March 2010

KATHERINE O'BRIEN, Staff Writer

The news is good -- nurses are in demand across Canada, so much so that the Ontario government is guaranteeing graduates full-time jobs. As well, in an effort to keep experienced nurses in the workforce longer, the government has put in place a late career initiative (PDF) that allows nurses over 55 to spend one day a week in less physically demanding roles, such as teaching patients or mentoring younger nurses.

Due to the advancing age of Canada's population, the excellent job market for the nursing professions is not expected to slow down. According to a 2009 report by the Canadian Nurses Association (CNA), there may be a shortage of 60,000 registered nurses (RNs) by 2022. The CNA notes that the greatest demand is for nurses with skills in areas such as emergency or critical care and those willing to work in small or isolated communities.

A Profession With Many Wings
Not only are there a lot of jobs you can do as a nurse, there are different nursing designations you can pursue In Ontario you can work either as a registered nurse (RN) or a registered practical nurse, (called licensed practical nurses in other provinces). Although there is overlap in duties, RNs study nursing in greater depth than practical nurses (RPNs).

Registered nurses provide care to patients who have more complex health issues and where it is likely there will be less predictable outcomes. For example, a practical nurse could teach new diabetics how to manage their disease, but an RN might deal with diabetics who have additional medical conditions such as heart disease. Registered nurses can also specialize in 19 areas, such as cardiovascular, psychiatric and gerontology nursing, each with its own professional association

As well, after at least two years in the field some RNs can pursue postgraduate education and become nurse practitioners (NPs), which allows them to take on additional functions, some that used to be exclusively performed by doctors.

Job Duties
Both practical and registered nurses provide hands-on care, such as taking vital signs (temperature, blood pressure), giving medications or injections, treating bedsores or applying dressings. They also collect samples for testing, record food and fluid intake and output, and help patients with personal hygiene.

Some of the duties of a primary health care nurse practitioner are:

• Performing annual physicals
• Diagnosing and treating short-term acute illnesses and injuries
• Immunizing against and screening for diseases

Like practical and registered nurses, NPs monitor the health conditions of patients, coordinate treatments with other health care professionals, and teach patients about health issues and how to manage their illnesses.

Aptitude & Personal Characteristics
Those considering the nursing professions should have a genuine interest in helping people and a caring, compassionate attitude. Oral communication and problem-solving skills are important as are strong critical thinking and organizational skills. As well, you must be able to prioritize tasks under stress and stay calm when dealing with emergencies. You also need stamina and physical strength for some nursing positions.

Working Conditions
Nurses commonly work 8- to 12-hour shifts, they may have to lift patients or heavy equipment, and they are routinely exposed to sickness and disease.

In addition to working in hospitals, nurses can find jobs in doctors' offices, long-term care and rehabilitation facilities, hospices, research institutes, laboratories, public health units and community health clinics. Some registered nurses work in the Telehealth Ontario call centre answering health questions from the public.

Nurse practitioners generally work as part of a multidisciplinary team but may work alone in rural or remote areas. Adult and pediatric NPs tend to work in hospitals and provide specialized health services to patients with specific health conditions such as heart disease or cancer.

Salary
According to Ontario Job Futures, the average salary for a practical nurse (PDF) in 2005 was around $42,000, about $20,000 less than that of a full-time RN (PDF). Most full-time NPs make between about $60,000 to $100,000, according to a 2005 survey done by the Nurse Practitioners' Association of Ontario (NPAO) and the Centre for Rural and Northern Health.

Education
All practical nursing graduates in Ontario must have a two-year diploma in nursing from a community college. Locally, City Adult Learning Centre and Yorkdale Adult Learning Centre have developed a collaborative practical nursing program with George Brown College. Students can earn high school credits while completing the first semester of the program.

To become an RN you must complete a four-year Bachelor of Nursing (BScN) degree. In Toronto, Ryerson University and Centennial and George Brown colleges offer a Collaborative Nursing Degree Program. (You can complete all four years of the program at Ryerson or you can attend Centennial or George Brown for the first two years of the program, finishing up at Ryerson.) To find other programs, check out TorontoEducation.org.

In Toronto, York University offers a MSN Primary Health Care Nurse Practitioner (PHCNP) Program, and the University of Toronto offers a Master of Nursing (Field of Study: NP) and a Post-Master's Nurse Practitioner Diploma. Additonally, Ryerson provides two options: a certificate in PHCNP, or a Master of Nursing degree and a certificate in PHCNP.

Registration
Both registered and practical nurses must register with the College of Nurses of Ontario before they can practise their profession. Nurse practitioners must register as members of the extended class of nursing.

Internationally Educated Nurses
If you've been trained outside of Canada, check out the CARE Centre for Internationally Educated Nurses. CARE can help you prepare to take the Canadian nursing registration exam and to upgrade your skills. As well, you might want to investigate York University's Post-RN BScN for Internationally Educated Nurses. You can also learn how to qualify for professional practice by going to the HealthForceOntario Access Centre. Another resource is the College of Nurses of Ontario's registration guide for internationally educated nurses.