Enhancing health system integration of nurse practitioners in Ontario

ABSTRACT

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.