Karen Hart walks downstairs to the child care space at Nutana Collegiate to check on some of the infants and toddlers in care. She knows the names and faces of many of the 600 students and most of the children in the child care. Hart is a nurse practitioner (NP) based at Nutana Collegiate. Hart’s placement at Nutana Collegiate shows the diversity of the work environment for a NP. “Nutana is a regular high school. However, a lot of the students have had difficulty staying in school for many reasons,” she says. About 80 per cent of the students are over the age of 18. “I deal with everything from sore throats to sexually transmitted infections, birth control to mental health issues. Anxiety and depression are very common.”

Karen Hart examines a toddler at Nutana Collegiate's child care.

Karen Hart examines a toddler at Nutana Collegiate’s child care.

Nurse practitioners are registered nurses who are trained further to fulfill a special role in a primary health setting. An NP can diagnose illnesses, prescribe medications and treat common and chronic conditions. They can also order tests and perform common medical procedures such as removing moles and suturing simple wounds.

“We’re not physician replacements. We work in teams,” she says. “The job changes with the community you serve. And you have to evolve with that community to fulfil their needs. My team looks very different compared to other NP teams. Without the full support of the whole staff at Nutana, I couldn’t do my job and most of them are not in health care.”

Hart has capitalized this team environment to create a program that reaches beyond a typical NP role. She partnered with social worker Dawn Rain from Mental Health and Addiction Services to start an equine-assisted psychotherapy program based on a model of equine therapy called EAGALA.

“We work as a team with a horse specialist and a mental health specialist. The program is experiential in nature. The participants learn about themselves and others by participating in activities with the horses and then processing feelings behaviours and patterns.”

The program doesn’t teach riding or horsemanship. Participants work with horses from the ground and learn to apply certain skills. Hart says horses mirror human body language.

Did You Know?
During the Health Region’s recent accreditation survey, the Region met 100 per cent of the criteria for the priority process of principle-based care and decision making. Accreditation Canada praised the bio-ethics program and its ethical decision-making framework.

“Horses are honest which makes them very powerful messengers. Since the horse’s actions and behaviours mirrors the participant’s, the person can identify his own actions in relation to this,” Hart explains. “What unfolds in the arena with the horses is like a window into the participant’s life. For example, they may complain that the horse is stubborn or doesn’t like them. The lesson participants learn is that if they change their own behaviour, the horse responds differently. As facilitators, we try to help the client see this connection.”

Developing connections and encouraging positive relationships is a large component of Hart’s role at Nutana. She will often work with students who typically don’t have a primary care provider to help them find a family doctor rather than going to the emergency department for care. Sometimes, students will continue to see her for health-care needs after they graduate. “I try to connect them to the health-care system outside the school before they leave,” she says.

But the on-going visits are a clear indication of the trust she has established with both the young and adult students. “I rarely have to write a prescription,” Hart says. “We can start an appointment with what’s wrong with their arm, but after a few minutes, or perhaps the next visit, they tell you what’s really bothering them. It is very important to be able to build relationships with the students.”

Nurse Practitioner Karen Hart is among 24 NPs who work in Saskatoon Health Region.

Nurse Practitioner Karen Hart is among 24 NPs who work in Saskatoon Health Region.

Saskatoon Health Region employs 24 nurse practitioners. Many work in rural settings where the need for their professional input is heightened by the busy physician practices and limited access to every day health care needs. Currently, the Region has nurse practitioners working in communities such as Watrous, Wakaw, Duck Lake and Strasbourg. There are also NPs working in acute care and private practice throughout the province.

Hart believes firmly in what she does and the people she works with, both in the school and in the health-care community beyond the building. “The best health care is when we work together as a team.”