Registed Nurses' Association of Ontario

Using RNs to their full scope + evidence = better health care for less money

Using RNs to their full scope + evidence = better health care for less money


TORONTO, Mar. 1, 2012 – One hundred and fifty registered nurses (RNs) and nursing students are gathering at Queen’s Park Thursday to outline a plan that will provide better health care for Ontarians, at a lower cost. The elected leaders of the Registered Nurses’ Association of Ontario (RNAO) are presenting their recommendations, many of which were discussed in Don Drummond’s report, during meetings with Health Minister Deb Matthews, opposition leaders Tim Hudak and Andrea Horwath, and more than 70 MPPs and cabinet ministers.

RNAO says nurses are well positioned to play a leadership role in bringing about changes to the health-care system, especially as the McGuinty government considers its next budget. “The government has already removed barriers to practice for nurse practitioners and thousands of Ontarians are benefiting from their expert care. Now, we need to remove the obstacles that prevent RNs from working to their full scope of practice,” says David McNeil, president of RNAO citing the need to give RNs who work in primary care a greater role in care coordination, house calls, dealing with minor ailments and prescribing medications within their scope -- as they do in the U.K.

Another top priority for RNAO is an increase in the supply of registered nurses to bring the province’s RN to population ratio in line with the rest of the country. Currently, there are 72.1 RNs for every 10,000 residents compared to 82.9 nationally, which makes Ontario’s rate the second lowest in Canada. “We can’t afford to ignore this. If we don’t educate and hire more RNs, Ontario will fall further and further behind and patient care will suffer,” says McNeil.

One area in the Drummond Report that came under nurses’ criticism is the suggestion that for-profit services be considered an option to deliver health services. “We think the verdict on for-profit delivery of health services is in,” says Doris Grinspun, RNAO’s executive director, adding that market approaches to health care don’t measure up; pointing to the mounting evidence that not-for-profit health care delivers better health outcomes for less money. Grinspun adds “using evidence to drive health policies and clinical practices is the only way for Ontario, and any other jurisdiction, to lead healthy and cost-effective reforms.”

RNAO says the accountability requirements of Ontario’s Excellent Care for All Act and the Council of Federation Health Care Innovation Working Group looking at clinical best practices are excellent examples of change driven by evidence. “Tapping into nurses’ expertise in leading through evidence can serve our governments well as we strive to provide better care and system efficiency,” says Grinspun, adding “RNAO is a leader in developing and supporting implementation of clinical best practice guidelines since the program’s inception in 1999.” RNAO’s guidelines are now used provincially, nationally and internationally.

Other recommendations being discussed by nurses during their day-long visit to Queen’s Park:

Raising the share of RNs working full-time to 70 per cent by 2015
Ensuring every Ontarian has access to a primary care provider
Expanding the capacity of the existing 26 Nurse Practitioner-Led Clinics, and funding 50 new ones
Ending competitive bidding in home care to ensure service stability for clients
Strengthening integration of care across the health system
Improving staffing levels for nursing homes
Improving mental health and addiction services
Increasing social assistance rates to reflect actual livings costs
Building affordable housing
Ending reliance on coal-fired generators and cancelling plans to build nuclear plants
The Registered Nurses’ Association of Ontario (RNAO) is the professional association representing registered nurses wherever they practise in Ontario. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health-care system, and influenced decisions that affect nurses and the public they serve.

For more information about RNAO, including a copy of its policy recommendations, visit You can also check out our Facebook page at and follow us on Twitter at


Marion Zych, Director of Communications, RNAO
Cell: 647-406-5605 / Office: 416-408-5605
Toll free: 1-800-268-7199 ext. 209