Shari Comerford, the National Director Nurse Practitioner Professional Practice of the
Victorian Order of Nurses (VON) addressed Saugeen Shores Council as part of the Health update report given by CAO, David Smith.
The VON pioneered health care at home and has a long history of more than 120 years. “It was founded in 1897 and officially began in 1898 in Vancouver, Toronto, Montreal, Regina and Kingston, back when it was truly pioneering,” said Comerford. “When I lived in the Yukon where the first nurses were VONs and today it still means innovation, tenacity and courage to bring comprehensive health care to people.”
According to Comerford, people still confuse Nurse Practioners with RPNs. “Nurse Practitioners are advanced practice nurses who must first be a Registered Nurse,” she explained, “followed up with intense advanced practice education. We can assess, diagnose and order diagnostic tests and medications. The scope has now been expanded to include prescribing controlled drugs and substances which is a challenge. We hope to soon add MRI and CT scans to our scope.”
Comerford said that VON does more than home visits. “We also have community support services, primary health care clinics and more and we are governed by the College of Nurses of Ontario. NPs are in primary care, acute care, long-term care, mental health and across the board.”
Comerford went on to say that physicians or health care providers work on a capitation model through the Ministry of Health and they are paid $150 per patient per year plus bonuses and they can also bill for certain things. “It’s a complicated method,” she said.
Comerford then described stand-alone Nurse Practioner (NP) clinics. “This model was established by the Ministry of Health, in the late 1990s, when many people were without a doctor and it was a way to ensure that they had primary health care in partnership with municipalities. The funding however was not robust and only included a salary, benefits and a little bit of overhead.”
She said that the model was outdated but it did facilitate strong partnerships with stakeholders such as municipalities. The VON has 13 long-term care contracts across the province and Saugeen Shores is one of them. Some stand-alone clinics work in isolation while others have access to a physician. Currently, VON provides health services to 13,000 Ontarians with over 40,000 primary health care visits in 2018.
Saugeen Shores VON Nurse Practitioner, Colleen Fowler, works out of the Saugeen Shores Medical Clinic in Southampton with a case load of more than 600 patients and also provides outreach to two retirement residences. Many VONs have more patients and some less.
The VON and the municipality have been working to find a more suitable location which will enable a second Nurse Practitioner to be brought on board. In addition, due to privacy laws, it would ensure that there is confidentiality when it comes to patient records and documentation which Fowler currently does not have given that she is sharing electronic medical records and space.
CAO David Smith said that the VON is a critical part of health care in the community. “Staff have been working with the VON for approximately one year and having a second Nurse Practitioner would dramatically increase access to health care for our residents who do not have a family doctor and also for the many visitors we get each summer. It is expected that a stand-alone VON clinic will also potentially reduce Emergency Room visits.”
Comerford explained that she had approached the Ministry regarding ‘dormant contracts’ and she has been given permission to revive the contract for a second NP. Finalizing a partnership agreement between the Municipality and VON is now being worked on.
Mayor Luke Charbonneau said that there are a lot of transient people who come to the community and in doing so are away from their family physicians. “This will provide a huge opportunity for them and will be a great benefit and is really an exciting thing. We will make this happen to have these two Nurse Practitioners in our community.”