When her young patient entered the office, Julie Poirier, specialized nurse practitioner (IPS) at Saint-Étienne Family Medicine Group (GMF), in Chaudière-Appalaches, saw a vague disappointment in her eyes. “She wanted at all costs to see a doctor, but there was no longer any available beach,” says this IPS in practice for 10 years.
The pout quickly gave way to a smile when the young woman, struggling with excessive periods, found that the nurse could not only auscultate him, but prescribe all the diagnostic tests required, perform an ultrasound, a biopsy and ensure his follow-up the following week.
“In the end, she was overwhelmed. With me, she had the right to the total! Otherwise, she would have had to wait a month before seeing the doctor, who would have sent her anyway to get the biopsy, ”adds IPS, specializing in contraception and pregnancy monitoring.
At GMF Saint-Étienne, the presence of IPS has made it possible to increase the number of time slots for walk-in consultations and to take patients orphaned by family doctors. Exactly the purpose of the new bill tabled Thursday by Quebec: to improve the care of patients deprived of general practitioners. “We must change the network, but also change the reflex of patients to always go see a doctor for everything. A young woman who needs birth control does not absolutely need to see a doctor, ”insists Julie Poirier.
Expanded role
There are 842 IPS in Quebec with advanced training (master’s degree) who practice in various FMGs and clinics, while 564 others are in training. An insufficient quota to meet the needs. For now, the reduced number of internship locations for graduates limits the number of graduates, explains Julie Fortier.
Since January 2021, these professionals have been authorized to perform no less than 13 reserved acts and can now practice solo. “But in practice, this is rarely the case”, specifies Mme Pear tree.
Most IPS – several specialize in mental health, obstetrics, neonatology or pediatrics – work in concert with general practitioners, in clinics or in FMGs, where patients can be referred directly to them. The law now allows them to “diagnose diseases”, prescribe drugs and treatments, and use invasive diagnostic techniques or treatments.
But in practice, these nurses focus on the follow-ups of patients already seen by a doctor and in particular those of pregnant women and patients with diabetes, hypertension or high cholesterol. “The law has broadened our role, particularly in mental health,” explains Julie Poirier. But there are still limits for some diagnoses. However, the needs are immense! IPS in mental health are among the most sought after by FMGs. “
Like physicians, IPS in Quebec are distributed across the territory according to regional staffing plans. Ontario, which has more than 3,500 of these nurses, has granted them much more autonomy than Quebec, in particular the right to set up clinics formed only by NPs and to practice assisted dying. “What is very effective, assures Julie Poirier, is to have a core of IPS in the same clinic. It really seems in the waiting time to get an appointment. “