Community health nurses: the mainstay of remote primary care in the Canadian North

Since the 1950s when aboriginal people in the Canadian North began to be settled in communities health care has been provided by a variety of agents including missionaries, RCMP, trading post staff among others. This evolved finally into a system of 'Nursing Stations' staffed by 'Community Health Nurses' in small, remote communities across the Canadian Arctic and sub-Arctic. These nurses worked independently as advanced practice nurses with varying degrees of support from general practitioner/family physicians. They are often the only care provider in the community, and over a thousand kilometers away from a tertiary centre, they are obliged to deal with whatever medical problems present to them. Community Health Nurses work in large numbers in Nunavut and the other Northern Regions of Canada. These nurses work with family practitioners in a more collaborative relationship as opposed to the more traditional consultative physician - nurse model that is seen in other health care settings. This presentation will review the close working relationship between Community Health Nurses and family physicians in the Canadian North; will reference the potential for new classes of providers including Nurse Practitioners and Physician Assistants; and will identify some organizational and technological innovations that may enhance the working relationship between the advanced practice nurses and family physicians; and identify some challenges facing this critical group of health care providers: lack of appropriate training, outdated staffing models, high rates of staff turnover.

This abstract was presented at the Innovative Solutions in Remote Healthcare - 'Rethinking Remote' conference, 23-24 May 2016, Inverness, Scotland.