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Why Canada needs a Chief Nursing Officer - Now

by Sonya Grypma, PhD, RN



As a nurse historian I love the fact that my tenure as President of the Canadian Association for Schools of Nursing runs through 2019 and 2020 – two years of historical significance for Canadian nurses.  First, the year 2019 marks 100 years of baccalaureate nursing in Canada, with the offering of the first university program for nurses at UBC in 1919.  The universities of Toronto and McGill followed in 1920, the same year that Western offered its first Public Health certificate. At the CASN Council meetings in Ottawa this past week, among those honoured were nurse historian Dr. Sioban Nelson (Ethel Johns Award) and UBC (Institutional Outstanding Achievement Award).  Second, the year 2020 marks 200 years since Florence Nightingale’s birth, and has been designated by the World Health Organization as the Year of the Nurse and Midwife.

In my President’s Report, I noted that it is no accident that Canada took up the cause of university-level education for nurses; the dual tragedies of the First World War and the Spanish Flu heightened the public’s awareness of the need for well-educated nurses to respond to pressing health needs of Canadians. Indeed, changes in nursing educational standards are almost always in response to societal changes, and nursing educators have invariably taken leadership roles in these changes.  The seriousness with which Canada takes high quality nursing education characterizes how other countries see us.  As does the seriousness with which Canadian nurses take their commitment to the global community.

Which was why the fact that Canada no longer has a Chief Nursing Officer – and the need to rectify that now! – struck me so deeply as a Canadian delegate to the International Council of Nurses Congress in Singapore last June.

It was in Singapore, at a reception hosted by the Canadian Nurses Association, that Claire Betker (CNA President) and I, together with International Council of Nurses Board Member Lisa Little, decided to immediately pen a letter to Prime Minister Trudeau, appealing for a Chief Nursing Officer (CNO) to be reinstated in Canada by May 2020.  You see, we, along with the 5300 other delegates, had just learned about how Dr. Tedros Adhanom Ghebreyesus, Director General of the World Health Organization, had taken it upon himself to reinstate the CNO position in the WHO in 2017.  Dr. Tedros and the WHO CNO, Elizabeth Iro, were among the distinguished guests who attended the intimate CNA reception.  They graciously posed for pictures with a group of nursing students from Thompson Rivers University who, with the nudging of TRU Dean Donna Murnaghan, took the opportunity to ask questions. One was, “What advice would you give to help reinstate the CNO position in Canada?” Dr. Tedros  responded, “Write Justin Trudeau right away, let me know when you do, and I will follow up with a letter of my own.” The letter was drafted within a week, refined back in Canada, and sent to the Prime Minister on August 28, 2019.

The CNA has identified the establishment of federal, provincial, and territorial CNOs who are in positions of leadership as one of three pillars of Nursing Now Canada, a global movement with the primary intent of improving health by raising the profile and status of nursing and midwifery.[1]  Why does it matter that Canada reinstates the federal Chief Nursing Officer position? And why is this so urgent?  In our letter to the Prime Minister,[2] we noted that WHO’s reinstatement of their CNO position recognizes “the vital role of nurses in achieving the United Nations Sustainable Development Goals (SDGs), to which Canada is a signatory.”  We urged that the “achievement of the SDGs is dependent on strong nursing leadership in every country” and that most countries have senior nurses in their federal governments. In Canada, however, there is “no clear focal point of nursing policy leadership and the gap is being felt in Canada and among our international partners.”

This means, for example, that there is no point person to contribute to the WHO State of the World’s Nursing Report, being published in 2020, declared by WHO as Year of the Nurse and Midwife. Nor is there a “recognizable senior nurse to work directly with provincial and territorial government nursing leaders and to act as a governmental liaison” with the CNA and other nursing leadership groups Canada-wide.

Canadian nurses have demonstrated commitment to global health issues for over a century – not least of all by our involvement in the ICN and WHO.  Lyle Creelman, for example, was the Chief Nursing Officer of the World Health Organization between 1954 and 1968.[3]  In 1968, Verna Huffman Splane became Canada’s first official CNO. [4]  By 1993, 98 countries had a CNO position, including Canada, where it was positioned in the Office of the Deputy Minister of health.  In the last decade, it was abolished.

As we noted in our letter, reinstating Canada’s CNO will help the federal government be effective in delivering on its health policy mandate. This includes “better understanding of the value and contribution of the country’s 426,000 regulated nurses to impact population health and deliver better health care.” Reinstating the position by May 2020 will “increase Canada’s visibility and voice on the global stage, and particularly showcase our leadership at the World Health Assembly during the historic Year of the Nurse and Midwife.”

And you can help!  A quick way to get the word out is to Tweet and retweet your support of the Canadian Nurses Association’s Nursing Now Canada initiative to reinstate a Chief Nursing Officer by May 2020. Use the hashtag #CanadaCNO

Sonya Grypma, PhD, RN

President, Canadian Association for Schools of Nursing

[1] Shellian’, B (July 19, 2019) Nursing Now Canada … ready, set, go! A movement with meaning. Canadian Nurse.
[2] Letter to Right Honourable Justin Trudeau, PC, MP, 28 August, 2019.  

[3] For a fascinating exploration of Creelman’s life and achievements, see Armstrong-Reid, S. (2014). Lyle Creelman: The Frontiers of Global Nursing. University of Toronto Press.

[4] Splane, R.B., & Splane, V. H. (1994).  Chief Nursing Office Positions in National Ministries of Health:  Focal Points for Nursing Leadership.  (San Francisco:  UCSF School of Nursing). 

About Dr. Sonya Grypma

Dr. Donna Murnaghan, Dr. Sonya Grypma, Dr. Cynthia Baker with Dr. Tedros, WHO Director General, at CNA Reception in Singapore, June 2019

Sonya Grypma, PhD, RN, is President of the Canadian Association for Schools of Nursing. She recently served as Professor and Dean of Nursing at Trinity Western University in Langley, BC, where she is now Associate Provost (Leadership) and Dean of TWU GLOBAL. Sonya has also served as Chair of the Nursing Education Council of BC, and as a delegate to the NNPBC. An award-winning nurse historian, Sonya is currently completing her third scholarly book on the history of Canadian missions and nursing in China.

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