Ted Semmens isnB次元官网网址檛 shy about giving Janice Robinson a friendly earful about his meals at Lodge at Broadmead.

Breaking into a smile, Robinson listens and asks a few probing questions of the 92-year-old Second World War veteran. HeB次元官网网址檚 happy to talk and give a rundown on how heB次元官网网址檚 been feeling over the past few days.

Robinson is the LodgeB次元官网网址檚 nurse practitioner, a health care job that fits in the grey area between doctor and registered nurse. Within legislated limitations, she can prescribe medications, diagnose symptoms and order blood work B次元官网网址� much of the work a doctor would otherwise do. If a Lodge nurse detects that a resident has a sudden change in consciousness or needs urgent care, they call Robinson.

B次元官网网址淚 can respond quite quickly, can be there in five minutes. I think having a nurse practitioner on site does help with timeliness of care,B次元官网网址� she said. B次元官网网址淚 can get started on antibiotics, discuss a course of action with the family and get blood work going. It prevents people from going to emergency.B次元官网网址�

As useful as the position is, a nurse practitioner at a residential care facility is extremely rare in B.C. and is effectively an experiment that is running out of time.

In 2009, publicly funded Broadmead Care managed to pay for a half-time NP position out of its $23 million budget, for a three-year pilot project. And only that was due to wiggle room afforded from extra funding from Veterans Affairs B次元官网网址� about 30 of Broadmead residents are Korean War or Second World War veterans.

The centre needs to fundraise another $10,000 to afford the NP position through to next March. After that, itB次元官网网址檚 not clear what itB次元官网网址檚 going to do. David Cheperdak, CEO of Broadmead Care Society says once a nurse practitioner is on the team, itB次元官网网址檚 hard to step back.

B次元官网网址淚t will be very challenging for us. ItB次元官网网址檚 hard to go back from such a substantial contribution to the quality of care,B次元官网网址� he said.

B次元官网网址淲e are caring for people at the end of life, most with dementia. The average stay is 18 months, but for some itB次元官网网址檚 only three to six months,B次元官网网址� Cheperdak said. B次元官网网址淭hat care we provide can be intense. A nurse practitioner we believe is an essential role.

B次元官网网址淟ike most of the health care sector, we are under significant financial pressure.B次元官网网址�

A dozen core doctors oversee most of the 225 residents at Lodge at Broadmead, which falls under the Broadmead Care Society, but all have their own busy family practice offices elsewhere in the city.

With the team of nurses, Robinson takes on that day-to-day role of monitoring residents, most who have multiple chronic diseases and take multiple medications.

B次元官网网址淚tB次元官网网址檚 a collaborative role. NPs arenB次元官网网址檛 replacing doctors, but they are complementary roles,B次元官网网址� said Fiona Sudbury, director of care with Broadmead Care. B次元官网网址�(NPs) will diagnose, order tests and get the ball rolling on medication changes, and communicate with the doctor and consult with them."

Nurse practitioners are relatively new in B.C. health care, although its a position has long been used in Ontario, for instance. About 250 NPs are licenced to work in B.C. B次元官网网址� compared to 36,000 registered nurses B次元官网网址� and the Ministry of Health is funding 45 NP positions per year for the next three years. Seven of those are allotted to the Vancouver Island Health Authority.

Competition for NPs is fierce. For the first round of seven positions, VIHA received 30 proposals for funding and Broadmead Care didnB次元官网网址檛 make the cut. A full-time NP position would cost Broadmead Care about $100,000 per year.

Norm Peters, director of continuing health services contracts for VIHA, said BroadmeadB次元官网网址檚 pilot project has demonstrated a strong case for an NP, and that such positions save money over the long run and improve patient care.

B次元官网网址淚t is a worthwhile project with great outcomes,B次元官网网址� Peters said. B次元官网网址淐ertainly based on what weB次元官网网址檝e seen, NPs improve the quality of care ... for people in residential care.

B次元官网网址淚tB次元官网网址檚 not only improvement to the quality of care. ThereB次元官网网址檚 savings to the system. There is a distinct advantage of having a nurse practitioner involved.B次元官网网址�

Peters said Broadmead Care will be considered in the next round of funding for NP positions. B次元官网网址淲e will continue to advocate for (BroadmeadB次元官网网址檚) goal to have a NP,B次元官网网址� he said.

In the meantime, Robinson continues to work half time as the centreB次元官网网址檚 nurse practitioner, and half time as a clinical nurse specialist, although she never really turns off her role as NP.

B次元官网网址淚n other jurisdictions in Canada and the U.S., there are lots of NPs in residential care,B次元官网网址� she said.

B次元官网网址淚B次元官网网址檓 passionate about care for frail, older adults and making sure they have the care they need. Having a nurse practitioner helps with that.B次元官网网址�

For more see .

editor@saanichnews.com