By: Daris Klemmer-Lamoureux
Although NPs have practiced in Alberta since the 1970s, the title only became protected in 2003 under the Health Professions Act (HPA). Prior to this some of the NP skill set was encompassed under the auspices of “RN extended class” and entry to practice could be extended class certification or Masters Degree. Following the introduction of the HPA in Alberta there was a push for Master’s degree entry to practice for Nurse Practitioners in Alberta, thus seeding the development of the programs we see today.
Once the HPA was created, NP education began to receive a lot more attention at a national level. The CNA launched reviews and created initiatives which greatly influenced the development of programs moving forward. RNs wishing to pursue NP practice were required to choose one of the three streams of practice before entering, and switching between them could be challenging. As of 2013/14 there were 28 NP programs across Canada and 3 in Alberta: The University of Calgary offers an adult/acute program, Athabasca University offers Family/All-Ages program and The University of Alberta offers family all ages, adult and neonatal programs. All of these programs require a Master’s degree as entry-level to practice.
In recent years, there has been a lot of discussion and debate surrounding NP education. Health care is a constantly changing and adapting industry, and so too are NP scope of practice and roles. Athabasca University developed the opioid prescribing course for NPs when federal legislation changed and NPs were able to prescribe Schedule 2 medications; they also offer a mental health course for NPs.
The programs in Alberta offer something unique depending on the type of NP work that is of interest – primary care, care of the adult, neonatal care or Adult acute care – and provide high-quality education The fact that we have the first program in the country to be accredited is a big ode to this continued dedication to improvement. Some wonder whether choosing a practice stream is the best way to provide education, and whether the current education adequately prepares practitioners for practice. Is it too limiting? Not limiting enough? Enough practice hours? Tell us what you think!
Marcie Smigorowsky who currently works in adult cardiology and completed some PhD research related to NP specialties has these thoughts:
“Nurse Practitioners are integral to the healthcare system including specialty areas of care(e.g. ICU, Emergency, Cardiology). Currently there is a push for NP education to develop generalist NPs. This creates a reduced capacity for NPs to attain knowledge in specialty practice areas. What knowledge and skills are required to be competent in the area? As NPs become entrenched in healthcare, post generalist NP education opportunities (possibly residencies or post NP programs) need to be developed for NPs to gain advanced specialty knowledge in order for other colleagues, patients and leadership to know what knowledge and skills a specialty NP should have to provide safe competent care”. Marice is also the Professional Practice Lead for Advance Practice Nurses in the Edmonton Zone for Alberta Health Services.
As NPs become further embedded in the Albertan and Canadian Health Care Systems the education programs will need to adapt and change. There has been a push from the National NEPAB/CASN regarding the development of a more generic NP education with movement towards postgraduate specialty certifications. This is being discussed very intensely at the national level and will, of course, affect education programs across the country.
It will be interesting to follow the accreditation of NP programs in Alberta and across the country – who will be accredited next?
Dr. Tammy O’Rourke, an associate professor with Athabasca University, offered her thoughts:
“Nursing practice has changed significantly over the past 50 years and more recently, the last 10 years have seen monumental changes in the scope of practice for Nurse Practitioners. As the scope of practice for this unique profession has changed, so must the educational content, teaching and learning processes and the structure of educational programs. The need for longer, more comprehensive programs for NPs in Canada is sure to follow the U.S. trend towards lengthened programs and the need to move content to a doctoral program for qualification, [and] entry to practice in Canada”.
The continued evolution of education is sure to be a hot topic in the coming years and will lead to much debate. How will NPs find and fund continuing education – particularly if NPs become more specialized? Most RNs continue to work and find balancing the current programs very challenging. How will this change if programs lengthen? There are also many who have a difficult time justifying the time and effort current programs require with the lack of monetary compensation and limited job environment for NPs. With this already a deterrent to enter the programs, how will enrollment be affected by more extensive programs? Leave us a comment or join the discussion on social media!
Editor’s Note: Academic institutions are currently adapting to new fiscal and practice realities. The University of Alberta program is just launching a new curriculum which allows for more distant/remote learning. The University of Calgary is about to embark on a curriculum redesign. The Canadian Council of Registered Nurse Regulators is recommending a single licensure category, moving away from specialty Master’s-level education. Much change is on the horizon. And, as you expected, the NPAA is in the thick of it! We are involved with government, education, and regulators as all groups work to advance the Nurse Practitioner profession in Alberta. Stay tuned, become a member, ensure that your voice is heard!
In addition, many of you may not realize that your membership has lapsed. It is crucial that we have the support of as many NPs as possible in the province as we enter a critical period of negotiation with government. Go to our website and log-in to confirm you are an active member. If you are, you should be able to see various member perks in the menu. If they are not visible to you, your membership has lapsed! Consider signing up for automatic membership renewal so you do not miss out on upcoming opportunities.