2023 Annual Report

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Annual Report 2023

Meeting of members

June 13 | 12-2 p.m. ET

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Shaping the future of nursing

As we reflect on the past year, I am honoured to address you as CNA president. Together, we have navigated unprecedented challenges, exhibited allegiant commitment, and made significant strides in advancing the nursing profession.

Since assuming the role of president on April 1, 2022, and leading the organization’s board of directors, I have been privileged to witness the remarkable commitment of the nursing community. Nurses and CNA members from across Canada have showcased their unwavering advocacy and commitment and continue to shape the future of nursing. We participated actively at the Council of the Federation meeting in Winnipeg in July and the health ministers’ meeting in Charlottetown, providing solutions to solve the nursing workforce crisis. Following these political representations, we were solicited for numerous media interviews across the country. Additionally, we held a Hill Day in November, where we met with ministers and elected officials from all political parties to ensure that nurses’ voices were heard by decision-makers.

There were many highlights last year, but the one that stands out for me was the International Council of Nurses (ICN) Congress in Montreal. I consider it a culmination of everything that I stand for, and the pinnacle of my professional career. During this event, I had the privilege to welcome a delegation of over 5,000 nurses, health-care professionals and policy-makers. I met politicians and dignitaries from across the globe, including Prime Minister Justin Trudeau, former Health Minister Jean-Yves Duclos, ICN president Dr. Pamela Cipriano, and Princess Muna Al-Hussein of Jordan (the World Health Organization’s patron for nursing and midwifery), as well as other national and international leaders of nursing organizations.

In 2023, we were proud to launch Inspire Nursing: A LEADS-based Leadership Program, in collaboration with the Canadian College of Health Leaders. This revolutionary program is built to support new and emerging nurse leaders on their educational and professional journeys.

My term as president has come to an end, and I extend my heartfelt gratitude to every one of you for your continuous engagement, passion and resilience. It has been an honour and a privilege to serve as your president. I look forward to the continued journey ahead as we shape the future of nursing together.

Sincerely,


Sylvain Brousseau, RN, PhD, FFNMRCSI, FAAN
President (2022-2024)

We are delighted to present CNA’s 2023 annual report, which is organized in accordance with our strategic plan (2023-2026). We take great satisfaction in reflecting on the past year’s successes and showcasing CNA’s work. CNA has undergone one of the largest transformations in its history, introducing a new governance structure and membership model. Last year was pivotal for us. Like a phoenix rising from the ashes, we have begun to regrow our membership numbers on our arduous journey to sustainability. This marked a significant milestone in our organization’s evolution and commitment to serving the nursing community effectively for many years to come.

Throughout the year, we have focused on supporting nurses and the health system. We continued to collaborate with health partners and participated in initiatives that relate to nurses’ key priorities, including the Coalition for Action for Health Workers, whose aim is to alert governments to the impending crisis within health care. We also participated in the development of the federal government’s Nursing Retention Toolkit, which was developed last year and launched in early 2024.

One of our greatest achievements was the development and launch of the Stellar Certification Program, a significant step towards recognizing health-care facilities for their workplace excellence. Our first client signed on in late 2023, marking a milestone in our journey to improving working conditions for nurses and ensuring better care for people in Canada.

Our advocacy efforts have been strategic and focused on innovative solutions — such as enhancing roles for nurses and nurse practitioners working in primary care — in an effort to maximize nursing roles and improve access to care.

The permanent reinstatement of the federal chief nursing officer serves as a testament to nurses’ pivotal role in shaping health-care policy and practice. The Canada Health Transfer agreement has been finally signed and includes funding for tailored bilateral agreements with each province and territory to support key CNA advocacy priorities such as nursing retention, ensuring better data sharing, enhancing culturally safe health services, and stabilizing the nursing workforce. In Charlottetown, federal, provincial and territorial health ministers agreed to common objectives that reflect CNA’s advocacy efforts, including our health human resources policy recommendations, to solve the nursing shortage crisis.

We recognize the importance of addressing the Calls to Action outlined in the Truth and Reconciliation Commission and are actively developing our reconciliACTION plan to guide our organization in implementing meaningful steps towards reconciliation. Through our collective efforts, we continue to advance nursing excellence and positively impact health-care outcomes for all Canadians.

To our members, nurses, health partners, and supporters, thank you for an extraordinary 2023.

Sincerely,

Tim Guest, RN, BScN, MBA, FFNMRCSI
Chief Executive Officer



CNA is the unified voice of Canadian nursing. We represent retired nurses, nursing students, and all categories of nurses (registered nurses, nurse practitioners, licensed and registered practical nurses, and registered psychiatric nurses) across all 13 provinces and territories.


OUR MISSION

To make nursing better — for nurses, for patients, and for our public health systems.

OUR VISION

Progressive leadership that unites nurses to advance our profession, the health of Canadians, and a healthier environment and society.

OUR VALUES

Courage | Equity | Diversity | Excellence | Innovation | Trust

Strategic directions


Strong nursing leadership identity and presence

Ensure and reflect nurses’ voices in policy decisions

Meaningful engagement and value among members

Innovation and expanded nursing practice

Fiscal and operational stability

Strong nursing leadership identity and presence

We speak out against inequity and inequality, participate in political processes, and advocate for nursing-focused policy options that are informed by evidence.

Advocacy

CNA emerged as a pivotal force in health-care advocacy, again earning recognition from The Hill Times as one of the most influential health lobbyists. Throughout the year, we engaged in over 70 meetings with public officials at all levels of government, advocating for nursing concerns and addressing the pressing health human resources crisis. Collaborating closely with esteemed partners like the Canadian Federation of Nurses Unions, Canadian Medical Association, College of Family Physicians of Canada, and various nursing organizations, we championed a collaborative, team-based care approach to confront health-care challenges head-on.

Our relentless advocacy efforts yielded significant results. We successfully secured the permanent reinstatement of the federal chief nursing officer, along with increased resources to fulfil the position’s pan-Canadian mandate effectively. Additionally, we supported the establishment of Health Workforce Canada, whose aim is to enhance data-driven decision-making in workforce planning for a resilient health-care system. 

Looking forward, our proactive stance is evident in our pre-budget brief to the federal government for the 2024 budget. Our brief outlines six strategic recommendations. These recommendations include creating a comprehensive pan-Canadian health human resources strategy, ensuring universal access to health-care providers across Canada, and prioritizing the mental well-being of nurses and health-care workers.

At the core of our endeavors is an unwavering commitment to shaping policies and initiatives that prioritize the health and well-being of all Canadians. Together with our partners and collaborators, we continue to advocate for a sustainable and inclusive health-care system that meets the needs of our diverse population.


In July, CNA co-hosted the International Council of Nurses Congress. We held numerous meetings with dignitaries, including Prime Minister Justin Trudeau, the federal health minister, Princess Muna Al-Hussein of Jordan (the World Health Organization’s patron for nursing and midwifery), and other leaders of nursing organizations.

In July, CNA participated in a Council of the Federation meeting in Winnipeg, where we met with premiers and advocated for solutions to nursing shortages.

In October, CNA participated in a health ministers’ meeting in Charlottetown, sharing our perspective on the health human resources crisis, and voicing our support for growing momentum for health reforms that unlock nurses’ potential.

In November, CNA re-started our annual Hill Day event, which includes in-person meetings with parliamentarians from all the federal political parties.


Health human resources

  • For years, health-care associations, unions, economists and other experts have been sounding the alarm about health worker shortages, particularly in nursing. A stable and sufficient supply of health professionals continues to be one of Canada’s greatest health-care challenges. Shortages have produced long and frustrating wait times, adverse events for patients, and untenable working conditions for nurses and other health-care workers.
  • The COVID-19 pandemic greatly exacerbated the ongoing nursing workforce crisis in Canada. Nurses are burned out, demoralized and exhausted as they care for patients and there is a worrying number of health-care workers leaving the profession. Excessive workloads and understaffing have pushed nurses and health workers past the breaking point. The lack of supports and increasing stress levels have forced nurses to retire early, switch to part-time employment, or leave their jobs or the profession altogether.
  • Furthermore, better data is needed to ensure the health workforce supply meets the population demand. Poor data means decisions around planning, staffing, deploying and recruiting and training continue to be made in the dark.
  • One of the key projects we collaborated on in 2023 was an event that led to the publication (in February 2024) of Co-creating Our Future: Integrated Health Human Resource Planning, Reimagined.
  • CNA jointly submitted, with the College of Family Physicians of Canada and the Canadian Medical Association, health human resource policy recommendations to the federal, provincial, and territorial governments.
  • CNA was invited to participate in the coalition for action for health workers, joining representatives from key groups, including nurses, doctors, personal support workers, colleges and universities, patients, and equity-seeking communities in collaboration with the federal government. The coalition reports to the Deputy Minister of Health, and contributes to nationally coordinated efforts to deliver concrete results; the federal government remains committed to protecting and strengthening our publicly funded health-care system and influencing health workforce retention.

Nursing Retention Toolkit

After much collaboration and consultation with CNA and other nursing and health partners for most of 2023, the long-awaited Nursing Retention Toolkit: Improving the Working Lives of Nurses in Canada was released in early 2024, with an executive summary released in late 2023. This resource recognizes nurses as the largest group of regulated health professionals in Canada. It looks at the impacts of pressure on the nursing workforce and health-care system and proves to be an in-depth resource for nurses and nursing retention in Canada. We are proud to have been consulted at every step of the way in developing this excellent evidence-based resource.


Anti-microbial stewardship

Nurses play a critical role in antimicrobial stewardship (AMS). In October 2019, the Public Health Agency of Canada (PHAC) awarded CNA a grant to develop AMS competencies for all categories of nurses in all practice settings. The project was designed to reinforce safe and effective nursing practice for managing patients undergoing antimicrobial therapy. Its goal was to help reduce antimicrobial resistance (AMR) across Canada. In late 2023, an online event hosted by PHAC and CNA showcased the research and scope of work on the project. We were proud to introduce Antimicrobial Stewardship Competencies: A Pan-Canadian Framework for Nurses, in early 2024 after the bulk of work was completed in 2023.


Nurses and the environment

CNA is committed to advancing environmental sustainability through advocacy, education and collaboration.


National Nursing Week 2023

For CNA, National Nursing Week is an exciting time to boost spirits and promote nursing in Canada. We strive to celebrate and promote the efforts of nurses, ensuring their voices are heard and valued at the forefront of leadership discussions. 2023 was no exception, with a lovely letter from the Governor General of Canada and inspirational video tributes.

Former Minister of Seniors Kamal Khera, RN

Prime Minister Justin Trudeau

CNA president Sylvain Brousseau


Media


press releases

Throughout the year, CNA has conducted media interviews, in all regions of the country, in both official languages, advocating for nurses, most notably on the ongoing health human resources crisis and our health systems’ nursing shortages.


As the co-host of the International Council of Nurses Congress 2023, CNA was pleased to welcome nurses and delegates from across the world to Montreal for a once-in-a-career opportunity.

National Nursing Week marks one of the most important times to recognize the contributions of nurses in Canada. CNA president Sylvain Brousseau was pleased to be interviewed by The News Forum.

The Gritty Nurses interview CNA CEO Tim Guest at the International Council of Nurses Congress 2023.


Ensure and reflect nurses’ voices in policy decisions

CNA actively encourages its members to participate in discussions with us to ensure that our policy and advocacy efforts accurately represent the viewpoint of nurses across Canada. In 2023, we added a student representative to the board of directors and invited the president of the Canadian Nursing Students’ Association to engagement events and the CNA Hill Day in November.


Supporting Indigenous nurses and Indigenous health

CNA is dedicated to enhancing the nursing profession by engaging with First Nations, Inuit, and Métis communities. With the guidance of our Indigenous relations advisory council, we are working on a reconciliACTION plan for responding to the calls to action from the Truth and Reconciliation Commission of Canada. Stephanie Tuurngaq Gilbert, CNA’s first Inuit board representative, wrote a message for the National Day for Truth and Reconciliation, entitled “Guided by Indigenous voices in nursing.” We advocated for funding for Indigenous nurses to pursue a profession in nursing, and advocated for continued secure funding for the Indigenous research chairs in nursing. CEO Tim Guest attended an invitational event entitled, “National Dialogue on Addressing Anti-Indigenous Racism in Canada’s Health Systems.”


Anti-racism in nursing

CNA is actively working to combat racism in nursing and amplify the voices of underrepresented nurses. In consultation with our anti-racism advisory council, we are planning CNA’s third anti-racism summit. In collaboration with the American Nurses Association, we co-hosted a symposium called “Addressing Racism within the Nursing Workforce” at the International Council of Nurses Congress. CNA is leading a Canadian Institutes for Health Research project focused on tackling racism and discrimination in nursing in Canada. We played a pivotal role in promoting this research project to ensure that nurses' voices are heard. The majority of the work was conducted in 2023, culminating in the publication of the first phase of the report in 2024.


The future of nursing

CNA believes a big part of its future lies in its ability to engage those entering the nursing profession. With this in mind, we added a student representative to the board of directors last year. We also invited the president of the Canadian Nursing Students’ Association to several important events, including our Hill Day in November. The president and CEO spoke to graduate and undergraduate nursing students throughout the year, sharing CNA’s advocacy priorities, the role of nursing in advocacy, and nursing leadership.


The International Council of Nurses Congress 2023

CNA co-hosted the International Council of Nurses Congress from July 1-5, 2023, at the Montreal Palais de Congrès, under the theme “Nurses together: a force for global health.” As the host country, Canada welcomed over 5,000 delegates in person and over 2,000 online from around the world to this prestigious event. Many visitors from around the world got to experience Canadian nursing firsthand by joining us for professional visits at partnering health organizations in Montreal. Before the Congress, the Council of National Nursing Association Representatives (CNR) was held. These gatherings provided valuable opportunities for global networking, knowledge exchange, and collaboration among nursing professionals dedicated to advancing global health initiatives.

ICN


CEO Tim Guest connects

Town hall

CNA members from across the country joined Tim Guest in June for an engaging and insightful session aimed at fostering connections and deepening understanding of our programs, services, and advocacy initiatives. The event included a dynamic Q&A session where attendees had the opportunity to pose questions directly to the CEO, gaining valuable insights into the organization’s strategic direction.

Townhall with special guest Dr. Leigh Chapman

In September, CNA hosted another town hall, this time with federal chief nursing officer Dr. Leigh Chapman. This event was an exciting experience for all involved, including a Q&A discussion after the presentations. With participation from all provinces and territories in Canada, it was a great success!

Longwoods Breakfast Series event

Tim Guest, Dr. Leigh Chapman, and Globe and Mail health reporter Carly Weeks held an engaging Longwoods Breakfast Series event in December. The event, titled “Why you can’t recruit your way out of a crisis,” focused on current issues and strategic solutions for the future of nursing. After an engaging conversation and Q&A session, the speakers concluded that recruitment alone isn’t the answer because the nursing shortage is a global crisis.


Stellar Certification Program

CNA launched the Stellar Certification Program, a game-changer for workplace excellence in nursing. Through meticulous planning, collaboration, and dedication, the program boasts a comprehensive framework that will be used to recognize organizations that uphold excellence in workplace safety, use best staffing practices, support nurses’ development through education and professional development, and ensure an inclusive workforce that reflects Canada’s diverse population.

Josée Morin, RN, is the lead of the Stellar Certification Program.

Josée Morin with Stellar pilot representative Rinda Hartner, RN, director of the Grace Dart Extended Care Centre in Montreal.


CNA Accreditation Program

The CNA Accreditation Program continued to promote and uphold standards of quality for continuing professional development for nurses in Canada.

accreditations awarded

accreditations renewed

Specialty Certification Program

CNA specialty certification represents a significant achievement in a nurse's career, validating their expertise and dedication to delivering exceptional care within specific domains of nursing practice. It is a mark of excellence that benefits both nurses and the patients they serve.

certified nurses in Canada

newly certified nurses in 19 specialties

renewed nurses in 22 specialties

exams written


Inspire Nursing Program

CNA and the Canadian College of Health Leaders launched the Inspire Nursing: A LEADS-based Leadership Program in July. The program, which replaced the popular Dorothy Wylie Health Leaders Institute, is designed for nurses at all levels of care and leadership. It equips nurses with the expertise to become influential leaders in health care. Participants benefit from a dual membership in both organizations and have the opportunity to earn the Certified Health Executive (CHE) designation and the option to pursue CNA certification.


Canadian Academy of Nursing

The Academy is dedicated to identifying, educating, supporting, and celebrating nursing leaders across all the regulated categories and all domains of practice.

At a celebratory event in October, the Academy was pleased to welcome 21 new Fellows as well as recognize the Jeanne Mance Award and Order of Merit award recipients. The virtual event featured keynote speaker Dr. Leigh Chapman, the federal chief nursing officer.

In 2023, there was a 33% growth in Academy and premium members.


Meaningful engagement and value among members and nurses

The ongoing objective of bolstering membership remains a top priority for CNA as we transition to a membership model where individuals join voluntarily. As predicted, 2023 was a challenging year, with numbers below what we had planned. We were pleased we had a 37% increase over the year even with the impact of the pandemic, global nursing shortage, and continued confusion that leads some to believe that CNA membership is bundled with their provincial licensure (this is not the case in any province or territory). Membership is the lifeblood of our organization, and its growth remains a high priority on the road to sustainability.

In line with our commitment to enhancing member benefits, we proudly announced partnerships with UpToDate and GoodLife Fitness. These collaborations enabled us to offer exclusive discounts and perks to our members, enhancing the overall value of their membership.

Additionally, we offered a special discount for the International Council of Nurses Congress. Over 1,000 nurses seized the opportunity to attend the Congress, which was co-hosted by CNA.

Misty Fortier, CNA director of the credentialing centre and nursing policy, at the Canadian Association of Schools of Nursing conference in St. John’s, Newfoundland.


Social media and online engagement

In addition to enjoying discounts and benefits, CNA members gained exclusive access to the CNA online community, a platform where the latest developments in nursing and health care are shared. Complementing this resource, CNA disseminates a monthly newsletter to both members and subscribers, ensuring they stay informed about all CNA-related matters.

CNA also maintains highly active social media channels and a dynamic website, serving as hubs for up-to-date organizational information, news, and engagement. These platforms have never been more vibrant, offering members and followers valuable insights and opportunities for interaction within the nursing profession.

CNA’s flagship publication continued to inform and inspire nurses with its weekly content consisting of expert advice, analysis, best practices, opinions and profiles. Our social media presence continued to grow and drive traffic to the website.

  • 67 manuscripts submitted
  • 57 articles published
  • 9 profiles published
  • Canadian Nurse’s followers across all social networks grew by over 28% in 2023
  • 34,950 engagements (likes & shares)
  • 12,220 article clicks

  • CNA’s social media efforts have been instrumental in fostering engagement, sharing valuable resources, and amplifying our message to the nursing community and beyond.
  • We have over 140,000 social media followers across all our channels: X, Instagram, Facebook, LinkedIn, and YouTube

In continued partnership with Longwoods Publishing, the Canadian Journal of Nursing Leadership, which is included with CNA premium membership and available at a discount to general members, remained a highly regarded publication last year. The top topics searched within the journal included nursing leadership, mental health, leadership development, patient safety, and access to care.


Outreach and engagement

CNA is actively engaged in outreach efforts to promote the nursing profession. In 2023, our representatives attended a large variety of events and speaking engagements, directly interacting with students, practising nurses, and health partners. Our outreach efforts are integral to building a strong and supportive community of nurses nationwide.

outreach


Innovation and expanded nursing practice

In 2023, CNA embarked on significant collaborative efforts with our health partners, marking a milestone in our commitment to advancing health care and nursing in Canada.

CNA signed a memorandum of understanding with the Society of Nurse Scientists, Innovators, Entrepreneurs and Leaders (SONSIEL) and SE Health that amplifies nursing innovation nationwide. Through our collaboration, we aim to influence and inform diverse audiences about the profound impact of nursing innovation as we reshape the narrative of Canadian nursing.

CNA was also pleased to create one new academic partnership with the Learning Institute for Health Care Providers, which is offered by Nova Scotia Health.


Fiscal and operational stability

Statement of Revenue and Expenses

Year Ended December 31, 2023

The charts below are derived from the 2023 financial statements, which were audited by Baker Tilly Ottawa LLP.


Revenue


Expenses


Statement of Net Assets

as at December 31, 2023



CNA members can view the complete financial statements by signing in.