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A podcast that brings together primary care providers, healthcare planners, patients, innovators and others to talk about the changes that are happening in primary care in British Columbia.
Morgan TLM103 MixPre: Have you heard
about certified practice nursing?
Are you wanting to learn more?
Are you wondering how it's
relevant for primary care?
Yeah, me too.
I'm on my own this episode.
Sarah's living her best life.
I want to take this episode to
talk about certified practice
nursing in British Columbia.
Now this episode is BC specific,
and I imagine other jurisdictions
have similar designations.
I just don't know them, so I'm going
to speak specifically from my context.
The BC College of Nurses and Midwives.
BCCNM have defined five different
specific areas that have certified
practice designation in BC for nurses.
Each certified practice allows
for autonomous diagnosis and
treatment within a defined scope.
Are they useful for primary care teams?
I'll cut right to the chase.
I think certified practice
is great for primary care.
In fact, in our clinic, I think every
nurse has certified practice or is
in the process of getting certified.
I'll go through each of the
five certified practices.
But first, certified practice
is not the same as some other
designations, like advanced practice
nursing, which basically means that.
For the most part is nurse practitioners.
It's not the same as nursing
specialties or even the same
as expanded practice scope.
It's not the same as the Canadian
Nursing Association's 22 different
nursing practice specialties either.
There are a lot of ways nurses
pursue professional excellence.
Many nurses have taken extra training
to expand their scope, and this can be
very relevant for primary care, and those
are not necessarily certified practice.
Like drawing blood.
This can be incredibly
helpful in primary care.
but in bC, the five certified practice
designations are the following.
And these are all available for
registered nurses and one for
registered psychiatric nurses.
So the first one is reproductive health
with a focus on contraceptive management.
And this allows nurses to
assess, educate, and recommend
and prescribe different hormonal
contraception for low risk patients.
There's also reproductive health
for sexually transmitted infections.
With this certification, nurses
can assess and treat a range of
STIs as well as uncomplicated lower
tract urinary tract infections.
There's a certification for
opioid use disorder treatment.
And this expands scope to allow
for assessment and management of
patients who are using opioids.
And this actually can include
prescribing a suboxone, methadone,
or a long acting morphine.
The next two are, there's a fair
bit of overlap between the first
one is, RN first call certified.
And this is really to help increase the
scope of practice for more acute issues.
I think of acute primary care issues.
So this could include, treating
various common infections,
pharyngitis, dental abscesses, UTIs
as well, plus some other, urgent
presentations like corneal abrasions.
And the last one, which is
probably the largest scope, is
the remote practice certification.
And this was really developed to allow
nurses to work alone where, Family
physicians or NPs were not available.
there's a lot of overlap with first
call certification, but a larger scope,
which includes things like treating
cellulitis and abscesses and animal bites.
Now within each of these five, everything
is clearly defined with specific
and formal decision support tools.
You'll hear a lot about DSTs when
talking about certified practice
and there's a whole list and
they're all available online.
And here's Angela from NNPBC who really
helped set me straight on what DSTs were.
Angela: Decision support tools or
DSTs are formal, and I think that
that word is really important because
DSTs tend to be something that are
required through a regulatory mechanism.
DSTs are not generally what we refer
to as the kinds of clinical guidance
that you would describe as clinical
practice guidance or care pathways.
Morgan TLM103 MixPre: All of the
certified practice include the ability
to independently dispense medications
when it's in scope for that specific
certified practice and the DSTs are very
clear when consultation is required.
NBC prescribing requires some
additional training as well.
And getting a prescriber
number in British Columbia.
So that's just an important thing to
remember that, having the prescriber
number is also important if you
want to have nurse in your practice
that is independently prescribing.
If they don't have that number, they're
still able to independently dispense.
if there are clinic stores
for certain medications.
You can certainly look to the
college and the managers of the
specific DSTs to better understand
the scope for each of the five.
There's a lot of material.
So I've been asked which certified
practice is good for your practice.
And I think that really depends on
what the needs are of your patients.
for some STI and contraception
certification can be very helpful.
that's for a majority of
primary care practices.
working with a remote
certified practice nurse.
feels like you've met a unicorn, or
you've met Ann Drost, who is a remote
certified nurse that I've had the pleasure
of working with for over 10 years.
And it's just amazing to have
that experience of what that
remote certification scope is.
I think it overlaps incredibly
well with a lot of what we do in
primary care practice, but only if
you're working together to ensure
that the nurse is working at the
full scope of their practice.
Otherwise, it's.
It's, not a great use of a unicorn.
So, what to do?
I think if you're interested in hiring a
nurse in your practice, you can plan to
either recruit a nurse who has certified
practice, or I think you should start
talking about Getting certified practice
with any nurse that you might hire.
I actually think it's that important to
think about that additional scope and
the benefits that that brings to your
patients and talk about it early and plan
to have a nurse, either develop those
skills and take the training or come in
with the additional certified practice
as an employer.
If you're an employer of the nurse
in the practice, please consider
providing the training as part of the
integration of a nurse into your team.
There's no question this will help your
patients and it will help your team.
So it'll show, it'll show the
value of the nurse in your team.
It'll help with retention of that nurse.
If you still have questions about.
Certified practice, talk with a nurse
or get in touch with NNPBC and I'll put
some links in the show notes for this.
And if you're not from British Columbia,
please reach out to your own provincial
nursing college or associations to
learn more about what is similar
and likely similar in your province.
Thank you for listening to
this short episode of team up.
I hope you enjoyed.
And if you have any questions
or topic suggestions, please
email us at isu at familymed.
ubc.
ca
Sarah: The Innovation Support Unit is
a distributed multidisciplinary team.
We work mostly remotely from communities
across the Lower Mainland and
Vancouver Island in British Columbia.
Morgan: Sarah and I are both recording
from our offices in the territories
of the Lekwungen speaking peoples, the
Songhees and Esquimalt First Nations.
Sarah: And recognizing the colonial
history and the ongoing impacts of
colonization and healthcare systems
and in Indigenous communities in
Canada and around the world, as we
move through the season, we'll work
to bring an equity lens to this work.
And we really encourage you, our
listener, to reflect on your past,
present, and future participation.
On the indigenous lands
where you are situated.
Morgan: we'll see you in
the next episode of team up.