Nurse practitioner grads can't get jobs in N.B., despite minister's promise to public

Natasha Stephen, along with six of her classmates, will graduate from UNB Fredericton's nurse practitioner program this summer, but she isn't hopeful they will be hired by Horizon Health to care for New Brunswickers.

Stephen and other members of her class have sent their resumés to officials with the health authority but haven't heard back from anyone.

The lack of interest, Stephen said, has come as a surprise since the province is in desperate need of primary care providers, and Health Minister Dorothy Shephard has pointed to nurse practitioners as the solution.

"We've been very persistent and proactive, but we have no indication from Horizon that they actually want us," Stephen said. "It's led to some of us exploring options in other provinces such as Nova Scotia and Prince Edward Island."

Stephen said she and her classmates are being "actively recruited" by other provinces, which are offering signing bonuses and "more robust salaries."

Students want to stay

Earlier this month, Shephard said "every physician and nurse practitioner should be working within the Medicare system," and pointed to 18 vacant nurse practitioner positions that she would "dearly love to fill."

Shephard told CBC News, "I will hire them today."

Raelyn Lagace, president of Nurse Practitioners of New Brunswick, was doubtful this could happen.

"It would be nice if it would be that simple, but it's not," Lagace said. "There's a little bit of disconnect, I think, between the health authorities and government … hopefully they can figure that out and help these students get some jobs."

Shephard said her goal is to eliminate the wait list for primary care in the province within six months by hiring 18 nurse practitioners.

As of Dec. 31, there were 44,226 people registered with Patient Connect New Brunswick, which pairs residents with a family doctor. 

As Premier [Blaine] Higgs has said many times — it's not always about needing more but using what you have. And here we are, we're sitting here in New Brunswick, and we're ready to be part of that solution.- Natasha Stephen

Stephen agrees there is clearly a "bit of a disconnect" between what the health minister is saying and what is happening.

"From February until now, we have all, as a class of seven, repeatedly sent our resumés not just to the general application pool, but for specific job postings, and just no contact whatsoever."

"As Premier [Blaine] Higgs has said many times — it's not always about needing more but using what you have. And here we are, we're sitting here in New Brunswick, and we're ready to to be part of that solution."

Shephard said earlier this month that she has "not been satisfied" with New Brunswick's "recruitment process" and that the Department of Health was now leading recruitment, rather than Horizon and Vitalité.

That prompted criticism from Horizon's board chair John McGarry, who has since been fired by Shephard.

Jobs requirements exclude grads

One of the hurdles for nurse practitioner graduates is a hiring requirement by Horizon Health that you have "at least two years of primary health-care experience."

All nurse practitioner graduates are already certified registered nurses with several years of clinical experience, but that doesn't meet the baseline set by the health authority.

Stephen said the requirement might make sense in some rare circumstances, for instance in rural places where there wouldn't be other health-care providers to offer support, but nurse practitioners are graduating with the experience and education they need to start practising right away.

"We already have well-established professional judgment … I just want to make it clear that we really will be equipped to do the job that we've been trained to do when the time comes for us to graduate."

"It's concerning," Lagace said. "Because they put all of this effort in with expectations that there is a need, which we know there is, and then at the end of it, they come out and they can't get hired and they're at risk of losing everything. It's sad."

In a statement, Horizon Health Network's chief human resource officer Maura McKinnon said representatives met with the graduating class in February and "our interest was expressed."

She said some, but not all, nurse practitioner positions require experience and suggested any of the grads who want an update on the status of their application write to a general Horizon email address.

CBC asked what positions are available to nurse practitioner grads but has not yet received a response.

On Wednesday afternoon, Shephard said "provisionary offers" will be going out in May to some who have applied for available positions. She added that since many of the nurse practitioner grads are currently employed by Horizon as registered nurses, "they would know that there is a collective agreement which would guide the whole process."

Shephard said there is no disconnect between her department and Horizon and that she is looking "at every possibility to keep every New Brunswicker out here."

Nurse practitioners want to provide care

Stephen has three young sons and after years of working in the Northwest Territories and Nunuvut she wants to stay in Saint John and would love to work with high-risk populations.

"My hope is to be able to become a primary care provider in the Saint John area, which is my hometown, where I have my roots and my family. So that really is my goal."

Stephen said unless the health authorities will hire them, new grads will have to either leave the province, or return to nursing and waste their new education. In the past they could have opened a practice outside of Medicare, but recent policy changes by the Department of Health make that impossible.

As of April 1, any health-care provider who charges a patient directly will be billed by the Horizon or Vitalité health authorities for any diagnostic or lab tests they order for a patient.

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"I think a great place to start would be for human resources in Horizon to sit down with each of us and get to know us better," Stephen said. "So it's just a matter of starting those talks."

She graduates this summer from the two-year program and will be able to work as a graduate nurse practitioner until she writes and passes the licensing exam in October, at which point she is fully qualified to practise.

"I've lived away for most of my adult life and it's been a real joy to be back in my home province and reconnecting with people and really feeling rooted in a place," she said.

"So my hope is absolutely to stay here and to provide a much needed service to my fellow New Brunswickers."