Providing Health Care Services for Those with High Need

Since the initiative began in September, the nurses have provided health check-ups, pregnancy tests, wound assessment and care, mother and baby health teaching, nutrition education, and more. They’ve also advocated for clients, helping them navigate the health care system and access additional resources – some cases have been critical.  

One day, Jane* and her mother, Lily*, came to the clinic. Lily had just come to Canada to visit her daughter and Jane noticed how fragile her mother looked. She found out that her mother could not access her diabetic medication, which resulted in her body becoming weaker. Jane was concerned but knew that because her mother did not have insurance at that time, she had to turn to alternative methods. She called the clinic to make an appointment for her mother and was promptly provided with a visit for the following day.

Lily received a physical assessment and health education related to her condition from Paollo Aracama, a fourth-year Humber nursing student and Sue Ferri, an experienced nurse and Humber clinical teacher. Topics such as the importance of diet, hydration and at-home solutions were discussed. Based on the review of her physical assessment findings – she was reported to be in need of urgent medical attention – the nursing team directed Lily and Jane to visit a local medical health clinic.

“We offered follow up care but stressed that she needed urgent attention. We indicated that we would be happy to provide follow up care and even a visit with our Nurse Practitioner (NP) – but this was in addition to the urgent care she required at that first meeting”, said Sue.

Two weeks later, the clinic received a call from Jane, saying that Lily’s condition was worsening and they hadn’t been able to receive medical help. “Our office was the only place where they were seen in a timely manner and they felt comfortable calling us again even in light of the fact that they had not been seen by a medical doctor as we had directed”, explained Sue. Fortunately, Tamiza Kassam, an experienced NP and Humber faculty, was scheduled to come in the next day. According to Sue, it is within a nurse practitioner’s scope of practice to provide more advanced care. They can also order medication and make referrals that other nurses usually can’t.

“During my assessments, it was quite clear that she was acutely ill at that point and that her blood sugars were really high,” said Tamiza.

Tamiza knew that if Lily was not seen promptly by a facility that could provide her the care she needed, her health would deteriorate further. She was seriously ill and required urgent medical care – regardless of her insurance status – and she was sent to the emergency department. The HAP clinic sent all the appropriate documentation, making for a smooth transfer. Paollo made follow-up calls to Jane a week after the transfer, making sure that Lily had been well taken care of.

We’re really addressing the whole issue, taking a deep dive, looking at the individual and their whole life situation and how can we best help them,” said Sue.

The new community health services have created a mutually beneficial relationship between the clients and the nursing students. Paollo said, “Before this placement, I did not really have any experience with this type of population where they’re very vulnerable so it was really eye opening to see the gaps in our health care system.” As the students serve those with most need, it exposes them to the realities of the equity issues in Canada, tapping into so much more than in-class learning.

*Names have been altered for privacy reasons.