Services offered by specialized nurse practitioners

A specialized nurse practitioner (SNP) is a health care professional who can provide advanced medical and nursing care.

An SNP is a nurse with a bachelor’s degree who, after gaining some experience, pursues further university studies by completing a master’s degree in nursing and an advanced graduate diploma (DESS). SNPs hold a licence to practise issued by the Ordre des infirmières et infirmiers du Québec (OIIQ). A mechanism for monitoring their professional activities, overseen by the OIIQ, ensures the quality and safety of SNP services.

In their clinical practice, SNPs mainly serve the general public in collaboration with other members of the care team (doctor, nurse, pharmacist, physiotherapist, etc.). SNPs can refer patients to another health care professional if needed.

SNPs work in five specialties:

• Primary care (public SNP clinic, family medicine group, medical clinic, CLSC, CHSLD, home support, etc.)
• Mental health
• Pediatrics
• Adult care
• Neonatology

In addition to the activities nurses are permitted to perform, such as assessing a person’s physical and mental condition or treating wounds and alterations of the skin, SNPs, depending on their specialty and area of expertise, are authorized to do the following:

• Diagnose illnesses
• Prescribe diagnostic examinations (e.g., X-rays, ultrasounds, blood samples)
• Use invasive or potentially harmful diagnostic techniques (e.g., skin biopsy, lumbar puncture)
• Determine and prescribe medical treatments
• Request consultations with other medical professionals or specialists
• Prescribe, administer, or adjust medications and other substances
• Perform various procedures, such as stitching or joint infiltration
• Provide pregnancy follow-up
• Assess and follow up with a patient as part of a CNESST or SAAQ file
• Prescribe medical leave and document insurance forms when needed
• Provide palliative and end-of-life care
• Perform other clinical activities

People of all ages in need of community-based health care, including people with mental health problems. SNPs provide care and support to these individuals for their health issue, for chronic illnesses (e.g., diabetes, hypertension), and for the treatment of common health problems (e.g., otitis, urinary tract infections). They can also perform minor surgeries, provide pregnancy follow-up for up to 40 weeks, as well as deliver palliative and end-of-life care.

Health needs

Primary health care nurse practitioners can treat common health problems that do not require specialized or ultra-specialized care.

Examples:

• High blood pressure (hypertension)
• Ankle sprain
• Pregnancy follow-up
• Pediatric care
• End-of-life palliative care
• Infections (throat infection, urinary tract infection, otitis, etc.)
• Musculoskeletal problems
• Medical leave, SAAQ, CNESST

Practice settings and colleagues

The following are examples of practice settings of primary health care nurse practitioners:

• Public SNP clinic
• CLSC, home support, hospice
• Family medicine group
• CHSLD, senior and alternative housing
• Aire ouverte (youth services)
• Women’s health
• Family planning clinic
• Infiltration clinic

Interprofessional collaboration (care team):

• Nurse, physiotherapist, nutritionist, social worker, etc.
• SNP from other specialties or areas of care
• Family doctors or medical specialists
• Pharmacists

People of all ages in need of community-based specialized or ultra-specialized mental health care. SNPs provide care and support to individuals with a mental health problem or mental disorder.

Health needs

Caring for patients with a mental health problem or mental disorder.

Examples:

• Bipolar disorder
• Schizophrenia
• Alcohol or drug dependence
• Depression and treatment-resistant depression
• In-patient monitoring to initiate treatment
• Prevention of risks such as suicide

Practice settings and colleagues

The following are examples of practice settings of specialized nurse practitioners working in mental health:

• CLSC
• Outpatient psychiatric or mental health clinic
• Assertive community treatment
• Hospital care unit
• Emergency consultation
• Family medicine group
• Public SNP clinic
• Aire ouverte (youth services)
• Addiction treatment centre

Interprofessional collaboration (care team):

• Nurse
• SNP from other specialties or areas of care
• Physiotherapist
• Nutritionist
• Social worker
• Doctor
• Pharmacist
• Etc.

People under 18 requiring specialized or ultra-specialized care, including for mental health issues. SNPs support children and teens in the management of chronic or acute problems (e.g., cystic fibrosis, asthma).

Health needs

Any complex, highly complex, chronic, acute, or critical pediatric health problem requiring specialized consultation and/or care. Often referred by a physician or primary health care nurse practitioner.

• Uncontrolled or severe asthma, respiratory failure
• Oncology
• Development problems
• Metabolic disorders, inflammatory diseases
• Cystic fibrosis
• Etc.

Practice settings and colleagues

The following are examples of practice settings of specialized nurse practitioners working in pediatrics:

• Public SNP clinic
• Pediatric outpatient clinic
• Hospital care unit
• Emergency consultation
• Intensive home care

Interprofessional collaboration (care team):

• Nurse
• SNP from other specialties or areas of care
• Physiotherapist
• Nutritionist
• Social worker
• Family doctor
• Pediatrician
• Pharmacist
• Etc.

Adults with health problems requiring specialized or ultra-specialized care, including mental health problems. SNPs provide care and support for people with chronic or acute conditions.

Health needs

Management of patients requiring specialized care, often referred by a family doctor, specialist, or SNP.

Examples of medical specialties in which SNPs working in adult care provide care and follow-up:

• Cardiology
• Nephrology
• Rheumatology
• Neurology
• Oncology

Practice settings and colleagues

The following are examples of practice settings of specialized nurse practitioners working in adult care:

• Public SNP clinic
• Specialized outpatient clinic
• Hospital care unit
• Emergency consultation
• Home support
• Assertive community treatment
• Palliative care

Interprofessional collaboration (care team):

• Nurse
• SNP from other specialties or areas of care
• Physiotherapist
• Nutritionist
• Social worker
• Doctor
• Pharmacist
• Etc.

Newborns requiring specialized or ultra-specialized care. SNPs provide care to premature or full-term newborns with health problems.

Health needs

Care of premature or full-term newborns who require specialized or ultra-specialized care for complex, highly complex, acute, or critical health problems for which community-based care is insufficient.

Examples:

• Cardiorespiratory problems
• Artificial nutrition
• Congenital malformation

Practice settings and colleagues

Hospital neonatal unit (intensive care)

Interprofessional collaboration (care team):

• Nurse
• SNP from other specialties or areas of care
• Nutritionist
• Pediatrician
• Pharmacist
• Etc.

SNPs are members of the Ordre des infirmières et infirmiers du Québec.

The following sites provide more information on available training programs, the training required to become a specialized nurse practitioner, and the skills needed to practise this profession:

• Avenir en santé
• Ordre des infirmières et infirmiers du Québec
• Association des infirmières praticiennes spécialisés du Québec