(Canada) Nurses Prevented From Assuming New Roles By Medical Establishment

[HuckleB]

http://www.medicalnewstoday.com/articles/171216.php

"Physicians still retain the bulk of decision-making power over nurses in Quebec - a situation that's detrimental to evolving nursing roles. According to a new study by Université de Montréal researchers, published in Recherches Sociographiques, nursing functions are still very much assigned by physicians who often oversee family medicine groups (FMGs), specialized nurse practitioners (SNP) and oncology nurse navigators (ONN).

"MD power is legal, political and organizational and exercised through positions of managers and directors, which leaves nurses with the feeling of being underutilized. In FMGs, physicians decide the nature and extent of nursing roles such as whether nurses serve as assistants or follow-up on patients," says co-author Danielle D'Amour, a professor at the Université de Montréal Faculty of Nursing and scientific director of the FERASI Centre.

...

Nurses in all three groups do feel underutilized and must still convince physicians that they contribute differently to patient care. The study reveals many physicians feel the new role of nurses is an unacceptable intrusion into their area of expertise, which could explain their resistance of sharing professional responsibility.

The research team found the current health-care system gives physicians control over the practices of other professional groups. That establishment of authority, the researchers argue, must be redefined to permit that nurses be increasingly heard in the public arena and provided with more decision-making power.

..."

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I'm not completely sure where I stand on this matter, but it does seem like health care could be improved if more of its practitioners had more of a voice.

[juno jones]

1. Many RNs have as many years in training as docs do

and they work with patients a bit more one to one, so they may see something docs don't. I have one RN friend who, in the 25 years I've known him, has probably spent 20 years of that getting extra medical schooling, he's pretty much a doctor in all but name. Other RN's I know are nurse practitioners who are extremely well educated in their fields.

Docs just have to accept that they aren't always right and in this day and age of physician shortages, nurses can fill the gap admirably, probably better because they didn't necessarily get into medicine to 'make money'.

Then again, nurses saved my life when docs were assholes. I'm a bit biased. :)

[SidDithers]

2. That's in Quebec...

health care in Canada is a provincial responsibility, but is partially funded by the Federal government and must still adhere to the Federal Canada Health Act.

In Ontario, another Nurse Practioner-run clinic was just announced for Barrie.

http://www.rnao.org/Page.asp?PageID=122&ContentID=3097&SiteNodeID=451&BL_ExpandID=

Sid

[HuckleB]

4. Thanks for that link.

I was hoping to use this as an anecdote to lead to the general discussion, but your point is well taken.

[Warpy]

3. Canadian nurses are often amazed

at the increased scope of practice in the US. Oh, that doesn't mean that nurse practitioners don't have to be shepherded by an MD or that any nurse is able to determine medical treatment. It means that the docs have pushed a lot of stuff off on us that they'd have had to come in to the hospital in the middle of the night to do themselves.

Unfortunately, there is precious little autonomy afforded nurses in either country, with physicians and management both underestimating the education, ability and responsibility the nurse possesses.

Half of all licensed RNs in the US have quit practice because of poor working conditions. The lack of autonomy is certainly part of it.

[snagglepuss]

5. My doctor has switched to a FMG. I had my full physical with the SNP and I

was very happy. She had more time to spend answering questions and she was very knowledgeable.