Registered nurses are on the frontline of rural access

Many of Saskatchewan’s remote northern communities only have access to a physician a few days a month. In these instances, it’s up to registered nurses and the health care team on the ground to ensure patients are getting the care they need when they need it.

Rural and remote communities face unique challenges. They have lower life expectancy and higher overall mortality rates, driven by cardiovascular diseases, diabetes, injuries and suicides. Young boys and girls under the age of 20 living in remote areas have the highest risk of dying from suicide. Boys are more than four times, and girls almost seven times as likely to commit suicide than their urban counterparts.

Access to primary health care services, chronic disease management, diagnostic imaging, homecare to allow the elderly to age in their communities longer, mental health services, specialists, and even transport to urban centres to receive care are ongoing challenges.

With almost one third of Saskatchewan’s population living in rural and remote communities, having access to a skilled team of frontline professionals on the ground is essential.

Meet Dre Erwin, a Registered Nurse (RN) stationed in the remote community of Pinehouse, Saskatchewan, 800 kilometers north of Regina. Erwin is a RN with Additional Authorized Practice (RN(AAP)), meaning he has met the educational and licensure requirements to independently diagnose and treat limited, common medical disorders.


What are the unique challenges you face from day to day working in such a remote community?

Definitely one of the biggest challenges is the lack of access to physicians. This can make things like getting a prescription difficult. Another huge challenge is the isolation, which can lead to so many issues from addictions to coping and mental health problems for the community. Working this far north means we are often working by ourselves. A lot of the people we work with closely are situated elsewhere, such as physicians in La Ronge or pharmacists in Prince Albert. Our team does consist of a social worker and addictions counsellor, however, it’s us RNs that really are the primary caregivers for the community. We are the first people patients see when they walk in the door.

What about teamwork?

One of the most important parts of working in Pinehouse is having a very strong, trusting relationship with the physicians in La Ronge. Because they aren’t physically here, they’re relying on our ability to assess patients and clients that walk through our doors. As a RN I need to be confident in my assessment skills and knowledge, and the decisions I am responsible for making as a first responder.

How does having the RN(AAP) designation benefit the Pinehouse resident’s you care for?

As a RN(AAP) I follow a strict set of standardized guidelines called Clinical Decision Tools (CDT) which allows me to assess, diagnose, treat, prescribe if necessary, and evaluate patients with common medical disorders, such as bronchitis and pneumonia or throat infections. For example, if someone comes in with a throat infection and a swab shows they have a streptococcal infection, I’m able to treat them with amoxicillin. We can order certain tests and evaluate those tests. We can suture and do emergency deliveries as well as perform pap smears and prenatal assessments. Additional authorized practice really gives us a very extensive list of things that we can and cannot do. It allows patients to get more timely care when they don’t have direct access to a physician. It means they can get treatment faster and better faster.

Why have you chosen to work in such a remote part of the province?

It’s incredibly rewarding work. I get to not just work in the community but actually live in the community. The people become your friends, they become your family, and this really helps me to get to know them on an individual level. I’m able to develop a rapport and greater level of trust with the community and this helps me get a better understanding of what their specific needs are. I know their history and where they are coming from. Primary care is amazing, but in the north it’s so much more. I am a role model, a friend and someone in the community people look up to, and that’s a really important and rewarding part of the job.