Community efforts pay off with new health services for Blue River
By Rachel Fraser
Blue River is benefitting from increased services at its Health Centre, thanks to the advocacy of residents and the commitment of a highly skilled nurse.
Bettina Panio is a Remote Certified Registered Nurse (RN) whose additional training allows her to take on some primary care that is typically outside of the RN Scope of Practice. She travels to Blue River from her home just north of Kamloops to provide health services in the community two days per week.
“We’re trying to expand the services there and show what remote clinics can offer,” Panio said of efforts by Interior Health to find solutions to serve the residents of the small community 116 kms away from the nearest hospital.
The historic Blue River Outpost has previously been staffed by general duty nurses, offering essentially first aid – basic wound care, assessing vitals or educating people on certain health issues – to residents and visitors.
“By moving to the Remote Certified RN, we can provide more collaborative services, link patients to appropriate supports like physicians, nurse practitioners, pharmacy, and provide more clinical services to the patients of Blue River,” said Heidi Schilling, manager of clinical services in Clearwater and the Blue River site.
Panio said the extended services include the ability to diagnose and treat sore throat, bronchitis, urinary tract infections, minor skin infections, “I can assess, diagnose and dispense medications to treat you on very specific conditions and illness that I’m allowed to do (under her certification).”
She can also support her patients in navigating the health system and coordinating care, which she said means helping patients to get telehealth or virtual sessions with their physician, and to help connect with community resources or using telehealth to connect with social workers or psychology/psychiatry.
The good relationship she has with the physicians in Clearwater will mean more effective and efficient care for her patients, according to Panio, and she says one of the benefits of the expanded scope of practice for remote certified nurses is relieving the pressure on clinics and emergency rooms.
Panio also holds Reproductive Health Certified Practice where she can offer nursing services that include contraceptive care and sexually transmitted infection care. This includes the diagnosis and treatment of sexually transmitted infections, pap tests and the prescribing and dispensing of contraception.
Panio and Schilling are working on the contraceptive management piece right now. Since 2023, most prescription contraception is free in BC. “It’s fairly new for nurses to now have the contraceptive medications completely in the clinic,” Panio said.
The insertion of IUDs is not included in her certificate, but she said the option is there to take a course to be able to do it.
Panio says that even though the certifications she’s received allow her to only do certain things, remote nursing offers a lot of add-on course options for her to expand her skills and certifications to be able to offer more and more services out of a remote clinic.
“There’s certain skill sets, [I can] take a weekend course and just be shadowed and then have it completely done… You can definitely branch out whenever you take a course and then just keep going with it.”
She said she’s hoping to get the suture course, so she can do sutures out of the clinic rather than send people down the highway to the emergency room.
“We’re just enhancing and expanding as we can fit things in,” Schilling said.
Panio is in the clinic Tuesdays from noon to 8 p.m. and Wednesdays from 8 a.m. to 4 p.m. Walk-ins are welcome, but Bettina said appointments give her more time to spend with patients, to be thorough or make them more comfortable. Clinic information can be found here.
She plans to start doing education sessions in the clinic as well, either one-on-one or in groups.
Shilling said that two meetings were held with the community over the last year to get a sense of what services community members would like to see.
“We got really great community voices coming forward… that have highlighted what the need is, so that’s really helped us in how we prioritize bring new services in,” Shilling said.
Lee Onslow, TNRD Area B Director, has been advocating for increased services at the Blue River Health Centre since becoming a director.
She would still like to see laboratory collections available in town, a service Panio says is a work in progress. She can currently collect swabs, urine or stool samples, which are sent out for analysis, but blood collection requires special equipment and will take some time to get set up.
“This will save many hundreds of kilometers of travel for our residents, and it would be greatly appreciated,” Onslow said.
Additionally, she said she would like to see a full integration of the tele-health and virtual health systems to allow residents access to medical professionals throughout the province without travel.
“I am proud of these efforts and proud of Interior Health for listening to the concerns of the residents of Blue River, and that they have taken action,” Onslow said.
The ability to administer ECGs (electrocardiogram – a test that records the electrical activity of your heart for diagnostic or monitoring of heart health) is also on Panio’s wish list for the clinic.
“We’re just on a journey right now,” said Shilling. “A lot of great services have surfaced and we’re doing our research (and collaborating with) the other IH partners to look at what’s possible and how we can integrate more services. So it’s just taking us a little bit longer to ensure we’ve got a fulsome infrastructure behind us… to be sustainable moving forward.”
