I've been thinking a lot lately about why I do what I do. And I realized it all comes back to 2002.
That year changed everything for me. I graduated as a nurse, stepping into the greatest joy of my career. But within months, I lost my sister to poor outcomes in the healthcare system I'd just committed my life to. When I asked her doctor how her diagnosis was missed, his response was dismissive. It wasn't good enough. It never is when you're the one left behind.
That loss taught me something early, before the word "advocacy" even existed in nursing curricula: people need someone in their corner. Someone who asks questions. Someone who fights for clarity and dignity when systems fail them.
For 23 years, I've carried that lesson
I've sat in countless healthcare settings and watched what happens when people have no voice. Patients confused across from doctors. Families lost in systems they don't understand. People leaving appointments without clarity, without power, without an advocate.
In 1994, I started my journey in healthcare at George Brown College. By 1995, I was in my RN diploma program. But nowhere — nowhere — in my nursing education was I taught the word "advocacy." It wasn't in the curriculum in the 90s. It wasn't there when I graduated in 2002. Our healthcare system was built by professionals who believed they knew it all, and patients were expected to listen, leave, and not question.
For many of us, especially those of us of colour, we didn't have the knowledge or the confidence to say "that doesn't feel right." And we've lost so many good people because of that silence — because fear kept us from standing up for what we knew was true.
Then came 2011
When I founded JA Smith Consulting and Nursing Services, I searched Canada for a model of patient advocacy, and found nothing. So I looked to Florida, where patient advocacy was already thriving because of their large senior population. I modeled my business after what was working there, brought it north, and dubbed myself a "health and social advocate."
People spent years asking me, "What does an advocate do?" It wasn't a household term. Neither was "culturally competent healthcare," but that's what I built my entire model around from day one. I was pioneering something Canada didn't even have a name for yet.
In 2015, my need became greater
As my work deepened and the community's needs grew, I founded JA Nursing We Care Inc. — my nonprofit division dedicated to health and social literacy, advocacy, and community empowerment. The for-profit and nonprofit worked together under one mission: to serve vulnerable populations and advance health literacy across the Greater Toronto Area and beyond.
Then came 2017 — a turning point
I became ill. My own health journey forced me to live what I'd been teaching all along. I navigated my own diagnosis, my own disability, my own system. And through that personal experience, I deepened my understanding of what people really need when they're struggling.
That same year, I pursued my Professional Designation in Disabilty Management as av Certified Return to Work Coordinator (CRTWC). My personal health crisis became my professional catalyst. I wasn't just talking about disability management and workplace navigation anymore — I was living it, learning it, mastering it. That credential completed my toolkit and expanded the populations I could serve: workers facing disability, return-to-work challenges, occupational health — the whole spectrum.
Here's what I want you to understand about advocacy in Canada
In 2011, when I founded my business, I dubbed myself a "health and social advocate." But that word — advocate — wasn't part of our healthcare vocabulary yet. Advocacy wasn't taught in nursing school. The healthcare system was built by professionals who believed they knew it all, and what they said went. You listened. You left. You didn't question.
When I launched my business in 2011, I searched Canada for a model to follow and found nothing. So I looked south to Florida, where patient advocacy was already established and thriving. I modeled my business after what was working there, brought it north through a culturally competent lens, and became Canada's leading resource for culturally competent health care advocacy.
For years, people asked me, "What does an advocate do?" The word wasn't mainstream. The concept didn't exist in Canadian healthcare. But I kept building, kept documenting, kept pioneering.
Fast forward to 2019: Canadian Health Advocates Inc. was founded, eight years after I started. By then, the field was finally recognizing what I'd already been doing.
In 2016, I documented this entire journey on my blog, citing a Vancouver Sun article confirming that healthcare was "behind the times on advocacy." That post became proof — timestamped proof — that I wasn't just talking. I was building, documenting, pioneering before anyone else in Canada was even using the word.
The evidence is clear My nursing education (1995-2002) had zero advocacy training. When I launched in 2011, Canada had no patient advocacy model — so I created one based on Florida's success. My 2016 blog post proves I was documenting this journey years before it became mainstream. And by 2019, the first documented health advocacy organization in Canada was founded — eight years after me.
I say this not to diminish others doing this work now. I say it because it matters. It matters that you know I've been fighting for this for 15 years. It matters that I modeled my business on what works. It matters that I didn't wait for the world to catch up. I built it anyway.
And now, in 2026, here we are
Introducing Health Care Shield Workbook
After 23 years of nursing, after founding a consulting business that pioneered patient advocacy in Canada, after creating a nonprofit, after navigating my own disability and earning my CRTWC credential, after witnessing what happens when people navigate healthcare alone — I've created something I wish existed when my sister was alive.
Health Care Shield is a practical guide to taking control of your health and navigating the healthcare system with confidence. Inside, you'll find:
✔ Family health history tracker
✔ Symptom tracking and pattern monitoring
✔ Medication and supplement log (12+ slots)
✔ Doctor visit preparation and notes pages
✔ Action items and follow-up tracking
✔ Healthcare team contact information
✔ Legal and end-of-life planning sections
✔ Space to document your story
But here's the thing: this workbook isn't just paper. It's your advocate on paper, yes, but I'm a phone call away too. Whether you need clarity on what your doctor said, help preparing for an appointment, or someone to talk through your health journey with, I'm here.
Health Care Shield is the tool. I'm the support. Together, we make sure your voice gets heard.
Whether you want to be proactive about your wellness, support an aging parent, navigate a new diagnosis, or take back control of your health — this workbook is for you.
"Lack of knowledge is the worst disease." That's what I've believed for 23 years. That's what drives everything I do.
Be the first to know when Health Care Shield launches: https://www.janursingservices.com/health-care-shield.html
Read more about advocacy in Canadian healthcare: https://janursing.blogspot.com/2016/02/healthcare-advocates-will-be-greatest.html
Thank you for following my journey. For believing in the power of advocacy. For letting me be your voice.
Your health. Your voice. Your advocate. ❤️
Michelle Smith
Founder, JA Smith Consulting and Nursing Services
Founder, JA Nursing We Care Inc.
The Voice of the Community
















