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‘Feasible and affordable’

Nursing faculty member builds case for family practice nurses


By Marcia Porter

How do you pack a full research agenda into a six-minute presentation that’s interesting, informative and connects with your audience?

Young nursing professor stands with arm foldered in the School of Nursins learning resource centre
Dr. Julia Lukewich’s own clinical experience in primary care nursing informs her research.
Photo: Rich Blenkinsopp

That’s what Dr. Julia Lukewich, assistant professor in the School of Nursing, had to consider when crafting her presentation, Achieving Excellence in Primary Health Care through Family Practice Nursing, for MUNButtoned, a festival of knowledge held recently in downtown St. John’s and organized by Memorial’s Harris Centre.

“I want to get people thinking about how family practice nursing might be able to contribute to a better health-care experience for individuals, their families and the communities they live in,” said Dr. Lukewich, a faculty member in the SON since 2015, and who is also cross-appointed with the Faculty of Medicine.

Family practice nurses are registered nurses (RN) who work in primary care settings delivering a broad range of health-care services to patients of all ages.

Primary care is considered the entry point into the health care system; it’s where you go to receive care from your family doctor.

Nurses’ contributions

A graduate from the School of Nursing at Queen’s University in Kingston, Ont., Dr. Lukewich earned a 2017 Doctoral Dissertation Award from the Council of Ontario University Programs in Nursing for her doctoral research about the contributions nurses make in the primary health-care setting.

She found, for example, that primary care practices employing at least one RN exhibited better diabetic care than those without RNs.

“It’s the place where chronic diseases like diabetes should be managed,” she said. “It’s also where health promotion and disease prevention are undertaken.”

Improved experience for patients

During her undergraduate years, Dr. Lukewich worked as a research assistant to Dr. Joan Tranmer, a nursing professor at Queen’s whose research program focused on primary care nursing. It’s where she developed her own interest in this area of nursing.

Since then, she has seen first-hand how RNs contribute to an improved experience for patients in primary care through her own clinical background in family practice nursing/primary care nursing.

“I worked in a primary health-care team and was responsible for leading diabetes education days, a nurse-led telephone line and walk-in, same-day appointments,” she said.

“Patients could directly book appointments with me. I conducted regular followups, and could walk down the hall to consult with doctors, nurse-practitioners, social workers and other providers as needed.”

Dr. Lukewich is looking at how family practice nursing could address significant health care issues in Newfoundland and Labrador, such as the high prevalence of chronic diseases, low physician retention in rural areas and difficulty accessing services.

“There’s enormous potential in Newfoundland and Labrador to . . . improve access, quality of care and reduce costs.” — Dr. Julia Lukewich

It’s work that she’s doing in collaboration with the provincial department of Health and Community Services and the Family Practice Renewal Program; recently she was awarded a $35,000 research grant by the department to advance the integration and evaluation of family practice nursing in primary health care.

With family-practice nursing still a novelty in this province, the role is already well-integrated in primary care in many provinces, including Nova Scotia, Alberta, Ontario and Manitoba.

“There’s enormous potential in Newfoundland and Labrador to better utilize other health-care providers, such as nurses in primary care, to improve access, quality of care and reduce costs,” said Dr. Lukewich.

‘It’s time’

As the president-elect for the Canadian Family Practice Nurses Association, and working with an expert research team, she’s leading development of a defined set of national family practice nursing competencies.

She’s passionate about her research and about helping establish a role for family practice nursing in Newfoundland and Labrador.

“Not only do we need primary care nurses in our province, we must ensure their roles are utilized to their full potential within primary care teams,” said Dr. Lukewich. “Evidence shows they contribute to improved access to care, quality of care and reduced cost of primary health care services.

“My key message is that family practice nursing represents a feasible and affordable solution to addressing these issues with primary health care in the province,” she continued. “It’s time to formally integrate this important role into the health-care system.”

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