Greetings from Kathleen MacMillan, RN, MA, MSc executive director, Office of Nursing Services First Nations and Inuit Health Branch

Aboriginal Nurse, The,  Jun 2002  by Kathleen MacMillan

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Since I came to the Branch in December of 2001, much has happened. I would like to share with you some initial observations and what our plans are for nursing services in the Branch.

First, the Office of Nursing Services has been established as a visible focus for nursing and the position of Executive Director has been created. On March 13 the Branch Executive Committee (BEC) endorsed the general direction for a "Transformation Strategy" for FNIHB nursing services. This strategy was developed with Regional Nursing Officers and staff of the Office of Nursing Services in Ottawa and shared with the Regional Nurse educators and some middle managers this month for critique and feedback. It is a work in progress that will be continuously shaped over the next year as we work to identify specific projects that will support implementation of the strategy.

Firstly, our shared vision and strategic direction for nursing in FNIHB is:

* Nurses are competent and valued health professional leaders who are supported by Branch Headquarters and Regional Offices to:

* Contribute professionally to the FNIHB and HC vision and goals for the health of First Nations and Inuit

* Work with key stakeholders (FN & I health authorities, F/Pfr governments and NGOs) to achieve mutual goals through a focus on primary health care and public health principles

* Provide quality, evidence-based, culturally safe care to FN & I clients and communities in an advanced practice nursing model

* Practice to their full scope in safe, healthy, and supportive environments

* Grow as individuals through continuing education and professional development.

We have used the term "Transformation" quite deliberately. Successful retention and recruitment of nurses is dependent on ensuring that nurses have a satisfactory professional practice and satisfaction with their practice setting and supports. Much of this will involve a cultural change for the organization at all levels as we seek to move from a traditional view that nursing services are a large cost centre to be controlled, to a view that nurses are intellectual capital that an organization must invest in to achieve greater productivity and better results.

As a Branch, we have a good idea what the problems are that nurses are experiencing in the field. The challenge is for us to develop processes and structures that will support successful resolution and address long standing structural problems so that we can achieve real and lasting change. This is a worldwide problem that is made more challenging in FNIHB by geographic and professional isolation. As many nurses say, "I love nursing; I hate my job!"

It because of the size, scope and complexity of the nursing retention and recruitment problem that we have chosen to identify key levers: areas where if we make a change, it will cause or support other needed changes to occur.

We are grouping our strategies into 5 main categories: Leadership Capacity:

As an organization we must move from a focus on managing nursing services to one that involves professional leadership at all levels. Personally, I anticipate that we will stop using the term "supervision" to describe how we relate to our nurses. Professional staff are not "supervised" but supported to achieve professional goals and to deliver quality services. Our goal is to support managers to evolve into leaders and to have leadership occur at all levels of nursing services.

Information Technology (IT):

A significant challenge to strengthening nursing services in the Branch lies in overcoming professional isolation and we are working closely with IT personnel to advocate for better Internet access for our nurses. IT support is critical to success in transforming our nursing services and we are working with other directorates within the Branch to link the nursing agenda.

Competency and Professional Practice:

We will be adding to our staff in Ottawa another nurse consultant with educational expertise to lead development of continuing education opportunities. We need to establish closer relationships with academic nursing 'so that we can provide better supports to students and new graduates in addition to supporting continuing education for our incumbent staff.

Human Resource Planning and Management

Most organizations do not conduct regular human resource planning and this is becoming more critical as health human resources planners predict a large shortage by the end of this decade. We will be conducting a nursing workforce survey this May and June to lay the foundation for a HR data base for FNIHB nursing services. For this first phase, we will concentrate on FN lHB employed nurses. Depending on the response rate and results, we will consider a second phase that will include band employed nurses. One of the biggest issues for nurses everywhere is workload so one of our priorities will be to develop a nursing workload measurement system for nursing services in the Branch. Such a system would inform staffing requests but would also contribute to our capacity to conduct research that would link nursing human resources to client and community outcomes.