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Statement on Inequitable Nurse Practitioner Compensation During COVID-19 Pandemic

The current COVID-19 pandemic has caused a significant strain on our health care system. Health care providers in every sector have stepped up and are working at full capacity to screen, assess, monitor, and treat both asymptomatic and critically ill patients. Governments have allocated enormous financial resources to the fight against COVID-19.

Recognizing that, in Ontario, we have different health care delivery models, we have seen Nurse Practitioners (NPs) being redeployed from primary care settings into acute care, including COVID-19 screening centres, Alternate Level of Care (ALC), COVID-19 vaccination centres, COVID19 inpatient units, and COVID19 ICUs. Additionally, we are aware that NPs from specific primary care models, such as Family Health Teams, Community Health Centres, and Nurse Practitioner Led Clinics, are being redeployed, or are volunteering, to work in high needs areas such as screening centres, ICUs, Emergency Departments, and vaccination centres. The funding model in Ontario for NPs is a salaried one, with funding flowing through the Ministry of Health to primary care sites, hospital global budgets, and Long Term Care homes. Unlike physicians, NPs do not bill the Ontario Health Insurance Plan (OHIP) for their services. We have become aware of significant discrepancies in compensation for NPs who are working in COVID-19 screening and vaccination centres and who are redeployed to other areas of the hospital, including ICUs, as compared to their physician colleagues who are performing the same role. While recognizing the difference in education and scope of practice among health care providers, NPAO supports the contributions of our physician colleagues and fair compensation for them; however, this should not come at the expense of nurses who have been consistently at the front line of patient care during this pandemic and have been held to minimal compensation increases and denied overtime and vacation.

Nurses in general, including Nurse Practitioners, are increasingly becoming exasperated and demoralized by seeing the new OHIP codes being created to compensate physicians for consulting with COVID patients, providing vaccinations and numerous other functions that are traditionally within the nursing scope of practice. Just recently, physicians, even if they do not have appropriate training, have been provided with very generous OHIP billing codes to support the work of nurses in ICUs. While the sentiment of support is admirable, the duplicity of providing funding for one group of health care providers and not another doing similar extraordinary work in the same settings has increased the frustration of nurses and sets a very concerning precedent.

NPAO is hearing the aggravations of nurses on an increasing basis and strongly encourages the government to take immediate steps to address the funding inequity, by recognizing the contributions being made by nurses that are critically important to the pandemic fight and related patient care. NPAO is very worried about the long-term impact this disregard could have on the nursing profession and the potential negative impact on patient care.

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