BCNU Update Magazine Feb-Mar 2015 by BC Nurses' Union

FEBRUARY/MARCH 2015

STANDING UP FOR MIGRANT HEALTH CARE

BREAKTHROUGH DEAL AT PRINCE GEORGE HOSPICE

FLU POLICY FLOP: IT’S TIME FOR A RE-THINK

UPDATE BRITISH COLUMBIA NURSES’ UNION

ON THE

WWW.BCNU.ORG

FRONT LINES BCNU community nurses are part of the solution to BC’s mental health crisis

RURAL HEALTH: WILL THE CARE BE THERE? SUPPORTING TOMORROW’S NURSING LEADERS

INTERNATIONAL WOMEN’S DAY

Sunday MARCH 8 MAKE IT HAPPEN

celebrate the achievements of women while calling for greater equality

@womensday #makeithappen International Women’s Day

UPDATE MAGAZINE February/March 2015

UPDATE

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CONTENTS VOL 34 NO1

FEBRUARY/MARCH 2015

NURSES UNITED Ontario community health nurse Christine Giles-Mohabeer is joined on the picket line by BCNU Coastal Mountain chair Kath-Ann Terrett and BCNU organizer Todd Decker.

UPFRONT

Check In

News and events from around the province.

12 Masking Frustration

It’s time for a re-think of BC’s seasonal flu policy.

14 Workplace Violence

Action is still needed to keep BCNU members safe on the job.

16 Sanctuary Health

Fighting for the rights of all patients.

18 Will the Care be There?

BCNU is calling for action on BC’s rural health care crisis.

39 From Generosity to Gratitude

Annual Human Rights & Equity conference brings activists together. DEPARTMENTS

5 PRESIDENT’S REPORT 38 YOUR PENSION 44 WHO CAN HELP? 45 COUNCIL PROFILE 46 OFF DUTY A healthy future

Read about how BCNU is supporting tomorrow’s nurse leaders p. 31

FEATURE

ON THE FRONT LINES

BCNU community nurses are part of the solution to BC’s mental health crisis COVER PHOTO: PETER HOLST

BC Nurses’ Union

MOVING? NEW EMAIL?

UPDATE MAGAZINE

OUR MISSION STATEMENT BCNU protects and advances the health, social and economic well-being of our members and our communities. BCNU UPDATE is published by the BC Nurses’ Union, an independent Canadian union governed by a council elected by our 42,000 members. Signed articles do not necessarily represent oﬃcial BCNU policies. EDITOR Lew MacDonald CONTRIBUTORS Juliet Chang, Sharon Costello, Monica Ghosh, David Cubberley, Gayle Duteil, Gary Fane, Catherine Fast, Shawn Leclair, Michelle Livaja, Catherine Pope, Shirley Ross, Dan Tatroff PHOTOS Lew MacDonald, Catherine Pope, Caroline Smith, Dan Tatroff

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PRESIDENT’S REPORT

UPDATE MAGAZINE February/March 2015

GAYLE DUTEIL

UNITED FOR SAFE PATIENT CARE

PHOTO: ALEXIS SULLIVAN WALTERS

HEN OVER 3,000 NURSES IN ONTARIO’S COMMUNITY sector went on strike last month, the BC Nurses’ Union was there to answer their call. It was a proud moment. Ontario law limits nurses’ strike activity, and the Ontario Nurses’ Association members who found themselves on the picket line had limited job action experience. We immediately responded by sending some of our most experienced staff and union leaders to assist during the critical early stages of the strike. In helping to coordinate the Ontario nurses’ efforts and joining colleagues arm-in-arm on the picket line – in minus 20 degree weather I might add – they earned the admiration and respect of ONA’s leadership and frontline members. Why would BCNU care about what’s happening across the country? And why spend our precious resources there? The answer is clear: their fight is our fight and their success in the fight for safe patient care can’t help but lead to greater successes for the entire nursing profession. Union representatives are often called upon when our members face difficult situations, and it’s easy for any of us, after a long day, to be reactive or harsh, rather than open and compassionate in addressing the concerns of others. But it’s important to remember that when we help each other, we’re focused on success – on achieving our goals. To be part of a union collective and the professional voice of nursing means taking all of

our individual successes and building on them together. Nurses today have a responsibility to protect our earlier successes while fighting to improve the working conditions we now face. And I am proud of the work our members are doing on behalf of their patients and each other. Many activists and members have worked incredibly hard these past few months, standing up for safe patient care with our successful grievance campaign efforts. Charge nurses are standing strong, trying their best to advocate for proper staffing, despite the lack of nurses and available beds. BCNU has also been extremely successful in keeping the plight of our overcrowded hospitals and the absence of necessary community and residential resources front-andcentre in the public eye. We are re-engaging our members in a variety of settings and hearing first-hand what a day in the life of a nurse truly is about. And, most importantly, we continue to strive to care for an increasing number of patients and residents with the professional approach we have been educated to provide. Indeed, it is the patients of British Columbia who benefit from our successes, be it the success of finding that elusive bed for the patient who has spent seven days on an emergency stretcher, or finally finding a quiet moment to have that difficult conversation with the family of a palliative patient in one of our rural communities. There is no question that all of our efforts to advocate for safe care, including successful grievances, PRFs and public outreach, can improve staffing levels and reduce the use of overcrowded hallways and other unacceptable places for patient care. Like our colleagues in Ontario, we are in this together. If we are united on our units, in our health centres, at our regional union meetings, or wherever else nurses convene, we’ll be positioned to build on our successes in the year ahead. We will be united for safe patient care. update

CHECK IN

NEWS FROM AROUND THE PROVINCE

PENSION REMINDER DON’T FORGET!

LONG-TERM CARE NURSES PLAN FOR BARGAINING

EAVY WORKLOADS. LONG HOURS. NO replacement staff. Workplace violence. These were just some the priority issues flagged by a group of long-term care nurses gathered in Coquitlam on the evening of Jan. 31. Their concerns might sound familiar to many nurses working in other parts of the health care system, but the purpose of the meeting was to gather input first-hand from nurses who work in the long-term care sector. The meeting was the first in a series of dinners the union has organized to listen to the voices of some of the more than 6,500 long-term care nurses across the province who are members of BCNU. BCNU Treasurer Mabel Tung provided the group with an overview of the current bargaining climate and reminded them of the important staffing language that was bargained during the last round of provincial negotiations. Stewards were encouraged to file grievances and document contract violations, and speak out for safe patient care. Participants shared their feelings on what they valued most about their work, gave suggestions about what the union could do to support them in the their workplaces, and talked about the reality facing long-term care nurses today – from increasingly complex patient needs, to employers’ use of agency nurses and the lack of continuity in care delivery. All of the information gathered at the meetings will be used to assist BCNU at the bargaining table. update

March 31, 2015 is a key date for Municipal Pension Plan members considering buying back pensionable service for unpaid leaves of absence. Details concerning purchase of service can be found on the Municipal or Public Service Pension Plan website at www.pensionsbc.ca.

PRIVATIZATION

Medicare under attack

DAY IN COURT FOR-PROFIT HEALTH CARE TRIAL TO GO AHEAD IN MARCH

A for-profit health care promoter’s legal stalling has come to an end, as the Charter trial being waged by the Vancouver-based for-profit Cambie Surgeries Corporation (CSC), has finally been scheduled to begin on March 2. For years, CSC owner Dr. Brian Day has railed against medicare laws that protect patients’ access to necessary care, regardless of their income. Day has fully admitted to breaking the law and charging patients thousands in illegal fees. He has been litigating since 2008 in order to prevent the province from enforcing the BC Medicare Protection Act in the interest of all British Columbians. Day used the courts to delay a government audit of his clinic for three years – and when the

audit was finally conducted in 2012, it showed that CSC illegally billed patients almost half a million dollars over a 30 day period alone. The BCNU has supported patients who are interveners in the case. They were set to bring important affidavit evidence to trial last September attesting to their negative experiences with for-profit health care in BC. At the time, CSC legal counsel said that it wished to delay trial proceedings yet again in order to allow for settlement discussions with the provincial government. A settlement was not reached, and now patients should finally have their day in court.

COMPUTER WARNING

UNIQUE PERSPECTIVE BCNU Simon Fraser region long-term care nurses met last month to share their workplace experiences.

BCNU members are reminded that they can be disciplined for using their employer’s computer for personal business. Members are also asked to use a personal – versus a work – email address when conducting union business.

UPDATE MAGAZINE February/March 2015

HUMAN RIGHTS & EQUITY

ENDING VIOLENCE AGAINST WOMEN

Men in Nursing raises funds for EVA BC

SKILLFUL STEWARDS BCNU’s education department held advanced steward training workshops this January. For the ﬁrst time, participants included former Union of Psychiatric Nurses stewards who have joined BCNU since the recent merger of both unions. The January 27 workshop participants are shown here. Back row, from left, Kim Bentley, Ron Morley, Donna Moore, Bobbie-Jo Allen, Katrina Webster, Suellen Larsen, Sue Janzen, Margaret Doniec, Susan Sitter, Amy Bordas, Richard Massey, Yolanda Hamilton, Ian Dayneswood, Sue Bateman, Christine Brisebois and Pam Ferguson. Front row, from left, Jody Blackman, Jaswinder (Jassi) Chahal, Megan Kok, BCNU executive councillor Dan Murphy, Gordon Wilson and Tiger Robinson.

MAKING NEWS

BCNU in the headlines

PATIENTS IN HALLWAYS – AGAIN

Earlier in the month, Sorensen blew the whistle When a 68-year-old patient on overcrowded conditions recently spent more than at the University Hospital three weeks at Royal of Northern BC, where Columbian Hospital recovpatients were lined up in ering from major surgery the hallways, lounges and in a hallway – one of shower room. “It dozens of patients was very disin the halls of the tressing to see hospital – BCNU Vice the level of care President Christine that was being Sorensen told CTV provided because News that the the nurses were problem was more working in a very than just a seasonal Christine Sorensen diff icult situaphenomenon at the tion,” she told facility. “We’re seeing Global News on this, it’s a pervasive probFeb. 6, fearing that patients lem across the province,” will continue to face extenSorensen told the network sive waits and poor care on Feb. 10, adding that she conditions. “I’m very, very had also seen overcrowding concerned for patients in hospitals in Abbotsford in the province of British and Prince George. Columbia.”

HEN BCNU MEN IN NURSING GROUP members grew their mustaches last November to raise money and awareness for men’s health, the group challenged the union’s provincial executive to match the amount they raised dollar-for-dollar. The group was able to raise $4,060 for the Movember Foundation and, true to its word, BCNU issued a cheque for the same amount – made out to the Ending Violence Association of BC (EVA BC), a provincial organization representing more than 240 anti-violence and victim service programs across the province that responds to sexual and domestic violence, child abuse and stalking. “I am so proud of our group,” says BCNU South Fraser Valley region lobby coordinator and Men in Nursing group chair Walter Lumamba. The Surrey nurse feels that EVA BC deserves the group’s support. “It’s important for us to create awareness, we are men and we should be respectful to women.” EVA BC Executive Director Tracy Porteous is grateful for the support. “The anti-violence sector is predominantly women, and when they first heard about Men in Nursing initiating contact to support us, I heard from many of my colleagues across the province who were astounded,” she reports. “I’m blown away by the commitment of a small group of men who could do something as big as this – $4,000 is huge for our organization.” Established in 1992, EVA BC provides its membership with program support, training, resources and tools. It works with communities across BC to end violence against women and children. It collaborates with government, police and communities to ensure that victims of violence do not fall through the cracks. update SUPPORTING ANTIVIOLENCE BCNU nurses present cheque to the Ending Violence Association of BC. From left: BCNU West Kootenay region chair Lorne Burkart, EVA BC Executive Director Tracy Porteous and BCNU South Fraser Valley region lobby coordinator and Men in Nursing chair Walter Lumamba.

CHECK IN

INDEPENDENT BARGAINING

BREAKTHROUGH AT PRINCE GEORGE HOSPICE

PICTURE OF SUCCESS Prince George Hospice workers achieved an independent contract that comes close to matching the provisions of provincial collective agreements. From left: Susan Ohlin, Lynell Dondale, Cynthia Marquez, Melissa Styles, Tanya Gibbs, Brenda Callaghan, Mara Helkenberg, Christine Truden, Harriet Watson and Katherine Mueller.

N JANUARY 23 THE 28 STAFF MEMBERS WHO WORK AT PRINCE George’s Hospice House voted to ratify a new three-year collective agreement. And while the day marked the successful completion of the group’s third contract, for many workers at the palliative care facility, this year feels like a new beginning. Hospice House workers organized seven years ago and bargained their first collective agreement in 2009. The process wasn’t an easy one. After many long and difficult sessions, a first contract was only achieved through mediation at the BC Labour Relations Board, and workers achieved little in the way of wage or other monetary improvements. However, despite this early difficulty, staff were able to gain essential fundamental rights and negotiate an important letter of understanding requiring the employer to achieve parity with provincial collective agreements as soon as its financial conditions would allow it. Although the palliative care facility serves the entire northern city of 70,000, it is run

by a local non-profit society, and as a result only 49 percent of its funding comes from the province. As an employer, the hospice society is independent from the provincial government, which means that Hospice House staff must negotiate their own collective agreement, separate from the majority of health care workers in Prince George and other cities in the province who are employed by health authorities and covered by a provincial contract. The facility is a so-called wall-to-wall certification, with BCNU representing all of the non-management staff, which includes registered nurses, care aides, a volunteer coordinator and operations clerical support. After successfully organizing their workplace, the bargaining team struggled to keep all of the BCNU members at the facility strong and cohesive in the face of a difficult and at times disrespectful employer. Despite significant gains made during the second round of bargaining, parity with provincial contracts seemed a long way off and an unachievable feat given the current economic climate. But during the latest round of negotiations the bargaining team worked long and hard, stuck to its mandate, and successfully achieved a tentative agreement last December that made huge leaps forward. Christine Truden has worked as a Hospice House care aide since 2006 and has been on the bargaining committee for the past three years. “I’m feeling good about this,” said the steward on the day of the ratification vote. “In this hard economic climate it’s not so easy to get a good contract, and because we are hospice [and not fully funded by the government] we have to ‘beg borrow or steal’ the rest – and it’s not so easy to do that.” Truden and her bargaining team success-

UPDATE MAGAZINE February/March 2015

fully negotiated wage increases of 5.25 percent for RNs, 4.5 percent for care aides, and 4 percent for the other classifications, bringing them to less than a dollar short of the Nurses’ Bargaining Association and Facilities Bargaining Association provincial collective agreements.

“I’m feeling good about this – in this hard economic climate it’s not so easy to get a good contract.” CHRISTINE TRUDEN

But Truden remains modest about her group’s accomplishments. “We realized that our expectations couldn’t be as high as those in the acute care sector, but I’m very glad we were able to get the 5.25 percent raise for the nurses because they were really quite far behind, and it’s really hard to get them to come and work for us with these kinds of wages.” Truden is also optimistic that new management will make her workplace more attractive. “The old manager is retiring

at the end of the month,” she notes. “I’ve heard nothing but positive comments about the new manager, so hopefully things will go a lot smoother than they have for past three years.” Other highlights of the new Prince George Hospice contract include parity with the NBA contract vacation grid resulting in a one week increase in vacation entitlement for half of the members; responsibility pay for RNs that will help with recruitment into the current vacancies at the site; an increase in vision care from $350 to $600 per 24 months and an increase from $50 to $125 per year for eye exam coverage; an increase in the employer’s portion of employee extended health care premium costs, from 60 percent on the date of ratification to 90 percent over the remaining two years; and an increase to employer-paid RRSP contributions, from 4 percent to 6 percent over two years. “It’s a good start,” said care aide Harriet Watson on the day of the ratification vote. “I’m happy with the new vacation language and wage increase.” Steward and bargaining committee member Cynthia Marquez agrees that the new contract will make it easier to attract other nurses. “Right now we are so near to what nurses under the provincial contract are getting; I’m so happy with everything that’s in there.” update

BCNU STAFF NEWS THE NEW YEAR HAS ALREADY brought fond farewells for many long-serving BCNU staff members. In January the union’s servicing department saw the retirement of both of its senior labour relations officers, Christine Bounsall and Frank Morgan. Christine worked in longterm care for many years and was an active steward before coming to work for the union. She began as a temporary labour relations officer in 1992 and became a regular employee in 1994. Christine was very active in the union’s organizing and servicing departments, and became a servicing coordinator in 2010. Frank worked in child psychiatry at BC Children’s Hospital. An active member and steward, he was involved in organizing and servicing in his role as a labour relations officer. Frank headed up BCNU’s organizing department and became a servicing coordinator in 2010. BCNU also said goodbye to Farida Jessa this year. Farida came to BCNU in 1993. She was known to all staff and

Farida Jessa

visitors in her receptionist position that she assumed in 2009. Prior to this she worked as a servicing secretary. Retirement has also come for Gwen Mackinnon of BCNU’s education department. Gwen began working as an education officer in 1994. She served as acting department coordinator many times over the years prior to being awarded the position in 2014. Late last year BCNU also said goodbye to Doreen Plouffe. Doreen began working as an organizer in 2009. As an LPN, Doreen played an important role in working to unite all of BC’s nurses in one union. The BCNU thanks all of these staff members for their years of dedication and service to BC’s nurses. update

Christine Bounsall and Frank Morgan

Gwen Mackinnon

Doreen Plouffe

FEDERAL ELECTION 2015

N ITS JUST OVER THREE YEARS with a majority in the House of Commons, political observers have watched the federal government demonstrate its intent to perform a historical 180, and effectively abandon Ottawa’s leadership role in the area of public health care. And with a fall federal election on the horizon, watchdog groups are warning voters that our public health care system will be at even greater risk if the Harper government is re-elected in October. The government’s pattern of neglect began in the first year of its current mandate, when it came time to re-negotiate the federal-provincial health accord, an important 10-year agreement that brought about an increase in the federal share of health care funding and tied the use of those funds to reforms that support national objectives. The federal government simply refused to sit at the table with provinces to discuss funding levels or policy directions. In December 2011, it chose to unilaterally announce reduced federal transfers in the 10 years following the expiry of the heath accord. The new fiscal reality is set to take effect next year, when federal transfers will begin shrinking, and ultimately deprive provincial health care budgets of at least $36 billion in federal investments over the next decade. There’s no question that provinces desperately need these revenues to meet the current rise in demand as the baby boom bulge passes age 65. Provincial premiers have already established a health care working group to address how to create new capacity in home care and community care, and relieve pressure on acute care hospitals. Historically, Ottawa would play a coordinating role in these kinds of policy efforts. But the federal government is nowhere to be found.

Another step away from federal stewardship was witnessed last year with the decision to shut down the Health Council of Canada (HCC). Established as part of the health accord in 2003, the HCC may not have been a household term – even among health care workers – but it played an important role in setting targets and ensuring that federal funding went towards pressing problems, like reducing wait times WALKING AWAY The Harper Conservatives left provinces holding and improving access to the health care bag when they refused to negotiate a renewed health accord last year. primary care. Without it, there is no federal agency responsible for the overall stewardship of public health care, medications, due to a patchwork of provincial and its absence has now removed the federal and employer-based plans, contradicts the government from its role in ensuring innova- key principle of universal access to benefits. A growing chorus of policy makers has been tion and reform that’s consistent with the calling for action to bring pharmaceuticals principles of Canadian medicare. under the public health care umbrella, and The Harper Conservatives’ indifference a broad consensus of citizens and provinces clashes with how most Canadians see the favour the creation of a truly national plan. federal government’s role in health care, But the Conservatives have refused to even which is akin to a “sacred trust”, in the words consider expanding medicare to include a of a former Tory prime minister. Having single-payer insurance program with national custody of that trust implies a hands-on standards that would improve drug access role for the federal government in funding at greatly reduced costs to individuals while and modernizing the system, in order to ensure that changes continue to embody the offering family protection against catastrophic drug bills. principle of universal access to comprehenThe economic benefits of a national plan, sive medical care without regard for ability based on substantial savings from bulk to pay. purchasing of brand and generic pharmaceuCanada is the only major industrialized ticals, were recently pegged at $11.4 billion country outside the US without a national a year according to a study done for the insurance plan for prescription drugs. And Canadian Federation of Nurses Unions. Yet Canadians pay more for their pharmadespite the financial gains, a political consenceuticals than their counterparts in other sus and the chance to tame the fastest growcountries. Uneven access to prescription

PHOTO: CHRIS WATTIE / REUTERS

CONSERVATIVES TURN AWAY FROM HEALTH CARE LEADERSHIP

UPDATE MAGAZINE February/March 2015

ing cost-driver in health care, the Harper government simply walked away from the commitment without any discussion. Ottawa was more focused on negotiating the Comprehensive Economic and Trade Agreement (CETA) with the European Union. This free trade agreement gives European drug makers greater access to Canadian markets while increasing drug costs for consumers. This leadership vacuum comes at a crucial time for public health care, which is under pressure to meet the needs of an aging population. Faced with a neglectful federal approach and shrinking funding, Canadians generally, and nurses in particular, have good reason to worry about health care’s overall sustainability. BC nurses understand how provincial underfunding of hospital capacity results in their working short, and how it tempts health authorities to introduce care models that increase patient loads and harm patient safety. Those financial constraints are already downgrading the quality and safety of care in BC – and the cuts to federal health transfers have yet to kick in. Ottawa’s “hands-off” approach with the provinces is anything but benign neglect. A government that simply walks away from leadership, cuts the provinces adrift while slashing funding, and withdraws from any cooperative discussion is in effect deliberately sabotaging a public health care system that the majority of Canadians, including Conservative voters, support and rely on. update

ARBITRATION DECISION LIMITS SCOPE OF ATTENDANCE AND WELLNESS PROGRAM Ready decision says joint disability management programs trump employer’s attendance management program

JANUARY 28 ARBITRATOR’S DECISION HAS put major limitations on a Vancouver Coastal Health Authority program that targets employees with higher than average absences from work. The BC Nurses’ Union argued that because it negotiated a collective agreement program – the Enhanced Disability Management Program (EDMP) – the employer should not be allowed to unilaterally use its own Attendance and Wellness Promotion (AWP) program in its place. Arbitrator Vince Ready agreed with BCNU’s argument that the negotiated EDMP trumps AWP. While not eliminating the AWP program entirely, the decision narrows the program’s scope significantly. The decision says that the employer cannot include an employee in an AWP program if they are in the EDMP. This includes members who are off work for five or more consecutive shifts, off work with a work-related illness or injury, or who have self-referred and been accepted into the EDMP. EDMP is a comprehensive disability management program that is supportive and collaborative. It was negotiated as part of the Nurses’ Bargaining Association provincial collective agreement, and the Ready decision should act as a precedent in other health authorities. Any member who would benefit from EDMP is encouraged to contact the program. If you are struggling at work or having difficulty with attendance, consider self-referring to EDMP. The arbitration began in April 2012 and is ongoing, with other aspects of BCNU’s grievance yet to be resolved. The union continues to argue that the AWP program violates privacy rights and nurses’ professional standards and that it is fundamentally a disciplinary and punitive program rather than one that is focused on wellness. update

YOUR LICENCE YOUR PATIENT YOUR HEALTH Know your rights 1. You do not have to have a personal discussion with your manager about your private medical information. 2. Your medical care, your diagnosis and treatments are not public information. 3. You can ask to have all questions referred to your union representative. 4. Your Provincial Collective Agreement gives you up to 18 days a year off for legitimate illness, a right negotiated fairly over a decade ago, agreed to freely by management, and ratified by our members. 5. As a licensed nurse, you have a professional responsibility to your patients and your own health not to work when legitimately ill. IF YOU ARE SUMMONED TO AN ATTENDANCE MANAGEMENT MEETING 1. Do not attend without bringing your union representative along to protect your rights. 2. Recognize that managers may show concern for your health, but they’re there to send you a message that you’ll be disciplined if your sick time is above average. 3. If you don’t know who your BCNU Steward is, call us at 604.433.2268 or toll free 1.800.663.9991.

FLU SEASON FLOP

VACCINE’S FAILURE DEMANDS A RE-THINK OF EMPLOYERS’ SEASONAL POLICY

T’S A DUD. THAT’S THE verdict on this year’s seasonal flu shot according to a study published in January confirming that the vaccine does not appear to protect against the dominant flu strain in circulation. The lead author of the study is none other than Dr. Danuta Skowronski, epidemiology lead for influenza and emerging respiratory pathogens at the BC Centre for Disease Control. She and other researchers studied data from patients in this province, as well as Alberta, Ontario and Quebec, and discovered that a high number of laboratory-confirmed influenza cases occurred amongst individuals who had been vaccinated. The news comes as cold comfort to Abbotsford’s Shelley Blair. The nurse of 19 years suffers from a degenerative bone condition in her jaw that was triggered by a childhood injury. Her lower jaw has been rebuilt and is in the process of healing. Her x-rays reveal the extent of the damage – and the reconstructive surgery – that her jaw has undergone. She explains that the post-operative recovery has been a delicate one, and pressure against her jaw could jeopardize her recovery. But Blair says that’s exactly what the surgical mask that she’s required to wear is doing. The strap in particular rubs against an area that should not receive any pressure. “The healing is important,” she says. “The face is how we communicate with patients and other nurses.” She adds that the heat generated by the mask immediately after her surgery was at times unbearable. Blair works in the ER at the Abbotsford Regional Hospital and Cancer Centre.

A triage nurse for the past 12 years, she says she knows no one who is more pro-vaccination than she is. However, she says her promotion of infection control does not extend to support for BC health employers’ seasonal flu policy. Blair has documented reactions of throat swelling to some milk products. Presently being treated by an allergist, she had a severe reaction to a flu shot she received in 1998. Already aware of the flimsy evidence supporting vaccine manufacturers’ claims of effectiveness in the 80 percent range, and concerned about her preexisting health conditions, Blair opted to forego the flu shot. She was then required to wear a mask at the beginning of this year’s flu season. Her manager was initially supportive and agreed that the registration area where no patients were allowed could qualify as “administration” under the policy, and that Blair could remove her mask between triaging in order that her jaw could heal. However, she says that before long, hospital administrators put pressure on managers, demanding that unvaccinated staff wear a mask in all areas of the hospital outside of the staff room and cafeteria, with no exceptions. Blair was then warned she would be disciplined if she did not comply. Today, Blair is only working .6 FTE and not picking up any extra shifts as she would have in the past in order to minimize the amount of time she needs to wear the mask, which she says is near to unbearable over an entire shift. “Betrayed and confused,” is how the nurse describes her feelings about her employer’s indifference. “I feel our voice and our choice has been taken away,” she says. “Everything that we value: integrity,

MASKING FRUSTRATION Abbotsford Hospital ER nurse Shelley Blair feels betrayed and confused by her employer’s indifference to her medical condition.

UPDATE MAGAZINE February/March 2015

openness, honesty, education, everything that matters to who we are – this policy seems to betray it.” Blair also values her advocacy role, and fears the requirement for unvaccinated health care workers to wear a mask at all times sends the wrong message to the public. “Many in the public might conclude that nurses are concerned about or opposed to all vaccines, not just the flu vaccine,” she says. “This is ironic – and unfortunate.” Provincial health employers continue to require flu vaccinations despite the most recent research showing this year’s vaccine doesn’t seem to be able to halt the H3N2 virus, which is causing the vast majority of flu cases. BC Nurses’ Union President Gayle Duteil says the inflexibility makes no sense, and has called on the provincial government to revise its vaccination policy for health care workers. “It’s difficult to function for a 12-hour shift wearing a mask,” she says, adding that the policy has always been more punitive than evidence-based. “Nurses should be able to choose whether or not to get vaccinated or wear a mask during flu season, especially with this year’s mismatch with the prevalent influenza strain. “Our members are receiving vaccinations that have proven to be ineffective against this strain of flu,” says Duteil. “We are asking health authorities to revise their policies because they make no sense.” update

FOLLOWING THE EVIDENCE A GROWING NUMBER OF POLICY LEADERS QUESTION SEASONAL FLU VACCINES BC’S CHIEF MEDICAL HEALTH officer Dr. Perry Kendall is the province’s primary spokesperson for the seasonal flu vaccine, and an ardent defender of health employers’ mandatory flu shot or mask policy. The doctor criticized the BC Nurses’ Union when it called for an end to the policy’s masking requirement after studies showed there was no evidence that this year’s flu vaccine offers protection against becoming sick. “It makes no sense to me,” said Kendall, speaking to the media in response to BCNU’s call. “We should be doing everything in our power as health care workers to protect those vulnerable people. We have an ethical duty to care for our patients.” Despite Kendall’s enthusiasm, there are other more sober voices in the health policy community who are also speaking out. Dr. Richard Schabas is a public health physician in Ontario and a former chief medical officer for that province. Like Kendall, he supported flu vaccines when they were introduced. He’s since changed his position. “Our understanding of vaccine effectiveness has eroded a lot over the years,” he told CBC Radio in January. ”The average effectiveness of flu

vaccines in all years averages out to about 40 percent – so the numbers are nowhere near as good as we thought they were when we got into this.” He argues that it’s time to take a step back from policies that promote the vaccine. “Fundamentally, we’ve turned the flu into the great public health monster of our time and we’ve turned influenza vaccine into the great public health saviour of our time – and I don’t think either end lives up to its billing.” Schabas is concerned about the vaccine’s continued promotion despite the dismal efficacy numbers. “Public health officials are certainly overselling it, and the media is overselling it, and I guess the industry that makes the vaccines has been guilty of overselling it,” admitting that he was once part of this effort. But he is not bound to his position. “I went with the evidence at the time and now I’m changing my opinion as the evidence changes – that’s what good doctors do.” Dr. Michael Gardam is the director of infection prevention and control at the University Health Network in Toronto. He’s a leading Canadian voice in the field of infection control, and was one of the most recognized public

health spokespeople during the recent SARS and H1N1 outbreaks. Gardam said he used to be in favour of mandatory flu shots for health care workers, but changed his opinion three years ago after he began investigating the literature. “I actually was quite alarmed,” he said when speaking to CTV recently. “The support for vaccine versus mask policies is not nearly as robust as we’re being led to believe. And that really started to worry me.” The virus doesn’t spread unless symptoms are present, Gardam explained, so forcing workers to wear a mask while they appear healthy is needless. “And given that most influenza-like illness is not influenza, and the flu shot is by no means perfect, wearing a mask when you don’t have symptoms, is not doing anything,” he explains. “A far more intelligent policy,” he said, “would be simply, if you’ve got influenzalike illness, to stay home until you’re better. “If you have to come to work, wear a mask while you’re at work, wash your hands a lot, and then get the heck out of there when you’re done.” update

NURSES AND POST TRAUMATIC STRESS POST-TRAUMATIC STRESS DISORDER – or PTSD – is the result of experiencing events that are outside the normal range of human experience and an individual’s ability to cope. During the course of their working lives, nurses are witness to, and experience, various critical incidents that accumulate and manifest as burnout, depression, anxiety and stress. Although PTSD has long been identified as a problem for certain groups such as military veterans, little research has been done on the effects of PTSD on nurses. The Manitoba Nurses Union (MNU) is currently studying this issue and has already made some key findings: The 5 top stressors that lead to PTSD: 1. Death of a child, particularly due to abuse 2. Violence at work 3. Treating patients that resemble family or friends 4. Death of a patient or injury to a patient after undertaking extraordinary efforts to save their life 5. Heavy patient loads The MNU research shows that between 30 and 40 percent of nurses have PTSDlike symptoms, which may be lower than the actual number, given that nurses are not likely to self-identify, and that PTSD in women is often misdiagnosed as anxiety, depression and burnout. The development of PTSD is a gradual process that can take years to manifest and diagnose, since it’s a condition that is related to an individual’s processing of a traumatic event. Common symptoms of PTSD • Intense fear • Helplessness • Flashbacks

OH&S

HEALTH EMPLOYERS MUST TAKE ACTION TO ADDRESS CHRONIC WORKPLACE VIOLENCE

Research shows Post-traumatic Stress Disorder to be a growing occupational hazard

SPEAKING OUT ABOUT VIOLENCE IN THE WORKPLACE Grand Forks nurse Lezlie Russell was beaten by a patient last August. The emotional scars remain to this day.

“I WAS SCARED TO DEATH – I KNEW he meant to kill me.” Those terrifying thoughts were racing through Lezlie Russell’s mind during a brutal attack she suffered at the hands of a patient last August. It happened at the Boundary Hospital in Grand Forks. Russell was working the 5:00 p.m. to midnight shift when a psychiatric patient was admitted to the medical floor from the ER. Known for his aggression, the patient’s chart was marked with the required purple violence alert. Concerned by his demeanor, Russell took precautions and

removed things from the unit that could potentially be used as a weapon. But even after having taken these precautions, when the attack happened, Russell never saw it coming. It happened at 9:00 p.m., when the nurse was in a room with two other patients. The patient came up from behind and punched her in the head. The second blow knocked her to the ground. Russell was wearing Vocera, a two-way radio device which enables nurses to call for help. But she was unable to speak – her teeth had been broken off in her jaw. Eventually, other nurses heard the

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commotion and called police for help. Two RCMP officers escorted the patient out of the hospital. Russell suffered a concussion, whiplash and has been diagnosed with post-traumatic stress disorder (PTSD) – see sidebar. And she still faces extensive restoration work on her teeth. Russell has tried to return to work – three times. And in a profound understatement, she says her life “has been altered.” “Interior Health may say they can’t afford to pay for security on-site. But can BC afford to pay for what’s happened to me?” she asks. “Can the public afford the burden of my health care? For how long?” Despite the media attention that Russell’s assault attracted, health employers still appear to be in denial when it comes to addressing the issue of violence in the workplace. BC Nurses’ Union President Gayle Duteil says health authorities aren’t doing enough to protect staff. “BCNU has repeatedly demanded the health authorities in some regions address our safety concerns. We’ve asked them to hire 24-7 safety officers so nurses can be protected while caring for patients,” she says. “Getting hurt is not ‘part of the job’, as some seem to believe. Nurses shouldn’t be expected to endure physical violence while doing their jobs.” Unfortunately, stories like Russell’s are not uncommon and the number of health care workers who have been injured and off work because of violence has been steadily rising. In 2013, WorkSafeBC accepted 879 claims from workers in the health and social services sectors after physical assaults by patients, clients and others. That’s up from 529 in 2009. Many more incidents of violence go unreported. According to a BCNU survey of members in 2009, 61 percent of respondents reported experiencing physical violence while on the job, while 86 percent

have experienced verbal abuse. When health care workers are asked why they don’t report violence, they most commonly state that the incident was not associated with injury or lost work, that reporting is too time-consuming or lacks supervisory support, or that they believe reporting won’t make any difference Duteil met with Health Minister Terry Lake in January to press for immediate action to make worksites safer for nurses. “We don’t need more talk,” she says. “We need action now to protect nurses from patients who could hurt them. That includes trained security personnel working 24-7 in psychiatric and forensic facilities, personal alarms and appropriate staffing levels – especially when nurses have to deal with aggressive or psychiatric patients.” She says the sad reality is that the therapeutic relationship for patients who are most in need is damaged when nurses are put in a position of being the enforcer of safety and security procedures for those in their care. update

CRITICAL INCIDENT RESPONSE AND CRITICAL INCIDENT STRESS DEBRIEFING

After a traumatic incident, seek critical incident response and critical incident stress debriefing (CISD), even if you think you don’t need it. CISD can significantly reduce your chances of developing post-traumatic stress disorder (PTSD) if provided in a timely manner, optimally within 24-72 hours, following the incident. Places to access CISD include your employer, Workplace Health, the Employee & Family Assistance Program, and WorkSafeBC.

HAVE YOU EXPERIENCED A VIOLENT INCIDENT AT WORK? HERE’S WHAT TO DO. 1. Notify your supervisor or manager about all incidents, even if there is no injury. 2. Seek ﬁrst aid or medical attention (if required) as soon as possible. If you need to leave your work area, tell your supervisor. Make sure you say that the incident happened at work. 3. Report the incident as soon as possible, using the employee incident reporting process for your worksite (i.e. call centre, electronic or paper employee incident report), even if there is no injury. 4. Start a WorkSafeBC claim for medical treatment and/ or missed time from work. Complete a WorkSafeBC Form 6, online (www.worksafebc.com), or by Teleclaim (1-888-967-5377). 5. Tell your BCNU representative on the Joint OH&S Committee about the incident. 6. Participate in the incident investigation with your BCNU representative on the Joint OH&S Committee. 7. Ask to attend workplace violence training. For more information, visit www.worksafebc.com

SANCTUARY HEALTH

VANCOUVER NURSES NATALIE BLAIR, SARAH REABURN AND ANAHITA SEBTI ARE FIGHTING FOR THE RIGHTS OF MIGRANT AND REFUGEE PATIENTS

ATALIE BLAIR, they support and care for marSarah Reaburn and ginalized populations. Anahita Sebti are “Being a nurse allows me to passionate about advocate for all my patients the work they do based on what’s fair and just,” as volunteers with Sanctuary she says. “As far as I’m conHealth in Vancouver. cerned, ‘status’ is just a piece Their group is a grassroots of paper, and nothing else. As network of community health a nurse, being told that you workers, organizers and others can’t provide someone with the from diverse backgrounds who services they need because they advocate that all people should don’t have immigration papers have access to health care. It was causes moral dilemma and discreated in June 2012 in the wake tress. Research shows that moral of federal government cuts to the distress affects rates of burnout Interim Federal Health Program in the nursing profession.” (IFHP) that funds health care Reaburn worked with a similar services for refugee claimants. group in Toronto before movOn a day-to-day basis ing to Vancouver. She says the Sanctuary Health responds to fact that a person’s immigration emergent issues by word-ofstatus could impact their health mouth or referral by community was not taught to her in nursing agencies or members. They school. “I thought health care provide outreach and hands-on was free for everyone because medical care to anyone who we live in Canada.” cannot access care or is fearful She recalls the day a pregnant of going to hospital for fear of woman came into the clinic deportation or arrest. The health where she worked, complaincare volunteers are reliant on free HEALTH CARE FOR ALL Anahita Sebti, Sarah Reaburn and Natalie ing of lower left quadrant pain. Blair are committed to the rights of migrant and refugee patients. clinic space and supplies, and “The staff were concerned that operate without any funding. she had an ectopic pregnancy All three nurses are new graduand told her that she needed ates with less than five years of experience. health care services they need, when they an urgent ultrasound at a local hospital, They say they’re grateful for a nursing career need them. but she didn’t have immigration status in where they have had the privilege to sup“Health care is a fundamental right. Canada and couldn’t afford the test.” The port and care for people who are marginalEveryone deserves care no matter who they woman told them that the last time she had ized, whether homeless, suffering from are, where they live or what their immigragone, the hospital threatened to call the drug addiction, low income or affected by tion status might be,” says Blair. She believes Canada Border Services Agency, but didn’t other forms of oppression. Their goal is to that advocacy and ethics – a fundamental under the condition that she pay for her challenge and stop systemic injustices so part of nursing practice – should be the treatment. that everyone has appropriate access to the impetus for all nurses regardless of whether “She knew how important it was to get

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the ultrasound, but said, ‘If I get sent back to my country, I will die. If I don’t go to the hospital, I will die. I have better chances surviving here.’ She left the clinic that day and I didn’t see her again,” says Reaburn. “I have never forgotten her story – which makes the work here even more critical ensuring access to health care for all people, regardless of immigration status.”

“Being told that you can’t provide someone with the services they need because they don’t have immigration papers causes moral dilemma and distress.” NATALIE BLAIR

Sebti’s family entered Canada as refugees from Iran, and she has her own personal lived experiences of being a migrant. Like many migrant families, hers came to Canada because they were fleeing unsafe circumstances. “Migration is often forced and communities are displaced due to the impacts of globalization, resource extraction, colonization and occupation,” explains Sebti, who says that it’s critical for the nursing profession to understand and actively work to eradicate systemic discrimination and racism. “As a nurse it is my responsibility now to provide equal compassionate, competent and ethical care for all people regardless of their background.”

Sanctuary Health’s current goals include advocating for the full reinstatement of the IFHP that the federal government cut in 2012 (see sidebar: “Denying Care”) and lobbying the city of Vancouver to designate itself a “sanctuary city”, where services are accessible to everyone based on need. In Vancouver, there were three cases in the last year where individuals were deported by CBSA directly from their hospital beds. All three nurses ask that their colleagues not discriminate by providing care based on status. They hope that all nurses can embrace the same beliefs, values and principles that they do, so that undocumented people have the same access to safe quality care and respect that any other patient, client, family member or friend would have. “As nurses we are taught to think critically,” notes Reaburn. “And I know that if people stopped for a minute to think about the desperation it requires to leave your home, your family, your language – they would understand it’s not about ‘taking advantage of a country’ – it’s just not!” She says Sanctuary Health has a need for more health care volunteers, including nurses, as well as clinic space and supplies. The group’s members are also available to deliver workshops and discuss ways various organizations can adopt Sanctuary’s principles in their workplaces. Blair’s message to the public is clear: migration is natural. “Migrants and refugees have always been part of BC’s history and social fabric,” she notes. “We all have different life stories and experiences but it is these stories and who we are that make our communities rich and diverse – acknowledging that we are all part of one humanity, regardless of our status, would be a great first step.” update For more information on Sanctuary Health, email sanctuaryhealthvancouver@gmail.com or visit their Facebook page: SanctuaryHealth.

DENYING CARE The federal government’s ongoing determination to deny health care services to refugee claimants has outraged health care workers across the country. Many have organized in order to advocate for their patients. They have also taken to legal advocacy in order to force Ottawa to honour its obligations under United Nations treaty conventions. The battle began three years ago and continues today. The government’s sweeping changes to the Interim Federal Health Program (IFHP) came into effect in June 2012. At the time, all refugees except government-assisted refugees lost access to medication coverage, vision and dental care. And many lost all health coverage, including urgent and essential care, except in cases of specific infectious diseases. Since then, there have been many documented cases of people being denied access to necessary health care services, including pregnant women and sick children. Media have also reported shocking examples of very ill patients being denied care because they were not insured by the federal government. Some have become so sick that they eventually have to be admitted to hospital, incurring costs that could have been prevented. The cuts were challenged in court, and in July 2014 the changes were ruled “cruel and unusual”. The Federal Court gave the government four months to reinstate the former program. However, at the fourmonth deadline, the Harper government did not restore the IFHP as mandated. Instead, some categories of refugees had their benefits restored, while others did not, in violation of the court order. In addition to flouting the law, the federal government continues to overhaul the immigration system in a way that is creating more and more situations where people are living with precarious immigration status. It is estimated that in 2010 there were more than 50,000 people living in Canada with undocumented status. update

ASLO RESIDENT KENNETH Austin recalls the small cut he got on his elbow when playing hockey four years ago. He didn’t think much of the injury when it happened, but a few weeks later he fell on the same elbow, and the pain was excruciating. Unable to sleep that night, he finally decided to seek help and went to the emergency room at the local hospital. At 5:00 a.m., the doctor on duty suspected fractures, prepared paperwork for x-rays, and sent Austin to Nelson, an hour’s drive away. The x-ray showed no fractures and Austin was sent home. From there, his problems only got worse. The father of four ended up sleeping for 18 hours, and when he finally awoke he felt lethargic and was dripping with sweat. The pain in his elbow continued and he noticed that the cut was now leaking pus. Austin’s wife called the hospital and, after describing the symptoms, was asked to bring him to the ER again.

THE FUTURE IS UNCERT RURAL HEALTH CARE I

WILL CARE THER

RTAIN FOR IN BC

THE E BE RE?

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Nurses at the hospital immediately knew the situation was serious. They prepared an IV, hooked Austin up to a heart monitor, stabilized his condition and in 20 minutes had him in an ambulance ready for transportation back to Nelson. From there he was transferred to the region’s major trauma centre in Trail. Upon arrival, Austin was taken straight into surgery. Doctors in Trail called Austin’s wife using his cell phone to tell her he loved her on the way into the operating room. The surgeons were not sure he would survive the operation, and were quite sure he would lose his arm if he did. Diagnosed with a group A streptococcal infection, Austin ended up spending 12 days in the hospital and underwent five surgeries. The Trail doctors were able to save Austin’s arm, but told him that if he had arrived five minutes later, they wouldn’t have been able to bring him back. Austin says the staff in Kaslo’s ER saved his life. “Without the emergency room in Kaslo, and especially without 24-hour, seven-day-a-week service, I would not be here to today – it was their quick thinking, skillful diagnosis, organization and planning that put into motion all the events that lead to me keeping my life, and limb.” However Austin is also certain that if the same events happened today, he would be dead. That’s because last year the Interior Health Authority implemented cuts to services in Kaslo, reducing the hours of the ER at the Victorian Community Health Centre down to Monday to Friday, 9:00 a.m. to 5:00 p.m. It was a hugely unpopular move made against the wishes of Kaslo residents and other communities in the northern Kootenay Lake region that have relied on the facility for the past 70 years. The decision to cut Kaslo’s health services was made the previous fall after a difficult, year-long, and ultimately futile, attempt by the community to convince Interior Health officials that the town’s hospital was not only a necessary service, but also an

important asset for the economic future of the entire north Kootenay Lake region.

ike those in many other rural communities in BC, the residents of Kaslo are resourceful and creative when dealing with shared challenges – it’s a trait that comes with the territory. In 2012, when Interior Health first indicated that it would be altering the hours of operation of the town’s health centre and reducing emergency services – something it said was done reluctantly based on the frequent and unpredictable unscheduled service disruptions – the decision was not accepted by the community. Interior Health argued that the staffing issues were the result of both nursing and physician shortages, and following similar trends across Canada. The community proposed that the health authority work collaboratively with residents, and the Kaslo and Area Health Care Working Group was established with the intent on working to explore alternative solutions. A steering committee was established and Interior Health then commissioned the Ross Report in which Dr. John Ross, a Nova Scotia physician and expert on rural health, explored the current state of health care in Kaslo. Among other things, Ross suggested 24-7 ER services be maintained using remote physician support and technology. When Ross’ report was published, residents were optimistic given the recommendations that were made. But, in a devastating blow, Interior Health announced – despite Ross’ recommendations, that the Kaslo ER be reduced with after-hour and weekend coverage provided by Nelson and Trail hospitals, both hours away in good weather. A town’s hopes were dashed. In October 2013 the Kaslo village council officially stated it had no confidence in Interior Health’s senior management, and passed a formal non-confidence resolution as a result of the health authority’s decision. Kaslo’s council also heard from BCNU West Kootenay region lobby coordinator

BEFORE THE CUTS Kaslo’s Victorian Community Health Centre nurses outside the facility in October 2013. From left: Jessie Renzie, Nicola Candy, Rhonda Addison, Danielle Newson, Marilyn Keith, Imelda Loimand and Georgie Humphries. Renzie, Candy and Keith are no longer employed at the facility.

Jessie Renzie, who has 22 years nursing experience and had been working for the last few years at the town’s heath centre. She told council of the important role of rural emergency departments in rural health care. “Losing 24-7 emergency services in Kaslo would reduce the ability to triage and stabilize patients with medical emergencies,” she said. “Those patients may then require more critical intervention and the delay in providing service may result in increased complications and deaths.” Large traumas are only a small percentage of late night admissions, but Renzie said lesser emergencies such as a sick child at 2:00 a.m. and seniors who have fallen and fractured hips still need immediate attention. “Patients need to be treated and stabilized prior to ambulance transfer to hospitals, sometimes hours away, and cardiac patients need immediate treatment to prevent further damage to their hearts and health.” Kaslo’s Chamber of Commerce also spoke out against the decision and led a letter writing campaign. “This isn’t just a

health issue, it’s an economic issue,” said chamber president Daphne Hunter. “Our local business stakeholders rely heavily on an already short summer tourism economy,” she explained, noting that the last three years have seen a substantial decrease in visitor numbers due to economics, bad weather and natural disasters. “If our tourism numbers dwindle any further because visitors are worried about inadequate emergency services, local business will be forced to move to more lucrative areas.” In the wake of the decision, Kaslo residents organized a last-ditch town rally before a village council meeting where representatives from Interior Health were invited. Kaslo resident Tyler Dobie has been a vocal proponent of the community’s 24-7 ER, and was one of the rally organizers. “We don’t know what Interior Health is coming to say at our village council meeting, and the community is coming out to listen, but also to show that we are united in insisting that Interior Health explore the many solutions which have been presented to keep our rural facility open,” he said.

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VOICES OF A COMMUNITY

Kaslo’s fight to maintain 24-7 ER services has involved the entire community – including local businesses, who warn that the future economic prosperity of the region is directly related to the accessibility of comprehensive health care services. PART OF THE HEALTH CARE TEAM

Kaslo pharmacist Ward Taylor purchased the town’s drug store in 2012 after visiting the area and falling in love with the mountains and the quaint village environment. His decision was based on the assumption that Kaslo’s health centre would continue to provide the acute care services it has for the past 70 years. Now, he’s concerned about the effect the ER closure will have on his business and others. 24-7 NO MORE BCNU West Kootenay region lobby coordinator Jessie Renzie stands in the Kaslo health centre ER in 2013. The department is now closed on weekends.

Unfortunately, for Dobie and many other Kaslovians who had worked diligently on to find creative solutions, Interior Health’s spokespeople had come to say that its position was final. On the same day, the health authority also issued a notice of staffing changes to BCNU under the labour code, informing it that three FTE DC1 nursing positions would be cut.

hen talking with Randy Morse, it’s hard not to be optimistic about Kaslo’s future. The former university professor and publisher has an infectious energy that belies the fact that he’s retired. In fact, the community’s economic development is his primary preoccupation since moving here 10 years ago. Like many so-called knowledge workers, the former

LOCAL COLOUR Town

florist Louise de Pape moved from Edmonton to Kaslo with her accountant husband after he retired in 2007. Like many older residents who moved to the town post-retirement, she’s now worried that health care services won’t be there when she needs them.

VOICE AND VISIONARY Local broadcaster and Kaslo Institute founder Randy Morse has articulated an economic vision that sees the town as a high-tech creative, environmental and recreational hub. He says that all of this is threatened if necessary rural health care services continue to be cut.

Oregonian fell in love with Kaslo on a family visit years earlier. Standing on Kaslo’s Front Street, he points to the shores of Kootenay Lake and the panoramic Selkirk Mountains that surround the town, and says the idyllic location and pre-existing infrastructure have the makings of an economic renaissance. “This is a stunningly beautiful place, full of wildly creative people,” he says, “an alpine village on a lake.” A community organizer, Morse established the Kaslo Institute after moving to the area. A self-described non-profit “think-and-do-tank”, he says its research is dedicated to exploring how creativity and technology can help provide residents of rural communities with a high quality of life. With its tagline, “creativity, technology, sustainability,” the organization is focused on the future. But Morse warns that this vision is very much reliant on the community infrastructure that has been built up to this day – and that includes health services. Like Hunter, Morse realizes that the

STRONG MESSAGE BCNU President Gayle Duteil handdelivers thousands of letters and postcards to Health Minister Terry Lake on Jan. 29 calling for improved rural health care.

artists and knowledge workers of the new economy, who could be attracted by Kaslo’s charm, might think twice about settling in the community if they can’t access urgent or emergency care in a timely fashion. There’s no question that comprehensive health care services are a prerequisite for a healthy local economy. But Kaslo’s leaders’ vision illustrates that, far from being simply a service, in a post-resource economy, health care services can help promote new economic development.

I ACCESSIBLE CARE? Sign outside Ashcroft hospital. ERs in smaller communities across BC are seeing their hours reduced.

n the months following Kaslo’s 24-7 ER closure, Interior Health continued to search for the doctors required to fill the two permanent full-time positions that were being covered by locums. It was successful last summer, and today the new physicians support primary health care and 9 a.m. to 5 p.m. weekday ER services in the community. Regardless of Interior Health’s cuts, the provincial government’s mandate remains unchanged. The BC Ministry of Health’s service plan states that the province “faces a challenge in ensuring that all parts of society and all populations can access

health care services and enjoy good health” and that “while the majority of British Columbians’ health care needs can be met through primary and community based health care, the citizens of British Columbia also require timely access to safe and appropriate hospital services that support the needs of patients and their families.” BCNU is committed to holding the government to its stated objectives. At the 2013 convention, delegates approved a resolution calling for the union to lobby for rural emergency departments and work closely with rural ERs struggling with physician coverage and at risk of cutbacks and closure. Last year, union activists were busy lobbying for the inclusion of nurse-focused solutions for BC’s rural health care challenges (see sidebar: Rural Health Care Challenge) and in January it presented the provincial government with thousands of letters and postcards from patients and nurses calling for improved rural health care. Patients, like Austin, are surely grateful for these ongoing efforts. “I now have five kids who I get to enjoy and play with,” he says. update

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BC’S RURAL HEALTH CARE CHALLENGE Nurses provide the solutions Policy discussions regarding rural health care services – especially acute care – are all too often focused on physician care. Nursing practice can often be overlooked in health authorities’ quest to recruit and retain doctors. But investing in nurses is a cost effective long-term strategy for a comprehensive and sustainable health care system. That was a key message in BCNU’s recent submission to the provincial government’s all-party Select Standing Committee on Health. The Select Standing Committee on Health works to identify potential strategies to maintain and improve BC’s health care system. Each parliamentary session, it invites submissions based on an annual mandate. During the last legislative session, the committee asked: How can we improve health and health care services in rural British Columbia? In particular, what long-term solutions can address the challenges of recruitment and retention of health care professionals in rural British Columbia? BCNU’s report to the committee stressed that a nursing approach to care strongly aligns with the philosophy of patient-centred care – much more so than the traditional medical model. Policy makers can make use of nurses’ expertise in order to deliver health care services in rural areas. But an adequate number of nurses is essential if this is to happen. Health facilities in rural areas face challenges recruiting and retaining all health care professionals, yet the same level

of resources is not allocated to nurses compared to other providers, particularly physicians. There are a number of solutions available to address the challenge of recruiting and retaining nurses. This includes: • Offering incentives to recruit nurses to rural areas, similar to those provided to doctors. Incentives make it easier for nurses to make the decision to locate to rural and remote areas by compensating for the lack of family and career supports and general amenities available in urban centers. • Supporting rural nurses in working to their full scope of practice. This would increase job satisfaction, which assists in recruitment and retention and provides better care for patients. • Developing regional float pools for nurses in order to replace and reduce the need for expensive agency nurses while guaranteeing full-time hours and adequate compensation for the life disruption that comes with increased travel away from home. • Investing in training and education that can assist nurses in rural emer-

gency facilities obtain and maintain skills sets and competencies that directly impact the quality of care they provide. • Providing personal and professional support to rural health workers in the form of career development programs and public recognition measures such as rural health days. BCNU’s submission also highlighted nurses’ potential within interdisciplinary primary and acute teams, and recommended that investments be made in this area to both contain costs and cope with rising demand. This includes: • Educating and funding health authorities to support more nurse practitioners in providing primary care to underserved areas. • Increasing the number of registered midwives with admitting privileges in rural areas and creating collaborative practices between midwives to address concerns that nurses have related to keeping their obstetric skills current. • Promoting “Nurse First Call” and Remote Nursing Practice certification to reduce the dependence on doctors for overnight emergency care. There is no question that investing in nurses will improve rural health care. The challenge now is to ensure that nurses’ voices are heard. update

Read the BCNU report to the select standing committee on health on your mobile device

FEATURE

ON THE

FRONT LINES

Sara Bates says sheâ&#x20AC;&#x2122;s always had a dream about working in Vancouverâ&#x20AC;&#x2122;s Downtown Eastside. The community mental health nurse recalls visiting the neighbourhood with her father when he worked there as a police officer years earlier.

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TEAM PLAYERS Vancouver Coastal Health community health care workers are helping people with severe addiction and mental illnesses meet the challenges of day-today living. From left: Assertive Community Treatment (ACT) team nurse Daniel Tweede, Assertive Home Based Treatment program nurse Ashley Peterson, ACT team nurse Sara Bates, ACT team Care Coordinator Johnny Moore and ACT team nurse Leanne Maylam. PHOTO BY PETER HOLST

FEATURE

BCNU’S MENTAL HEALTH STRATEGY

SUPPORTING NURSES, CARING ABOUT PATIENTS In November 2013, BCNU Council approved a new and exciting strategic direction for a Mental Health Strategy. The decision reflects the union’s commitment to advocate for patients and families and to offer ideas grounded in best practice and evidence, informed by the frontline experience of our members. The costs incurred through the current ineffective and siloed approaches to mental illness within the health care, policing and criminal justice systems are enormous. The people of British Columbia want all parties to collaborate in devising programs and services that deliver safe, sustainable quality mental health care now and for the future. BCNU is now working to lead the development of a new model of care that supports better outcomes and delivers value to the people of BC. GOALS FOR THE MENTAL HEALTH STRATEGY

Better care for patients • Fixing a fragmented and overburdened system that drives a vicious cycle of homelessness, incarceration and despair. • Using research and evidence to identify leading practices and innovation from across the globe. • Asking nurses for their ideas on issues and solutions. Safer workplaces for nurses • Addressing violence, bullying, workload and creating respectful and supportive workplaces. • Using data to identify best practices for great nursing workplaces. • Enforcing safe staffing and bargaining for better benefits for mental health treatment. • Providing resources and supports for members struggling with mental illness. A better system for British Columbians • Creating a media campaign to highlight issues and the important role nurses play in the solutions. • Emphasizing the cost to the system – human and financial – of the current model.

ON THE FRONT LINES continued from page 24

“He used to drive me through there, so as a child I was very aware of the mental illness in the Downtown Eastside. That was one of the reasons why I went into nursing. Also, my grandma was a psychiatric nurse as well.” Today, Bates is a member of one of Vancouver Coastal Health’s Assertive Community Treatment teams that work in the community. The ACT team that Bates works on provides community treatment and rehabilitation for clients struggling with mental illness who may also have addictions. That includes providing long-term 24-7 health care and life skills supports, including job training, assistance with finding independent housing, social interaction counselling, and maintaining physical and mental wellness. Bates’ team members include nurses, social workers, peer support workers, physicians, nurse practitioners, psychiatrists, occupational therapists and vocational rehabilitation specialists. Vancouver Coastal Health established the first ACT teams in January 2012 in partnership with the Vancouver Police Department and BC Housing. The teams are currently one of the most visible policy responses to what is arguably the greatest health care challenge the province and city have ever faced: the crisis-proportions rise of individuals with severe mental illness and/or addictions living the country’s poorest neighborhood. The dearth of community mental health services is a story familiar to many working and living in the Downtown Eastside (DTES). And the neighborhood’s chronic level of poverty and homelessness is directly related to the closure of Riverview Hospital – the region’s major psychiatric facility (see page 30: “New Life for Riverview). But the provincial government’s lack of investment in social services and preven-

tive health care finally came to a head in recent years. Left untreated, serious mental illness and addiction will have long-term negative consequences. Risks to physical health intensify and may result in multiple substance use and mental health disorders, as well as other chronic health problems. Nowhere is this reality more evident than in the DTES. According to a September 2014 City of Vancouver report, there are an estimated 2,000 single-room-occupancy hotel tenants who are “severely ill” and receiving no care for mental health issues or problems related to addiction. In addition, two-thirds of the city’s over 500 homeless people are “in urgent need of adequate mental health and addictions supports”. The city of Vancouver has also put the price tag of untreated mental illness at over $30 million per year. This includes costs such as policing, first responders, emergency housing needs, as well as expenditures which focus on prevention and interventions, such as capital for housing, homelessness outreach, and social grants. In 2013, Vancouver’s mayor and police chief declared a mental health crisis in the city, and signaled a call to action to support Vancouver’s most vulnerable residents and to create a coherent and adequately supported mental health care system. A task force was struck, and stakeholders – including BCNU – released its first report and recommendation to the province last year (see sidebar: Defining the Issue). This included ACT teams to support psychiatric patients living in the community.

ates’ team of 12 workers has 60 clients who are typically referred from other mental health teams. These clients usually make high use of hospital ERs, or are unable to make use of traditional mental health services. They must be suffering from a severe and persistent mental illness and have difficulty

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living independently in the community. Bates says she enjoys the ACT team’s laterally integrated care model. “You have a whole bunch of people that specialize in different things. We nurses focus on the medication, and then we have occupational therapists that can help clients with recreational stuff, and getting jobs, those kinds of things,” she explains. “So we all work collaboratively and we all take care of the client together, which is great.” Leanne Maylam is new to the ACT team and community nursing. The RPN worked in the Psychiatric Assessment Unit at VGH for 12 years before starting on the team last August. Like Bates, she says she was drawn

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We provide a bridge from hospital to home and to clients’ primary care providers, because often they’re just leaving the hospital and going home. KARYN GOULDHAWKE

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to the team’s interdisciplinary model. She also wanted to move away from inpatient care. “I felt that we weren’t expected to look at clients holistically, and we just kind of rushed them through the system,” she said of her hospital experience. “And I wanted to get back to why I got into nursing, and that was to see the patients doing well and work with them and do the most we can with them. Not just see them for one day and have them leave in the next hour.” She worked a shadow shift on the ACT team and was impressed with the work they did. “I thought, that’s what I’d prefer to do – seeing people doing well and if they’re not doing well then doing my best to make sure

they get well again.” She doesn’t regret the move. “I’m astonished at how much I enjoy working in the community. I love it. It’s been such a great change for me. Maylam also feels proud to be practicing using a model that she knows is getting a lot of attention in policy circles. “I’ve heard of ACT teams all over the country now and also in the States. Some of our nurses have worked in the States on our ACT team,” she notes. “I just think it’s a great initiative and it’s doing a great service to the clientele that would otherwise get lost in the cracks.”

ccess to adequate housing is critical to any serious policy effort to address mental health. Stable housing is one of the most basic social determinants. But in Metro Vancouver, housing – for all residents, not simply those with mental illness – is in chronically short supply. And singleroom-occupancy hotels are the unfortunate home for many people living with serious mental health and addictions. Social and supportive housing remains especially difficult to access despite concerted efforts in recent years by both the province and the city of Vancouver to construct new spaces. BC Housing’s wait list for supportive housing has more than quadrupled, from 1,165 names in January 2011 to 5,642 in November 2014. Adequate housing is critical for keeping people healthy and out of hospitals. But housing itself is simply four walls and a roof. Services are needed to ensure that, once someone finds housing, they remain healthy at home. Karyn Gouldhawke is an outreach nurse working in Vancouver Coastal Health’s Assertive Home Based Treatment (AHBT) program. It’s a relatively new service that provides short-term, mental health treatment in continued on page 29

VANCOUVER’S MENTAL HEALTH CRISIS DEFINING THE ISSUE The BC Nurses’ Union is a stakeholder organization that sits on the city of Vancouver’s Mayor’s Task Force on Mental Health and Addictions that was created in 2013 to tackle the ongoing mental health crisis facing the city. The task force’s first report was released last September, defining the issue and establishing recommendations to the province.

THE ISSUE

SURGE OF PEOPLE IN MENTAL HEALTH CRISIS IN VANCOUVER • 43% increase in emergency mental health visits at St. Paul’s Hospital.

• 18% increase in mental health act apprehensions by police.

• 2,000 SRO tenants are severely ill and receiving inadequate or no care for mental health and addictions problems.

• Two-thirds of homeless in urgent need of adequate mental health supports.

THE RESPONSE

FOUR RECOMMENDATIONS TO THE PROVINCE 1 Add 300 long-term and secure mental health treatment beds. 2 More staffing at supportive housing sites to support tenants with psychiatric issues. 3 More significant support through Assertive Community Treatment (ACT) teams for psychiatric patients living in the community. 4 Develop an enhanced form of urgent care centre (crisis centre) and a joint treatment model (Vancouver Police Department – Vancouver Coastal Health Authority).

FEATURE

ENGAGING MEMBERS

“Mental health has a lot of issues and huge problems that affect every single person no matter where we work or who we are – it’s a Mental health position statement workshops part of everything that we do.” capture the voice and experience of frontline nurses Nicole Abbott is an RPN who works at Developmental Disabilities Mental Health Services in Port Coquitlam. The only nurse for the youth team in her region, which spans from Delta to Boston Bar, she works with people who have a dual diagnosis of mental illness with developmental disability. Like Ryujin, she’s also grateful that mental health is being put in the spotlight. “I was an active UPN member,” she says, “and the merger with BCNU is an exciting opportunity to have a greater and more powerful voice in spreading the mental health word. We are so underserved and have a mental health crisis in this area. I’m glad to have the BCNU involved in helping us get more funding and services and get the word out to the public.” Budai, Ryujin and Abbott, along with SHAPING MENTAL HEALTH POLICY Participants at BCNU’s Jan. 28 Mental Health Strategy Workshop shared their experiences and developed valuable policy proposals. From left: Jon other workshop participants across the Gojevic, Jeanette Ryujin, Christine Brisebois, Sherrie Budai, Sharon Forde, Amelia Claassen, Nicole province, have begun to identify common Abbott, Maureen Roper and Jo Jo La Rosa. issues facing their patients. This includes the siloed nature of services provided to mental health clients – something which ends CNU’s MENTAL HEALTH workshops are designed to be highly inter- up creating barriers to access and leads to strategy is a major new initiaactive and participatory with each group frustration for patients and families trying to tive for the union. It’s based on engaging in a series of activities which navigate the system. nurses’ commitment to advoculminates in the creation of a consensus They have also identified stigma as a barcate for BC patients and their position statement document. rier, and point to the inequities in funding families, and to advance concrete policy Sherrie Budai attended the Jan. 28 and care for the treatment of mental illness proposals that will make a real difference workshop in New Westminster. A nurse at as compared with other chronic diseases. in people’s lives. There’s no better place to Victory House in the Downtown Eastside, Jon Gojevic sees these inequities in begin this process that with the frontline she works with 47 clients who have medical his work every day. A case manager at mental health nurses who deliver care and mental health conditions. Strathcona Mental Health, he has a caseload every day. “I wanted my voice to be heard. I feel that of about 60 people. He helps them meet An important initial step for the union’s we provide a valuable service and that we’re their daily needs and tries to improve their strategy is the development of a BCNU neglected and being cut,” she said when quality of life. position statement on the mental health asked why she attended the workshop. “There is a high concentration of mentally care system that highlights gaps in the “But we are cost effective in the long term ill, addicted and homeless people here – and current system of care and presents nurses’ because we keep people supported and mental health is at the heart of that,” he says. ideas for positive change in the creation of a safe and therefore not needing to access “If we are going to address that situation I robust, safe, sustainable system. emergency care.” think we have to turn the clock back 30 years Workshops began this year, and over Jeanette Ryujin was also in attendance. A and find out where we went wrong and ask, 90 members across BC are contributing shift leader at HealthLink BC, she’s pleased ‘how did this happen’? So my focus is really to BCNU’s mental health care vision. The that mental health is a priority for the union. on early intervention and prevention.”

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Addressing the past and looking to the future is how workshop participants develop innovative ideas for system change. Proposals to-date include the creation of a Provincial Advocate for Mental Health similar to the Representative for Children and Youth or the province’s new Seniors’ Advocate; developing roles for Psychiatric Nurse Practitioners, particularly in regions where psychiatrists are difficult to access;

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I didn’t realize how hands-on it would be and how much of a voice we would all have in creating the final product. NICOLE ABBOTT

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embedding mental health nurses in schools to provide education, support anti-stigma programs and provide assessment and referrals for children and youth showing early signs of mental illness. Many participants have reported that the workshops exceeded their expectations. “The workshop was far more than I thought it would be,” said Abbott. “I anticipated today to be more of a learning opportunity where we would be told about what’s coming – I didn’t realize how hands-on it would be and how much of a voice we would all have in creating the final product.” The workshop series concludes in March, after which a completed consensus document will go to BCNU’s mental health strategy steering committee for their input and creation of a final document which will be forwarded to BCNU Council for discussion and approval. update

ON THE FRONT LINES continued from page 27

home settings, and is designed for people experiencing an increase in symptoms or distress related to mental illness or substance use. Gouldhawke worked in inpatient psychiatry at UBC Hospital for 17 years before moving into community mental health nursing two years ago. “We go into people’s homes, which is unusual because not very many [mental health] programs offer that kind of service, and we basically come in, monitor their mental status, monitor their medication, make sure they’re complying taking their medications, ensuring they’re not having any adverse side effects.” She talks about her work in terms that make it clear how important nurses are for ensuring all of the parts of the health care system function efficiently together. “We provide a bridge from hospital to home and to clients’ primary care providers, because often they’re just leaving the hospital and going home,” she explains. “And they sort of feel vulnerable during that period of time, and that is often a high risk period for re-hospitalization or suicide and a whole variety of things behind that.” Gouldhawke describes the bulk of her work as short-term crisis intervention that’s provided anywhere between one and three weeks. Her team assesses whether clients need other services in the community and refers them if needed. “We see a variety of clients. We accept clients as young as 17 years of age and I think the oldest client I’ve had is 92 years of age. And the diagnosis varies completely across the board – basically any kind of mental health illness that you can think of, and addiction.” Gouldhawke says the ABHT program is one of the clearest examples of how community mental health services help contain costs in the acute care system. “I think the health care system would be in absolute crisis – overcapacity would be completely

unmanageable,” she says when asked about the value of her program. “One of the main things we do is clearing out emergency departments. We have a two hour time span to respond to emergency room requests, and we go in and provide referrals to clients that aren’t a high enough risk to be hospitalized and we try to see if the client is agreeable to a program,” she says. “We service Mount St. Joseph Hospital, Lions Gate Hospital, Vancouver General Hospital and St. Paul’s – all those emergency departments.”

he ACT teams and the AHBT program both illustrate the important work that community nurses are doing to address mental health challenges in their communities. They are two examples of care models for mental illness that meet the needs of patients and their families in a way that minimizes the costs – both human and financial – of the current mental health system. But they are being provided within the context of a fragmented and overburdened system that is struggling to deliver care. It’s clear that BCNU members, collectively, possess a wealth of knowledge and experience that the union will use to guide its mental health strategy (see page 28: “Engaging Members”). Presenting BCNU members’ collective voice for a better mental health care system will go a long way to improving nurses’ working and care conditions – and this is the focus of the union in the years ahead. In the meantime, members like Bates continue to be grateful for the resources they do have, and their ability to do the work they do on daily basis. “You take someone from the Downtown Eastside, you see them every day, you watch them slowly get better, slowly start to get different interests, stop using drugs – I’ve seen that with our clients,” she says. “Seeing somebody starting to volunteer and to get off substances and to live in a nicer neighbourhood. That, to me, makes all the difference.” update

FEATURE

NEW LIFE FOR RIVERVIEW HOSPITAL

EW DISCUSSIONS ABOUT mental illness, addiction and housing in Vancouver do not involve Riverview Hospital. The Coquitlam facility shut its doors in 2012 after almost 100 years of service in British Columbia’s mental health system. Riverview was the major psychiatric hospital in the province, at one time housing more than 5,500 people. But its importance and role began to decline in the 1980s with a gradual closure that was undertaken with the laudable goal of “deinstitutionalizing” people with mental illness, and transitioning patients into community living settings – closer to home and family.

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The costs of the closure, both human and financial, have been too high.

”

BCNU EXECUTIVE COUNCILLOR DAN MURPHY ON THE CLOSURE OF RIVERVIEW HOSPITAL

For some former Riverview patients this move has been a success. They are now living with supports in place to ensure they have appropriate housing, medical treatment and other needed services. Many other patients, however, have not received the care they need since leaving Riverview. Supports across all systems (public health, social services, disability services, etc.) are not in place or have not been adequate for individuals with severe addictions and/or mental illness – SAMIs, for short. This group has become the most visible face of Vancouver’s mental health

crisis. Last year, the Vancouver Coastal Health Authority estimated that their numbers could be as many as 2,000 – with the majority experiencing a vicious cycle through emergency hospitalization, the criminal justice system and homelessness. Critical community services are needed to support all patients, but it has become clear that deinstitutionalization is not the ideal solution for everyone. “A need remains for specialized, long-term psychiatric care facilities of the Riverview type,” is the message contained in a 2014 report by Dr. John Higenbottam, entitled, Into the Future: the Coquitlam Health Campus – A Vision for the Riverview Lands. Higenbottam notes the parallels between deinstitutionalization and the increase of social problems in the community related to mental health and addiction, and argues that there are patients that would benefit from a facility like Riverview. He notes that the wholesale closure of the facility has, for large numbers of people with serious mental illness with or without accompanying addictions and other chronic health problems, had the effect of them “being condemned to lives of isolation and squalor.” “Despite advances in medical, acute and community mental health care, there remains a significant number of former and new patients who either require specialized, longer term treatment that exceeds the capability of general hospital psychiatric units and/or who are so unstable that even extensive community supports are not sufficient to allow them to live in the community,” concludes the report. Last December, the provincial government announced 14 new long-term beds at a newly-renovated building at Riverview.

SOLUTION FOR SOME A signiﬁcant number of former Riverview Hospital patients require the specialized, longer term treatment the facility once provided.

Along with the relocation of 26 beds from the Burnaby Centre for Mental Health and Addiction, the facility will be home to 40 long-term care beds for people who struggle with mental health challenges. There are plans for a further 20 new beds at the site. “I’m pleased to see this announcement,” says BC Nurses’ Union Executive Councillor Dan Murphy about the reimagined plan for the old hospital. He says it’s ironic that, despite the expectation that community care for former Riverview patients would be cheaper, the facility’s closure has actually resulted in greater taxpayer costs through increased policing, emergency room visits, acute care admissions and social service expense. “The costs of the closure, both human and financial, have been too high.” Murphy urges the government to continue to invest in better care for British Columbians with mental illness, and notes that the BCNU will be advocating on patients’ behalf in the coming year as part of the union’s mental health strategy. “We look forward to partnering with government to move forward an agenda which invests in quality health care for people with serious mental illness, including new services at Riverview.” update

UPDATE MAGAZINE February/March 2015

SUPPORTING TOMORROW’S NURSE LEADERS

hen the BCNU West Kootenay region circulated its proposal to “adopt a student nurse” last winter, members in other parts of the province embraced the idea. The call to organize support for students who were struggling financially was readily taken up by members who realized that these individuals were “one of their own.” The adopt-a-student nurse initiative is just one example of BCNU’s close connection with student nurses. The union recognizes that its future leaders are studying in colleges and universities right now. From building relationships with nursing faculties for the delivery of BCNU student modules, to recruiting students to serve as union liaisons on campus, to negotiating the employed student nurse program that allows students to gain paid, practical job experience before graduation, BCNU’s work is focused on tomorrow’s nurses. And from establishing the Young Nurses’ Network that provides peer support across the province, to sponsoring the work of the Canadian Nursing Students’ Association, the union continues to be active on many fronts as an organization that is relevant in students’ lives. Read about these efforts in the following pages, and learn more about how BCNU is supporting tomorrow’s nurse leaders.

TOMORROW’S NURSE LEADERS

BCNU STUDENT LIAISONS

TOMORROW’S NURSING LEADERS AN INNOVATIVE PROGRAM that introduces nursing students to BCNU is helping transform today’s students into tomorrow’s nursing leaders. The Student Liaison Program matches an elected BCNU regional chair with nursing schools across the province. Each class elects one or more volunteer students to liaise with the chair at least four times each year. The student liaisons gain invaluable leadership and development opportunities while serving as a resource for their classmates. Ashley Naaktgeboren and Brianna Hardy agreed to become student liaisons after BCNU representatives delivered an informative presentation to their Level One class at BCIT last year. “They discussed what BCNU does and how it relates to us – now as students and in the future as nurses,” says Naaktgeboren. “Brianna and I were both looking for an opportunity to get involved outside of class, and becoming student liaisons provides us with the chance to learn more about our rights and the ways we can shape our workplace.”

“For example,” explains Hardy, “since becoming student liaisons we’ve met with Liz Ilczaszyn, the co-chair of the Simon Fraser region, and discussed ways in which we can better inform our classmates about what BCNU can do for them.” “Our role as student reps,” adds Naaktgeboren, “is to share information about BCNU with our peers. We are currently planning a luncheon for our

fellow students. Liz Ilczaszyn will be coming in to talk about employer policies, safety and our workplace rights.” “We also try to get our classmates involved with current BCNU issues,” says Hardy. “When we attend a BCNU event, we report what we learned back to our fellow students.” BCNU Council’s student liaison rep is North West chair Sharon Sponton. She

A FOUNDATION OF TRUST BCNU Simon Fraser region co-chair Liz Ilczaszyn works with student liaisons Brianna Hardy and Ashley Naaktgeboren to help inform BCIT students about the importance of the union in nurses’ working lives.

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says there are currently 30 student liaisons across the province. “They’re such a great resource,” says Sponton. “I’d like to continue recruiting

“I believe that fostering a relationship with students helps BCNU build a foundation of trust – and knowing we have BCNU’s support helps ease our transition from student nurses to registered nurses.” BRIANNA HARDY

more of them, to help maintain a strong link between our union and student cohorts.” Hardy hopes to work at Children’s Hospital specializing in pediatrics after graduating in 2017, while Naaktgeboren plans to deliver

care in an emergency setting. Both believe it’s critical for future nurses to take an interest in BCNU issues before graduation. “It is important for us to be informed about BCNU and how it advocates for our rights,” says Naaktgeboren. “Many students haven’t had much experience with unions. So part of our job is to inform them about the benefits and securities that come with union membership. “We will all be looking for positions when we graduate and it is important to know the advantages and disadvantages of job opportunities in relation to benefits and workers’ rights.” “I believe that fostering a relationship with students helps BCNU build a foundation of trust,” says Hardy. “And knowing we have BCNU’s support helps ease our transition from student nurses to registered nurses. “As student liaisons, we hope to make ourselves and our fellow students more aware of what to expect from BCNU and employers when we enter the workforce. We feel we can make a difference by increasing students’ confidence as new employees and by advocating for a better workplace.” update

INSPIRING EXCELLENCE BC delegates are a major presence at Canadian Nursing Students’ Association national conference BC NURSES’ UNION delegates attending the 2015 Canadian Nursing Students’ Association’s national conference in Saskatchewan say the event provided them a unique opportunity to discuss common concerns with students from across the country. “I always look forward to this CNSA conference,” says third-year Thompson Rivers University student Paige Bewley. She is one of 16 future nurses sponsored by BCNU to attend this year’s

SUPPORTING STUDENTS BCNU Young Nurses’ Network provincial chair Catherine Clutchey attended this year’s Canadian Nursing Students’ Association’s national conference in Saskatchewan. From left BCNU North East chair Roni Lokken, Clutchey and BCNU Fraser Valley region YNN co-rep Rupali Kapila.

TOMORROW’S NURSE LEADERS

“It is important for students to become well-versed in issues that impact all nurses, particularly if your interests include the political aspects of healthcare.” JOSEPH ZELLER, UNBC NURSING STUDENT

conference, held in Regina, Saskatchewan in late January. “Our Kamloops chapter promotes the conference. I’m proud to say that 14 students from TRU alone attended this year. As always, I was impressed by the professionalism and networking opportunities offered.” “It more than lived up to my expectations,” says second-year BC Institute of Technology nursing student Gina Neumann. “A highlight for me was meeting students from across Canada, learning about their programs and seeing how much they share my excitement – and fear – about our profession.” Neumann says BC students struggle with many of the same issues faced by their counterparts from other regions of Canada. “We are all passionate about our future profession and we are all looking forward to starting our new careers,” she says. Joseph Zeller, a third-year student at the University of Northern British Columbia’s Quesnel campus, believes “it is important for students to become well-versed in issues

that impact all nurses, particularly if your interests include the political aspects of healthcare. I found the conference’s guest speakers provided great insight into issues that I may not hear about in my smaller community.” In addition to the student nurses, BCNU’s delegation to Regina also included Young Nurses’ Network provincial chair Catherine Clutchey (see page 37 for more info), Fraser Valley YNN co-chair Rupali Kapila, South Fraser Valley chair Jonathan Karmazinuk and North East chair Roni Lokken. BCNU North West chair Sharon Sponton serves as Council’s student liaison. She’s attended several national and regional CNSA conferences and says sponsoring students to attend the organization’s events is a win-win situation for both BCNU and our future members. “For example,” says Sponton, “one of the North West students we sponsored to attend a past conference eventually became very involved with BCNU and is now our region’s member educator.”

Sponton says the 25,000-member CNSA has represented the interests of nursing students to governments, healthcare organizations and the media for over 40 years. Its regional and national conferences provide nursing students with an opportunity to meet with their peers on educational, professional and social levels. This year’s national conference included speakers, panels and breakout sessions. Topics ranged from Surviving Your First Year as an RN to Chemicals and Your Health. “One of the best ideas I heard,” says Bewley, “was from a young gentleman who created an after-school club for individuals with autism and incorporated intersectoral disciplines. It was inspiring to see what he has achieved before even graduating.” “My favourite speaker at the conference,” says Neumann, “was Barb Langlois, who told us, ‘When you make patients visible, they feel valuable. The reverse is also true.’” Neumann will be informing her classmates and instructors about what she learned in Regina. In fact, she began blogging about it while still at the CNSA conference. update

Use your mobile device to visit Neumann’s blog

WHAT THE CNSA CAN DO FOR STUDENTS • Provide an opportunity for participating members to acquire and demonstrate leadership and organizational skills. • Increase students' awareness of relevant political and ethical issues, which will affect their future as health care professionals • Prepare students for active membership within professional nursing associations • Provide insight into the business procedures and policies of professional organizations • Provide opportunities for involvement in health care issues and health promotion • Offer exposure to changing nursing philosophies and specialty areas of nursing. CNSA PRINCIPLES AND OBJECTIVES

The CNSA is guided by the following underlying principles and objectives:

1. To be the primary resource for nursing students. 2. Influence and advance innovation in nursing curriculum and research. 3. Strengthening linkages and creating new partnerships.

UPDATE MAGAZINE February/March 2015

WORKING WITH STUDENT NURSES IN THE FRASER VALLEY “ONE OF THE BEST things about my new job as chair of the Fraser Valley region is the opportunity it gives me to talk with students and young nurses,” says Katherine Hamilton. “It’s wonderful to meet with so many new and future BCNU members,” says the veteran nurse who became regional chair last September. “They’re eager to learn and so full of energy. They especially enjoy hearing from the Fraser Valley’s two Young Nurses’ Network co-reps, who were students themselves just a few years ago. I’m so lucky to have them working with me.” The co-reps, Rupali Kapila and Janelle Halldorson, organize YNN meetings every two months. “We usually get between 10 to 20 people coming out,” says Halldorson. “We have a Fraser Valley Young Nurses’ Network Facebook page with over 400 members, that helps us stay in contact with young nurses in our region.” “We also visit nursing schools in the Fraser Valley to talk with students,” says Hamilton. “They want to know about wages and benefits, working conditions, how to file a grievance or PRF and the Employed Student Nurse (ESN) program. They’re also happy to learn BCNU offers $250 student bursaries and sponsors two people from each region to attend the Canadian Nursing Students’ Association’s national and

are supernumerary, and should always be mentored, not left on their own in charge of patients.” Hamilton points out that it can be difficult for nurses in understaffed facilities to act as mentors when they’re trying to cope with unsafe workloads. Inderjit Rai, who recently

“I learned so much just meeting and listening to these nurses – it was a real positive experience, and it makes me feel much more comfortable about my future.” REACHING OUT The BCNU Fraser Valley regional executive has made a strong effort to connect with nursing students in their communities. Members of the group met recently in Langley. Back row, from left: BCNU Fraser Valley region Young Nurses’ Network co-reps Rupali Kapila and Janelle Halldorson, BCNU Fraser Valley region chair Katherine Hamilton, University of the Fraser Valley second year nursing student Kristina Ruprecht, and recent nurse graduate Inderjit Rai. Front row: BCNU Fraser Valley region lobby coordinator Tracey Greenberg and OH&S rep Heather Wiens.

regional conferences.” To make it easier to reach out to students, BCNU has developed a series of modules that members deliver at nursing schools across the province. Hamilton, Kapila, Halldorson and four members of the Fraser Valley executive met with several young nurses over dinner at an Abbotsford restaurant in late January. Kristina Ruprecht, a secondyear University of the Fraser Valley student, says she came to

the YNN meeting to learn from the experiences of frontline nurses. She hopes to become an ESN soon and says the innovative program “gives students the opportunity to gain clinical experience in various health care facilities at our current skill and knowledge level.” Halldorson, who graduated just over two years ago, says it’s important for ESNs to understand their rights under the collective agreement. “They sometimes don’t know they

INDERJIT RAI

graduated as an LPN at Vancouver Career College, but hasn’t yet landed her first nursing job, says she came to the meeting to discover more about her new profession. “I learned so much just meeting and listening to these nurses,” says Rai. “It was a real positive experience, and it makes me feel much more comfortable about my future.” “It’s important for BCNU to continue building connections between our union and young nurses,” says Hamilton. “They are our future. We want them to become strong advocates for their patients, other nurses and themselves.” update

TOMORROW’S NURSE LEADERS

NEW NURSING EXAM IS CAUSE FOR CONCERN NURSING SCHOOL IS already challenging enough. Imagine the additional stress of not knowing what’s going to be on the final exam. But this is the reality for thousands of fourthyear nursing students who are aiming to graduate in 2015. That’s because the National Council Licensure Examination (NCLEX) is being introduced to Canada this year for the first time. NCLEX is an examination for the licensing of nurses in the United States. There are two types, the NCLEX-RN for registered nurses and the NCLEX-PN for licensed practical nurses. After graduation from a school of nursing, a student takes the NCLEX exam to receive their nursing licence. A nursing licence gives an individual the permission to practice nursing, granted by the state – and now province – where the student met the requirements. From their first year, nursing students in the US are taught with the knowledge that they will be required to take the NCLEX. But students in Canada are feeling caught off guard, and are worried that they will be at a disadvantage as a result of the transition from the old Canadian Registered Nurses’ Exam, which was retired in October 2014 (LPN students in Canada are not yet required to take the NCLEX,

and continue to write the Canadian Practical Nurse Registration Exam). Winica Dewangga is a fourth year student currently studying at the BC Institute of Technology. She says that she and many others in her cohort are not feeling adequately prepared for the NCLEX. “The information sessions that have been presented to us have provided different and vague information relating to the exam,” she reports. “We have had three mini-announcements and none have really provided me or other students with solid information that would make us confident about what we were getting into.” She adds that the faculty is not able to confirm how many times students are able to take the exam if they fail and whether this information would be disclosed to employers. Students like Dewangga, while aware of rumours that the NCLEX might replace the CRE, were never told that they may be required to take the NCLEX when they enrolled in their programs. “An informal announcement was provided during our second year,” she recalls. “At that time, the faculty was also provided with very little and inconsistent information, therefore what was passed on to us reflected this.” “I have heard this exam is

very pathophysiology-based, and if that is the case, I think BCIT has done a fantastic job with providing students with knowledge of pathophysiology,” she says, explaining that she does not feel completely unprepared. However, she says there are other knowledge areas she remains concerned about. “We have been taught in the Canadian metric system, but as the NCLEX is an American exam we are still unsure about the expectations,” she says. “For example, the blood glucose level normal range is slightly different between the two countries. Canadian normal levels are between 4 and 7 mmol/L, whereas in the US the normal range is between 70 and 130 mg/dL.” Still, Dewangga says that she hasn’t felt completely unsupported. “In one of our courses, called Problem Based Learning, our instructor has given us NCLEX sample questions and encourages us to incorporate NCLEX-like questions into our presentations. I felt this gave us a little taste of what to expect on the NCLEX.” Dewangga understands the rationale behind the standardization of exams. SEEKING CERTAINTY Fourth year BCIT nursing student Winica Dewangga says the lack of clear and consistent information regarding the switch to the NCLEX has created unnecessary anxiety.

It’s the implementation of the transition that she takes issue with. “Students recognize that by writing a standardized nursing exam, ultimately patient care in both countries will improve and it would then be expected that patient outcomes will improve as well,” she says. “However, we feel that with the lack of information provided, it is hard to determine what is to be expected.” She suggests that nursing departments and faculty provide students with more information on the “need-to-knows” of the exam. For more information about the NCLEX, visit the BCNU website (Home>Member Services> Student Nurses). update

Q&A

UPDATE MAGAZINE February/March 2015

YOUNG NURSES’ NETWORK

AN INTERVIEW WITH YOUNG NURSES’ NETWORK PROVINCIAL CHAIR CATHERINE CLUTCHEY

BCNU’S POPULAR YOUNG Nurses’ Network (YNN) has expanded rapidly since the Fraser Valley region launched the first network in 2010. Today, 11 of our union’s 16 regions have active networks, representing the special concerns and interests of members under the age of 35. Update recently asked BCNU’s Young Nurses’ Network provincial chair Catherine Clutchey to discuss the group’s mandate and future plans. Clutchey, who graduated from Douglas College in 2004, delivers care at Surrey Memorial Hospital’s neonatal intensive care unit. She is also a BCNU steward and an adoptive, biological

and foster mom to five young children. UPDATE Why is it important for BCNU to support the YNN? CLUTCHEY It sounds kind of clichéd, but young people are the future of nursing and they are the future leaders of BCNU. Statistics show that currently up to 50 percent of new nurses leave the profession in their first five years. To change that, we need to ensure that young nurses are supported and mentored from day one. We must also ensure that BCNU works to create future leaders. UPDATE Why should young nurses get involved in BCNU’s Young Nurses’ Network? CLUTCHEY Young nurses want to be involved and want to support each other. The YNN offers them an opportunity to connect with other young nurses, share experiences, address concerns, learn about BCNU and have easy access to experienced stewards. The YNN supports young nurses through educational opportunities and social gatherings. It’s also pretty fun. For example, we often hold our meetings at restaurants, we participate in CIBC’s Run For The Cure and we organize social outings during the union’s annual convention.

We currently have eight active YNN Facebook groups with over 1,000 members. It is a great place for young nurses to share some humour, hear about upcoming events and find helpful contact information. Student nurses are also welcome at YNN events and in our Facebook groups. (To learn more about the Young Nurses’ Network, please visit BCNU’s Young Nurses’ Network Facebook group). UPDATE What is your role as the YNN’s provincial chair? CLUTCHEY My role is to support and mentor regional YNN reps and to organize provincial events and meetings. I also work with the provincial office to ensure the concerns of young nurses are heard at the provincial level. UPDATE What does the YNN hope to achieve this year? CLUTCHEY We are still a very new group and are working on growing and becoming visible in every region of the province. We currently have active representatives in 11 regions, and would love to have reps in all 16 BCNU regions by this time next year. We also want to improve the work/life balance of our young members. UPDATE How bad is the current work/

life balance situation for young nurses in BC? CLUTCHEY We know that young nurses are often in casual positions, which are very difficult to manage in general, but especially so when you are new to the profession and trying to consolidate your learning. Young nurses are also often taken advantage of when they don’t know their rights under the collective agreement. And we know from statistics that young nurses are leaving the profession, which to me is a clear sign that the work/life balance is not being maintained. UPDATE What’s the best way for young nurses to get involved with BCNU’s Young Nurses’ Network? CLUTCHEY Anyone interested in representing their region’s YNN, or who would like to learn more about the group, can email YNN@bcnu.org or contact their regional chair. update

Your Pension SECURING YOUR FUTURE

TAKING A LEAVE FROM WORK? DON’T FORGET TO PURCHASE YOUR SERVICE WHEN YOU RETURN WHEN TRACY MUSEY went on maternity leave with her first child, she didn’t think about the implications it would have on her pension. Like many young workers, she said she was focused on responsibilities of parenthood and not too

concerned about an event that was 40 years in the future. When a pension plan member is on a leave without pay – when they are on Employment Insurance maternity benefits, for example – they do not receive pensionable or contributory service, and this “time away” from the plan will have the effect of reducing the total amount of their pension entitlement when they retire. Fortunately, pension plan members can maximize their retirement entitlement by buying back service for any unpaid leaves of absence they take. It’s an opportunity that Musey encourages all BCNU members to take advantage of. “Your pension is important – purchase leaves whenever you can because it will make a huge difference later on when you retire,” she says. Musey recalls being vaguely aware of the option when she began working, but didn’t give it much consideration at the time. “When you’re younger you’re in a different stage of your life and just thinking about the day-today things,” she says. “A yearand-a-half worth of pension didn’t seem like a lot then, but I knew at some point it

SAVVY FINANCIAL PLANNER Kamloops nurse Tracy Musey made sure to buy back service from her unpaid maternity leaves and encourages other pension plan members to do the same.

would be,” she admits. “I had older co-workers tell me that as you get older and get closer to retirement, even a month of pension contributions makes a difference, and when you are ready to retire all of that time adds up,” she recalls. “They said it’s really important, and the sooner I bought it back the cheaper it would be.” Musey was prepared before she went on her second maternity leave and planned on putting aside money to purchase it when she returned to work. “I had my daughter in 1999, had my son in 2002, and I bought back that whole year plus the six months I was off with my daughter – all at once,” she says, noting that she was still within the requisite five-year window. Pension plan members are able to buy back service for any unpaid leaves taken in the previous five years. Other times when they were not contributing to their pensions can also be purchased as long as it is within five years of the application date. This includes probation and time worked as a casual or parttime employee when they were not a plan member. Musey says there’s really no reason to avoid buying back service. “Make sure that you maximize your pension because it’s basically guaranteed funds for when you choose to retire,” says the Royal Inland Hospital steward. “You may not think about it when you’re younger, but all of that time adds up and it is important to get your full retirement entitlement.” update

PENSION REMINDER

DON’T FORGET! March 31, 2015 is a key date for Municipal Pension Plan members considering buying back pensionable service for unpaid leaves of absence. Up until March 31, members of the MPP can buy back pensionable service for unpaid LOAs taken in 2014, and their employer will be obligated to pay their share of contributions to their pension plan for the first 20 days (150 hours) of unpaid leave. After March 31, members will be required to pay the employers’ portion of their pension contribution, as they would for unpaid leave time beyond the first 20 days (150 hours). Details concerning purchase of service can be found on the Municipal or Public Service Pension Plan website at www.pensionsbc.ca.

DID YOU KNOW?

You can transfer money from your RRSP without penalty when using it to buy back pensionable service.

BCNU HUMAN RIGHTS & EQUITY CONFERENCE

FROM

GENEROSITY TO GRATITUDE

he more than 150 BCNU members who gathered at the Sheraton Vancouver Airport Hotel in Richmond last December for the union’s annual Human Rights & Equity Conference were asked what they were grateful for. Their thoughtful responses were written down, photographed, and then attached to a tree at the conference’s entrance.

CULTIVATING AN ETHIC OF JUSTICE AND EQUITY FOR ALL BCNU President Gayle Duteil welcomed union members to the conference.

“An ethic of justice and equity is a power we naturally possess as caregivers, nurses and health care workers – a power that is magnified and enriched in its sharing with others.” GAYLE DUTEIL

WORKING FOR DISABILITY JUSTICE Writer, community educator and organizer Mia Mingus shared her insights on identity and disability in her talk, entitled “The Transformative Power of Gratitude: Toward a Politic of Interdependence”.

As the photographs began to fill its branches, the tree became an important symbol of connectedness. The many individual photos, while attached to separate branches that reached in many different directions, nevertheless shared common roots. With this powerful symbol in mind, BCNU President Gayle Duteil welcomed conference participants by reminding them that we are all connected, and that much work needs to be done to ensure that equity and justice are the birthright of all human and non-human beings on this fragile planet. “When we look at the daily reality that far too many people on this earth must endure – from Syria, to Sierra Leone, to the poverty and marginalization that mark our cities and hinterlands across this land we call home – we may count ourselves amongst the privileged few,” she said. She noted that the conference theme,

WE ARE ALL ONE Statliem First Nation elder and cultural advisor Gerry Oleman shared his wisdom and insight at the opening of the conference.

“From Generosity to Gratitude”, was a natural starting point for reflection on the thwarted rights of others and how we might become agents of transformation – cultivators of an ethic of justice and equity. She asked participants to consider the generosity of the First Peoples of the land they now occupy as a guide for how they themselves might reflect on the relationship between generosity and gratitude. “What does generosity and gratitude look like?” she asked. “On our wards? In our communities? In our long-term care facilities? In this room? Amongst our friends and families?” She suggested that it begins with being seen and heard, and to be deserving of an act of kindness. “An ethic of justice and equity can be cultivated through the daily enactment of

UPDATE MAGAZINE February/March 2015

BCNU RIVA region communications secretary Liz Goba attended this year’s Human Rights & Equity conference. She is from Sierra Leone and many of her family there have been directly affected by the Ebola epidemic. She read the following poem to conference attendees. HELP US FOR WE ARE DYING

By Liz Goba

HELP US FOR WE ARE DYING BCNU RIVA region member Liz Goba read a heartfelt poem describing the devastating effect of the Ebola crisis on her native Sierra Leone.

these simple gestures,” Duteil suggested. “And in their very simplicity and ease of performance lies their ritual power. It is a power we naturally possess as caregivers, nurses and health care workers – a power that is magnified and enriched in its sharing with others – in community and solidarity.” A variety of guest speakers brought their own unique knowledge and wisdom to bear on this theme throughout the day. Speakers also included BCNU RIVA region executive member Liz Goba. Dressed in a resplendent costume from her native Sierra Leone, she read her poem, ‘Help Us For We Are Dying’ (see sidebar). The heartfelt composition described the devastation of the Ebola crisis and the profound effect it has had on her homeland. She described how the disease has destroyed so many lives – both young and

Help us for we are dying Ebola in town, and now we’re crying So tiny, yet your hostage we’ll be, You hibernate within us, and silent you keep Planning our demise for 21 days Piercing every blood vessel you face Vigorously attacking every living cell that you embrace Once happy people we once were Now women are crying, innocent children are dying Go back to hell from where you once came Help us please for we are dying. Ebola so tiny, but yet very strong You fight from within with flames of fire And fever we feel, and get very tired You turn us into your punching bag Until we’re fatigued, pale, and sad African beauties turned into living dead With bright red eyes, and bleeding beds Our bodies turned into ocean of blood Vomiting, diarrhea, and rashes we flood Compliments of ebola send you to your grave Brothers! Sisters! Where are you? When are you coming? Help! Help! Please help us! For we are dying. 5000 dead, and yet more to come Ebola you are no friend of this town You have no mercy for the victims you pick Grandpa, Grandma, Parent, and kid Where did you come from you powerful thing Such a tiny bully who kills from within

You know no color, gender, or race You are no friend of this human race You touch it, you’ve got it Just one plane flight a ride We must come together and fight this tide Help us please! Or you’ll one day join our cry. Conspiracy theory says you were made More questions that have confused us these days Ebola why are you so strong? In bio weapon labs they say you were born Human lab rats to become your prey What do greedy people or politicians have to gain? However, my humble scared people cast no blame The truth still remains, That women are crying, and children are dying Help! Help! Please help us for we are dying. I’m the only one left of my family tree No one in town, but the bumble bees My voice soon will be silenced too Not one of us left to cry with you Ebola has swept our whole town clean Please don’t allow Ebola to be a queen My doctor and family lay beside me dead I now feel my body getting weak But before my soul to keep I cry one more time for you to speak Don’t allow Ebola to win Let’s fight this horrible thing Help! Help! Please help! For I am crying, Very soon I’ll be dying.

WORKING WITH TRAUMATIZED YOUTH IN THE COURSE OF CONDUCTING her research, Elizabeth Saewyc has heard many harrowing stories about vulnerable youth and children who have experienced trauma. Saewyc is Professor of Nursing and Adolescent Medicine at the University of British Columbia. Her research has focused on

Professor Elizabeth Saewyc the health issues of youth, with a particular emphasis on understanding how certain groups of young people are targeted and stigmatized, how this influences their coping and risk behaviours, and what protective factors in their relationships and environments can help buffer this risk and influence their health. Saewyc reminded Human Rights & Equity conference participants of the impact nurses can have on a child or youth who comes into a public health facility. She told the story of Jessie

(not her real name), who was put into foster care at the age of six because her father had been taking pornographic pictures of her. At 13 she ran away with a man who made pornographic films. She became pregnant at 14, and that’s when she showed up at a public health clinic. Jessie’s traumatic history led her to believe that adults would have either a judgmental or sexual response to her. Saewyc urged nurses to ask themselves these questions when dealing with a traumatized youth: • Do we only focus on their problems and not their strengths? • Are we judgmental? (We're not their parents) • Must they reveal the trauma to get respect, empathy or caring? • Do we only provide respect to “deserving” teens? Saewyc believes a few minutes – even as little as 90 seconds – of caring and connectedness can have an impact on a vulnerable teen.

old – and how it affects us all. BCNU has since donated $10,000 to Doctors Without Borders to assist with the Ebola crisis. During his talk, entitled “Gratitude and Other Invisible Things”, Kabir Helminski told all conference participants that they have A NEW LANGUAGE OF something to be grate- SPIRITUALITY Kabir Helminski ful for: they are alive, shared his contemporary conscious and capable approach to Islamic concepts and practice. of thanks. Helminski is a translator of the poetry and writing of Jalaluddin Rumi – a 13th century Persian-Muslim scholar and mystic. He said the most important things in life are invisible: integrity, friendships, compassion, happiness and love. When we catch ourselves judging others, remember to think of Ho’oponopono – an ancient Hawaiian practice of reconciliation and forgiveness – and say, “I’m sorry, please forgive me, thank you, I love you.” Helminski has been named one of the 500 Most

WHAT DOES PRACTICE LOOK LIKE THAT FOSTERS RESILIENCE IN TEENS?

• Search for their positive attributes, strengths, assets and coping skills • Offer true caring and unconditional positive regard and respect • Be happy to see them • Model positive, respectful relationships

BUYING HAPPINESS Dr. Lara Aknin, Assistant Professor of Psychology at Simon Fraser University, shared her research on generosity and pro-social behavior, and told conference participants that money can buy happiness – if it is spent on others.

UPDATE MAGAZINE February/March 2015

GIFTED MUSICIAN Conference participants were treated to performances by Amir Koushkani, one of the foremost expositors of Suﬁ music. A composer, arranger and instructor of the traditional Persian stringed instruments, Tar and Setar, Koushkani is a scholar-in-residence at Simon Fraser University and teaches in the Music Department at Toronto’s York University.

Influential Muslims in the World. He said that by being intentionally connected to each other we can have a positive relationship with the people in our life. Lara Aknin’s presentation was a highlight for many attendees. According to Aknin, an Assistant Professor of Psychology at Simon

THE FACE OF BCNU Sixteen lucky participants of this year’s Human Rights & Equity conference were selected to be part of BCNU’s new brand identity photo shoot. The day-long event took place at Vancouver Community College, where the nurses from across the province were photographed using a variety of sets and backdrops. It’s all part of BCNU’s new look. If you know of a colleague or co-worker who attended the shoot make sure to look for their faces in BCNU advertisements and promotional materials in the year ahead!

Fraser University, money can buy happiness. But there’s a catch: it only works if we give the money away. Aknin says her research led her to conclude this theory holds true across all income levels and has been replicated in other countries. She says there is no question that giving promotes well-being. So technically money can buy happiness, we just have to spend it on other people! In addition to listening to speakers in the main plenary, members also participated in smaller breakout sessions led by several other guest speakers. Many attendees reported that the day was a special one that provided them with much knowledge and insight to take back to their work on BCNU’s human rights and equity caucuses. update

HOW TO CONTACT YOUR HUMAN RIGHTS AND EQUITY REPS BCNU Human Rights and Equity Committee Mabel Tung, Chair C 604-328-9346 E mtung@bcnu.org Aboriginal Leadership Circle Michelle Martinson, Chair E aboriginal@bcnu.org Lori Pearson, Council Liaison C 250-919-4890 E loripearson@bcnu.org Workers with Disabilities Caucus Kelly Woywitka, Chair E disabilities@bcnu.org Roni Lokken, Council Liaison C 250-960-8621 E veronicalokken@bcnu.org LGBT Caucus Cynthia Reid, Chair E lgbt@bcnu.org Kath-Ann Terrett, Council Liaison C 604-828-0155 E kterrett@bcnu.org Men in Nursing Group Walter Lumamba, Chair E meninnursing@bcnu.org Lorne Burkart, Council Liaison C 250-354-5311 E lorneburkart@bcnu.org Workers of Colour Caucus Jessica Celeste, Chair E woc@bcnu.org Mabel Tung, Council Liaison C 604-328-9346 E mtung@bcnu.org Young Nurses’ Network Catherine Clutchey, Chair E ynn@bcnu.org Jonathan Karmazinuk, Council Liaison C 604-312-0826 E jonathankarmazinuk@bcnu.org

Who Can Help?

BCNU IS HERE TO SERVE MEMBERS

BCNU CAN. Here’s how you can get in touch with the right person to help you. CONTACT YOUR STEWARDS For all workplace concerns contact your steward. REGIONAL REPS If your steward can’t help, or for all regional matters, contact your regional rep. EXECUTIVE COMMITTEE For all provincial, national or union policy issues, contact your executive committee.

EXECUTIVE COMMITTEE PRESIDENT Gayle Duteil C 604-908-2268 gayleduteil@bcnu.org

EXECUTIVE COUNCILLOR Deb Ducharme C 250-804-9964 dducharme@bcnu.org

VICE PRESIDENT Christine Sorensen C 250-819-6293 christinesorensen@bcnu.org

EXECUTIVE COUNCILLOR Dan Murphy C 604-992-7568 danmurphy@bcnu.org

TREASURER Mabel Tung C 604-328-9346 mtung@bcnu.org

EXECUTIVE COUNCILLOR Will Offley C 604-240-1242 woffley@bcnu.org

REGIONAL REPS CENTRAL VANCOUVER Judy McGrath Co-chair C 604-970-4339 jmcgrath@bcnu.org

Marlene Goertzen Co-chair C 778-874-9330 marlenegoertzen@bcnu.org

COASTAL MOUNTAIN Kath-Ann Terrett Chair C 604-828-0155 kterrett@bcnu.org

SIMON FRASER Liz Ilczaszyn Co-chair C 604-785-8157 lilczaszyn@bcnu.org

EAST KOOTENAY Lori Pearson Chair C 250-919-4890 loripearson@bcnu.org

Debbie Picco Co-chair C 604-209-4260 dpicco@bcnu.org

FRASER VALLEY Katherine Hamilton Chair C 604-793-6444 katherinehamilton@bcnu.org NORTH EAST Veronica (Roni) Lokken Chair C 250-960-8621 veronicalokken@bcnu.org NORTH WEST Sharon Sponton Chair C 250-877-2547 sharonsponton@bcnu.org OKANAGAN-SIMILKAMEEN Rhonda Croft Chair C 250-212-0530 rcroft@bcnu.org PACIFIC RIM Jo Salken Chair C 250-713-7066 jsalken@bcnu.org RIVA Lauren Vandergronden Chair C 604-785-8148 laurenvandergronden@bcnu.org SHAUGHNESSY HEIGHTS Claudette Jut Chair C 604-786-8422 claudettejut@bcnu.org

SOUTH FRASER VALLEY Jonathan Karmazinuk Co-chair C 604-312-0826 jonathankarmazinuk@bcnu.org Michelle Sordal Co-chair C 604-880-9105 michellesordal@bcnu.org SOUTH ISLANDS Adriane Gear Co-chair C 778-679-1213 adrianegear@bcnu.org Lynnda Smith Co-chair C 250-361-8479 lynndasmith@bcnu.org THOMPSON NORTH OKANAGAN Tracy Quewezance Chair C 250-320-8064 tquewezance@bcnu.org VANCOUVER METRO Meghan Friesen Chair C 604-250-0751 meghanfriesen@bcnu.org WEST KOOTENAY Lorne Burkart Chair C 250-354-5311 lorneburkart@bcnu.org

UPDATE MAGAZINE February/March 2015

Council Profile

HERE’S WHO’S WORKING FOR YOU

LIFELONG LEARNER WEST KOOTENAY CHAIR LORNE BURKART

EMPOWERING MEMBERS

“We are a democratic, professional union that engages with, and empowers, our members to find their strength and the safety in their nursing practice.” says West Kootenay chair Lorne Burkart.

QUICK FACTS NAME Lorne Burkart. GRADUATED UBC School of Nursing 1996. UNION POSITION West Kootenay chair. WHY I SUPPORT BCNU? For the many opportunities it offers members who want to be involved. I’ve never been part of any other union like it – we are the BCNU.

LORNE BURKART NEVER thought he would be a nurse when he began working in health care. Nursing came as a second career, after he developed a desire to increase his knowledge while working as an emergency medical technician for several years in BC’s lower mainland and Whistler areas. Burkart knew he liked working with patients, but when he went to nursing school, he specialized in pediatrics because he felt like it was an area that was lacking from his EMT training. “I’m not your stereotypical nurse, especially in pediatrics.” Burkart says that, at one point, he was told by an instructor that he would scare the children because he was a man. “But I had a few really good instructors and some great supporters

who helped me get through it,” he recalls. After receiving his nursing degree from the University of British Columbia in 1996, Burkart continued in pediatric nursing until he decided to move on to critical care and finally ER nursing. He eventually found a job in the Kootenays that suited his skills and experience and has called the area home ever since. First elected in 2012, Burkart is currently in his second term as chair of BCNU’s West Kootenay region. He served as OH&S rep, lobby coordinator and acting chair for several years prior to seeking a position on BCNU Council. Regarding his current responsibilities as regional chair, Burkart says that the work is familiar territory given his years serving as a BCNU steward. “I still do a lot of steward work. At the end of the day, whether they’re seeking information, wanting to be heard, to be engaged, empowered, or just seeking assistance, it’s the members who are the driver behind our work,” he says. Burkart serves as chair of BCNU’s Personnel Committee,

and is responsible for labour relations matters to ensure that union members are provided with quality, cost-effective services in a sound and supportive workplace. He also serves as Council Liaison for the union’s Men in Nursing caucus, in addition to serving on the union’s Policy Review Committee. “I support BCNU because of the values the organization has strived to achieve,” says Burkart when asked why he chose to stand for election as chair of his region. “We are a democratic, professional union that engages with, and empowers, our members to find their strength and the safety in their nursing practice.” Burkart also admires BCNU for the many opportunities it offers members who want to be involved in the union. “I’ve never been part of any other union like it – we are the BCNU.” But all the hard work also has some very special rewards. “I’m most proud when I hear the words ‘thank you’,” says Burkart. He heard those words again and again after his region developed the ‘adopt-a-student nurse’ initiative that was recently approved by other regions in the province. “At the end of the day, what keeps me going is when someone says that I helped them,” says Burkart. “Maybe they don’t know the right lingo or have the right connections, so to be able to help them stand up for themselves, I think that’s what drives everybody.” update

UPDATE MAGAZINE February/March 2015

Oﬀ Duty MEMBERS AFTER HOURS

VANCOUVER ISLAND NURSE MONICA CIOLFI IS PROVIDING CARE TO PATIENTS FROM A SHIP IN THE INDIAN OCEAN

NURSE ON BOARD Monica Ciolﬁ is proud to be delivering free health care to poor patients in Madagascar.

is doing almost three months of nursing off the coastal city of Toamasina, Madagascar. Ciolfi has just begun serving with Mercy Ships, an international faith-based charity using volunteers aboard hospital ships to deliver surgeries and health care free-of-charge to poor populations. Established in 1979, Mercy Ships has visited more than 580 ports of call and cared

PHOTO: 2014 MERCURY SHIPS – JUSTINE FORREST

CLOSE YOUR EYES AND imagine 30 degree temperatures, being docked on a cruise ship off the coast of Africa and gazing at lush rainforest terrain. Does this look like an amazing vacation? Add in odd shifts, hard work, and up to 10 patients to care for each day, and it looks more like nursing. And that’s exactly what it is for 26-year-old Monica Ciolfi who

for some two-and-a-half million direct beneficiaries. The ship is a controlled, safe and clean environment ideally suited for serving patients and crew. Even though Ciolfi spent a week of training in Texas covering “Fundamentals of Mercy Ships”, the Qualicum Beach native still wasn’t sure what to expect. The nurse’s journey started shortly before her 2011 graduation. One of her best nursing friends suggested she volunteer for this humanitarian effort. “I always knew I wanted to do it at some point, but you have to have two years’ experience before you can apply”, she says. Ciolfi admits that the actual application process was a four month ordeal. After her combination of procrastination, apprehension, reference letters, vaccinations and a physical exam, the application was officially put in the mail in January 2014. The Nanaimo Regional General Hospital nurse also had to raise $3,000 for her flight and accommodations. One year later, Ciolfi is now sleeping on the top bunk of a shared six-person dorm room aboard the Africa Mercy along with five other young nurses. She notes there are a handful of other nurses from around BC on the ship, and suspects there are over a dozen other nationalities on the ship including volunteers from Norway, England,

Switzerland and Australia. Meal times are set, but Ciolfi says that the food quality has been good and there are lots of health eating options. Despite the intensity of her work – she’s been working mostly with burn patients – she says the wards so far have been one of her highlights, and notes that the spaces are open and the patients can interact with one another. “There are kids and some of the patients have babies, so it really brightens things up. It’s a lovely place to nurse,’ she says. “There are day crews that come in to translate and charting is quite minimal and straight forward.” Ciolfi suspects one of her biggest challenges during her time on the ship will be adjusting to the lack of personal space, but she notes there are beaches and a gym close by that she can use on her time off. “I have taken several personal pleasure trips and if I wanted a nice suntan with hot showers, I wouldn’t be here,” says Ciolfi. “When the time was right, I knew I would use my nursing skills to help those born into less fortunate lives. I was ready for a purposeful and productive experience.” update If you are interested in supporting Ciolfi’s efforts or reading more about her experience, you can read the live blog at: Monicaciolfi.wordpress.com

I’m

ENGAGED

“

My path to engagement in BCNU began with the encouragement of my union stewards. I am thankful for this, as my involvement has been an invaluable journey. Knowing my rights as an

RN, especially early on in my career, has not only helped my

professional growth but has also helped me advocate for what nursing is all about: safe patient care.

September 2013

Registered in BCNU’s online member portal Ellen Christison BCNU North West region

October 2013

Attended first BCNU regional meeting

November 2013

Took BCNU “Building Union Strength” course

December 2013

Attended BCNU Provincial Bargaining Conference

March 2014

Attended first BCNU convention

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