A unique nurse practitioner clinic that opened in Sudbury last summer will serve as a model for 25 similar clinics across the province.

The provincial Liberals promised to invest $38 million in the clinics in their March budget.

“We were overwhelmed and thrilled for our counterparts. It’s also really good news for the people of Ontario who don’t have access to care,” said Sudbury nurse practitioner Marilyn Butcher, who along with colleague Roberta Heale, pushed for the creation of the Sudbury District Nurse Practitioner Clinic.

“Certainly, to have the health minister and premier say ‘We’re doing this based on what you did’ doesn’t happen every day.”

Ontario Premier Dalton McGuinty visited the facility April 10, and Butcher filled him in on what she and her staff do on a daily basis.

She said there are already several groups of nurse practitioners in Northern Ontario and across the province who are ready to set up clinics in their communities and are waiting for the call for proposals to be issued by the government.

“It’s going to increase access to health care in the North. The patients we’re bringing in are not part of existing primary care practices. They are patients who have been going to walk-in clinics for 10 years and don’t have a good understanding of what their health issues are.”

With the collaboration of doctors, nurse practitioners can prescribe certain medications, diagnose, treat and monitor minor illnesses, order specific X-rays, lab tests and ultrasounds, and provide preventative care.

Nurse practitioners working in Ontario must have a bachelor’s degree in nursing, two years of experience in their field within the past five years, and a post-bachelor’s nurse practitioner certificate.

While the nurse practitioner clinic is enjoying great acclaim and success, it didn’t come into existence without a lot of trials and tribulations, said Butcher.

Two years ago, there were eight nurse practitioners in Sudbury, including Butcher, who were unemployed, underemployed or had to travel to other communities to work because there weren’t enough funded nurse practitioner positions in the city.

Laurentian University has had a nurse practitioner program since 1996, and graduates weren’t able to find work in Sudbury. Lakehead University in Thunder Bay also has a nurse practitioner program.

Butcher and Heale began working on a proposal for a nurse practitioner clinic. They submitted their proposal to the province as a Family Health Team in January 2006 even though they knew it didn’t quite fit with the required model.

“It wasn’t quite what the ministry was looking for, but there was no other avenue for us to put our ideas forward. We used that call anyway, and the proposal was turned down,” said Butcher.

Following the rejection, the women wrote a letter to Health and Long-Term Care Minister George Smitherman and copied it to several other people, including Registered Nurses Association of Ontario executive director Doris Grinspun.

Grinspun began campaigning for the clinic proposal. Butcher and Heale did interviews with local media and made presentations at Sudbury city council.

“Within a few months we heard from the ministry that there was some interest there.
Then in November 2006 we got the announcement that the ministry was going to fund the nurse practitioner clinic,” said Butcher.

From there, the clinic quickly came into existence. A site on Riverside Drive in Sudbury was acquired, and the clinic opened its doors to the public in July 2007.

“I thought if I put an ad in the paper saying to come for 10 am, it would be all right. But it wasn’t. I came in that day at 7 am, and there were people lined up outside. What it shows is there is a tremendous need out there.”

The clinic currently has three full-time nurse practitioners and one part-timer on staff, along with two physicians who come in to see patients as needed.

A second location within Sudbury was originally supposed to open in the outlying community of Dowling, but the clinic’s board of directors was unable to develop a lease agreement with the landlord.

Another location in an outlying area of the city has been pinpointed, but Butcher is not yet ready to reveal where it is. Another two nurse practitioners will be hired to work at the location.

A social worker and dietitian will also be hired by the clinic and will travel between the two locations.

Six times a year, staff also travel to Chapleau, located about 300 kilometres northwest of Sudbury, and stay for a week at a time to provide services to citizens at an existing clinic in that community. There are currently no physicians or nurse practitioners living in Chapleau.

Including the patients in Chapleau, the clinic’s patient list currently stands at about 1,800. That number will eventually increase to 4,000 as the second Sudbury location is opened and patients continue to access the clinic’s services.

Because some of the people who are being seen at the clinic haven’t had access to stable primary care for years, a lot of them are being diagnosed with chronic conditions like Type 2 diabetes and high blood pressure, said Butcher.

In an attempt to improve their patients’ health, the nurse practitioners have introduced weight loss and smoking cessation programs.

Butcher said people have been extremely receptive to receiving care from nurse practitioners. She and her staff ensure patients understand how the clinic works.

“Let’s say this was your first visit. What I would say to you is ‘This is a nurse practitioner clinic, and when you call to book an appointment, it will be with me because I’m your nurse practitioner, and if I happen to be away, you may see one of my colleagues.

“‘If you can help it, I’d like you not to go to a walk-in clinic, but come here instead for your care so I know about all of your health issues. If you need to see a physician, I’ll make arrangements for you to see one at this clinic, but I need to make sure that it’s not for something I can look after’.”