0:00

Are you a nurse who's thinking about joining a primary

0:02

care clinic? Do you have any questions about

0:04

what nursing in primary care even looks like?

0:07

Would you consider yourself primary

0:09

care curious? Me

0:11

too. So

0:44

Morgan, what do we have going on today?

0:47

Today, Sarah, we've got a bit of a different episode.

0:50

We thought it'd be great to shed some light on what primary

0:52

care nursing is, but for

0:54

curious nurses who maybe haven't worked

0:56

in primary care before.

0:58

turn the tables a bit and talk

1:00

to nurses, maybe speak to those who

1:02

haven't been working in primary care about

1:04

primary care. I like this. And

1:07

I know a lot of nurses who are

1:09

being hired into kind of the nursing practice roles

1:11

haven't necessarily worked in primary care before.

1:14

So I think, I think this could be really useful. So

1:16

what's our plan?

1:18

Well, our producer, Michael, spent some time

1:20

talking with a couple of primary care curious

1:22

registered nurses last summer. And

1:25

Sarah, you know, both of them, and they've

1:27

been working with us over the summer, Diana and Nikki

1:30

are two RNs who are actually

1:32

both doing their dual masters in nursing

1:34

and health information science. And they did their summer

1:36

co ISU. And

1:38

they both originally come from acute care nursing

1:40

settings.

1:41

That's right. Diana has been working for several

1:43

years as an acute care nurse who works primarily

1:46

with seniors with chronic illnesses.

1:48

She also has experience working in a public

1:50

health system support role. Nikki

1:53

has been in emergency and ICU.

1:55

She's even been the head ICU nurse.

1:57

And they came to us with lots of nursing

1:59

experience and an interest in evaluation,

2:01

but neither of them had worked in primary care nursing.

2:04

And here at the ISU, we're focused

2:06

on team based care in primary

2:08

care. I'm really curious

2:11

to hear what questions they had as

2:13

these primary care curious nurses.

2:16

I'm guessing it was things like, if I

2:18

was applying for a job at a clinic,

2:20

What kinds of things would I need to know?

2:22

Exactly. So they had lots of questions they

2:24

were interested in learning more about how things

2:27

work and what the expectations

2:29

are for primary care from a nurse's

2:31

perspective.

2:32

So where should we start this episode?

2:35

how about, Sarah, we start at the beginning. What

2:37

do you need to know to be a primary care

2:39

nurse?

2:40

So if I was a nurse and I was thinking

2:42

about this, my question would really

2:44

be, you know, what do I need to get a job?

2:47

This is going to sound sort of frank,

2:49

but I would want to know what does a primary

2:51

care nurse do?

2:52

That's Nikki, the ICU nurse. She's

2:55

new to this podcast season.

2:56

Like what are the specific skills

2:59

that I would need to acquire

3:01

or that I would hope to acquire in order to work

3:03

as a primary care nurse? What

3:05

will I get to do on

3:07

a day to day basis? what

3:10

sorts of Certificate

3:12

programs or advanced training can I

3:14

look into if I want to be a primary care

3:16

nurse or, or what should I be looking into?

3:19

what does a primary care nurse do

3:21

uniquely from other areas of nursing?

3:24

This is a really common question and I think is

3:26

a good starting point for anyone that's

3:28

primary care curious. You're going to

3:30

wonder what you need to do academically

3:32

or professionally to allow you to be

3:35

well suited to being a primary care nurse.

3:37

But thankfully, Sarah, that answer to those questions,

3:40

they aren't quite as scary as you might think. In BC

3:42

we've talked about, how there's different support

3:44

programs are being developed by NNPPC.

3:47

but there's other certified practice that

3:49

you can take to expand your scope. Having

3:52

said all that, general nursing

3:54

skills are very transferable to

3:56

primary care.

3:57

Yeah, just bouncing off of what

4:00

Nikki was saying. I think for me,

4:02

And that was Diana. Keen

4:04

listeners might recognize her voice from episode

4:06

four earlier.

4:07

I would really be curious, you know, as

4:09

a new graduate nurse to know

4:12

what sort of entry level nursing

4:14

positions are there in primary care.

4:17

Or anything like that. Rather, what I need to do

4:19

a couple of years of medical surgical nursing

4:21

and have that under my belt before I

4:23

can join a primary care team, you

4:26

know, what sort of specialty training

4:28

or competencies are teams

4:30

looking for in the nurses that they hire,

4:33

because that could help me to tailor

4:35

the different roles and opportunities.

4:38

job opportunities I take on, in

4:40

the coming years and tailor them around

4:42

what I will hope to do in a primary care setting.

4:45

This makes total sense. As much as we

4:47

expect nurses to love their job

4:49

for what it is, we have to recognize that,

4:51

bills need to be paid and food needs to be on the

4:53

table. There's some very practical sides here.

4:56

Another thing I think I really

4:58

wanted to know is, how would I find out about

5:00

these job opportunities? Where would I find

5:03

them posted? Who can I talk

5:05

to to learn more about them in my

5:07

local community

5:08

and I guess, you know, what does the job market look

5:10

like for primary care nurses in BC and how can,

5:13

I access these jobs? These would be other

5:15

questions. Where, where can people go, Morgan?

5:17

Well, there are some resources to find out where jobs

5:20

are and, we'll put them in the show notes. FPSC

5:23

is sort of coordinating a lot of the

5:25

job applications that'll be coming out soon

5:27

for the nurse and practice program in BC. in

5:30

other provinces, it's, a bit different and I don't actually

5:32

know, where to look, but

5:34

many of the clinics who are hiring nurses will be posting

5:37

on their own.

5:37

So there's more to working in primary care than,

5:40

the job itself, you know, arguably the most

5:42

important part and, The basis for

5:44

our entire podcast and work in the ISU is

5:47

this idea of team. You know, if I was

5:49

a nurse curious about entering a new line of

5:51

work, something I would want to know is,

5:53

what does the team look like? This is also

5:55

something that both Diana and Nikki reflected

5:57

on.

5:58

What is the team? Who all is involved

6:00

in the care of these patients? And

6:03

kind of how do we come together

6:05

as a group to decide what the day is going to look

6:07

like or what the week's going to look like? I'd

6:09

also like to just get a chance to meet everybody,

6:12

right? I know that different primary care teams

6:14

have different types of healthcare professionals

6:16

and disciplines that are all working together.

6:19

So I'd love to see how I

6:21

work together with those different individuals,

6:24

how we communicate together and just

6:26

kind of coordinate care around the patients

6:29

Diana has some great questions and, you

6:31

know, it does vary by practice. So

6:34

these are actually good questions to

6:36

ask the practice if you

6:38

are applying for the position. or

6:41

for the practice to highlight when they're posting

6:43

for a position.

6:44

So I think you've made a really valid point there.

6:47

getting to know what the team environment is like

6:49

as a nurse is, huge. And so knowing what

6:51

that would be like in primary care would be really important for

6:53

me too.

6:55

I would say that it's actually for some nurses.

6:57

I think that would be a deal breaker.

6:59

And that's so true. There's no real surprise here.

7:01

When I reflect back on, you know, all the jobs

7:04

that I have enjoyed working at and why I think

7:06

I love the innovation support unit, you

7:08

know, it's the people that makes the difference. The team really

7:10

has a huge, huge part in job satisfaction.

7:15

environment started a great discussion on

7:18

what Diana and Nikki believe to be some of the most

7:20

appealing aspects of being a primary care

7:22

nurse.

7:23

thinking that a nurse might actually have a role to

7:25

play in that team is quite exciting to me.

7:27

It's something fresh and something new. As

7:30

well, I do think that it would allow

7:33

nurses to maybe navigate

7:35

and see what else they can do with their scope of practice.

7:38

And I think that there's a lot of opportunity

7:40

for nurses to kind of explore what

7:43

their role is going to look like within teams,

7:45

you know, see how they can bring

7:47

some of their unique skill sets and

7:49

assets to the team. we

7:51

have the ability to help

7:54

manage chronic conditions

7:56

and coordinate care plans, do

7:58

patient education and teaching. there's

8:01

just so many different ways that we can really,

8:03

expand on our scope and really work

8:05

to the fullness of our scope within primary

8:08

care that you may or may not see

8:10

those opportunities in acute care

8:12

settings.

8:13

and thinking about the team really

8:15

allows you to kind of leverage different aspects

8:17

of your scope. I think you can really provide strong

8:19

support as a nurse within a primary care

8:21

setting based on the experiences that you're bringing

8:23

in and sort of how your team is working together.

8:26

Yeah, Sarah, that's right. I think bringing, your

8:28

skills into a team and the team

8:31

recognizes your unique contributions.

8:33

that's a big part of, working well together.

8:36

And that makes your job, clinically

8:38

and professionally satisfying. But

8:40

also that you can see how you're working

8:43

together and that builds that bond between

8:45

people as well.

8:46

I would add to that, Diana, when I think

8:48

of, uh, my work in acute care, I think often

8:50

what we are doing. we are treating

8:52

a problem way downstream.

8:55

So, exacerbations of chronic conditions

8:57

are an example of that. So, what

9:00

I think is great about primary care is you have this opportunity

9:02

to engage with a patient on their healthcare

9:05

journey before we've, and

9:07

intervene before a problem really

9:09

gets bad and then it

9:11

requires acute care. I

9:13

think there's a certain

9:15

amount of. Gratification

9:17

in that, I think it's, really rewarding

9:20

to be able to see a patient

9:23

thriving before their condition

9:25

gets to the point where I'm

9:27

seeing them in an emergency department

9:30

or in critical care my thought

9:32

is that you'd maybe get a little bit more

9:35

of an opportunity to. See

9:38

the fruits of your labor and your team's

9:40

work with a patient.

9:42

Both Diana and Nikki had similar thoughts about,

9:44

you know, what was appealing about being a primary

9:46

care nurse. The third topic we

9:49

really wanted to focus on here is the question of,

9:51

what the role of a primary care nurse is.

9:53

And this is an interesting question. because

9:56

there's many right answers to this, within

9:58

the scope of, a nursing profession, there's

10:00

a lot of ways that you can focus.

10:03

and what you prioritize in this answer is,

10:05

telling of your background in health

10:07

care and in what you value as

10:09

a nurse. being a primary care nurse

10:11

means you can fill different niches

10:14

in the practice. you actually can,

10:17

you know, adjust things quite a bit

10:19

in terms of charting your own path as

10:21

a primary care nurse and making an impact.

10:24

both within the clinic and within the community.

10:27

Diana and Nikki had some interesting thoughts

10:29

around this.

10:30

So my idea

10:32

of a nurse's role in primary

10:34

care stems from my experience

10:36

of the nurse in an interprofessional

10:40

team and acute care. So

10:42

as an acute care nurse, I often interact

10:45

with many different healthcare professionals.

10:47

collaborating pretty closely with, the

10:50

physician in the care of my patients feel

10:52

as though there should be some level of overlap

10:55

as, you know, the role of the nurse,

10:58

the kind of competencies and skills that they

11:00

bring to the team, those same sorts

11:02

of competencies would be just as relevant

11:04

and applicable in acute care, as

11:06

I would hope they should be in a primary care

11:08

setting

11:09

So Nikki alluded to the benefits of

11:11

continuative care earlier and

11:13

she drives this point home a little further here.

11:15

Diana, I agree with you there. So, I think

11:18

in the nursing discipline, there's a lot of

11:20

discussion around what nurses

11:23

uniquely offer apart

11:25

from other disciplines within

11:27

the medical realm. So from

11:29

my perspective, what nurses offer

11:32

uniquely and, maybe not uniquely,

11:34

maybe just in a different way from

11:37

other disciplines is. how well

11:39

they know their patients I

11:41

think by being able to see a patient repeatedly,

11:44

you are further building

11:46

that relationship. the more times that

11:48

you see a patient, the better you get to know them,

11:50

and the longer the relationship has existed,

11:52

I think the better you get to know a patient So,

11:55

if you're seeing a patient for the first

11:57

time, as a nurse, or as a

11:59

physician, or any, healthcare discipline really,

12:02

you're just sort of getting to know them, and you're just getting a

12:04

snapshot of how they are in that moment. But I do

12:06

think, in primary care, Having

12:08

the ability to see this patient multiple times,

12:11

and establishing that relationship does

12:13

give you a better idea of

12:16

what's normal for this patient and, what's

12:18

not.

12:19

That's a great point.

12:20

I don't think you'd be overstated about how vital it

12:22

is to see a patient to treat a problem

12:24

before it becomes, you know, something that

12:26

that Nikki is going to see in the emergency room or the or

12:28

the ICU. You that's why I went

12:30

into primary care too. So, robust primary

12:32

care network. improves the health care

12:35

for everybody, it'll lighten the load

12:37

on the merge. It will, engage

12:39

and empower patients. And I think that's a, that's a key

12:41

part of the role of the nurse in primary care.

12:43

That kind of feels like a good spot to wrap

12:45

up. this episode, I think, talked on a lot of

12:47

important questions and concerns that

12:49

primary care curious nurses might

12:52

have. What were some of the key takeaways

12:55

that you noticed, Morgan?

12:58

I, noticed that they didn't really talk about

13:00

shift work,

13:01

Mm

13:01

I, I thought might come up. And

13:04

if you're a primary care curious nurse, there's

13:06

definitely much less shift work in primary

13:09

care, but that didn't come up. Some of the things

13:11

that did come up were how it's fulfilling,

13:13

how you can build relationships and how

13:15

you can support the healthcare system and

13:17

how you can tailor your practice to, to leverage your

13:20

own personal strengths as a nurse.

13:22

the key takeaway for me today is maybe a little bit

13:24

more meta. important to always

13:26

ask questions, to stay curious.

13:28

both Diana and Nikki brought up some great

13:30

questions. I think that, People who are listening can maybe

13:32

ask themselves or potential employers,

13:35

if their primary care curious nurse,

13:37

I think it's easy to kind of go along for the ride

13:39

and take any offer that sort of put

13:41

out there, but to really think critically about

13:44

the role you can provide the, role, the clinic

13:46

is able to, play in the community.

13:48

team dynamics, and how that'll

13:50

influence. how you're working and what

13:52

you're able to bring to the table. I think those are just

13:55

really important things to think about to set you up for

13:57

success during any kind of career

13:59

transition more generally.

14:01

Yeah, I think that's a good point. and in this day

14:03

and age, I think the nurse

14:05

who's applying for position can really think about

14:07

where's a good fit and maybe

14:10

even ask about doing some, short stint

14:12

in the clinic to see how it works for them. Those

14:15

things I think are important. A little bit of a, not, not

14:17

so much a job shadow, but, a trial

14:20

to see how it works. That's something that, as you just

14:22

said, that I couldn't help but think, yeah, that's a That would be

14:24

really useful for somebody to see how the clinic really

14:26

works versus just a job interview.

14:28

Yeah, I agree, Morgan.

14:29

Well, maybe that's a good place for us to wrap up this episode.

14:32

It was really interesting to hear what Nikki

14:34

and Diana thought, we talked to them

14:37

early on in their co op, so they learned

14:39

a lot with us about primary care over the whole

14:41

summer. So I kind of want to go back

14:43

and revisit with them maybe later on to see if

14:45

it influenced their thinking about primary

14:47

care, maybe sometime next year. Anyway,

14:50

for today, thanks for listening to the podcast.

14:53

You have any questions or topic suggestions, please

14:56

email us at isu at familymed.

14:59

ubc. ca.

14:59

See you next time on team up.

15:03

The Innovation Support Unit is a distributed

15:05

multidisciplinary team. We work

15:08

mostly remotely from communities across

15:10

the Lower Mainland and Vancouver Island in

15:12

British Columbia.

15:14

Sarah and I are both recording from our offices

15:16

in the territories of the Lekwungen speaking peoples,

15:18

the Songhees and Esquimalt First Nations.

15:21

And recognizing the colonial history

15:23

and the ongoing impacts of colonization

15:25

and healthcare systems and in Indigenous

15:27

communities in Canada and around the world, as

15:29

we move through the season, we'll work to bring an equity

15:32

lens to this work. And we really

15:34

encourage you, our listener, to reflect

15:36

on your past, present, and future participation.

15:39

On the indigenous lands where you are situated.

15:42

we'll see you in the next episode of team up.