To accommodate the continued containment of cost, the ways in which
health services are delivered must be changed. Government policies are
critical factors in implementing the change. Funding to health care
facilities has been restructured, and the number of nurses, doctors,
technicians and maintenance staff has been reduced in hospitals and
publicly funded institutions. There has been a shift of care from the
hospital to the community. Since medical services represent the largest
expense in delivering health care services, attempts are being made
to decrease that expense. One way has been to use nurse practitioners
in the struggle to provide more cost-effective health care in Canada.
Nurse practitioners are registered nurses with additional education
that enables them to diagnose, treat and prescribe. They are likely
to practise in community health centres and public-health clinics. Government
policies on educational funding, training requirements and certification
affect how the nurse practitioner solution is implemented. Governments
decide how many practitioners need to be trained and open up or limit
the entrance of students into the programs.
Telehealth in Canada*
Top clinical applications in use in Canada are teleradiology,
teledermatology, telepsychiatry and emerging medicine.
In five years, telemedicine centres in Canada grew from one to
22.
British Columbia has a network that links all the pharmacies
and about 1,500 pharmacists in the province.
The Nova Scotia Telehealth Network, an $8 million project, claimed
to be the first telemedicine system in the world to connect all
hospitals in an entire health jurisdiction.
*Information from The Telehealth Sector in Canada
(1999).
Ontario, Newfoundland and Alberta have legislation to enable nurse
practitioners to provide the additional services. Most other provincial
governments are implementing such legislation.
Those interested in the nursing field are well advised to obtain a
university degree as part of their education. Many provinces already
require a baccalaureate degree in nursing and more will require it in
the future. Registered nurses are in demand, and there is a need for
specialists in the fields of critical care, operating room and mental
health nursing.
It appears that nursing is heading in the same direction as the clerical
field: a declining demand for middle-level skilled workers, such as
general duty nurses who don't have a degree, and an increased demand
for highly skilled registered nurses with a specialization and a master's
degree. There is also an increased demand for lesser- skilled licensed
practical nurses (LPN).
