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    • #2821

      How Health Care Decisions Get Made, The Policy Cycle and How Policies Get Made

      Discussion starters:

      What are some examples of the different types of policies that affect nursing in Canada? Would you consider yourself a “politically astute” nurse?  What are some ways in which nurses can become active in policy as advocates?

    • #3161

      1. What are some examples of different types of policies that affect nursing in Canada?

      Some of the different types of policies that affect how we nurse in Cananda are CNO policy how nurses are governed ,hospital the policies that hospitals use to govern their employees , union policies that are put in place for the good of the people,ministry of health policies.

      2. Would you consider yourself a “politically asute” nurse?

      I have a strong understanding of the policies that are in place at my work place and why we have them. I have a general knowledge of policies at the municipal, provincial, and federal level.

      3. What are some ways in which nurses can become active in policy as advocates ?

      As a nurse if we notice common problems that affects our clients at the workplace there are things we can do to advocate for them to help bring change, ie talk to the doctor ,or nurse manger about their concerns. If we want to impliment change in the community we can develop strategies like lobbying polititians make them aware of what is happening in the community. Involve those that are directly affected create public support, ie community meetings, flyers and information packages.

    • #3165
      Amy- Marie

      1) What are some examples of the different types of policies that affect nursing in Canada?
      Policies that affect nursing in Canada include the College of Nursing standards Policy. Nurses need to ensure that they are following their standard of practice as that is a bible or do’s and don’t for the most part. There are also the policies in which we follow within our workplace. The CNO can provide an overview of what we can and can not do, but then the policy of the organization that we work for can then decide to expand what we can and can not do. Lastly, some organizations may have unions that will govern the employee.
      2) Would you consider yourself a “politically astute” nurse?

      I am aware of the policies that govern safe nursing practice. I wouldn’t say that I know them like the back of my hand. However, if there are ever questions in the back of my mind regarding my best practice guidelines for nursing, I would look them up before doing anything that I question.
      I often refer back to the policies of the hospital that I work for as they are often changing and it’s not a bad thing to really understand those.
      As for government policy- those I don’t keep up on as they are not something I use in my daily work life.
      I would say that I am a “politically astute” nurse when it comes to knowing my policies while working and if I ever question something I always try and find out the answers before proceeding.

      3) What are some ways in which nurses can become active in policy as advocates?
      A professional nursing organization like the RPNAO or the CNO. The CNO may have lobbyists that bring nursing issues to capitol hill- like during COVID- 19 there was some lobbying taking place to cancel Bill 124. Having a big voice with unions in the workplace also helps to be active with policies within the workplace.
      Collaborating with other members of the health care team members and push for change.
      Involving those who are directly affected by issues that are happening. Providing information to the community and making them informed- helps drive for change and it advocates for the community.

      • #3317

        I understand that the CNO is lobbied by nursing associations (CNA and WeRPN) and other external forces. Its purpose is not to do the lobbying. An example of this is the changes to the scope of practice for RPNs.

    • #3181

      Hi everyone,

      My name is Melissa and I’ve been an RPN nurse for 9 years now. I have taken several online and in class courses to enhance my ability to provide the best care possible. I enjoy working with the elderly and have recently been moved to a dementia unit. I have taken Leadership 1 and look forward to completing this one. Can’t wait to explore and learn with everyone in the coming weeks.


    • #3194

      Hi Everyone ,

      My name is Kari-Lynn Madden I have been a mental health nurse for 14 years on a dual diagnosis ward in a locked unit. It was a very rewarding job I loved it. I was able to take early retirement just about a year ago. I spent this last summer with children at day camp as camp nurse, it was a great summer working with the kids and camp counsellors. I took Leadership 1 and I look forwad to working with all of you to complete this one.

      Warm Regards


    • #3249

      As a mental health nurse working on a dual diagnosis floor for 14 years (schizophrenia/cognitive impairment) There have been many times that I had to advocate for my patients. When we notice common problems that affect our clients we collaberate with our colleges to push for the change needed. As part of a nursing team we must have a voice for those that need to be heard so that change can happen wether it be in the community or hospital setting . We did this through use of hospital policies and CNO policies that help govern us in the right direction. Like nurses in Toronto did when they started the lengthly process of lobbying the provincial health ministry to come up with other ways to facilitate access to health cards for the homeless. This brought on policy changes now the ministry of Health brings its health card replacement service to community health centres and recognizes addresses such as shelters. It’s because nurses understood policy needed to change for these clients so they could have their health care needs taken care of.

    • #3266

      Hi all,

      Thank you for your inputs on policy.
      Canadian health policy has its strengths but as most of you working in healthcare know, it also needs work. As the demands for health services grow (due to an aging population), the stress on the system will only get worse.
      Speaking of policies…pause for a quick second, and think: was there a specific policy and its implementations that proved effective during the early days of the pandemic? Also, as frontline workers , did you experience a a gap in communications of the said policies especially since the process involved so many: provincial government, local public health units, municipal and regional government and your unit?

      And in case you’re interested, check out the Commission on the Future of Health Care in Canada (the Romanow Report). In 2002, the Commission recommended policies and measures that, while respecting all relevant jurisdictions and powers, would ensure long-term sustainability of a universally accessible, publicly funded system offering quality services.

      See you in the next module. Happy reading.

      “Good management is the art of making problems so interesting and their solutions so constructive that everyone wants to get to work and deal with them,” Paul Hawken.

    • #3274

      My names is Sarah. I have been in nursing for 8+yrs, mostly long term care and primary care.
      I feel there are many types of policies in nursing ranging from work place health and safety to patient care. I do not feel like I am an astute policy nurse. at this time, but I would love to change. I am aware of the policies, where they can be located and refer to them if I feel I question something. Understanding how the policies are derived and written would be a valuable asset, to better understand the dynamics of how they are made. I feel nurses can become more involved by providing work flow input, actively assisting in the creation of policies, and once enacting the policies providing feed back as to wether or not the policy is working.

    • #3306

      What are some examples of the different types of policies that affect nursing in Canada?
      According to the readings, substantive and administrative policies play huge roles on the nursing profession. Specifically, substantive policies are concerned with the legislation, programs and practices that govern the substantive aspects of community work. For example, policies from CNO governs how nurses practice within the profession while policies in the workplace governs what nurses can do while in a working environment.

      Would you consider yourself a “politically astute” nurse?
      I am aware of the issues taking place in health care and would consider myself politically aware. I think nurses are aware of facility or general governing policies but often, we lack awareness of the specifics of how policies affect nurses on the frontline. For instance, in the upcoming elections I would base my vote on the campaign that offers the most to my profession. As nurses we should vote to ensure our profession is not overlooked.

      What are some ways in which nurses can become active in policy as advocates?
      I notice nurses become frustrated by policies affecting them. Policies are frequently written by individuals with limited healthcare knowledge and experience. I believe working nurses need to advocate more for policy. This could be through petitioning with larger nursing bodies like CNO, RPNAO or RNAO, or joining and discussing policy through your local unions.

      • #3316

        I agree with Melissa, It is very important that nurses vote for the political party that will support healthcare. It is not the time to make any cuts in federal transfer payments or Provincial funding. As Radhika stated our aging population has put additional strain on our already crumbling health care system. Nurses are in an ideal position to advocate for positive changes in health care.

    • #3310

      My name is Martha. I have been a nurse since February 2020. I started working at the beginning of the pandemic, talk about trial by fire. I completed Leadership 1 in the winter and look forward to increasing my leadership skills.

      • What are some examples of the different types of policies that affect nursing in Canada?

      The Canada Health Act 1984 – This legislation replaced the previous federal hospital and medical insurance acts, and consolidated their principles by establishing criteria on portability, accessibility, universality, comprehensiveness, and public administration. The Act also added provisions that prohibited extra billing and user fees for insured services. (

      The Nursing Act, 1991, along with the Regulated Health Professions Act, 1991 (RHPA), determines how the nursing profession is regulated in Ontario. The RHPA applies to all of Ontario’s self-regulated health professions. The Nursing Act establishes the mandate of the College of Nurses of Ontario and defines the scope of practice for the nursing profession. (

      Public Hospitals Act 1990 – Restricts nurses from initiating controlled acts in a hospital setting. Where all orders must be from a Doctor, NP, Dentist or midwife. (

      Long Term-Care Home’s act 2007 – All long-term care homes in Ontario are now governed by this one piece of legislation. The LTCHA is designed to help ensure that residents of long-term care homes receive safe, consistent, high-quality, resident-centred care. (

      • Would you consider yourself a “politically astute” nurse? If yes, why? If no why not and what skills and/or knowledge do you think you need?

      Yes I believe myself to be politically astute. I am aware of the legislation governing healthcare and that changes need to be made to keep Canada’s healthcare in a top position worldwide. I intend to be a part of positive change in healthcare. Reductions in federal transfer payments and cuts in provincial funding have severely affected Ontario’s healthcare. The system has been crumbling for years and especially during the COVID pandemic Official finally realized the poor state our long-term care homes are in.

      • What are some ways in which nurses can become active in policy as advocates at a micro (unit level/individual), meso (workplace/organization) and macro level(government)?

      Micro Level – Nurse must be aware of and ensure that MOHLTC guidelines are being adhered to on a daily basis. Nurses are responsible to educate and monitor UCP’s to ensure residents are being cared for. CNO Mandatory reporting is a policy compelling Nurses to report any abuse towards a resident and which provides whistleblower protection

      Meso – Nurses must work with management to ensure policy in being communicated and acted upon. As a nurse in LTC , I offer my support to my management team. I let them know that I am part of the team and that I want to be part of any positive change. I do not subscribe to clinging to the “old ways” especially during the COVID pandemic.

      Macro – Nurses should be positively engaged in their association and union. It is through WeRPN and the respective RPN unions that lobbying the government for positive change happens.

      • #3320

        Great insight into these questions Martha! I like that you looked at the different levels of how nurses can become advocators. Great work.

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