Summary
Highlights
Mike Villeneuve, CEO of the Canadian Nurses Association (CNA), expresses his delight in participating in the 'Nursing the Future' speaker series. He notes that 2020, designated the Year of the Nurse and Midwife, has been particularly challenging due to the COVID-19 pandemic, leading to significant disruption and recognition of nurses' sacrifices worldwide.
Villeneuve clarifies the distinct role of the CNA as a professional association, differing from unions (focused on individual rights and employment) and regulators (focused on public protection and licensing). The CNA represents the professional voice of nursing, aiming to advance the profession, impact health systems, build leadership, and serve the public interest.
The world and Canada are rapidly aging, with more people over 65 than under 15 for the first time in history. This demographic shift means the vast majority of nursing care will be for older, frailer individuals, posing challenges for healthcare systems regarding funding, chronic disease management, and long-term care. The number of people over 75 is expected to double in the next 20 years.
Villeneuve discusses the growing burden of chronic diseases and the resurgence of communicable diseases due to vaccine resistance. He also highlights critical issues in Canada: limited access to affordable long-term and home care (not covered by Medicare), and a significant mismatch between the need for palliative care and its actual delivery.
Patient safety is a major concern, with thousands of hospital beds occupied by patients due to preventable adverse events. A significant portion of healthcare funding disproportionately goes to acute care (hospitals, doctors, drugs), despite 70-80% of health outcomes being determined by social, economic, environmental, and indigenous factors. This funding model, designed for a younger population in 1975, is ill-suited for today's aging population with chronic conditions.
Politics is identified as the most crucial determinant of health. Villeneuve emphasizes the need for nurses to be at the table when healthcare decisions are made, using the example of the politicization of COVID-19 in the United States as a cautionary tale of its damaging effects on public health.
The CNA's priorities include pandemic preparedness, investing in virtual care, improving support for the aging population, strengthening anti-racism strategies, enhancing primary care access, implementing pharmacare, and increasing mental health funding for healthcare professionals, especially nurses.
To move forward, interprofessional collaboration is essential, where team members blur roles and share leadership. However, current healthcare systems often suffer from role ambiguity, hierarchies, and 'turf protection' among different nursing categories (RN, LPN, NP) and other healthcare workers, hindering effective patient care and requiring strategic restructuring.
Villeneuve challenges nurses to question the relevance of their actions and whether they truly meet patient needs. He calls on new graduates, the 'best educated generation of nurses,' to optimize their scope of practice. The public expects nurses to take on more responsibilities like prescribing and managing healthcare facilities, demanding a shift away from outdated practices and rigid silos based on who 'owns' a competency.
Research shows nurse-led models are clinically effective, satisfying for patients, and cost-efficient. However, political inertia often prevents their wider adoption. He then transitions to the critical state of long-term care in Canada, which was severely exposed during the COVID-19 pandemic. A vast majority of Canadians needing long-term care prefer to stay at home, yet the system is heavily reliant on institutional settings often staffed by underpaid and racialized support workers.
Canada faces a looming crisis with the baby boomer generation entering old age and an estimated need for 200,000 more beds in the coming decades, which is unrealistic. Villeneuve urges new generations of nurses to rethink aging, long-term care, and how to support people to stay at home longer, leveraging new technologies and innovative models of care.
Villeneuve concludes by celebrating the 'Year of the Nurse' and expressing immense pride in the profession. He acknowledges the current difficulties posed by the pandemic as a 'blip' and encourages new nurses to be active and 'disruptive' in improving healthcare systems. He emphasizes the high public trust in nurses, urging them to use this influence to lead and advocate for necessary changes within the healthcare system by joining professional associations like the CNA.