Weighing the costs and benefits of health care
Article: Evan Radford – Contributor
On Monday, Oct. 21 the University of Regina and SIAST announced a new Master of Nursing program collaboratively offered by both schools, beginning in Sept., 2014.
The program will provide training to registered nurses intending to obtain Registered Nurse-Nurse Practitioner (RN/NP) status. Fifteen seats will be available each academic year. Currently, says program head Joyce Bruce, 25 people are expressing interest in the program.
The professional group, Nurse Practitioners of Saskatchewan, lists 161 licensed nurse practitioners in the province.
Nurse practitioners have broader and deeper training than RNs, so they can diagnose and treat patients’ ailments, as well as prescribe various medications. Furthermore, nurse practitioners perform certain types of surgeries and sutures, says nursing professor Glenn Donnelly.
Donnelly says nurse practitioners complement the roles of physicians, especially in clinics and health centre settings. He says this allows physicians to focus on their specialties, while nurse practitioners handle patients with chronic conditions and they develop community-based programs.
Lynn Digney Davis, Saskatchewan’s chief nursing officer, adds that nurse practitioners provide needed support to the province’s rural communities.
She says, since “rural communities are more spread out, many nurse practitioners work where they live. A lot of folks take training and have jobs where they live. They can provide consistent, ongoing service.”
An important difference between nurse practitioners and physicians is the amount they earn.
In the 2012-2013 Regina Qu’Appelle Health Region annual report, physicians’ annual salaries ranged from just over $50,000 to $946,695. Some salaries include costs for maintaining offices and staffs.
In its collective bargaining agreement with the Saskatchewan Association of Health Organizations, the Saskatchewan Union of Nurses lists a starting wage for a nurse practitioner at $46.70 per hour (step 1). After 12 months of work, or after 1948.8 hours of labour (whichever comes later), his/her wage increases to $48.61 per hour (step 2).
Assuming forty-hour work weeks, a step 1 nurse practitioner earns $89,664 per year, before deductions. A step 2 nurse practitioner earns $93,331.20 per year, before deductions.
Digney Davis says physicians and nurse practitioners see problems around remuneration, because physicians cannot bill for the work that practitioner nurses do.
She says, “If you’re a fee-for-service physician and you have a nurse practitioner working with you, you do not get paid for any of what the nurse practitioner does.”
She says this is problematic for the team-based approach promoted by nurse practitioners. Furthermore, there are many physicians who choose not to use a nurse practitioner because it affects their own income, she says.