Health committee  Thank you for that question. Ironically, I would suggest that if from a purely scope-of-practice perspective, nurses in remote and rural areas are most likely to be able to work to their full scope because of the shortage of resources. From a scope-of-practice perspective, they have full scope; they are often the only provider in an isolated setting, and they thrive on that kind of practice.

Health committee  I'm happy to start, and I invite Anne and others to join in. I'll be very quick. With regard to staff mix, CNA does have an evidence-based staff mix review tool which it has published. I have personally used that in my practice, most recently in the past year when we were looking at our patient population.

Health committee  The best example I can give you, as I alluded to in my presentation, is the Controlled Drugs and Substances Act, where we appreciate so much the work of Health Canada in working with nurses at CNA and with others to expand that provision so that nurse practitioners could prescribe narcotics, opioid-based narcotics, and drugs used in mental health, such as benzodiazepines.

Health committee  I don't think that it even may need to be an institution. I think it may need to be just another step that's recognized as part of those kinds of processes.

Health committee  Excellent. Thank you very much for the question. First, in terms of harmonization of scopes of practice across the country, I will give you a very resounding and enthusiastic yes. We totally believe that would be helpful in several ways. I mentioned the concept of mobility across the country.

Health committee  That's a difficult question to answer. I would invite my colleague, Josette, to respond to that. But from my perspective, it means that the care that's being provided is often support care, supportive care: meal preparation, shopping, laundry, personal care, the care that may not require the direct provision of registered nurse or licensed practical nurse oversight.

Health committee  Thank you for inviting the Canadian Nurses Association to be part of today's proceedings. I am Barb Mildon, president of CNA. I am pleased to be joined by Josette Roussel, who is a senior nurse consultant at CNA. I am a certified community health nurse and have worked in clinical and management positions in both B.C. and Ontario for many decades.