New Brunswick

How nurse practitioner clinics will operate

On Monday, the provincial government announced it will open nurse practitioner clinics in Fredericton, Moncton and Saint John, hoping to take the pressure off the primary care provider waiting list. Here's what we know so far about how this strategy will work.

The nurse practitioners will be taking the load off of the New Brunswick primary healthcare wait list

Health Minister Ted Flemming announced three new nurse-practitioner clinics to be opened in Fredericton, Moncton and Saint John. (Shane Fowler/CBC)

The provincial government announced this week it will open nurse practitioner clinics in Fredericton, Moncton and Saint John to try to shorten the waiting list for doctors.

The Department of Health is hiring 32. Eighteen of them will be primary care providers in clinics. Eight will be staffing emergency rooms in the three cities to deal with patients with less-urgent needs, and six will be dispersed throughout the province at yet-to-be-determined locations.

Here's what we know so far about how the primary care nurse practitioners will operate in clinics:

Matching nurse practitioners with patients

The new nurse practitioners, who will be hired by the regional health authorities, will be taking on patients according to the date they got on the waiting list for doctors, from earliest to latest.

However, the province will be skipping people who already have a provider and are on the list to get a new one, said Department of Health spokesperson Bruce Macfarlane. 

"Patients are referred on a first-come, first-served basis," Macfarlane said.

Each clinic being set up by the Horizon and Vitalité health networks will be staffed by six nurses.

Each nurse will have a patient load of 800 to 1,000 patients.

Health Minister Ted Flemming said the province hopes to reduce the waiting list by half. There are about 36,000 people on the list, he said. The department couldn't say how many of these are people who have providers but want to change them.

How the list works

The Patient Connect waiting list is for people who don't have a primary health-care provider and don't have the resources or connections to find one on their own.

The list is run by the province and matches people with either family doctors or nurse practitioners who will become their first point of contact if they need non-emergency medical care.

Not every New Brunswicker who doesn't have a primary health-care provider is on the list, since having one is not mandatory. 

People can register to be on the list by calling 811 and giving their name, address, phone number and Medicare number, or provide that information online.

Each nurse practitioner or doctor will only be connected with patients in his or her community.

Not walk-in clinics

Macfarlane said the newly announced nurse practitioner clinics are not meant to operate as walk-in clinics. So they will effectively be offices for the nurse practitioners and likely won't take walk-ins.

He said they'll have standard office hours, but some of them may shift their schedules so they can see their patients after hours.

How they will connect with GPs

According to the Nurses Association of New Brunswick, a nurse practitioner can diagnose illnesses and injuries, order and interpret tests and prescribe medications.

Terry-Lynne King, secretary of Nurse Practitioners of New Brunswick, said if a nurse practitioner sees a patient whose care is complex or beyond their scope of practice, he or she can refer the patient to a specialist. 

"This would be no different than a physician," she said.

She said nurse practitioners can also collaborate with physicians for advice or questions about the patient.

"There also may be situations that the [nurse practitioner] can transfer care of a patient to a physician if required," she said.

Where the nurses will come from

King welcomed the province's plan to make greater use of nurse practitioners. 

She said her organization has been talking to nurse practitioners who had left the province to work elsewhere — Prince Edward Island, Nova Scotia and Ontario, for example. She said they're hopeful this announcement means some of them will come back home.

"A lot of those nurse practitioners did not want to leave New Brunswick, but due to the fact that they needed to find work and they had to go elsewhere," she said.

She also said there are some nurse practitioners working as registered nurses because they couldn't find jobs in their field. She hopes some of them will rejoin the ranks. 

"I feel fairly confident that these positions will be able to be filled with nurse practitioners," she said.

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