Canadian nurse practitioners battle underutilization.

Initially, nurse practitioners in both Canada and the United States were trained to meet physician shortages. This shortage no longer exists. The issue of optimally utilizing well-prepared nurse practitioners is complex and involves physician resistance, lack of government initiative and nurses' attitudes. Isolated examples do exist where nurse practitioners are accepted, cost-effective, competent and well-utilized. However, many nurse practitioners find it difficult to practice independently in most urban centers. Solutions may involve provincial governments and educational institutions, but nurses themselves must decide their role in meeting Canadians' needs for increased quantity, quality and accessibility of health care.