History of Nurse Practitioners in Canada and Alberta

Introduction to Advanced Practice Nursing in Canada

Advanced practice nursing is one of the fundamental components of the Canadian health sector and has continued to experience tremendous growth in recent years (Kaasalainen et al., 2010). Nurse practitioners are among the major professionals in Canadian advanced practice nursing. Nurses have traditionally practiced in expanded roles in remote and rural areas across Canada, particularly in an informal capacity. The role of the nurse practitioner was first introduced in the country in the 1960s and 1970s. This introduction was attributable to various factors, including a perceived physician shortage, the launch of universal publicly funded medical insurance, increased medical specialization, and an increased focus on primary healthcare. The nurse practitioner role is one of the advanced practice nursing roles that emerged in Canada during this period due to the belief that nurses were suitably positioned to meet the nation's emerging healthcare needs.

Early Development and Initial Controversies

In the initial years of its introduction, the nurse practitioner role in Canada was characterized by widespread controversy regarding the education and positioning of these nurses within the healthcare system. This contributed to numerous published studies and initiatives established to help address the issue. For example, two groundbreaking randomized controlled trials conducted in Ontario in 1974 and 1975 demonstrated the effectiveness of the nurse practitioner role. However, integration of the nurse practitioner role in Canada failed in the 1970s despite strong evidence demonstrating its effectiveness. The failure was mainly attributable to the lack of funding for the nurse practitioner role, a perceived oversupply of doctors, inadequate public awareness of the NP role, lack of proper legislation, and insufficient support from health providers and policymakers (Kaasalainen et al., 2010). Despite this initial failure, most graduate nurse practitioners from Canadian university programs continued to practice between the 1970s and 1983, primarily in northern remote health facilities and community health centers.