Nurse Informatician

Featuring: Barb Cross, RN, MN, Clinical Informatics Leader and Past-President of the Canadian Nursing Informatics Association

With over 40 years in healthcare- and the last 20 of those years dedicated to Clinical Informatics Leadership- Barb has had the pleasure of celebrating extraordinary opportunities alongside numerous dynamic care teams across Canada. She holds a Bachelor of Science in Nursing (BScN) and a Master of Nursing (MN), with directed studies in Health Informatics and a strong passion for data, data quality, and benefits realization. 

 Her education, along with her previous roles on provincial and national boards and a broad range of clinical experiences—including direct patient care, nursing practice, educating nursing students, and leading clinical programs and informatics teams across multiple  healthcare organizations—has deepened her knowledge and fuelled her passion for  making the often-invisible aspects of health and care, visible. 

As a Health Informatics Consultant and Past President of the Canadian Nursing  Informatics Association (CNIA), Barb remains honoured to collaborate with nurse  informaticians and other professionals committed to advancing clinical practice in  digitally-enabled care environments. Her shared focus includes research, education,  competency development, data standards, and inter-professional networking across Canada. 

In her current work, Barb is engaged in key initiatives centred on benefits realization,  data literacy, technology enablement (including interoperability), and care that is  informed by patient and family engagement. Nursing is her profession, and she is  excited to continue advancing the digitization of health and care—ensuring that  patients and families' voices are at the centre of the care team’s practice and work.

Barb Cross’s nursing journey offers a powerful example of how a career in nursing can grow across settings, leadership roles, and entirely emerging fields. What began as a love of learning, variety, and complexity has developed into a career dedicated to transforming how nursing is supported, understood, and included in system design. Her work in nursing informatics continues to shift how nursing practice is recognized, particularly through digital health planning and system transformation.

Throughout her career, Barb has practiced in northern Canada, worked as a nurse educator, managed perianesthesia services, informed national standards, served on the provincial nursing association board and served as president of the national nursing informatics association. She has shaped electronic health record systems, influenced policy discussions, and continually advocated for the visibility of nursing knowledge. Her leadership demonstrates how nurses can evolve their careers in response to burgeoning needs and take their place at the table where systems and strategies are decided.

Beginning her Nursing Journey

Barb’s interest in nursing began early in life. She recalls being drawn to a career that would be fast-paced and dynamic, and she desired a field that would offer variety, challenge, and opportunities for growth. Nursing has proven to be a profession that has met all those desires, and led to lifelong learning, innovation, and leadership. 

Barb graduated from the first diploma nursing program in Victoria, BC, where she began her career-long pattern of being a trailblazer, navigating the long-held traditions, culture and expectations remaining from hospital training programs. Soon after graduation, Barb cemented her early career growth in Whitehorse, serving the Yukon. This was a formative time in her career as she began her practice while being immersed in a high-acuity setting with limited resources and little new-graduate support. The hospital was the only acute care facility north of Fort St. John and served a wide area. It was not unusual for Barb to care for more than 30 patients on a night shift, often with only one other staff member. She also recalls that during her early critical care years, nurses were fully responsible for the manual cleaning and maintenance of ventilators. Every second night, nurses had to disassemble the tubing, clean the components, and reassemble them for continued use while a nurse colleague manually bagged the patient.

This challenging environment forced her to learn quickly and to problem-solve constantly. It also introduced her to the reality of system-level gaps. There were no mentors or structured supports for new graduates. At the time, there was no regulated college in the Yukon, and there were minimal policies to guide practice or licensing. At risk of sounding unrealistic, Barb recalls her reliance upon the CNA Code of Ethics as a new graduate, where the lack of a nursing college or association in the Yukon meant she leaned upon and later participated in CNA committees and Standards development.

Barb became involved in the Yukon Nurses Society and later began passionately and regularly contributing to national committees with the Canadian Nurses Association. Her experience in northern Canada shaped her understanding of what nurses need in order to thrive and planted the seeds of a career focused on system improvement.

For Barb in the early Yukon years, a subscription to a nursing magazine called Nursing Life replaced some of the support she was lacking, sharing that she read and referred to it like scripture. This and other journals, full of both practice and person-focused guidance, saw her through much of her early growth, helping her understand what it meant to be a nurse.

 From PeriAnesthesia Leadership to System Transformation

Barb’s clinical career included roles in medical-surgical nursing, intensive care, and perioperative care. Following the growth of her family, Barb pursued perianesthesia and perioperative nursing work, which in the technology era and remote setting remained a challenge requiring creative resource management and problem-solving. She pursued specialty education through the University of Alberta and BCIT, and she later became the manager of perianesthesia nursing services in Nanaimo. Throughout this time, she contributed to curriculum development, co-authored national standards, and supported certification efforts in her specialty area. She also taught in a diploma nursing program while continuing to work clinically.

Despite her success in clinical leadership, Barb began to notice that nursing contributions were often minimized in decision-making and especially planning. While Barb continued to work dedicatedly on policies and standards, they were often stored in binders and not actively used. She saw that nurses were documenting important assessments and interventions, but that this information was not reaching decision-makers or being reflected in system design. She began to ask how nursing knowledge of patients, patterns and responses could be made visible, actionable, and integrated into the systems that shape care.

This question led her to graduate studies in nursing and health information science. At a time when dual degrees in nursing and informatics were not yet established, Barb created her own academic path. She relished emerging courses in informatics, policy, and standards development. She studied with pioneers in the field and began to understand how clinical standards, technology and data could be used to support and elevate nursing practice. Barb credits her early understanding of nursing informatics to the influence of pioneers such as Dr. Kathryn Hannah, who co-taught her first informatics course and remained a lifelong mentor, Dr. Lynn Nagle, whose published work helped shape her thinking around nursing science and digital systems, and Dr. Gail Mitchell, whose interdisciplinary contributions further informed her understanding of how technology intersects with clinical practice.

Understanding Nursing Informatics

Barb describes nursing informatics as the intersection of nursing science, technology, and information systems. Nurse informaticians help design, evaluate, and improve systems such as electronic health records, clinical dashboards, and decision-support tools. Their goal is to ensure that these systems work for the people using them and ultimately improve patient care.

In Barb’s view, nurse informaticians are clinical translators. They understand the context of care and bring that knowledge into system design. Without their input, tools are often built by information technology professionals who do not work at the bedside and do not fully understand the impact of poorly designed interfaces, workflows, or documentation processes. Barb has spent much of her career ensuring that nurses have a voice in these conversations and that systems are built with clinical realities in mind.

Highlights and Challenges

One of the most impactful projects Barb has led was a benefits realization initiative across three major health authorities in British Columbia. The goal was to assess whether the implementation of systems were resulting in measurable improvements to patient care and system performance. Barb and her team gathered data, spoke with clinical teams, and worked with analysts to understand how the system was functioning in practice. The project demonstrated how informatics can support decision-making, enhance care quality, reduce waste and lead to improved clinician usability/experience, and health system transformation. It also revealed how essential it is for nurses to be present at the planning and procurement tables.

Barb has faced resistance throughout her career. She has been told many times that her ideas were ten years ahead of their time. She has worked in systems where nurse input was excluded from technology design and where critical safety concerns were ignored because of cost or politics. These experiences have only deepened her commitment to advocacy and to the development of nurse informatics leadership.

Advice for Students and New Graduates

Barb encourages any nurse interested in informatics to begin exploring early and to seek out learning opportunities wherever possible. She advises students and new graduates to take electives related to health data, nursing informatics, or information systems during their nursing programs or as post-baccalaureate courses. For those already practicing, she recommends reaching out directly to informatics professionals within their own healthcare organizations, as there are often nurses quietly working in these roles who are eager to share their knowledge. 

Barb emphasizes that new graduates are frequently invited to participate (as they are already subject matter experts) in system redesigns or workflow evaluations and that their recent clinical experience is a valuable asset. She also recommends connecting with the Canadian Nursing Informatics Association (CNIA), whose communications team can link interested nurses with local, experienced informaticians across the country. For Barb, the key message is that nurses do not need to be “tech people” to enter the field. What matters most is a desire to improve systems and advocate for tools that support better care. If a nurse understands how technology affects their ability to provide safe and effective care, and they are willing to ask questions and speak up, then they already have what it takes to contribute meaningfully to the world of informatics.

Looking Ahead

As Barb transitions into her role as Past-President of CNIA, she remains active in consulting, mentorship, and leadership. She is particularly interested in the unique benefits of clinical data being stored on cloud-based systems, artificial intelligence, and the use of early warning scores translated into decision support tool implementation. She believes these tools have incredible potential, but only if they are designed with nurses’ input and a focus on patient-centered care.

She continues to advocate for roles such as the Chief Nursing Informatics Officer, a position that she believes is essential for integrating nursing knowledge into executive-level decision-making. She is also committed to ensuring that technology remains person-centered, with a focus on real-time data that supports planning, safety, and transitions of care.

For Barb, informatics is not a separate discipline from nursing. It is a pathway that elevates the profession and brings visibility to the knowledge that nurses use every day. She believes the future of nursing depends on our ability to show not just what we do, but what we know.

Barb notes that nurses “are the coordinators of care, the interpreters, and the advocates. Informatics allows us to make that role visible, measurable, and respected. It helps us design systems that truly work for people”.

Final Thoughts

Barb’s story is a reminder that nursing is a profession of possibility. It can evolve, adapt, and lead. Whether in northern hospitals, national associations, hospitals or distinct specialties, nurses like Barb are shaping the future of health care. Her career reflects a commitment to quality, innovation, and transformation.