Close X
Thursday, November 28, 2024
ADVT 
National

Some nurse practitioners in Canada not being paid for administering MAID

Darpan News Desk The Canadian Press, 20 Nov, 2023 11:20 AM
  • Some nurse practitioners in Canada not being paid for administering MAID

For the past year, Ellen Gretsinger, a nurse practitioner in Ontario's Niagara region, has been providing patients with medically assisted deaths — and not getting paid for it.

She has a full-time nursing job and a side gig offering virtual care, and in the evenings and on weekends, assesses patients for medical assistance in dying — known as MAID — and delivers the procedure. Like many provinces, Ontario does not have a mechanism for nurse practitioners to take on independent work and be paid for it, like a fee-for-service structure often in place for doctors.

And demand for MAID is growing across the country. So Gretsinger does the work for free. She believes in it, especially after watching her mother suffer before she died of cancer.

"I just feel that when people are suffering, and this is something that they've been told that they can access, then access needs to be there," Gretsinger said in a recent interview. "So that's why I have decided to do as much as I can."

The number of doctors and nurse practitioners available to administer MAID in Canada has not kept up with increasing demand. A report last month from Health Canada shows the number of MAID providers has grown by an average of 18 per cent each year, but the number of medically assisted deaths — often referred to as provisions — has grown by nearly 33 per cent each year. According to federal law, MAID provisions and assessments can be done by nurse practitioners or doctors, and each request must be assessed by at least two providers.

There are a host of reasons why medical professionals may not be taking on MAID requests, from overwork in a strained system to hesitancy about MAID itself, said Dr. Tim Holland, head of bioethics at Dalhousie University. He considers medically assisted death to be the biggest cultural shift related to medicine since abortion.

But there are nurse practitioners like Gretsinger who are eager to take on the work.

"Finding a model that will allow nurse practitioners to be able to do this, in addition to their standard practice, would go a long way to increase capacity," Holland said in an interview. "Every time we have a MAID conference, (the question) comes up every time … 'How are we all going to advocate to get nurse practitioners paid?'"

Stan Marchuk, president of the Nurse Practitioner Association of Canada, said he's aware of "a number" of nurse practitioners who are doing unpaid MAID work.

"I think it speaks to the fact that we just don't have good compensation mechanisms in Canada for nurse practitioners," he said in a recent interview. "We need more flexible models of compensation to allow nurse practitioners to be able to practice to their full scope in Canada."

Compensation models for nurse practitioners have remained largely unchanged for decades, despite significant innovations in medicine and reforms to health systems, Marchuk said. In most provinces, nurses are salaried and tethered to health authorities, with no way to be compensated for work done outside their jobs.

Doctors, meanwhile, bill health authorities for any work they do, Marchuk said, adding that his organization is pushing for more flexible compensation models that would allow nurse practitioners to offer more services — or even set up independent practices providing MAID assessments and provisions.

"I think it's really shameful that … people are providing a service for which they're not being compensated," he said.

British Columbia has made headway in offering different compensation models, and Alberta is in the process of figuring it out, Marchuk added. 

In Newfoundland and Labrador, nurse practitioners can file up to five extra hours to do a MAiD assessment or provision outside of regular work shifts. It's a new rule, part of the collective agreement between registered nurses and the provincial government, which was signed in July. Before that, nurse practitioners were doing the work for free, on their own time, just as Gretsinger is, said Yvette Coffey, president of Newfoundland and Labrador's registered nurses' union.

"They saw the need," Coffey said in a recent interview. "And at the end of the day, it's the needs of the patients that trump everything else."

Gretsinger said she'd like to see Ontario health officials offer nurse practitioners a billing code for the work she does on medically assisted death. Until then, she'll keep going. She worries that if she turns down those requests for assessments, patients would suffer longer. She said a woman had to adjust her desired day to die four times because it was hard to find providers.

"She suffered for another two months," Gretsinger said. "It breaks my heart."

 

MORE National ARTICLES

'Damaged' India-Canada relations getting traction in Chinese media

'Damaged' India-Canada relations getting traction in Chinese media
Canadian Prime Minister Justin Trudeau had told his country’s lawmakers on Monday that Canada is probing “credible allegations” of Indian government's involvement in the killing of pro-Khalistani leader and Canadian citizen Hardeep Singh Nijjar outside a gurdwara in Surrey, British Columbia, on June 18. The Indian government has strongly denied the allegations, calling them "absurd".

'Damaged' India-Canada relations getting traction in Chinese media

Diplomatic fallout: Number of Indian students going to Canada may drop

Diplomatic fallout: Number of Indian students going to Canada may drop
Given the current situation between India and Canada, there may be a drop in the number of Indian students going to Canada for higher studies, said a consultant with Star Global Education Alliance. According to Veeravalli, there is a general sense of uneasiness in Canada among the students who are expecting some kind of retaliation by the Canadians.

Diplomatic fallout: Number of Indian students going to Canada may drop

COVID19 infections back in the fall

COVID19 infections back in the fall
Public health officials say new COVID-19 infections are creeping back up just as the respiratory virus season in the fall and winter is set to get underway. Ottawa is sending a new COVID vaccine out to the provinces and territories, which are in charge of rolling it out to the public.

COVID19 infections back in the fall

Canada Post reviewing use of address data following criticism from privacy watchdog

Canada Post reviewing use of address data following criticism from privacy watchdog
Canada Post said Friday it is reviewing how it uses data for tailored marketing campaigns after the federal privacy watchdog found the post office was breaking the law by gleaning information from the outsides of envelopes and packages. The information is then used to help build marketing lists that Canada Post rents to businesses.  

Canada Post reviewing use of address data following criticism from privacy watchdog

Here's what Canada is pledging in multi-year support for Ukraine, updated trade deal

Here's what Canada is pledging in multi-year support for Ukraine, updated trade deal
The two countries have also signed a modernized trade deal as Ukrainian President Volodymyr Zelenskyy visits the country for the first time since Russia's full-scale assault of Ukraine began last year. The multi-year commitment includes $650 million over three years for 50 armoured vehicles that are to be built in London, Ont.

Here's what Canada is pledging in multi-year support for Ukraine, updated trade deal

Critical incident involving RCMP, B.C. Premier David Eby says

Critical incident involving RCMP, B.C. Premier David Eby says
British Columbia Premier David Eby says there's been a critical incident involving RCMP in the Metro Vancouver suburb of Coquitlam. A witness on the scene says she saw an officer with a bloody leg and a tourniquet above the wound. 

Critical incident involving RCMP, B.C. Premier David Eby says