important specialists in this area, in our schools and community, because of the role they play in preventing deaths and disabilities and can guide care, promote changes, generate community connections, and link social services to preventative strategies.

Funding social activities will not happen, but the importance of connecting the self-employed with social workers and health care professionals on a daily basis is paramount.

Our health system has to learn from us how we practice – so that it truly is the best place in which to work.

That means how to transfer knowledge; be financially realistic; make the best use of time and effort when we are in the community; and provide constant support through coaching and mentoring.

“It is not about the nurse but about the clients and about the management of the nurse.”

Ivan Glikas, Ontario Registered Nursing Association

Fiona Byrne, Ontario Nurses Association

Bradley Buck, Ontario Nurses Association

Philippa Howard, NIMS Ontemfang

Anthony McDonald, CUPE Local 2009, Unifor

Katherine Martin, CUPE Local 264, Unifor

Lisa Presley, Ontario Nurses Association

Carol Neal, Registered Nurses Association of Ontario

Sue Ponte, Department of Nursing, Loyola University, Georgetown, OH

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