Nurse Practitioner Major LeBlanc in CAF Alert assessing a patient while participating in a CFS Alert Station wide mock disaster, mass casualty exercise – Supplied Photo
November 12-17 marked Nurse Practitioner Week in Canada, a week devoted to recognizing the unique contributions Nurse Practitioners make to healthcare every day across the country. Nurse Practitioners (NPs) are graduate-prepared healthcare providers with an autonomous and legislated scope of practice. With a role dating back to the 1960s, NPs are self-regulated by provincial legislation to provide direct care to patients, diagnose disease, manage acute and chronic conditions, prescribe medications, order and interpret laboratory and diagnostic tests, and initiate referrals to specialists.
In 2001, 11 Nursing Officers were selected for sponsored NP training to complement the in-garrison health care team and deployed taskings. Following the implementation of this project, a review of uniformed NP employment was conducted and found “the NP profession to be suitable and adaptable to a broad spectrum of military deployments”. NPs were deemed employable in areas, including, but not limited to:
- wide-scale Search and Rescue, disaster relief,
- international humanitarian assistance,
- surveillance and control of Canadian territory and its approaches,
- protection and evacuation of Canadians overseas, and
- peace support operations, and collective defence operations.
In 2004, despite successful employment, the uniformed NP concept was not adopted, and sponsored training ceased. An occupational structure was never established for the uniformed NP at the time of their introduction, and over time, these practitioners returned to the parent occupation and were employed in nursing jobs.
Over 20 years later, the concept of reintroducing uniformed NPs was assessed. The Surgeon General enabled all NP qualified nurses with proof of licensure to apply for and be granted NP Clinical Practice Privileges. As part of the Nursing Military Employment Structure Implementation, a Concept Analysis with a focus on the Reserve Force (Res F) was initiated. This analysis generated the creation of a formalized NP job definitions and Occupation Structure, which would be later adopted by the Regular Force (Reg F) for Total Force implementation.
In April 2021, Health Services approved the creation of 40 Res F Nurse Practitioner positions. Two weeks following the Res F NP implementation, a Res F NP was successfully deployed to Task Force Poland to aid in the medical care of Ukrainian Refugees. Domestically, three Class B contracts were initiated within Canadian Forces Health Services (CF H Svcs) Centres across Canada. Additionally, Direct Entry for the NP trade are now accepted into the Reserve Force!
In December 2022, the establishment of 11 Reg F NP positions was approved by the Canadian Forces Health Services (CFHS) Health Services Board. This enabled CFHS to move forward with allocating postgraduate funding for six Reg F candidates in Fall of 2023, and five candidates in the Fall of 2024. These Reg F positions will offer support to the CAF through primary care delivery in designated CF H Svcs Centres as early as 2024, as well as some isolated positions in the near future.
The establishment of a Total Force NP sub-occupation enables financial stewardship, enhances the timely delivery of care in garrison and on operations, and promotes optimization of resources in a resource scarce system. It enables the Canadian Armed Forces (CAF) health system to evolve in line with the Canadian Health System, and promotes the delivery of needs-based healthcare. Questions regarding the NP implementation can be directed to the NP Implementation Lead, LCol M.L Klepach: (Nurse Practitioner-IPS@forces.gc.ca).