Nursing Issues and Canadian Healthcare System

Week 1: Introduction to Nursing Issues and Political Action

• Nursing issues require a framework for analysis
• Issue identification involves clearly defining the issue and its relevance to nursing, including who is affected and why it matters
• Issue analysis includes historical, ethical, social, cultural, political, critical feminist, and economic analyses
• Potential barriers to issue resolution include limited resources, lack of awareness, power imbalances, and resistance to change
• Strategies for resolution include lobbying, advocacy, education, collaboration with stakeholders, and policy development
• Nurses play a crucial role in influencing healthcare policies
• Nursing advocacy for patients and the profession is a form of political action
• Understanding the healthcare system is essential

Week 2: The Canadian Healthcare System

• Healthcare insurance plans must be administered by a public authority (Canada Health Act - Five Principles)
• All medically necessary services must be covered (Comprehensiveness)
• All insured residents are entitled to the same level of healthcare (Universality)
• Healthcare coverage must be maintained when moving within Canada or traveling abroad (Portability)
• Reasonable access to healthcare without financial barriers (Accessibility)
• Responsibilities for delivering healthcare are divided between federal and provincial governments (Governance)
• Key reports include the Lalonde Report and Romanow Report, assessing healthcare system sustainability and determinants of health

Week 3: Race, Racialization, and Indigenous Health

• Racialization is the process of ascribing racial identities to a group, leading to discrimination and social inequalities
• Race is a social construct, not a biological fact
• Barriers for racialized students in education include microaggressions, discrimination, cultural alienation, financial hardships, and limited access to resources
• Impact of racism on healthcare includes disparities due to systemic racism, underrepresentation in healthcare professions, and reduced access to culturally competent care
• The Indian Act has controlled many aspects of Indigenous peoples' lives, contributing to loss of culture, language, and autonomy
• Indigenous health inequities include high rates of chronic diseases, mental health issues, and reduced life expectancy, stemming from historical trauma, socioeconomic disparities, and inadequate healthcare access
• White privilege refers to unearned advantages experienced by individuals perceived as white
• Allyship involves active support and advocacy for marginalized groups, listening, learning, and taking action to address inequalities.

Week 4: Professional Associations and Regulation

• Nursing professions have authority to regulate its members through a governing body (Concept of Self-Regulation)
• Regulatory colleges and professional associations ensure safe and competent nursing care, enforce standards of practice, provide guidance, and support nurses
• Nursing legislation defines scope of practice and regulatory framework, varying by province/territory
• The CNO Quality Assurance Program ensures continuous learning, self-assessment, and professional development.

Week 5: Unions and Workplace Safety

• Poor working conditions, long hours, low wages, and lack of professional recognition were historical influences leading to unionization
• Nurses desired to improve patient care and professional autonomy, which led to collective bargaining
• Collective bargaining is the process of negotiation between unions and employers on behalf of their members to achieve fair wages, benefits, and working conditions
• Collective bargaining aims to protect nurses' rights, advocate for safe staffing levels, and enhance job security and professional development

Week 6: Ethical and Legal Issues in Nursing

• Ethics is the study of moral principles guiding behavior; morality involves beliefs about right vs. wrong; moral distress arises when nurses know the ethically appropriate action but cannot act due to constraints; bioethical dilemmas involve conflicting moral principles
• Levels of moral response include expressive (emotional reactions), pre-reflective (societal norms), and reflective (ethical principles and consequences)
• Ethical principles like beneficence (promote good), nonmaleficence (do no harm), justice (fair treatment), and autonomy (respect for patient decisions)
• Codes of ethics provide frameworks for practice and decision-making
• Negligence is failure to meet the standard of care, and liability is legal responsibility for actions or omissions

Week 7: Issues Arising from Nurses' Work and Work Environments

• Increased patient acuity and complexity increase workload for nurses.
• Staffing shortages lead to excessive workloads, impacting patient safety, and quality of care.
• Work Place Bullying, including excessive criticism, exclusion, and undermining are factors impacting job satisfaction.
• Nursing shortage occurs from fluctuations due to economic conditions, budget cuts and policy changes.
• Inadequate working conditions, lack of support, and burnout contribute to nursing shortage

Week 8: Interpersonal Violence and Abuse

• Increased demand for medical and support services; emotional toll on providers; and financial costs contribute to societal needs for healthcare improvement
• Healthcare systems need to address factors like underreporting, societal norms that might minimize abuse, and the issues of abuse and neglect for older Canadians and Indigenous people.

Week 9: Gendered Nature of Nursing

• Gender is a social construct, and nursing roles/expectations are determined by societal norms
• Historically, nursing was a feminine profession, and this continues to impact professional identity and opportunities
• Stereotypes, biases, and underrepresentation of men in nursing are also barriers
• Ethical responsibilities include advocating for equity and justice, providing culturally competent care, and upholding patients' rights regardless of gender identity/sexual orientation

###Week 10: Contemporary Nursing Leadership

• Nursing leadership is essential for advancing the nursing profession and improving healthcare outcomes.
• Nurses at all levels can demonstrate leadership qualities.

Week 11: Interprofessional Practice

• Interprofessional practice must address issues like delegation and supervision, competence, and safety in the context of healthcare teams.
• Nurses need to communicate, share mutual respect, and contribute toward collaborative and shared goals
• Understanding diverse backgrounds and tackling cultural barriers contribute to successful collaboration among teams.
• Power imbalances and inequitable participation need to be addressed in healthcare teams

Week 12: Healthcare for an Aging Population

• Healthcare must focus on individuals' abilities rather than chronological age for personalized care planning and appreciating diversity in aging
• Ageism, or stereotyping, needs to be avoided.

Week 13: Environmental Issues and Career Planning

• Environmental factors have a significant impact on health
• Environmental issues include climate change and global warming and their health consequences
• Nurses are involved in advocating for environmental health
• Important to ensure safe and healthy indoor environments to address issues like air quality, hazardous materials, and ergonomics
• Career planning models include stages like scanning, self-assessment, visioning, and planning