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About Us

Who are Advanced Practice Nurses?

There are two types of Advanced Practice Nurses recognized in Ontario: The Clinical Nurse Specialist (CNS) and the Nurse Practitioner (NP). Both have additional university education with advanced knowledge in a specialized area of their clinical practice. Clinical Nurse Specialists are general class registered nurses and Nurse Practitioners are registered in the extended class of nursing with the College of Nurses, Ontario. The NP is registered with a certificate in one or more of Adult, Paediatrics,or Primary Health Care.

What is our Focus?

  • to provide and support exemplary patient care
  • to provide a forum to address professional practice issues
  • to address and support clinical, educational and research accomplishments and challenges
  • to identify and influence corporate, local, provincial, national and international policy affecting health care and the advanced practice nursing role

What do we Do?

The Clinical Nurse Specialist (CNS) is a registered nurse with minimal preparation at the Master level, usually in the profession of nursing. The CNS is registered in the general class of nursing. This nurse possesses a comprehensive nursing knowledge base and clinical competence in caring for a select patient group with specialized health needs. The CNS assists patients and families with hospitalization, education around a diagnosis, adjusting to special needs at home, and family adaptation to patient problems. In addition to clinical practice, the CNS provides leadership at the program, corporate and professional levels; education of staff and clinical partners as preceptor, coach or mentor; and formal and informal consultation to the interprofssional team members and clinical partners regarding patient, family, and professional practice issues.


The Nurse Practitioner
(NP) is a registered nurse with minimal preparation at the Master level, usually in the profession of nursing, who has completed an approved nurse practitioner program. The Master level of education prepares the graduate to provide leadership at the program, corporate and professional levels, coach and mentor others, and engage in research. The title nurse practitioner is legally protected in Ontario and requires registration in the extended class of nursing. Graduates of NP programs are eligible to write a certificate examination as an Adult, Paediatrics, or Primary Health Care NP. The NP program provides the graduate with the ability to function in a clinical role by focusing on advanced health assessment, advanced pathophysiology, advanced pharmacotherapeutics, incorporated with medical decision-making and diagnostic reasoning.The registration in the extended class of nursing as an NP authorizes the NP to order most diagnostic tests, make a diagnosis, and prescribe treatments and medications (controlled substances excepted). With the addition of the medical model into their nursing knowledge base, NPs are able to provide comprehensive management of complex patients autonomously or in collaboration with physician partners. NPs in Ontario also have the authority to admit and discharge patients from hosptials.

The Nurse Practitioner-Adult or Nurse Practitioner-Paediatrics has completed NP education that focuses on either adult or paediatric (including neonatal) patients. NPs certified as NP-Adult or NP-Paediatrics almost always work within the hospital setting with in-paients, out-patients, or a combination of the two. They provide comprehensive care to specialized patient populations supporting life-saving and curative goals as well as evaluating health risks. They provide leadership within their programs and corporation, and often are clinical researchers.

The Nurse Practitioner - Primary Health Care has completed NP education through the province wide COUPN NP program. NPs certified as NP-PHC mainly work in community settings such as family health teams, community health centres, community care access, or public health. The also work in Long Term Care (nursing homes), emergency departments, and ambulatory clinics. Within these settings, the NP-PHC provides individuals of all ages, families, groups, and communities with health services in health promotion, disease and injury prevention, cure, rehabilitation, and support. Some NP-PHC have begun to work within the hospital setting alongside their NP-Adult or NP-Paediatrics colleagues.

The NP-Anesthesia is a fourth class of certification for NPs. The advanced knowledge of the registered NP is furthered with specialty anaesthesia education. Currently there is not a registering examination, although a small cohort of NPs have completed the anaesthesia program. These NPs often work in pain and symptom management and other anaesthesia related fields.

How do we Contribute to Health Care?

  1. Streamline Patient Care Process
    • provide holistic assessment and management of patient/family health which may include tasks that have previously been in the domain of medicine (e.g. ordering medications)
    • coordinate discharge follow-up with family physicians, specialists, homecare and other agencies
  2. Saving Health Care Dollars
    • decrease length of stay in acute-care facilities
    • optimize patient health and safety prior to admission and discharge
    • coordinate care to reduce duplication and expedite the process of care
    • facilitate appropriate and efficient use of resources in alternate levels of care
    • provide continuity of care to patients/family
  3. Pro-active approach to health promotion & illness prevention
    • collaborate with patients/families to enable health promoting behaviours
    • refer to allied health members and rehabilitative professionals
    • provide education and counseling
  4. Professional Leadership
    • support quality of health care education by teaching, mentoring and participating in program development and evaluation
    • promote excellence in care through evidence-based and innovative practice
    • promote patient advocacy
  5. Research
    • identify clinical questions; initiates research to expand knowledge
    • interpret and communicate research through presentations and publications
    • initiate changes in practice based on new research findings

    Updated 09/14