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Tim Guest is the CEO and Past President of the Canadian Nurses Association (CNA) and the former board member of several other nursing associations and colleges across Canada. Now in his fourth decade as a registered nurse (RN), he has applied his nursing and management skills in rural and urban organizations to direct care, clinical nursing unit management, and executive leadership, as well as healthcare consulting, and now nursing advocacy and policy at the national level.
When Tim graduated with his Diploma in Nursing from Red Deer College, the nursing jobs in Alberta were limited. As a result, Tim worked as a float nurse, giving him valuable experience in different work environments, recalling “there isn’t an area of the hospital that I didn’t work in.” It was during this time that he became involved in the local nurses’ union, sparking his interest in advocacy and system-level change and which ultimately led to his decision to pursue a management track and continuing education, including a post-RN Bachelor of Science in Nursing and a Master of Business Administration.
Much of Tim’s management career involved roles with regular connections to direct care and allowed him to still be closely involved in clinical practice. “While I didn’t work at the bedside, I was more closely involved and continued to participate in decision-making that was really informed by direct care nurses.” He frequently sat down with nurses for coffee to understand the challenges that they were facing on the floor and used this perspective to inform decision-making.
“If you want to make decisions that impact individuals, if they are given an opportunity to influence the decision, they will be more willing to accept the change and come along with you. Leaders need to have conversations with people, and they need to have an understanding of the decisions they make and how they impact the teams for you to be a reputable leader.” This approach has continued to shape his leadership philosophy to this day – while one-on-one coffee chats may be more challenging as the CEO of the CNA, Tim regularly speaks to groups of nurses and incorporates opportunities for dialogue into his travels across Canada to better understand the issues that they’re facing.
Tim is passionate about the nursing profession, and its need to understand and represent the diverse population of those living in Canada, and sees this as a priority for the CNA. He would like it to be easier for nurses from diverse backgrounds, including internationally educated nurses (IENs), to join the profession and be successfully supported within it. Early in his career, he saw how the discrimination of one nursing leader prevent colleagues of colour from advancing to leadership roles – an experience that has made an impression on him to this day and underscores his commitment to working with stakeholders across Canada to increase the diversity of Canadian nurses and nursing executives. “Social justice is part of the fabric of nursing practice – we have a role in understanding what the health determinant issues are and being a voice for that too,” says Tim, going on to point to an example of the CNA’s advocacy around safe drinking water in First Nations’ communities.
The CNA is the only national organization that represents all Canadian nurses across all practice settings, including unionized and non-unionized nurses, academics, nursing students, retired nurses, and others. The COVID-19 pandemic has required the CNA to use its voice to advocate for the health and safety of its members and the nursing profession as a whole at an unprecedented pace, including around mask mandates, personal protective equipment, and vaccinations. This has often included working with other stakeholders, such as nurses’ unions. Despite the ongoing challenges of the COVID-19 pandemic, Tim sees a silver lining; “what the pandemic did is educate the public on what a nurse does, the importance of our contribution and our value more than ever in our history.”
The health human resource (HHR) crisis that Canada is currently facing continues to require advocacy on the part of CNA. While the HHR crisis has been exacerbated by the COVID-19 pandemic, Tim is quick to point out that many of the issues leading to it have been issues present in the Canadian healthcare system for decades – these include workload, lack of work/life balance, lack of input into decision making, additional non nursing duties that impact the delivery of nursing care, job satisfaction, and burnout. Tim is particularly concerned about the increase in societal violence, including against healthcare workers, that he’s observed over the last decade – another factor that contributes to burnout among nurses.
As part of its efforts to increase diversity of the nursing workforce and to address the HHR crisis, the CNA continues its advocacy to make it easier for IENs to practice in Canada, including participation on national tables advocating for improved regulator processes and supports for successful integration into the Canadian health care workforce.
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