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CAMH Stories Centre for Addiction
and Mental Health

Nursing @ CAMH – our vision

May 10, 2016 - This Nursing Week we are celebrating the outstanding contributions of CAMH’s nursing staff. Today we hear from four leaders on the vision of nursing at CAMH. Let’s take a closer look at how we lead, how we innovate, how we leverage technology, and how we continue to evolve the specialty of mental health and addictions nursing.

Nursing at CAMH

Kamini Kalia, Dr. Rani Srivastava, Gabriella Golea and Dr. Kristin Cleverley
From left: Kamini Kalia, Dr. Rani Srivastava, Gabriella Golea, Dr. Kristin Cleverley.

How we lead

By Dr. Rani Srivastava, Chief of Nursing & Professional Practice

Nursing Leadership at CAMH is multifaceted. It can be seen in evolving nursing roles and positions -- and also in how nurses across this organization use their expertise and wisdom to influence their colleagues, to drive change, to achieve CAMH’s goals.

Being a leader means intentionally taking on the responsibility of influencing others in positive ways. Nursing Leadership at CAMH continues to grow because we see more nurses embrace the opportunities to influence the work that we do and how we do it!

It’s about leadership in action – for example, through the ideas exchanged at a CAMH Nursing Practice Council meeting, in the projects led by a Barford Scholar or Intern, or through the work of our dedicated After Hours Managers and charge nurses/team leaders at CAMH. At every turn, you will see nursing knowledge combined with leadership to support high quality care at CAMH.

Developing role models

We are also developing roles that tap into nursing expertise and serve as role models and support growth opportunities for others. Here are just a few examples of new and evolving roles for our nursing leaders: 

  • Dr. Kristin Cleverley is Joint CAMH-University of Toronto Chair in Mental Health and Addictions Nursing
  • Gillian Strudwick is an Advanced Practice Nurse for Research and Innovation, to support professional practice innovation and scholarship.
  • Frances Abela-Dimech is CAMH’s Quality Patient Safety & Risk Specialist focusing on the area of clinical risk and quality initiatives to mitigate risk and promote a Safe & Well CAMH 


Influencing the health system

Many of our CAMH nurse leaders also influence the health system by actively engaging with local, provincial, and national groups such as the Canadian Federation of Mental Health Nurses, Mental Health Nursing Interest Group, the Academy of Chief Executive Nurses, and the Registered Nurses Association. We are also welcoming more nursing students at the graduate and undergraduate level who come to CAMH with a focus on learning more about mental health as well as nursing leadership.

With a knowledge base that combines medical and psychiatric care -- and a 24/7 presence to support clients, families, and colleagues -- our nurses offer a unique perspective on care. Nursing Leadership is critical to transforming care and Transforming Lives.

I invite each nurse at CAMH to develop his/her leadership and embrace opportunities to influence -- with knowledge, with intention, and with pride!

How we innovate and leverage technology

By Kamini Kalia, Manager of Clinical Education and Informatics

We’ve made some significant strides in the area of clinical informatics over the last two years at CAMH. This would not have been possible without the clinical expertise and support from nurses across the organization.

With the introduction of the I-CARE clinical information system in 2014, we now benefit from a fully integrated system with new electronic documentation practices, and mobile devices. Under continuing I-CARE optimization that aligns with CAMH strategic goals, we’re working with nurses to identify ways to improve the care workflow experience. This will enable more one-on-one time with clients and improve the overall functioning of the system.

Optimizing Care banner

Bringing care closer to clients

CAMH nurses utilize technology to bring care closer to clients, and to increase client choices and strengthen client voices. As a source of data, nursing documentation alone is integral to understanding the client experience and care provided. This data will continue to be utilized for clinical and operational decision-making, both at the bed-side and across the organization. It’s about continuous improvement to the quality, safety and effectiveness of the care we provide.

Our nurses are influencers of care and technological innovation. They will continue to be closely involved and drive change -- every step of the way.

How we foster inquiry and scholarship

By Dr. Kristin Cleverley, CAMH Chair in Mental Health Nursing Research and Clinician-Scientist

We’ve seen an exponential growth in innovation, inquiry and scholarship of professional practice at CAMH in the past few years. This has been driven partly by the excellent work completed during the Best Practice Spotlight Organization (BPSO) initiative, the Barford Advanced Practice Scholarship and Internship Program, the Care Delivery Model Review (CDMR) project and the ongoing collaborations with our academic partners.

Positioning CAMH as a leader in mental health nursing

All of these activities have provided opportunities for clinical staff -- both front-line and advanced practice -- to participate in projects that position CAMH as a leader in professional practice development and scholarship within mental health and addictions nursing.

Over the past year, several of these initiatives have led to presentations at local and national conferences, opportunities to consult other organizations, and several manuscripts submitted for publication in leading nursing and mental health journals. We are excited to keep this momentum going with the leadership of our Professional Practice Office and the opportunities provided to our nursing staff through the Barford Program and other initiatives at CAMH.

How we continue to evolve the specialty of mental health and addictions nursing

By Gabriella Golea, Director of Interprofessional Practice, CMI

Defining the model of care

It starts with a holistic approach.

Contemporary mental health nursing uses theories from the biological, psychological, spiritual, and social sciences as a basis of practice. This holistic approach is necessary to understand and care for our clients: people who are experiencing mental illness and/or addiction problems. The scope of mental health nursing practice may also include areas of specialization such as child-adolescent mental health, geriatric mental health, forensics, and addictions.

History gives context to show how far we have come. In the 1800s, nurse Florence Nightingale aimed to meet the needs of psychiatric patients with a custodial approach including proper hygiene, better food, light and ventilation. In Canada, the first mental health nurse training school was established at the Kingston (Ontario) Rockwood Asylum in 1888.

Moving to evidence-based care

In the 1950s, an American nurse named Hildegard E. Peplau emerged on the scene. Now known as the “mother of modern psychiatric nursing,” Peplau helped revolutionize the academic preparation of mental health nurses. Her approach recognized the importance of establishing therapeutic relationships with patients, and providing evidence-based care to them. 


Hildegard E. Peplau

The discipline of nursing in general adopted the theoretical basis of mental health practice, while adding new frameworks of psychiatric nursing to the discipline: holistic, interprofessional and interpersonal.

During the 1980s, the Canadian Federation of Mental Health Nurses (CFMHN) was formed as an interest group of the Canadian Nurses Association (CNA).  In 1995, this group published the first Canadian Standards of Psychiatric and Mental Health Nursing Practice.  Relying on these standards, the CNA then created the opportunity for nurses to become certified in mental health nursing -- as part of their larger certification program involving various nursing specialist areas.

CFMHN logo

Strategic directions going forward

Fast forward to 2016. Both the International Council of Nurses (ICN) and the CNA have taken the position that all registered nurses must have the knowledge and skills to respond to mental health needs. As well, subsequent to the work of the Mental Health Commission of Canada (2012), six strategic directions have been guiding the Canadian approach to mental health care and mental health nursing practice. These include promoting mental health across the lifespan and preventing illness, fostering recovery, providing timely access to care, reducing inequalities, working with First Nations, and mobilizing leadership for knowledge and collaboration.

Organizations like CAMH continue to align with and help drive these strategies and the improvement of mental health nationally and across the globe. For example, CAMH nurses have played key roles in the development of integrated care pathways.

Every day, our nurses deliver mental health care across the lifespan to clients, their families, and the community – and advance knowledge in the mental health field.

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