Nursing Agency in Nova Scotia - Essay Example

Beyond Boundaries: Nursing Care in Nova Scotia, Canada Transcending beyond material limitations is one of the biggest challenges faced by the nursingprofession worldwide. The cry for improved nursing care system is resounding not only in Nova Scotia but around the world. The numerous demands of the profession are simply not commensurate with the compensation received by nurses. Sadly, however noble a nurse’s motivation might be, she simply has to meet material demands of herself and her family. Continuous education and training is also required of nurses. A nurse has to update herself on the latest health care techniques in order to deliver the best service to the patient. These are just some of the professional problems faced by nurses. Add to them some of the economic and political problems of their country, and you come up with a perfect recipe of a nursing headache faced by hundreds of nurses. These pose a huge challenge to government agencies and to the health care sector of a province. The nurses of Nova Scovia have taken up the challenge of an ever-challenging health care system. Through conjoined efforts of various sectors, the province was able to recognize problems faced by the nursing profession and to pose a strategy to combat these challenges. It is the foremost objective of the paper to present how the province of Nova Scovia has responded to the issues of nursing agency. A brief background of the province will set the mood for a more comprehensive discussion of the nursing profession in the province. The development of the nursing agency in the province will also be discussed. Current issues and trends in the health care system with focus on nursing agency will be discussed. Implications of the issues will also be tackled. Finally, future directions of the nursing agency in Nova Scovia will be discussed. Recommendations will also be presented in the last part of the paper. The Province of Nova Scovia Nova Scotia is a Canadian province located on Canada’s southeastern coast. It is he second smallest province of Canada. The total land area of the province is 55,284 square kilometers. In 2006, the population of the province is 934,405. As such, it is the fourth least populated but second most densely populated province of Canada (Canadian Population, 2006). Between 60% to 75% of the population lives in rural areas. Nova Scotia is considerably more rural than Canada as a whole and more rural than most other provinces and territories. Only two provinces (New Brunswick and Prince Edward Island) and the three northern territories have a greater percentage of their population living in rural areas (Painting the Landscape of Nova Scotia, 2006). Diversity is what best describes the heterogeneity of the population and cuture of Nova Scotia. The factors that brought about the said situation as well as its implications ill be discussed in the succeeding parts of the paper. Cultural differences abound the area. Some of the Nova Scotians are Scottish, Irish, German, Italian, Chinese, Ukraiinian, North American, Indian, Dutch, Polish, East Indian, Norwegian, Portuguese, Welsh, Jewish, Russian, Filipino, Metis, Hungarian, American, Greek, Spanish, Jamaican, Danish, Vietnamese, British, Austrian, Lebanese, Romanian, Belgian, Finnish, Swiss, Korean, Quebecois, African (Black), Croatian, Iranian, Japanese, Haitian, Czech, Icelandic, Pakistani, Arab, Acadian, Yugoslav, Sri Lankan, West Indian, Inuit, Serbian, Black, Guyanese, Slovak, Trinidadian/Tobagonian, South Asian, Punjabi, Latin/Central/South American, Egyptian, and Armenian (Painting the Landscape of Nova Scotia, 2006). French and English are the major languages in Nova Scotia. The capital of the province is Halifax. A look on the demographics of the province reveals great diversity due to the influx f migrants in the recent years. The influx of migrants was, in turn, brought about by the decline in the local population. The population was simply not enough for the jobs available in the province. As such, they had to invite foreigners to migrate to their country and even offered shared citizenship to them. Despite the number of migrants, there are still more jobs in the country than the population can handle. A number of researches and demographic studies have speculated that the decline will continue in the next few years. Income in the province of Nova Scotia , the income of families living in rural areas is lower than the income of those in urban areas . This is contradictory to the rest of Canada where the income is greater for those in rural areas is greater than those in urban areas. The Changing Environment and their Impact on the Nursing Agency of Nova Scotia As stated, a number of researchers have documented that the changes experienced by Nova Scotian population will continue until the future. These demographic changes will, of course, have an impact on economy, labor force and government economics. It will also affect the thrust of social and health policies. Experts foresee that the changes will be felt for as long as 20 years. In a study by Canmak Economics Ltd. (2006) entitled, “ Nova Scotia Demographic Research Report: A Demographic Analysis of Nova Scotia into 2026.” , it was stated that extrapolation given the traditional Nova Scotian migration patterns will yield that the population will not be enough for jobs until the year 2026. Their fear is that the proportion of people leaving the population, naturally, either due to retirement or death will continue to grow. The labor shortage will continue for a twenty year period. In the same study, they foresee that the population will further decrease. However, the population of Senior citizens will continue to increase putting more burden on the working age group. A problem seen is the increase in senior citizen population with a steady decline in studying and working age group. Faced with these extrapolations, there will be a shift. In the past, and in other countries, it is the issue of finding jobs for people. In the next twenty years, on the contrary, Nova Scotia will have to find people for the jobs. This will be true for all sectors but will especially be felt in the healthcare sector most especially in the nursing profession. The direction is to attract nurses from other countries instead. This will also be the paradigm to be followed by policy making bodies. One major concern presented by the abovementioned paper is the higher tax revenues needed to pay for the much in demand public services needed by the aging population. A great burden on the healthcare cost will also be felt. Likewise, there will be an ever-increasing demand for healthcare workers who will care for the aged people. A demand for continued and more specialized education for healthcare workers, especially nurses will be felt. As the population ages, there will be a shift in the focus of policy makers and of the social and cultural life as a whole. Faced with the abovementioned future problems, there is a need for a well coordinated, interdepartmental cooperative effort to come up with policies which will work for the best of the Nova Scotians. This, the nursing agency , has successfully and comprehensively outlined in a Nursing Strategy. The challenge, however, is an equally well-synchronized implementation of the plan. Health Care System of Nova Scotia Before the Nursing Agency and their Strategies are discussed, a brief description of the Nova Scotian health care system will be presented in this section. The health care system of Canada is publicly funded. The tax revenues paid by the people funds healthcare facilities. The system has evolved through the years. Described by “Canada’s Health Care System” pamphlet (www.hc-sc.gc.ca) as a “medicare system”, it is a system of interconnected provincial and three territorial health insurance plans. The coverage of the health care system encompasses medically necessary hospital and physician services. The citizens can avail of the services for free. To ensure high quality of service of the health care system, the release of funding is regulated by periodical assessments. Criteria for assessment are: comprehensiveness, universality, portability, accessibility, and public administration (Canada, 2002). The health care system follows a hierarchical model. First, the people go through primary health care professional. They then contact a secondary health care professional and finally, if needed, proceed to a tertiary institution. Nurses play a pivotal role in the forefront of primary health care. First, they provide direct provision of health care services at first contact. They also ensure continuity of flow through the health care system. Because of this, it is a must that a nurse working at the primary health level be well-informed and well-trained to administer such services. In the recent years., the health care system of Canada, and in turn, of Nova Scotia has seen many changes. The health care system is affected by the demographic change, of course. The aging population serves as a major concern for the system. Healthcare programs are geared towards complying with the needs of the aging population. There is also the shortage of health care professionals and nurses. Diversity in health care workers also exist. This is due to the entry of other nationalities in the health care sector. There is also the challenge of the high cost of advanced technology. Much talk has been done regarding the lack of funding especially in nursing care. As such, the paper will try to dwell on other factors affecting nursing care and not so much on funding issues. Being a public entity, Canadian health care system is based on political, social and economic unions. A look at the history of the Canadian health care system will reveal an institution which has undergone changes following significant events in the history of the country and Nova Scotia. In 1867, the Constitution Act required that provinces be responsible for establishing, maintaining and managing health care institutions. Financial matters were also taken cared of by the Federal Government. In 1919, the Department of Health was created. Through the years, the health care system has evolved. In 1967, the Hospital Insurance Diagnostic Services Act was established which provided subsidy for diagnostic services. Years after that, provinces and territories began provigin publicly funded health care services. The federal government also passed the Medical Health Care Act which provided reimbursement of half of expenditures for medical services. The Health care Act paved the way for the criteria of continuity of funding for health care delivery. In 1977, the federal-Provincial Fiscal Arrangements and Established Programs and Financing Act was passed. The reimbursements were replaced by block funds allotted per province. With this new arrangement, the provincial and territorial governments allotted the block funds according to the needs of the constituents. The allotment differed from one province to another as tailored to the needs of the people in the particular place. In 1984, the Canada Health Act was passed. In the said act, no extra billing or extra services were to be charged (Dumont-Lemasson, 1999). In the year 2000, provinces and territories began to do researches and reforms in their individual health care systems. The focus was primary health care (Kraker, 2001). The country was also realizing the value of fast-changing technology and the possibility of tapping the modernization potential for improving health care delivery. In the year 2003, a concensus was reached which aimed at reforming the then health care system. Thus, Accord on Health Care Renewal was passed. Long-term sustainability was the central theme of the project. In the following year, a ten-year plan was passed. At present, in correspondence with the ten-year plan, the government has escalated the allotment of funding for the health care sector (WHO, 2005). Thrust was given to reporting of diseases. The countrywide healthcare plan is to be passed to the level of the province of Nova Scotia. In addition to the National Health Plans and Projects, the province, through their health sector, has also drafted their own set of long-term plans for sustainability. Nursing Agency of Nova Scotia History of Nursing in Nova Scotia Nursing skills in Nova Scotia were passed down , initially, by word of mouth. Female members of the family trained other female members of the family to become nurses. The manuals made by previous generations were kept as family heritage and were passed down from one generation to another. Manual of skills needed as well as of herbal remedies, which we now call medicines, were passed down through generations. In the nineteenth century, the field of medicine saw advancements. The field of nursing, on the contrary, experienced many obstacles. The male members of the family were given priority as regard education. The female members had a hard time taking care of the sick members of the family. The first hospitals, which became last resorts for sick patients who cannot be treated at home emrged. These were staffed by women who lacked formal training. The growing number of sick people became a challenge and motivated the government to fund modernization of the hospitals. The first training school for nurses was established. Dr. Theophilus Mack established the first nursing school in Canada in 1874 at Mack’s General and Marine Hospital in St. Catharines, Ontario. The first training school for nurses in Nova Scotia opened in 1890 at the Victoria Hospital in Halifax (www.msvu.ca/library/archives/nhdp/copyright.htm). In the beginning, there were a few student nurses. However, the people realized that there will be a demand for nurses with formal training in the future. The enrolees gradually increased in number through the twentieth century. In 1919, the first university based nursing school in Canada was established at the University of British Columbia. Gradually, there grew a distinction between the schooled nurses and those who were just trained informally. A need for standardization and later, registration was felt. In May 1925, the first examination for registration was done. The passers were rightfully called registered nurses. From then on, the examination became a requirement for entry into hospital work. .  In the 1950’s there was a felt need for more nurses. Thus, male nurses were allowed to enter the profession. The nursing profession continued to see changes since then. At present, the Nursing Agency of the Province is Moving towards digitizatrion of the nursing practice, integrating computer technology to enhance training and communication (www.msvu.ca/library/archives/nhdp/activities.htm.). A recent census revealed that in the past five years, there are 199 registered nurses in Nova Scotia. The figure is greater than in the past five years (Wong, 2007). The provincial Nursing network, on the other hand, is made of nurses and leaders across the province. The Network encourages practice of nurses in the rural areas. At present, nurses have to be registered before practicing in a hospital. A code of ethics guides registered nurses. In the code, nursing values and responsibilities are defined. A registered nurse is expected to provide safe, competent,, and ethical care. They are supposed to promote health and well-being. The principles of dignity, confidentiality and justice predominate in the values expected of nurses. Accountability is also required of nurses. The end goal is a high quality of practice environments where the patient is the center and the nurse is satisfied with his (www.cna nurses.ca/CNA/documents/pdf/publications/CodeofEthics2002_e.pdf). A walk through the history of nursing in the province of Nova Scotia leads one through a bell shaped situation. In the beginning was the steady increase in the number of nurses. With the peak reached in the twentieth century. Today, there is again, a felt need for nurses to occupy jobs. However, the current situation is part of the plateau in the timeline. Efforts are made to sustain the profession. The next path will be a challenge for the health care sector and nursing agencies. Health Care Delivery system A discussion of the present nursing care system will use an investigation entitled, “A Profile of the Structure and Impact of Nursing Management in Canadian Hospitals” (Wong, 2007). as its take off point. The study was done as part of the 2007 Nursing Leadership Conference in Ottawa, Ontario, Canada. Key points and implications of the observation on nursing and health care were tackled in the investigation. The population was the whole Canada. Nova Scotia was a part of the study. One of the key observations in the above investigation was that a small percentage of administrative nurses were young (Ages 26-35 years old) (Wong, 2007). This poses a problem of lack of senior nurses holding administrative positions in the future. Furthermore, the general population of Canada is aging. If at present, there are no young nurses holding key jobs , then, the problem will be more felt in the future when the general population is old. A previously mentioned study predicted that the population supposedly serving labor positions in 20 years have already been born. Judging from the trends, according to the author, there will surely be a lack of personnel for jobs in twenty years. A more open country for migrants will be the only remaining hope for the nursing sector. A more serious problem seen in the investigation was the lack of succession especially in managerial level nurses (Wong, 2007). If at present, there is already a lack of personnel in the junior level positions, there seems to be lack of successors for more senior positions. On a positive note , however, the study showed that there is a level of job and role satisfaction in the nursing field. In the face of funding problems and the lack of manpower, which , in turn, forces the nurses to do double jobs, they seem to be satisfied with their jobs. As stated in the Nova Scotia’s Nursing Strategy Summary ( Nova Scotia Department of Health, 2006), the level of satisfaction of the personnel will determine the quality of health care delivery in a particular place. There is, likewise, a high level of empowerment and perceived organizational support in the nursing agency. The current nurse leaders are very experienced individuals with enormous responsibility for patient care within the health care system. Nurse leaders are positive about their work and ability to be effective in roles. In the case of Nova Scotia, the Provincial Nursing Network, in cooperation with the Department of Health, have formulated a nursing care strategy. It is a ten-year plan outlining the focus of every aspect of nursing care in the province. It is a collaboration of sectors in an effort to make the direction of efforts at improving nursing care constant and sustainable. Training and Recruitment In the face of declining demography in the province, one of the thrusts is improving the pool of nurses in the province. Improvement in recruitment and the retention of present nurses are imperative. As part of the Nursing Strategy Plan, the nursing recruitment resources have been improved ( Nova Scotia Department of Health, 2006). Data based on latest studies suggest that the strategy is working, with the current number of nurses greater than in the previous years. More comprehensive approaches are also being conducted. Job fairs are being done in dofferent parts of the province. Partial funding to encourage re-entry of nurses into the field is being given ( Nova Scotia Department of Health, 2006). Allowances are also generously distributed to relocated nurses to compensate for adjustments they have to make. The agencv is also tapping technology to better disseminate and market the nursing field ( Nova Scotia Department of Health, 2006). The abovementioned strategies clearly show the effort of the health care sector to increase the pool of nurses in the province. Aside from improving the number of nurses, efforts are also made to ensure job satisfaction of nurses in the country. Nursing Education Undergraduate Nursing Students Cooperative learning has played a key role in nursing education in Nova Scotia. The system has provided nursing students with valuable experiences and technical skills needed in the practice. The strategy has also eased the process of integrating students into the career and has encouraged newly graduate students to engage in their career. The Nursing Agency is continuously conducting studies to improve education and training of nursing students. Generous compensation is also given as incentives for students to exert their best in their training. Continuing Nursing Education A challenge for the current workforce in Nova Scotia is continued education. This is especially relevant in the face of an aging population. More demanding needs will have to be complied. Advancing knowledge and training is required of the nursing personnel. Part of the Nursing Strategy of Nova Scotia is the development of opportunities to upgrade the skills of current professionals. Efforts include provision of funding for conferences and seminars to upgrade their knowledge to currently available technology. The provincial government is also sponsoring workshops and seminars ( Nova Scotia Department of Health, 2006). The Bright Future of Nursing in Nova Scotia The conceptualization and subsequent implementations of the Nursing Care Strategy of Nova Scotia is an evident effort of tapping innate resources and maximizing available potentials to triumph beyond demographic, physical and financial obstacles. The Nursing strategy of the province is an clear evidence of the effect of channeling efforts into a single direction to achieve consistent and more sustainable results. With the improvement of nursing care system in the province will be a subsequent improvement in the quality of health care. Patients will be the end beneficiaries of all consolidated effort. Some of the future plans of the Nova Scotia Nurse’s Union are clearly geared to sustaining the nursing industry in the country. One of them is the Health Human Resources (HHR) Planning ( Nova Scotia Department of Health, 2006). In this program. Retiring nurses will be offered additional and lucrative compensations for them to stay in their nursing career. This is to patch up for the vacancies in the nursing profession while maintaining the same high quality of health care delivery. Another pilot project will be the launching of a standard software which will pre-arrange placement of nurses in training. This will also benefit nursing students ( Nova Scotia Department of Health, 2006). Two advantages are clearly implied by this initiative. First, there will be uniform, consistent reporting and monitoring of placements in the province. Another advantage is an equal chance for all trainees and students. In turn, the quality of nursing graduates is improved and training is comprehensive. As regards continuing education and insurance of high quality of nursing professionals in the province, two initiatives were made. One is the Internationally Educated Health Professionals (IEHP) ( Nova Scotia Department of Health, 2006) of the country. This will enhance the training of nursing personnel. It will also broaden the horizon and thinking of nurses and will open their eyes on different cultures. Another effort is the Inter- professional Education for Collaborative Patient-Centeredd Practice (IECPCP) ( Nova Scotia Department of Health, 2006). This project is part of an umbrella project in the whole country which aims to improve nursing field with the patient in mind. A unique project is the Rural Nursing ( Nova Scotia Department of Health, 2006) project which provides new opportunities , supports and enhances nursing in rural areas. This is especially needed in the province, with its population being rural. New researches, improved data handlingand more strategies for improving human resources are still on their way. With the abovementioned projects and the recognition of concerns in nursing field, particularly in the province, the future of nursing field in Nova Scotia remains bright, transcending physical obstacles. References Canada. Commission on the Future of Health Care in Canada. Building on Values: The Future of Health Care in Canada. Saskatoon, Sask.: The Commission,3. “Canada’s Health Care System” pamphlet (www.hc-sc.gc.ca) Canadian Population.(2006). Statistics Canada. Last updated on September 28,2006. in www.wikipedia.com Canmac Economics Ltd., Jozsa Management and Economics, McNiven, J., David Sable and Associates (2006) “Nova Scotia Demographic Research Report: A Demographic Analysis of Nova Scotia into 2026”. Canada,6. Dumont-Lemasson, Mireille, Carol Donovan and Maggie Wylie. (1999). Provincial and Territorial Home Care Programs: A Synthesis for Canada. Ottawa: Health Canada. Kraker, Daniel. “The Canadian Cure”. The New Rules. Minneapolis, MN: Institute for Local Self-Reliance, Spring(2001)in Painting the Landscape of Nova Scotia (2006), 7. Wong, K. (2007) A Profile of the Structure and Impact of Nursing Management in Canadian Hospitals. Nursing Research School of Nursing, University of Western Ontario London, Ontario. World Health Organization(1996. [Update due late 2005]). Health Care Systems in Transition: Canada. Preliminary Version. Copenhagen: WHO Regional Office for Europe, 15. www.cna-nurses.ca/CNA/documents/pdf/publications/CodeofEthics2002_e.pdf www.gov.ns.ca/health/nursing www.msvu.ca/library/archives/nhdp/copyright.htm Read More