When people think about patient safety in health care, they often equate safety to the physical, cultural or psychological delivery of care. But Cynthia Johansen sees another way of ensuring that patients are kept from harm, and that’s why she’s spent the past two decades working toward public protection through regulation.
Cynthia is the Registrar and Chief Executive Officer of the British Columbia College of Nurses and Midwives (BCCNM), the regulator for the province’s 67,000 nurses and midwives.
The BCCNM plays an integral role in the health system. As a regulatory college, it has a legal obligation to protect the public through the regulation of nursing and midwifery by ensuring competent people enter the professions, setting the standards of practice for safe, ethical care, holding registrants accountable for applying the standards, and taking action when those standards are not met.
“Effective regulation means practitioners are engaged professionals who understand their role and deliver safe, competent, and ethical care,” says Cynthia. “Ensuring that nursing and midwifery standards are clear and enforceable, and the public understands the regulator’s role and how to make a complaint is key to supporting a safe and accessible health care system.”
Throughout her career, Cynthia has recognized opportunities to incorporate best practices into health profession regulation to better protect the public. She has a track record of bringing people and organizations together to improve professional practice standards and transform health profession regulation in BC and across the country.
Cynthia’s regulatory career began in 2003, as Registrar of the College of Dental Hygienists of BC. She joined the College of Registered Nurses of BC (CRNBC) in 2006 as Director of Registration, Inquiry, and Discipline, becoming Registrar and CEO in 2012.
Cynthia guided CRNBC through its transition to a college focused solely on public protection and was a catalyst for developing collaborative and productive relationships across the health care system, working with registrants, health authorities, nursing organizations, other regulators, and government to ensure the public is protected through the effective regulation of nurses and midwives.
She was instrumental in bringing the province’s nursing colleges together as a single regulator for all nursing designations in 2018, and then a further amalgamation in 2020 with the provincial midwifery regulator. Now known as the BCCNM, it is the largest regulator in Western Canada and the country’s first combined nursing and midwifery regulator, representing licensed practical nurses, nurse practitioners, registered nurses and registered psychiatric nurses as well as midwives.
Cynthia was also instrumental in founding the BC Health Regulators Society, providing an administrative and organizational foundation for collaboration between the health colleges to improve regulation and regulatory practice across the organizations. She kickstarted BC’s health profession regulatory overhaul in 2016, inviting the UK Professional Standards Authority to review then-college CRNBC, demonstrating her commitment to improvement and regulatory excellence.
Under her leadership, the registration and application process for Internationally Educated Nurses has been streamlined; nursing standards have been harmonized and strengthened; and BCCNM’s processes and platforms are undergoing rigorous modernization and improvement.
But her legacy may well be a result of her passion to dismantle anti-Indigenous racism and redress historical harms, to make BC’s health care system culturally safe for Indigenous Peoples.
From the outset of the establishment of BCCNP in 2018, Cynthia made it a priority to embed Indigenous Cultural Safety and Humility (CSH) into the college’s operations. The release of the In Plain Sight report in 2020, an independent review into the extent of Indigenous-specific racism in the BC health care system, reinforced her belief that BCCNM had a responsibility to take a leadership role within the regulatory context.
She made this an organizational priority, informing work at all levels within BCCNM and in collaboration with other health regulators. On May 11, 2021, Cynthia took action on one of the first recommendations from In Plain Sight, bringing together BC’s four largest health regulators to issue and apology to the Indigenous Peoples and communities who have experienced racism while engaging with the regulators and the health professionals they regulate. The apology also contained commitments to take meaningful actions towards reconciliation and inspired other regulators to make similar apologies.
Many other actions toward reconciliation have followed, and the driving force behind them is Cynthia herself and her unwavering and deeply personal commitment toward protecting patients and making the health care system safer for all.
