The Next Decade

The Next Decade: CNA’s Vision for Nursing and Health

This vision builds on today’s trends and the dialogue with nursing and non-nursing partners across the country.

Nurses are the largest group of health-care providers in Canada and around the world and, as such, are uniquely placed to address health priorities. While the Canadian health system is evolving to address this country’s health priorities, it is doing so in a global context. This presents a number of challenges stemming from national and inter­national pressures, including increasingly complex health demands and a shortage of health-care professionals. If we continue to work with current policies and delivery models, the gap between health-care needs and our ability to address them will grow.

However, this gap is not inevitable.

Working collaboratively with partners to develop far-sighted policies and well-targeted actions, the Canadian Nurses Association (CNA) is helping build a high-quality and sustainable Canadian health system. This vision focuses on keeping people well by linking health to social determinants, supporting health promotion and promoting community-based care as well as acute illness care. Nurses are at the forefront of mapping the future of health care, strongly believing in health as a human right.

Making new models of health care a reality means changes. It means re-examining how nurses¹ are educated and regulated and how they practise. It means determining how their competencies can be used to best advantage. It means breaking down divisions within nursing, as well as barriers between nursing and other professions, so that we can work collaboratively as health-care professionals, policy-makers and leaders to build a healthy tomorrow. It means working across sectors – with engineers, environmentalists, foodsafety experts and many others. It also means actively engaging the public, whose views must be heard and integrated into the future system.

So, what is our vision for nursing and health?

This vision focuses on keeping people well by linking health to social determinants, supporting health promotion and promoting community based care as well as acute illness care.

• CNA envisions a tomorrow in which all Canadians benefit from access to a comprehensive, not-for-profit, publicly funded, publicly administered health-care system. An expanded health-care system better serves the needs of vulnerable populations and includes national pharmacare and home-care programs. Nurses are present throughout the system – in homes, hospitals, clinics and other community settings – helping deliver the health care Canadians need. Even though there is a growing focus on health promotion and the prevention of disease and injury, illness care remains one of the priorities. Supportive care is always provided, including at the end of life. Hospitals are settings for emergency services and for short-stay and critical care. Surgical and diagnostic wait lists are non-existent or at an acceptable minimum level, and the need for institutional beds is substantially reduced.
  
  
• Nurses support individuals and communities in managing their own health. Nurses care for those who are ill and have an increasing role helping clients manage chronic diseases. Thanks to increased nursing support, clients are making many more decisions regarding their care, quality of life and health promotion at every age and stage of their lives. Nurses are part of a collaborative team of health-care professionals and support staff. They are one of the everyday entry points to this health-promotion, disease-prevention and illness-care system.
  
  
• Nurses exercise leadership in all areas of the health-care system; in addition to direct clinical care, nurses are senior executives, educators, researchers and policy-makers. Nursing curriculum is based on nationally determined competencies in accordance with regulatory requirements for entry to practice. The undergraduate and graduate curricula are designed to address the shift from an illness treatment model to one that focuses on keeping people well, with care and support for maintaining health delivered in the community. Mentorship programs, internships and other supports help nurses adapt to the dynamic environment and transition to new and emerging roles. These initiatives also help retain senior nurses in clinical roles as mentors.
  
  
• Nurses practise in a healthy environment that prioritizes their safety and mental wellbeing. They express satisfaction with their work, are supported by sufficient numbers of colleagues and mentors, and want to remain in the profession. The talent and competencies of nurses working in clinical settings are put to full and efficient use. They work with other regulated health-care providers as well as support staff; all non-nursing work is carried out by other personnel.
  
  
• Interprofessional teams across the health system are well supported by information and communications technology that seamlessly links patients, health services and health professionals, regardless of geographic borders. Technology allows nurses and other health-care professionals to provide patients with access to the right care at the right time. Every Canadian has an electronic health record.
  
  

• Nurses are present throughout the system – in homes, hospitals, clinics and other community settings – helping deliver the health care Canadians need.

  The key to effective nursing education remains nurses teaching nurses. Nurse experts in the field provide clinical support as mentors and preceptors and are important partners in curriculum development. Education programs support nurses and nursing students at all levels through strong, effective partnerships among nurses in education, clinical practice, research, policy and administrative roles.
  
  
• Nursing education uses interprofessional and innovative curriculum models to prepare nurses to work confidently in a world of robotics, gene therapy, complex information technologies, and constantly evolving clinical decision-making tools. Having completed their basic nursing education, nurses have a broad, solid foundation for providing direct clinical care to people of all ages from birth to death, in homes, hospitals and communities, and in areas ranging from child-bearing to mental health to illness prevention and palliative care. Bridging programs recognize prior learning and allow nurses to move into different regulated categories of nursing. Nurses are committed to learning throughout their careers and readily demonstrate this through their participation in continuing competence programs.
  
  
• All levels of nursing education programs are accredited and all are funded appropriately for classroom, online, laboratory and clinical learning. Education requirements are consistent across the country. Doctoral programs are available in all provinces and support well-developed nursing research programs. A variety of doctorates, including clinical and others, are available to those interested in pursuing specialized practice.
  
  
• A robust pan-Canadian health human resources plan means that Canada graduates sufficient nursing students to meet the country’s needs. It also supports nurses who choose to come and work in Canada. The plan, based on population health needs, projects Canada’s requirements on a 20-year horizon and is updated regularly; policy and funding decisions are based on the plan. The women and men who make up the nursing workforce reflect the diverse communities they serve.

The next decade will bring a Canadian health system different from the one we have now in ways we can’t foresee. Many of those changes will have been driven by new knowledge and new technology, increasingly influenced by global and regional dynamics. Now, more than ever, we need the knowledge, expertise and capacity of nurses to bring solutions to our health-care challenges. Nurses are, and will continue to be, at the heart of the system’s transformation, driving and managing change.

This vision builds on today’s trends and the dialogue with nursing and non-nursing partners across the country. It is designed to guide CNA strategic directions and initiatives by creating a clear understanding of our shared vision. We hope it will continue to stimulate discussion among nurses themselves, and between nurses and other health professionals and the public. It is intended to help individual CNA members work in their own communities and areas of practice so that nursing can contribute its best for the health of all Canadians. We hope that it will generate coordinated action by CNA members in the provincial and territorial jurisdictions, in our national associate and affiliate member organizations, and through national and international partnerships.