Calls for national-level chief nursing officers are over a century old. However, global uptake of these roles and Canadian opportunities for nurses to lead in federal health policy environments have been limited. The absence of such a role in Canada limits connection to global activities, reduces Canadian capacity to participate as a member state in World Health Organization–led nursing activities and, within our borders, leaves the healthcare system without national leadership to coordinate and liaise with senior nurses across our provinces and territories for the benefit of our citizens and systems. In this article, a brief history of global advocacy for state or national level chief nursing officer roles and examples of federal chief nursing officers, in the Canadian context, offers a consideration of the unique contribution of nursing knowledge and leadership to health policy – extending arguments for nursing leadership in the policy arena beyond traditional arguments of strength in numbers or unique claims to caring. Findings from a Canadian national project by the Global Nursing Leadership Institute further illuminate the concrete steps we need to take toward enabling full-spectrum nursing leadership in policy, where policy science, political competency, identification of policy nurses and a revitalization of organizational structures across the country can extend the vision for nursing leadership in policy beyond a single seat at a single table.

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