As a lifelong resident of the Beach and local health care provider, I often have neighbours telling me that their family doctor has retired or moved away, asking me if I know where they might be able to get primary health care. Fortunately, here in the East End we have a variety of places that provide comprehensive health care to individuals and families that utilize a team of health care professionals. I encourage people to look at places that have Nurse Practitioners (NPs) working alongside family physicians, as part of an interdisciplinary team. People are often surprised to hear about recent changes to the role of NPs making them more autonomous and accountable.
NPs complete a Baccalaureate degree in nursing, work for at least five years and then return to university for additional education and experience before writing a specialty exam through the College of Nurses of Ontario. There are now more than 2,000 NPs practising in Ontario.
NPs who specialize in primary health care provide care across the lifespan from infants to the elderly.
“My focus is on promoting health and well being. I do complete physicals, well baby and child care, emphasizing health promotion and illness prevention. I help to ensure that people can be seen quickly, when they are sick, not in a few weeks,” said Marianne Surbeck, one of two NPs at the Southeast Toronto Family Health Team affiliated with Toronto East General Hospital (TEGH). “I also provide home visits to frail and house bound seniors.”
Their new site at 1871 Danforth Ave. also has an NP, and that site is now accepting new clients. At Southeast Family Health Team, the NPs work with family physicians, dietitians, chiropodists, social workers and other health care providers. They even have a care navigator who helps people as they move through the health care system, making sure that their care is seamless and coordinated, helping individuals fill out forms and get to the right provider.
East End Community Health Centre at 1619 Queen St. E. (at the corner of Coxwell Avenue) has four NPs who specialize in primary health care. They also work with a team of health care providers including family physicians, psychologists, social workers, dietitians, chiropodists and clinical assistants.
“Sometimes patients are surprised at how much Nurse Practitioners can do. They aren’t always aware that we can order most medications with the exception of narcotics, order any laboratory test, and order most diagnostic imaging tests such as x-rays, ultrasounds etc.,” said Barb Hood, who has been an NP for more than 30 years.
Lynne Haslett, who is currently an NP working at East End CHC, says that she often receives positive feedback from clients who had no previous experience working with an NP. “The patients tell me they can’t believe how much time we spend with them. Some of them have been to places where they were told they could only discuss one issue per visit or where their complete physical took less than 10 minutes. We have a very different approach here, really getting to know the whole person and linking them to them to the services they need.”
Joanne Opsteen, who has worked at East End CHC for more than 15 years, also states that people don’t always know NPs can monitor and manage chronic diseases such as COPD, diabetes, cardiovascular disease, and mental health conditions. Findings of a recent meta-analysis show that NPs can manage chronic disease as well as family physicians. The NPs at East End CHC also work with members of the community outreach team, helping to provide educational programs and resources for people with diabetes, young mothers, newcomers, and others. East End CHC is also accepting new patients.
Access Alliance Multicultural Health Centre has set up a satellite clinic at 3079 Danforth Ave. (where Regal Tile used to be). Their team of NPs, MDs and allied health provide services primarily to new immigrants and refugees, especially those living near Victoria Park and Danforth. They are also accepting new clients who meet their criteria.
More recently, legislative amendments to the Public Hospitals Act have been made enabling Nurse Practitioners to admit, treat and discharge patients within and from hospitals. Many hospitals have also incorporated Nurse Practitioners into various clinical specialty areas such as cardiology, geriatrics, mental health, pediatrics and pain management with excellent patient outcomes. The literature indicates that integration of NPs into hospitals can decrease length of stay, improve client outcomes and client satisfaction and decrease costs. NPs working in emergency departments help to expedite care and decrease wait times. They can order x-rays and lab tests, provide stitches and cast certain fractures. At this time, TEGH does not have any NPs. But as East Enders journey through the health care system, they are bound to encounter an NP!
Theresa Agnew is the Executive Director of the Nurse Practitioners’ Association of Ontario and works part-time at East End Community Health Centre as a Primary Health Care Nurse Practitioner.