With an eye to helping solve the crisis in health care, Angie Grewal, a University of Lethbridge fourth-year master of nursing student, believes that expanding the role of nurse practitioners could help address the shortage of physicians in Alberta and lead to more accessible and cost-effective care.

She, along with Kate Bykowski, a nurse practitioner and PhD student at the University of Alberta, put their ideas onto paper and submitted them to the Hunter Prize for Public Policy. The two teamed up at the suggestion of Dr. Carmel Montgomery, an associate professor at the U of A. The prize is designed to rally fresh ideas, energy and voice to tackle a so-called wicked problem, in this case, health-care wait times, to improve the economic and social well-being of Canadians. They recently learned their submission made the top 10 finalists.

“I was very honoured and excited,” says Grewal. “The master’s program at ULethbridge empowered me and provided me with tools to transform the frustrations I feel about the health-care system. I think this is why I am so excited to be a finalist, not for the prize but because maybe someone will listen. Working in ICU since 2009, I have seen what inadequate access to primary care can lead to, and conversely, how complex patients are upon discharge. We need more clinics, and NPs have a lot to offer, and can fill that gap in the community setting.”

“In my experiences of Angie, she consistently demonstrates nuanced insights with applying ethical frameworks and principles of equity to meeting population health needs in a publicly funded health system,” says Dr. Lisa Howard, a ULethbridge Faculty of Health Sciences professor. “The Hunter Prize submission is a stellar reflection of the aforementioned and another thoughtful product of Angie’s scholarly skills and practice insights.”

“It was clear to me when I taught Angie in the MN program that she was an outstanding student possessing excellent critical thinking skills and an ability to synthesize complex concepts,” says Dr. Peter Kellett, ULethbridge assistant professor. “I have little doubt that being shortlisted for the Hunter Prize will be one of the first of many accomplishments she will achieve as an emerging nursing leader and scholar.”

Nurse practitioners (NPs) are health-care professionals who are trained to provide primary and specialty care to patients. They are licensed to diagnose and treat various illnesses and injuries, prescribe medication and provide preventive health services. As such, they are an integral part of the health-care system.

In their submission, Grewal and Bykowski also point out that NPs have a lower salary than physicians, which leads to cost savings in the health system. Through government-funded nurse practitioner-led clinics (NPLCs), patients get improved access to care in a timely and efficient manner. These clinics are important resources for post-operative patients, as they provide close monitoring and follow-up care. This has the potential to lead to shorter hospital stays, thus freeing up acute-care beds.

“NPs provide care that is more patient-centred and tailored to the needs of individual patients,” says Grewal. “Cardiac patients are complex and evidence indicates that NPs spent more time with their patients, allowing for holistic assessments, development of a therapeutic relationship and comprehensive care that takes patients’ physical, emotional and social needs into account.”

NPLCs, by providing timely and appropriate care, education and support in outpatient settings, lead to improved patient satisfaction. Providing care in the community or through telehealth technologies improves access for patients who live in rural and remote areas.

“Health care is a fundamental human right,” says Grewal. “By establishing government-funded NP-led clinics for primary care, we can ensure that health care is available to everyone who requires it. This leads to better health care and, in turn, contributes to a healthier population.”

As one of the top 10 finalists, Grewal and Bykowski receive $2,500. The Hunter Prize winner receives $25,000 to translate their idea into public policy, while the runner-up receives $5,000.