President Yvette Coffey on CBC Newfoundland Morning

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Interview Transcription

Martin Jones: Well, this is Nurse Practitioners Week in Canada. With a shortage of nurses and the resulting emergency room closures and diversions in this province,  these professionals are vital to our healthcare system. To talk about how nurse practitioners can help fix the problems with access to care – and when they’re asked to do too much – we’re joined now by Yvette Coffee. She’s the president of the Registered Nurses Union of Newfoundland and Labrador. Welcome back.

Yvette Coffey: Good morning, Martin. 

Martin Jones: I think if you do a third appearance on the show in a row, you get like a, a turkey or something.

Yvette Coffey: Awesome. I’ll have to come back to Corner Brook.

Martin Jones: Exactly. Listen, we know that Nurse Practitioners can do a lot of things that doctors do. They can assess a patient, make diagnoses, and prescribe medications. What else is in their scope of practice?

Yvette Coffey: So Nurse Practitioners are highly skilled practitioners who assess patients, order and interpret many diagnostic tests… prescribe medications, diagnose, treat a wide variety of healthcare conditions… and they practice in a holistic and patient centered approach that includes health promotion and patient education. And they care for people from birth to death. Wide variety in between. They are in every sector of healthcare throughout the province of Newfoundland and Labrador, be it in the communities, mental health and addictions, long term care, cardiovascular, cardiac surgery, urology, cancer care, and the list goes on and on.

Martin Jones: With a list of skills like that, I’m curious to know how well are Nurse Practitioners in our province being used within that scope of practice?

Yvette Coffey: Well, right now we know that we have a lack of primary healthcare providers. We have over 135,000 residents in Newfoundland and Labrador who do not have a family physician, who do not have a Nurse Practitioner to care for their basic needs, be it yearly assessments, physical pap smears – and we know Nurse Practitioners do a lot of pap smear clinics out in the communities and that. 

People need to have prescriptions renewed. People need to have their basic needs met from health promotion, diabetes management, management of their high blood pressure, for instance. And we know that the government announced last week that they have directed the regional health authorities (RHAs) – the employers – to look at the healthcare needs, the primary healthcare needs of the residents in their respective RHAs, and to post positions for NPs to have their own clinics within the publicly funded healthcare systems, so that the primary healthcare needs of patients can be met. 

And this in turn. We’ll keep people out of the emergency departments. Right now, our emergency departments are being overcrowded with residents of Newfoundland and Labrador who have nowhere else to go to have their primary healthcare needs met.

Martin Jones: You mentioned there about having these clinics that Nurse Practitioners can run. Eastern Health announced a virtual ER for the Bonavista Peninsula, for the Bonavista Hospital, rather staffed by one Nurse Practitioner with a doctor available by phone. What are your thoughts on using Nurse Practitioners that way?

Yvette Coffey: So we do know, in order to keep from having to close emergency rooms such as Bonavista, we have been utilizing Nurse Practitioners. And a Nurse Practitioner has to – within their scope of practice – to run an emergency room and be the primary provider there, but they have to upskill. 

So airway management is one of the biggest things, having advanced cardiac life support courses – there’s specific courses that you need in order to work in an emergency department and be the primary, sole provider. So, we have people who are upskilling, and we do have a Nurse Practitioner out in Bonavista who operates that emergency room independently.

We always have backup from, so Bonavista would be Clarenville, the next biggest emergency department. The same as with if a family physician was to go work in an emergency department, they have to upskill as well – because that’s something that you learn in school, but if you don’t practice it and have those advanced skills, you can’t practice independently in an emergency department. 

Martin Jones: Sure. 

Yvette Coffey: So this is what our Nurse Practitioners are doing, and they are providing a great service so that we don’t have to close these emergency rooms.

Martin Jones: I’m quickly running out of time here, but I wanna know – what do you think we need to do to make the best use of nurse practitioners without overtaxing them?

Yvette Coffey: We need to look at the primary healthcare needs – we have an urgent need for that – and we need the healthcare authorities to quickly look at the needs and to quickly post these positions, and get Nurse Practitioners working under the RHAs. And we also need to recognize them for the skills, expertise, and the education that they bring to the system. They are the lowest paid in the country right now. 

We need to work out how much they get paid for covering an emergency room, which is a great responsibility. And right now, there is no increased pay for them for that. And we need to recognize them for what they can do for health care and improving health outcomes for the people of Newfoundland and Labrador. 

And before we go, I have to have a big shout out to our Nurse Practitioners and say happy Nurse Practitioners Week, and thank you for everything you do for the people of Newfoundland and Labrador, and what you bring to the system. 

Martin Jones: Yeah, we absolutely echo that sentiment as well. Yvette. Listen, always good talking to you. Thank you again for some more time. This. Morning.

Yvette Coffey: All right. Thank you. 

Martin Jones: Yvette Coffee is the President of the Registered Nurses Union of Newfoundland and Labrador.