Reflections and Learning Experiences: Foundations of Health Systems in Canada.

MHST/NURS601 - Foundations of Health Systems in Canada was a thought provoking and enriching course, both professionally and personally. Discussions with classmates and our professor in forums, enabled a deeper understanding of the issues in our healthcare system and of our roles as healthcare providers. We learned that having a professional digital identity is both a privilege and a responsibility. It is a privilege because as health professionals we have a strong collective voice that is respected and heard. We can advocate for change in health policies, we can participate in evidence based research that guides our practice, we can advocate for patients and their right to self-determination, we can actively listen to our patients’ opinions and have them collaborate in health issues as partners, and we can impart information to the public that can help prevent illnesses and improve health (Canadian Nurses Association (CNA), 2013; Mamishi, 2017). It is a responsibility as well though, because we must preserve our professionalism in our identity by upholding our professional code of ethics, maintaining confidentiality, and being responsible to the public and our professional order (Canadian Nurses Association (CNA), 2017); Fitzer, 2019).

The Role of Nursing in Healthcare

Nursing has a special and important role in healthcare. As nurses we advocate for our patients, who are always our first priority. We advocate for changes in healthcare policies to try and make them more equitable, promoting the rights of each patient for quality care. Nurses promote health awareness and educate on health prevention. We care for patients holistically and individually, trying to meet each need that is specific to each person. We live by our professional code of ethics, “providing safe, compassionate, competent and ethical care, promoting health and well-being, promoting and respecting informed decision-making, honouring dignity, maintaining privacy and confidentiality, promoting justice, and being accountable” (CNA, 2017, p.3). Finally, we give health a broader definition, thinking of it not just as an absence of disease, but a balance, between a person and his social and physical environment (Sartorius, 2006). Therefore, a patient with an illness can be balanced and feel fulfillment and well-being in life, and the more we interact with patients on many levels, the more we begin to understand that their own perceptions of health, which are influenced by their own experiences, beliefs, cultures and values can impact in a positive way on their quality of life.

Equitable Care in Vulnerable Populations: Socioeconomically Disadvantaged and Minority Women and Indigenous Peoples

Our Canada Health Act (CHA) guarantees equal rights to health access and quality care for all citizens (Government of Canada, 1985). Yet, many of our most vulnerable populations have limited access and do not receive this care. In fact, socioeconomically disadvantaged and minority women and Indigenous Peoples have sub-par social and structural determinants of health which impact on their morbidity, quality of life and mortality, and create barriers to the quality care they need (Warnecke, Campbell, Vijayasiri, Barrett, & Rauscher, 2019).

To advocate for equity of these health determinants must always be a part of our current and future nursing responsibility, but in the short term we can make positive changes through interventions by a number of strategies to overcome these barriers. Using a multilevel approach to creating and implementing interventions in a marginalized population can surmount many of these barriers and using the input of the target population itself, to design and initiate interventions can make them more successful by incorporating the thoughts, beliefs and cultural values of the people they are intended for. Using outreach programs to personally engage the target population and trying to make access to healthcare more accessible and convenient, can increase compliance with program initiatives. Finally, because education on health promotion and prevention can be more effective with the collaboration of the target population and its community, it can therefore more easily itinfluence their health and well-being in a positive way (Rural Health Information Hub. 2019; UICC, n. d).

The Future of Healthcare

The future of healthcare looks exciting and hopeful, bringing forth new technologies like artificial intelligence and wearable devices, and therapies like immuno-oncology, that will help in prevention, diagnosis and treatment (Bourla, 2018). The patient though, is always of primary importance now and in the future. Care must always be holistic and personalized, and it must consider the patient’s own thoughts, concerns, beliefs and values (Zamboni, 2018).

Conclusion

In conclusion, this course has inspired me to think more deeply about many issues. A digital identity is personal, but a professional digital identity influences our professional reputation and that of our professional order. It must be kept separate and maintain an integrity and ethical foundation. Further, social media can and should be used as an extension of our nursing practice, to promote health awareness and prevention and it can act as a platform for discussion of important concerns in healthcare (Fitzer, 2019). The role of the patient in our nursing practice is at its core and should always be its priority. I strongly believe in the patient’s right to make informed decisions about his own health and care. This course has re-enforced this belief and made me more aware that social determinants of health, like cultural beliefs and values, play an important part in the patient’s decision making (UICC., n. d.). As well, this course has stimulated me to think about the unequal determinants of health, around the world and here in our own country. It is our responsibility as healthcare providers to work towards making changes in health policies and to try to make improvements in the health and well-being of vulnerable populations through health promotion and prevention programs which are socially and culturally acceptable to them (UICC., n. d.). Finally, the future of healthcare makes me hopeful that effective technologies are available and there are more on the horizon, and that our nursing practice is always evolving, shifting the focus, from patient as a recipient of care to patient as a partner in care (Zamboni, 2018).

References

Bourla, A. (2018, January 19). 5 key trends for the future of healthcare. World Economic Forum. Retrieved from https://www.weforum.org/agenda/2018/01/this-is-what-the-future-of-healthcare-looks-like/

Canadian Nurses Association (CNA). (2013). Registered nurses: Stepping up to transform health care. Retrieved from https://www.cna-aiic.ca/~/media/cna/files/en/registered_nurses_stepping_up_to_transform_health_care_e.pdf

Canadian Nurses Association (CNA). (2017). Code of ethics for registered nurses. Retrieved from https://www.cna-aiic.ca/-/media/cna/page-content/pdf-en/code-of-ethics-2017-edition-secure-interactive.pdf?la=en&hash=09C348308C44912AF216656BFA31E33519756387

Fitzer, A. (2019) Social media and client confidentiality: Are you violating your ethics code? Ethics. Retrieved from https://www.abacnj.com/fitzers-corner/social-media-and-client-confidentiality-are-you-violating-your-ethics-code/

Government of Canada. (1985). Canada Health Act. R.S.C., 1985, c. C-6 An Act relating to cash contributions by Canada and relating to criteria and conditions in respect of insured health services and extended health care services. Retrieved from the Justice Laws website https://laws-lois.justice.gc.ca/eng/acts/c-6/FullText.html

Mamishi, N. (2017, November 3). The role of nurses in primary care reform: “The wheel and hub of health care system. The McGill Journal of Medicine (MJM). Retrieved from https://www.mjmmed.com/article?articleID=5

Rural Health Information Hub. (2019). PRECEDE/PROCEDE. Retrieved from https://www.ruralhealthinfo.org/toolkits/health-promotion/2/program-models/precede-proceed

Sartorius, N. (2006). The meanings of health and its promotion. Croatian medical journal, 47(4), 662–664. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080455/

Union for International Cancer Control (UICC). (n. d.). Prevention: Breast cancer risk factors and prevention. Knowledge Summary. Retrieved from https://www.fredhutch.org/content/dam/public/labs-projects/Science-Projects/bci2_5/pdf/UICC_Prevention_Risk_Factors_FA.pdf

Warnecke, R. B., Campbell, R. T., Vijayasiri, G., Barrett, R. E., & Rauscher, G. H. (2019). Multilevel examination of health disparity: The role of policy implementation in neighborhood context, in patient resources, and in healthcare facilities on later stage of breast cancer diagnosis. Cancer Epidemiol Biomarkers Preventions, 28(1) 59-66; DOI: 10.1158/1055-9965.EPI-17-0945 retrieved from http://cebp.aacrjournals.org/content/28/1/59

Zamboni, A. (2018, January 12). Individualized patient care: A simple concept that is difficult to get right. Studer Group. Retrieved from https://www.studergroup.com/resources/articles-and-industry-updates/insights/january-2018/individualized-patient-care-done-right