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Josephine Muxlow, RN, MS, CPMHN(C)

Atlantic Canada

Why did you decide to become a clinical nurse specialist?
I completed my nursing diploma and midwifery certification in England. When I came to Canada, I did a post-RN baccalaureate degree in nursing at Dalhousie University, and my area of specialty was mental health. As a certified midwife, I was really interested in advanced practice nursing. When I looked into pursuing my master’s at Boston College, there were two choices: an NP stream or a CNS stream. Since I was very clinically focused, I wanted to do things that were related to my clinical practice and ended up choosing the CNS track. I believed it would provide me with a body of knowledge at a higher level than what I was using at the time. I felt it was a good way to gain the expert knowledge to enhance my practice and provide the best care for my clients.

How do you feel you help patients the most?
My role in helping clients is indirect. By providing health-services staff with evidence-based knowledge to inform their clinical practice, I enhance the quality of services and health outcomes for clients. I provide evidence-based knowledge, while focusing on system leadership through consultation, collaboration and education, which is a little bit different than clinical care nursing.

What is the most rewarding aspect of your job and what is the most challenging?
The most rewarding aspect of my job is being able to use the knowledge and skills I have to improve health systems internally and externally. Internal improvement is about working in different areas to enhance education, leadership and consultation. Externally, it is about working within communities, either with other health-care professionals or provincial health authorities.

I think the most challenging part of my work is not being able to participate in the hands-on clinical aspect of the CNS role. In my role as a CNS, I am employed by the federal government and thus work with First Nation communities located in the Atlantic region. Whereas, other CNSs in the Atlantic provinces are employed by the provincial government or health authority. The services I deliver are therefore different from other CNSs in Canada who work either in community or clinical care settings.

More about Josephine
My passion has been clinical practice and psychiatric mental health nursing. It’s really important for me to look at all my work through a public health lens. I bring a wealth of knowledge from many different areas of mental health. My main focus right now is looking at the health outcomes of clients from a social determinants and inclusion. Cultural safety is an important aspect of my work.

I’m affiliated with many associations both internationally and in Canada. Many colleagues in diverse areas inform the work that I do. For example, at the Guidelines International Network, they help me to look at policy and guidelines through the lens of standardization and evaluation. Colleagues at the Society for Clinical Nurse Specialist Education inform my role through the lens of academia. These affiliations also provide me the opportunity to work with CNSs who have been instrumental as mentors in my role.

Recently, I was honoured to be the president of the Clinical Nurse Specialist Association of Nova Scotia. It is a new association, incorporated in February 2016, which afforded me the wonderful opportunity of working with CNSs who are doing great work here in Nova Scotia. Several of our CNSs are doing groundbreaking work, such as helping perinatal mothers who have addictions and reducing psychotropic drug use for mental health clients. Within my work organization, other CNSs focus on chronic disease management and mental health. So for me, it has been a very rich experience having colleagues who bring such diverse expertise, knowledge and skills.