Increasing number of nurse practitioners in Ontario

There are four women who have something to be proud of this year. Maureen Loft, Grace Bradish, Patti Staples and Jo-Anne Costello, all nurse practitioners, were among the first in the province to pass the Adult Nurse Practitioner Exam, put forth by the College of Nurses of Ontario last year. And they couldn’t be more excited about it. “It was a tremendous relief,” says Loft, about receiving her results. “It’s great to have the recognition now for having done the program and it gives a legitimacy to the role,” adds Staples.

The four women, like all other nurse practitioners, work in a variety of settings. Jo-Anne. Costello works at the Guelph Family Health Team and specializes in treating adults who are at high risk of developing, diabetes and cardiovascular disease. Maureen Loft works with adult orthopedic patients at St. Joseph’s Health Care London, and Grace Bradish also works in London, but specializes in treating adult cancer patients at London Health Sciences Centre. Pattie Staples specializes in working with cardiovascular patients at Hotel Dieu Hospital in Kingston.

Nurse practitioners are nurses with additional education and experience that allow them to diagnose disease and illness, prescribe medications and order tests for patients. They work in clinics, hospitals and medical centres. Sherri Adams, a pediatric nurse practitioner at the Hospital for Sick Children, also completed the registration process in Ontario and now holds the title Nurse Practitioner – Paediatric. She deals with children who have multiple diseases and illnesses.

All five women, though each having very different roles, strive to do the same thing: provide complete care for their patients and families. They say since passing their exam, their scope of practice has expanded to be able to do more for their patients. “I can order prescriptions and blood work from community labs and the results will come back to me,” explains Staples. “I can now order laboratory tests needed by my patients so they don’t necessarily have to see a doctor,” Costello adds pointing out that this improves access to care and decreases wait times.

Decreasing wait times and making it easier for patients to get the care they need faster is just one of the ways nurse practitioners have made an impact on the health-care system.

Bradish says working as a nurse practitioner has another distinct advantage: “I think my position is privileged with the gift of time,” adding she can take time to educate and explain things to patients who require more than the usual interaction.

In addition to clinical practice, the nurse practitioner role often expands to include educating colleagues, and some administration. For Costello, this means attending board meetings, and being the voice for the seven other nurse practitioners on her family health team. For Staples, it’s providing a great deal of education to help people improve their health care skills and striving, along with her health-care team to keep patients out of the hospital by learning to better manage their own care.

While the five admit expanding their scope of practice was a step in the right direction, they admit there are still hurdles to overcome. “The barriers (for nurse practitioners) are more around the legislation,” Costello explains. It is more restrictive than in some other provinces and this hinders nurse practitioners’ ability to fully and completely care for patients. Adams agrees: “The current way nurse practitioners are regulated, (and the) list of drugs we can prescribe is very limiting, especially for pediatrics.”

Despite this barrier, all three nurse practitioners echo one another when it comes to the love of their work.“(The best part) is working with the patients and their families, and seeing them rise to the challenge of treating and dealing with illness,” says Bradish.

“It’s the families, patients and team I work with,” agrees Adams. “We have a great collaborative team. It’s very rewarding.”

For Loft, it’s not one thing over another. “I genuinely love coming to work,” she says. “There are times when you almost feel a little bit guilty because there are people who aren’t happy with what they do. I love the patient interaction, I love working within the team. It’s great to be in this role at this time.”

These five women aren’t the only nurse practitioners in Ontario. There are more than 1,000 nurse practitioners employed in clinics, hospitals and medical centres throughout the province. For more information on nurse practitioners, or to find one in your area, visit