By Kendall King
Southern Alberta Newspapers
Nurse practitioners across the province are advocating for greater awareness of their scope of work, and for better overall recognition of the vital role they play in a health-care system limited in resources.
Belonging to a unique field of health care, nurse practitioners are registered nurses who have received additional advanced training which allows them to exercise many of the same duties general physicians do.
Able to work in primary or acute care settings, NPs can assess patients, order tests, provide diagnoses, formulate treatment plans and prescribe medication. While NPs do have some limitations to the scope of their work compared to physicians – NPs do not provide specialized or surgical care – the primary difference between the two is the level of schooling each group completes.
“One of the ways that I describe it to patients when they ask me ‘What’s the difference between a nurse practitioner and a physician’ is that (NPs and physicians take) different pathways,” Milk River NP Sara Lee told Southern Alberta Newspapers. “Physicians take one path through medical school and (NPs) take a different pathway through nursing school, but our scope of practice is pretty aligned.”
Despite sharing many of the same responsibilities however, nurse practitioners have historically received significantly less pay than physicians, and far less recognition for the work they do.
“We are an under-recognized portion of the health-care population,” Lee said. “(NPs) are not something that’s been around forever like physicians have. Everyone understands what physicians do, everyone knows how they work, but nurse practitioners is more of a challenge because people don’t understand what our capabilities are and what our scope is. So oftentimes, we’re not having enough recognition by the public (for our) abilities.”
As an NP, Lee is able to independently oversee operations of Milk River Health Centre’s emergency department, which has gained considerable attention over the past year for frequent temporary closures due to a lack of physician coverage.
Lee says she and a very limited number of physicians work together to try and ensure there is someone available to provide coverage, and thus prevent temporary closures of the ED, however the ongoing shortage of health-care workers makes doing so very challenging.
On top of that, Lee faces additional challenges because of her status as a nurse practitioner.
“I see higher acuity patients than the previous community physician did, and am on call 24 hours of the day and night,” said Lee. “Yet, for all of that, I make less money than I did as a registered nurse and significantly less than any physician who would work the exact same hours.”
Nurse Practitioners Association of Alberta president Susan Prendergast says multiple factors play a role in the wage disparity, particularly that NPs are paid on salary rather than through a fee-for-service model.
With NPs facing many of the same challenges other, higher paid health-care workers are facing – like higher patient loads, increased work hours, widespread burnout – Prendergast says she and association members are now highlighting the disparity with the goal of gaining fair compensation, as well as much deserved recognition; and in the hopes it might inspire investment in the field.
“Right now in Alberta, there’s over a million Albertans that don’t have a primary care provider,” said Prendergast. “There are no physicians (but) there’s over 850 of us (NPs) who could actually provide the care that’s needed for all those people that don’t have a provider.
“The problem is (Alberta’s health-care system) is still led by physicians, but if you don’t have enough physicians, then how are you going to change the primary care access gap? So, what we’re hoping is the government will (recognize) us.”