A nurse practitioner is a registered nurse with a graduate degree in advanced practice nursing. Graduate nursing degrees include the Master of Science in Nursing (MSN) and Doctor of Nursing Practice (DNP).
A nurse practitioner is someone who has completed one of these two degrees and passed the licensing examination.
A nurse practitioner can specialize in a variety of areas and practice with different patient populations, which determines their licensure requirements. Depending on the province, nurse practitioners may have prescriptive authority and collaborate with doctors or practice independently.
Providing everyday care to patients as well as preventing and treating illnesses are the main responsibilities of a nurse practitioner.
Over the last few decades, the healthcare system has undergone drastic changes. As a result, patients may receive care differently. Nurse practitioners fill a critical gap in the healthcare system, especially in primary care.
If you’re a nurse practitioner or looking to become one, opening your own clinic may be appealing to you.
Nurse practitioners enjoy the autonomy they have in caring for their own patients. Since full practice authority differs depending on location, it’s important to consider the regulations for the area you’re looking to practice in.
Do You Want More Autonomy As a Nurse Practitioner?
After working as a nurse practitioner for a period of time, you may be looking for more independence as you gain experience. When confidence and competence grow, the need for consultation decreases.
On the other hand, more complex situations require more collaboration. Expertise is built on knowledge and experience. Continuing education opportunities and on-the-job training are essential for nurse practitioners to enhance and maintain competency.
It is the nursing practitioner’s responsibility to practice in accordance with the laws and regulations of their jurisdictions. A nurse practitioner practices nursing according to the standards and ethics of the profession.
Having additional education and experience increases their ability to provide high-quality care, which increases Canadians’ access to health services.
A nurse practitioner can make a positive contribution to the Canadian healthcare system and to Canadians’ health as a nurse practitioner, especially if they’re wanting to open their own clinic.
A nurse practitioner is a regulated health care provider who works independently. Nursing practitioners need medical directives only for those controlled acts they cannot do on their own.
The scope of nursing practice in Ontario, for example, does not currently include ordering CT scans or MRIs, so nurse practitioners would require a medical directive for this purpose. However, in other provinces, this is part of the nurse practitioner’s role and within their scope of practice.
Opening a Nurse Practitioner Clinic In Canada
What Are The Requirements?
You can open your own clinic once you have passed your licensing exam and obtained your Nurse Practitioner designation. Upon graduation, there are no requirements or limits to what you can do.
The knowledge, skill, and judgment of a novice nurse practitioner are naturally limited. In order to function autonomously, nurse practitioners do not require medical directives.
Do I Need a Supervisory Doctor?
There is no formal requirement for nurse practitioners to have a supervisory doctor, but they often work together with doctors.
Despite the fact that nurse practitioners do not need doctor oversight or medical oversight, they are still working with a team and consulting with other members of the team as necessary. A nurse practitioner is usually welcome to consult with doctors or to assist them with patients if necessary.
Opening a Clinic Without a Doctor
It is also possible for nurse practitioners to open up their own clinics independently of doctors. A nurse practitioner leads these clinics, which are fully funded by the government.
Currently, there are 25 nurse practitioner-led clinics in Ontario serving almost 100,000 patients. While their budgets are quite small compared with other programs, the Ontario Government will increase funding and expand nurse practitioner programs.
Shortage of Healthcare Providers
Canada needs to adopt new funding models for nurse practitioners if it is serious about addressing its shortage of primary health care providers.
Recently, Canadian headlines have been dominated by healthcare horror stories. More than 5,000 people in Prince Edward Island are without a family doctor as a result of four doctors abandoning their practices recently. These individuals will join the 24,000 Islanders already waiting for family doctors.
At least one million Ontarians lack regular access to primary care, according to the Ontario Medical Association (OMA). There is even a greater shortage of doctors in northern Ontario, where the OMA says the healthcare system is threatened by a shortage of 100 primary care doctors and 130 specialists.
Moreover, the Canadian Federation of Nurses has issued ominous warnings, saying the healthcare system is on the verge of collapse. The president of Doctors Manitoba explained it as the healthcare system has been slowly declining, but COVID came along and destroyed it.
Nurse Practitioners Can Bridge The Gap
Our strained healthcare system needs nurse practitioners to relieve some of its burdens. Advanced practice nurses receive two additional years of education, allowing them to assess, diagnose, prescribe, and manage primary healthcare patients, even in their own clinics.
According to the Canadian Institute for Health Information, more than 6,500 nurse practitioners were licensed to practice in Canada in 2020, with about 35% working in hospitals and 36% working in community organizations.
The number of nurse practitioners in Canada looking to become more involved in primary care is rising, but compensation models have created stumbling blocks that prevent them from expanding their practice.
While family doctors run their clinics as small businesses and bill their provinces for services, nurse practitioners are paid by salary, leading to some systemic problems.
In some provinces, such as Ontario, nurse practitioners are permitted to open their own primary-care clinics, but if nurse practitioners worked more in family doctor clinics, we could expand nurse practitioner involvement in primary care more rapidly.
In addition to this, the Ontario government pays the salaries of nurse practitioners who run clinics or work in hospitals. However, nurse practitioners who work in a family doctor’s clinic are generally independent contractors, and their pay is not paid by the government.
The majority of family doctors across Canada cannot afford to pay $100,000 a year to take on a nurse practitioner in their practice. In a province like Ontario, they can fund nurse practitioners in hospitals.
There shouldn’t be any reason those same funds don’t extend to primary-care doctor clinics, or offer incentives, such as 50% funding splits.
Consider a possibility where the financial incentives were offered to family doctors across the country to hire nurse practitioners as a part of their team.
Due to staffing shortages, some Canadian emergency departments have been closing for periods due to staffing shortages. Participating clinics could increase their hours of operation and reduce demand.
In our healthcare system, primary care providers act as the initial point of care for patients. To see a specialist for any type of issue, patients must have a referral from their primary care provider.
It is these providers who are most likely to manage a patient’s condition and help them achieve a better health outcome because they know the patient best.
Medical school graduates would also be encouraged to pursue careers as family doctors if nurse practitioners were seen as valuable components of the primary care system.
A nurse practitioner will provide them with the support they need to better manage patients’ needs, ensuring they are able to focus on their practice.
In order to improve the quality of our healthcare system, we desperately need more nurse practitioners. In order to accomplish this, provincial health ministries must recognize that the rules concerning funding are outdated and need to be changed.
Nurse Practitioner Competencies
Having a clear understanding of nurse practitioners’ expectations is crucial. Their experience in the field of nurse practitioner, their knowledge of it, their values, the degree to which they can adjust their skills in order to undertake new assignments, their attitudes, and the capacity they possess for learning new skills.
Understanding how they will interact with colleagues, patients, and other members of the team is essential. It is also crucial to understand the development of nurse practitioner expertise and interdisciplinary team development over time as a contributing factor.
Despite its importance, a nurse practitioner’s role has lacked transparency. The reason for this is that each jurisdiction has written their own scope of practice, definitions, and educational requirements for nurse practitioners, under provincial authority.
Additionally, federal, provincial, and territorial governments, associations, and regulatory colleges distinguish between nurse practitioner and other roles of advanced practice nurses.
Nurse practitioner education approval, review, and recommendation processes are also identified in provincial legislation. Therefore, it is difficult to define characteristics for nurse practitioners at the national level.
In order to provide a basic preparation for nurse practitioners, there is a set of Canadian core competencies that all the nurse practitioners will need to demonstrate and develop as part of their preparation.
Regardless of the patient populations or practice environments, these core competencies describe the minimum knowledge, judgment, attributes, skills needed by entry-level nurse practitioners for safe and ethical practice in a specific role and setting.
There are core competencies required for registered nurses, and these nurse practitioner competencies build on those.
There are four categories of nurse practitioner core competencies:
- Assessments of health and diagnostics
- Preventing illness and promoting health
- Complications and injuries
- Roles and responsibilities of the profession
- Management of healthcare and therapeutic interventions
With a variety of clinical role skills, nurse practitioners are able to practice in a variety of settings, often in ambiguous and/or complex situations, where their reasoning, critical thinking, and decision-making are informed by complex reasoning, critical thinking, and analysis.
As a result, the nurse practitioner must possess the ability to be a self-directed learner who has a constant interest in gaining new understandings through a variety of means that enhance their ability to reflect critically on their work.
Nursing practitioners are well-versed in communication, negotiation, and conflict resolution skills, which enable them to demonstrate leadership in the plan, implementation, and evaluation of interventions.
Nurse practitioners provide care to a variety of patients by caring for them in a wide range of settings, including their own clinics.
Written by Joanne Potter
Joanne, BSN and RN, is a writer that specializes in health and wellness. She has fifteen years of experience as a Registered Nurse in the NICU (Neonatal Intensive Care Unit). Her years working at the bedside and extensive neonatal knowledge enable her to write with a deep understanding of what patients and families want from their communities. Visit her LinkedIn page.