REGULATING NURSING IN THE NORTH

CANNN's vision for greater inclusion in public protection and nursing support

The Registrar

The Canadian North is a large, remote region, characterized by towering mountain ranges, vast boreal forests, icy coastlines along the Arctic Ocean, and the majestic Northern Lights painting the night sky with vibrant colours.

Communities are small and dispersed, with many residents in the region having deep, cultural ties to the land. Integral to the health care system in the Canadian north is the College and Association of Nurses of the Northwest Territories and Nunavut (CANNN), whose work is essential in maintaining the well-being of these communities across the landscape.

As the regulatory body for nursing in the territories, CANNN is responsible for ensuring that nursing professionals are competent, ethical, and able to meet the health care needs of the diverse and often isolated pop- ulations in the north. A dual-mandate regulator, CANNN also serves as the voice of nurses in its jurisdictions.

The Registrar Magazine spoke with CANNN’s Executive Director and Registrar, Megan Wood. A Registered Nurse raised in Prince Edward Island and now longtime resident of NWT, she describes the organizational structure, transformation, and vision for the future.

A tale of four professions in two territories

CANNN has undergone several changes over the last four decades, with the organization originally established in 1975 as the Northwest Territories Registered Nurses Association (NWTRNA).

In 1999, the NWTRNA became the regulatory body and professional association for both the Northwest Territories and Nunavut, before becoming the Registered Nurses Association of Northwest Territories and Nunavut (RNANT/NU) in 2004.

New legislation in 2023 saw the creation of two new Nursing Profession Acts: The Nursing Profession Act of N.W.T. and the Nursing Professions Act of Nunavut and was renamed CANNN. The organization now regulates and speaks for Licensed Practical Nurses, Nurse Practitioners, Registered Nurses, and Registered Psychiatric Nurses.

Establishing a solid foundation

A name change was one of many new experiences for the organization in recent years, Wood says. After becoming executive director and registrar of CANNN in June 2024, she says that adjustments to leadership included updating Board structure and prioritizing Diversity, Equity and Inclusion (DEI).

“With the amalgamation of four designations, it also means that we want to bring them into the fold in the new board structure,” Wood says. “It’s a high priority for jurisdictions.”

- Megan Wood me to get LPNs and RPNs and have their voices heard. There is also the critical cultural aspect to the work we do, and if we don’t hear the voices of the public that we’re serving, then we’re not making informed decisions.”

The unique dual mandate structure of CANNN allows the organization to also expand team responsibilities. She says that a search is currently underway for a new director of quality practice, to enable CANNN to handle the volume of association-related responsibilities, while also engaging with the public to effectively protect the public interest.

Addressing unique complexities

Wood notes that the addition of two new nursing professions and two distinct legislative acts being present was an initial challenge once CANNN was established.

“Not only are we looking at a member's scope of practice in two jurisdictions, but there was also a requirement to consider what is included in both Acts for enforcement purposes, when it comes to professional conduct in those jurisdictions,” she reveals.

Unlike most Canadian provinces, the North relies on nurses from other jurisdictions to fill their health care needs. Culture shock may take some from other provinces by surprise Wood emphasizes the need for those coming up north to be well-informed about the landscape, so that their practice can ultimately be successful. “When someone’s registered and they want to come up here to work, we want to ensure they are aware of the landscape they’re coming to and ensure they are in-the-know,” she adds.

The COVID-19 global pandemic required many regulatory authorities to institute new policies and practices for registrants to abide by to ensure public safety, and CANNN was no different. As a member of one of CANNN’s committees prior to assuming her existing role, Wood reflects that the pandemic disrupted their ability to find nurses due to travel restrictions.

Previously working in mental health and addictions recovery, and applying principles of public and cultural safety from past roles, she notes that creating opportunities for learning about the North was crucial. “In my personal experience working on the frontline before this position, it [COVID-19] impacted my fitness to practice and ability to provide care,” Wood says. “Now that I’m at CANNN, it’s crucial to focus on member education, and how well they are being prepared before they walk into a community health centre with just one nurse responsible for the entire population.”

Traditional and new technologies to ommunicate

CANNN is committed to developing resources for members to stay engaged. This includes the quarterly CANNN newsletter which provides information on organizational activities, trends and issues in the North. Additionally, opportunities

"Now that I’m at CANNN, it’s crucial to focus on member education, and how well they are being prepared before they walk into a community health centre with just one nurse responsible for the entire population."

-Megan Wood such as becoming National Council Licensure Examination (NCLEX) RN writers and reviewers, enable registrants to contribute to their profession beyond their clinical roles. NCLEX tests the competency of nursing school graduates in the U.S. and Canada.

It's a key component of CANNN’s modernization efforts, and Wood says that it’s important to have those working in the North to have a better lens of both territories. Critical to the organization’s communication strategy is keeping members engaged with its media platforms. She adds that member education on areas like fees, for example, will demonstrate how certain standards contribute to a sustainable practise in both territories.

“Part of our communications-focused work will be to start getting more members engaged,” she explains. “It’s important for nurses to know what to expect in the north when working at CANNN, but also bring more members, volunteers and more eyes. This ultimately drives more public awareness, especially in nursing, where changes in healthcare, technology, and societal needs can significantly affect professional practice and standards.”

While CANNN is active on social media platforms like Facebook, LinkedIn, X, and Instagram, Wood points out that radio is just as integral to communicate.

“One of the unique parts about being in the North is that a lot of small, underserved communities don’t have bandwidth, with a large amount of information being distributed by radio,” she reveals. “A big part of modernization at CANNN specifically, is making sure that if something noteworthy or important is going on, we air it on the public radio station while being creative and asking listeners for feedback or suggestions on what they want to hear.”

Ambitions of becoming a leader in nursing regulation

Despite having a small number of staff having to cover a large portfolio of work in four different nursing professions, Wood is positive that CANNN is equipped to stay on top of new developments and establish itself as a prominent regulatory leader in the field.

“I’m most excited about bringing us to the forefront of the sector, and ensuring that education for the public is just as engaging as education for our members,” Wood says. “CANNN is here as a resource to help nurses, and bringing awareness to who we are as an organization in this particular location will allow us to become a regulatory leader in this space.”