Nurse practitioners (NPs) play a crucial role in providing holistic, patient-centered medical care – but despite their vital contributions, the role is not always fully understood.
An NP is a registered nurse (RN) with additional graduate level education, clinical training, and experience. Licensed by the College of Nurses, NPs operationalize the knowledge they acquired as nurses, and can do so autonomously. They complete assessments, diagnose, order and interpret diagnostic tests, draw up a plan of care, and write prescriptions.
"There can be misconceptions about what NPs do," says Tara Bolden, UHN's Nurse Practitioner Lead. "Understanding the advanced skills and scope of practice of NPs is important, especially when it comes to enhancing access to comprehensive, specialized patient care."
UHN employs about 125 NPs – and each one provides highly specialized, high-quality care by combining extensive medical knowledge with the holistic lens required to enhance the patient experience.
November 7 to 13 is National Nurse Practitioner Week, a time to celebrate the vital work NPs do and raise awareness about the profession.
Read more about NPs in Ontario.
Versatile and dynamic scope of practice
"Someone once made the analogy of NPs being the Swiss army knife of healthcare, referring to the versatility and dynamic nature of NP practice," says Tara. "I really appreciate that description."
Take NP Sue Devries for example. Sue has been at UHN for 37 years. In that time, she's spent 30 years in vascular surgery at the Peter Munk Cardiac Centre, and the last 15 years practicing as an NP.
At 7 a.m., Monday to Friday, you can find Sue and the medical team making their rounds on the floor, reviewing patients recovering from a variety of vascular surgeries and illnesses.
Sue and the team discuss plans of care, identifying emerging medical concerns, and follow up on consults.
Every now and then, Sue adds in a non-medical detail. Outside one room, she mentions that the patient prefers the term "partner" instead of "wife" for their caregiver. Outside another, she reminds the team of the patient's preferred pronouns.
These seemingly small details are a big part of Sue's job helping patients feel seen and respected during their stay in hospital.
There's no place like home
By 8:15 a.m., Sue is preparing for her daily meeting with Nursing and Allied Health. After Sue provides her updates, the group will collaborate on a game plan for the day.
"For a lot of patients – especially those with complex medical issues and disability, getting home is a huge victory," Sue says. "We do a lot of detailed, interdisciplinary work to move patients through the system safely and make sure they get home."
Not surprisingly, there are a lot of moving parts involved in getting a patient home after vascular surgery.
"I'll sit down with a number of specialists and team members, whoever is relevant to the patient, to make sure the patient has everything they need to get home," Sue says.
To Sue, the beauty of her role is in the interdisciplinary coordination of care for patients.
"I think of myself as the quarterback," she laughs. "I'm coordinating all the different pieces so we can get to where we want to go – but I can't do it without our team.
"I pull in everyone I need to make each patient's life better."
Every day is different
"What's great about UHN is that we have such a breadth of expertise and clinical specialty areas, so the spectrum of NP practice at UHN is huge," says Tara.
"You can see all the different ways the role can be lived out, with NPs incorporating their clinical skills, leadership, education, and research competencies into their daily work.
"It's a real mosaic of experience and skills, but the foundation of NP practice never changes."
Sue says at its core, "being an NP is about teamwork, education, and patient care. You have to be keen to learn and keen to get to know your patients."
"One of the best parts of my job is that every day is different – and one of the biggest challenges is that every day is different. But I get up in the morning with a smile on my face. I like going to work. Who knows what's going to happen."
