The land where Medicare was born is now at a crossroads, according to the head of the union representing Saskatchewan’s 10,000 registered nurses, and nurses can point the way.
Saskatchewan is poised to once again lead the world in health care, says Tracy Zambory, president of the Saskatchewan Union of Nurses (SUN). “Right now we are in the most unknown territory that we’ve ever been in in health care in this province,” she says. “Right now we have the opportunity to build the best health care system that this world has ever seen and to do that, we need to utilize registered nurses and nurse practitioners.”
Zambory says, registered nurses are uniquely positioned to lead the way into the future of health care. Registered nurses work with patients from start to finish. “We are the health care providers who touch the patient more than anybody else. We have the most interaction. We are there to admit them into the system, and most times we are there to discharge them,” she says. Registered nurses, including RNs, Nurse Practitioner)s (RN(NP)s), Registered Psychiatric Nurses (RPNs) and graduates work with patients both in and outside of hospital settings throughout Saskatchewan.
The key, she says, is to look beyond patients’ specific ailments to the individual as a whole and the circumstances in which they live to determine the root causes of ill health, including housing and nutrition, financial security, access to education and access to clean water. As frontline care providers, registered nurses see the effects of these social determinants of health every day.
“For a person to be healthy, they have to be guaranteed some things in their life and if any one of those is not in place, it will have a negative impact on the health of that individual and that individual’s health can impact other people’s health around them,” Zabory says.
The Encyclopedia Britannica defines holistic medicine as a “doctrine of preventive and therapeutic medicine that emphasizes the necessity of looking at the whole person…rather than at an isolated function or organ and which promotes the use of a wide range of health practices and therapies.”
The concept can be overwhelming, Zambory says. “It’s like an umbrella for a bunch of other things — it’s secure housing; it’s security of income; it’s security of education; it’s security of access to health care – it’s all these things that the majority of us take for granted, that makes us able to thrive and survive in society,” she says.
While registered nurses most often are able to talk with patients about their situation and help determine the basis of their health problems, there’s only so much they can do, especially to address the financial difficulties that are often the root cause of many of their problems. Without money, people may not be able to afford housing, food, education or their medication. The 2016 Canadian Community Health Survey found that almost a million Canadians skimped on necessities to pay for their medicine. Jobs may not always easy to find and those that are available may be what labour leaders term precarious work, jobs that are poorly paid and without benefits or security.
Registered nurses can, again, lead the way in talking with government to address many of the issues that can lead to poor health. “We can speak to the people in power about building a robust primary health care system,” Zambory says. In Saskatchewan, low income individuals and families can apply for the Special Support Program to help pay for medicine, and the federal government recently announced plans for an advisory council on options to proceed with a national pharma care program, Pharmacare.
But, more needs to be done, Zambory believes, and addressing those root causes of health problems and helping people become “wholesome contributing member of society” offers a financial benefit to government and the people of Saskatchewan as well. Not doing so can lead to repeated access to the health care system, with emergency visits costing the most to taxpayers.
“We end up in such a cycle that we can’t break out of, and it becomes a costly cycle, not just in human resources but for that person’s health and wellbeing,” Zambory says.
Registered nurses can also help in a more tangible way, especially by providing expanded services in communities that don’t have fulltime access to a doctor. While nurse practitioners can now perform some of those tasks, Zambory believes all registered nurses should be able to diagnose, treat and even prescribe medication for certain common medical ailments for example, with graduates being designated as Registered Nurse (Additional Authorized Practice). “We believe that nurses with that level of education and training and skills is what the province needs to create the best health care system that the world has ever seen,” she says.
“Registered nurses are ready, willing and able to take a leadership role in helping build the new Saskatchewan health system,” Zambory says. But, they can’t do it alone. “It takes a community,” she says. Working together as a community, especially in the area of health care, has proven successful for our province in the past, and with registered nurses leading the way, hopefully will be so again in the future.
Read the full special feature here: 2018 National Nurses Week: leader Post and Star Phoneix