Nurse prescribing improves access to care at the Northern Alberta Continence Services Clinic

For many women, getting help for continence concerns means multiple appointments, repeated assessments and long waits between visits.

That experience is changing for women who are patients at the Northern Alberta Continence Services Clinic located at Covenant Health’s Misericordia Community Hospital. Since mid-September, three registered nurses at the clinic have received specialized training that allows them to prescribe select medications and pessaries (medical devices that support the pelvic organs and treat incontinence) as part of their patients’ care.

“We’re already doing the assessment and the education,” says Alicia Jones, registered nurse. “Prescribing pessaries allows us to complete that care instead of stopping part-way through.”

Along with Alicia, the training has included registered nurses Cathy Grant and Nancy Dar. It is part of a nurse prescribing initiative that aims to improve patient access and continuity of care while allowing nurses to work to their full scope of practice. The initiative reflects Covenant Health’s commitment to compassionate, efficient, whole-person care.

A smoother path to care

Before Alicia, Cathy and Nancy began prescribing pessaries, patients had to book follow-up appointments with their family physician to obtain prescriptions as part of conservative continence treatment. That extra step added time, inconvenience and stress.

Now, care can often be completed in one visit.

“Patients are relieved,” says Cathy. “They’re grateful not to be sent somewhere else to finish the process. Everything happens here, and they can move forward right away.”

The change is especially meaningful given the personal nature of continence care.

“These are intimate conversations,” says Nancy. “Building a relationship with one provider instead of repeating their story again and again helps patients feel comfortable and supported.”

Clinic staff say patient feedback has been overwhelmingly positive, with many patients describing the clinic as professional, knowledgeable and a safe place to receive care.

A meaningful impact

In the first two months after the initiative launched in September, the nurse prescribers at the clinic wrote 37 prescriptions. For Jodi Normandeau, a unit manager for the clinic, the number represents more than improved efficiency. 

“That’s 37 patients who avoided extra appointments and unnecessary delays,” Jodi says. “It’s time saved for patients and for the health system.”

By streamlining care, nurse prescribing also reduces pressure on community physicians.

“It creates a true one-stop experience,” Jodi says. “The nurses here are specialists. Allowing them to prescribe completes the circle of care.”

Unit manager Nancy Maykut says the pilot was carefully designed to strengthen the clinic’s nurse-led model while keeping patients at the centre.  

“Our nurses are continence specialists,” Nancy M. says. “They’ve always had the knowledge to recommend these treatments. Now they can apply that expertise fully and prescribe what’s appropriate, without bouncing patients between providers.”

Built on knowledge, training and teamwork

Before beginning to prescribe medications and pessaries, the clinic nurses completed advanced education focused on pharmacology, clinical decision-making and regulatory standards. They also developed clinical support tools to guide safe prescribing.

“It’s a big responsibility,” Alicia says. “You look at the patient more deeply and think very carefully about every decision. The education prepared us well for that shift.”

Cathy says the experience strengthened both their individual and team practice.

“We went through the training together,” she says. “That collaboration made a huge difference. We talked through situations and supported each other.”

Designed for safe, sustainable care

The Northern Alberta Continence Services Clinic was selected as the first site for registered nurses and registered psychiatric nurses to serve as prescribers after extensive planning, says Kim Strach, Covenant Health’s clinical workforce planning senior practice lead for nursing.

“This work started well before the initiative launched,” Kim says. “We focused on building the policy, framework and supports needed to ensure (nurse) prescribing could be done safely and responsibly.”

Because the clinic serves a defined population and prescribes a limited range of medications, it was well-suited for the initiative, Kim says.

“From the patient’s perspective, this improves access and continuity of care.  From a system perspective, it helps ensure everyone is working to their full scope of practice.”

Looking ahead

While Covenant Health continues to monitor outcomes, early feedback from patients and staff has been strongly positive. Nurse prescribing will continue at the clinic, with learnings helping to inform future decisions.

“The registered nurse and registered psychiatric nurse as prescribers initiative is supported by executive leaders as a top clinical workforce planning priority,” says Kim. “We’re exploring additional practice settings where this model could make sense. Any next steps will build on what we’re learning here.”

For the nurses delivering care, the impact is already clear.

“This has elevated our practice,” Nancy D. says. “But what matters most is that patients get timely, compassionate care and they leave feeling supported.”