NURSING 201 sept 17
Historical Moments in Canadian Nursing (1600s onward)
Indigenous caregivers and Indigenous healers often left out of history due to lack of professional education and training; Indigenous midwives also played roles.
Catholic nursing sisters built nurse-run hospitals and contributed to early hospital systems in Canada.
1639: Hôtel-Dieu de Québec City established as an early hospital run by nuns.
1617: Marie Rollet Hébert involved in early nursing/hospital efforts in New France.
1629: “Sick Bay” with male attendants; early nursing roles included male attendants; missionaries were involved in health care delivery.
Hospital system in Quebec founded by nuns as charitable institutions.
Male attendants were among the first nurses; nursing was one of the first employment options for women.
Nursing sisters ran hospitals in Canada, shaping early nursing leadership and hospital administration.
Modern Nursing
Emergence of modern nursing; remote nursing and missionary nursing in late 1800s.
Late 1800s: Canadian missionary nurses helped establish hospitals and training schools in China.
Canadian nurses remained engaged in international work; linked with organizations such as the WHO (founded in 1948).
GLOBALIZATION: Remote nursing is a hallmark of Canadian nursing; health in remote areas depended on nurses.
Historically and today, remote areas lack physicians; outpost nursing stations provide public health, emergency services.
Responsibilities in remote settings historically included medication administration, midwifery, public health, first aid; today also include suturing, administering anesthesia, x-rays, and diagnosing illnesses.
Important Historical Moments in Canadian Nursing Education
Training schools and university programs developed to professionalize nursing education.
1874: Canada – St. Catharines, ON becomes a key site for nursing education/training expansion.
1884: Mary Agnes Snively (Toronto General) introduced a 3-year program combining practical nursing and teaching.
By 1930: there were 212 training schools.
1919: University of British Columbia established nursing education.
1920s–1930s: 5-year non-integrated degree programs appeared.
1932: Weir Report shaped nursing education policy.
1960s: Movement to separate nursing education from hospital authority.
1982: CNA resolution states nurses need a degree as an entry-to-practice requirement.
2000–2010: Degrees become entry-to-practice in every province and territory except Quebec.
1959: First Master’s degree program at the University of Western Ontario (UWO).
1967: First Nurse Practitioner program established.
1991: First doctoral nursing program at the University of Alberta.
2021: Doctor of Nursing (DN) program launched at the University of Toronto.
Modern Nursing Education and National Standards
1874 onward and 1884 program developments lead to broader education.
1930s–1950s: Growth of nursing education and professional standards.
CANADA: Canadian Association of Schools of Nursing (CASN) develops standards and national framework.
National Nursing Education Framework: A consensus-based framework describing expectations for baccalaureate, master’s, and doctoral nursing education.
CASN ensures nursing programs maintain quality and respond to changes in health care.
NCLEX (National Council Licensure Examination): Requirement to be licensed in Canada and the United States.
Nursing Identity Assignment (course activity)
Review assignment description and marking rubric posted on D2L.
Review Nursing Identity Assignment FAQ on D2L.
Post questions on D2L discussion board.
Late submissions: late unless extension granted; email both instructors at least 24 hours before due date.
Regulatory Understanding & Influence on Professional Identity & Practice Part 1
Presenter: Diana Snell; NRSG 201; Sept 15, 2025.
Governing Bodies, Regulated Health Professions, and Professional Organizations
Federal Government: Sets and administers national principles; finances health care through transfers; delivers services for Indigenous peoples, veterans, federal inmates, and RCMP; provides national health policy and programming; regulates drugs, health products, environmental/ workplace health, food and nutrition, health care system, disease prevention, health research.
Provincial/Territorial Government: Develops and administers health care insurance plans; manages and finances delivery of insurable services; determines hospital/long-term care locations; employs health providers; determines funding levels; reimburses physician and hospital costs; focus on prevention, public health threats, and informed decision making.
Canada Health Act: Federal legislation for publicly funded health care insurance; primary objective is to protect, promote, and restore physical and mental well-being and to facilitate reasonable access to insured health services without financial or other barriers; insured services provided on a prepaid basis without direct charges at the point of service.
Alberta Health and Nursing Regulation
Alberta Health: Sets policy, legislation and standards for the health system; allocates funding; administers the Alberta Health Care Insurance Plan; provides expertise on communicable disease control; ensures policy compliance.
Nursing regulation: Regulated at the provincial level; provincial legislation authorizes a nursing regulatory body to operate and regulate nursing practice; regulator is accountable to the public for safe, competent, and ethical care; each province/territory has its own nursing regulation.
Nurses must be registered in the province/territory where they work; requirements vary by jurisdiction.
Regulated Profession and Self-Regulation
Regulated profession: Self-regulation based on a formal agreement with government to regulate activities and protect public interest.
Government delegates regulatory authority to bodies with specialized knowledge.
Self-regulating professions set standards of competency and conduct and discipline members who fail to meet them.
Health Professions Act and Regulatory Framework
Health Professions Act governs the practice of regulated health professions.
Sets standard processes for registration, continuing competence, complaints, and disciplinary actions; establishes a board to advise the Minister.
Enables overlapping scopes of practice so no single profession owns a specific skill or health service; different professions may provide the same services.
Regulatory Bodies in Alberta
Regulatory bodies exist to protect the public; they self-govern and set/monitor standards for regulated nurses.
Councils exist in every province/territory; they are not post-secondary institutions; they are legal entities that regulate health professions to serve the public.
Alberta has 29 regulatory colleges; some regulate single professions, others regulate multiple professions.
A key responsibility is investigating complaints about regulated members and imposing sanctions when appropriate.
CRNA and Alberta Practice Regulation
CRNA (nursing-specific regulatory body in Alberta): sets standards and codes of ethics; supports safe practice; requires a practice permit to practice;
To maintain permit: meet ongoing registration requirements; adhere to CRNA standards and code of ethics; comply with applicable legislation.
The CRNA Council governs operations, setting governance policies and bylaws, adopting standards of practice, and appointing leadership; hearing decisions can be appealed.
Publicly accessible disciplinary outcomes promote safe nursing practice.
Professional Organizations and Networking
A few professional organizations exist to connect nurses across practice areas for advocacy, policy development, and professional leadership.
These groups support dialogue on health systems and health outcomes, and provide guidance on profession-wide issues.
They differ from unions and specialty practice organizations and can form alliances among nurses, students, and retirees.
The CNA, AIIC (and related networks) link nursing professionals to broader societal issues affecting health care.
Nursing Unions and Specialty Organizations
Nursing unions and specialty practice organizations exist to support labor rights and professional development.
Examples include: Canadian Nurses Association (CNA) network; Canadian Network of Nursing Specialties (CNNS); Alberta nursing associations.
Links and memberships include CNA and provincial organizations.
Regulatory Understanding & Influence on Professional Identity & Practice Part 2
Presenter: Diana Snell; NRSG 201; Sept 17, 2025.
Code of Ethics, Conduct & Discipline, Standards, Guidelines & Competencies, Legislation
Agenda items: Code of Ethics; Conduct & Discipline; Standards, Guidelines & Competencies; Legislation.
Code of Ethics in Canada
Nurses are bound to a code of ethics as part of regulatory process that protects the public; it states ethical values and commitments to people receiving care.
Provides guidance for relationships, behaviours, and decision-making in practice.
Used alongside standards, guidelines, research, and laws to guide practice; applicable to all settings (hospitals, community, self-employment, education, administration, research, policy).
Not tied to a single philosophy; allows theoretical diversity; developed by nurses for nurses; supports self-evaluation and peer review; revisions reflect social values and evolving needs.
In Canada: CNA adopts the ICN (International Council of Nurses) code as its first code of ethics; CNA Code of Ethics: an Ethical Basis for Nursing in Canada was adopted in 1980; an earlier ICN-based code was adopted in 1954; subsequent CNA updates occurred in 1985, and later revisions in 1991, 1997, 2002, 2008, 2017.
Conduct & Discipline
Regulatory framework addresses complaints about professional conduct of nurses across grades (RNs, NPs, GNs, GNPs, and permits holders).
Anyone can file a complaint regarding unprofessional conduct; definitions are specified in the Health Professions Act (HPA).
Investigations may lead to hearings; outcomes can include dismissal or disciplinary action.
Sanctions and conditions on a practice permit are public; decisions may be published to inform the public and guide registrants.
If a complaint is dismissed or if there is an appeal outcome, some publications may be withheld.
Standards, Guidelines & Competencies
Standards describe minimum expectations for RNs and NPs; standards vary by province/territory; nurses must meet or exceed all applicable standards.
Standards regulate professional obligations, safety, and public protection; accessibility to the public ensures accountability.
Standards can be developed or revised due to government legislation changes or emerging healthcare issues; ongoing review occurs annually.
5 standards framework (illustrative):
Safety of patients and practitioners
Legal references and compliance
Accessibility of information and transparency to the public
Alignment with government legislation and policy changes
Responsiveness to emerging trends and issues in health care
Documents are reviewed annually through assessment, consultation, and approval phases.
Guidelines provide principles, direction, and decision-making frameworks for RNs and NPs; help registrants apply standards; accessible to the public.
Competencies: the specific skills, knowledge, and abilities required for a nursing role; may vary by province/territory; undergraduate curricula aim to prepare students to meet these competencies; examples include the 2019 entry-level competencies document for RNs.
Legislation in Nursing
Health Professions Act: governs the practice of regulated health professions; outlines registration, continuing competence, complaints, and discipline processes; fosters non-exclusive, overlapping scopes of practice.
Health Information Act
Adult Guardianship and Trustee Act
Child, Youth and Family Enhancement Act
Public Health Act
Protection of Persons in Care Act
Mental Health Act
There are many more acts to explore; nursing practice must comply with all applicable legislation.
Connections and Practical Implications
Historical shifts show how nursing moved from religious/charitable roots to formalized education and licensure, enabling standardized practice and mobility across provinces.
Regulatory structures exist to protect the public, not to restrict practice; they balance professional autonomy with public accountability.
Nature of colonial and Indigenous health care influences current emphasis on cultural safety, equity, and addressing past inequities (e.g., Indigenous health services history).
National frameworks (CASN) and licensure (NCLEX) support consistency while allowing province-specific adaptations.
Ongoing ethics, discipline, standards, and guidelines ensure that nursing practice remains aligned with evolving societal values, legal requirements, and health system needs.
Real-world Relevance for Exam Prep
Be able to outline the evolution of Canadian nursing from 1600s to present, including key players and institutions (nuns, Indigenous healers, missionaries, Florence Nightingale’s influence).
Explain the role of CASN and NCLEX in nursing education and licensure.
Describe governance at federal and provincial levels and how the Canada Health Act shapes health care access.
Discuss Alberta-specific regulation, including the Health Professions Act, CRNA, and the role of regulatory bodies.
Define self-regulation and its public-interest focus; explain the purpose and mechanisms of conduct, discipline, and public reporting.
Articulate the structure of standards, guidelines, and competencies, and how they interact with legislation to shape nursing practice.
Recognize major ethical frameworks and the rationale behind revisions to the CNA ICN-adopted code of ethics.