DPN 2 (midterm)

British North American Act

British North American Act

british law that created canada and made basic constitutional functions

is the BNA the same as the constitution

yes it was renamed

what was the BNA in relation to the provincial governments

it was the federal government, (national umbrella)

what was one think the BNA act did

lay out which government would take care of which aspects of healthcare (federal vs provincial)

responsibilities of the federal government (BNA)

health of indigenous people, health policy and contagious disease, pharmaceutical and food safety

the department of health looked over

pharmaceutical and food safety

the department of health is now known as

Health Canada

provincial and territorial government responsibilities

public health, hospitals and asylums, education

why was it the provinces that looked after social services?

it wasn’t clearly laid out in the BNA act

Insanity act is now known as

Mental Health act

which act was passed following the BNA act

Insanity act

Asylums according to islamic society

seen as a retreat from society centered on compassion and peaceful environment. believed that early intervention and several months of rest people with mental ilness could be cured

Asylums according to European society

built on ideas of demonic possession and sin

Bedlam

european travel destination to watch mentally ill people as a form of entertainment

the first hospital to specialize in mental health

Bethlem Royal Hospital

Philippe Pinel

introduced Moral Therapy to mental health treatment; More humane approach

Moral therapy

social and psychological approaches to Mental Health; Phillippe Pinel

Dorthea Dix

advocate for humane treatment of patients. influential in changing conditions of mental health facilities

early “cures” for mental illness

radical therapies such as leeching, spinning, hydrotherapy, insulin shock treatment

what was the desired outcome of insulin shock treatment

inducing a coma, hoping for behaviour change for when or if they came out of the coma

Electroconvulsive shock therapy

still used today (in a much less invasive way) to treat depression as a last resort; has been shown to be very effective

Lobotomies

nerve fibres in frontal lobe were severed producing a flat affect

Psychotherapy treatments

began with Sigmund Freud; 1;1 sessions examining pts subconsious desires, repressed urges, and relationships with family and friends, to find explanations for mental breakdowns and personality disorders.

Psychotropic drugs

chlorpromazine, antidepressants, antipsychotics

De-institutionalization lead from

changing values and new mental health treatment philozophies

Canadian Mental Health Association (CMHA)

published the framework for mental health reform begining a new social and political action

what was the goal of CMHA

to medicalize mental health care; treat it as a physical illness

how did psychotropic medications help deinstitutionalizing

made it possible to discharge pts into the community (community care)

why was dehospitalization better than institutionalization

shifted care to the community, more humane, less expensive

why was deinstitutionalization less successful than planned?

discharge rate was faster than resources; resulted in social isolation, stigma, exclusion from workforce, poverty, and sometimes prison

First Canadian Hospital

Hotel-Dieu de Quebec

who formed Hotel-Dieu de Quebec

the french nursing sisters

Order of St John

first aid, disaster relief, home nursing

Canadian Red Cross Society

provided home care

Victorian Order of Nurses

focused on health needs of women and children

Childrens Aid society

food and shelter for disadvantaged children

what is one of the oldest continuing voluntary health organizations in Canada

CMHA

Medical care for the poor (1800-1900)

no healthcare; care was provided by family or overcrowded hospitals

medical care for the wealthy (1800-1900)

Avoided hospitals; hired Drs privately; care provided at home by nurses

traditionally Healthcare provided for indigenous people by

Shamans, Medicine men/ women;

Indigenous philosophy of health

connection to earth; balance and harmony among spiritual and natural elements; Illness was a community problem rather than individual

medical advances from the world wars included

anasthesia; infection control; surgery; triage; stored blood; Xray machines improved; powerful electron microscopes; oximetry; penicillin

blood banks were perfected during

WWI

Hans Selye

stress research

Canadian medical discoveries

Insulin; Artificial kidney machine; lumpectomy for breast cancer treatment; radiation device for cancer treatment; stem cell discovery; first artificial knee joint

Mckenzie King (PM)

amended BNA for national unemployment insurance

National Health Grant Program

money to provinces to update hospitals

Before WWII, healthcare in canada was

privately delivered

Tommy Douglas

believed health was a basic human right available to anyone on the basis of need; leader of first socialist party; premier of saskatchewan;

who lead the way for social reforms for Canada on the basis that health should be available to anyone

Tommy Douglas

first stage of medicare evolution

remove money as a barrier to access care

Municipal and Hospital Services plan

guaranteed residents of saskatchewan hospital care based on insurance premiums

how were physicians paid during the first stage of medicare

a fee for service based on a fee schedule

Hall commission

Report done by Justice Emmett Hall to explore whether medicare was a good idea nationally (based on saskatchewan success)

Hospital Insurance and Diagnostic Services Act

all residents entitled to insured health care upon terms and conditions; introduced by John Diefenbaker (fed government); cost split 50/ 50 (province; federal)

Medicare

publicly funded taxed based system to finance hospital and medical services

Medicare = Medical Care Act

reinforced MDs as primary health care providers as the services of other HCW cost a fee

5 pillars of Medicare

universality; portability; comprehensive coverage; public administration; accessibility

universality

all insured residents are entitled to health care services

portability

health coverage comes with you for a period of time when you move to another province

comprehensive

all insured services must be provided if needed from hospitals and physicians

public administration

each province must run the not-for-profit public authority

accessibility

all insured people are guaranteed reasonable access to insured health care regardless of age, health, and financial status.

what does medicare cover

hospital costs and medically necessary expenses

second stage of medicare

prevention

Federal Provincial Fiscal Arrangements

established the Programs Financing act

why did the federal provincial fiscal arrangement establish the EPF

Healthcare system flourished and spending increased; the government didnt want to share the cost anymore as it became too expensive and the provinces were unhappy with restrictions put on spending

Established Programs Financing Act (EPF)

funding was reallocated to community services, long term care, ambulatory care, and some components of home care; allowed provinces greater freedom in setting their own policies and the federal government to control its share of the costs.

T/ F; very province or territory have its own minister of health

true

ministers of health are appointed by

premiers

T/ F: canada has a single national health care plan

False

Canada Health Act

national health insurance program designed to ensure all residents in canada have reasonable access to medically necessary hospital and physician services on prepaid basis and uniform terms and conditions

Uzoma Asagwara

first elected non-binary MLA in manitoba legislature serving as official opposition critic for health

Healthcare Reform

Hospital cutbacks and services getting delisted due to provinces paying more than feds; physician wages got restricted; user fees and extra billing

extra billing

billing of insured heath service by a medical practitioner in an amount greater than amount paid

Hall Report #2

Emmett Halls investigation found that no one wanted medicare abolished; accessibility added

when was accessibility added to medicare

during Hall report #2

Healthcare reform lobbied for

Canadian Nurses Association; Nurse unions; maintenance and improvement for medicare

Healthcare reform lobbied against

Physicians; Dr strike in ontario; banning extra billing violated rights to contract directly with patients

what happened to hospitals during Healthcare Reform

reduced funding meant closures, restructuring, downsizing, services cuts, and layoffs; public hospitals and number of beds declined; Drs and Nurses left the country; nursing education programs were also cut

what lead to provinces introducing extra billing

increased healthcare costs

Senator Michael Kirby

said Medicare was not sustainable; suggested new taxes or insurance based income; privitazation

Royal commission

official inquiry into matters of public concern

the Commission on the Future of Health Care in Canada

a Royal commission to preserve medicares survival

Romanow Commission

consultations across the country; HC was sustainable; Recommended policies and measures to improve system and long term sustainability including reducing wait times; create a health council of Canada

Rural and Remote Access Fund

improve timely access to care in rural and remote areas

Diagnostic Services Fund

improve waiting times for diagnostic services (i.e. MRIs)

Primary Health Care Transfer

provide funding needed to accelerate development and implementation of primary care

Home Care Transfer

provide foundation for eventual national home care strategy

Catastrophic Drug Transfer

allow provincial and territorial drug programs to expand and improve coverage for residents, especially in conditions that can lead to serious financial burdens

what were Romanows Recommendations

Rural and Remote Access Fund; Diagnostic Services Fund; Primary Health Care Transfer; Home Care Transfer; Catastrophic Drug Transfer

BNA Act divided

Federal and Provincial responsibilities

Medical advances moved healthcare delivery from ____ to ______

Volunteer agencies; hospitalsreco

very from Great Depression called for the need of

social safety nets

Reaffirmation of medicare was done through

Canadian Health Act; Kirby Report; Romanow Commission

why do we care about history of nursing

builds context; understand transformation of the profession in regards to gender, practice, and healthcare; explains the future and provides a way to look forward

Canadian Association for Shools of Nursing (CASN)

believes nursing programs must include foundational courses including history

according to CASN, history explains the present by

recognizing that what happens in the present is not an accident; its got a past

Isabel Maitland Stewart

graduate of Winnipeg General Hospital Training School for Nurses; believed in tracking social and political trends including HC policies

a quote from Isabel Maitland Stewart

nurse educators should prepare nurses for not only wat is but also what might be