Nursing leadership (Toronto, Ont.)最新文献

The sustainability of a country's health human resources depends on the supply and mobility of its healthcare workers. Globally, nursing occupies the largest health professional labour group (59%), with a growth of 4.7 million nurses seen from 2013 to 2018, amounting to a nursing workforce of 27.9 million worldwide (WHO 2020a). Despite this increase, it is estimated that the world will need an additional nine million nurses and midwives by 2030 (WHO 2020b). Given these projections, enhanced nurse mobility can be anticipated and expected.

The complexity of nursing in Canada is evident in the diverse designations and jurisdictional approaches to legislation and regulation of the profession. The ever-evolving scope of practice of each designation of nursing shows the ability of nursing and nurses to adapt to the external environment and evolve to meet the needs of clients, the profession and the healthcare system. This commentary highlights the "made-in-Canada" research regarding intraprofessional collaboration. It also presents recommendations to strengthen intraprofessional collaboration over the next decade.

Expedited in the midst of the COVID-19 pandemic, virtualization of healthcare is becoming an inevitable norm. While this conveys hope for improving health systems performance, inequitable access could result in consequences that intensify health disparities and increase the burden on the health system. Nurse leaders are optimally positioned to tactfully influence policy directions on virtual care and shape a comprehensive research agenda that includes virtual nursing care in all domains of practice. With virtual care advancing into the mainstream, it is time to mind the health equity gap and co-design virtualized care that ensures the needs of all are met.

This is the final issue of the Canadian Journal of Nursing Leadership (CJNL) for 2021, and the final issue for this editor-in-chief. It is with some reluctance that I step away from this role, but I am a firm believer in knowing when your expiry date is pending. When I took over CJNL from Dorothy Pringle in 2010, the task seemed daunting - what big shoes I had to fill - and almost immediately, imposter syndrome took hold of my psyche. But clearly, I forged ahead, and more than 10 years later, I have reflected on my editorial tenure, but more about that later.

Advanced practice nurses' (APNs') role definition, education, regulation, scope of practice, working conditions and integration vary worldwide. Clarity and alignment of foundational APN tenets can strengthen future workforce harmonization, innovation and models of care and data reliability for discussions and decision making. This global clarity and consistency can inform the design, delivery and leadership aspiring for health, education and socio-economic systems. Healthcare demands related to the COVID-19 pandemic, opioid crisis, aging population, non-communicable diseases, natural disasters and climate change have exposed glaring health needs and taxed workforces' and service capacity locally and globally. A fulsome deployment of nurse practitioners is one strategy that could help mitigate the impacts of these forces.

Given the nursing shortage, nurse educators and leaders are responsible now more than ever to advocate for baccalaureate education as an entry-to-practice requirement for registered nurses. The world today is complex, with population health issues stemming from the COVID-19 pandemic, high patient acuity and climate change. Accordingly, a nursing workforce that receives high-quality education is required. In this paper, an overview is provided about the evolution of a baccalaureate degree in nursing as an entry-to-practice requirement. We highlight evidence about patient outcomes associated with baccalaureate-prepared nurses, identify gaps and examine the nature of workplace environments in optimizing contributions stemming from baccalaureate-prepared nurses.

This postscript to the issue is a series of reflections by Dorothy Pringle, the previous editor-in-chief, on the contributions Lynn Nagle has made as editor-in-chief of the Canadian Journal of Nursing Leadership over the past 11 years and the richness of the perspectives of the authors of the 18 invited papers. The author also reflects on the contrast between the amount of attention and accolades nurses as care providers have received during the pandemic while having few, if any, nurses emerge as spokespeople or interpreters of the nursing roles and the contributions that nurses have made. Unlike other disciplines and despite their contributions, we have not learned the names of any nursing experts.

Nursing leaders play a critical role in responding to health human resource challenges. Innovative approaches are needed to retain and support the nursing workforce; recruitment alone is unlikely to address the gap. Actions to robustly support the onboarding of new graduate nurses, ongoing professional development opportunities and creative scheduling arrangements are all required to retain nurses. Shifting to a widened definition of the "health team" and a move from the traditionally siloed scope of practice models will require a transformational shift in thinking, and nursing leaders must lead that change. Health human resource planning must also occur in lockstep with population health planning.

Canada desperately needs more doctoral graduates. We also need more diverse graduates to move into education and leadership roles across the country. This article examines the origins and development of doctoral education for nurses in Canada and the continuing dire shortfall of doctorally prepared nurses to meet the expanding needs of the profession. In the context of this desperate shortage, this article then moves to examine the critical issues of equity, diversity and inclusion and the failure of the nursing academy and the profession to address these long-standing matters. These two issues - the shortfall of doctoral graduates and the lack of diversity in education and leadership in nursing - need to be addressed through a combined and focused strategy if we are to ensure the future sustainability of the profession. Given the decade-long lead time required to effect significant changes in doctoral graduations, the article concludes with a call for a national strategy engaging multiple stakeholders to increase awareness of the issues and their implications for the sustainability of the profession. It concludes that only through the united efforts of the profession will Canadian nursing be able to ensure that nursing education will produce a sufficient number of graduates for the needs of education, practice and policy across the country and that these graduates will better reflect the diversity of the nursing profession and the Canadian population, overall.

This commentary challenges historic and contemporary issues within nursing and provides direction toward a more inclusive future for nursing. This is a call-to-action for nurses, nursing students and nurse allies to advance effort toward the elimination of anti-Black racism in nursing in Canada. To achieve this, it is imperative to move beyond the performative and adopt practices that enable critical reflection and action. Addressing the manner in which exclusion is reinforced and perpetuated requires interrogation of four distinct yet interconnected processes of racial exclusion and discrimination. Notwithstanding, the future of nursing requires a critical examination of the role of nursing in and relationship with oppressive institutions, including prisons. Abolition, regarded as a radical stance, argues that beyond disproportional incarceration rates, prisons exist within a system of punishment that inflicts long-lasting irreparable mental and physical trauma upon individuals, families and communities. The effects of incarceration on mental, physical and spiritual health is a healthcare crisis that is in direct opposition to the core tenets of nursing and health.