Expanding the role of licensed practical nurses brings care closer to home

For Alicia MacLeod, a Licensed Practical Nurse (LPN) in St. Peter’s, helping people feel supported and cared for in the place they call home is what matters most. 

And now a new pilot project in St. Peter’s is making that care easier for Alicia and her colleagues to provide.

Alicia is part of Nova Scotia Health’s Continuing Care community nursing team that supports people to recover after being in hospital, or to stay in the place they call home and in their community.

“Our team typically cares for older residents and those with mobility challenges that can’t attend a clinic,” says Alicia. “We do a lot of wound care.” 

Community nurses provide compassionate, skilled care, helping people heal, stay well and remain independent in the place where they feel most comfortable, their home. This support can bridge the gap between hospital and home. “Nurses in the community usually have more time to listen, explain care plans and advocate for other supports that may help people live well at home, such as meal programs, health equipment or home care,” says Alicia.

The St. Peter’s nursing team is testing a new approach to improve and bring care closer to home. The pilot program allows LPNs to provide more treatments in people’s homes, including some IV medications. LPNs already give IV medications in hospitals. This project brings that same care into the community, allowing more people to receive treatment at home instead of travelling to a hospital or clinic. Typically, IV medications, which can be delivered outside of a hospital, are provided by registered nurses (RNs).

With added education/training and clear clinical oversight, LPNs with Continuing Care in St. Peter’s can now practise closer to their scope of practice. For Alicia, this pilot builds on skills she already used in hospital settings. “Before I began working as a community nurse about four years ago, I provided IV medications in acute care in the hospital,” says Alicia. 

This change may sound small, but it can make a big difference. This adjustment will increase the staff in the community who have the training, skills and education to provide this care.

The benefits also extend to the broader health system. By matching care needs with the most appropriate provider, the pilot helps make better use of limited nursing resources. RNs can focus on more complex cases, while LPNs handle care that fits within their training. This improves efficiency and reduces pressure on hospitals, all while maintaining safe, high-quality patient-centred care.

Receiving care at home means less waiting and fewer hospital visits. For older adults, being at the place they call home can reduce stress and confusion while keeping them close to family and their community. In rural areas like St. Peter’s, home‑based care is especially meaningful, helping people avoid long drives, particularly during Cape Breton’s tougher winter months.

Equally important is the human connection. Community nurses often care for people they know. “I grew up in L’Ardoise, about five minutes from St. Peter’s, so I know many of my clients, or they know my family,” she says. “Seeing a familiar face is helpful, especially for older people who may feel uneasy about strangers in their home,” she says. “We are caring for our neighbours the way we always have, which is the Cape Breton way.”

By expanding the role of LPNs, this pilot shows how smart changes can strengthen community care, bringing the right care to the right place, at the right time. The pilot is supported by Nova Scotia Health’s Interprofessional Practice and Learning team and the Nova Scotia College of Nursing to ensure strong training, oversight and evaluation. Lessons learned in St. Peter’s will help decide whether this model can be expanded to other communities.

If you or someone you know needs help to stay at the place they call home, Nova Scotia Health Continuing Care can assist. Call 1-800-225-7225 or visit www.nshealth.ca/continuing-care

Photo of Alicia MacLeod.