October 30, 2019

The FIQ acknowledges a major day in the history of nursing care in Québec, by the addition of three new medical activities to the specialty nurse practitioners’ (SNP) scope of practice. The Federation acknowledges the Minister of Health and Social Services’ leadership in advancing their practice, and access to care for Quebecers with Bill 43. The Federation also positively welcomes the opening of multiple laws and regulations, finally recognizing the SNP’s professional judgment, particularly for occupational diseases, occupational health and safety, protection of vulnerable people and public health.

By giving them more autonomy, it’s possible to believe that they can truly put their skills to work for patients. The medical community control felt by many SNPs every day was senseless and ineffective. The healthcare system needs a strong and diversified front line and SNPs can make major contributions to it. The SNPs in Québec are the best trained in all of Canada, but were those with the most limited autonomy. When we know that access to care is a major problem in the healthcare system, the gap between the autonomy of Québec SNPs and those in the rest of Canada was quite shocking.

Of the three activities set out in the bill, it must be noted that the one on the diagnosis of common diseases includes numerous limitations and the Federation questions some of them. To foster real interprofessional collaboration, the physicians’ right to oversee the SNPs’ practice that results in individual partnership agreements also needs to be questioned as they can be limiting, going so far as preventing the practice of the new activities. The FIQ wants to play a proactive role in the discussions on the bill and will propose paths to enhance the SNPs’ and other nurses’ professional practice to improve the management of Québec patients’ health care.

The FIQ believes there are still numerous obstacles to the SNPs’ practice and finds that though Bill 43 is a step in the right direction, there is a lot of work to do with the MSSS, professional orders concerned, nursing departments and  employers for the SNPs’ skills are effectively used to attain the key objective of fostering access to care.

Despite a few obstacles, the announcement of Bill 43 is great news and let’s now hope that the Québec government and administrators draw on this spectacular progress so that the logic of full recognition of the vast areas of expertise of all healthcare professionals becomes the norm.