Canadian nurse practitioner's quest for identity: A philosophical perspective

Abstract

The role of nurse practitioners in primary healthcare has been validated over the years and is now being considered as a key solution in various primary healthcare settings to the provision of comprehensive care. The context in which the role has been established positions nurse practitioners' practice within medical and nursing paradigms. As the healthcare system evolves, nurse practitioners must define their identity to advocate for roles that reflect their professional values. A historical overview highlighting the context in which the NP role expanded will guide a philosophical discussion regarding role identity. After exposing tensions between the nursing and medicine disciplines, Abbots' theory of profession will be utilized to understand the foundations leading to initial research on nurse practitioner integration within the healthcare system. Feminist philosopher bell hooks' discourse on marginality will serve as a platform to reflect on the nurse practitioner identity within the current social context. Foucault's notions of governmentality, parrhesia and care of the self will then guide reflections regarding ways for nurse practitioners to locate themselves as a profession.

Exploring an Innovative Care Model and Telemonitoring for the Management of Patients With Complex Chronic Needs: Qualitative Description Study

“…In fact, several participants described their reliance on the NP and integrated team to manage their needs, despite likely entrenched knowledge of traditional models of care delivery (eg, primary care and specialty care) and conventional leadership roles of medical providers (eg, physicians and nurses). In Canada, although NPs have been in practice since the early 1970s [ 43 ], role recognition outside of primary care [ 44 ] and funding [ 45 ] remain significant barriers to clinical practice, role familiarity, and scope expansion. Integrated colocated models of care are historically entrenched within primary care.…”

Enfermería de práctica avanzada: praxis, políticas y profesión

“…Su evolución ha gravitado principalmente hacia zonas geográficas no atendidas por médicos y especialidades con escasez significativa de médicos (12,14). Por consiguiente, los obstáculos para la expansión de roles enfermeros se explican precisamente por tratar de suplir esa escasez, además de otros aspectos sociopolíticos y económicos durante las reformas (14,10). Así también, las presiones políticas en la década de 1970 desencadenaron una disminución del desarrollo de la práctica avanzada en Canadá encontrando opositores fuera y dentro de la profesión.…”

“…Asimismo, la expansión de su papel ha generado temor entre las propias enfermeras a que los fundamentos de su disciplina puedan ser desplazados por esta medicalización progresiva (10,14), aun si la EPA incluye muchas actividades de enfermería, no sólo las delegadas (39).…”

Strategies for primary care providers in British Columbia's community primary care practice settings to prevent burnout

“…Lastly, frail patients are those who are 65 or older, have been deemed palliative, are receiving frailty-based care, and/or have met at least two criteria of the Edmonton Frailty Scale (Langton et al, 2020). While many PCPs in BC have patient distributions that mirror the above patient population groups, others do not (Delvin et al, 2018). For example, Canadian NPs often work with underserviced patient populations who have complex health conditions and social needs (Delvin et al, 2018).…”

“…While many PCPs in BC have patient distributions that mirror the above patient population groups, others do not (Delvin et al, 2018). For example, Canadian NPs often work with underserviced patient populations who have complex health conditions and social needs (Delvin et al, 2018). More than 60% of BC's population has at least one chronic disease and it is estimated that, in BC, one million new patients will be diagnosed with the top five chronic diseases (depression, hypertension, osteoarthritis, diabetes, and asthma) by 2036 (Prodan-Bhalla & Scott, 2016;Wister et al, 2019).…”