A TRU-ly unique rural health initiative

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The TRU North Health Clinic is lead by Family Nurse Practitioner, Sandra Lachapelle (left), shown here with UVic NP student Bhavan Manhas (right).
submitted by Sandra Lachapelle, MSN, NP(F) and  Rhonda McCreight, BScN, MN

Thompson Rivers University (TRU) – Williams Lake Campus, fondly referred to as ‘TRU North’, is a rural university with a goal to increase its capacity in the hopes of attracting university students from all over the globe.

Both Interior Health (IH) and TRU face ubiquitous challenges in providing equitable and attainable services to a region with an enormous geographical size. Although Williams Lake has a core population of approximately 10,000, this city-hub actually serves an outlying area of hundreds of square kilometers in the north-eastern section of the Cariboo-Chilcotin region, bringing the total population of the area closer to 26,000.

For TRU North, providing educational programming to a unique population means considering collaborative partnerships and looking at innovative and creative solutions. University administration agreed that an on-campus health centre was a logical step in addressing this systemic issue; however who would staff a Health Centre in light of a chronic physician shortage already identified as the root issue?

The epiphany came to TRU North Nursing faculty, who advised administration that one of the Nursing Department’s sessional faculty members was a Family Nurse Practitioner (NP). Sandra Lachapelle had been dividing her time between traveling to rural and remote communities in the Chilcotin, and teaching in the Bachelor of Science (Nursing) and Practical Nursing programs at TRU.

It was around this time that the BC Ministry of Health announced funding for additional NP positions throughout the province (NP4BC). TRU North decided to apply for this NP4BC funding and was successful! The TRU North Health Centre opened its doors October 15, 2013, with Sandra Lachapelle leading the centre as the full time Family NP, with the support and mentorship of two family physician colleagues. Under the auspices of partnership between IH and TRU North, the Health Centre’s mandate and goal was created. On advice and input from the Cariboo-Chilcotin community, it was decided that the health centre would serve three main groups of clientele:

  • Unattached patients, in particular those new to the community. Offering another access point to primary health care made the university, as well as Williams Lake, more attractive to those considering relocating.
  • Sexual health. This was identified as a need by a number of community organizations, including the local Boys and Girls Club, Communities That Care, and Public Health. Teen pregnancy and STI rates were noted as being particularly high for the area, and a lack of health care access was attributed to this.
  • Urgent but non-emergent care needs. Average wait time for a physician appointment in Williams Lake is one to two weeks, leaving patients with urgent health issues no option but to visit the emergency department (ED). In 2011, the number of CTAS level 5[1] visits in Williams Lake, and people who left the ED without being seen, were nearly double that of any other ED in Interior Health.

An unexpected but welcome effect of this health initiative was that a number of LaChappelle’s rural Aboriginal patients from the Chilcotin were continuing to see her at the TRU North Health Centre. The decision to provide inclusive access to all members of the region has served to encourage an increased [and diverse] presence of people on campus, who may not have otherwise set foot in a university environment. This innovative project will hopefully encourage enrolment of students from around the region, and raise the profile of TRU North in the community in general.

Although there are several health centres or clinics offered in university settings across BC, very few are led by Nurse Practitioners and none have opened their services to all public members of the community and region. TRU North Health Centre is based on a solid partnership, whereby the aim is to build capacity and infrastructure that will address issues of recruitment and retention both inside and outside the university walls. Students at TRU North are not only offered a health service that is convenient and accessible, but are also offered educational opportunities. For example, students in health programs are welcomed to participate in clinical experiences in this unique setting under the mentorship and guidance of the Nurse Practitioner.

The Health Centre provides both health care service and education to all community members. TRU North’s vision and mission to build a community of health and learning is well on its way!

Visit the TRU North Health Centre online or like them on Facebook.

Sandra Lachapelle is the Family Nurse Practitioner lead for the TRU North Health Centre and works for Interior Health. Rhonda McCreight is the Nursing Programs Coordinator for TRU North.

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[1] CTAS Level 5 refers to the Canadian Triage and Acuity Scale. It is a means of assessing patients who go to an emergency department seeking healthcare. Level 5 patients present with non-urgent symptoms and conditions.

 

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