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The author reflects on her time as executive director of Health Canada's Office of Nursing Policy (ONP) and the important role it played in the health policy of Canada. She discusses the association between ONP and team work, building relationships and forging partnerships within Health Canada, her experience of working with an extraordinary team of nurses and others with high levels of expertise and dedication, and her outlook for the health system and for nursing in Canada.

Aim: To examine the influence of personal and situational factors on direct-care nurses' interests in pursuing nursing management roles., Background: Nursing managers are ageing and nurses do not appear to be interested in nursing management roles, raising concerns about a nursing leadership shortage in the next decade. Little research has focused on factors influencing nurses' career aspirations to nursing management roles., Methods: A national survey of nurses from nine Canadian provinces was conducted (n = 1241). Multiple regression was used to test a model of personal and situational predictors of nurses' career aspirations to management roles., Results: Twenty-four per cent of nurses expressed interest in pursuing nursing management roles. Personal and situational factors explained 60.2% of nurses' aspirations to management roles. Age, educational preparation, feasibility of further education, leadership self-efficacy, career motivation, and opportunity to motivate others were the strongest predictors of aspirations for management roles., Conclusions: Personal factors were more strongly associated with career aspirations than situational factors. There is a steady decline in interest in management roles with increasing age., Implications for Nursing Management: Nursing leadership training to develop leadership self-efficacy (particularly for younger nurses) and organizational support for pursuing advanced education may encourage nurses to pursue nursing management roles., (© 2012 Blackwell Publishing Ltd.)

Within Canada's fast-paced, ever-changing healthcare environment, providers are experiencing difficulty practising according to their professional ethical standards, leading many to experience moral or ethical distress. Limited attention has been paid to improvements in the ethical climate in healthcare settings in research focusing on nurses' workplaces. In this three-year study, we focused on how the ethical climate in healthcare delivery can be improved and how the use of participatory action research methods can lead to continued enhancements and lasting changes in services delivery. Together, we developed strategies for taking action, aimed at improving the quality of the work environment. This action involved both nurses in direct care and those in key leadership positions (CNOs or their equivalents). Through the active participation of those for whom the research-based change was intended, these strategies were tested in various sites across British Columbia and can be used as templates or designs for use in other settings. A key component of the success of the projects and action plans that were created was the integral involvement of nurse leaders through all phases.

Today's globalized economy creates opportunities for health professionals but corresponding challenges for countries facing significant shortages of these professionals. The uneven playing field between developed and developing countries hampers the latter in recruiting and retaining trained professionals to oversee and maintain their health systems. Given the salary differentials and variance in working conditions between developed and developing countries, developing countries may lack the pull factors to keep their nurses and doctors from emigrating. However, many developed countries have made significant investments to address this challenge.

The purpose of this study was to describe the profile of nursing leadership structures in Canada and to assess relationships among structures, processes and outcomes pertaining to nurse leaders' work. Data were collected from nurse leaders in 28 academic health centres and 38 community hospitals in 10 Canadian provinces (n = 1,164). The results of this study revealed that the current contingent of nursing leaders in Canada see themselves as an empowered and influential group within their organizations. Despite very large spans of control, nurse leaders at all levels were positive about their work life and confident in their ability to provide effective leadership on nursing affairs within their organizations. Structural and process factors significantly affected nurse manager outcomes at all levels. Senior nurse leaders' work-life factors had a significant effect on middle and first-line managers' perceptions of patient care quality in the organization. Nurse leaders averaged 49 years of age highlighting the need for succession planning.