1. NP Roles:A good fit for Public Health? Primary Health Care System

2. What is Public Health Mandate? Promote health for the population Prevent Disease in the population Monitor communicable diseases/ take action in epidemics Population approaches/ Individual approaches NPs are skilled at health promotion/ disease prevention and at community development approaches

3. Primary Health Care Nurse Practitioner 1998 legislation was passed allowing NPs an autonomous scope of practice RN(EC) the legislation was passed without consideration for funding the role May 2000 was the first dedicated funding for new NP positions in Ontario COUPN graduates 75 to 100 new NPs annually but there has been no commitment to fund positions yet

4. NP Role The expanded aspects of the nursing role allow NPs to diagnose and treat common illnesses, monitor chronic stable illnesses, provide well person care such as annual health examinations The COUPN program prepares the PHCNP and the RN(EC) designation is specific to NPs specializing in Primary Health Care

5. CNO Expectations Competence statements for RN(EC) Expectations for consultation Standards for prescribing drugs Standards for ordering lab tests Standards for ordering x-ray and u/s

6. Primary Care Delivery of a complex set of services, which includes the first contact and maintenance care In the current health system primary care or that first point of contact into the health system is provided by the family physician role about 95%

7. Traditional Nursing Hospital acute care Long Term Care facilities Community Nursing Public Health Nursing

8. Primary Health Care emphasized well being as a fundamental right and a world wide social goal- WHO essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible through their full participation and a cost that the community can afford

9. Principles of Primary Health Care Essentiality Community Participation Inter-sectoral collaboration Access Empowerment PHCNPs live and breath this philosophy and role model it for nursing and the other professions

10. Developing New Roles and Positions The NP role has great potential to improve patient care, increase access, emphasis on prevention and health promotion and a cost that the system can afford we need to engage in thinking outside the box for creative solutions Public Health Units with their focus on health have great potential

11. Implementing a New NP Role Involve all of the stakeholders in discussions Frequent communication to help them to understand the role Focus on the benefits to patient care and access Find a supportive physician to act as a leader for the physicians

12. Demonstrate the NP role there is no sales pitch as good as a success to successfully implement the NP role in an area that has not experienced NP care; you need a NP with superior communication skills you need a NP with great clinical skills; that is how she will be judged as you demonstrate the role you will create demand for the role

13. Public Health Sector Potential Roles: Sexual Health Clinics Well Women Clinics Well Baby Care and Immunization Outreach services to difficult to serve populations

14. Barriers in the Public Health Sector Administrative mindsets accustomed to traditional nursing roles Fee for service doctors/ fear loss of income Turf Fear about how it fits with the PHN role/ ONA Lack of leadership within the agency Funding

15. Public Health Positions Stepping Stones Resource Centre; sponsor VON; partnership with Brant County Health Unit Haldimand Norfolk Regional Health Unit; sexual health services; mainly 13 to 19 year olds, outreach clinic in Cayuga to reach high school students Algoma Health Unit, sexual health services

16. Other NP roles in Health Units 5 positions were announced for PHUs to improve cervical screening rates through Cancer Care Ontario; 1 or 2 may have hired Sudbury has received some additional money via Women’s Health Council

17. Community Roles that support Public Health mandate NPs in clinic settings such as Student services at a college, or in family practice where NP is offering women’s health services NP clinic: outreach to Indian Friendship Centre, Crisis Centre, Soup Kitchen Outreach roles: into high schools Focused populations

18. The Future Is Ours to Develop! The NP role gives us an incredible opportunity to create and improve patient care Many successes already We need the networking of NPs to build on the successes, not re-invent the wheel.