November 11, 2014
Cindy Pritchard, RN(EC), BScN, NP-PHC
I am currently working as a nurse practitioner in the Integrated Community Access Program (ICAP) at Ontario Shores. I work in three outpatient clinics: Anxiety and Mood Disorders Clinic, Psychosis Clinic, and Women`s Consultation Clinic.
In my current role I screen, assess, and treat mental health conditions such as bipolar disorder, schizophrenia, generalized anxiety disorders, and women’s health issues such as postpartum depression. While the particular focus of my clinical practice is on mental health, I rely on my primary care clinical skills to assess for medical conditions such as diabetes, dyslipidemia, hypertension, etc. as clients with mental health disorders run a high risk of acquiring these medical issues.
On a typical day, I will see anywhere from 8-12 clients per day and may do the following:
• focused mental health assessment and evaluation (in person or via Telemedicine)
• focused physical health assessments (e.g. cardiac and respiratory assessments, neurology assessments to evaluate abnormal involuntary movements related to medications)
• medication adjustments, changes, or renewals
• order and interpret laboratory testing to assess metabolic status, therapeutic drug levels of medications, rule out medical causes contributing to mood (e.g. anemia, hypothyroidism)
• order diagnostic tests such as electrocardiograms to assess for cardiac dysrhythmias, as this can impact medication decisions
• health education and teaching re: healthy eating, exercise, sleep hygiene, importance of monitoring Body Mass Index and waist circumference
• provide supportive counselling and maintain an appropriate sense of humour, as it is so appreciated by clients!
• smoking cessation counselling and prescribing nicotine replacement therapy (NRT) and other cessation agents
• provide individual and family-centred care; advocate for clients in the community
• consult with psychiatrists, registered nurses, social workers, and other members of our mental health care team, including community agencies
• shared care and collaborate with primary care providers in the community, with the ultimate goal of helping clients recover so they can be successfully transitioned back to their primary care providers
At the present time, one in five Canadians will develop a mental illness or addiction in their lifetime and two thirds of these Canadians will have difficulty accessing mental health services due to a lack of mental health services, shortage of psychiatrists, etc. Nurse practitioners have the skill and knowledge to provide timely assessments of clients and they can address safety issues by ensuring that clients who pose a risk to themselves or others are treated. This current role has provided me with the opportunity to focus my clinical practice on mental health, with the goal of becoming an “expert” in this area of nurse practitioner practice.
While there is no current designation for a mental health nurse practitioner with the College of Nurses, my hope is that one day this dream will be realized as it is such a crucial component in the holistic care of Canadians.
