ARNBC has been working hard to raise the voice of nursing with government and partners in B.C. and across Canada.  We have met with the Minister of Health and other key government leaders to share our ideas about how to strengthen primary care services in B.C., increase collaboration between health professions and reform some of the tools we need and use on a regular basis such as best practice guidelines.  We look forward to continuing to bring the voice of B.C. nurses forward at policy tables and with stakeholders in the months and years to come.

To assist nurses in speaking up for health and health care during the provincial election campaign, ARNBC has compiled resources for nurses to use during the campaign. As part of this innovative Online Toolkit, we have added new Issues Notes on Rural Health and Mental Health with background information and sample questions to pose to candidates during All Candidates’ Meetings in your communities.

As your professional association, ARNBC has been engaged in exciting initiatives during the past few months. We were pleased to collaborate with the BC Nurse Practitioner Association and the Licensed Practical Nurses Association of B.C. to propose significant changes to primary care through the development of an interprofessional council of health professions to oversee these needed changes.  Recently ARNBC, BCNU and CRNBC developed a joint statement on the need for a Provincial Nursing Plan. We are revitalizing a network of professional practice groups in the province and providing opportunities for local groups of nurses and others to link and network together through our new Network Leads Project.  We continue to work with the Canadian Nurses Association to strengthen the voice of nursing in Canada, and were proud to co-lead their Nurse Practitioner campaign in B.C. in 2012 and to bring a B.C. nursing perspective to the CNA Board of Directors.

On June 26, 2013, we will be holding our second Annual General Meeting at the Paetzold Auditorium at Vancouver General Hospital.  All B.C. registered nurses, as well as students and retired RNs, are welcome to attend.  And if you can’t be in Vancouver on June 26, rest assured that we will make sure you can participate via webcast.  We look forward to seeing many of you there.  To register for the AGM, and to sign up to vote in the Board election, please visit our AGM Page where you will find registration forms and a call for nominations for four Board positions.

Our social media platforms continue to thrive.  We are always interested in hearing from nurses who have a passion and want to share their opinion on a current public policy or advocacy issue by writing a post for our blog.  Feel free to comment here to tell us what you and your colleagues are doing for Nursing Week and how you’ve been involved in raising health issues during the provincial election campaign.

It is a busy time for the nursing profession in British Columbia, and we are proud to be raising our collective voice in support of important changes to our healthcare system.  We are continuously reminded of how insightful, knowledgeable and passionate nurses are about providing quality, patient-centred health care.  You do an amazing job, each and every day, and we are so proud to support you in all of your efforts as a leading force for change.

Happy Nursing Week 2013!

ABOUT ARNBC

The Association of Registered Nurses of British Columbia (ARNBC) is a professional organization that provides a unified voice for registered nurses and nurse practitioners in the development of health, nursing and public policy that advances the health of British Columbians.

We welcome comments on this or any other blogpost!

Nursing is one of the most respected, valued and strong professions in B.C. with a long history of providing advice to elected representatives around public policy issues that impact the health and well-being of British Columbians, their families and the communities they live in.  Now is the time for B.C. nurses to seek answers from their local candidates about how they will begin to address some of the issues facing the healthcare system if they are voted into office.

Nurses across the province have asked ARNBC to provide some tools and tips to help them be engaged in this election campaign and to raise the issues and concerns that are important to our profession and the health of the patients we work with.

We encourage all B.C. nurses to visit our Election Page [or click here] and review and use the materials to engage your local candidates.  If you have any questions or ideas about additional issues you would like us to share, we would we be happy to hear from you.  Drop us an email at admin@arnbc.ca, post a message on our Facebook page or send us a Tweet.

As well, any nurse who is interested in writing an election specific item for this blog should have a quick look at the Blog Submission Guidelines and then email your submission to admin@arnbc.ca.

Let’s keep health and healthcare front and centre throughout the election campaign and make sure our professional concerns as nurses are heard loud and clear as we work together to determine who should represent the province in the Legislature.

ABOUT ARNBC

The Association of Registered Nurses of British Columbia (ARNBC) is a professional organization that provides a unified voice for registered nurses and nurse practitioners in the development of health, nursing and public policy that advances the health of British Columbians.

We welcome comments on this or any other blogpost!

April 2^nd was proclaimed by the B.C. Government as Oncology Nurses Day. That evening, the Honourable Margaret McDiarmid, B.C. Minister of Health, made a surprise visit to an oncology nurses event that was held at the Vancouver Cancer Centre and joined via teleconference by nurses from 12 sites around the province.  The Minister spoke from her heart – as Minister of Health and a former BCCA cancer patient – about the irreplaceable role that nurses play every day in providing patient-centred care. McDiarmid recalled how nurses brought an intelligent practicality to the daunting prospects of chemotherapy while supporting her with compassion and individualized guidance.  She recalled watching how nurses interacted with all of the patients in the chemo unit – careful and thoughtful, inspiring patients with a sense of competence that shone through all they did.

“I don’t think you ever get thanked enough for what you do,” McDiarmid said.  “Never forget what a profound difference you make for people at the most vulnerable times they will ever face in their lives – and not just the patients but also their families.”

And after making brief remarks, McDiarmid stayed to hear nurses talk about their practice and about their passion for oncology care. One nurse from the interior spoke about her study of the grief of family caregivers who had found themselves unable to manage the home care for their dying loved one at home until the very end.  A student nurse on the brink of graduation shared her excitement about beginning her career in cancer nursing and the many mentors who had inspired her along the way. And another nurse from the north spoke of the massive challenges her team faced in establishing the first BC cancer centre in Northern B.C. Each of these nurses spoke with commitment and passion, reminding their colleagues in the B.C. Oncology Nurses Group (the B.C. branch of the Canadian Association of Nurses in Oncology) why they came to work each day and the difference they knew they could make for patients with, through and beyond cancer.  The Minister remained throughout the entire evening, taking extensive notes and remaining after the program to speak with individual nurses and share her gratitude for the nursing care she herself received.

Minister McDiarmid acknowledged that her Ministry is well aware of the challenges B.C. nurses have faced in recent years in bringing the distinctive professional nursing perspective to matters of health and healthcare policy. However, she also assured the nurses present that she has been inspired by nurses across the province throughout her term as Health Minister. In every sector of the health care system, she sees nurses stepping up to the plate with the same kind of inspired intelligence she herself witnessed as a patient.  Clearly she understands – as BC Cancer Agency President & CEO Max Coppes said, “Nurses Rock!”

For further information about the BC Oncology Nurses Group, please contact Johanna den Duyf, President, at jdenduyf@bccancer.bc.ca

ABOUT DR. SALLY THORNE

Dr. Sally Thorne, RN is a Professor at the UBC School of Nursing, where she has been a faculty member for over 25 years. A nurse researcher and educator, she draws attention to the contribution of professional nursing to the lives of persons with cancer and chronic disease. She represents nursing as a board member in the non-profit and health sectors both in British Columbia as well as nationally.

The ARNBC has joined with the British Columbia Nurse Practitioner Association (BCNPA) and the Licensed Practical Nurses Association of B.C. (LPNABC), to convey concerns about recently announced changes to primary care in British Columbia.

Nurses have expressed their frustration that government is moving ahead with plans to ‘solve the physician shortage’ without considering the numerous ways nurses and other health professionals can, and do, improve primary care. We know that nurses are confronted on a daily basis with patients’ unmet needs and are frustrated because they know better solutions are possible. Our three Nursing Associations are committed to finding collaborative ways to bring nurses’ voices and ideas to this critical policy issue.

We have recently conveyed our concerns and our proposed solutions in an op-ed published in the Vancouver Sun, a news release and a letter to the Minister of Health.  In formulating our position and proposed solutions, ARNBC takes direction from evidence-informed policies, some of which were recognized decades ago. These include the Hastings Report on the Community Health Centre Project, the Romanow Report and the most recent Expert Commission on Nursing and Health Care. We also look to emerging models, such as the inception of family care clinics in Alberta, as a way of opening up choices in primary care providers through collaborative, interprofessional, patient-centred, community based clinics with increased hours of access. Other provinces and territories have also shown demonstrable impact on population health through implementing interdisciplinary community health centres.

ARNBC, BCNPA and LPNABC have asked government to strike an interprofessional advisory committee of nurses, physicians and other health professionals to advise the Minister on what is needed to shift the focus of care from physician office services to models of care that are in sync with real patient needs.

In late March, ARNBC will launch a dedicated Elections webpage which will share our position on primary care and other key election issues, and provide nurses with tools and ideas for communicating these issues to candidates. Our hope is that all MLAs will head to Victoria with a solid understanding of the issues facing primary health care, and a resolve to make positive, lasting health policy decisions for all British Columbians.

In the meantime, please add to this blog post with your experiences and ideas — we need to hear from you!

ABOUT DR. SUSAN DUNCAN

Dr. Susan Duncan is a faculty member at Thompson Rivers University in Kamloops. She has over 30 years of experience in nursing practice, education and leadership roles. Susan has represented nursing on regional health and hospital boards and completed a term on the Board of Directors of the Canadian Association of Schools of Nursing in 2011.

On December 5th, 2012, student’s and nurses from the Comox Valley gathered together to discuss re-establishing a local ARNBC chapter. The meeting was full of enthusiasm and energy as members shared a sense of excitement to be reconnecting with each other and strengthening the professional presence of nursing in the region.

The group was comprised of students, retired, and practicing nurses from a variety of agencies in the community. Many of the attendees were previous chapter members with RNABC and shared what they most valued previously, the feelings of loss and disconnect since its dissolution, and their visions for moving forward as a group. Themes that emerged from the meeting included: providing an outlet for professional advocacy, seeking a connection with professionalism, mentorship amongst nurses outside of the workplace, educational opportunities, having a connection with larger nursing associations, and the opportunity to have fun and socialize with other nurses.

Communities across B.C. have experienced numerous challenges when trying to connect with nurses due to a lack of accessibility regarding contact information. Our group was faced with a similar challenge and we took a grassroots approach to connecting with nurses, beginning with personal contacts and previous Registered Nurses Association of BC chapter members. We found that there was a large knowledge gap about the past history and different roles of the nursing organizations. With this in mind we recognized the need for a professional and political voice and we believe ARNBC will fill the current void. We were able to devote time and resources through our undergraduate leadership course in the efforts of promoting the association, hosting scholarly events, and exploring the initiation of a local ARNBC chapter.

Suggestions for connecting with nurses in your area:

• Social media challenge. We found this to be an effective way of having people engage with ARNBC. Within three weeks, ¾ of the nursing student body at the local college had “liked” the ARNBC page on Facebook, and the prize was only a baked good delivery to the winning class.
• Sharing information packages through hardcopy and an email chain letter. We included the ARNBC documents: FAQ, timeline, and changing regulatory framework.
• Brief presentations at community nursing agencies.
• Media releases through local newspaper, radio, and hospital newsletter.
• The local college hosted a scholarly night where ARNBC president-elect Julie Fraser and projects-manager Nora Whyte were the guest speakers.
• Poster advertisements around hospital and community agencies.
• Local MLAs visited our classroom and we promoted the local ARNBC group to these political leaders.

Although our academic semester is over, our role in connecting nurses with ARNBC will be ongoing. Our challenge for nurses across the province is to rebuild and strengthen networks in their own communities and then join with ARNBC to project our professional voice at a provincial and national level.

Comox Valley student nurses meet with ARNBC President Elect Julie Fraser. From left, Callan Lansdowne, Trish Sanvido, Julie Fraser, Leah Peters-Michaud.

ABOUT CALLAN LANSDOWNE, LEAH PETERS-MICHAUD and TRISH SANVIDO

Callan Lansdowne is currently completing her baccaleureate degree of nursing at North Island College. She resides in the Alberni Valley but continues to stay involved in the Comox Valley ARNBC chapter as it offers an outlet to stay connected with other nurses and the opportunity to create lively discussion about issues affecting nursing. Callan has enjoyed the variety and opportunities that nursing offers and is excited about her upcoming career where she intends to pursue critical care nursing.

Leah Peters-Michaud is currently completing her final year in the registered nursing baccalaureate program at North Island College. Strengthening and being a part of the collective nursing voice is what inspired and motivated Leah and her colleagues to form a local chapter in the Comox Valley. Her passion for nursing leadership, advocacy and social justice will help guide her practice as she begins a promising career in public health and aboriginal health nursing.

Trish Sanvido is a fourth year North Island College nursing student . She has enjoyed her practice experiences in acute and home and community care and looks forward to furthering her nursing career in acute care settings. She is dedicated to advocating for excellence in stroke care and looks forward to furthering her education in critical care nursing.

Happy New Year to all B.C. nurses.  As we move into 2013, I hope all of you had opportunity to enjoy some rest and relaxation over the holiday season and appreciate time with your family and friends.

I am excited about 2013 and the many opportunities that are ahead of ARNBC in the coming months.  We experienced significant successes in 2012 and the Association has gained support from nurses in all corners of the province, from our colleagues and stakeholders within the profession and from government.  We have been especially proud of a number of key milestones that occurred during 2012:

• holding our first AGM where B.C. nurses elected a new Board of Directors
• having the opportunity to represent the voice of nurses in policy discussions with government and at conferences and events
• being named the official representative for all B.C. nurses to  the Canadian Nursing Association
• participating in a number of key healthcare meetings with government, our regulatory college and other healthcare associations
• hosting province-wide consultations where we listened to the ideas and concerns of nurses in big hospitals and small communities across B.C., with a commitment to working together to address their concerns and advance their ideas
• making inroads into re-establishing the professional practice and specialty nursing groups that so many nurses have told us they miss
• continuing leadership in social media and nursing

The ARNBC Board has been inspired by the commitment B.C. nurses have to building a relevant and influential professional nursing association.  This blog provides numerous examples of how nurses are bringing a nursing perspective to a wide range of social, health and public policy issues.  Please continue to express your ideas, challenge assumptions and share your thoughts through our social media channels, or consider guest-authoring a blog by emailing admin@arnbc.ca.

Meeting with the Minister of Health

Julie Fraser (President Elect) and I met with Dr. Margaret MacDiarmid, the Minister of Health, on December 6, 2012. This was a very important and positive meeting, which gave us an opportunity to talk about how ARNBC can bring the nursing voice to health and social policy development in an even more direct way.  We were able to share the key policy issues that have been identified not by our Board, but by B.C. nurses at the Nursing Forum in 2011 and during the ARNBC 2012 Consultation.  Specifically, we talked about the importance of advancing role of RNs and nurse practitioners in primary care, the need for greater interprofessional collaboration, seniors care, and challenges and opportunities around nursing skill mix and care delivery models.

Canadian Nurses Association Board of Directors

In November 2012, we took CNA to Parliament Hill and held meetings with 45 parliamentarians and senators. We engaged in advocacy efforts to promote equity-based health-impact assessments for all cabinet and federal government department policy and program decisions. We also championed the top five in five: the achievement of a top-five ranking among nations on five priority health and systems performance outcomes by 2017. We hosted a reception on Parliament Hill for 65 politicians, reinforcing our advocacy efforts to create the best health outcomes for Canadians.

The CNA Board recognized the important decision made by Health Canada to publish new regulations with more prescribing authority for nurse practitioners (NPs), midwives and podiatrists. These new regulations will enable NPs to provide Canadians with the advanced level of care that is in keeping with their expanded education and skills. Another highlight of the meeting was witnessing the first vote cast at a CNA board meeting by a student representative.

During the board meeting, we approved key resources to guide nursing advocacy efforts in mental health, primary care and harm reduction. We had a robust discussion about flu shots and supported the Position Statement on Influenza Immunization of Registered Nurses.

Connecting with Students and Specialty Groups

Key student events during the fall of 2012 provided us important feedback and ideas in building an innovative nursing association. There was amazing energy from the students and nurses at the Canadian Nursing Students’ Association Western Conference, the Camosun College/University of Victoria Event, the North Island College Scholars Event, and the University of Fraser Valley fourth year political action class. Selkirk College students worked on a leadership project to raise awareness about professional associations and North Island College students facilitated a meeting of nurses in the Comox Valley to explore reinventing a local chapter.

We also had an opportunity to bring together representatives from a number of specialty nursing groups to discuss how to revitalize the network of specialty and professional practice groups which were an important part of the B.C. nursing community for so many years.

2013 Priorities

In 2013, we will continue to focus on engagement with B.C. nurses, development of key partnerships, and sustainability of the association. New opportunities to engage with us to build the associationwill continue to be posted on our website and we will update you on our policy work.  We encourage you to stay connected though our website, our blog, Facebook and Twitter to learn more about these opportunities.

Thank you for your ongoing support in establishing a strong, effective and relevant provincial nursing association.

ABOUT DR. SUSAN DUNCAN

Dr. Susan Duncan is a faculty member at Thompson Rivers University in Kamloops. She has over 30 years of experience in nursing practice, education and leadership roles. Susan has represented nursing on regional health and hospital boards and completed a term on the Board of Directors of the Canadian Association of Schools of Nursing in 2011.

On January 5, 2013, the Globe & Mail published an excellent article by Rod Mickleburgh entitled “Are Nurse Practitioners the cure for B.C.’s family doctor shortage”.  [Click here to view]

This timely and informative article included comments from Rosemary Graham, President of the BC Nurse Practitioner Association (BCNPA) as well as Shelley Ross, President of the British Columbia Medical Association (BCMA).  In great part due to Dr. Ross’ comments, the article has received more than 80 comments and sparked broad discussion in British Columbia and across Canada.  ARNBC chose to write a Letter to the Editor to highlight our concerns over the comments attributed to Shelley Ross and the BCMA.  To read ARNBC’s Letter to the Editor, click here.

To further the discussion, on January 7, 2013, Rosemary Graham and Shelley Ross were interviewed on CKNW’s Simi Sara Show.  Click here to listen to the full audio of both interviews, and the comments made by callers. [Listen to mp3.]

ARNBC is proud to be a partner and friend of the BC Nurse Practitioner Association, and we encourage all nurses and all British Columbians to learn more about the important role nurse practitioners can play in improving the health of individuals and communities across the province.  Recently ARNBC partnered with the BCNPA and the Canadian Nurses Association on the www.npnow.ca campaign to raise awareness of NPs in the province.  Visit our NP Page to view materials and information from the campaign.

Visit the BCNPA website for more information on nurse practitioners, or to download their Position Statement on Nurse Practitioners in Primary Care.

ARNBC will continue to advocate in support of strong, collaborative healthcare teams that are led by the most appropriate healthcare professional  – whether that is a nurse practitioner, a physician, a registered nurse, a physiotherapist, an LPN, a midwife or another health provider.

ABOUT ARNBC

The Association of Registered Nurses of British Columbia (ARNBC) is a professional organization that provides a unified voice for registered nurses and nurse practitioners in the development of health, nursing and public policy that advances the health of British Columbians.

We welcome comments on this or any other blogpost!

The events of the past week in Newtown, Connecticut are almost beyond comprehension.  Whilst the media attempt to help the public ‘make sense’ of a senseless tragedy, social media sites are alive with debate on who is to blame, how further tragedy can be avoided and questions about what happens next.

As a Registered Nurse who has worked with marginalized populations for my (to date) 20 year career in nursing, it saddens me deeply to see discussions and reports that further stigmatize both youth and people living with mental illness.  Our collective cultural deification of violence and guns lies in stark contrast to our attitude and approach to mental illness and the vulnerability of youth.

But there is hope.  There are people who care deeply about youth mental health and are willing to make a difference by putting compassion into action and dollars behind their words.   As Director of Urban Health and HIV/AIDS at Providence Health Care, I am proud to co-lead the Inner City Youth Mental Health Team.  Launched in 2007 as a pilot project in partnership with Covenant House, a dedicated and compassionate team of Psychiatrists, Nurses, Social Workers, Occupational Therapists and Youth Workers make a difference every day in the lives of Vancouver’s most marginalized youth.

Silver Wheaton, a Vancouver based mining company, has seen the value of addressing youth homelessness, detachment and mental illness and donated $1.6 million to help our program reach yet more youth.  This kind of socially just, community aware approach to business is what our city, and cities across North America needs.    Our next generation is worth the investment.

Our culture in North America promotes a ‘together alone’ life, where we are connected by technology and not humanity.   Youth are labeled, dismissed and told ‘you will grow out of it’, or ‘it gets better’.   Mental illness and personality disorders are personalized and stigmatized – another way of making a distinction between ‘me’ and ‘you’.

The mental health and wellness of our communities is our collective responsibility.  As nurses, we have the opportunity to not only provide care at the frontlines, but to influence policy, be leaders in community responses to mental illness, crime and dysfunction and model our values of compassion, attachment and caring.    Our society is facing a crisis – and where there are crises, there are nurses.   Not only can we, as Registered Nurses, make a huge difference, in the moment and face to face with those who are hurt and grieving, but as policy makers, advocates and role models.   It is time for nursing to stand up and show people that there is hope.

ABOUT SCOTT HARRISON, RN, BScN, MA, CCHNC

Scott Harrison RN BScN MA CCHN(C) is Director of Urban Health & HIV/AIDS with Providence Health Care and President of the Canadian Association of Nurses in AIDS Care. Originally from the UK, Scott is an experienced nurse, midwife and health care leader with over twenty years of clinical experience with marginalized populations. Focussing on HIV/AIDS, mental illness and poverty, he is a passionate advocate for nursing, social justice and compassionate care.

It was a normal Friday morning and having not yet weaned myself from “Good Morning America” after six months in B.C., I was checking in on the news.  I was shocked to hear of a shooting at Sandy Hook Elementary School in Newtown Connecticut, my home for the past twelve years until I moved to Vancouver last summer. Shock and disbelief followed, but the early reports did not sound too bad – one or two victims. By noon, my 18-year-old son, who is in university in Philadelphia, skyped me with more details – 28 were dead by the hand of a student who was a year ahead of him in high school.  And the shooter’s older brother, an early suspect who was not involved and has been cooperating in the investigation, graduated with my daughter. Another classmate, who is now a writer, eloquently described the loss of privacy, innocence, and anonymity and how the memories we shared have been destroyed.

http://www.theatlantic.com/health/archive/2012/12/did-this-really-happen-in-my-elementary-school/266317/

As a parent and a nurse, envisioning the impact on this small community has been unbearable. In an interfaith service in Newtown Sunday night, President Obama spoke of this tragedy having an effect nationally and internationally.

From a healthcare perspective, Suzanne Gordon’s recent blog discusses the moral distress of healthcare practitioners when public policy fails to create reasonable laws and the public lack the capacity to take sensible action.

http://suzannecgordon.com/health-care-professionals-should-stand-up-en-masse-for-gun-control/

Proof of the lack of sensible action and American’s “love affair” with guns (I might call it an obsession) are the 400 gun stores within a four county radius and 36 gun stores within 10 miles of the shooting. Statistics demonstrate that in the U.S., there are more gun retailers nationally than supermarkets or McDonalds. Some believe it is beyond the point of no return with over 200 million guns in circulation in the U.S., and the purchase of firearms increasing whenever there is a “threat” of changing policies. On “Black Friday” this year, the FBI processed 154,000 background checks for firearm purchases.  In November, with the anticipation of President Obama’s re-election, two million guns were purchased. Similarly, this weekend, after the tragedy in Connecticut, sales of automatic weapons, especially rifles, increased with the fear that they would soon be “off the shelves”.

Another issue is the ineffectiveness of background checks – because of the civil liberties act and privacy laws in the U.S., single men with psychiatric backgrounds may not be identified in the system.  In the Newtown attack the guns were not his but his mother’s and easily accessible in the house.  Shooters such as this are referred to as determined, psychotic, and suicidal.  And the way the media idolizes them and creates immediate celebrity status only encourages others, who might otherwise quietly commit suicide, to be attracted to this horrific method of killing so they too can go down in history. I think the Canadian approach of not naming the shooter and minimizing media exposure decreases the risk of the “copycat” scenarios that seem all too common in the U.S.

What about the effect of violent movies and video games?  Does the enhanced social interaction and realism make it difficult for young men who have mental health problems to differentiate between fantasy and reality? Most shooters are described as “angry, alienated, and disconnected” and yet an act like this tragedy involved pre-meditation and the use of assault weapons – automatic rifles which shoot the equivalent of 30 guns almost instantaneously and ammunition which causes utmost damage. These weapons should only be accessible to the military and law enforcement – why are they in the hands of civilians? Because as Donna Brazile, the ABC News Consultant said in an interview with George Stephanopoulos Sunday evening, “U.S. gun safety laws are broken.” It remains to be seen whether there will be any changes to the U.S. gun control laws, but in Canada, gun policy must be seen as a public safety issue.

Finally – the biggest elephant in the room – access to mental health care. In the U.S., access to mental health services is limited. The cost of care runs $13,000-$17,000/year with few beds and facilities open. In this case, the mother had expressed frustration with lack of support for managing her son’s mental health issues. In the Canadian system, we must maintain strong advocacy for an effective and publicly funded mental health system. Mental health services should never be considered a luxury for those who can afford it.

So as a nurse educator, practitioner, and grief counselor, how does this experience affect my view? My heart is with all involved, including the first responders (many of whom are volunteers who live in the community), the medical examiners, spiritual and grief counselors, doctors, nurses, teachers and parents.  This has touched everyone in one way or another and nothing can ever prepare one for this. Nurses can play a strong role working with politicians and policymakers to develop policies for better gun control and sufficient mental health care services, and we can support society to manage conflict in non-violent ways. We can monitor the media, including news reporters, movie-makers, and video-game creators, and hold them accountable. We can educate the public about mental health signs and symptoms and provide the support necessary in our schools, clinics, and medical offices, working closely with parents, teachers, counselors and the justice system to manage situations before they escalate to the extent of this tragedy. Finally, we can continue to educate staff and students on quick action in case of emergency, which certainly saved many lives in Newtown. Finally, we need to help all nurses be prepared to work with people who have been traumatized by their own tragedies. Teaching self-care and mutual support has never been so important.

I know the strength of this small town community. It was a major attraction when we moved there, and I know they will overcome this tragedy in time and be stronger for it. But it will be a long and painful process. Although I will be visiting Newtown for the holidays and will participate in the vigils and grieving, my new home is here in Vancouver, and some of the aspects of Canadian life that have drawn me here have been reinforced the past few days. There is much that B.C. nurses can do to speak out for sensible public policies, strong mental health services to all in need, and for creating a more caring and compassionate society.

ABOUT SUZANNE CAMPBELL

Dr. Campbell is the Director of the University of British Columbia School of Nursing. She graduated with her BS and MS in Nursing from the University of Connecticut and her PhD in Nursing from the University of Rhode Island. She obtained her post-master’s certificate as a Women’s Health Nurse Practitioner from Boston College. Her clinical background of maternal-child health and lactation for the past 30 years has led to the support of families and the education of health care professionals in a variety of settings. She served as Director of Research and Special Projects to the Board of the International Lactation Consultant Association (ILCA) (Term 2006-2009) and presently sits on the Lactation Education Accreditation and Approval Review Committee (LEAARC) as the Higher Education Administration representative. Dr.  Campbell has consulted with the Connecticut State Women, Infants, and Children (WIC) Supplemental Nutrition Program. She was IT and curriculum expert for a grant which updated the Peer Counseling Program/Curriculum for WIC nationally. Dr. Campbell has published articles on lactation, nursing education, and is co-editor of a simulation book Simulation Scenarios for Nurse Educators: Making it Real. She was elected into the Nursing Academy of the National Academies of Practice and received the International Nurses Association of Clinical Simulation Learning (INACSL) Excellence in Academic Setting – Mentor Award. Dr. Campbell is committed to the education of all health care professionals, recognizing nursing’s role in an interprofessional setting and the continued need to develop knowledge, partnerships, and collaboration for the provision of excellent health care.

In the recently released report of the National Expert Commission (NEC), nurses were challenged to use their collective knowledge to be a mighty force in ensuring better health, better care and better value in healthcare delivery for all Canadians. The Commission noted that new models of care delivery “should be centred on what individuals and families need, should treat the individual as a whole person…, and should ensure that all professionals, including nurses, work to their full scope of practice.”¹ But to what extent is the Registered Nurse community prepared to respond to that challenge?

There is no question that Registered Nurses (RNs) should be an entry point to health promotion and disease prevention as well as to illness care, and that nursing education currently equips RNs to address the shift from an illness model to keeping people well. But to what extent do RNs in practice actually champion excellent care, caring, and preventative care? ²

Research on nursing scope of practice ^{3 4 5} has revealed that we lack a compelling vision for nursing that differentiates the distinct roles of Nurse Practitioners (NPs), RNs, and Licensed Practical Nurses (LPNs) in care delivery.  There is little evidence that differences in education (i.e., in nursing knowledge) account for how nursing providers are utilized, which contributes to significant role overlap and duplication, as well as to tension and mistrust between RNs and LPNs in the workplace. This role ambiguity is sometimes also reflected in staffing decisions made by nurse managers, who may fail to consider the potential impact on patient outcomes of replacing one type of provider with another when dealing with staffing shortages.  RN practice in acute as well as in primary care has been demonstrated to over-emphasize the management of disease and illness, with insufficient time spent on assessment of population risk factors and individual health needs. The practice of many RNs has been narrowed to a heavy focus on the performance of tasks and activities related to the bio-medical management of patients, although many of those also fall within the scope of practice of other providers.

Developing a meaningful approach to achieving the vision for nursing and healthcare that is reflected in the NEC report will be impossible in the absence of a long-term, shared vision among decision-makers (i.e., employers),  educators, regulators, policy-makers and RNs themselves. RNs recognize they are currently not working to the full extent of their knowledge and skill and are unduly absorbed by the bio-medical needs of patients, at a time when all levels of government are calling for a renewed focus on promoting health and wellness. Shifting our system away from its almost singular focus on illness toward an equal preoccupation with health and wellness will simply not happen if nurses don’t lead the way. The sustainability of our health system depends on the willingness and ability of RNs to refocus their practice toward interprofessional models of service delivery that will allow them to more effectively engage in the promotion of health and well being with individuals sick or well, which is the very essence of professional nursing practice. This will require individual commitment and collaborative effort to move beyond talking to actually making change happen.

Is anyone ready to lead the way?