Enhancing health system integration of nurse practitioners in Ontario
Publication year: 2018
Nurses have a long tradition of informally working in
expanded roles in rural and remote communities in
Canada (e.g., outpost nurses).(1; 2) The formalization of
the nurse practitioner role in Canada began in the mid1960s as a response to four interrelated factors: 1)
introduction of publicly funded healthcare; 2) perceived
physician shortage; 3) increased attention on primary
care; and 4) increased medical specialization.(1) In the
1970s there were a number of initiatives led by
provincial nursing groups to legitimize expanded
nursing roles, which led to the development of
educational programs.(1) The ways in which the nurse
practitioner role has been formally introduced to health
systems has varied across provinces and territories in
Canada, and has resulted in jurisdictional variability in
terms of the scope of practice (e.g., prescribing and
referrals to specialists), remuneration and employment
settings.