Nurse-run clinic slated for the Outaouais, health authority says

A health clinic run by nurse practitioners could open its doors in the Outaouais in the coming years, part of an ambitious project by the region's health authority as locals struggle to find family doctors and emergency rooms are overrun.

Discussions for the clinic between the Centre intégré de santé et des services sociaux de l'Outaouais (CISSSO) and Quebec's Ministry of Health are well underway, Radio-Canada has learned.

"We have started discussions with the ministry. We are at the very beginning," said Serge Gauvreau, deputy director of CISSSO's nursing department, in a French-language interview.

The clinic would see patient care managed by specialized nurse practitioners rather than by family physicians. They would work alongside other professionals including social workers, nursing assistants and administrative staff.

More complex cases would be referred to family physicians or specialists as needed.

The clinics are among the measures introduced by the province's crisis team formed to tackle overcrowding in ERs. Health Minister Christian Dubé has already announced that Quebec plans to open 23 primary care nurse practitioner clinics by 2028.

Patients regularly visit the ER for comparatively minor issues like fractures, ear infections, stitches, urinary infections or respiratory viruses.

According to the Association of Specialized Nurse Practitioners of Quebec, 95 per cent of ER visits are for reasons that can be treated at nurse practitioner clinics already running in the province.

"We cannot be against bringing about consistent change focused on the needs of the public, respoding to their needs in a timely manner with the right resources and the right people," president Christine Laliberté told Radio-Canada in French.

Gauvreau said his team will develop a plan in the next year, taking into account all the requirements from the health ministry.

The clinic's location still needs to be determined, but will be based on where the greatest health needs are in the Outaouais.

Nearly 50 nurse practitioners already working in the Outaouais

Although the clinic model is relatively new in Quebec, nurse practitioners are well represented in the province's health-care system, including in the Outaouais. 

The region has 47 practicing nurse practitioners, the majority of whom work in primary care under the province's family medicine group. They have an average of 400 patients under their care, and are able to see around 350 patients every week on a walk-in basis. 

CISSSO said it wants to hire at least another 13 nurses practitioners by the end of 2025, although that target will likely need to be raised in order to open a clinic. 

Gauvreau estimated it would likely take more than 20 nurse practitioners to run it seven days a week, including on evenings and weekends.

Recruitment an obstacle

To become a nurse practitioner, registered nurses must have worked at least three years in the field — either in hospitals or in a family medicine group — before also obtaining a master's degree in their field of specialty and completing a 950-hour internship. 

Lucie Lemelin, head of the nurse practitioner program at the University of Quebec in the Outaouais (UQO), said it's a big commitment for students, many of whom are nurses with young children in their care. 

"They're already established health professionals. They put their careers on hold and come here for two-and-a-half years, having a financial loss and having a loss on accumulating their seniority," Lemelin said in French.

According to CISSSO, approximately three to five nurses in the region choose to enrol in a nurse practitioner program every year, with eight spots available at UQO's campus in Gatineau.

With open spaces remaining in the program, the health ministry is offering a $60,000 grant to minimize the financial impact of returning to school.

Despite the shortage, Gauvreau said he's confident that he'll be able to recruit enough nurse practitioners to open the clinic in the coming years.

According to him, it's an "innovative and attractive" project. 

While it's still too early to determine a timeline, Gauvreau said he wants to move forward as quickly as possible and that CISSSO will have to step up its recruitment outside the region as well.