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The rise of the Nurse Practitioner

Sarah Adair, Nurse Practitioner (NP) and UVic graduate with the class of 2019, now works as a Primary Care Provider at the West Shore Primary Care Centre in Colwood. Her first day was January 6, 2020, marking the Year of the Nurse and Midwife.

 Having invested eleven years of education and work experience to prepare for this role – a four year undergraduate degree completed at UVic, a one year critical care specialty program with BCIT, a two year master’s program with UVic, plus working as an RN in the Emergency Department at the Royal Jubilee Hospital for four years – Adair not only feels ready, she can’t wait to take on full responsibility.

 “I’m pretty excited to start a practice of my own,” she says, keen to work with a new interdisciplinary group of care professionals. “I think we’ll be a beautiful new addition to the primary care network here.”

That network includes the West Shore Urgent Primary Care Centre, which is on the same site where Adair works. Both centres are strategically located 7.8 km from Victoria General Hospital to help divert clients with urgent care needs.

Adair is one of three NPs working in the primary care clinic which is open five days a week. The urgent care centre is open seven days a week. Anyone can walk in and receive care at either centre. Folks can also schedule private appointments or arrange for home-based telehealth visits.

These centres are part of a new approach forged by the BC Ministry of Health and the province’s health authorities to resolve crisis-level care shortages across Greater Victoria while relieving pressures facing hospital emergency departments. Ten new primary care centres are slated to open across the province; West Shore is home to the first such care centres on Vancouver Island.

“Bringing a Nurse Practitioner into an existing practice to manage patients and work with a care team, that’s a whole new ball game for BC’s health care system,” says Adair.

 It’s a whole new contract structure, too, wherein Adair opted to incorporate her own business noting that physicians go through the same process. She now works with her professional association, the Nurses and Nurse Practitioners of BC, to advise other NPs on how to manage their businesses as independent contractors.

 “I want to help my colleagues understand this is a more seamless method for NPs who want to create their own professional practice,” she explains. “It’s complicated because there are multiple care streams, some which are still in development. Even so, these next five years will be foundational for primary care delivery and I think NPs need to get ready for that.”

Estimates project 128 patient visits per day and up to 40,000 a year for the centre. Three NPs will establish a patient list of 1000 per NP, and provide detailed care plans similar to that of a GPs. Adair points out, “The future primary care model will include NPs and GPs as equals in the provision of primary healthcare”.

“Primary care is an ever-changing dynamic world of work,” says Adair, explaining just how nimble the primary care professional must be today. “You’ve got new medications coming available along with more effective, proven treatment methods being introduced. There are always changes in health care so you have to accept the fact that, in this role, you must always be learning and discussing new protocols with your team.”