Registered nurse psychotherapist Sheena Howard is not only changing the lives of her clients through her services at Acceptance Nurse Psychotherapy, but she is also changing the lives of nurses in Ontario by inspiring and supporting them as they launch their own independent practices.
Her goal is to change how we see nursing.
“I’m always shocked when people are surprised that I don’t work in a hospital,” Howard says. “Ideally, I would love it if eventually it got to the point where people saw nurses as being able to (work) across all fields and in all places and spaces.”
Located in Peterborough’s The Be Well Centre at 459 George Street North, Acceptance Nurse Psychotherapy is, according to Howard, the only psychotherapy clinic in Canada owned and staffed exclusively by nurses.
The clinic offers in-person and virtual sessions to clients, with a specialization in ADHD, trauma, anxiety, and depression, as well as practitioner services including gender-affirming care, and perimenopausal and menopausal care.
“My professors (in school) all said things like ‘You shouldn’t go into public health or primary care because you’ll lose all your skills if you don’t go into the hospital right away’,” she says, noting that path didn’t appeal to her. “It wasn’t where my heart was. My heart was in public health and primary care.”
Howard found a job that allowed for both in Haida Gwaii, British Columbia. However, when she moved her family back to Ontario, she was no longer able to do similar work due to how “siloed” Ontario’s nursing is. Instead, she worked in primary care and as a mental health nurse clinician at Lakefield College School.
After being laid off during the pandemic and then hired in a role that did not appeal to her, she took a risk and established her own psychotherapy practice in 2023.
“Part of the reason why I started my private practice was in order to fill some gaps in the mental health (care) system because there was a mental health crisis,” Howard says.
“Nurses are the original therapists. If we think about nursing from a historical context … nurses did everything, and that included mental health, so it made a lot of sense to me that nurses could be able to provide the heart of nursing and the art of psychotherapy and blend it together.”
Howard notes that other nurses were questioning her idea at first — not because they weren’t supportive, but because entrepreneurship in nursing is not common.
“Nurses don’t generally, in Ontario anyways, own their own businesses or work in independent practices,” she says. “They’re usually associated with an institution.”
As of 2023, there were reportedly 1,787 registered nurses in independent practice and 79 active health professional corporations registered with the College of Nurses of Ontario (CNO). That totals a small fraction of the more than 180,000 nurses registered with the CNO.
“Nurse business owners are so rare and there isn’t a lot of support in the nursing community, simply from a concerned perspective,” Howard says. “Nurses are always worried about losing their job. We’re taught not to make mistakes because we’re impacting people’s lives, so going out and taking a risk to own or start your own business or your own private practice gets a lot of concerned statements from people.”
“Any nurse will tell you that their biggest fear is having somebody take their license,” Howard says, before adding she has no doubt nurses have the skillset to run their own businesses if they take the risk.
“Nurses innovate in all areas of practice. We see it from the professors who educate us, all the way to the nurses that are on the street working with our unhoused folks. They’ve innovating all the time. The difficult thing is for nurses to move beyond their small sphere.”
Howard was booked up within four months of launching her private practice. While she attributes this in part to long waitlists for mental health care, she also felt she was able to support clients who were being told by other psychotherapists that their care was too “complex.”
“Nurses have this really amazing capacity to sit with people during their most joyful moments and their most difficult moments,” she says.
“We’ve seen everything, we’ve heard everything … so we have a really unique opportunity to use all of that skill, and you can’t buy that kind of education of sitting with people in those moments. Blending in psychotherapy along with all that extra knowledge gives us a real capacity to provide holistic mental health care.”
With the high demand for her services, Howard says that having to turn down clients or being unable to see them for several months was “creating a lot of moral injury” for her.
That’s when she brought in her first associate, and now there are six psychotherapists practising out of Acceptance Nurse Psychotherapy. Howard has also recently enlisted three nurse practitioners to support assessment, diagnosis, and treatment for mental health and hopes to soon have a pediatric nurse practitioner serving children as young as eight years old.
“At Acceptance, they’re doing their job on their own terms and that feels really good,” Howard says. “Everybody is really happy being able to have their own hours, do the work they love, be valued for the work they love, and being on a team who wants them to work to their fullest scope and capacity.”
Howard hopes that Acceptance can expand across Canada to help support nurse psychotherapists who are starting up their own independent psychotherapy practices.
In summer 2024, she launched BizNurse Saavy, which works to support nurse entrepreneurs as they establish and grow their own independent practices, whether it’s foot care, home care, or any other specialization.
“Nurses just need the role modelling to see that it’s possible, and then they also need the business acumen and entrepreneurial guidance to be able to look at a stepwise way of starting,” Howard says. “We’ve been trained to be really skeptical and it’s just part of our training to ask questions, so we can talk ourselves right out of any innovation or any thoughts about owning our own business — and that is a real shame.”
Howard’s hope is that, by supporting nurses as entrepreneurs, fewer will decide to leave nursing and pursue other careers.
“There are nurses that are leaving the profession earlier than they ever wanted to, which means we’ve lost a huge amount of skilled knowledge and social capital,” Howard explains. “We also have seen brand new nurses just decide that they don’t even want to do it after three years.”
“It would be a terrible loss for Ontarians to lose that expertise. If we can create a pathway for nurses to be able to continue to share their expertise — and do it in a way that is in line with our regulations but also gives them an income and gives them a good work-life balance — why wouldn’t we do that?”
Through Howard received the Nurse Innovation Award from the Registered Nurses’ Foundation of Ontario in 2023 for Acceptance Nurse Psychotherapy, perhaps the greatest measure of success for her is that she has never found anything but joy in her job by doing it her way.
“Following my heart, taking a risk, and going outside the traditional rules of nursing has allowed me to keep loving my job, loving my role, loving the profession, and wanting to help more people do the same.”
For more information about Acceptance Nurse Psychotherapy, visit www.acceptanceclinic.ca.
