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The best things come out of the hardest times

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Andrea Van Hal sits on a set of steps, leading to a beach.

Meet Andrea Van Hal, RN Prescriber at Twin Oaks

Nursing runs in Andrea Van Hal’s family. Her mother was a nurse and spent 33 years as a clinical leader in a 60 bed nursing home. And Andrea’s aunt (and her mother’s twin) was also a nurse.

“I knew from a relatively young age that I wanted to do something in healthcare,” said Van Hal. “I had a very strong example set for me, of nurses who loved their jobs. And they were really passionate about what they did.”

Van Hal has been a Registered Nurse for 20 years. She first worked on the inpatient pediatric unit at the IWK, then moved to the IWK’s emergency department. She left that position a little over a year ago, and now works at the Emergency Department at Twin Oaks in Musquodoboit Harbour.

“With a pediatric and emergency background, I can honestly say I have never been as enthusiastically welcomed as when I arrived at Twin Oaks,” said Van Hal. “Pediatrics can be unnerving to a lot of people who are not used to working with children, especially in emergency situations. And so, my colleagues were quite happy to have my experience and knowledge to draw on at Twin Oaks. It’s been really great to feel so appreciated.”

In 2021, Van Hal became aware of the RN prescribing program at Dalhousie University and felt that it would be a new and exciting challenge to take on.

Registered Nurses in Nova Scotia, who have completed advanced, post-secondary education, can now prescribe a limited number of medications, devices and order relevant screening or diagnostic tests within their specific areas of expert nursing practice. This model has already been effectively implemented in other Canadian provinces and over twenty years ago in the United Kingdom and other parts of Europe.

Van Hal graduated in 2022 and is part of the first cohort of RN prescribers practicing in Nova Scotia. She was also the first RN prescriber hired to work in the Emergency Department specifically in this role, above the hospital’s core number of nurses. This newer, expanded role is an extension of her RN position, and allows her to really practice more efficiently and provide nursing care more seamlessly.  

“I think nurses are uniquely positioned in the care that we provide, and the way we provide care, to really establish relationships with the patients,” said Van Hal. “We all come with experiences that we can utilize to really better improve access and make the overall system work more efficiently.”

When she started practicing as a prescriber, Andrea and her manager looked at the data from the emergency department, and which days had the highest volume of patients, longest wait times, and the busiest hours. They used that information to create her schedule and provide extra support on the unit during the highest volume times.

“I can still do all the RN duties with the added scope of prescribing and being able to see patients and help improve the flow,” says Van Hal. “This allows physicians to better focus on the higher acuity patients and have me see some of the lower acuity things, where people end up waiting for long periods of time.”

Van Hal notes that her colleagues have been incredibly supportive of her involvement in this program, and her new role at Twin Oaks.

“I honestly can say I’ve never felt so supported in my nursing career,” says Van Hal. “My coworkers, whether it’s the physicians, nursing staff, or management, have all been really excited about how this can help our location.”

Val Hal feels that the education program is only one piece (albeit a crucial one) required of the role and it is the role itself and the expert and educated RNs in it that will make the difference to access to care for Nova Scotians.. She notes that nurses all come into the work with experiences that they can utilize to improve access and also make the overall system more efficient.

“The one thing about challenging times is that if everything worked perfectly, we’d never have innovation,” says Van Hal. “We’d never have innovation or new opportunities. The fact that we have roles like this as an option for nurses gives me hope that things can get better. Obviously, there’s a lot of pieces to it. But sometimes the best things come out of the hardest times.”