As a nurse, leader and advocate, I have witnessed firsthand the transformative power of nursing leadership. From my early days of clinical practice to my tenure as the chief executive officer (CEO) of the Canadian Mental Health Association (CMHA) at the Simcoe County Branch (SCB), I have seen how effective leadership can drive change, improve patient outcomes and enhance the work environment for employees. However, I have also observed the challenges that arise when leadership is fragmented or siloed. To truly transform Canada's health system, we must embrace the full spectrum of nursing leadership and unite in our shared purpose. 

When I joined the CMHA SCB in March 2020 when the coronavirus disease (COVID)-19 state of emergency was declared, I inherited an organization that had lost confidence in leadership and was disengaged. Through a transparent and inclusive leadership approach, we focused on one key goal: engaging our people. From town halls and surveys to virtual workshops and validation exercises, we made it a priority to listen to staff, validate their experiences and co-create a vision that was grounded in respect and shared purpose. Professional development, including leadership development, was identified within our 2021–2025 strategic plan as part of a courageous culture shift grounded in transparency, staff engagement and evidence-informed planning and lifelong learning.

For this article, I reviewed my “Leadership and Action Planner” assignments that I completed in autumn 2023 and winter 2024 from the LEADS Leadership Foundations Program (facilitated by the Canadian College of Health Leaders [CCHL] 2025). I secured funding for 54 CMHA SCB leaders at all levels of the organization to participate in the CCHL program. The learners were divided into two cohorts, with one cohort comprising all levels of management and corporate services and the other cohort comprising regulated health professionals, unregulated workers and peer support workers with two management participants. We used the assignments to develop a common language for achieving the organization's mission and co-creating our future directions and plans.

The transformation we achieved was nothing short of remarkable. Staff, who once felt disconnected, became deeply invested in our vision. This experience reaffirmed my belief that engaged, empowered teams deliver extraordinary results. We achieved a perfect score and exemplary status from Accreditation Canada in March 2024, but more importantly, we transformed how we lead and how we care. The positive impact we had at CMHA SCB demonstrated that people-centred leadership – rooted in trust, transparency and accountability – drives change. This approach is just as crucial in the broader nursing profession. When we bring our collective leadership together, we can overcome the challenges we face and elevate the nursing profession to new heights.

Shifting from being a CEO as an “employer” for a healthcare organization to being a CEO for our national nursing association has caused me to examine how the different parts of our profession come together to advance the nursing profession and unify our efforts to build a stronger, healthier Canada. Over the past nine months, I have had the privilege of re-connecting and collaborating with nursing leaders in every part of our profession (regulatory, association, union, education, policy and direct care/service), and I have been inundated with the countless exemplars of nursing excellence in every corner of the nation. I believe that nursing leadership at every level of direct care organizations must be amplified to ensure that we sustain our achievements and design a future that unleashes nurses' true value and retains and optimizes the nursing workforce.

The Current Landscape: Challenges and Opportunities

Despite my assertions of nursing excellence and countless exemplars, Canada's health system is at a crossroads. Nurses are experiencing unprecedented levels of burnout, workload pressures and moral distress. The COVID-19 pandemic exacerbated these issues, leading to increased attrition and a growing shortage of nursing professionals. According to the Canadian Medical Association (Duong and Vogel 2023), approximately 6.5 million Canadians lack regular access to a health practitioner, and ongoing health worker shortages threaten the sustainability of our health system.

Despite these challenges, there is a silver lining. The Canadian Nurses Association's (CNA 2025) Policy Road Map for 2025 and Beyond outlines a comprehensive vision for health system transformation, emphasizing the need to expand nurses' roles, invest in nursing leadership and create healthy work environments. These recommendations align with the experiences and lessons that I have learned throughout my career.

The Role of Employers and Nurse Leaders in Direct Care Settings

While national policies and strategies are essential, the most significant impact on nurses' daily experiences occurs within the workplace. With over 90% of nurses working in direct care or service settings (CIHI 2024), employers and nurse leaders in these environments play a pivotal role in shaping the profession's future. It is within these settings that nurses provide patient care, collaborate with interprofessional teams and contribute to and evolve organizational culture.

Employers must recognize nurses as knowledge workers, not just skills-based, task-oriented workers. This recognition involves providing opportunities for professional development, fostering a culture of respect and collaboration and ensuring that nurses have a voice in decision-making processes. By investing in nursing leadership at the organizational level, employers can create environments where nurses feel valued, supported and empowered to lead.

Aligning with the CNA's 2025 Federal Election Platform

The CNA's (2025) federal election platform, A Healthier Canada, Powered by Nurses: A Vision for 2025 and Beyond, provides a roadmap for transforming Canada's health system. The platform's key priorities include the following:

1. Optimizing nursing workforce: Modernizing regulatory requirements and federal legislation to enable nurses to work to their full potential. This includes the development of national framework and supporting ethical international recruitment.
2. Investing in nursing leadership: Increasing investments in nursing leadership, education and digital health to achieve better outcomes at lower costs. This will help to create a more responsive health system.
3. Reinforcing healthy work environments: Protecting nurses from workplace violence, moral distress and mental health challenges. The CNA calls on the federal government to implement national workplace protections and evaluate strategies that promote mental health and well-being.
4. Addressing social determinants of health: Tackling environmental factors such as housing, food security and income stability, as well as reducing the health sector's carbon footprint. Nurses are critical partners in this work.
5. Strengthening public health systems: Enhancing disease surveillance, investing in public health infrastructure and combating misinformation about health interventions and healthcare. Nurses can lead evidence-based public education campaigns to support these efforts.

These priorities align closely with the experiences and lessons that I have learned throughout my career. They emphasize the need for a holistic approach to health system transformation – one that recognizes the integral role of nurses at all levels and in all settings.

A Unified Call to Action

To achieve the vision outlined in the CNA's (2025) federal election platform and policy imperatives, we must come together as a unified nursing profession. This means:

• Recognizing the value of all nursing roles: Whether you are a direct care nurse, nurse educator, researcher, regulator, union leader or employer, your contributions are vital to the health system's success. We must value and respect each other's roles and work collaboratively toward common goals.
• Investing in nursing leadership: Employers must invest in nursing leadership at all levels. This includes providing opportunities for professional development, fostering a culture of respect and collaboration and ensuring that nurses have a voice in decision-making processes. CNA is working in partnership with CCHL to offer the Inspire Nursing: A LEADS-based Leadership Program (CCHL 2025).
• Advocating for policy change: We must advocate for policies that support the nursing profession, including expanding nurses' roles, creating healthy work environments and addressing social determinants of health.
• Embracing technology and innovation: Nurses must be at the forefront of digital health transformation. This includes leading data governance, ethical artificial intelligence (AI) use and digital health initiatives to ensure that technology serves the needs of patients and healthcare providers.
• Fostering inclusivity and equity: We must work to eliminate racism and discrimination within the nursing profession and the broader healthcare system. This includes providing training in anti-oppression, anti-racism, cultural safety and humility, and increasing the recruitment and retention of internationally educated nurses and Indigenous, Black and Persons of Colour into nursing careers. Continued action is needed to implement the health-related Calls to Action of the Truth and Reconciliation Commission, ensuring meaningful progress toward reconciliation and equitable access to care for First Nations, Inuit and Métis Peoples (Government of Canada 2024).

Conclusion

Canada's health system is facing significant challenges, but these challenges also present opportunities for transformation. By embracing the full spectrum of nursing leadership and uniting in our shared purpose, we can create a health system that is equitable, sustainable and responsive to the needs of all Canadians.

As I reflect on my journey – from clinical practice to executive leadership – I am reminded of the power of nursing leadership to drive change. Now, more than ever, we must come together to lead the transformation that our health system desperately needs. Nursing leadership is the solution, but it will only work if we unite.

Let this be the moment we unite: stronger together.

Let this be the moment we see every nurse as a leader in the movement to redesign and reimagine our healthcare system.

Let this be the moment we come together – as a collective force – to lead Canada toward a more just, sustainable and people-centred health future. To every nursing leader reading this article, please reach out to me at executiveoffice@cna-aiic.ca to join forces.

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