S07 E07 teamBIT on Running A Nurse Clinic in Your Practice

In this TeamUP! teamBIT Morgan is on his own again. This time he's talking about how to plan and promote a dedicated “nurse clinic” in your primary care practice to boost the presence of new nursing staff in your practice. The discussion includes selecting a focus area for the clinic, organizing appointments, and effectively promoting the clinic through various channels.

Examples given include clinics for blood pressure, immunizations, well-baby checks, diabetic foot checks, and STI screenings. The episode also emphasizes the importance of teamwork and patient engagement, with insights on making nurse clinics an accessible and valuable addition to practice.

Special Thanks

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Throughout this season you’ll hear from several amazing nurses:

• Angela Wignall is a Registered Nurse who has worked in perinatal health and public health. Since recording this episode Angela has been promoted to the CEO of the Nurses and Nurse Practitioners of BC from her position as Senior Executive Director. Angela is also a board member at the Canadian Nurses Association.
• Diana Boateng is a Registered Nurse and is working on her dual master’s degree in nursing and health informatics. In her Masters, she is a co-op student working with the Innovation Support Unit. Her background is mostly in acute care but she has been interested in exploring what it means to be a nurse in primary care.
• Hannah Roy works as a Registered Nurse in primary care and urgent primary care. She has certified practice in STI management and is completing her Masters degree to be a nurse practitioner.
• Jamie Duteil is a Registered Nurse and the Health System Improvement Director at Health Quality BC. She has managed urgent primary care centres and acute care centres.
• Kacey Wall is a Registered Nurse and a diabetes educator, she has worked in primary care networks and is a team member of the Innovation Support Unit.
• Nikki Kafal is a Registered Nurse and has spent her career working in emergency and critical care settings. She is completing a dual master degree in nursing and health informatics and joins the Innovation Support Unit as a co-op student.

What is Team Up! Team-based primary and community care in action?

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 SM7b-MixPre: Do you
have a new nurse in your team?

Do you want a way to promote
them to your patients?

Do you also want to provide better
access to care for your patients?

Yeah, me too.

Sarah's away this week on an
adventure and she'll be back soon.

So that means I'm solo today and
I wanted to take that time to do a

mini episode, a team bit, on planning
a nurse clinic in your practice.

So let's dive in.

planning a special nurse clinic, which
is a dedicated half day or a full day

to a specific clinical area that the
nurse will run, is a great way to promote

the new nursing role in your practice.

It's also how you can promote
the new nurse as a person

to your practice as well.

So why do this?

First off, and I'm going to say this a
couple of times, it promotes the nurse.

Running that clinic means it's their day.

The nurse clinic is all about them.

It also gives the advantage
of addressing the specific gap

or care need in your practice.

Because it's focused on a specific area,
the visits are going to be shorter.

And because you're focused on a specific
area, you're promoting that gap,

that clinical need to your patients.

And that'll bring in people who
need that specific type of care.

So if you're interested,
what should you do?

First, you want to pick the
area of focus for the clinic.

And I like to use two criteria
when thinking about this.

first is, the focus should be something
that the nurse is already an expert in.

And then second, it matches
a need in the practice.

And every nurse I talked to
for this season really liked

the idea of nurse clinics.

They're comfortable with this approach.

Some even ran nurse clinics
during their training.

Now, while they were all comfortable
with this approach, they all had

their own ideas of what a good
focus would be for a nurse clinic.

And that was based on their expertise
and their experience and the practice

populations that they work with.

So, some common ideas that came up
included doing a blood pressure day,

running an immunization or vaccine clinic,
well baby checks, diabetic foot check day,

STI screening clinics, At our community
health center, we do PrEP clinics,

and PrEP is pre exposure prophylaxis.

So it's making sure people who are
potentially exposed to HIV or are

expecting to be exposed to HIV are
getting pre exposure treatment to

reduce the risk of transmission.

All of these are really potentially
effective for different practices.

And I think together, your
team will find the focus area

that's right for your practice.

Now you can do a nurse clinic
in a couple different ways.

You can have a series of
short one on one appointments.

Or you can think about a mix with a group
visit or an education session, and some

one on one appointments before and after.

Both of those good ways to go.

So, The series of short appointments
in an afternoon is definitely

the easier way to organize if you
haven't done one of these before.

once you've picked your topic area,
your area of focus, and how you're

gonna run the clinic, be it one on
one appointments or a mix of that and

a group visit, what do you do next?

It's promotion.

Now you can do more than one clinic.

Start with one.

I would promote the nurse
clinic to all of your patients.

And you can do that through your
newsletter, posters on the wall, and

to patients when you're seeing them.

I think it's important for the
existing team, the established

team, to promote the clinic.

It helps stretch that umbrella
of trust to the new team member.

I plan it out several weeks in
advance so people can book in.

And it also gives you time to make
it a bit more of a special event.

And then you can promote the individual
nurse as well in the process.

So by advertising the date of the whole
practice, you're promoting the topic,

but you're also really promoting the
value of the new nurse in the team.

So even if it's not a particular fit
for me, I'm still learning about the

nurse, and that's really valuable.

And then you have the clinic on the day.

I think the mechanics of the clinic
are actually pretty straightforward.

do something that's a pre book
rather than just a drop in, that

way you can have a sense of numbers
and you can manage the day better.

Have your MOA highlight this as a
special clinic with focused and shorter

appointments just so everyone's prepared.

And then once the day's full,
on the day of, the nurse

might need some time prepare.

And that could be pre reviewing charts
for patients who are booked in, getting

specific supplies ready if it's a
procedure based or say an immunization

clinic, and making sure the right,
Paperwork and patient specific orders

are all lined up and ready to go.

And then you go.

By having the nurse seeing the
patients, it shows off their skills.

You've structured it in a way
that the nurse can start to build

relationships more quickly with patients
that they might not have met yet.

And then you actually create
capacity in the clinic.

Here's Hannah from Kool Aid.

And she talks a little bit about
some of the clinics that she's run.

Hannah: I think because we can prepare,
, whether it's PrEP or doxypep, or treatment

for STIs, we can kind of have all the
forms laid out, I think one night and

two hours we had 14 screens we did

Morgan SM7b-MixPre: Now you
may have noticed, Hannah

mentioned a bonus move here.

That's to run the clinic in the evening.

If you do that It doesn't have to be
every single time, of course, but if you

do that, you actually give a different
kind of access to part of your practice

that might not always be available, to
come in during the day on a workday.

By doing it a little bit later in the
afternoon or evening, you can open

it up to make it more accessible to
a different part of your practice.

So then the last question I often
hear is, well, What does the family

doctor or the nurse practitioner
do during a nurse clinic day?

It's pretty much business as usual.

You have your own room,
you're seeing patients.

the tips and tricks I would say
are, be happy in the waiting

room about the nurse clinic.

Say hi to patients and promote and
Say how exciting it is to have a

nurse who's here and, and working
with you and helping the patients.

And then I would keep a little bit of
extra capacity in my own day, in my

own schedule, just in case, you know, a
few patients that are seeing the nurse

might need a quick consult from me.

that's a great way to catch up a
couple of little things that could

just fit right into the nurse clinic.

Maybe it's a, just a quick change of
an order to catch up something else.

. could be a quick medication renewal,
those things can all be fit in really,

really smoothly into a nurse clinic.

And then it shows that you're
working together as a team as well.

And that's it.

So just to wrap this short episode
up, once a nurse is in your team, sit

down as a whole team and brainstorm,
you know, I like to say five topic

areas for the nurse clinic day.

And then pick one of them, and I use
two criteria just to keep it simple.

Pick an area that the nurse feels
confident in and they have expertise in.

And then secondly, the topic that
you're most excited about, that you

think will help your patients the most.

And then book ahead, start to
promote it, and run the day.

If all goes well, you can
make this a regular thing.

It could be monthly.

You can book an afternoon, have
15 or 20 appointments, and then

you've suddenly created some extra
capacity in the team and that's it.

Thanks for listening to team up.

And if you have any questions or
specific 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.