Oddly enough, I didn’t realize that I wanted to become a nurse until the end of my third year at Mt. Allison University where I was completing my Bachelor of Biology. This revelation came to me while watching a National Geographic documentary about a RN in rural Kenya who would travel between villages via motorcycle. At that moment I knew I wanted to combine my background in science with my desire to help others. I promptly began looking for an accelerated BSc in Nursing program, and ended up at St. Francis Xavier, where I graduated in December 2006.
From Nova Scotia, I moved to Salinas, California where I worked as a RN in an ICU- stepdown unit. After three years working with critically ill patients, I transitioned to the Emergency Department. This proved to be an invaluable experience where each shift provided an opportunity to quickly assess acuity, while contemplating which labs, imaging and medications the clinician would order. This ritual provided an integral foundation in my transition from RN to NP. In 2013, my wife Tara and I moved back to PEI where I was fortunate enough to start the UPEI Master of Nursing program. Since graduation in May 2015, I have worked as a primary care nurse practitioner at Harbourside Health Centre (HHC) in Summerside. This clinic serves approximately 4500 patients across the health and life spectrum. I am constantly humbled at the vast amount of information expected of a primary care NP. The workplace provides ample opportunity for lifelong learning. In the past year I have been fortunate to mentor several NP and RN students. I typically see 16 patients per day, more on Tuesdays when I do a prescription refill clinic. On Thursday afternoons I work at the Holland College Summerside campus where I help run a health clinic for students. This has proven to be a refreshing reprieve.
I want to publicly thank three special nurse practitioners who have inspired me along my journey. Sherri McKinnon has quietly and competently served rural, eastern PEI for years. Her steadfast dedication to Souris has acted as a bulwark in a sea of change. Sherri’s practice is now woven into the very fabric of the community. I want to thank Melanie McCarthy who graciously mentored me while I was a student NP. Melanie helped pave the way at HHC for all future NPs. My tenure at HHC is more rewarding because of Melanie’s pioneering spirit. Last but not least, I would like to thank Rebecca McCarvill, my friend and colleague at HHC for her calming presence and enduring willingness to collaborate on challenging cases.
I didn't always want to be a nurse, but I graduated high school (in NB) not really knowing what I wanted to do. And so I worked various different jobs over a few years and decided that it was time to go back to school and figure some stuff out. I thought university for business or maybe college for nursing... with no background in chemistry in high school I asked a recruiter at a mall about it - turns out, there were two years left in Ontario when you could get your RN at college, and not have to have your high school chemistry. SOLD! And so in 1999 I started my nursing journey.
I graduated in 2001 from Conestoga College in Kitchener and by the time I had graduated I had already had some amazing experiences with the Registered Nurses Association of Ontario, doing a pre-graduate placement in Kenora and some training in Critical Care. I started my career in the ICU at St. Josephs in Toronto and never regretted a moment of becoming a nurse.
My career as an RN took me to Nunavut where I realized the incredible power that nursing can have in a community. Then to Ottawa in a level 1 Trauma ER and teaching hospital where I learned the power of working with other disciplines to do the best things for patients - I learned about paramedics and their role, about working with all levels of learning physicians and nurses.
As an RN I taught students - nursing, medicine and paramedicine alike. I was able to go to the Olympics and lend my skill as a critical care RN. I was able to help set up and deliver simulation based training to help learning physicians go through crisis in a safe environment and when I felt like I needed a new challenge.... I returned to school.
To be perfectly honest, I went back to school with the intent of becoming a physician and by virtue of getting my undergraduate degree in nursing, I was reminded of all of the wonderful ways nursing, and that lens, affects patients and can make a huge difference. So I continued at University of Ottawa and got my masters of nursing and certification as a primary health care nurse practitioner.
And when I thought of my career and where I felt I made the most difference overall, I was reminded of Nunavut and working a rural areas like Kenora. And the rest of my family was still home in the Maritimes... so I decided to move closer to home and Montague seemed like a perfect fit.
Montague, at the time, had a clinic with 4 physicians looking to add to their group. The RNs here did COPD and INR clinics as well as spirometry and I would be working with LPNs on a daily basis. Any patient of the clinic overall would be able to see me and if I needed to ask any questions or wanted a second pair of eyes I had physician colleagues just down the hall willing to help. There had never been an NP here so it would be new but I do love a challenge.
It's been 4 years. Our RNs now do mental health collaborative care and counselling. I now have 6 physicians in my group. I teach, not just clinically but also was a sessional professor this year at UPEI for their NP program. Every day I see people across the spectrum of their lives and answer their questions about.... anything. While a lot of my practice focuses on women’s health, and mental health there is no limit to what I do in a day. And if I have a question, there are still physician colleagues just down the hall willing to help out. And, just as often, I am there to help them too.
I completed my BscN at UPEI in 2004, and proceeded to have a diverse and fulfilling career as an RN. The majority of my career was as an emergency room RN at the Queen Elizabeth Hospital, with experiences in ICU/CCU and northern outpost nursing. The skills and knowledge built as an RN have proved an invaluable asset for the progression to the next chapter of my career.
I have always known that I would advance my education and the nurse practitioner role felt like a natural progression for me. I graduated from Dalhousie University in 2015 with my Masters of Nursing- Nurse Practitioner (Family/all ages). For the past two years I have worked within the provincial diabetes program and primary care.
My role within the Provincial Diabetes Program is to provide care for islanders living with type 1 and 2 diabetes, who do not have access to a primary care provider. I work autonomously as well as collaboratively with clients and health team members to identify the best management as guided by evidence and theory, with careful consideration of the determinants of health. Achieving and maintaining optimal diabetes management is inherently a team effort. I have been privileged to work collaboratively with RN’s, physicians, social workers and dieticians (amongst others) in order to assist patients in managing their life with diabetes.
Health education regarding diet and lifestyle is central to diabetes management- however, various medications are also available to assist with diabetes management for both blood sugar control and vascular protection. I assist patients in making the decisions for their care plan by ensuring they have evidence based information, engagement and opportunity for discussion. Each client is central in any decision.
Diabetes care is complex and the technology is rapidly changing and expanding. As a part of my role in the diabetes program I am a member of the adult insulin pump team- caring for islanders who are using insulin pump therapy to manage their diabetes. While insulin pump devices, sensors, and blood glucose meters key to care, the technology progresses at an astounding rate that challenges me to ensure I maintain my education levels in this ever changing world of diabetes care.
Currently my role in primary care is providing prenatal care to women (who are referred from the patient registry) for up to 32 weeks, providing primary care to those clients living with diabetes, fill in for NP walk in clinics, and refer and collaborate when appropriate to ensure optimum patient care.
Thank you to the nurse practitioners who have facilitated the growth and progression of the profession to where it is now. I look forward to all of the opportunities for growth and learning that this role will bring, and to translate that learning and growth to the optimal care of the clients I am privileged to care for.
Why did you decide to become a nurse practitioner?
When I was in nursing school, they asked everyone in the class who was planning on doing their master’s to raise their hand. I put my hand up right away — I always knew I would further my education. When it came time to decide what to do for a master’s, the NP program appealed to me so much because it took me to the next level, offering autonomy as well as hands-on care. Becoming an NP helped me to get more medical knowledge but still from a nursing perspective, such as looking at things with a client-centred approach. When I first entered the workforce, I always wanted to work in the ICU as an RN, so I had to work on a general floor, then took the ICU course, then two years after that I decided to go back to get my master’s. I worked as an RN for three years before I went back to do my master’s.
How do you feel you help patients the most?
I think one of the things I do the best with patients is to help them learn more about their illness or disease process. The more I can teach patients, the more they understand, and the more they can help themselves through the process — allowing them to be in charge, with a lot of empowerment. By educating the patient on their illness and treatment, this helps them understand themselves throughout the process and really be involved.
What is the most rewarding aspect of your job and what is the most challenging?
The most rewarding aspect is when I can see a patient really take charge of their own health through the information and education they have received. An example would be a patient who has COPD that we have been talking to about the importance of taking their puffer — and then finally the lightbulb goes on and they understand the importance of everything and their health starts to change. That is very rewarding for me. I think the most challenging aspect is that NPs are still new in P.E.I., so sometime there is still a lot of misconception about the role and scope of the NP. It can be frustrating to explain the role of NPs to those working in the health-care system and to patients. For the first year of my job, many members of the health care team struggled with understanding my role. They have all come on board very well and now understand the NP’s role. Now it is patients who we are still explaining our role to on a day-to-day basis, but as they understand our role they become our number one fan and supporter.
More about Kelsey:
In February 2016, I went on a month-long trip to Rwanda and volunteered at a hospital and two medical centres, working on policy and education for the nursing staff. My focus was on increasing physical assessment skills for the internal medicine nurses. My mother is an RN and she came with me. It was amazing to work together with her and with the nursing staff in Rwanda.
Credits to the Canadian Nurses Assocation
My first exposure to the Nurse Practitioner role was in my fourth year of the UPEI nursing program. I had a wonderful opportunity to have a clinical placement with Janet Loo, a Nurse Practitioner working in Hunter River, PEI at the time. I was so impressed by the quality of care that Janet provided; I knew it was a role that I was interested in pursuing in the future.
After graduating in 2008 from UPEI with a BScN, I worked as a registered nurse in a variety of clinical settings including; emergency and medical units in hospital, and community health clinics. I also had the unique opportunity to work as a health promotion intern in The Gambia, West Africa, with the Nova Scotia Gambia Association, through the Canadian International Youth Employment Program. It was this experience that confirmed my desire to work in a community setting with the focus on health promotion and illness prevention and I pursued further education. I graduated from Dalhousie University with a Masters of Nursing- Family All Ages Nurse Practitioner in 2014.
I now work as a primary care nurse practitioner at a unique and innovative primary care clinic at CHANCES. CHANCES is a family resource centre dedicated to providing a comprehensive continuum of support for young Island families. The clinic was created through funding from Medavie Health Foundation, in an effort to improve primary health care services to young families who access CHANCES programs and were without a primary care provider.
The clinic opened to patients in November of 2014 and I am now the primary care provider to approximately 550 patients who were previously unaffiliated. I am fortunate to care for young families from diverse cultural and social backgrounds. Patients come to the clinic for a wide variety of reasons ranging from episodic health concerns to chronic disease management. I collaborate and consult with physicians and other health care professionals regularly in an effort to provide high quality care to patients. The unique model of this health clinic allows me to connect young families to other CHANCES services that could be of benefit to their overall wellbeing. It also allows me the necessary time with patients to incorporate principles of health promotion and illness prevention into each visit. It has been a privilege to see this clinic grow from a desire of a non-profit organization, to address a growing need within the population that it serves, to the busy clinic that it is today. It is also exciting to see the nurse practitioner role thrive within a family resource centre and to play a part in improving access to primary care services for young Island families.
Chelsea Rogerson NP “consults with all disciplines in the health care field in an effort to provide clients with the highest, quality care possible.” I work as a primary health care nurse practitioner (family all ages) for Health PEI. I graduated from UPEI with my BScN in 2006, from Lakehead University with an NP-PHC certificate in 2013, and from Athabasca University with a Master of Nursing: Nurse Practitioner in 2015. I decided to return to school and do my NP after working as an Advanced Practice Nurse in Northern Manitoba.
I have a roster of clients in which I am the primary health care provider; I also provide overflow care for the clients of my three collaborating physicians. Additional to this, I provide care on an as needed basis for unaffiliated clients. My day consists of pre-booked appointments, follow-ups, and same-day appointments that range from fifteen minutes to one hour, depending on the clients concern. My practice is based out of the Murphy’s Parkdale Medical Centre.
Clients are welcome to book appointments for health concerns as they see necessary. In my practice I offer a wide variety of services, however, my days frequently consist of chronic disease management, prenatal care, health screening, counseling, episodic care and IUD insertions. At the clinic we offer client and family-centered, holistic care. We strive to offer accessible care by offering same day appointments, early morning appointments and a weekly evening clinic. I collaborate and consult with all disciplines in the health care field in an effort to provide clients with the highest, quality care possible. Originally, my position started as a pilot project, creating an opportunity for a PHC-NP to work with their own client base, rather than only seeing clients of collaborating physicians. Because of the overwhelming success of this pilot project, it became a permanent position which I reside in today. This position requires a great deal of autonomy and independence, and the opportunity has helped me to grow substantially as a primary health care provider within the community.”
Lynne Fraser BScN, MN, NP Working as a Primary Care Nurse Practitioner – Family All Ages, since 2013
Originally from Sault Ste Marie, ON, I completed my BScN at Laurentian University (Sudbury, ON) in 2001. I moved to PEI in the spring of 2001 and have worked in a variety of roles as a Registered Nurse (Medical, Surgical, ICU, Clinical Educator) before returning to school in 2011. I graduated from Dalhousie University in 2013 with my Masters of Nursing – Nurse Practitioner stream.
Presently, I primarily work in a family practice setting, providing care to patients of all ages, presenting with issues ranging from acute to chronic. • I cover the overflow patients from the practice of my collaborating physician, to allow for increased access to the clinic. • There are also a number of patients for whom I am their primary health care provider and I manage all of their health concerns in the community, consulting with physicians and other professions as needed. • I provide prenatal care to women up to 32 weeks gestation, who are either referred to me or do not have a primary Health Care Provider. • For the last 3 years, I have run a NP clinic once a week at Holland College (Charlottetown Campus), providing students with access to walk in clinic services as well as ongoing follow-up for management and support.
From the early years of the BScN program, I knew I was interested in pursuing the Nurse Practitioner program. In the primary care setting, I have a lot of autonomy in my practice, am challenged regularly, and continue to learn new things everyday. I am fortunate to be able to develop long term therapeutic relationships with patients and feel privileged to hear their stories and to work with them in addressing and managing their health needs.
The role of the Nurse Practitioner in PEI continues to evolve and it is amazing to see our numbers increasing and new opportunities emerging. Our role is not to replace other professionals, but rather augment our current system and help improve access to care for individuals and families.
For more information about Nurse Practitioners, please visit: www.peinpa.ca Prince Edward Island Nurse Practitioner Association www.npac-aiipc.org Nurse Practitioner Association of Canada
Kirsten Mallard GNP and Megan Smallwood GNP Nurse Practitioners We are geriatric nurse practitioners who work with the Provincial Geriatric Program. Kirsten has been with the program since 2014 and Megan since 2016. Prior to this we both have been nursing in various roles in PEI since 2003 and 2002 respectively. In our current practice we service the entire province, tip to tip. Kirsten is the NP covering Queens East and Megan from East Prince to West Prince. We work collaboratively with our three geriatricians to service individuals 65 and older. We receive referrals from physicians and nurse practitioners to assess individuals for various reasons, like dementia, medication review, frailty, home safety, depression and anxiety. We see individuals in clinic settings, acute care, community care and in their homes. We conduct comprehensive geriatric assessments and make recommendations to the primary providers to implement. We work primarily as consultants to primary care providers.
We have strong partnerships with home care and primary care through our COACH program. This program stands for caring for the older adult in community and home. The goal of this program is to keep frail seniors in home by working with home care and primary care. It has proven very successful in reducing ER visits, hospital admissions and primary care visits in this complex group of patients. We both have a strong passion for providing quality care and access to our senior population and their families. We also are a resource for other health care professionals in conducting education sessions on topics specific to the senior population. Our roles are in a specialized area that is ever increasing and becoming more complex but very significant with our aging population
Prince Edward Island wasn’t on Melinda Ells’ radar when she started her job hunt after graduating from Dalhousie University as a nurse practitioner
But after five years here, the 34-year-old Advocate Harbour, NS native can’t stop singing the Island’s praises.
“It’s very peaceful. It’s calming; you get away from the business of a big city,” she said. “The people here are very warm, the summers are great; you get the four seasons, and there is a really nice work-life balance.”
As a nurse practitioner, Ells sees everyone from children to pregnant women to seniors in her practice at the Central Queens Family Health Centre in Hunter River. She shares the practice with five physicians at the central PEI location, and visits patients at other sites as well.
“Hunter River offers a wide variety of patients and patient issues,” she said. “The people here are sweet; it’s just like home for me.”
Nurse practitioners (NPs) are registered nurses who have additional training to assess, diagnose and treat common, acute and chronic health conditions. They can order tests, prescribe treatments and medications, and make referrals to other health care professionals.
Ells said she’s impressed with how the province has embraced the role of nurse practitioners, an important component of primary health care on the Island. Their additional education and experience enables nurse practitioners to function both independently and collaboratively with other health care providers.
“We are a valued part of the overall health care team,” Ells said. “We collaborate on multidisciplinary teams along with physiotherapists, labs services, and anyone who integrates in one way or another with a nurse practitioner.”
NPs have taken on a larger role in Island health care since the creation of primary care networks. A typical network has family physicians, a nurse practitioner, nurses, allied health professionals, and administrative support working together to assure that all Islanders are within 30 kilometers of a primary health centre site. (Credits PEI Gov 2017 photo and write up)