December 15, 2024 • 28 mins
This week, join host Allyson Thomas on the Nursing Grand Rounds podcast as she sits down with Tannis Andersen to explore the essential world of primary care nursing. Tannis shares her expertise on providing holistic, patient-centered care in diverse community settings. The episode dives into the key responsibilities of primary care nurses, the importance of building strong patient relationships, and how they act as the backbone of preventive healthcare. Whether you’re passionate about primary care or curious about the field, this conversation offers valuable insights into the rewarding challenges and opportunities it presents.
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Episode Transcript
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(00:09):
hello, and welcome to the interior health nursing grand
rounds, a podcast conversation. i am your host,
allison thomas. and on this podcast,
we talk all things nursing and health care.
i work as the clinical nurse specialist in the trauma services
network in interior health. interior health would like to
(00:31):
recognize and acknowledge the traditional ancestral and unceded
territories of the dekalbanae, tanaha,
inlakatma, chihuahuan, statlian, syilx,
and chikotun nations, where we live,
learn, collaborate, and work together.
and today i'm so thrilled to be able to introduce you to my
(00:54):
colleague, tanis anderson. so tannis is here to talk to us
about primary care nursing. today,
i'm really excited about all the things i'm going to learn from
her. and, um, maybe, tannis, can i just ask you to introduce
yourself and tell us a little bit about your nursing background?
yes. so i would like to acknowledge that i have the
(01:14):
privilege to live on the traditional ancestral and unceded
territory of the syoaks nation in what is known as kelowna,
british columbia. this is where i get to enjoy the beauty of the
lands every day, and i'm very thankful to be able to learn,
work, and play here. um, i have a beautiful family with two amazing
(01:35):
adult children. i've been a nurse for over thirty years.
and the first part of my career, i spent in seniors health,
while the latter half of my career,
i've been able to spend in primary care.
i started as a diploma nurse and then obtained my nursing degree
at the university of calgary and then completed my master's in
(01:56):
nursing at athabasca university with a teaching focus.
amazing. so you come with, uh, such great background for us and,
um, you have lots of expertise to share.
uh, maybe, tannis, this might seem like a silly question,
but could you tell me what is primary care and who works there?
(02:17):
so primary care, uh, is providing care across the lifespan
in patient medical homes through a team based care environment,
looking at a model of staying healthy,
getting better, living with chronic illness and disability,
and coping with end of life through a person and family
centered lens. the patient medical home is an optimized
(02:41):
family practice that provides patients with comprehensive
longitudinal primary care. it is a foundation of an integrated
system of care. and then within bc,
we have primary care networks where the patient medical homes
and other primary care providers, health authority providers,
first nations and community organizations are networked
(03:03):
together to provide the primary care services that a local
population requires. within this, we also have urgent
and primary care centers in british columbia,
which provide urgent primary care for conditions that require
primary care within twelve to twenty four hours but don't
actually require the resources of an emergency department.
(03:25):
one of the greatest benefits of of primary care is that we work
within a team based care and it provides health services within
the patient medical homes and urgent and primary care centers
to individuals, families, and other communities through a
variety of health professions working collaboratively together.
the team may consist of physicians,
(03:46):
nurse practitioners, medical office assistants,
nurses, and allied health. examples of allied health are
pharmacists, dieticians, occupational therapists,
physical therapists, and social workers.
and then as health professionals, we each have different skills and
knowledge to help our patients. and depending on the patient's
(04:08):
needs when they visit, they may actually see one or more team
members. each patient medical home and urgent and primary care
center team members will be unique based on their community
needs. i would like to outline, though,
that the most important person of this team is actually the
patient. through person and family centered care,
patients are at the forefront of their health care,
(04:31):
and they lead their care through informed decision making in
collaboration with their health care team.
when i talk about staying healthy within primary care,
we really want to be able to involve supporting promotion and
prevention activities within the communities.
and in british columbia, we follow what's called the bc
(04:52):
lifetime prevention schedule. this schedule looks at clinical
prevention services across the lifespan and includes screening
recommendation and behavioral interventions.
this also includes health education,
risk screening, health counseling,
health promotion, primary prevention,
and immunizations that all fall within staying healthy.
(05:17):
and then when we look at the getting better,
getting better provides that episodic care,
including treatment of acute conditions.
and then living with chronic illness and disability,
we are able to support through chronic disease management and
secondary prevention. secondary prevention is reducing the impact
of that disease. and we also look at rehabilitation and long term
(05:40):
care. and then the last area for primary care is coping with end
of life care, and that includes physical comfort and supporting
emotional and spiritual needs. wow.
so, basically, what you're telling me,
tanis, is primary care does everything,
uh, everything that a patient might need.
um, so that's amazing. that's such an it is the critical part
(06:04):
of our health care system, isn't it,
the primary care? it is. it's our first entry into the health care
system. and our goal is definitely to support that
longitudinal practice and be able to support individuals,
families, and communities across that lifespan,
keeping them healthy as well as supporting them when they have
(06:25):
medical health care needs. mhmm. i i love the focus on,
um, person centered care and and what's important to the person,
not just what we think as health care providers should be their
priorities. i love that. um, could you tell me a little bit
more about the role for nurses in primary care?
(06:49):
the role for nurses in primary care is very vast as
you can tell from when you look at what is primary care.
um, but the registered nurse in primary care is also known as a
family practice nurse, a primary care nurse,
or a nurse in practice. the nurse provides care across the
(07:11):
lifespan, and they form long term continuous longitudinal
relationships with the patient in the medical home.
they help patients navigate the system and access resources.
they can provide education and support directed at health
promotion, disease prevention, and management of chronic
conditions. the nurse is a valuable team member within the
(07:33):
patient medical home. and depending on the reason for the
patient visit, there may be times when the patient actually only
sees the registered nurse or may see the registered nurse and
other members of the healthcare team.
through professionalism, clinical practice,
communication, collaboration and partnership,
quality assurance, evaluation and research,
(07:55):
and leadership, the primary care nurse can provide multiple
services. so a few of the services or care that the nurses
can provide, um, is prenatal care,
well baby checkups and annual exams.
primary care nurses can support reproductive and sexual health.
(08:15):
they may be helping the patient navigate the health care system
and transitions between settings. they provide care in between
settings. they provide care and collaboration and also
support case management, conduct preventative screening,
coordinate and implement primary care based programs for healthy
living. they can connect and refer you to other health
(08:38):
professional services and supports in the community,
provide mental health and addiction support,
work with patients to understand their medications,
support illness management. and a lot of conditions that we support
are diabetes, asthma, copd, heart disease,
high blood pressure, um, renal, and,
(09:01):
uh, any liver problems. and so the list is actually quite
extensive. um, providing health education.
uh, we do provide direct care. so we do procedures such as simple
or basic wound care, ear syringing,
routine adult immunizations, plantar wart treatment.
(09:23):
we do point of care testing, which is really like blood
glucose monitoring, pregnancy tests,
urinalysis screening, cognitive screening.
in some primary care practices, registered nurses actually have
the ability to obtain certified nursing practice,
which is specific to bc. and this also optimizes their scope of
(09:44):
practice and ability to provide advanced nursing care.
areas that nurses can obtain the certified practice in are sexual
health, contraceptive management, opioid agonist treatment,
and treatment of common primary care conditions.
registered nurses in primary care,
as you can tell, are really generalists.
(10:04):
and they need to know a little about a lot.
and they support their autonomous practice with continuous learning
to remain current and following evidence informed practice.
wow. tanis, um, tell me about what
are what are some of the things that you love about primary care
(10:26):
nursing? why has this become your home?
um, when i was looking at that question,
i was like, i'm like, i love everything about primary care
nursing. um, it really is my passion.
and once i fell into it and started working within it,
(10:47):
um, i have had a great opportunity to advance my nursing
career and have hopefully a positive impact on primary care
nursing. as a clinical nurse specialist in primary care,
i get to support, uh, primary care from a clinical consult
perspective, a leadership perspective,
(11:08):
advancing nursing practice a lot through education and
evaluation and research and sitting on research projects as
well. it's really exciting to be able to work in the four domains
of clinical nurse specialist practice.
and as the primary care nursing has the ability to positively
(11:29):
influence the health of individuals,
families, and communities through relationships in a team based
care environment, it just warms my heart to be able to
uh, practice and be able to make that difference.
the ability to change lives and shape the future of health care
provides an exciting opportunity to make that difference and
(11:51):
really be a part of giving back. and then just the scope and
breadth of primary care nursing and working across the lifespan
provides unending excitement, growth,
and relational care. and those are all amazing aspects that,
uh, really speak to me and speak to my nursing practice.
(12:12):
and while it does hold a lot of responsibility as primary care
nurses, we are definitely equipped to do all of this and
more. mhmm. so knowing what you know now,
if you could go back in time to the time that you transitioned
into primary care, would you make that decision again?
i absolutely would, um, move into primary care.
(12:35):
i would have say i would like to have moved into it earlier than i
had moved into it. mind you, i do love my seniors' health and a lot
of transition from seniors' health into primary care are all
of the same principles and concepts.
but i definitely would move into primary care.
and i am just so excited when nurses are interested in primary
(12:56):
care, and i can talk endlessly about it and encourage everyone
to move into primary care. right. what do you think are or do you
think there are, i guess, but what do you think are some
misconceptions that people have about primary care nursing?
well, i've been specifically speaking about registered nurses
(13:16):
in primary care, but i do believe it's really important to
highlight that there are multiple nursing roles available to
support primary care. so we do have nurses working that are
licensed practical nurses, registered psychiatric nurses,
registered nurses, and nurse practitioners.
and as nurses, we can really work together to optimize each of our
(13:38):
scopes and work as a team and provide that primary care nursing
within the patient medical home. having these multiple nursing
roles complements each other to provide nurses with many avenues
to enter primary care nursing and work within the scope that meets
their career goals. so there's a place for every nurse within
primary care. then i guess i would say probably
(14:03):
the second thing that i would like to bring awareness to is
that all nurses are regulated health care professionals.
all nurses have their own scope of practice,
standards of practice, and educational requirements,
and that they really work within four levels of control and
practice that include regulation and legislation.
so a lot of our government, uh, regulations and legislation that
(14:26):
are passed as well as, nationally.
we also are supported by our regulatory body,
which is the british columbia college of nurses and midwives.
we're supported also by our employer through our clinical
decision support tools, our policies,
and our procedures. and then lastly,
(14:47):
we are responsible for our own individual competence,
and we do have the ability to be working autonomously within our
scope that is outlined by the ccnm.
this does all impact the work and care that we provide within
primary care setting, and it helps ensure quality safe patient
(15:07):
care. mhmm. great. and so if you could talk to
every primary care nurse in the world,
um, from your from your lens, you i think you get to see kind of a
bird's eye view of what's going on,
uh, at least in our health region and,
uh, probably elsewhere. is there one or two things that you
(15:30):
would like every primary care nurse to know?
i really feel that, uh, it's like every primary care nurse to know
that primary care nursing is an amazing field to work within and
that primary care nurses really are making a difference.
and this is, you know, locally within the own community.
(15:52):
we're making a difference with our patients themselves,
with our families, and with our communities.
but we're also making a difference provincially,
nationally, and internationally. and one of the best
pieces about being a primary care nurse is those relationships and
the person centered care are at the heart of being a primary care
(16:15):
nurse. and that is really the foundation of
being able to provide primary care nursing and having the time
to be able to provide that relational care.
if there is somebody listening out there who's thinking,
oh, i think primary care is for me,
(16:37):
uh, and how do i move into that kind of work?
do you have any suggestions for where people might start?
is it as simple as looking for job postings,
or how would you suggest someone goes about that?
so absolutely. the first, um, would be looking at job postings
that are available. but there are so many vast areas within
(17:02):
primary care. so, you know, we have outreach clinics.
we have patient medical homes. we have urgent and primary care
centers. uh, we have community health centers.
we have, uh, primary care network hubs.
so there are multiple, um, positions that are available to
(17:22):
be able to look and find. there is the canadian family practice
nurses association, which is national across canada.
and that is a really good place to really start to look towards
primary care nursing. the cfpna has webinars about primary
(17:42):
care nursing on their website. they also have posted our
canadian core competencies for primary care nurses and really
encompasses what those national competencies are available.
reaching out to any nurse that is in primary care.
i'm always more than happy and excited to talk to nurses about
(18:05):
primary care. and then canadian nurses association,
they also have a website on primary care nursing and what's
happening nationally. the world health organization has
information on primary care internationally and what is
involved within that. so many avenues to reach out and
(18:30):
start investigating and and, uh, determining if primary care is an
area they would be interested in. great.
and you've already, i think, pointed us to some really good
places to look for resources, but i'm wondering if you can share
maybe some of your favorite resources for primary care
(18:50):
nursing and and point us in the right direction if we're looking
for, um, really quality resources.
yeah. so the canadian family practice nurses association,
as i've mentioned, is, uh, probably the best,
um, place to start. and as i said,
(19:10):
they host the national competencies for registered
nurses in primary care. they have their webinars.
they also, uh, this year have started a primary care team
nursing for education, which is a two and a half hour free
course to be able to take if you're a member of cfp and a.
(19:33):
and it really provides the foundation of what is primary
care nursing and what types of skill sets and education do
you really need to start having. so,
again, it talks a lot about that team based care,
talks about what the patient medical home is more in-depth,
talks about critical thinking and care planning,
(19:54):
and really provides a good strong base of primary care nursing.
i spoke also briefly earlier about the bc lifetime prevention
scale. and so that is a great place to go,
uh, for british columbia because it does outline clinical
prevention services for british columbia.
(20:15):
and it is across the lifespan. so it looks at,
you know, supporting children, infants,
prenatal care. it looks at, you know,
supporting chronic disease management.
it looks at supporting when should you start screening for
certain types of cancer, what type of screening and when should
you start for, say, chronic disease management like diabetes
(20:38):
or hypertension? and so it's a really good place to go to
really look at what the heart of primary care is and helping keep
british columbians healthy. i'm gonna go look that up as soon as
we're done talking. the other thing
that is available in bc, it's called bc guidelines.
(21:00):
and they're clinical practice guidelines and protocols that
provide recommendations to b. c. practitioners.
and there is a whole list of health care conditions and how to
support and manage those conditions.
and it is also kept current, so it's very evidence informed.
and it helps guide practitioners in managing different conditions
(21:23):
that their patients have. and if it's not necessarily specific
to each condition, particularly, we know that there's a lot of
specialties within those bc guidelines.
and so when you're starting to go into those bc guidelines and look
things for, like, pediatrics, it sends you back to the bc child
(21:47):
health because that is going to be our expert in that area.
or there is perinatal services, and it will direct you to the
perinatal services area. um, if you're looking up diabetes,
it helps support you to go into the canadian diabetes association
where the diabetes clinical guidelines are.
(22:07):
so it's kind of a one place for bc practitioners to be going to
support. and it's a really good place for nurses to go because
then we're able to help support the practitioners when we
understand what guidelines they're working from.
and so i always recommend individuals go into those bc
guidelines and be able to stay evidence informed within their
(22:29):
practice. i'd also really like to say that the university of
british columbia okanagan is really leading the way in primary
care nursing education through either a post baccalaureate
primary care nursing certificate or a primary care practice
essentials micro credentialing. and the really exciting piece
(22:50):
about that is the post baccalaureate primary care
nursing certificate is brand new and has just been approved.
and, uh, so we're getting that going.
and that's going to be amazing because we're going to have
baccalaureate nurses as well as master's nursing students all
(23:11):
be able to take this certificate program.
and then the essentials for the micro credentials is also new.
it started earlier this year with a health assessment course,
and now they're going to be moving into a case management
care coordination course. the nice thing about the micro
credentials is you can just take one course or another,
(23:34):
like one course, or you can take all of the courses when they're,
um, available. but some nurses find that that just might fit
into their practice a little bit easier than having to take a
certificate program. so really exciting,
uh, with these new courses and education that is available to
(23:55):
primary care nursing and certainly is one of a kind and
one of the few education available for primary care
nurses, uh, beyond what um, they're able to
take within their nursing programs.
would you like to comment, um, tanis,
on your involvement in developing that work at ubc?
(24:16):
i think you're being modest. um, i've been very excited,
um, through that work. so, um, sheila epp is,
um, been amazing and has been leading the work along with neli
oakley. and so when they were looking at it,
i had the opportunity to be able to provide some feedback and some
(24:39):
content expertise. and then i've also been able to
develop post baccalaureate primary care nursing certificate
courses. so, um, it started off with one,
um, primary care nursing course, and now we're going to be
creating a level two course and then a a practicum.
(25:00):
so i've had the pleasure of being able to be thoroughly involved
within it. um, but definitely, sheila and neli,
um, have been the experts and have,
um, graciously brought myself in, um,
to be able to support and advance nursing.
(25:21):
amazing. and, uh, curriculum development is no joke.
that is a lot of work. so congratulations for your
involvement in that. i also recently
had the opportunity to attend the international council of nurses
conference, uh, nurse practitioner,
(25:43):
advanced practice nurses in september.
and i was really excited when i was there because within the
opening of the conference, the international council of nurses
actually launched a new position statement and discussion paper
setting out the revolution in the delivery of primary health care
(26:03):
and saying that nursing is going to be the key profession
to transform primary health care and is essential to meeting their
goal of universal health coverage.
and so this position statement is called nursing and primary health
care. and so there is a big focus internationally on what
(26:25):
primary care nurses can do and how we're really going to be able
to impact primary care, not only locally,
but nationally and internationally.
so really, really excited about that.
and then the other article that i was really excited to see
was the opinion paper that sylvain brosseu released in may
(26:50):
of twenty twenty four for canadian nursing week.
and he's the president of canadian nurses association.
and his opinion paper is called once and for all,
it's time to recognize that all nurses are the solution to
bettering primary care access. so there is a really big focus on
what primary care nurses can do. and i'm just so excited that that
(27:12):
recognition is happening and that there are actually guidelines and
processes that are recommended that we can start at
an individual primary care nurse level,
but also at a systems level to be making that difference.
mhmm. mhmm. incredible. what an exciting time in primary care,
(27:35):
isn't it? doesn't it feel like things are really starting to
come together? it really does. it really feels like everything is
coming together and that we are actually making movements
forward, and we're seeing primary care coming out to become more
of a specialty of its own. and i'm really excited about that as
(27:57):
well because we know that there's a lot of excitement working in
acute care, working in emergency, working in icu.
uh, we know that there's a lot of excitement working around
perinatal, uh, pediatrics. and then home health and
public health. also, there's a lot of interest in those areas.
(28:20):
but now we're recognizing that primary care is also a specialty
area and a place to start moving into and that
it can actually provide a very exciting career.
well, i'd like to just thank you, tanis,
for all the work that you do supporting your nurses who are
(28:45):
pivotal in supporting people's health and wellness in our
communities across the region. so i know that you have a huge
portfolio. thank you for all that you do.
and, uh, i just want to express the appreciation
i have for nurses working in primary care,
and it's such a treat today to get to highlight that really
(29:08):
important work and, um, hear from an expert like you.
so i just wanna say thanks for that.
and then, um, i do you have anything that you didn't get the
chance to talk about that you'll you wanna talk about today,
tanis, before we wrap up? uh, no. i think everything's
great. i i really thank you for the opportunity to be able to
(29:31):
speak about primary care nursing and all the wonderful
developments that are happening within within the area.
great. well, i could just talk to you all day,
so i'll i'll let you go. i won't be selfish.
um, but before we go, i just would like to,
um, thank the interior health professional practice office for
supporting this project. and if you have any questions,
(29:55):
comments, um, or suggestions for future episodes,
please email us at professional practice at interior health dot c
a. and i'd like to thank our sound editor extraordinaire,
duane walwin, for all the work he does behind the scenes to make
this, uh, podcast possible. so thanks so much,
(30:15):
tanis, and, uh, hope we get to talk to you again soon.
great. thank you so much. bye bye.
that's all for this episode. thank you for joining us today.
we know you're busy and your time is valuable.
thank you for spending some of it with us.
thank you for your commitment to your profession and to your
(30:36):
patients and being a part of the journey of building a culture of
excellence around nursing in our health region.
hello, and welcome to the interior health nursing grand
rounds, a podcast conversation. i am your host,
allison thomas. and on this podcast,
we talk all things nursing and health care.
i work as the clinical nurse specialist in the trauma services
network in interior health. interior health would like to
(00:31):
recognize and acknowledge the traditional ancestral and unceded
territories of the dekalbanae, tanaha,
inlakatma, chihuahuan, statlian, syilx,
and chikotun nations, where we live,
learn, collaborate, and work together.
and today i'm so thrilled to be able to introduce you to my
(00:54):
colleague, tanis anderson. so tannis is here to talk to us
about primary care nursing. today,
i'm really excited about all the things i'm going to learn from
her. and, um, maybe, tannis, can i just ask you to introduce
yourself and tell us a little bit about your nursing background?
yes. so i would like to acknowledge that i have the
(01:14):
privilege to live on the traditional ancestral and unceded
territory of the syoaks nation in what is known as kelowna,
british columbia. this is where i get to enjoy the beauty of the
lands every day, and i'm very thankful to be able to learn,
work, and play here. um, i have a beautiful family with two amazing
(01:35):
adult children. i've been a nurse for over thirty years.
and the first part of my career, i spent in seniors health,
while the latter half of my career,
i've been able to spend in primary care.
i started as a diploma nurse and then obtained my nursing degree
at the university of calgary and then completed my master's in
(01:56):
nursing at athabasca university with a teaching focus.
amazing. so you come with, uh, such great background for us and,
um, you have lots of expertise to share.
uh, maybe, tannis, this might seem like a silly question,
but could you tell me what is primary care and who works there?
(02:17):
so primary care, uh, is providing care across the lifespan
in patient medical homes through a team based care environment,
looking at a model of staying healthy,
getting better, living with chronic illness and disability,
and coping with end of life through a person and family
centered lens. the patient medical home is an optimized
(02:41):
family practice that provides patients with comprehensive
longitudinal primary care. it is a foundation of an integrated
system of care. and then within bc,
we have primary care networks where the patient medical homes
and other primary care providers, health authority providers,
first nations and community organizations are networked
(03:03):
together to provide the primary care services that a local
population requires. within this, we also have urgent
and primary care centers in british columbia,
which provide urgent primary care for conditions that require
primary care within twelve to twenty four hours but don't
actually require the resources of an emergency department.
(03:25):
one of the greatest benefits of of primary care is that we work
within a team based care and it provides health services within
the patient medical homes and urgent and primary care centers
to individuals, families, and other communities through a
variety of health professions working collaboratively together.
the team may consist of physicians,
(03:46):
nurse practitioners, medical office assistants,
nurses, and allied health. examples of allied health are
pharmacists, dieticians, occupational therapists,
physical therapists, and social workers.
and then as health professionals, we each have different skills and
knowledge to help our patients. and depending on the patient's
(04:08):
needs when they visit, they may actually see one or more team
members. each patient medical home and urgent and primary care
center team members will be unique based on their community
needs. i would like to outline, though,
that the most important person of this team is actually the
patient. through person and family centered care,
patients are at the forefront of their health care,
(04:31):
and they lead their care through informed decision making in
collaboration with their health care team.
when i talk about staying healthy within primary care,
we really want to be able to involve supporting promotion and
prevention activities within the communities.
and in british columbia, we follow what's called the bc
(04:52):
lifetime prevention schedule. this schedule looks at clinical
prevention services across the lifespan and includes screening
recommendation and behavioral interventions.
this also includes health education,
risk screening, health counseling,
health promotion, primary prevention,
and immunizations that all fall within staying healthy.
(05:17):
and then when we look at the getting better,
getting better provides that episodic care,
including treatment of acute conditions.
and then living with chronic illness and disability,
we are able to support through chronic disease management and
secondary prevention. secondary prevention is reducing the impact
of that disease. and we also look at rehabilitation and long term
(05:40):
care. and then the last area for primary care is coping with end
of life care, and that includes physical comfort and supporting
emotional and spiritual needs. wow.
so, basically, what you're telling me,
tanis, is primary care does everything,
uh, everything that a patient might need.
um, so that's amazing. that's such an it is the critical part
(06:04):
of our health care system, isn't it,
the primary care? it is. it's our first entry into the health care
system. and our goal is definitely to support that
longitudinal practice and be able to support individuals,
families, and communities across that lifespan,
keeping them healthy as well as supporting them when they have
(06:25):
medical health care needs. mhmm. i i love the focus on,
um, person centered care and and what's important to the person,
not just what we think as health care providers should be their
priorities. i love that. um, could you tell me a little bit
more about the role for nurses in primary care?
(06:49):
the role for nurses in primary care is very vast as
you can tell from when you look at what is primary care.
um, but the registered nurse in primary care is also known as a
family practice nurse, a primary care nurse,
or a nurse in practice. the nurse provides care across the
(07:11):
lifespan, and they form long term continuous longitudinal
relationships with the patient in the medical home.
they help patients navigate the system and access resources.
they can provide education and support directed at health
promotion, disease prevention, and management of chronic
conditions. the nurse is a valuable team member within the
(07:33):
patient medical home. and depending on the reason for the
patient visit, there may be times when the patient actually only
sees the registered nurse or may see the registered nurse and
other members of the healthcare team.
through professionalism, clinical practice,
communication, collaboration and partnership,
quality assurance, evaluation and research,
(07:55):
and leadership, the primary care nurse can provide multiple
services. so a few of the services or care that the nurses
can provide, um, is prenatal care,
well baby checkups and annual exams.
primary care nurses can support reproductive and sexual health.
(08:15):
they may be helping the patient navigate the health care system
and transitions between settings. they provide care in between
settings. they provide care and collaboration and also
support case management, conduct preventative screening,
coordinate and implement primary care based programs for healthy
living. they can connect and refer you to other health
(08:38):
professional services and supports in the community,
provide mental health and addiction support,
work with patients to understand their medications,
support illness management. and a lot of conditions that we support
are diabetes, asthma, copd, heart disease,
high blood pressure, um, renal, and,
(09:01):
uh, any liver problems. and so the list is actually quite
extensive. um, providing health education.
uh, we do provide direct care. so we do procedures such as simple
or basic wound care, ear syringing,
routine adult immunizations, plantar wart treatment.
(09:23):
we do point of care testing, which is really like blood
glucose monitoring, pregnancy tests,
urinalysis screening, cognitive screening.
in some primary care practices, registered nurses actually have
the ability to obtain certified nursing practice,
which is specific to bc. and this also optimizes their scope of
(09:44):
practice and ability to provide advanced nursing care.
areas that nurses can obtain the certified practice in are sexual
health, contraceptive management, opioid agonist treatment,
and treatment of common primary care conditions.
registered nurses in primary care,
as you can tell, are really generalists.
(10:04):
and they need to know a little about a lot.
and they support their autonomous practice with continuous learning
to remain current and following evidence informed practice.
wow. tanis, um, tell me about what
are what are some of the things that you love about primary care
(10:26):
nursing? why has this become your home?
um, when i was looking at that question,
i was like, i'm like, i love everything about primary care
nursing. um, it really is my passion.
and once i fell into it and started working within it,
(10:47):
um, i have had a great opportunity to advance my nursing
career and have hopefully a positive impact on primary care
nursing. as a clinical nurse specialist in primary care,
i get to support, uh, primary care from a clinical consult
perspective, a leadership perspective,
(11:08):
advancing nursing practice a lot through education and
evaluation and research and sitting on research projects as
well. it's really exciting to be able to work in the four domains
of clinical nurse specialist practice.
and as the primary care nursing has the ability to positively
(11:29):
influence the health of individuals,
families, and communities through relationships in a team based
care environment, it just warms my heart to be able to
uh, practice and be able to make that difference.
the ability to change lives and shape the future of health care
provides an exciting opportunity to make that difference and
(11:51):
really be a part of giving back. and then just the scope and
breadth of primary care nursing and working across the lifespan
provides unending excitement, growth,
and relational care. and those are all amazing aspects that,
uh, really speak to me and speak to my nursing practice.
(12:12):
and while it does hold a lot of responsibility as primary care
nurses, we are definitely equipped to do all of this and
more. mhmm. so knowing what you know now,
if you could go back in time to the time that you transitioned
into primary care, would you make that decision again?
i absolutely would, um, move into primary care.
(12:35):
i would have say i would like to have moved into it earlier than i
had moved into it. mind you, i do love my seniors' health and a lot
of transition from seniors' health into primary care are all
of the same principles and concepts.
but i definitely would move into primary care.
and i am just so excited when nurses are interested in primary
(12:56):
care, and i can talk endlessly about it and encourage everyone
to move into primary care. right. what do you think are or do you
think there are, i guess, but what do you think are some
misconceptions that people have about primary care nursing?
well, i've been specifically speaking about registered nurses
(13:16):
in primary care, but i do believe it's really important to
highlight that there are multiple nursing roles available to
support primary care. so we do have nurses working that are
licensed practical nurses, registered psychiatric nurses,
registered nurses, and nurse practitioners.
and as nurses, we can really work together to optimize each of our
(13:38):
scopes and work as a team and provide that primary care nursing
within the patient medical home. having these multiple nursing
roles complements each other to provide nurses with many avenues
to enter primary care nursing and work within the scope that meets
their career goals. so there's a place for every nurse within
primary care. then i guess i would say probably
(14:03):
the second thing that i would like to bring awareness to is
that all nurses are regulated health care professionals.
all nurses have their own scope of practice,
standards of practice, and educational requirements,
and that they really work within four levels of control and
practice that include regulation and legislation.
so a lot of our government, uh, regulations and legislation that
(14:26):
are passed as well as, nationally.
we also are supported by our regulatory body,
which is the british columbia college of nurses and midwives.
we're supported also by our employer through our clinical
decision support tools, our policies,
and our procedures. and then lastly,
(14:47):
we are responsible for our own individual competence,
and we do have the ability to be working autonomously within our
scope that is outlined by the ccnm.
this does all impact the work and care that we provide within
primary care setting, and it helps ensure quality safe patient
(15:07):
care. mhmm. great. and so if you could talk to
every primary care nurse in the world,
um, from your from your lens, you i think you get to see kind of a
bird's eye view of what's going on,
uh, at least in our health region and,
uh, probably elsewhere. is there one or two things that you
(15:30):
would like every primary care nurse to know?
i really feel that, uh, it's like every primary care nurse to know
that primary care nursing is an amazing field to work within and
that primary care nurses really are making a difference.
and this is, you know, locally within the own community.
(15:52):
we're making a difference with our patients themselves,
with our families, and with our communities.
but we're also making a difference provincially,
nationally, and internationally. and one of the best
pieces about being a primary care nurse is those relationships and
the person centered care are at the heart of being a primary care
(16:15):
nurse. and that is really the foundation of
being able to provide primary care nursing and having the time
to be able to provide that relational care.
if there is somebody listening out there who's thinking,
oh, i think primary care is for me,
(16:37):
uh, and how do i move into that kind of work?
do you have any suggestions for where people might start?
is it as simple as looking for job postings,
or how would you suggest someone goes about that?
so absolutely. the first, um, would be looking at job postings
that are available. but there are so many vast areas within
(17:02):
primary care. so, you know, we have outreach clinics.
we have patient medical homes. we have urgent and primary care
centers. uh, we have community health centers.
we have, uh, primary care network hubs.
so there are multiple, um, positions that are available to
(17:22):
be able to look and find. there is the canadian family practice
nurses association, which is national across canada.
and that is a really good place to really start to look towards
primary care nursing. the cfpna has webinars about primary
(17:42):
care nursing on their website. they also have posted our
canadian core competencies for primary care nurses and really
encompasses what those national competencies are available.
reaching out to any nurse that is in primary care.
i'm always more than happy and excited to talk to nurses about
(18:05):
primary care. and then canadian nurses association,
they also have a website on primary care nursing and what's
happening nationally. the world health organization has
information on primary care internationally and what is
involved within that. so many avenues to reach out and
(18:30):
start investigating and and, uh, determining if primary care is an
area they would be interested in. great.
and you've already, i think, pointed us to some really good
places to look for resources, but i'm wondering if you can share
maybe some of your favorite resources for primary care
(18:50):
nursing and and point us in the right direction if we're looking
for, um, really quality resources.
yeah. so the canadian family practice nurses association,
as i've mentioned, is, uh, probably the best,
um, place to start. and as i said,
(19:10):
they host the national competencies for registered
nurses in primary care. they have their webinars.
they also, uh, this year have started a primary care team
nursing for education, which is a two and a half hour free
course to be able to take if you're a member of cfp and a.
(19:33):
and it really provides the foundation of what is primary
care nursing and what types of skill sets and education do
you really need to start having. so,
again, it talks a lot about that team based care,
talks about what the patient medical home is more in-depth,
talks about critical thinking and care planning,
(19:54):
and really provides a good strong base of primary care nursing.
i spoke also briefly earlier about the bc lifetime prevention
scale. and so that is a great place to go,
uh, for british columbia because it does outline clinical
prevention services for british columbia.
(20:15):
and it is across the lifespan. so it looks at,
you know, supporting children, infants,
prenatal care. it looks at, you know,
supporting chronic disease management.
it looks at supporting when should you start screening for
certain types of cancer, what type of screening and when should
you start for, say, chronic disease management like diabetes
(20:38):
or hypertension? and so it's a really good place to go to
really look at what the heart of primary care is and helping keep
british columbians healthy. i'm gonna go look that up as soon as
we're done talking. the other thing
that is available in bc, it's called bc guidelines.
(21:00):
and they're clinical practice guidelines and protocols that
provide recommendations to b. c. practitioners.
and there is a whole list of health care conditions and how to
support and manage those conditions.
and it is also kept current, so it's very evidence informed.
and it helps guide practitioners in managing different conditions
(21:23):
that their patients have. and if it's not necessarily specific
to each condition, particularly, we know that there's a lot of
specialties within those bc guidelines.
and so when you're starting to go into those bc guidelines and look
things for, like, pediatrics, it sends you back to the bc child
(21:47):
health because that is going to be our expert in that area.
or there is perinatal services, and it will direct you to the
perinatal services area. um, if you're looking up diabetes,
it helps support you to go into the canadian diabetes association
where the diabetes clinical guidelines are.
(22:07):
so it's kind of a one place for bc practitioners to be going to
support. and it's a really good place for nurses to go because
then we're able to help support the practitioners when we
understand what guidelines they're working from.
and so i always recommend individuals go into those bc
guidelines and be able to stay evidence informed within their
(22:29):
practice. i'd also really like to say that the university of
british columbia okanagan is really leading the way in primary
care nursing education through either a post baccalaureate
primary care nursing certificate or a primary care practice
essentials micro credentialing. and the really exciting piece
(22:50):
about that is the post baccalaureate primary care
nursing certificate is brand new and has just been approved.
and, uh, so we're getting that going.
and that's going to be amazing because we're going to have
baccalaureate nurses as well as master's nursing students all
(23:11):
be able to take this certificate program.
and then the essentials for the micro credentials is also new.
it started earlier this year with a health assessment course,
and now they're going to be moving into a case management
care coordination course. the nice thing about the micro
credentials is you can just take one course or another,
(23:34):
like one course, or you can take all of the courses when they're,
um, available. but some nurses find that that just might fit
into their practice a little bit easier than having to take a
certificate program. so really exciting,
uh, with these new courses and education that is available to
(23:55):
primary care nursing and certainly is one of a kind and
one of the few education available for primary care
nurses, uh, beyond what um, they're able to
take within their nursing programs.
would you like to comment, um, tanis,
on your involvement in developing that work at ubc?
(24:16):
i think you're being modest. um, i've been very excited,
um, through that work. so, um, sheila epp is,
um, been amazing and has been leading the work along with neli
oakley. and so when they were looking at it,
i had the opportunity to be able to provide some feedback and some
(24:39):
content expertise. and then i've also been able to
develop post baccalaureate primary care nursing certificate
courses. so, um, it started off with one,
um, primary care nursing course, and now we're going to be
creating a level two course and then a a practicum.
(25:00):
so i've had the pleasure of being able to be thoroughly involved
within it. um, but definitely, sheila and neli,
um, have been the experts and have,
um, graciously brought myself in, um,
to be able to support and advance nursing.
(25:21):
amazing. and, uh, curriculum development is no joke.
that is a lot of work. so congratulations for your
involvement in that. i also recently
had the opportunity to attend the international council of nurses
conference, uh, nurse practitioner,
(25:43):
advanced practice nurses in september.
and i was really excited when i was there because within the
opening of the conference, the international council of nurses
actually launched a new position statement and discussion paper
setting out the revolution in the delivery of primary health care
(26:03):
and saying that nursing is going to be the key profession
to transform primary health care and is essential to meeting their
goal of universal health coverage.
and so this position statement is called nursing and primary health
care. and so there is a big focus internationally on what
(26:25):
primary care nurses can do and how we're really going to be able
to impact primary care, not only locally,
but nationally and internationally.
so really, really excited about that.
and then the other article that i was really excited to see
was the opinion paper that sylvain brosseu released in may
(26:50):
of twenty twenty four for canadian nursing week.
and he's the president of canadian nurses association.
and his opinion paper is called once and for all,
it's time to recognize that all nurses are the solution to
bettering primary care access. so there is a really big focus on
what primary care nurses can do. and i'm just so excited that that
(27:12):
recognition is happening and that there are actually guidelines and
processes that are recommended that we can start at
an individual primary care nurse level,
but also at a systems level to be making that difference.
mhmm. mhmm. incredible. what an exciting time in primary care,
(27:35):
isn't it? doesn't it feel like things are really starting to
come together? it really does. it really feels like everything is
coming together and that we are actually making movements
forward, and we're seeing primary care coming out to become more
of a specialty of its own. and i'm really excited about that as
(27:57):
well because we know that there's a lot of excitement working in
acute care, working in emergency, working in icu.
uh, we know that there's a lot of excitement working around
perinatal, uh, pediatrics. and then home health and
public health. also, there's a lot of interest in those areas.
(28:20):
but now we're recognizing that primary care is also a specialty
area and a place to start moving into and that
it can actually provide a very exciting career.
well, i'd like to just thank you, tanis,
for all the work that you do supporting your nurses who are
(28:45):
pivotal in supporting people's health and wellness in our
communities across the region. so i know that you have a huge
portfolio. thank you for all that you do.
and, uh, i just want to express the appreciation
i have for nurses working in primary care,
and it's such a treat today to get to highlight that really
(29:08):
important work and, um, hear from an expert like you.
so i just wanna say thanks for that.
and then, um, i do you have anything that you didn't get the
chance to talk about that you'll you wanna talk about today,
tanis, before we wrap up? uh, no. i think everything's
great. i i really thank you for the opportunity to be able to
(29:31):
speak about primary care nursing and all the wonderful
developments that are happening within within the area.
great. well, i could just talk to you all day,
so i'll i'll let you go. i won't be selfish.
um, but before we go, i just would like to,
um, thank the interior health professional practice office for
supporting this project. and if you have any questions,
(29:55):
comments, um, or suggestions for future episodes,
please email us at professional practice at interior health dot c
a. and i'd like to thank our sound editor extraordinaire,
duane walwin, for all the work he does behind the scenes to make
this, uh, podcast possible. so thanks so much,
(30:15):
tanis, and, uh, hope we get to talk to you again soon.
great. thank you so much. bye bye.
that's all for this episode. thank you for joining us today.
we know you're busy and your time is valuable.
thank you for spending some of it with us.
thank you for your commitment to your profession and to your
(30:36):
patients and being a part of the journey of building a culture of
excellence around nursing in our health region.
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