Nursing in an Evolving Canadian Healthcare System
- chantellemhs
- Aug 2, 2022
- 10 min read
Updated: Aug 2, 2022
By: Chantelle Shepperd
August 2, 2022
MHST/NURS 601 - Critical Foundations in Health Disciplines
Athabasca University - Master of Health Studies
The illustration is by Tim Boelaars for the Globe and Mail article, "Fixing Health Care: 10 ways to make Canada’s health care system better, faster and more cost-effective right now, (Globe and Mail, 2022)." The article reveals that the covid 19 pandemic has made it clear that Canadian healthcare system needs reform (Globe and Mail, 2022).
According to David Coburn, nursing is a vital health occupation (Coburn, 1988). Nurses provide professional care for patients in hospitals (Coburn, 1988). Now nurses can support patients in various healthcare settings, not only in acute care facilities but also in community settings. I am proud to be a registered nurse with a Bachelor of Science in nursing in Ontario. I am regulated by the College of Nurses of Ontario (CNO), which is the governing body for registered nurses (RNs), registered practical nurses (RPNs), and nurse practitioners (NPs) in Ontario, Canada (CNO, 2022). The CNO fulfills its role by establishing requirements for entry to practice, developing and enforcing practice standards, and determining that members are providing quality care (CNO, 2022). Overall, the CNO has a set of standard practice guidelines that applies to all its members (CNO, 2022). I am also a member of the registered nurse’s association of Ontario (RNAO), a professional association representing RNs, NPs, and nursing students in Ontario (RNAO, 2022). The RNAO has a set of best practice guidelines (BPG) for registered nurses in Ontario (RNAO, 2022). Members are offered advocacy with the federal and provincial government; development of best practice guidelines; legal protection (professional liability protection insurance (PLP)); cyber liability protection (CLP support is online legal aid support); and access to members-only exclusive offers (RNAO, 2022). Nurses play a vital role in the Canadian health care system as we collaborate with other multi-disciplinary healthcare professionals within any environment or sector where nurses are employed. The RNAO states convincing evidence that nursing (RN) care is linked to positive patient outcomes, decreased mortality, and morbidity rates (RNAO, 2021). Nurses are patient advocates and support those within the patients' support network. I have learned various concepts throughout the Critical Foundations in Health Disciplines course (MHST/NURS 601) and how the nursing profession fits into the healthcare system. Undoubtedly, registered nurses must maintain a professional identity online to build trust within the public, using the guidance of creditable resources and by setting boundaries outlined by professional authorities. Nurses have a broad grasp of knowledge as evidenced by their understanding of critical principles including health, determinants of health, the Canadian health act, multi-level approaches to health, and the importance of chronic disease prevention and management by recognizing changes in the healthcare delivery system to improve outcomes for vulnerable populations.
Nurses need to have a clear understanding of professional conduct and identity online. We live in a society where social media is a popular tool where people of all professional disciplines gather and share information. Social media are web-based sites that allow people to interact with each other by sharing and consuming information (Nations, 2021). Popular social media sites include LinkedIn, Instagram, Facebook, Twitter, Tik Tok, and YouTube. The International Nurse Regulator Collaborative (INRC) is a global collaboration between nursing regulatory organizations (International Nurse Regulator Collaborative, 2016). It involves the CNO and eight other organizations that promote research, share intelligence, and influences policy development to protect the health and safety of the public (International Nurse Regulator Collaborative, 2016). The INRC’s position statement for nursing expectations on social media indicates that nurses should conduct themselves considering the benefits and risks, maintaining their professional image and reputation; confidentiality and privacy; boundaries, integrity, maintaining a positive environment; following employer policies; being accountable; and they should consider the implications of posting information in haste or anger (International Nurse Regulator Collaborative, 2016). In addition, this course has allowed me to discover the significance of content curation. Content Curation is the act of discovering, gathering, and presenting digital content about a specific subject matter (Tilt.com, 2022). Kay Oddone (2016) states that content curation is a valuable skill vital to digital literacy (Oddone, 2016). Digital content curation also allows individuals to develop digital literacies that will enable them to prepare for future learning in any area (Oddone, 2016). Overall, digital content curation is not simply collecting links; it is a process that involves a series of steps- “… finding, selecting, editorializing, creating, and sharing…” digital content (Oddone, 2016). Digital content curation involves gathering reputable resources (Oddone, 2016). Moreover, digital professional e-portfolios are valuable tools to showcase an individual’s professional identity online (the University of Lethbridge, n.d.). Professional e-portfolios display goals, growth, achievements, and professional attributes developed over time in collaboration with others (the University of Lethbridge, n.d.). They market professional practice and display evidence of an individual’s ability to deal with technology (the University of Lethbridge, n.d.). I have learned that in our modern day and age, it is essential to have a professional presence online, especially when competing for positions in the highly competitive job market. E-portfolios give professionals a competitive edge by highlighting a person’s unique knowledge and skills and providing evidence of this for employers (the University of Lethbridge, n.d.). Overall, social media, content curation, and professional e-portfolios play a critical role in nurses’ professional identity. The digital world and general technology rush constantly evolving.
Healthcare quality depends on nurses having a clear understanding of health, the social determinants of health, the Canadian health act, and the multi-level system approach to health. According to the World Health Organization (WHO), the definition of health, formulated in 1948, “... is a state of complete, physical, mental, and social well-being, not merely the absence of disease or infirmity (Huber, 2011).” Unfortunately, the WHO’s definition of health has been constantly criticized for using the word “complete” about well-being as populations have aged and changed (Huber, 2011). Disease patterns have changed since 1948 due to increased public measures to improve population nutrition, hygiene, and sanitation conditions (Huber, 2011). Also, more powerful healthcare interventions are used today to improve patient outcomes (Huber, 2011). The WHO’s definition of health is counterproductive as it labels individuals living with chronic diseases and disabilities as ill (Huber, 2011). The report minimizes the human capacity’s role in coping with the ever-changing physical, emotional, and social challenges of chronic disease and disability (Huber, 2011). Stakeholders who attended a Dutch conference tried to redefine health as “… the ability to adapt to self-image (Huber, 2011).” According to Brooks (2017), the definition of health should be expanded to include acceptance and tolerance. Social determinants of health are closely linked to the healthcare experiences that specific populations face (Richardson & Crawford, 2020). The WHO defines the social determinants of health as the condition in which people are born, grow, live, work, and age (Richardson & Crawford, 2020). Social determinants are closely related to the distribution of money, power, and resources and are driven by government policy choices (Richardson & Crawford, 2020). The Canadian health act adopted in 1984 outlined that universal healthcare coverage includes medically necessary hospital and physician healthcare services (Flood & Thomas, 2016). The act excludes other vital goods and services such as outpatient pharmaceuticals, dental care, long-term care, and many mental health services (Flood & Thomas, 2016). Unfortunately, Canada’s healthcare system needs modernizing as there are gaps in publicly funded healthcare services for patients (Flood & Thomas, 2016). According to Flood & Thomas (2016), the Canada Health Act should also include a broad range of health care services such as prescription drugs, diagnostics, psychological and mental health support, home care, and dental care (Flood & Thomas, 2016). Lastly, nurses need to understand multi-level approaches to understanding health clearly. A multi-level approach to health involves predicting health outcomes for specific populations and is based on many levels of organization that work together to produce health outcomes (Galea, 2015). Ultimately, a multi-level approach to health teaches us to ask how it is that social relationships grow healthy behaviors that are in a pathophysiological manifestation of the disease (Galea, 2015). Multi-level perspectives on disease consider multiple factors influencing social behaviors and diseases, such as genomic factors, environment, disparities, and access to quality care (Galea, 2015). In addition, understanding social-ecological model (SEM) concepts can help explain why a population might face a particular health issue. SEM is an interaction between and interdependence of factors within and across all levels of a health problem (Rural Health Information Hub, n.d). It is based on the idea that an individual’s health is influenced by many factors, including physical, social, and political environments (Neufeld et al., 2020). It involves various levels of influence, including intrapersonal, interpersonal, institutional, community, and public policy, to understand better health and human behavior (Neufeld et al., 2020). More specifically, the model addresses and interprets how health and human behavior reflect one’s interaction with different social and political systems (Neufeld et al., 2020). Overall, a multi-level understanding of health allows nurses to discover what multiple factors influence the health of populations and what valuable tactics might be used to improve population health (Galea, 2015).
CBC News National shows Dr. Mike Kirlew, an MD who travels to Northern Canada monthly to provide services to northern communities. These communities have access to way fewer healthcare services when compared to other places in Canada (CBC News: National, 2018).
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