Abstract
The clinical nurse specialist (CNS) and nurse practitioner (NP) are the two types of advanced practice roles recognized in Canada. Leadership is an essential dimension of both roles, but many factors internal and external to the advanced practice nurse impact on leadership role enactment. This chapter summarizes research findings on advanced practice nursing leadership and provides exemplars of CNS and NP leadership. Capabilities outlined from a Canadian health care leadership framework are used to examine CNS and NP leadership and to highlight success factors and provide solutions to optimize the leadership potential of these roles.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Acute Care Geriatric Nurse Network. ACGNN: Caring for older adults’ gerontology. 2017. http://acgnn.ca/. Accessed 1 July 2019.
Alegria CA. Transgender identity and health care: implications for psychosocial and physical evaluation. J Am Acad Nurse Pract. 2011;23(4):175–82.
Andreychuk S, Miller A, Evans D, Versluis D. Topical issues and implications for advanced practice nursing practice and policy: Medical assistance in dying and cannabis use. In: Panel presentation. Hamilton Health Sciences; 2019.
Booker J. Assisted death: a call to action to improve end-of-life care. Am J Nurs. 2019;119(7):11.
Bridges A. Answering the call for an assisted death has taught me more about living my life than dying: MAID manager. Toronto: Canadian Broadcast Corporation; 2019. https://www.cbc.ca/news/canada/saskatoon/maid-program-manager-saskatchewan-update-1.5132602. Accessed 1 July 2091.
Bryant-Lukosius D, Carter N, Kilpatrick K, Martin-Misener R, Donald F, Kaasalainen S, et al. The current and future role of clinical nurse specialists in Canada. Can J Nurs Leadersh. 2010;23(special issue):140–66.
Bryant-Lukosius D, Cosby R, Bakker D, Earle C, Burkoski V. Practice guideline on the effective use of advanced practice nurses in the delivery of adult cancer services in Ontario. Toronto: Cancer Care Ontario; 2015. https://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=340702.
Bryant-Lukosius D, Spichiger E, Martin J, Stoll H, Degen Kellerhals S, Fliedner M, et al. Framework for evaluating the impact of advanced practice nursing roles. J Nurs Scholarsh. 2016;48(2):201–9.
Bryant-Lukosius D, Martin-Misener R, Donald F, Tranmer J, Brousseau L, DiCenso A. Resources to facilitate APN outcome research. In: Kleinpell R, editor. Outcome assessment in advanced practice nursing. 4th ed. New York: Springer Publishing Company; 2017. p. 249–71.
Bryant-Lukosius D, Jokiniemi K, Martin-Misener R, Roussel J, Carr M, Kilpatrick K, et al. Clarifying the contributions of specialized nursing roles in Canada: results of a national study. In: Panel presentation. Canadian Nurses Association Conference, Ottawa, 20 June; 2018a.
Bryant-Lukosius D, Carter N, Boucher L, Durepos P, Breznik J, Pierazzo J, et al. Application of a curriculum review framework to guide renewal of graduate nursing education. Symposium. Montreal QU: Canadian Association of Schools of Nursing Conference; 2018b.
Canadian Council of Registered Nurse Regulators. Practice analysis study of nurse practitioners. Beaverton: CCRNR; 2015. http://www.ccrnr.ca/assets/ccrnr-practice-analysis-study-of-nurse-practitioners-report-final.pdf. Accessed 1 July 2019.
Canadian Nurses Association. Canadian nurse practitioner core competency framework. Ottawa: Canadian Nurses Association; 2010. http://www.cno.org/globalassets/for/rnec/pdf/competencyframework_en.pdf. Accessed 30 June 2019.
Canadian Nurses Association. Pan-Canadian core competencies for the clinical nurse specialist. Ottawa: Canadian Nurses Association; 2014. https://cna-aiic.ca/~/media/cna/files/en/clinical_nurse_specialists_convention_handout_e.pdf. Accessed 30 June 2019.
Canadian Nurses Association. National nursing framework on medical assistance in dying in Canada. 2017. Ottawa: Canadian Nurses Association. https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/cna-national-nursing-framework-on-maid.pdf. Accessed 2 July 2019.
Canadian Nurses Association. Advanced practice nursing. A pan-Canadian framework. Ottawa: Canadian Nurses Association; 2019. https://www.cna-aiic.ca/-/media/cna/page-content/pdf-en/apn-a-pan-canadian-framework.pdf?la=en&hash=E1387634D492FD2B003964E3CD4188971305469E. Accessed 23 June 2019.
Carr M, Hunt P. Report and recommendations. Acute care geriatric nurse network. British Columbia: Submitted to the Nursing Directorate, Ministry of Health Planning; 2004. http://acgnn.ca/wp-content/uploads/2010/11/ACGNNRReport2003-2004Final.pdf. Accessed 1 July 2019.
College of Nurses of Ontario. Medical assistance in dying. Toronto: College of Nurses of Ontario; 2018a. http://www.cno.org/en/trending-topics/medical-assistance-in-dying/. Accessed 1 July 2019.
College of Nurses of Ontario. Guidance on nursing roles in medical assistance in dying. Toronto: College of Nurses of Ontario; 2018b. http://www.cno.org/globalassets/docs/prac/41056-guidance-on-nurses-roles-in-maid.pdf. Accessed 1 July 2019.
DiCenso A, Bourgeault I, Abelson J, Martin-Misener R, Kaasalainen S, et al. Utilization of nurse practitioners to increase patient access to primary healthcare in Canada—thinking outside the box. Can J Nurs Leadersh. 2010;23:239–59.
Dickson G, Briscoe D, Fenwick S, MacLeod Z, Romilly L. The pan-Canadian health leadership capability framework project: a collaborative research initiative to develop a leadership capability framework for healthcare in Canada. Victoria: Royal Roads University; 2007. https://www.cfhi-fcass.ca/migrated/pdf/health_leadership_framework_e.pdf. Accessed 23 June 2019.
Doerksen K. What are the professional development and mentorship needs of advanced practice nurses? J Prof Nurs. 2010;26(3):141–51.
Donald F, Bryant-Lukosius D, Kaasalainen S, Martin-Misener R, Kilpatrick K, Kioke S, et al. Clinical nurse specialists and nurse practitioners: title confusion and lack of role clarity. Can J Nurs Leadersh. 2010;23(special edition):189–210.
Gehrs M, Ling S, Watson A, Cleverley K. Capacity building through a professional development framework for clinical nurse specialist roles: addressing addiction population needs in the healthcare system. Can J Nurs Leadersh. 2016;29(3):23–36.
Gehrs M, Strudwick G, Ling S, Reisdorfer E, Cleverley K. Addressing gaps in mental health and addictions nursing leadership: an innovative professional development initiative. Can J Nurs Leadersh. 2017;30(3):23–42.
Government of Canada. Medical assistance in dying. 2019. https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html. Accessed 1 July 2019.
Gruben V, Chandler J. Organ donation and medical assistance in dying in Canada. Transplantation. 2017;101(8S-2):S14.
Harbman P, Bryant-Lukosius D, Martin-Misener R, Carter N, Covell C, Donald F, et al. Partners in research: building academic-practice partnerships to educate and mentor advanced practice nurses. J Eval Clin Pract. 2017;23:382–90. https://doi.org/10.1111/jep.12630.
Heale R. Overcoming barriers to practice: a nurse practitioner-led model. J Am Acad Nurse Pract. 2012;24(6):358–63. https://doi.org/10.1111/j.1745-7599.2012.00737.x.
Heale R, Pilon R. An exploration of patient satisfaction in a nurse practitioner-led clinic. Can J Nurs Res. 2012;25(3):43–55.
Health Canada. Fourth interim report on medical assistance in dying in Canada. Ottawa: Health Canada; 2019. https://www.canada.ca/en/health-canada/services/publications/health-system-services/medical-assistance-dying-interim-report-april-2019.html. Accessed 1 July 2019.
Health Leadership Academy. Preparing for alternative futures. Why navigating the disruptive forces shaping health care requires transformative leadership. Hamilton, ON: Michael G. DeGroote Health Leadership Academy; 2019. https://healthleadershipacademy.ca/files/2019/04/Alternative-Futures-of-Health.pdf. Accessed 23 June 2019.
Hurlock-Chorostecki C, McCallum J. Nurse practitioner role value in hospitals: new strategies for hospital leaders. Can J Nurs Leadersh. 2016;29(3):82–92.
Jenner C. Transsexual primary care. J Am Acad Nurse Pract. 2010;22(8):403–8. https://doi.org/10.1111/j.1745-7599.2010.00532.x.
Kilpatrick K, DiCenso A, Bryant-Lukosius D, Ritchie JA, Martin-Misener R, Carter N. Practice patterns and perceived impact of clinical nurse specialist roles in Canada: results of a national survey. Int J Nurs Stud. 2013;50:1524. https://doi.org/10.1016/j.ijnurstu2013.03.005.
Kilpatrick K, Tchouaket E, Carter N, Bryant-Lukosius D, DiCenso A. Structural and process factors that influence clinical nurse specialist role implementation. Clin Nurse Spec. 2016;39(2):89–100.
Lamb A, Martin Misener R, Bryant-Lukosius D, Latimer M. Describing the leadership capabilities of advanced practice nurses using a qualitative descriptive study. Nurs Open. 2016;00:1–14. https://doi.org/10.1002/nop2.150.
Martin-Misener R, Bryant-Lukosius D. Guest editors’ reflections on progress in the development of advanced practice nursing in Canada. Can J Nurs Leadersh. 2016;29(3):6–13.
Martin-Misener R, Donald F, Wickson-Griffiths A, Akhtar-Danesh N, Ploeg J, Brazil K, et al. A mixed method study of the work patterns of full-time nurse practitioners in nursing homes. J Clin Nurs. 2014;24:1327–37.
Ministry of Health and Long-Term Care. Nurse practitioner-led clinics. 2015. http://www.health.gov.on.ca/en/pro/programs/np_clinics/default.aspx. Accessed 23 May 2019.
Nurse Practitioner Association of Ontario. Nurse practitioner-led clinics. 2019. https://npao.org/about-npao/clinics/. Accessed 23 May 2019.
O’Rourke T, Smith Higuchi K. Activities and attributes of nurse practitioner leaders: lessons from a primary care system change. Can J Nurs Leadersh. 2016;29(3):46–58.
Pesut B, Thorne S, Stager ML, Schiller CJ, Penney C, Hoffman C, et al. Medical assistance in dying: a review of Canadian nursing regulatory documents. Policy Polic Nurs Pract. 2019;0(0):1–8. https://doi.org/10.1177/1527154419845407.
Roberts TK, Fantz CR. Barriers to quality health care for the transgender population. Clin Biochem. 2014;47(10–11):983–7.
Vilches S, Fenwick S, Harris B, Lammi B, Racette R. Changing health organizations with the LEADS leadership framework: Report of the 2014–2016 LEADS impact study. Ottawa: Fenwick Leadership Explorations, the Canadian College of Health Leaders, & the Centre for Health Leadership and Research, Royal Roads University; 2016. https://www.cfhi-fcass.ca/migrated/pdf/health_leadership_framework_e.pdf. Accessed 23 June 2019.
Virani T. Interprofessional collaborative teams. Ottawa: Canadian Health Services Research Foundation; 2012. p. 1–142. https://www.cfhi-fcass.ca/Libraries/Commissioned_Research_Reports/Virani-Interprofessional-EN.sflb.ashx. Accessed 12 Apr 2017.
Waddell K, Moat KA, Lavis JN. Evidence brief: Preparing emerging leaders for alternative futures in health systems across Canada. Hamilton: McMaster Health Forum; 2019. https://www.mcmasterforum.org/docs/default-source/product-documents/evidence-briefs/health-ldrshp-eb.pdf?sfvrsn=2. Accessed 4 July 2019.
Yazdani S, Buchman D, Wright L, Chandler JA. Organ donation and medical assistance in dying (MAID): ethical and legal issues facing Canada. McGill J Law Health. 2018;11(2):59–85.
Ziegler E, Valaitis R, Yost J, Carter N, Risdon C. Primary care is primary care: use of normalization process theory to explore the implementation of primary care services for transgender individuals. PLoS One. 2019;14(4):e0215873.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Bryant-Lukosius, D., Ziegler, E., Kilpatrick, K., Martin-Misener, R. (2020). Advanced Practice Nursing in Canada. In: Hassmiller, S.B., Pulcini, J. (eds) Advanced Practice Nursing Leadership: A Global Perspective. Advanced Practice in Nursing. Springer, Cham. https://doi.org/10.1007/978-3-030-20550-8_7
Download citation
DOI: https://doi.org/10.1007/978-3-030-20550-8_7
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-20549-2
Online ISBN: 978-3-030-20550-8
eBook Packages: MedicineMedicine (R0)