Nurse practitioner says N.L. is favouring virtual care over empowering staff

The association that represents Newfoundland and Labrador's nurse practitioners says the provincial government has hurt its members by awarding a multimillion-dollar contract for virtual health-care, when that work could have been done by people already in the province.

Travis Sheppard, a nurse practitioner in Corner Brook and president of the Newfoundland and Labrador Nurse Practitioner Association, said he's disappointed by the province decision to give an $11-million contract to American company Teladoc Health. The money could have been gone to nurse practitioners in the province, who are capable of doing the work Teladoc can locally.

"Nurse practitioners haven't been really given a chance or given an opportunity to really show what they can do. We're being restricted too much by the government," Sheppard said Friday.

"We can diagnose, treat conditions, various types of chronic disease conditions across the lifespan, and we're not being given the opportunity to show that element in primary health care."

In some cases, he added, virtual care is already being provided by the province's nurse practitioners, citing their staffing of the provincial 811 medical line as an example.

The provincial government has said the implementation of virtual care will complement existing services and improve access to health care across the province.

Sheppard said he understands implementing virtual care will address care gaps but he feels it restricts the nurse practitioners' scope of practice. Nurse practitioners are being pigeonholed into working in government initiatives like family care teams, he said, when they could be doing much more.

"Why does Teladoc come ahead of supporting the NPs on the ground? It's backwards," he said.

"We're not going to probably find a physician or nurse practitioner to meet the needs of every region of this very diverse province, but … the government hasn't tried to do it. Nurse practitioners have tried to do that, and over time I think we're starting to get worn down."

In a emailed statement to CBC News on behalf of the Health Department, communications director Brian Scott said government values the work of nurse practitioners in the province, and that their scope of practice in Newfoundland and Labrador is less restricted than in other provinces.

Scott said recruitment of more nurse practitioners is continuing and  services offered by Teladoc will help residents in communities where it's more difficult to fill positions.

If more positions are filled, Scott said, the province will become less reliant on virtual coverage.

Other organizations that represent health-care professionals in Newfoundland and Labrador, including the provincial medical association and nurses' union, have expressed concern about the provincial government's embracing of virtual care.

Sheppard said the move has also left some nurse practitioners feeling demotivated by a lack of support from officials.

"It creates the perception that nurse practitioners can't provide the care," he said, adding they deserve better.

"You can throw money at the wall … but at the end of the day you have to keep them motivated. Because they're motivated by more than just money."

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