Category Archives: Nursing Associations

Primary Health Care & Universal Health Coverage 2024

Posted on by

The International Council of Nurses (ICN) released an important discussion paper in September 2024. Nursing and Primary Health Care: Towards the Realization of Universal Health Coverage authored by David Stewart, Madrean Schober, and Howard Catton.

As I write this blog just after December 12 – Universal Health Coverage Day – it is an opportune time to reflect on the topic of the paper and its recommendations. The paper is well organized  making it easy to work through its main body and appendices. Brief case studies are interspersed showcasing nursing leadership and innovations in different health systems and contexts.

In the introduction, the authors point out many of the current realities that stand in the way of achieving universal health coverage: resource constraints, fragmented care, underutilization of nurses, and lack of teamwork. They trace key developments in the PHC movement referring to the major global conferences and declarations – Alma-Ata (1978) and Astana (2018) – emphasizing foundational principles of primary health care. I was glad to see the sidebar quotation (page 8) on the difference between PHC and primary care, often a source of confusion.

Chapter 1: The case for change reviews the challenges and documented gaps. The value of PHC in improving population health outcomes is highlighted here. The focus on patients and a greater orientation to community control are highlighted throughout the discussion as is the case for funding. The key role of PHC in public health emergencies is illustrated by the COVID-19 pandemic. This chapter ends with a timely reminder about the vital aspect of PHC in delivering vaccination programs. Nurses have a key role in managing and delivering immunizations to all age groups and in a multitude of community settings.

Chapter 2: Reimaging the possibilities of nurses in primary health care. This chapter focuses on roles including advanced practice and documents how countries are promoting team-based models. Details are provided in tables and illustrations as well as in the case studies. The authors note that digital health is becoming more relevant to PHC education and practice and encourage innovation by nurses in design of appropriate digital tools.

Finally, it’s worth reading the conclusion; I find myself in complete agreement with the points offered including this statement: “PHC should be at the highest priority for governments because it is the cornerstone of a sustainable health system.” (page 51).

Appendix 1 offers a summary of ICN’s recent work on PHC highlighting papers, position statements, media initiatives, and ongoing partnerships.

The summary of the authors’ recommendations found in Appendix 2 is a useful tool organized into four groupings:

  1. Care coordination
  2. Integrated and team-based PHC
  3. Advanced practice nurses
  4. PHC nursing workforce

The recommendations encompass ideas for health system change, advocacy, interdisciplinary education, and action by professional associations. One of the many nursing workforce recommendations is to “increase the voice of PHC nurses in policy development and high-level decision making” (page 55).

Reading this rich discussion paper and reflecting on the interesting case studies reminded me of visits to primary health care centres in past travels to Aotearoa/New Zealand, Australia, Nepal, India, and at home in Canada. I wrote about experiences in Japan in my August 2024 blog Public Health Nursing in Japan: Then and Now reflecting on strengths of their system as it has developed. My appreciation of the reality of PHC is rooted also in early career experiences in a community health centre in rural Manitoba and at the Alexandra PHC Clinic in urban South Africa. In my home province of British Columbia, I worked with a coalition that promoted the CHC model and development of a network leading to the establishment of the British Columbia Association of Community Health Centres. Sometimes I wonder why we haven’t made greater progress when so many well-established centres exist as models in many countries including Canada. 

An excellent resource in Canada is the Canadian Association of Community Health Centres with member CHCs across the country. As highlighted on its website CACHC is “the federal voice for Community Health Centres and community-oriented, people-centred primary health care across Canada.” Recent announcements following provincial elections in New Brunswick and British Columbia provide optimism for new centres on the horizon in 2025.

It has been a turbulent year in geopolitics including concerns about the interconnected issues of conflicts, environmental crises, and global health. The positive messages of the 2024 ICN discussion paper do offer us hope for a time when universal health coverage is realized.

By Nora Whyte – December 17, 2024

I acknowledge with respect that I live and work on the Unceded traditional territory of the K’òmoks First Nation.

Nurses in the News

Posted on by

National Nursing Week in Canada is around the corner (May 6 to 12) and it is fitting to think about nurses in the news and how our vast experiences and perspectives are profiled. We often talk about the need for a much greater presence in the public media in our communities and around the country.

Two nurses who are bringing their expertise to the public discussion about health care in Canada are Amie-Archibald Varley and Sara Fung, co-hosts of The Gritty Nurse Podcast and authors of The Wisdom of Nurses. Since the release of their book, they are in demand for interviews and book signings. As I’m reading their book, I’m thinking about their questions and the multiple issues they raise about the profession. I’m pleased to see the attention the book is getting on social media and to learn that it has become a bestseller already.

Amie and Sara pose the question: “How many famous nurses can you name?” and then go on to share profiles of nurses from the past as well as current nurses who are well-known for their advocacy and contributions to changes in nursing and health care in Canada. They weave in their own personal stories – including their experiences in nursing school – as they describe their career paths in hospitals and, ultimately, the realization that they needed to make changes in their professional lives. They have included chapters by contributing authors to round out diverse voices and experiences.

I have no hesitation in recommending it and hope that readers will discuss it with people in their workplaces, in policy meetings, and in nursing schools across the country. Part of that discussion could explore the collective influence of nurses, thinking beyond one individual “famous nurse” to the groups of courageous nurses who came together to form nursing associations and unions not only in the distant past but also within the last 25 to 50 years. I’m thinking of the Canadian Indigenous Nurses Association, the Canadian Nursing Students’ Association, our national specialty groups, and the newly formed professional associations of the past 5 to 10 years, including the Nurses and Nurse Practitioners of BC in my home province.

Looking beyond our borders, we can celebrate the voice of national and global nursing organizations exerting their collective influence in reforming health systems and leading vital policy work. A great example is found in this recent announcement from the International Council of Nurses (ICN).

Dr. Cipriano, president of ICN will co-chair the global Steering Committee on Universal Health Coverage, known as ‘UHC2030’ with Dr. Magda Robalo:

UHC2030 warmly welcomes new co-chairs Dr Magda Robalo and Dr Pamela Cipriano – UHC2030

I feel fortunate that I have known famous nurses in my nursing lifetime, both in Canada and in countries I have visited for conferences and as a consultant. Memorable individuals and visionary groups of nurse leaders give me hope this Nursing Week.

By Nora Whyte – April 29, 2024

I acknowledge with respect that I live and work on the Unceded traditional territory of the K’òmoks First Nation.

Highlights of 2023

Posted on by

My professional highlight of 2023 was attending the International Council of Nurses (ICN) Congress in Montreal in July. I wrote about the experience in my summer post on the ICN Congress and have been reflecting on both the content and organization of the event since then. I was glad to meet new people and also to renew acquaintances with colleagues, some of whom I am connected with on social media and enjoy following their updates and commentary.

Photo credit: Renata Mares

The ICN Congress provided opportunities to hear from people I follow such as James Buchan and Howard Catton who discussed their report published by ICN Recover to Rebuild: Investing in the Health Workforce for Health System Effectiveness. Their key message is “that without sufficient investment in well-supported nurses there can be no effective healthcare system recovery and rebuild” (Buchan & Catton, 2023, p. 4).

The experience in Montreal alerted me to watch for and share statements from Dr. Pamela Cipriano, ICN President, and Howard Catton, CEO, in the latter half of the year during the UN General Assembly and other global meetings. Continuing on its important ‘Nurses for Peace’ campaign, the ICN Board issued a strong statement in November on the Israel-Gaza conflict and maintains a dynamic presence on social media. See links below to recent statements:

UN Declaration on Universal Health Care

Universal Healthcare Day Statement

Climate and Health Declaration at COP28

Statement on the Israel-Gaza Conflict

In addition to the experience of the sessions at the ICN Congress, I participated in several webinars offered throughout the year including events hosted by the Canadian Nurses Association: the annual meeting in June and a town hall in September. A notable webinar at the end of the year was a highly informative session with Natalie Bryant from Australia featuring her current work on ‘Indigenist Critical Policy Analysis’. Grounded in the United Nations Declaration on the Rights of Indigenous Peoples, it is a framework for assessing organizational policies to determine whether they uphold Indigenous rights and address issues in their policy processes. I look forward to learning more about using the framework. Thanks to the BC Indigenous Health Nursing Research Program and the Nuu-chah-nulth Tribal Council Nursing Services Department for hosting this session.

My consulting focused on work with the Nuu-chah-nulth Tribal Council as we concluded a community-based research project last year. As a team member, it was satisfying to have our article published in the Canadian Journal of Nursing Leadership:

Watts. J., Bourque Bearskin, L. Blackstone, D.  Christiansen, S. Young, K., Charleson, J., Charleson, R., Fraser, J., Sangster-Gormley, E., Dick, V., Duncan, S., & Whyte, N. (2023). Nursing the Nuu-chah-nulth Way: Communities driving nursing policy priorities. Canadian Journal of Nursing Leadership, 35(4), 55–67. doi:10.12927/cjnl.2023.27073

Another major highlight was the 50th Reunion of our UBC School of Nursing Class (BSN 1973) in May. It was a great, happy time of reminiscing and also gave us a chance to have conversations with classmates about our careers, families, and current interests. We spent time on the UBC campus and had a lovely evening at the Vancouver home of a classmate, Sherri Adams. The reunion committee did a fantastic job of arranging this milestone celebration!

My personal and professional worlds are intertwined in multiple ways. I think back on discussions this past year with a core group of friends and colleagues where the topics have covered writing and reading, conferences, career and retirement decisions, personal changes, the state of the world, travel, and gardening. Supportive friends, family, and close colleagues make it all worthwhile as the years go by.

By Nora Whyte – January 5, 2024

I acknowledge with respect that I live and work on the Unceded traditional territory of the K’òmoks First Nation.

Winter 2023 in the Comox Valley

ICN Congress 2023

Posted on by
Volunteers welcoming delegates
Credit: Renata Mares

The International Council of Nurses (ICN) held its 2023 Congress in Montreal from July 1 to 5, co-hosted by the Canadian Nurses Association. It marked the first in-person congress since 2019 and attracted 6,200 nurses from 145 countries. 

Delegates at ICN Congress, in national dress, before opening ceremony.
Delegates before opening ceremony – July 1st.

The congress theme – Nurses together: a force for global health – was evident throughout the event with inspiring plenary sessions by global leaders. In particular, I enjoyed several panel presentations featuring leaders from different countries and two policy cafés facilitated by ICN staff. Although it was impossible to take in all the presentations, it helped to talk with other participants about sessions they had attended. A customized congress app provided the daily schedule and access to all the abstracts and e-posters; it served as a useful tool throughout the event and to review information later.

Three volunteers at Booth at ICN Congress.
Volunteers at ICN Booth
Credit: Renata Mares

Plenary sessions focused on nursing workforce issues in the aftermath of the pandemic. I noticed greater awareness about ethical international recruitment practices and the urgency to ensure safe working environments. ICN leaders highlighted the new Charter for Change directed at government policy actions as the focus of a campaign, “Our Nurses. Our Future.” On the final day, we listened to powerful video presentations by nursing leaders living through current conflicts and disasters; we were touched by their courage in the midst of all the losses they have experienced.

Policy café: (Left to right) Mr. Howard Catton,
Dr. Amelia Tuipulotu & Dr. James Buchan

The new WHO Chief Nurse, Dr. Amelia Latu Afuhaamango Tuipulotu, was an active presence throughout the congress (and I was so pleased to have had a chance to speak with her at the end!). She moderated an excellent session on the current global agenda for nursing and midwifery in the context of Universal Health Coverage and also spoke about the importance of nurses’ voices in health policy.

Personal highlights included seeing people I’ve known over the years, especially nursing leaders from other countries and Canadian friends and colleagues. As we’ve remarked to one another, the mood was somewhat sombre and we sensed the fatigue nurses have experienced from the pandemic period along with global conflicts and humanitarian disasters. Some of the usual excitement found in these gatherings was missing although many attendees were enthusiastic about the opportunity to be together in Montreal. I especially enjoyed hearing impressions from first-time participants.

Outdoor Break at Congress Centre

Social media provided a glimpse into participants’ reactions to sessions and meetings throughout the congress. It gave us a sense of what was happening and who was attending; I made some new social media connections too! The ICN team sent out a daily summary each evening and used the app to notify participants of the next day’s sessions. The entire event required comprehensive planning and communication. Thank you to all the board members and staff of ICN and CNA for your leadership, along with many nurses who served on committees. The on-site volunteers – visible in their red shirts – were a great help to participants throughout the five days.

Dr. Carolyn Pepler & Renata Mares
Credit: Renata Mares

At the closing ceremony, a new ICN logo was launched – now featured on the revamped website. Visit the ICN Website for summaries of the congress and informative items about pre-congress meetings including the Student Assembly and the Council of National Representatives. During the closing ceremony, the Finnish Nurses Association issued a lovely invitation to the next ICN Congress to be held in Helsinki in June 2025. Please see this summary of the closing session: ICN Congress in Montreal closes with inspiring ceremony and the launch of its new visual image and logo | ICN – International Council of Nurses

By Nora Whyte – July 26, 2023

Updated: July 30, 2023

Thanks to Renata Mares for her kindness in sharing her photos of ICN volunteers and for giving me permission to use them in this post.

I acknowledge with respect that I live and work on the Unceded traditional territory of the K’òmoks First Nation.

Universal Health Coverage on the Agenda in 2023

Posted on by

The World Health Organization (WHO) Executive Board met recently from January 30 to February 7 in Geneva. A major theme this year is Universal Health Coverage (UHC) in preparation for the UN High-Level Meeting on UHC in September 2023. The previous High-Level Meeting on UHC in 2019 resulted in a commitment “to ensuring that, by 2030, everyone, everywhere will be able to receive quality health services without suffering financial hardship.” Further, UHC “covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care across the life course.” (WHO 2022).

Courtesy of UHC Coalition

There is an important connection between primary health care and sustaining the workforce to achieve the goal of UHC. I like the way it was expressed by the United Nations Foundation following the Executive Board meetings:

“Member States emphasized that stronger primary health care delivery and a robust health workforce were force multipliers that could jointly serve UHC and pandemic preparedness, response, and resilience goals and the Sustainable Development Goals writ large.” (UN Foundation 2023).

WHO’s Executive Board meeting sets the tone for a big year in global health (unfoundation.org)

The International Council of Nurses (ICN) delivered statements at the Executive Board meetings as part of civil society coalitions urging Member States to commit to investing in the health workforce for UHC. Themes of equity, patient advocacy, emergency preparedness & response and quality of care came through in the statements. A summary of ICN interventions on health care issues during this Executive Board session is worth reading to see the topics covered.

In keeping with the strong global health presence of ICN and its national nursing association members, the next ICN Congress holds promise for discussion of global policy directions. The ICN Congress co-hosted by the Canadian Nurses Association is taking place in Montreal from July 1-5. I have enjoyed participating in past congresses and look forward to attending this one on Canadian soil. The theme – Nurses Together: A Force for Global Health – provides optimism amidst troubling times for the profession and the world. I expect to hear perspectives on current global health challenges and examples of solutions to common issues: nursing retention, Sustainable Development Goals and contributions to achieving UHC. There will be symposia profiling national nursing associations and their activities, plenary sessions, a student assembly, posters and concurrent presentations.

Another feature is the Policy Cafés – highly informative and interactive as I observed in Singapore in 2019. For this congress ICN describes them as: “Located in the exhibition hall, the two Cafés give the opportunity for small group discussion with a panel of experts on a key ICN policy or priority topic. Arranged in an informal setting, the Cafés allow delegates to ask in-depth questions and interact with keynote speakers.” For registration and further details, please visit the ICN Congress Site and follow updates on social media.

By Nora Whyte – February 22, 2023

I acknowledge with respect that I live and work on the Unceded traditional territory of the K’òmoks First Nation.

Resources

UHC 2030 Coalition: Taking Action for Universal Health Coverage.

UHC 2023 Coalition: Universal Health Coverage Message Sheet for 2023.

World Health Organization (2022). Fact Sheet on Universal Health Coverage.

Sustaining the Canadian Health Care Workforce

Posted on by

As I write this reflection in late autumn 2022, the topic of the Canadian nursing workforce is on my mind. In the context of my consulting work I am often engaged in discussions on recruitment and retention of nurses in Indigenous communities. We look for ideas from many sources and consider strategies that will be most effective in the local context on Vancouver Island.

National organizations have issued statements and reports this month that highlight the urgency of human resources in the Canadian health system. In conjunction with a meeting of provincial and territorial ministers of health with the federal health minister, many organizations held meetings and issued briefing notes. The Canadian Medical Association (CMA), Canadian Nurses Association (CNA) and HealthCareCAN issued a “prescription for hope” that received media attention at that time. A follow-up letter to the Council of the Federation Chair of was issued on November 22 by the Canadian Federation of Nurses Unions (CFNU), CNA and CMA requesting an “urgent meeting” on finding solutions the health care crisis. I follow all these organizations on social media and appreciate seeing frequent updates and timely media releases. The media release and link to the letter are available here: Nurses and doctors engage Council of the Federation around solutions to Canada’s health crisis (cna-aiic.ca)

On November 17, the Canadian Health Workforce Network and the CFNU released a comprehensive report: Sustaining Nursing in Canada. I recommend working your way through the entire document when time permits as I’m doing at present. For a quick overview, I suggest the “Strategic Priority Actions” on page 9 followed by the Executive Summary. The “multi-layered solutions” offered are most welcome. We do need to think of steps and layers in a coordinated way and not a piecemeal approach. See also page 23 for a figure summarizing key points around retaining, returning and recruiting nurses.

Workforce planning is a strong theme of Sustaining Nursing in Canada with three steps identified on page 14: 1) Embed nursing workforce planning, 2) Enhance nursing data to support inter-professional workforce planning and 3) Enable nursing workforce partners access to evidence. In terms of priority actions, some are directed at employers and governments. I see a cluster of proposed actions that would help in nursing education and in mentoring students and new graduates as well as attention to supporting nurses over the course of a career. It’s intriguing to consider the idea of the national health workforce agency (pages 52-53) and I think that we may hear more about implementing something similar in Canada.

It is both a worrying and hopeful time as we reflect on media stories and personal experiences. I do hope that governments are paying attention at long last and that we will see solutions become a reality.

I end this post with images from earlier this fall when I visited the beautiful provinces of Nova Scotia and Newfoundland. I carry these memories with me with optimism for improvements in health care for people and communities in all parts of our country.

Peggy’s Cove Village, Nova Scotia
Government House Garden St. John’s, NL

By Nora Whyte – November 25, 2022

I acknowledge with respect that I live on the Unceded traditional territory of the K’òmoks First Nation.

Updates on Nursing Associations 2022

Posted on by
Parksville, BC – June 2022

I’m writing this update at the end of June in advance of our summer break in Canada. World events in the first half of 2022 have left us shaken and concerned about the future as we grapple with climate issues, global conflicts, food security, and population health. As I follow the daily news, I also turn my attention to developments in nursing and look for statements and opportunities for advocacy.

ICN Updates

The 75th World Health Assembly took place in May. It was interesting to follow on social media as it generated considerable attention this year. The International Council of Nurses (ICN) was active in presenting ‘Interventions’ on specific resolutions. See ICN’s summary here.

ICN along with the International Confederation of Midwives and the WHO met for their 9th Triad meeting in May. The representatives issued the 2022 Triad Statement focusing on health care workforce issues and reporting on what countries are doing in response to the Global Strategic Directions for Nursing and Midwifery 2021-2025. Howard Catton, ICN CEO, has been interviewed by many news media this year speaking about the war in Ukraine and related humanitarian crises and on the scale of the nursing shortfall globally.

Annual Meetings

The Canadian Nurses Association (CNA) and the Association of Nurses and Nurse Practitioners of BC (NNPBC) held their annual meetings in June. Both were open to all members and observers in a virtual format. The CNA Meeting of Members was noteworthy because it marked the first time that individual members could vote to elect candidates for the Board of Directors and vote on AGM motions. The previous federation model of territorial and provincial member associations carrying votes has ended. As a member who is following these changes, it will be interesting to see how the new membership structure will work and how the new Board will communicate with members throughout the country.  

After both meetings, I was left somewhat disappointed that there wasn’t more substance presented on what our associations are doing to demonstrate leadership during the current health care staffing crisis and other major issues in 2022 (I receive newsletters and view social media updates but others may not). I do recognize that annual meetings present highlights and financial statements on the previous year and are always six months out of date for the current year’s activities. It makes me wonder if members would be interested in (and commit to attending) an organizational update given in the autumn each year. We could meet the new Board members, hear their priorities for the current year, and ask questions – all through a virtual format, and in a less formal manner than at an annual meeting.

Annual meetings and major events aside, I do appreciate the ongoing work of our professional associations at all levels to bring a nursing perspective to provincial, national, and global health challenges and policy change.

By Nora Whyte – June 27, 2022

I acknowledge with respect that I live on the Unceded traditional territory of the K’òmoks First Nation.

Save the date for July 2023!

The Privilege of Membership

Posted on by

This is the time of year when membership fees are due and the reminders start rolling in. It is a time when I consider whether or not to renew my membership in various organizations and what commitments I’ll make in the year ahead. In particular at the start of 2021, I have been thinking about the privilege of membership in the Canadian Nurses Association.

As noted on its website, the Canadian Nurses Association (CNA) is “the national and global voice of Canadian nursing, working with nurses in all 13 jurisdictions across Canada to bring essential and meaningful change to health care and nursing in the country.” Membership is open to all regulated nurses who may join as individuals or through their membership in provincial and territorial associations in jurisdictions that are CNA members. Major changes in jurisdictional nursing organizations across Canada will continue to have an impact on national membership. For the first time, I will be taking out an individual membership because the annual membership fee in my provincial association, the Nurses and Nurse Practitioners of British Columbia (NNPBC), no longer includes CNA membership. I remain supportive of NNPBC and CNA and hope that we’ll see new membership models and fee structures in the coming years. Membership in CNA is a vital link to our dynamic global nursing body, the International Council of Nurses.

During the summer and fall of 2020, CNA conducted a member survey to build on dialogue and engagement sessions conducted in 2019 & 2020. For a good overview of survey results, see Your Voice, Your Association.  

Survey respondents viewed CNA in a favourable way with 81% noting that a national professional association is essential.  Communication is key to engagement and three preferred methods are: direct email, social media & webinars. Ideas for building a strong and effective association include:

  • Engage with membership on a grassroots level
  • Offer more mental health resources
  • Offer more continuing education opportunities
  • Forge strong partnerships with provincial and territorial associations

Highlights of the past year – shaped so dramatically and sadly by the pandemic – were linked to my longtime interest in professional associations and their role in policy advocacy clearly in evidence during 2020. It was satisfying to be a co-author with stellar colleagues, Patrick Chiu and Susan Duncan, on an article published in the Canadian Journal of Nursing Research:  

Charting a Research Agenda for the Advancement of Nursing Organizations’ Influence on Health Systems and Policy – Patrick Chiu, Susan Duncan, Nora Whyte, 2020 (sagepub.com)

In our abstract we indicate how we drew on “recent key national and global events including our systematic inquiry into Canada’s 2019 federal election, the Year of the Nurse and Midwife, and the Coronavirus pandemic to examine how Canadian nursing organizations respond in highly complex and evolving contexts.” Further, we used our observations to offer a vision and chart a research agenda for the advancement of nursing organizations’ influence on health systems and policy.

Another highlight that took place at the end of 2020 was receiving a Lifetime Achievement Award from NNPBC at a wonderful virtual 2020 Nursing Awards of Excellence Ceremony featuring music, dance, videos, and special messages from CNA and others. It was an emotional and proud moment to be among the group of BC nurses recognized for contributions to the profession in our province.  

Award from NNPBC – December 2020

I look forward to staying connected to nursing’s collective presence and voice provincially, nationally, and globally in 2021.

By Nora Whyte – January 19, 2021

I acknowledge with respect that I live on the Unceded traditional territory of the K’òmoks First Nation.

Postscript: February 21, 2021

For nurses from BC, the process of membership renewal in CNA was delayed at the start of this year. I was unable to renew in January as planned. Glad to see that the membership portal is working now and that we can renew or rejoin as BC registrants or retired members. Annual membership gives us access to the Canadian Nurse and opportunities to participate in our national association and the ICN. In fact, to submit an abstract (as first author) for the ICN Congress in November, one must belong to a National Nursing Association. I’m thankful that CNA is a member of ICN and that’s one of my primary reasons for renewing my CNA membership.