Author Archives: ARNBC

Back to the future – from evolution to devolution and back again, by Heather Mass, RN

As a granddaughter, daughter and mother of registered nurses (RNs) who, with me, have lived the history of nursing in B.C., and as a registered nurse who was privileged to be involved in the “Association” work of RNABC through the 1990’s and who was involved in the creation of ARNBC, it feels appropriate for me to share my thoughts on the history of nursing in this province at this time. It is my sincere hope that B.C. nurses will urge BCNU to put aside the belief that “power shared is power lost” and instead recognize wisdom of once again having three arms.


Beginning in 1909 when a small group of registered nurses formed the Graduate Nurses Association of Vancouver (GNAV) through to today, RNs in British Columbia have worked to create organizations that would support us and our profession. As these nurses achieved their goals, or as circumstances changed, the nursing organizations evolved – the GNAV evolved into the Graduate Nurses Association of BC (GNABC) which, in turn, evolved into the Registered Nurses Association of British Columbia (RNABC), which ultimately spawned the BC Nurses Union.

While each evolution occurred in response to changing circumstances, each “new” organization also continued to carry out three key functions:

1.  Regulation of the profession to protect the public (a regulatory function): members of the GVAV/GNABC/RNABC all lobbied for legislation that would require nurses to be registered and to ensure that people who call themselves “trained” nurses had the necessary competencies to provide safe care. Although the first step – the passing of the Registered Nurses Act was achieved in 1918 (in GNABC days), regulation did not become mandatory until 1988.

2.  Advocacy on behalf of the profession for improvements to health care and nursing practice (an “Association” function): from the beginning members of the GVAV/GNABC advocated on many issues related to health care and the profession, including championing improvements in nursing education to ensure nurses providing care were competent. As a result nursing education moved out of the patch work of “apprentice” programs that were common in the early 1900’s into institutions of higher learning which are the norm today. With the passage of new legislation – the Nurses (Registered) Act – in 1935 GNABC evolved into RNABC. While continuing the work of pursuing improvements in nursing education and working conditions, the RNABC’s Objects also permitted the Association to carry out initiatives designed to “Uphold the integrity of the nursing profession and support its contributions to the health and welfare of the people of British Columbia”.

3.  Acting in the interests of registered nurses (a labour relations function): the GVAV/GNABC/RNABC also worked hard to address issues of pay and working conditions for nurses. In 1976 a labour relations arm was created at RNABC to serve as a negotiator for better wages and working conditions for RNs.


By the late 1970’s it was becoming clear that while all three of these functions were necessary pillars of support for professional nursing, there was also a growing perception that having one organization perform them all was a conflict of interest. Once again, changing circumstances led to changes in the Organization and – over the next 30 years – resulted in the devolution of what was one all-encompassing organization into three separate ones. This devolution occurred in three steps:

1.  As efforts to address issues related to pay and working conditions of registered nurses grew, so did the recognition of a potential conflict of interest for organizations that were mandated to regulate nurses in the public interest also negotiating on their behalf for improved pay and working conditions. In keeping with similar actions in other Canadian provinces, in 1981 RNABC supported the severing of its labour relations arm. To assist with the development of a separate organization that would take up this work for nurses, RNABC provided both funding (2.7 million/year) plus staff to support the creation of the BC Nurses Union. With this devolution RNABC focused its efforts on the remaining two functions: regulating and, where it did not conflict with regulatory functions, upholding the integrity of the profession and enhancing the health and welfare of the people nurses served.

In 2005, as part of a broad restructuring of regulation for health professionals, registered nurses came under the provisions of the Health Professions Act, and nurse practitioners were introduced in B.C. The Act mandated that regulatory organizations focus exclusively on protecting the public through professional regulation. With this changing circumstance, RNABC evolved to become the College of Registered Nurses of BC (CRNBC) and once again the potential for conflict of interest arose. Although perhaps not as obvious as the conflict between regulating the profession and bargaining on its behalf, as CRNBC restructured to focus exclusively on regulation it gradually began to sever “association” functions. Among other things, it no longer launched projects and initiatives designed to demonstrate and build further awareness of the full scope of the practice of registered nurses or the importance of integrating nursing knowledge into policy decision-making at the government level. Projects that RNABC had once mounted, such as the “New Directions for Health Care” papers that made RNs among the first providers to advocate for primary health care and describe the role of nurses in it, and the Comox Valley Nursing Centre Demonstration Project or the RN First Call program that demonstrated the importance of nursing’s role in promoting health and preventing disease were now determined to be in conflict with the College’s regulatory mandate. Although BCNU made efforts to fill the resulting gap by picking up some of the “association-type” functions, concerns about a conflict of interest between negotiating on behalf of nurses on issues of salary and working conditions and “Upholding the integrity of the nursing profession and its contributions to the health and welfare of the people of British Columbia” began to arise. So even though the “association functions” were devolved – there was no organization developed to pick them up.

2.  Withdrawing from CNA: The Canadian Nurses Association (CNA) is primarily an “Association of Associations”. CRNBC – with its mandate is to regulate the profession in the interests of the public – was now a regulatory college. Since it was no longer an “association” CRNBC Board served notice that its membership in CNA was inappropriate. Again, because there was no organized developed at the time CRNBC was established to take up the “association” arm of RNABC (and no transfer of funding and resources to support its work) there was no organization that could readily assume the role of representing B.C.’s RNs and NPs at CNA.

Evolution – Round 2

At the same time as RNs began to notice the withdrawal from CNA and the loss of a professional voice for registered nurses in British Columbia, nurse practitioners, the newest addition to the nursing family under the Health Professions Act, came together to form the BC Nurse Practitioner Association (BCNPA) which has a rich 10 year history of advocating for NP professional issues in B.C. and provided an answer to the very same concerns that RNs were facing with the introduction of the Health Professions Act.

For many nurses in B.C. the notice of withdrawal of CRNBC from CNA was a “wake up call”. For others who had watched this progressive loss of an Association it was the “final straw”.

Once again a group of registered nurses came together to create a Nursing Association that could pick up the third function: to advocate for improvements in health care for those we serve, and to ensure the involvement of RNs in the forums where decisions that will effect both the health care system and nurses role within it are made.  In 2009, out of this effort, “evolution – round 2” was begun. In 2010 ARNBC was born, and, like BCNU before it, negotiated the transfer of funding and resources from CRNBC that had once supported “association-type” work at RNABC.  The association now works closely with its three counterpart professional associations (ARPNBC, BCNPA and LPNABC) to work collaboratively on health and nursing policy issues.

Today RNs are once again supported by three separate but essential organizations – college, union and association. Ideally these organizations would, while each carrying out their unique mandate, collaborate and cooperate with each other to ensure that the vision of our colleagues in 1909 lives on. Sadly, it seems that this vision is at risk because of BCNU challenging ARNBC’s right to exist and to undermine its role with registered nurses, nurse practitioners and others. It seems that the Union believes that the new Association will somehow undermine its power.

If we can work together we will all be stronger!


heathermHeather Mass is a nurse consultant. Prior to retiring she has held a variety of senior positions in nursing and health care administration, including the Chief Nursing Officer position for the British Columbia Children’s and Women’s Health Centre, and the Provincial Health Services Authority (PHSA). In the 1990’s she worked with the Registered Nurses Association of British Columbia as a Policy Consultant. During her time there she managed several innovative projects, including the Comox Valley Nursing Centre Demonstration Project and the RN First Call Project. She was a founding member of the group of nurses who initiated the development of the Association for Registered Nurses in British Columbia and continues to take an active interest in its success.

Seniors Advocate Takes a Strong Stance on Housing for Seniors, by Kathryn Seely

Seniors Housing in B.C.: Affordable, Appropriate, Available is a new report launched May 21, 2015 by the Office of the Seniors Advocate. This document makes progressive and bold recommendations that will enable better care for seniors and should be reviewed, discussed and acted upon by all B.C. nurses.

I was pleased to join Julie Fraser, President of ARNBC, and Patrick Chiu, RN/MPH Student and ARNBC Intern, at the release of this transformative report. There was a lot of energy in the room, which was packed with engaged and active seniors, advocates and stakeholders.

The report outlines the housing issues faced by B.C’s seniors living across the continuum from independent housing, to assisted living and to residential care, and finds that seniors’ housing must be more affordable, appropriate and available.

B.C. has the fastest growing rate of seniors in Canada. Although 93% of B.C.’s seniors live independently, 50% live on an income of $24,000 per year or less. According to this report, this is not adequate to maintain independent living conditions.

Over the course of the last year, the Seniors Advocate, Isobel Mackenzie, travelled across the province and met with thousands of seniors and their families. At each consultation she attended, housing and housing expenses were listed among seniors’ top concerns.

In her report, the Seniors Advocate urges the B.C. government to implement 18 recommendations to improve the health outcomes for low income seniors. We were impressed by the boldness of some of these recommendations, and hope nurses will take this opportunity to provide comments and feedback on this important report.

Seniors Housing in B.C.: Affordable, Appropriate, Available recommends that the B.C. government help low income seniors live in their homes longer by offering a government-backed line of credit, called a Homeowner Expense Deferral Account, which would allow low-income seniors to defer paying for utilities, home insurance and repairs until after their home is sold. This would help seniors live independently, and prevent them from paying housing expenses instead of healthcare needs, such as medications, dental care, hearing aids and medical supplies. Once their home is sold, the B.C. government would recoup its money, along with a low-interest charge. There is precedent for such a program in B.C.; seniors are able to defer their property tax payments under B.C.’s Property Tax Deferment program. The Office of the Seniors Advocate crunched the numbers and a homeowner deferral program is sustainable – most seniors would still have equity in their homes after 20 years.

The Seniors Advocate also recommends that the Registered Assisted Living program be redesigned to support more flexibility in the services offered, allowing more seniors to live independently for as long as possible. Ms. Mackenzie estimates that up to 15% of seniors in residential care could still be living at home with extra assisted living.

The other recommendation that caught my attention is that the B.C government commits to ensuring that by 2025, 95% of all residential care beds in the province will be single rooms equipped with ensuite bathrooms. A private bedroom and bathroom is enormously important to seniors, who view this as preserving privacy and dignity, at a very vulnerable time in their lives.

Please feel free to access the report, read the recommendations and let us know what you think by posting your comments.

Nursing knows the impacts that the social determinants of health have on the health of seniors and is pleased to see that the Seniors Advocate puts housing at the top of the list.

At ARNBC, we look forward to working with nurses and other stakeholders to improve seniors’ health and health care for seniors. As the Director of Nursing and Health Policy, I am committed to advancing policies that will improve seniors health, and would like to hear from nurses who have interest, expertise, or innovative ideas in this area. As the Seniors Advocate stated, these recommendations can only come to life, if we all make our voices heard.

Office of the Seniors Advocate News Release

Executive Summary


kathryn2Kathryn is a former nurse and lawyer who has spent the past decade working in the area of public policy and advocacy. Kathryn believes that effecting policy change is one of the best tools we can use to improve health outcomes and looks forward to working collaboratively with stakeholders to help develop nursing and heath policy in B.C to advance the health outcomes of British Columbians.  Kathryn is ARNBC’s Director of Health and Nursing Policy.

Why We Need ARNBC: The Comox Valley Experience, By Betty Tate, Trish Sanvido and Jessie Shannon

We are saddened by the legal action BCNU has taken against ARNBC and CRNBC and have been reading with interest the comments nurses are making. We hear some nurses asking why we need three organizations to represent nursing and in particular why we need the ARNBC. The ARNBC was the impetus for us to develop a community of dedicated and passionate practicing, retired and student nurses in the Comox Valley and continues to support us to advocate for the health care needs of members of our community. We would like to share our development and actions as an example of why we need ARNBC working in collaboration with BCNU and CRNBC in B.C.

In the fall of 2012, a group of 4th year nursing students at North Island College, as part of their leadership practice, researched the mandates of CRNBC, BCNU and ARNBC, understood the difference between their three roles and decided the Comox Valley needed a local ARNBC network to enhance the professional voice of nurses locally. The students distributed information, visited nurses in practice, talked with nurses who had been engaged in the Comox Valley RNABC Chapter and in Dec 2012 the first meeting of the Comox Valley Network of the ARNBC was held. Nurses who attended the meeting were very enthusiastic about having a forum to discuss local nursing issues and to move forward with action on some of the health issues in our community.

Since then our network has grown to over 100 retired, practicing and student nurses and we have:

  • Provided a valuable forum for nurses across multiple contexts of nursing practice to relationship build, support one another, find their professional voice and address issues
  • Engaged in the development of a new hospital being built in our community to increase the nursing and nursing education voice in the design
  • Engaged with the CEO on the plans for re-development of the existing hospital in our community and what services will be provided there
  • Connected with the Division of Family Practice on their primary heath initiatives in the community
  • Advocated for a renewed Federal-Provincial Health Accord
  • Engaged with Canadian Nurses Association to be informed about and participate in national nursing initiatives
  • Attended a Day at the Legislature organized by ARNBC where we met with the Minister of Health, Opposition Health Critics (both NDP and Green Party) and Ministry of Health staff to advocate for nurses and nurses voice at provincial policy tables.
  • Formed a Political Action Committee to address homelessness in the Comox Valley and to promote primary health care. To date we have been very successful with a campaign to vote yes on a referendum to support a tax to reduce homelessness in our community, lobbying local politicians to move forward with a housing project and begin a process to develop a regional service to address homelessness.

None of these activities would be possible without the ongoing Board, staff and financial support from the provincial ARNBC. For example, ARNBC has assisted us to be politically active by working with us in two workshops where we learned to define an issue, develop a campaign around the issue, write and present a brief to politicians and engage other members of the community in our advocacy. ARNBC has assisted us to connect with other nurses provincially and nationally. We have formed a bond between retired nurses, practicing nurses and student nurses in our community and we continue to reach out to more and more local nurses. We are respected in the community as a voice for nurses and feel empowered to continue to speak up for our rights and the rights of our community.

In our view neither BCNU nor CRNBC could or would have provided us with the support we needed to develop and grow – it simply is not within either of their mandates. We feel that ARNBC has filled the void that came about when CRNBC became a regulatory college and we lost local chapters and a professional association. As much as we respect and value the work of BCNU we know they did not fill this void in the years after local RNABC Chapters ceased nor can they speak for all nurses in B.C. as the ARNBC does.

We ask that BCNU stop the legal action with ARNBC and CRNBC and allow all three organizations to flourish and support nurses in B.C. to raise their voices in unison to positively impact nursing, health and health care across our province.


CVThe Comox Valley Network was formed in 2012 by a group of students who recognized the need to enhance the professional voice of nurses locally.  The group has continued to grow and has become a strong political and policy voice for health and nursing policy in the Comox Valley.  For more information contact




Current Lawsuits of BCNU, by Jessie Mantle, Retired RN

This blog is a copy of a letter addressed to union representatives in the south island area and which was copied to the Executive Director of ARNBC as well as the College of Registered Nurses of British Columbia. It is reproduced here with the permission of the author.


I write as a retired nurse in Victoria and a former member of the BC Nurses Union, although the name has changed since I belonged. I write with sadness as I read about the legal proceedings being pursued by the union against its brothers and sisters in the other nursing segments of our organized profession. In my career I belonged to and supported strongly the growth of the Nurses Union in its struggle to gain the rights of nurses in all fields to bargain for fair working conditions. You might understand my viewpoint and feelings when I note that I voted in the very first strike ballot of BC nurses in the 1950’s. Further when I was a teacher at St Paul’s Hospital School of Nursing (we were in the union at that time) we teachers asked that we not receive an increase in wages so that Head Nurses could bargain for a wage equal to ours (at that time they were paid much lower than we were and yet they were every bit as important and as busy). That negotiation was successful as I recall and reflected how nursing could care for all its members without competition or playing one aspect off against another. I was a very proud union member! Over the years I have seen that inclusive mood change as nurses in many areas – not just unions – set up territorial boundaries that divided nurses against each other.

Why does this matter? Over my lifetime of 80+ years I have witnessed in many areas of society and all over the world, that a house divided ultimately and always destroys itself. I fear this is happening to nursing. These lawsuits take the competitive battle to a new level of conflict. I am sure the union has a case to make for its grievance. But have you thought of the inevitable consequences of the approach you have taken? This move by the union provides ammunition to our adversaries. Consider that when registered nurses are under threat from the increasing use of non-registered personnel, when there is government intrusion into the rights of workers (here I ask you to review the issues being faced by the teachers’ union ) and the possible introduction of new non-nursing roles such as physician assistants, we are truly at risk. Our adversaries will argue that we cannot be viewed as accountable for the nursing care offered to the public because we have to resort to legal suits to get what one part of the profession wants at the expense of the other parts. To support this they will argue that as a profession we cannot manage our own internal affairs. They will argue that we ignore the professional standards we claim to meet – standards that protect the public and offer the assurance of safe care to our clients and patients. And they will argue that any group that attacks its own peers cannot be trusted to protect the public.

I cannot believe that the demise of the nursing profession in society and as we now know it, is the goal of the union. Thus I ask, indeed I beg, that you reconsider your approach to whatever problems you are facing and demonstrate the creativity and caring by which nursing has always been known and which forms the basis of trust that the public has always bestowed upon us.


Jessie is a graduate of the Royal Jubilee Hospital (1953).  She retired from the position of Clinical Nurse Specialist (Gerontological nursing) in 1995.


A Call to Cease Hostilities, by Paddy Rodney, RN

I love nursing. I loved it from the minute my feet ‘hit the ground’ as a nursing student 42 years ago and through all my clinical practice, teaching and research ever since. As I am sure is the case for most nurses reading this blog, my experiences caring for individuals, families and communities have taught me fundamental truths about what it means to be human, and I have treasured the nursing colleagues (including students) whom I have learned from and with.

I am fortunate to have had the privilege to witness and participate in constructive political action in nursing. I became one of the first BCNU stewards in 1981 when the labour relations division of the Registered Nurses Association of BC (RNABC [1]) broke away and formed an independent union ( And in 2009 I joined a group of nurses that led to the formation of the Association of Registered Nurses of BC (ARNBC) ( I became involved in the BCNU and the ARNBC because, like so many other nurses, I am passionate about the well-being of individual nurses, of our profession as a whole, and of the public we serve. I believe that in our economically constrained era, it is crucial that the foundational pillars of a regulatory college, a professional union, and a professional association stand together to support nursing practice [2].

However, I don’t love the political conflicts that erupt from time to time in nursing—especially right now in BC. The September 2013 lawsuit by the BCNU against ARNBC and CRNBC, alleges that CRNBC should not have provided a $1.5 million grant to ARNBC to support start-up costs. These start-up funds were intended to enable ARNBC to take over association-related duties that CRNBC was no longer able to fulfill, and to enable ARNBC to act as the member-driven professional association which nurses identified was missing in the Province. (Read CRNBC: Information about BCNU lawsuit against CRNBC and ARNBC)

The more recent action stems from the Association’s Extraordinary Meeting in February, which was held to update ARNBC’s bylaws and rectify some inconsistencies that occurred when ARNBC, as a fledgling organization, was non-compliant with the Societies Act (the Association chose to utilize electronic voting for Board Members in order to provide opportunities to vote to B.C. nurses from all parts of the province, despite the fact that our bylaws indicated a vote by ‘show of hands’ was required). This latest legal action actually seeks to declare almost everything ARNBC has done “null and void”, replace the board of directors, and cancel our May 28th AGM. Both legal actions seem like an overly strong response to an organization (and its individuals) that are working hard to build an Association that supports nursing and patients.

These attacks on the ARNBC right now risk all three pillars supporting nursing in BC. The association could lose its fiscal and administrative stability, the regulatory college could find itself without an arms length body to take up advocacy work, and the union could find itself losing a great deal of capital—dollars spent on legal onslaughts and respect lost from nurses, the public, and other unions.

So, in closing, I am requesting that these legal hostilities cease. None of our three organizations is perfect, but we need to build better communication and collaboration strategies, not try to destroy each other. Nursing needs and deserves better.


paddyPaddy Rodney, RN, is a nurse educator with a speciality in ethics. Paddy is currently an Associate Professor at the UBC School of Nursing and is affiliated with the UBC Centre for Applied Ethics, Providence Health Care Ethics Services, and the Canadian Bioethics Society. Over the last 25 years, she has lectured and consulted on nursing ethics for nursing associations and unions.



[1] The RNABC became the College of Registered Nurses of BC (CRNBC) in 2005 after the BC government brought in the Health Professions Act, which called for the separation of regulatory (public protection) from association (advocacy) functions.

[2] Duncan, S., Rodney, P.A., & Thorne, S. (2014). Forging a strong nursing future: Insights from the Canadian context. Journal of Research in Nursing, 19 (7-8), 621-633. See also International Council of Nurses (2014). Pillars and programmes. Available at: (accessed 30 May 2014).

My Journey with ARNBC, by Linda Axen, RN

Congratulations on finding your way to the ARNBC webpage! By cruising through the website and reading blogs you have already taken your curiosity from thought to action. I also took that step exploring ARNBC online a few years ago and now I find myself privileged to sit on the Board of Directors representing the diverse voices of nurses working in northern B.C. This blog is my story of taking action which I hope will inspire some of you who have been thinking about becoming more active in your profession to find ways to take the next steps.

A professional high-point for me was having the opportunity to attend and present at the Canadian Nurses Association 2012 Biennial Conference. Attending that conference, soaking in the words of Canadian nursing leaders was an awe-inspiring event. I encourage all nurses to endeavour to attend at least one CNA conference for the simple yet profound sense of professional pride you will enjoy. Of particular interest was the sharing of the report A Nursing Call to Action: The health of our nation, the future of our health system. It filled me with hope and a sense of purpose that nurses throughout the country were capable of contributing to solutions to better the health of Canadians.

In early spring of 2014 I received an email notification that nominations for the ARNBC Board were open. I wanted to have my name put forward but at the same time I was very nervous and reluctant to compete for a Regional Director position. I overcame my fears only because I knew my regrets would haunt me if I didn’t try for the position. I am so happy that I took that risk. As a Board Director, I have attended meetings which occur approximately five times a year face-to-face and a few times per year by teleconference. The time commitments for connecting with nurses in the regions vary for each Board member. At every meeting and teleconference I am continually inspired by the passion that fellow Board members exhibit in representing nurses throughout the province. I am proud to think   that time spent on Board activities Board allows me to contribute my voice to influencing positive change on social and health issues in British Columbia.

So if you are like I was a few months ago, thinking about being more active in representing the voice of nurses, take the time to familiarize yourself with the webpage, explore becoming a network lead or consider contributing your voice on the Board of Directors. Nominations for Directors are open, so visit our website for more information  and consider letting your name stand for nomination. It’s a decision you won’t regret.


Linda1Linda started with Northern Health in October 2011 as the Nursing Research Facilitator and is currently the Northern Health Cardiac Triage Coordinator. Prior to the Nursing Research Facilitator role, Linda worked for many years in clinical research in Vancouver including five years in Cardiology Research at Vancouver General Hospital. In completing her Master of Nursing in 2011 from the University of Victoria, Linda gained a greater understanding of the contributions nursing makes to health policy development and the complexities of the social and environmental forces within which nursing has developed as a profession.

Concurrent to working in Northern Health as the Nursing Research Facilitator, Linda co-taught the Introduction to Nursing Research course at the University of Northern BC. Working with the students afforded Linda insight into the amazing strength, energy and professionalism that newly graduated nurses bring to our ever-evolving work environments. Linda is passionate about encouraging practicing nurses to develop expertise in research and research-related activities and evidence-informed practice. Linda has been actively involved in the BC Ethics Harmonization Initiative and is a certified member of the Society of Clinical Research Professionals. She is well aware of the powerful economic contribution the north makes to the overall fiscal strength of our province and recognizes that this economic contribution requires a healthy and robust workforce.

Budget Lockup: Insights from ARNBC, by Zak Matieschyn, NP

Recently, I had the privilege of joining Joy Peacock, Executive Director of ARNBC, in the B.C. Budget Lockup. For those who are not aware, this is a secured room wherein around 200 stakeholders have an advanced preview of the details of the budget and service plans. This is also where the media interviews these stakeholders in order to get their stories aired in a timely manner following the budget speech.

This was the first time ARNBC was invited to participate in the Budget Lockup – an event that can only be attended by invitation of the Finance Minister. Beginning January 1 of this year, ARNBC entered a new phase, and is now a member-driven organization representing all B.C. registered nurses and nurse practitioners. Being invited to participate in Budget Lockup was a strong signal of how government views the importance of the Association and the work we’ve been mandated to do.

The budget itself was a relatively benign affair for healthcare. Increases to healthcare spending will be a very modest 2.9% per year. My review of the Ministry of Health service plan noted much of the same language as last year: commitments to primary disease prevention and health promotion, improving primary/community care through inter-professional teams, and improving rural healthcare to name a few. From a theoretical perspective – this is music to the ears of the nursing profession. As we know and have been educated, these points are among the mainstays of what are needed to reform healthcare. What is concerning is a lack of a blueprint of how we get there. We are talking about a fundamental shift in how healthcare is delivered to become more up-stream, integrated, and team-based. Uttering the correct words is a fine start, but such an objective will require dedicated monies to operationalize this plan, as well as an understanding that this will be a front heavy, longer term process. That is, the benefits will be slower to materialize than can fit in a single budget year or government election cycle. The other point lacking is collaboration with nursing. Registered nurses and nurse practitioners possess exactly the knowledge and expertise of a healthcare system described in the service plan. It is simply a waste of available talent, capacity and leadership to exclude nursing from the spheres of policy planning and implementation.

Also disappointing was the lack of mention of nurse practitioners when commenting on plans for improving access to full service primary care. Over the past 10 years, NPs have slowly been implemented to improve access for British Columbians to primary health care – both in urban and rural settings. Once again, new NPs find themselves without an existing hiring initiative, let alone a robust funding model, to permit them the opportunity to improve primary healthcare access to regions of the province in desperate need of help.

On the brighter side, I was pleased to observe the significant step of eliminating the clawback of child-support payments for single parents on income or disability assistance. This is a relatively low cost intervention (costing only $19 million annually but helping to lift nearly 6000 children out of poverty) which directly impacts the health of these individuals and the health of our society. Nursing has long known the impacts of social determinants on health and government would do very well to continue to explore these evidenced based health and social policy reforms.

The media scrum that occurred towards the end of lockup was a chaotic scene – throngs of stakeholders and reporters mobbing each other. I noticed a friend of mine in the crowd representing another group. “How does this thing work?” I asked. “You just grab the next available reporter and talk to them” she expertly answered. Seemed simple enough yet daunting to the novice that I am, but as I observed the goings on, there did seem to be an order amongst the madness. I did manage to speak with a few reporters about our associations’ reactions to the budget and with luck they may use the story.

I will sharpen my elbows for the next opportunity.


Zak’s interest in health and healing began at the early age of nine years-old when he would carry a small first aid kit while playing with friends. Since then, his passion for healthcare and health policy has been unwavering. He was particularly inspired by concepts of family, community, and societal health, as well as the social determinants of health during his nursing undergraduate (BSN UVic, 2000), graduate work (MN UVic, 2008), and clinical experience in urban, rural and remote B.C. communities.

Zak has served on numerous boards and committees, including the BC Nurse Practitioners Association Executive and is the only Nurse Practitioner in B.C. who has been invited to sit on a Division of Family Practice Board (Interior). Through this work he has gained valuable experience in member engagement, optimizing board governance, and relationship building among diverse stakeholders. In his clinical practice, Zak has worked med/surg, emergency, intensive care, vascular access and outpost nursing. After obtaining his NP education six years ago, he began a practice in a West Kootenay family clinic, providing primary healthcare to the general public with a focus on marginalized populations. Zak is president-elect of ARNBC.

Reflecting on our Success, by Julie Fraser, RN, MN, ARNBC President

As we move forward into 2015, and my final months as president of ARNBC, I value this opportunity to reflect on ARNBC’s achievements over the past year and look ahead to the future that is unfolding for the Association and nursing in BC. I am so proud that through the hard work and dedication of many nurses in BC, ARNBC has grown into its role as the professional voice for nursing leadership, policy and practice in British Columbia.

In January 2015, registered nurses and nurse practitioners began the registration process with the College of Registered Nurses of BC (CRNBC). This was an historic occasion as, for the first time CRNBC began collecting professional association fees on behalf of ARNBC. Through the Health Professions Act, the province has set a visionary and revolutionary precedent by providing professions with the ability to self-regulate in the interest of the public, while continuing to advance their profession and influence change for health and social policy issues.

Upon registration, CRNBC is now collecting a total of $450.18 from each registered nurse and $651.48 from each nurse practitioner. When you register, you will notice that a total of $98.82 is allocated as Association fees. Of this, CNA receives $57.69 and ARNBC receives $41.13. It is important to note that registration fees for individual nurses have not increased at all.

At this point in the registration process, nearly half of you have already registered for 2015, and just over 85% of you have clearly indicated that you want to hear from ARNBC and CNA. This is a fabulous show of support and validates what so many of you have been saying for the past decade – B.C. nursing needs the contributions of all three nursing organizations – the College, the Union and the Association. We value the trust you have placed in us and regard it as our responsibility to move forward with you in the months and years to come. That said, we are pleased to offer all registered nurses and nurse practitioners access to all ARNBC and CNA programs and services – even if you have chosen to not receive our information updates.

ARNBC continues to build a strong relationship with our national organization, CNA. As president of your Association, I sit on the CNA board of directors where I have the honour of raising health and nursing issues from a B.C. perspective at the national level. CNA continues to be one of our greatest partners and ARNBC is one of many associations and nursing groups that make up the CNA Board. We value their support and leadership in recognizing ARNBC as the best option for B.C. nurses to connect on a national and international level. ARNBC’s status as the CNA jurisdictional representative provides B.C. registered nurses and nurse practitioners with more than a subscription to Canadian Nurse: opportunities to be a voting delegate, chances to inform on CNA resolutions and bylaw forums, engagement in federal lobbying initiatives and connecting with specialty nursing groups.


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My greatest hope is that over the next weeks and months, nursing in British Columbia will begin to unify to claim the strong, compassionate, and informed voice that our patients have come to expect and trust from us. The College, the Association and the Union all bring unique but important perspectives to patient care and health system improvements – and at a time when there are so many important issues to manage, we need to work together for the health of our patients and the advancement of our profession.

As you can see, our list of achievements is long and growing steadily longer, in large part because you have told us what you would like to see in an Association. We are excited to be heading out to many parts of the province over the next few months, and hope that we will meet as many of you as possible and you will share your vision for what an Association can do for you. Every single conversation with a registered nurse or nurse practitioner is important to the Association. After all, your voice is our strength!

Click to view ARNBC programs and services for registered nurses and nurse practitioners.


JulieJulie Fraser is a Clinical Nurse Specialist in the area of Home Care. She has been a registered nurse for more than 15 years and has practiced in a number of different settings from residential care to acute medical and surgical care units, before focusing on community nursing, working in both clinical and educator roles.

Self-Care in Nursing: A Call to Action, by Maren Austen, BSN Student

There is evidence that nurses know that we should take care of ourselves and how we should be doing it, yet there is still a gap between what is known and what is practiced (Malloy, et al.). As a profession centered on caring, nurses spend much of our time providing care for others; unfortunately, we often do not give the same consideration to self-care – those activities we do to rejuvenate and refresh ourselves, our spirit, and our energy (Lombardo, et al). Kravits, McAllister-Black, Grant, & Kirk summarized the impact of poor self-care succinctly, “Nurses whose own emotional reservoirs are low are less equipped to meet the care needs of their patients, and this may negatively impact patient safety”.

The World Health Organization defines self-care as “activities individuals, families, and communities undertake with the intention of enhancing health, preventing disease, limiting illness, and restoring health”. According to the Buffalo University Master’s in Social Work Self-Care program, a successful self-care plan factors in six key areas: Physical, Mental and Emotional Wellness, Spiritual Needs, Positive Relationships, and School/Work/LifeBalance (Butler, et al). Exercising, journaling, eating well, meditating, maintaining outside interests, and praying, are examples of self-care strategies.

For many RNs, self-care is a concept that seems like a luxury that we do not have time for (Lombardo, et al). However, it doesn’t matter if you are a nursing student, new graduate, acute care nurse, or community health nurse, we all need to take care of our own wellbeing so that we can meet the challenges each of us will face at school, work, and home (Jackson, et al).

So how do you find the time for self-care? First of all it is important to acknowledge that there is no one-size-fits-all self-care plan. We each have different workloads, lifestyles, circumstances, interests, and needs. Therefore, it is important that each of us take a couple of minutes to identify our individual needs and priorities.

Self-Care Assessment – How are you doing?

As nurses, we are all familiar with the importance of eating healthy meals throughout the day, getting enough sleep, and exercising regularly but when was the last time you praised yourself? Belted out a song? How about made time to be sexual with yourself or your partner? These are all simple ways that we can recharge and refill our own personal energy stores. Butler et al. have created a comprehensive Self-Care Assessment Tool to help individuals evaluate their current self-care strategies. While I understand that this tool was developed by a Masters in Social Work program and not specifically for nurses, I believe it is a wonderfully comprehensive assessment tool from a fellow health care profession with similar caring and burnout concerns. Take a few minutes and follow this link to explore this assessment tool – you can’t fix what you don’t know!

Make a Self-Care Plan

Butler et al (2014) recommend making a self-care plan to help you maintaina positive self-care regime. Examine your Self-Care Assessment responses and look for trends and annomolies. Are there any areaslacking in support? For each of the six areas (physical, mental, emotional, spiritual, relationships, school/work/life-balance), write out your current practice and then below it, write out your new practice. Some areas might need only slight alteration and others might never have been consciously addressed before. Keep your goals interesting to you and simple enough to fit into your current schedule. Follow this link to a sample self-care plan by Butler et al, (2014):

Make a Commitment

Once you have developed an initial plan, it is time to make a commitment to yourself and share your commitment with those around you. If you are able to articulate to your loved ones, classmates, coworkers, and friends why you are taking time for you and how you are also making space and time for quality relations with each of them, they are better able to support you and your wellness plan. Also recognize that this plan is a work in progress and will need to be reviewed and adapted as you incorporate self-care into your lives and especially as your lives change and evolve.

Wishing you all balance and wellness!


I am a 4th year student in the Bachelor of Science in Nursing program at North Island College in Courtenay BC with a 4.0 GPA. Being a full-time student, working part-time as an employed student nurse in addition to raising my young daughter, I have come to understand the need for self-care first hand. This topic has become so important to my own overall wellbeing that I have felt compelled to share my learnings with those around me. With this in mind, myself and several classmates have spent many hours outside of the classroom creating opportunities for our fellow nursing students to engage in self-care and to help them develop the self-care strategies they will need to be compassionate, engaged nurses in their future practice.



Butler, Rinfrette, & Reiser, (2014). Self-care starter kit. Buffalo University Master of Social Work Program.

Jackson, J. & Gaudet, S. (2009). Self-care practices among nursing students. Canadian Nursing Student Association Positions and Resolutions.

Kravits, K., McAllister-Black, R., Grant, M., & Kirk, C. (2010). Self-care strategies for nurses: A psycho-educational intervention for stress reduction and the prevention of burnout. Applied Nursing Research, 23, 130–138. doi:10.1016/j.apnr.2008.08.002

Lombardo, B. & Eyre, C. (2011).Compassion fatigue: A nurse’s primer. The Online Journal of Issues in Nursing, 16(1). Retrieved from:

Malloy, P., Thrane, S., Winston, T., Virani, R., & Kelly, K. (2013). Do nurses who care for patients in palliative and end-of-life settings perform good self-care? Journal of Hospice & Palliative Nursing, 15(2), 99-106. doi:10.1097/NJH.0b013e31826bef72

WHO. (1984). Health education in self-care: Possibilities and limitations. World Health Organization, Geneva, Switzerland: WHO; 1984 Retrieved from:


Verna Huffman Splane: Our gentle giant – “Look up, look waaaay up”, by Michael Villeneuve, RN

Verna Marie Huffman Splane OC, Diploma in Nursing (Nicholls Hosp, Peterborough), Diploma in Public Health Nursing (Toronto), BSc (Columbia), MPH (Michigan), LLD (Hon, Queen’s), LLD (Hon, St. Francis Xavier), LLD (Hon, UBC), DSc (Hon, Toronto), Fellow of the American Public Health Assoc.

November 23, 1914 — January 10, 2015

Verna Splane WHO ID badge 1965

WHO 1965

The word giant has been tossed around by many of us this past week in reference to the life, career and persona of our colleague, teacher, mentor and friend, Verna Huffman Splane. First setting eyes on Verna, the word giant might, in the most literal sense, seem to have missed the mark; she was, after all, a petite woman of small physical stature. But to anyone who spent even a few moments with her, it was clear that one was in the presence of greatness, and indeed of a giant sprit and intellect. She was tiny but she was mighty in every sense of that word — and she was utterly unforgettable.

Verna had the bearing of a respected, elder statesman. If she set her eyes on you, they looked deeply into yours and stayed there. You were being checked out. They were heavy with wisdom and experience, but never world-weary. She sparkled with curiosity, engagement and interest in everything right to the end of her life.

When Verna entered a room, attention was paid. At the Carter Center in 2001, she and her beloved Richard were jointly awarded prizes by the Lillian Carter Center for International Nursing Award by Emory University “for their groundbreaking work to document the role of chief nursing officers worldwide.” Even President Carter and his friend, Archbishop Tutu — who was receiving a humanitarian award from the center — accorded her a respectful berth. They made a formidable collection of wise ones that sunny Atlanta day.

But there was little of Verna in the way of pretense, and she was dismissive of much fuss. She was gracious, charming, inclusive, impeccably mannered, well schooled in tact, and completely comfortable with the diversity of humanity. She was, quite simply, one of the most distinctive individuals who ever rose through the ranks of nursing to soar comfortably in the company of our greatest Canadians.

Officer of the Order of Canada, 1996

Officer of the Order of Canada, 1996

Verna’s importance to the nation was acknowledged with her appointment to Officer rank in the Order of Canada. On her appointment it was noted that she had “played a major role in raising the status of the nursing profession both nationally and internationally” and that her expertise had led to “improved health care in different parts of the world.”

For her life of public service she was presented with both Queen Elizabeth II Silver (1977) and Golden (2002) Jubilee medals by the Governor General, and the Canadian Red Cross Distinguished Service Award. She held the highest honour in Canadian nursing, the Jeanne Mance Award, and received a Centennial award from CNA in 2008. From academia she was conferred honorary doctoral degrees by Queen’s, St. FX, UBC and U of T — and she was named one of the Notable Ninety graduates of the Lawrence S. Bloomberg Faculty of Nursing on the school’s 90th anniversary in 2010.

After many years working with our federal government and the World Health Organization, in 1968 Verna famously took on the role as our first federal chief nurse, landing her in the midst of the country’s most senior health policy decision makers. She leapt from that role to an eight-year voluntary stint as a vice president of the International Council of Nurses, further cementing her stellar career and presence in global nursing and public health. And of course the 50-country study of government chief nurses she conducted with Dick is now the stuff of legend.

So yes, she was amazingly accomplished. And yes, in many ways, she was truly a giant; the examples here just hint at the impact of a massive, global career. And let’s not forget that she took on another 30 years of mentoring, networking, researching and teaching starting in 1985, after she retired.

But celebrated as she was, Verna was of course a real, ordinary and extraordinary human being.

She was fun and funny. Her humour could be subtle and as dry as dust — but she could also giggle like a girl. Her laugh forced her eyes closed and her face could turn from deep concern to jumping joy in an instant.

She had mastered the Spock eyebrow raise of concern or surprise.

She defined the notion of twinkle in the eye — and it could be hard to tell sometimes if that twinkle was inquisitive, teasing or laughing. She had a highly mischievous look about her at times.

Verna was generous with her time, intellect, energy and money, and she received generosity back with love, thanks and real appreciation.

She gave praise with sincerity. When she said, “Dick and I are just so proud of…” the recipient knew that was real. From them it meant something.

She was educated, articulate, hard working, principled and incredibly politically astute.

Verna was quiet and discreet — but she took no prisoners and she really respected intelligent, thoughtful people. She didn’t have a lot of time for silliness or disrespect.

Verna was infuriated with the dismantling of the former RNABC, and not afraid to say so or to ask tough questions in public ways. She put her name and money on the line in the fight to maintain a professional association in British Columbia. And while she supported the importance of the family of nursing organizations that support nurses, she was clear that, first and foremost, strong professional nursing advocacy and representation must be housed in strong professional nursing associations. End of story.

She hosted amazing cocktail parties and dinners at which she always included any nurses visiting Vancouver, not to mention a dazzling array of Canadian and global celebrities from many fields over the years. More correctly, she and Dick hosted those events together, because rarely did any sentence she uttered start without three important words: “Dick and I.”

Verna and Dick, 2014

Verna and Dick, 2014

During her WHO work as a nurse leader in the Caribbean, Verna befriended another famous nurse who studied at the University of Toronto — Dame Nita Barrow, who went on to be the first woman candidate for the presidency of the United Nations and later served as Governor General of her home country of Barbados. Verna travelled in some lofty circles. But the most novice student nurse was greeted with the same loving welcome at the Splane’s front door as the celebrated Dame Nita or the political elite here in Canada.

“Dick and I thought we’d have a little drinks party,” she’d offer. In the warm surroundings of their beautiful home at UBC, Verna greeted admirers and kept conversations going; Dick always wore a shirt and jacket, mixed great drinks and was her thoughtful co-investigator, asking probing questions about every topic. They were masterful tag-team referees of deep conversations tackling the implications of all strategic options for moving forward to ensure optimal success on any policy initiative.

Few gatherings were purely social; there would always be a professional opportunity for time with an important leader that “Dick and I thought you should meet.” She was a marvelous networker and connector. And in even the most social get-together, Verna might say “there are two or three things on my agenda I wanted to ask you about.”

“Dick and I thought we’d have lunch outside,” she would say at the cottage in Eastern Ontario, where they also invited nurses and other intimate and professional friends on the regional, national and global scene. A “casual lunch outside” with the Splanes could mean a roasted chicken on china plates, with a white tablecloth gentle flapping in the afternoon breeze under shade trees by the water. Not exactly the typical cottage hotdog set!

A dinner inside was just as wonderful: “Dick and I thought we’d have some tapas and open some good wine.” What 90-year-old white lady says that?! Verna Splane did, standing casually before the framed Orders of Canada and other honours mounted over the fireplace as the loons called out across the lake.

Verna was masterful at the leadership game and she knew just how to work a room. She had a fierce awareness of herself developed over many decades. But as she moved past 90, she was also living with some failing body parts, including her eyes and ears. But no mind; she handled her early sensory losses beautifully so no one would even know. She could be totally disarming, even to the point of seating herself dead centre on a small coffee table, framed by the fireplace behind it, wearing a completely black outfit and a perfect set of pearls, putting her hands down flat on the table on either side of her body, and with the intoxicating subtlety of Bacall seducing Bogie, leaning forward to look directly at a guest and say slowly, with that voice none of us will ever forget, “So tell me, how are you?”

She was radiant. And she was casually in total control of herself and the room in the most restrained way. It was delicious to witness, as her admirers can attest. And many visits were master classes in leadership, if not just decorum and diplomacy. She was in her 90s then, and she was brilliant. And of course beyond being able to charm the snow off a snowman, she could see and hear better because she was closer to her visitors sitting in that central position.

2012 Garden Party

2012 Garden Party

Verna loved being around nurses, especially novices, but in truth anyone who expressed an interest in nursing, health care, humanity at large, and above all, in public policy, was invited into the fold. For decades she mentored groups of loyal younger nurses working around the world who would gather for conversation, story telling and advice at the university or at the Splane home.

When Dick and Verna hosted a huge and elegant outdoor cocktail party on Allison Road in June 2012 for the board of the Canadian Nurses Association and the chairs and members of the National Expert Commission, her older friends and colleagues stood by like an honour guard of watchful sisters. They were there to bolster her and they did. Others surrounded Dick and kept him company so she could hold court. But not for long; soon he was beside her like always.

Students and young nurses lined up anxiously to have their pictures taken with Dick and Verna like they were with rock stars.

And those of us somewhere in middle age looked on with pride and gratitude just to enjoy a tiny part of those special lives and the whole scene. What a privilege.

That night, Verna said quietly, “this is it, there will be no more public events,” explaining that at 97 she was feeling tired and wanted to turn over those duties to those of us a generation or more behind. There was to be no major speech that warm June evening, but deliver one she did, sharing gracious, loving, and humorous comments that, as ever, championed nurses, the CNA, and her beloved professional association in British Columbia — then rising as the new ARNBC. And whether intentional or not, she bade a public farewell to nurses and to what she said had been “a wonderful life and a wonderful career full of these events.”

ARNBC Lifetime Membership

ARNBC Lifetime Membership 2013

In the end there would be one final public celebration at the house, in April 2013, for ARNBC leaders and members after they awarded Verna with a life membership on her 98th birthday — a quarter century after receiving the RNABC Award of Merit (1987). She was deeply honoured by that gesture, and to the end last week, was a fierce defender of the importance of professional associations to nursing in British Columbia and Canada at large.

Verna embodied the sort of gracious and mannered style that in some ways seemed out of step with the frenzied career and world around her. She was relentlessly busy, but carried herself with a grace and pace that felt relaxed, caring and considerate of those around her. A timeless lesson perhaps in the incalculable currency of a great education, a good set of pearls, the love of a great glass of wine, a terrific partner, and a keen, observant mind.

Today in Vancouver, prayers will be offered and tears shed said for Verna — and for her great love, Dick. And rightly so: She was a tremendous ambassador for nursing within her beloved British Columbia (home for 40 years), across Canada, and around the world. And she was a great wife, neighbour, friend, and honourary mother to many.

She was especially attached to UBC and her network of friends, contemporaries, colleagues and students there. She was so, so proud of the UBC School of Nursing and of British Columbia nurses. She was a powerful inspiration and beacon in Vancouver and our British Columbia colleagues will especially mourn her loss today.

In conjunction with CNA’s annual general meeting in Ottawa in June, as a larger profession and a country we will gather to grieve and say goodbye to a great woman who embodied leadership in all she did across some 70 years of nursing.

It will no doubt be said that, “she will always be with us.” Fair enough, but many of us will really miss her gentle physical presence. Great love and great people deserve great grieving, and for all those who were privileged to experience her unforgettable personal touch, integrating the reality of this loss will take a little time.

For all sorts of reasons, we will not see her like again. She was a class act and of a certain time, and she never went out of style. What a gift to British Columbia, to UBC, to Canada and the world.

Verna was indeed our gentle giant. She insisted that while we always have our eyes on those we serve, we must also look up and out at the larger world around us. So look up – look waaaay up. She will be there, like always, watching, smiling, and expecting nothing less than the best from us all.


Michael Villeneuve is a lecturer in the Master of Nursing, Health Systems Leadership and Administration program at the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto. Sincere thanks to Dr. Sally Thorne, professor at the University of British Columbia School of Nursing for her loving contributions to this reflection.