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Judith Shamian

Judith Shamian, RN, PhD
Past President, Canadian Nurses Association
Candidate for President, International Council of Nurses

“Health For All by the Year 2000” (WHO)

The wonderful scenarios we see in CNA’s primary health care (PHC) series bring to life what we have known for decades: nurses and nurse practitioners (NPs) are an enormous asset to this country. Nurses have a demonstrable impact on the well-being of communities and on those who comprise them. These stories about the many ways nurses make a difference are compelling. Just look around you and you’ll see evidence of this on a daily basis. Whether in public health, home care, primary care or at any point along the continuum, nurses are stepping up to make a real difference in the health of Canadians.

The illustrations captured in this series well articulate the contribution of nurses at the individual and community levels of care and across the continuum. Nurses and NPs are driving systems change at the meso- and macro-level by building programs and influencing policy. The evidence is clear, but the struggle is not over. The year 2000 came and went and Health for All has not been achieved. Even in a great country like Canada we are far from having Health for All. In fact, on some fronts we’re moving backwards, not forward.

Over the last few decades, we have come a long way by introducing PHC NPs into many health systems. While this is a great accomplishment, our progress has been insufficient. Yes, to achieve the optimal outcome of Health for All, we need NPs working with teams — but we need many more nurses in those teams working in an interdisciplinary fashion. This is what will lead the way to stronger and healthier communities. We have reached some milestones as well. Every province and territory now has the legislation and regulation in place to make independent NP practice possible. This is also great, but we must sharpen our focus on broadening the scope of practice for registered nurses if we are to fully realize the contribution they can make in PHC.

In addition to the “scope” issue, funding, turf protection and others barriers are still preventing the expansion of nursing contributions to the nation-building agenda. The CNA National Expert Commission called for Canada to be among the top five healthiest nations in five key health outcomes by 2017. This is a laudable goal, but we are well off that mark.

Whether in the areas of aboriginal health, mental health, access to care, the prevalence of chronic disease or the aging of our population, the health challenges we face as a nation now confront us on a daily basis. Yet, the solutions to much of what ails our health-care system are staring us in the face.

To address these issues, we need to use nurses to their fullest potential. When we do, nurses can drive improvements in the health of our population and the way our health systems work to support it. Let’s fix these problems by enabling nurses to do what they know how to do, what they are qualified to do and what they know needs to be done. We will all be better for it.