Staffing for remote, northern and specialized health settings

Many First Nations, Inuit and Métis communities are served by nursing stations, community health centres and community-run health programs. Health services are delivered through a mix of federal programs, provincial and territorial systems, First Nations health organizations and community-led services. Each community is different, and each sets its own priorities. This section describes what the work involves and how to prepare. It does not speak for any community.

• Who delivers care
• What the work involves
• How to prepare
• For employers

Who delivers care

Indigenous Services Canada (ISC) employs nurses who deliver primary health care in First Nations communities, mostly in remote or isolated places with sparse populations, geographic isolation and extreme climate conditions. ISC took over responsibility for First Nations and Inuit health services from Health Canada in 2017. ISC candidates must be a registered nurse or eligible to be one, a registered practical nurse, a licensed practical nurse or a nurse practitioner, and must hold a licence in the province where the position is located by the time of appointment.

In British Columbia, the First Nations Health Authority (FNHA) plans, designs, manages, delivers and funds First Nations health programs, in partnership with First Nations in BC. It took over the programs and services formerly handled by Health Canada's First Nations and Inuit Health Branch in 2013. In Nunavut, most health services are delivered through community health centres run by the Government of Nunavut and staffed mainly by community health nurses. In every case the employer sets the terms of the role.

What the work often involves

• Primary health care for clients of all ages, with ISC nurses working a full scope of practice as part of a team that can include other nurses, community health workers, paramedics and community members.
• Consulting a physician or nurse practitioner by telephone when one is not on site.
• Fly-in schedules. ISC gives the example of 2 to 4 weeks in a community and 2 to 4 weeks out, with accommodation that may be in or near the facility and often shared with other nurses. Arrangements differ by employer and location.
• Orientation. ISC says its orientation runs from 3 to 6 weeks depending on the location and the nurse's preparedness.

How candidates can prepare

Confirm your registration in the province or territory where the role is located. Some provinces authorize additional practice for remote nursing. In British Columbia, for example, BCCNM certifies registered nurses in Remote Nursing, which requires completing a BCCNM-recognized education course. Ask each employer what it requires in your case.

Learn about the community you would serve. ISC notes that each First Nations community has its own traditions, languages and governance systems, so avoid assumptions based on other places. Many health employers value cultural safety training. San'yas Indigenous Cultural Safety Training is a facilitated online program, developed by Indigenous educators in British Columbia and run by the Provincial Health Services Authority, that covers the history of Indigenous peoples in Canada and builds self-awareness of bias. Whether a given employer requires it is the employer's decision.

Plan for continuity. Care works best when relationships can form, so longer or repeat assignments are often a better fit than short rotations.

For employers and community health organizations

We recognize that many communities prefer Indigenous hiring and local capacity building. We support that, and we do not replace it. If you have roles that stay hard to fill, tell us the location, the role, the schedule, the travel and housing arrangements, and any training you require, and we will share those conditions with candidates before they commit.

Roles: registered nurses, nurse practitioners, licensed practical nurses, community health workers, midwives, paramedics and allied health.

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Pediatric care covers children's hospitals, pediatric units in community hospitals, outpatient clinics, and complex care and community programs. It calls for family-centred care and pediatric-specific assessment and medications.

Employers commonly ask for PALS, NRP (neonatal resuscitation) for newborn settings, and pediatric nursing experience. The Canadian Nurses Association offers specialty certification in areas such as critical care pediatric nursing and perinatal nursing, where relevant.

Roles: NICU nurses, ICU nurses, ER nurses, psychiatric and mental health nurses, speech-language pathologists and occupational therapists.