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How did you become a nurse practitioner?
I had been working in nursing for twelve years. When the new training program began in 1994, I jumped in with both feet. I had a year of training and graduated in 1995. I worked for a year under the supervision of a physician, assisting in his practice. In 1996, I was fortunate to work in the Ogden Community Health Centre as part of a multi-disciplinary team.
In 2000, I began working for the Community Care Access Centre. I would go to visit individuals living at home. I was on call 24/7 and it was very demanding.
In 2001, the Health Unit approached me to set up a cervical screening program. I agreed, but on the condition that we provide comprehensive care. I work under the Medical Officer of Health to whom I go for guidance and help. I also work in a building where there is an audiologist, dietician and other health care professionals, so we can offer holistic health care for the individual.
What type of work do you do?
I focus on primary care - a patient's first contact with the health care system - and health promotion. I have the chance to provide holistic care, looking at the whole picture of a patient's health.
Two days a week, I work in a satellite clinic for high-risk patients, including street people and the homeless.
One day a week, I work in a well baby clinic, taking care of immunization, education - like breastfeeding - and health assessment.
Two days a week, I work in the Health Unit, where I do general care. Because Thunder Bay is underserviced, I usually see people who don't have a family doctor.
I have appointments and also take walk-in patients if they have something that requires urgent assessment. I take phone calls. I am involved in community education, for instance I am going to see a group of women with young children next week. It will be a chance for them to ask questions that they would not normally ask in an environment in which they feel comfortable.
Even though I was hired to set up the cervical screening program, I ended up looking after many other needs. In all, I take care of about 900 patients.
How is what you do different from the work of a family physician?
The difference is the scope of practice. The diseases and conditions I follow are less complicated than those a physician would address. Also, I am able to write prescriptions for medication, carry out diagnoses and order testing, but on a more limited scale than a doctor.
In my case, I work as part of a team, which includes a physician, in my case the Medical Officer of Health. This is usual for Nurse Practitioners except those who are alone in a more isolated setting.
An important part of what I do is health promotion, taking the time to teach people about nutrition, handling their diabetes or some of the more common things patients have to deal with.
How are you different from a registered nurse?
Again, it's a question of the scope of practice. As a Nurse Practitioner, I am able to communicate a diagnosis, order prescriptions from a specific list and order certain laboratory tests as well as diagnostics, such as ultrasounds and X-rays. Another way of looking at Nurse Practitioners is that we are advanced practice nurses.
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