BCNU Update Magazine Feb-Mar 2013

february/march 2013 www.BCNU.ORG

time to endorse the $10 a day child care plan

ensuring a smooth transition to the 37.5 hour work week

pharmacare tie-in drug coverage: what it means for you

Update british columbia nurses’ union

2013 strategic plan PLUs

nursing autonomy position statement pull-out

Feb2013_v6.indd 1

Together in practice BCNU is working towards a cultural shift that respects the indispensible roles of all nurses in healthcare

2/18/2013 10:18:47 AM

THINK

before you

POST

Facebook and other social media sites help us stay connected, but some things should never be posted online.

Provocative statements about your employer, personal information about patients or discriminatory comments against individuals or groups protected under human rights law are examples of what health professionals shouldn’t post online.

Employers or colleges may try to enforce professional standards if social media postings are inappropriate. And comments on “closed” Facebook groups can be copied and made public.

So stay connected — appropriately Feb2013_v6.indd 2

2/18/2013 10:18:48 AM

update magazine February /March 2013

Update

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Contents vol 32 no1

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february/ march 2013

this is what autonomy looks like Royal Jubilee Hospital LPN Orthopedic Technicians Scott Kennedy, Cindy Devlin and John Gillies.

UPFRONT

6

Check In

BCNU members are speaking out for nurses and patients.

10 Unions Under Attack

New legislation is a wake-up call for public sector workers.

12 The 37.5 Hour Week

A process is underway to ensure a smooth transition.

13 Flu Season Flip-Flop

Province backs away from coercive vaccination policy.

14 PharmaCare Tie-in

Towards affordable and accessible drug coverage.

21 Full Potential

LPN-orthopaedic technicians are a model of autonomy.

DEPARTMENTS

5 President’s Report 16 HUMAN RIGHTS AND EQUITY 24 PrFs Work 26 LEARNING AND DEVELOPMENT 32 Council Profile 33 Who Can Help?

34 Off Duty feature

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together in practice

BCNU is working to create stronger, more powerful and united nurses who are valued and respected in their workplaces.

Feb2013_v6.indd 3

16 Crossing Identity Borders Christine Nombrado participated in BCNU’s recent Human Rights and Equity Conference.

2/18/2013 10:18:52 AM

4 BC Nurses’ Union

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 40,000 members. Signed articles do not necessarily represent official BCNU policies.

EDITOR Lew MacDonald CONTRIBUTORS Juliet Chang, Sharon Costello, David Cubberley, Gary Fane, Monica Ghosh, Hanif Karim, Robert Macquarrie, Debra McPherson, Art Moses, Patricia Wejr PHOTOS Sharon Costello, Lew MacDonald, Kath-Ann Terrett, Loretta Woodcock

CONTACT US BCNU Communications Department 4060 Regent Street, Burnaby, BC, V5C 6P5 PHONE 604.433.2268 TOLL FREE 1.800.663.9991 FAX 604.433.7945 TOLL FREE FAX 1.888.284.2222 BCNU website bcnu.org EMAIL EDITOR lmacdonald@bcnu.org MOVING? Please send change of address to membership@bcnu.org.

Publications Mail Agreement 40834030 Return undeliverable Canadian addresses to BCNU, 4060 Regent Street, Burnaby, BC, V5C 6P5

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2/18/2013 10:18:59 AM

president’s Report

update magazine February /March 2013

Debra McPherson

A TIME OF challenge and OPPORTUNITY

photo: Chris Cameron

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or many, if not most BCNU members, it’s a time of considerable challenge and opportunity.

One of the biggest challenges stems from the change to prescription drug coverage under the Nurses Bargaining Association provincial contract. Some members are discovering that certain pharmaceuticals you’ve come to rely on may no longer be covered. I want to acknowledge the stress and anxiety that is causing.

Let me assure you that this was not what we negotiated – and not the information we received from the employer about the drugs that would be covered – when we agreed to link our prescription drug coverage to the BC PharmaCare formulary.

What we’re learning now is that the information provided to us in good faith by health employers and the government was not entirely accurate. It turns out that several drugs we were assured would be covered – either outright or through Special Authority – apparently are not covered, and there’s extra red tape some members face that was also not part of the bargain.

We are now working with the Health Employers Association and the provincial government to try to rectify some of these problems and ensure that coverage reflects what we were told and what we agreed in bargaining (for more information see page 14).

Healthcare workers in the Community Bargaining Association have been covered by the PharmaCare Tie-in for several years. It also takes effect April 1 for the Health Sciences Association (paramedical professionals) and the Facilities Bargaining Association contracts.

The employers administer the plan and have first responsibility to communicate about it.

But at the same time, NBA members are right to complain that detailed information about the change may not have been provided as effectively and timely as it should have. For that I want to sincerely apologize. The recent contract settlement was a highly complex document, containing many changes – most of them very positive – that had to be communicated all

Feb2013_v6.indd 5

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at once. In our attempt to present all the new provisions, the PharmaCare Tie-in wasn’t explained as well as it could have been for members to completely understand the change. In any event, the very negative impacts some members are now reporting were not intended and not bargained. We will do everything we can to fix them.

The other major challenge for NBA members also holds the greatest opportunity.

It’s time to ensure your employers keep their contract promises on workload.

While developing new rotations for the 37.5 hour week can be unsettling, we have an agreement with health employers to make the transition as smooth as possible. The employer agreed no layoffs will result; the impact on individual nurses’ employment and security will be minimal; and casual, overtime hours and vacancies will be used to regularize positions and maintain current part-time employees’ hours of work. We will grieve any rotations that do not hold to these principles.

Furthermore, the 37.5 hour week was just one part of an overall package of measures to improve staffing and reduce workload. It includes access to detailed baseline staffing data, and enforceable commitments to hire more nurses, create more regular positions, replace nurses who are away for vacations, maternity, sick leaves or other reasons, and increase staffing for overcapacity.

This is important new language. It’s vital that every member understand it and work with your stewards to ensure it’s enforced.

Meanwhile, if you’re one of our 7,200 new LPN members there’s a great opportunity to further unite the nursing family and improve your professional status, once the provincial government agrees to move you out of the support workers bargaining unit and into the Nurses Bargaining Association. Your postcard campaign was an overwhelming success.

Now we wait and see whether the province will do the right thing and fulfil your request and aspirations.

Whether it’s fixing pharmaceutical coverage, improving your workloads for safe patient care or ensuring nurses will be able to bargain with nurses in one strong united bargaining team, you can count on strong support from BCNU. update

2/18/2013 10:19:02 AM

6

CHECK IN

News from around the province

taxes

TIME FOR TAX FAIRNESS

FIVE STOREY BUILDING Five new stories will be erected over two levels of underground parking for members and visitors to BCNU.

BURNABY OFFICE UNDERGOes MAJOR EXPANSION THIS YEAR

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his spring will see the beginning of a major two-year expansion project at our main Burnaby office that involves the construction of five new stories of office space and two levels of underground parking for BCNU members and visitors.

The union is working to secure temporary alternative parking space near the office and staff will be doing their best to ensure that the office remains accessible during construction. Members will be notified in advance of any service disruptions that result from construction.

Feb2013_v6.indd 6

A major highlight of the project is the creation of a new Education Centre that will house state of the art facilities for modern course delivery.

Over the years our education department has expanded to deliver more educational opportunities and to support new human rights and diversity initiatives. But due to space restrictions many courses had to be delivered off-site.

The Burnaby office expansion was authorized at Convention 2010, where delegates were given a detailed presentation and assurances that the project would be financed without any increases to members’ dues. update

With the amount of talk in the media about taxes being too high or being bad for the economy, nurses and other public sector workers who are paid through taxes could be forgiven for feeling discouraged and undervalued when it comes to negotiating fair wages.

But it turns out that taxes are not nearly as unpopular as we might think. In fact, British Columbians appear ready to approach tax reform – and even tax increases – with more openness than our political leaders give us credit for. This was the finding of a recent opinion poll conducted

by Environics Research and commissioned by the Canadian Centre for Policy Alternatives.

The poll offers some surprising insights into what people of different political stripes think about taxes, inequality and public services.

The overwhelming majority of British Columbians (90 percent) think there should be higher taxes for those at the top.

What’s more interesting is that over two-thirds of British Columbians say they are willing to pay a higher share of their income in order to help implement specific policies that alleviate poverty and social inequality. This includes things like providing more

The CCPA’s Shannon Daub says British Columbians are ready for a thoughtful discussion on taxes.

access to home and community based health care for seniors, increasing welfare benefit rates, creating a $10a-day child care program, or reducing class sizes in K-12 education.

The CCPA says the results call for a public discussion on tax fairness and a review of our overall tax system.

“It’s time for a thoughtful, democratic conversation about taxes,” says CCPA Communications Director Shannon Daub. “The idea that we should debate whether taxes are ‘good’ or ‘bad’ is old. The questions we need to answer now are: what are the things we want to pay for together, and how can we raise the necessary revenue so that everyone pays a fair share?”

The CCPA has produced a report to get the conversation started. Download “Progressive Tax Options for BC” at http://policyalternatives. ca/bc-tax-options. update

2/18/2013 10:19:05 AM

update magazine February /March 2013

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SANCTUARY HEALTH: SAYING “NO” TO REFUGEE HEALTH CUTS

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Lions Gate Nurses rally for safe care on January 12. From left to right: LPN Shirley Oandasan, RN Glowin Aquino and RN Carol Nakano.

making news OVERCAPACITY AT RJH

bcnu in the headlines

changes to the College of When Royal Jubilee Hospital Licensed Practical Nurses Regulation.

ER staff were faced with finding beds for 26 patients McPherson said the BCNU on New Year’s Eve, nurses generally accepts the prospoke to CTV about their posed regulations and has concerns. recommended only minor “It’s an unsafe situation,” changes to the government. said South Islands “I think [the co-chair Margo proposed Wilton. “Patients changes] provide are being moved some guidance to a sun room on for employers,” one of the units said McPherson. where here isn’t “Employers any oxygen or have been all suction.” over the map in Conditions at the province in South Islands co-chair the hospital have the absence of Margo Wilton been an ongoregulations on how ing problem for they’re utilizing nurses working there – with LPNs. In some cases LPNs many concerned for their haven’t been comfortable with practice due to chronic overhow they’ve been utilizing them capacity there.

- either under or over.”

NEW LPN REGULATION She said employers and BCNU president Debra nurses will benefit from the McPherson spoke recently new regulation because it will with The Prince George be evenly applied across the Citizen regarding proposed province.

Feb2013_v6.indd 7

atalie Blair is part of a growing movement of healthcare providers who are calling on their colleagues to oppose the federal government’s cuts to the Interim Federal Health Program.

The IFHP provides health insurance for refugees in Canada, and ensures access to medical care, diagnostic services and laboratory testing similar to that provided by provincial health plans. It also provides access to medications, emergency dental care and vision care similar to that available to people on provincial social assistance plans.

Cuts to the program, which came into full effect last December, now mean that the majority refugee claimants to Canada will be restricted to receiving “urgent or essential care” and be denied preventive care. They will also lose access to medication coverage, vision and dental care.

Blair, a Community Mental Health Worker at Rain City Housing RN Natalie Blair (left) and Sanctuary Health member at BCNU’s recent Human Rights and in Vancouver, says Equity Conference. the new policy goes against everything she has been trained to do.

“It wears on our moral conscience. We are being asked to meet people who are fleeing violence with violence. We are being asked to deny care,” she says.

Blair is a member of the Sanctuary Health, a grassroots organization of healthcare providers formed in response to the IFHP cuts.

The group’s Non-Cooperation Campaign aims to raise awareness among those workers who will be expected to implement the policy.

“Nurses have a professional and political voice,” says Blair. “We want to inform as many health professionals as we can. If they knew (about the scope of the cuts) they would say ‘no’.”

Cuts to the IFHP were implemented as part of the federal government’s 2012 omnibus budget bill and no provincial governments or medical and health care associations were consulted prior to the policy decision being made. The College of Family Physicians of Canada and the Canadian Nurses Association have also protested the cuts.

Learn more about Sanctuary Health’s non-co-operation campaign at http://www.sanctuaryhealth.blogspot.com update

2/18/2013 10:19:09 AM

CHECK IN

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CHILDREN DESERVE SAFE CARE

ABBOTSFORD PEDS NURSES ADVOCATE FOR SAFE AND APPROPRIATE CARE on BC FAMILY DAY

Addressing Aboriginal Health SFV Co-chair Lisa Walker, SFV Lobby Coordinator Walter Lumamba, retired BCNU member Alice Edge, BCNU Vice President Christine Sorensen and BCNU Treasurer Mabel Tung attend First Call’s 20th anniversary fundraising dinner. The evening featured Aboriginal child and youth advocate Cindy Blackstock’s presentation on promoting equitable and culturally-based child interventions.

IDLE? KNOW MORE!

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ttawapiskat Chief Theresa Spence’s hunger strike in midDecember may have lasted six weeks, but the impact of her actions will last much longer. Chief Spence’s wake-up call inspired a series of rallies, flash mobs and protest marches across North America and the world. Circle dances, traditional drumming and chanting, demonstrations and in some cases blockades gave rise to the “Idle No More” slogan.

The federal Conservative government’s passing of omnibus legislation which included Bill C-45 (amendments to the Navigable Waters Protection Act) and Bill C-38 (amendments to the Indian Act), was seen by many as an attack on the rights of Aboriginal people, and gained the sympathies of people around the planet.

Indigenous and marginalized communities across Canada are frustrated with their political and economic disenfranchisement both on and off reserve – and their protests have received unprecedented support and media coverage.

“Aboriginal people across the country have been joined by supporters around the globe to create a movement of solidarity and awareness that needs to continue,” says BCNU

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President Debra McPherson, who notes that the BCNU mission statement aims to protect and advance the health, social and economic well-being of our members and our communities.

“Inadequate housing, inequitable access to health care, and nonexistent employment opportunities are the reality for far too many Aboriginal peoples,” says McPherson. “We hope to build a world where extreme measures are not needed to get the attention of the government and the public when the health and safety of a group is compromised.”

“Addressing Aboriginal health inequalities is not merely a matter of funding more healthcare resources but also about ensuring that the social determinants of health like housing, education, food and water security are provided,” says BCNU Aboriginal Leadership Circle Chair Michelle Martinson.

Martinson also commented on the importance of looking for the truth in what is being reported in the media. “Seek to gain a clear understanding of what the issues are as things are often not as they seem,” she said, adding that nurses are able to use their knowledge and advocacy skills to improve the health status of Aboriginal people. update

Dozens of Fraser Valley pediatric care nurses have come together to take action on behalf of children in their care. They’re concerned about the inappropriate placement of adult patients in the Abbotsford Hospital’s Pediatric Care Unit and its effect on the quality of care available to children at the hospital.

The nurses have filed PRFs, sent letters to Provincial Health Minister Mike de Jong and Opposition Health Critic Mike Farnworth, had repeated meetings with management and started a public campaign with “Children Deserve Safe Care” buttons and “Call Your MLA” cards.

On November 29, BCNU members Deb McGhie and Joanne Hamberg joined Fraser Valley Regional Chair Linda Pipe and BCNU President Debra McPherson to present their concerns in a meeting with de Jong, who is also the MLA for the area.

The nurses raised the issue of safe care for children on the first new BC Family Day in Abbotsford. With the BCNU Campaign Bus along for the ride, nurses provided families with information, prizes and pizza in their continuing effort to motivate the public to support their campaign for safe care for all Fraser Health Authority children.

I speak for those who have no voice I give hope to those who have no choice I sit, I care, I listen, I dare I laugh, I heal, I give, I share I fight for you when you’re too weak to fight I stand up for what you believe is right I am not an angel or your best friend I am your nurse until the end Alana Smith BCIT Level 2 Nursing Student Simon Fraser Region 2013 CSNA Conference delegate

2/18/2013 10:19:11 AM

update magazine February /March 2013

9

FOR-PROFIT HEALTHCARE

VANCOUVER DOCTOR RESUMES LEGAL ATTACK ON MEDICARE

photo: global news

QUICK THINKING SAVES THE DAY AT SURREY MEMORIAL HOSPITAL When construction crews at Surrey Memorial Hospital ruptured a water main, quick-thinking nurses and hospital staff kicked into action to ensure their patients’ safety.

Shortly after 8:00 am on November 19th, staff became alarmed by rapidly rising water levels outside the glass block wall at the rear of the emergency department. With no time to spare, nurses moved all the ER patients and their families out of the area and to safety just minutes before the wall gave way and thousands of gallons of muddy water came crashing into the department.

The Surrey Memorial ER is the busiest in the province, treating about 300 patients per day.

“Everybody worked together, doctors, nurses and all the staff who were present,” explains BCNU worksite Steward Gail Conlin.

“What struck me was the team effort, how they became leaders.

They knew what had to be done, and everyone came together.”

The ER has since been repaired and re-opened and is currently operating one mobile MRI to replace a unit that was destroyed by the water.

As for the return to business as usual at SMH’s ER, Conlin says that “everyone is glad to be back where all the resources are in one area. ”Nurses are so happy to be ‘back home’,” she says.

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r. Brian Day, the country’s leading proponent of profit-driven, patient-pay healthcare has resumed his legal attack on public healthcare laws designed to ensure that access to care is based on patients’ needs and not their ability to pay.

Day is back in court this year, suing the provincial government in an attempt to avoid a court injunction that would require his Vancouver clinics – the Cambie Surgery Centre and Specialist Referral Clinic – to stop charging patients large user fees that are prohibited by BC’s Medicare Protection Act and the Canada Health Act. Day’s move comes in the wake of a 2012 provincial audit which revealed that almost half of all the services provided at Cambie and the SRC were eligible for public health insur-

challenge which argued that the government had no right to enforce laws that contravene the Canadian Charter of Rights and Freedoms.

They claimed people are unduly suffering and dying on surgical wait lists because for-profit investors are not legally allowed to charge patients additional fees for medically necessary health services already covered by public health insurance.

After two years of legal stalling the BC Court of Appeal ruled that the province does have the authority to audit Day’s clinics.

Audit results released last July confirm the assertions BCNU and the patients had been making in court and in public for years. Day and other physicians working at the clinics regularly extra-billed patients, often in addition to billing taxpayers for the service through MSP. Auditors found evidence of nearly $500,000 in illegal fees related to just a small sample of the total This is the latest chapter in a legal services provided at the facilities. case with critical implications for Day has resumed his the future of public healthcare Charter challenge and organized a group of patients who in BC and across Canada – and will join him in attempting to one in which BCNU has played a strike down the laws underpinning medicare. Because major role. of its role in the case, BCNU has been granted enhanced ance coverage, and that the clinics engaged intervenor status, with the ability to bring in illegal billing when providing almost all of forth evidence and cross examine Day’s witthese eligible services. nesses as needed.

This is the latest chapter in a legal case with “BCNU’s work on this case is important in critical implications for the future of public defending public healthcare from business healthcare in BC and across Canada – and one interests that are determined to undermine in which BCNU has played a major role. and ultimately destroy it,” says BCNU presiThe government first attempted to audit dent Debra McPherson. “As nurses we can’t sit Day’s clinics in 2008 after a group of BCNUidly by and watch the laws that are supposed supported patients went to court asking for an to protect patients from extra-billing openly order requiring the government to enforce the flouted. It’s positive the provincial government prohibitions on user charges and extra-billing finally took action against these violations. contained in BC healthcare law.

Now it’s critical we continue our support for Day, along with his allies in the growing the case to protect and expand public healthprivate medical clinic and insurance induscare and stop the push toward a US-style tries, staved off the audit by way of a Charter profit-driven system.” update

2/18/2013 10:19:12 AM

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CHECK IN

Labour Rights

Unions Face Unprecedented Attacks

Removal Of Ontario Teachers’ Right To Strike Should Be A Wake-Up Call For All Public Sector Workers

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orking people across Canada, including many nurses, are under the gun from what looks like a coordinated attack on labour rights unleashed by governments and their corporate allies.

In Ottawa the ruling Conservatives have repeatedly used their majority to pass back-to-work legislation imposing employer demands on workers in both the public (Canada Post) and private sector (Air Canada).

They went on to further abuse their majority in Parliament late last year when they rammed through a private member’s bill that imposed unprecedented bureaucratic disclosure requirements not required of any other professional or trade association in the country.

Bill C-377 is the product of a long lobbying campaign by the country’s non-union

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Lobby Day BCNU VP Christine Sorensen (right) and TNO Lobby Coordinator Kathy Moore (left) met recently with Kamloops— Thompson—Cariboo MP Cathy McLeod.

They discussed federal Bill C-377 and other issues of concerns to members.

construction contractors. First introduced

by Surrey-Cloverdale MP Russ Hiebert, the bill’s dubious rationale is that union dues are tax deductible, so unions owe taxpayers full public disclosure of where those dues go. Yet the Conservatives voted down an amendment to require similar disclosure from other professional organizations representing lawyers, doctors and businesspeople.

Bill C-377 also required unions to publicly disclose the names and addresses of all recipients who received annual payments of as little as $5,000 a year on the Canada Revenue Agency website. The threshold was increased to $100,000 after criticism from the Canadian Bar Association and the Federal Privacy Commissioner. But the paperwork burden will remain onerous for labour organizations that are among the most transparent in Canada in providing financial information to their members.

Critics have pointed out that it is disin-

genuous to imply that unions receive tax subsidies from the government. Union members – like members of any other professional organization – can deduct their dues from gross income and then pay tax on the net amount. Unions are financed by their members, and owe full disclosure of their finances to their members, not the government.

Bill C-377’s selective targeting of unions betrays its more likely motive: prohibiting unions from supporting social justice or political causes that are critical of the Conservative’s social and economic policies.

This was made apparent last summer when Phil Hochstein, head of BC’s Independent Contractors and Businesses Association (a huge financial contributor to the BC Liberals), publicly condemned BCNU for supporting the Musqueam First Nation’s campaign to save their sacred 4000-year-old village site in south Vancouver from a condo development.

Hochstein claimed the issue had nothing to do with collective bargaining, nurses or healthcare – something BCNU President Debra McPherson effectively refuted during a one-on-one radio debate.

Meanwhile, in Ontario the Liberal government of Dalton McGuinty made public sector wages and benefits the main target in a drive to reduce the provincial deficit.

McGuinty passed legislation that removed teachers’ right to strike and required elementary and secondary teachers to agree to contracts already imposed on French-speaking and Catholic teachers.

Those contracts contained a wage freeze, delayed increment steps, cut annual sick days from 20 to 10 and removed teachers’ ability to cash out banked sick days on retirement. The Ontario Labour Relations Board stopped a one-day protest walkout before it began January 11 by ruling it an illegal strike.

All the while governments’ anti-labour thrusts could count on approval from Canada’s major media outlets. On January 12 the Globe and Mail’s Margaret Wente wrote, “Teachers’ unions are obsolete … If (teachers aren’t) reined in, everybody else will fight back, too.”

On the very same day, Brian Crowley of the right-wing MacDonald-Laurier

2/18/2013 10:19:13 AM

update magazine February /March 2013

Institute opined in The Vancouver Sun, “Public sector’s right to strike a costly mistake: When politics is part of the equation, unions drag citizens into labour disputes”.

The same column made its way into The Province two days later: “Public sector unions should lose right to strike”.

Here in BC, Premier Christy Clark opened the 2012 round of public sector bargaining by musing about eliminating defined benefit pension plans. Thankfully, saner heads prevailed. After tough bargaining in a tough climate, most unions were able to negotiate modest improvements with minimal disruption for the public.

When compared to their Ontario counterparts, it would appear that public sector workers in BC are fortunate to have dodged the bullet. But these developments should be a wake-up call for all public sector workers.

For unions, onerous disclosure requirements and limited bargaining rights may be just the beginning. Many see these moves

Unions are financed by their members, and owe disclosure of their finances to their members, not the government. as a prelude to the ultimate prize for opponents of workers’ rights: the elimination of the so-called Rand Formula – a Canadian labour law requirement that workers who enjoy the wages and benefits of a union contract pay union dues, even if they don’t actually join the union representing workers at their place of employment.

Anti-union contractors’ groups have targeted the Rand Formula and compulsory union dues for many years, preferring US-style “right to work” laws – a position recently endorsed by Ontario Conservative opposition leader Tim Hudak.

“What we’re seeing is a series of unprecedented attacks on labour,” says McPherson.

“Our members need to contact their elected representatives in Ottawa and send a clear messages that these action are unacceptable.” update

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Home away from home Suzie DaSilva and Honour House General Manager Margaret J. Gordon.

Honour House When BCNU member Suzie DaSilva’s acutely ill son was diagnosed as needing specialist care, the long-time Kelowna ER nurse faced the challenge of admitting an 11-yearold to Children’s Hospital in Vancouver and figuring out how to live nearby during his treatment.

Enter Honour House, a unique service that provides temporary lodgings for up to ten families of Canadian forces veterans and first responders in

need of medical care. As an RCMP officer, Suzie’s husband Sergio qualified their family to access this much needed service housed in a converted residence on a quiet New Westminster street.

The DaSilvas simply can’t say enough about the surroundings and the support they received from professional staff and dedicated volunteers over the course of three long months. “Honour House turned out to be

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an oasis of support for us,” says Suzie. “They’re a class act dedicated to making people feel as comfortable as they can.”

Prompted in part by the many BC soldiers requiring specialist treatment after a tour of duty in Afghanistan, Honour House aims to be “a home away from home” for patients and their families.

First responders (ambulance, fire and police) are included in its target population because they also risk injury and illness in the line of duty.

Honour House provides a comfortable, restorative setting to relieve “the emotional and financial stresses that come with injury, illness and debilitation.” Honour House was established with a $2-million loan guarantee from BC Housing that enabled purchase of the building, which opened in 2010 after extensive modernization.

For more about Honour House, visit: www.honourhouse.ca. update

NURSES BARGAINING ASSOCIATION PRF PROCESS NOW IMPROVED New Professional Responsibility Form language provides a streamlined, responsive process for nurses’ professional, safety and workload concerns

A new PRF process gives nurses the opportunity to discuss issues with their excluded manager within 72 hours of the nurse identifying her concerns.

The excluded manager then must provide a written response to the nurse within 72 hours outlining actions to be taken.

Nurses will also have the

ability to bring a completed PRF form to the discussion with their excluded manger to help guide them in presenting their issue. If the matter is not resolved to the nurse’s satisfaction within seven calendar days of receipt of the written response, the nurse may submit the PRF to the PRF committee.

These new changes will support our goal of collaboratively resolving issues related to nursing practice conditions, patient and nurse safety, and persistent workload in a collaborative, timely fashion.

Members can contact their PRF Regional Resource person or Regional Chair for more information.

2/18/2013 10:19:13 AM

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EXTENDING THE WORKWEEK

BCNU works to minimize impact of new rotations

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he Nurses Bargaining Association’s agreement to move to a 37.5 hour workweek is part of an important strategy to ensure that nurses achieve their key bargaining goal of safe staffing for safe patient care.

In exchange for an increased work week, the Health Employers’ Association of BC accepted NBA workload proposals that will require employers to hire more nurses, create more regular positions to provide care and replace nurses who are away from the workplace. In addition to the 37.5 hour workweek, these agreements will go a long way to addressing the understaffing and overcapacity issues that are the root of nurses’ workload challenges.

The priority now is to ensure members are protected as the move to a 37.5 hour week is implemented. BCNU has set a process in place with health employers that will see managers engaging in detailed consultation with the union in order to obtain feedback from members on new rotations.

The union has appointed Bella Brown, an experienced Labour Relations Officer, as staff administrator of rotations and scheduling. The union will also appoint members experienced in rotations as BCNU regional Rotation Representatives to work with employer specialists.

The process will be based on the Memorandum of Agreement – Transition to the 37.5 hour work week – contained in the new NBA Provincial Collective

Feb2013_v6.indd 12

Agreement. The memorandum stipulates that no layoffs will result from the transition to the 37.5 hour week and that it will be done in a manner that minimizes the impact on individual nurse’s employment and security.

Under this transition agreement the employer has agreed to consider: • The regularization of casual and overtime hours (part-time or full-time basis) including creating built-in vacation relief or float positions • Using current vacancies to maintain current part-time employees’ hours of work • Offering job shares as per Appendix AA of the NBA Provincial Collective Agreement • Other options as mutually agreed between the union and employer.

The process will involve consultation between a BCNU Rotation Representative and the employer, who will provide the

data assumptions made to build the rotation, such as the number of FTEs, overtime hours, vacation relief needs for the unit and current vacancies.

Health employers have also agreed that it is a priority to maintain full-time positions and to minimize the impact on part time nurses by building in vacation relief.

Once a new draft rotation is agreed to, it will be submitted to members at the local level for review. This will give members an opportunity to amend the proposed rotation or develop a new one. If more than one proposed rotation meets the unit’s requirements, members will vote on which rotation to implement.

For rotations developed before March 29, BCNU has agreed to reduce the notice period to put the new rotation into effect

No layoffs will result from the transition to the 37.5 hour week and it will be done in a manner that minimizes the impact on individual nurse’s employment and security. from six weeks to 10 days. Thereafter, the collective agreement applies unless otherwise mutually agreed. The union has also agreed that: • Rotations will be based on a 52-week year (not 52.2) • If employees are already working extended shifts there is no need for the extended hours to be reapproved and no new overtime waivers will be required • Section 54 notice will not be required if only changes to rotations are being implemented.

BCNU members should direct any questions to their Regional Chair or to their Rotation Representative. update

2/18/2013 10:19:15 AM

update magazine February /March 2013

FLU SEASON FLIP-FLOP

Province backs away from coercive vaccination policy.

Health authority declares “public health hazard”.

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acing strong public Collaboration, the highly respected protests from BCNU, grievinternational scientific organization. The ances filed by BCNU and columns shredded the credibility of eviother healthcare unions and dence being used by BC officials to justify scientific evidence questioning the coercive flu shot policy for healthcare the effectiveness of flu shots, the provincial workers. government suspended enforcement of its While BCNU has long encouraged new coercive vaccine policy for healthcare members to get the shot as the best prevenworkers for the current flu season. tive measure available, evidence that it’s far The suspension was announced from reliably effective undermines employNovember 30 just hours before the policy ers’ justification for violating employees’ was scheduled to go into effect at midnight right to use their own clinical judgement December 1. about accepting medical intervention.

Unveiled to unions and the public in One public health official indicated the August, the policy was devised and pro“alternative” of wearing a mask is not really moted by BC’s provincial health officer and the medical officers from each of the health authorities and adopted at a meeting of health authority leaders (CEOs and chairs) in June.

The policy required – as a condition of continued employment – that all healthcare workers receive a flu shot or wear a mask Deputy Health Minister Graham Whitmarsh for the duration of flu season.

Workers were also required to a serious alternative at all, because the mask wear stickers showing their vaccination is so uncomfortable that after one year status and encouraged workers to report virtually all staff will opt to get the shot. colleagues who were not in compliance.

It was always understood that the situBut in a Nov. 30 letter to health authority ation would change once a flu outbreak CEOs, Deputy Health Minister Graham Whitmarsh declared that the government’s was declared in a facility. Under existing policy, during an outbreak non-immunized focus this year would be on education and employees can be sent home without additional consultation. “Therefore, in the pay unless they agree to take anti-viral first year, the enforcement components of medication. the policy will be in abeyance, and nonOfficials in all but one health region compliant staff are not to be disciplined,” say the flu season may be worse than the reads the letter. previous two relatively mild seasons, but In a letter mailed to all members in nothing they haven’t seen in the past. Only December, BCNU president Debra in Fraser Health did the medical health offiMcPherson urged nurses to contact their steward if any local managers didn’t get the cer go much further, claiming flu outbreaks much greater than reported in any other message. health region.

Suspension of the policy capped several On January 15 Dr. Paul Van Buynder weeks of media activity highlighted by used the Public Health Act to declare this newspaper columns from the Cochrane

In the first year, the enforcement components of the policy will be in abeyance, and non-compliant staff are not to be disciplined.

”

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year’s flu a “public health hazard”. He ordered all staff, volunteers and visitors at Fraser Health residential care and assisted living facilities to wear a mask if they have not been vaccinated.

The declaration trumps the Deputy Minister’s Nov. 30 letter in affected worksites where staff must comply.

The health authorities claim up to 75 percent of healthcare staff received the flu shot this season, a substantial increase from previous years, as workers anticipated the coercive policy would be enforced. update

Know your Rights: Flu vaccination Must I get a flu shot or wear a mask?

Ministry policy (2012) says YES you must.

But Ministry policy now says you can decline: • “Non-compliant staff are not to be disciplined” • “Enforcement components … in abeyance”.

Managers may say the mandatory flu policy stands, but then fail to tell you your choices.

You can decline without: • Putting up with harassment or bullying • Accepting threats of punishment • Displaying your vaccination status.

Managers may ask you to: • Get a shot or wear a mask • Display a sticker with vaccination status.

But for 2012/13 you can decline to: • Show proof or wear a mask • Wear a vaccination sticker WITHOUT risk of punishment.

It should be your choice.

BCNU will defend members’ rights.

Contact your BCNU steward to grieve any offences.

Visit www.BCNU.org for more info.

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14 DRUG COVERAGE

Attendance management Employer ordered to stop punishing sick staff, BCNU litigation ongoing

Hearings conducted as part of BCNU’s arbitration on Vancouver Coastal Health Authority’s Attendance and Wellness Program (AWP) are continuing over the winter.

In the meantime, arbitrator Vince Ready has ruled that the health authority must stop punishing its workers for calling in sick and end the practice of denying overtime, reducing hours or threatening to fire workers for illness or injury.

The ruling comes in response to a grievance launched last year by other health sector unions but which is separate from BCNU’s arbitration.

Effective January 18, all overtime bans must be lifted and any workers who have had their hours reduced under the program should have them reinstated.

The Ready ruling addresses issues contained in BCNU’s arbitration. The decision represents a victory and the nurses’ union anticipates that all other health authorities will follow the ruling.

BCNU’s hearing will continue to address outstanding issues, including the conflict between AWP and the negotiated Enhanced Disability Management Program.

Please contact your BCNU steward for the latest information.

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BALANCING ACCESS WITH AFFORDABILITY BCNU is working to address challenges associated with the move to the PharmaCare Tie-in

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he switch to drug coverage that’s based on the province’s list of publicly insured drugs (the PharmaCare Tie-in) was one of the most significant changes to nurses’ collective agreements.

It was a smart move – and it reflects BCNU’s commitment to retaining a comprehensive benefits package that’s 100 percent employer-paid.

Under the agreements, both Nurses and Facilities Bargaining Association members’ Pacific Blue Cross drug coverage is combined with the PharmaCare formulary. This was done to help reduce the costs of medications paid by employers while also guaranteeing that members have access to a comprehensive range of safe and affordable prescription medication.

Unfortunately, the switch to the PharmaCare Tie-in has come with some unanticipated challenges. Since the change, some members have told us that drugs they have been using are no longer covered. Others are discovering that they will be forced to suspend treatments mid-course, have reduced coverage if living

out-of-province, or endure long waits with no coverage while awaiting specialist approval.

“This news is troubling – and it does not reflect the agreement that was reached at the bargaining table,” says BCNU President Debra McPherson. BCNU has since brought its members’ concerns to the Health Employers Association of BC and demanded that the PharmaCare Tie-in be implemented in a manner that accords with the bargain.

The BCNU bargaining team negotiated the PharmaCare Tie-in using information provided by the employer in good faith. And if properly implemented it should serve as a sound alternative to cost-sharing (health employers were demanding that nurses begin paying one-quarter of our benefit costs, which as of 2011 totalled some $6,294 per nurse, excluding MSP).

Most members who occasionally have a prescription filled or already use prescription drugs included in the formulary should notice no difference in their coverage. For some, it will require their doctor making a request under Special Authority (see side bars “PharmaCare

PharmaCare Tie-in Drug Coverage PharmaCare provides three types of drug coverage:

Full Benefits

Member is reimbursed up to the full cost of the drug plus an eight percent markup. This primarily includes generics and some brands which do not have a generic equivalent.

Partial Benefits

For drug brands with a generic equivalent (e.g., Lipitor), PharmaCare covers the cost of the generic. If the member cannot tolerate the generic equivalent for whatever reason, the physician may apply for Special Authority.

If approved, PharmaCare reimburses the member for the full cost of the brand name drug.

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update magazine February /March 2013

Tie-in: What it means” and “Special Authority: How it works”).

The PharmaCare formulary has unique features that make it a compelling choice.

First, it’s based on scientific evidence, meaning that drugs are only approved for coverage after independent review shows they are both safe and medically effective.

Second, because PharmaCare favours lower cost generic versions of identical drugs to more costly brand-name drugs, listed drugs are cheaper than many of those on private insurance formularies.

Health researcher Colleen Fuller is the president of PharmaWatch, a consumer watchdog that monitors adverse effects from name-brand drugs. “BC’s PharmaCare formulary is the gold standard,” she says. “It provides drugs that are safe, medically effective, and affordable – and bases its drug choices on science that’s independent of drug company influence.”

Unions today are being challenged to get smarter with the money they invest in benefit packages. Soaring prescription medication bills means the cost of extended health plans has risen much faster than inflation, and drug costs are predicted to climb 11 percent a year. Over-prescribing, brandname bias and the provinces’ failure to fully exploit the benefits of joint generic drug purchasing are just some of the reasons – and all of them are leading employers to demand insurance premium co-payments from workers.

The switch to the PharmaCare Tie-in is a

Limited Benefits

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These drugs are only covered if the physician applies for Special Authority and it is approved. If any of these drugs are dispensed after February 01, 2013, the claim will be rejected unless the member provides Pacific Blue Cross with documentation that they have Special Authority approval from PharmaCare.

strategy already adopted by other health sector unions to deal with unmanaged drug costs that limit the flexibility of entire benefits plans. According to Fuller, prescription medications now account for between 70 and 80 percent of the total costs of benefit packages and threaten to overwhelm them Much work remains to be done in the effort to reign in prescription drug costs.

In the meantime, BCNU will be meeting with the provincial government and working with employers to ensure the accuracy of the information we received during bargaining. The move to the PharmaCare tie-in is a first step toward affordable drug coverage – the challenge now is to ensure it remains accessible and in doing so continue to improve our entire benefits package. update

PharmaCare Tie-in: What it means to you Most members, who only occasionally have a prescription filled or already use generic prescription medication included in the PharmaCare formulary, won’t notice any difference.

Those members currently taking prescription medications under extended benefits should advise their doctor immediately about the PharmaCare tie-in.

Members currently prescribed brand-name drugs not listed by PharmaCare, and who wish to continue using them for medical reasons, can ask their doctor to request Special Authority (see side bar: Special Authority – how it works).

On rare occasions, when neither a brand-name drug nor its generic equivalent is available, your doctor can also request Special Authority for medical reasons.

Anyone wanting to purchase a brand-name drug instead of a listed generic can do so by paying the difference in cost out-of-pocket.

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SPECIAL AUTHORITY How It Works Members currently prescribed brandname drugs not listed by PharmaCare, and who wish to continue using them for medical reasons, can ask their doctor to request Special Authority.

Here’s how it works: You Register for PharmaCare Register for PharmaCare online at www.health.gov.bc.ca/pharmacare or by phone toll-free: 1-800-663-7100.

Your Doctor applies to PharmaCare for Special Authority on your behalf Most doctors offices will have Special Authority forms on site. You can obtain a copy from your employer.

All forms must be completed by a licensed physician and faxed to the number indicated on the form.

PharmaCare notifies your doctor PharmaCare will notify your doctor of their decision in writing. This is known as PharmaCare’s decision document.

Request a copy of this decision document from your doctor or from PharmaCare directly.

You or your doctor notifies Pacific Blue Cross The PharmaCare decision is faxed to Pacific Blue Cross this along with your name, contact number or email, policy number and certificate number. This ensures your drug card will recognize this decision and pay for the drug for the duration of time indicated on the decision document.

PBC will notify you once the drug has been added to your card. You may now go to the pharmacy and use your drug card to purchase your prescription.

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Crossing Identity Borders BCNU HUMAN RIGHTS AND EQUITY CONFERENCE

Exploring Identity BCNU Human Rights & Equity Caucus chair Mabel Tung and hip-hop artist, beat-boxer, aboriginal youth educator, award-winning actor and member of the of the Nuxalk and Cayauga Nations Jerilyn Webster.

Conference attendees listened to a wide range of expert speakers and were invited to reflect on the complex intersections of identity

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ike many of the attendees at BCNU’s recent Human Rights and Equity Conference, Christine Nombrado has crossed many “identity borders” in her life’s journey.

The nurse and BCNU LGBT caucus representative from the South Fraser Valley region joined with her union sisters and brothers to consider how their identities are shaped by the forces that govern their daily lives. The move from home into the wider world and then into the workplace, for example, involves the crossing of multiple borders that ultimately shapes who we are.

This was the central theme of “Crossing Identity Borders”. Held on December 7 in Vancouver, the event attracted over 160 BCNU members from all regions of the province

Feb2013_v6.indd 16

– a small sample of BCNU’s increasingly diverse membership. “The conference was an opportunity to listen to the voices in our communities which are not often heard,” said Nombrado In her opening remarks, BCNU President Debra MacPherson suggested that our identities cannot be fully understood in isolation. “Who we are is invariably fashioned and refashioned within a complex network of social relations and interactions, as well as through the many social functions and roles assumed by a person throughout a lifetime,” she said.

Our identity is not only shaped by the acts of mutual recognition (or lack thereof) that mark our daily encounters, but also by historical forces that we are seldom conscious of. Jerilyn Webster, a.k.a. J.B. the First Lady, highlighted this fact for participants during her Aboriginal greeting.

A hip-hop artist, beat-boxer, aboriginal youth educator, award-winning actor and member of the of the Nuxalk and Cayauga Nations, J.B. kicked off the conference proceedings with a lyrically spiritual invocation and eloquent reminder to honour and respect the traditional territories and Aboriginal peoples of this place we call home.

Before bringing the room to its feet with beats from her latest single “Get Ready Get Steady,” she invited attendees to greet one another, identify their own nations and by doing so honour their ancestors.

C

omplex historical forces and the hidden narratives of history was the subject of Ali Kazimi’s presentation. Kazimi, a professor of film production at York University and author of the recently published “Undesirables: White Canada and the Komagata Maru,” offered a detailed account of the systematic attempts by the Canadian government to enforce a “whites only” immigration policy up until the 1960s.

Kazimi retold the story of the Komagata Maru, a ship carrying 376 immigrants from British India that was refused permission to dock when it arrived in Vancouver’s harbour in May 1914. He suggested that the

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Voices in our community Conference presentees from left to right: Ari Belathar, Jen Sung, Graeme McCreath.

BCNU President Debra McPherson, Adrienne Burk and Dr. Krista Carle.

Canadian authorities’ response to the presence of the vessel, that included the deployment of the navy, typified Canada’s desire to exclude non-whites.

In response to the ship’s arrival, B.C.’s premier of the day, Sir Richard McBride, wrote, “to admit Orientals in large numbers

would mean in the end the extinction of the white peoples and we have always in mind the necessity of keeping this a white man’s country.”

Kazimi observed that this attitude was not new, but merely an extension of long established colonial policies of the British

Empire that had already resulted in the dispossession and systematic marginalization of indigenous populations across the country.

D participants’ views

What does identity mean to you?

Janice Wendy Vanderspek As a nurse I am an advocate for the rights of all regardless of racial identity, gender identity, sexuality. As a human being I believe it’s a basic human right to live openly, safely and joyfully under the flag that you’ve been born.

You should not be subject to violence, discrimination or judgement based on the colour of that flag.

Feb2013_v6.indd 17

Enimien Elizabeth Aigbomian It is good that these aspects of life have been identified – being able to show who you are and where you come from without necessarily trying to blend in – into a system where eventually there will always be diversity.

Deborah Andreychuk You have to be very aware of where you came from and be at peace with that and continue that and carry that strength and peace with you throughout your life. It’s a constant battle sometimes but it’s just a personal strength that you have to keep believing in yourself.

r. Wendy Roth, an associate professor in the Department of Sociology at the University of British Columbia picked up where Kazimi left off and spoke to the ways in which identities are refashioned as borders are crossed. Her talk, “Crossing Racial & Ethnic Boundaries”, explored the ways in which racial categories define the lives of Latinos in Puerto Rico and the Dominican Republic and how these categories take on new meaning when ascribed to these individuals after they have immigrated to New York.

Roth also offered a fascinating glimpse into the many ways in which our sense of personal identity can be affected by a simple DNA test revealing that our ancestry may be more complex than previously thought. It was a clear reminder that identity borders are constantly shifting.

Conference attendees spent the afternoon in breakout sessions listening to Mexican poet and playwright Ari Belathar, learning about Hula from Dr. Candace Galla, discussing the power of public monuments with Dr. Adrienne Burk, looking at Queer rights with Jen Sung, hearing about the challenges of being a female continued on page 23

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Together in practice BCNU is working towards a cultural shift that respects the indispensable roles of all nurses in healthcare

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Teamwork: it’s critical to any successful group effort. The players on an effective team have welldefined roles and responsibilities and, with the right coaching, are able to coordinate their actions and support each other to achieve the team’s goal.

For nurses on the healthcare team, the goal is the provision of safe, quality care. All nurses have a professional responsibility to support one another in the delivery of care – and BCNU is committed to advocating for our members so they have working conditions that allow this to happen.

Unfortunately, history has often conspired to limit the promise of teamwork.

At one point, registered nurses’ bargaining was carried out by the labour relations arm of the Registered Nurses Association of BC, whose constitution only included RNs. This continued until a 1973 Supreme Court decision forced the separation of bargaining and professional functions for RNs (leading to the formation of BCNU in 1981).

Historically, licensed practical nurses have been represented by a variety of unions, none of which focused primarily on the priorities of nurses.

And unlike RNs, LPNs and RPNs are still wait-

Feb2013_v6.indd 19

ing for an approved regulation under the Health Professions Act – spelling out restricted activities and clarifying their scope of practice. This has often led to confusion regarding what procedures LPNs can carry out independently and has contributed to a lack of clarity about workplace roles and responsibilities.

Employers have often taken advantage of this situation by implementing skill mix changes that often focus on cost cutting by laying off or displacing one category of nurse or the other, depending on budgets.

The Health Professions Act regulatory framework has been undergoing significant reform since 2001, and approved regulations for all nurses should go a long way in helping clarify roles and responsibilities.

Today, the promise of teamwork is greater than ever. Now that 7,200 health authority-employed LPNs voted to join BCNU in 2012, nurses can look

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forward to working more collaboratively in a true team environment that should go a long way to overcoming many of the barriers that have divided nurses in the past.

New nursing regulations will clarify roles and responsibilities

BCNU has always been a determined voice for nurses. The union has advocated that nurses get adequate workplace training and the clinical supports they need to consistently deliver high-quality healthcare services.

And as the government finalizes new regulations that will change nursing practice across the province, we now have another opportunity to press employers to provide those workplace supports.

The government’s draft nursing regulations will introduce long-overdue changes.

While RNs will see minor adjustments to their regulations, RPNs and LPNs will experience significant changes to the regulatory framework of their practice.

Under the changes, RPNs and LPNs will have restricted activities defined – something that RNs and Nurse Practitioners have had since 2005. It’s a model where each professional is accountable for their own practice, and one that will see all nurses become autonomous

practitioners within their scope, individual competencies and employer policies.

These changes have the potential to increase nursing autonomy and clarify workplace roles and responsibilities – and BCNU supports them.

“The LPN regulation is a positive step forward as it supports standardized, autonomous practice,” says BCNU President Debra McPherson. “LPNs will be able to carry out activities, with or without an order, and not require supervision from an RN or other health professional.”

Collaboration and autonomy are important principles for nursing practice

Autonomy and collaboration are important principles that help nurses build practice environments that deliver high quality care.

Autonomy means nurses have the ability to independently deliver healthcare services that are within their scope of practice and individual competencies. To maximize autonomy, employers should invest in continuing education and workplace supports that facilitate nurses working to their full scope. It’s important for employers to implement clinical policies that maximize professional autonomy and clearly define the limits of each practitioner’s responsibility.

Collaboration means nurses should

RNs and Lpns together Vancouver Metro Region welcomes new lpns to bcnu during meet and greet at St. Paul’s Hospital on January 28. From left: BSN Program Camosun Student Charlotte, RN Mark, RN Anna, RN Nadia, RN Jen, LPN Katherine and RN Anna.

Feb2013_v6.indd 20

always feel comfortable seeking assistance from each other and from other health professionals. Again, the employer plays an important role by creating work cultures that encourage the free flow of information, and invest in professional development and clinical supports.

In the past, nursing practice was not always rooted in these principles. The regulation stipulating that RNs had to supervise, and be responsible for the practice of LPNs caused much confusion in the workplace and left RNs uncertain about the limits of their responsibility.

The proposed new regulation removes this requirement and BCNU supports this important change because LPNs have been self-regulating professionals for many years.

At the same time BCNU is concerned whenever employers remove supports available to LPNs as they take on greater responsibilities. For example, reducing the number of RNs available for consultation and support undermines effective teamwork and can put LPNs in potentially risky situations when facing issues that may be beyond their scope of practice.

Making a successful transition

Making a successful transition to the new nursing regulations requires adequate support and training from employers, and clear policies to maximize nursing autonomy.

However, previous changes to LPN practice have not always gone smoothly.

Vancouver-based LPN and BCNU VCHA Council Rep Marlene Goertzen has been nursing for more than 20 years. She says that inconsistent training for LPNs is a common problem that many have experienced.

“Not getting enough workplace training and support is a theme that runs through my entire career,” says Goertzen. “When LPNs were given new responsibilities, we mostly received on-the-job training to perform new procedures and we were rarely, if ever, given mentors to help us integrate new procedures into our practices.”

Goertzen says that many of her past employers didn’t provide LPNs with academic training to better understand the clinical implications of the new procedures they were asked to perform.

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FULL POTENTIAL

LPN-orthopaedic technicians have the training required to work as independent, autonomous members of the healthcare team

“I clearly remember when we were trained to insert and remove catheters, which are sterile procedures. We were trained on the job and didn’t have adequate mentoring so it was tough to gain confidence to perform this new procedure or consolidate it into our practices,” says Goertzen.

“Situations like this caused some LPNs to feel overwhelmed with their new responsibilities because we didn’t have the supports we needed to be confident in our expanded roles.”

Victoria-based LPN and BCNU VIHA Council Rep Barry Phillips agrees.

“When VIHA expected LPNs to begin working to their full scope in 2004, our employers developed a program with academic and clinical components in four areas of our expanding practice: pharmacology, head-to-toe assessments, doctor’s orders and IV therapy,” says Phillips.

“Parts of VIHA’s training template were good, but LPNs didn’t always get consistent clinical support to consolidate those new skills when they needed it.”

Phillips says that during most of his nursing career the type of structured training that VIHA provided in 2004 was an anomaly. It’s more common for LPNs to lack the training and clinical supports they need to confidently integrate new procedures into their practices.

“A lack of workplace support causes some LPNs to feel anxious about working to full scope,” says Phillips. “And anxiety causes nurses to resist expanding their practices. So it’s no wonder there’s a lot of confusion between RNs and LPNs about each other’s practice.”

“For LPNs who’ve been around a while, this is one of the reasons we were determined to join the nurses’ union. We couldn’t improve role clarity while we were in separate unions. But now BCNU gives us all nurses a shared institution where we can clarify our roles and improve patient care.”

It’s clear that Lindsay Gardner and Christie Bert enjoy their work. The two LPN-orthopaedic technicians work at Royal Inland Hospital in Kamloops – and both are proud of the skills they have brought to the healthcare team over the past three years.

The LPN-OT training that Gardner, Bert and other LPNs received is just one example of the workplace education and clinical support that’s needed for nurses to feel fully competent when integrating new procedures into their professional practices.

“Lindsay and I both worked in the ER, saw the amount of trauma there and had an interest in it. So we welcomed the opportunity to go through the program,” says Bert. “Before LPN-OTs were trained, orthopaedic surgeons would apply casts and often be tied up doing that for a good half-hour.”

“The surgeons and the ER physicians love having us because it frees them up to tend to other tasks,” she says. “But they are still available to provide direct supervision if needed.”

“We love the work,” says Bert. “We’re working with a great group of nurses and the surgeons value us – and that makes it a really fun job.”

The work of LPN-OTs like Gardner and Bert is a good example of the post-basic work that LPNs are currently carrying out throughout BC – so BCNU was

AUTONOMOUS PRACTICE Royal Jubilee Hospital LPN-orthopaedic technician Scott Kennedy demonstrates casting in the hospital’s ER.

continued on page 22

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Full Potential continued from page 21

surprised that this restricted activity was not included in the Ministry of Health’s proposed changes to the LPN regulation.

“We’re not sure why the activity of casting has not been included in the proposed new regulation,” says BCNU President Debra McPherson, who adds that the College of Licensed Practical Nurses of BC should develop standards, limits and conditions for the restricted activity.

McPherson says that BCNU has requested the inclusion of casting in the union’s submission to the Ministry of Health, and notes that while the proposed changes to the LPN regulation should go some way to giving LPNs more autonomy in their practice, the changes generally speak to entry-level competencies.

For nurses with additional education like Gardner and Bert, the proposed changes to the LPN regulation lack sufficient clarity and do not reflect the autonomy that these nurses have already been exercising in their daily practice.

“The fact that the work of LPNs with standardized, credentialed post-basic education is not fully captured in the new regulation speaks to the unevenness of LPN practice throughout the

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province,” says McPherson, noting that the nurses’ union will continue to advocate for more standardization of post-basic LPN education so that new competencies are recognized within the workplace and from employer to employer. “In addition to standardized LPN-orthopaedic technician training, there should be training for LPNs who want post-basic competencies in Dialysis, Peri-operative, Peri-natal care,” she says.

McPherson adds that training in post-basic areas of practice should be credentialed so the expanded competencies are recognized inside and outside the province, allowing LPNs to transport recognized competencies from employer to employer.

Gardner agrees, and feels that standardized, credentialed training will

LPN-OT training is just one example of the workplace education and clinical support that’s needed for nurses to feel fully competent when integrating new procedures into their professional practices. go a long way to help LPNs integrate their practice into a restricted activities model. “It means that everybody is on the same page knowing who can do what and with what guidelines,” she says. “Not having this had always caused a grey area for both RNs and LPNs working together and we were not always sure who could do what.

The fact that they are working on this [restricted activities] model of care is a good thing.” update

Together in Practice continued from page 21

Consistency in nursing practices will improve role clarity and collaboration

Goertzen also describes a lack of consistency in LPN practice within facilities and from employer to employer. In some places LPNs are encouraged to work to full scope and in other units LPN activities are restricted.

This frustrates professional cooperation because nursing collaboration is rooted in a shared understanding of each professional’s limits and competencies. The lack of consistent LPN practice causes confusion and patient outcomes are not optimized.

For Helena Barzilay, an RN in dialysis at East Kootenay Regional Hospital in Cranbrook, clarity and consistency are paramount.

“Employers need to change how they’re doing business,” she says. “We have a medical floor here where an RN and LPN are responsible for 10 patients, but the RN is in charge and the LPN is not given the autonomy to be in charge of their own patients, and that’s not right.”

“And it also depends on what floor you’re on. On some floors LPNs do have their own patients and on others they are not recognized and not allowed to practice to their full scope – it’s confusing for everyone.”

Barzilay feels the proposed new regulation moving LPNs to the restricted activities model provides the framework for a shared understanding of nursing practices.

“LPNs will know exactly what they can and can’t do – and others will know too,” she says.

She is also happy that BCNU will advocate for all nurses to get the academic training and clinical support they need to confidently work to their full scope of practice.

“LPNs have been underutilized in dialysis and I have been pushing for them to be involved in this area for the past 10 years,” she says. “In Alberta dialysis is mostly performed by an LPN with an RN

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as a clinical leader. Many of the procedures are technical and within the scope of LPN practice. But we don’t have RN-LPN teams in BC like they do in Alberta, who have been doing it for years.”

Barzilay says that the proposed regulatory changes and health authority-employed LPN’s move to BCNU is good timing – and will go a long way to improving nurses’ long-term relationship in a collaborative profession.

“Before LPNs came to BCNU they were often told they would not be allowed to practice at full scope. But it makes sense for all nurses to practice at full scope once they have clearly defined roles,” she says.

For BCNU’s leadership, the recent changes are the culmination of years of advocacy and organizing towards creating stronger, more powerful and united nurses who are valued and respected in the workplace.

“It’s all about advocacy for the diverse body of nurses, better contracts, stronger representation and improved practice conditions,” says McPherson. “BCNU is working towards a cultural shift that respects the powerful and indispensable roles of all nurses in healthcare, regardless of the area within nursing in which they work.”

Regional Educational will start BCNU’s discussion on collaborative, autonomous practices

BCNU is taking concrete steps to advance the discussion on nursing collaboration and autonomy. This winter’s Regional Educational gives members a forum to discuss how we will move forward together and navigate the changes we’re experiencing in our workplaces.

The educational will help nurses understand the implication of the proposed nursing regulations and build strategies to foster collaboration in their relationships. It will also help RNs and RPNs understand how their new contract will help better manage workload with its call for additional staff to improve nursing care.

More details about the educational are at BCNU’s online event calendar at BCNU.org. update

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crossing identity borders continued from page 17

police officer with retired RCMP constable Krista Carle, exploring the human rights of the blind with Graeme McCreath, and gaining an insight into Aboriginal identity and rights with Cree-Metis lawyer Dr. Tracey Lindberg.

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r. Jack Halberstam closed the conference with a brilliant romp through the shifting landscapes of marriage, sex, sexuality and gender norms. In a talk entitled “Gaga Feminism: Sex, Gender and the End of Normal”, Halberstam, a professor of English and Director of The Center for Feminist Research at University of Southern California, argued for the deconstruction (or more appropriately, the explosion) of “normal” when it comes to our received ideas about sex and gender. For Halberstam, the expression “Gaga Feminism” is an homage, in part, to Lady Gaga whose playful undermining of sex and gender norms are to be celebrated, but also to “gaga” as in crazy or wild. Thus, Gaga Feminism becomes “a new kind of gender politics for a new generation, a generation less bound to the romance of

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permanence (in the form of marriage, for example), more committed to the potential of flexibility (in the form of desire, for example), more tuned in to the fixity of power relations (in the form of capitalism).” It was an exhilarating conclusion to an engaging and challenging day.

“The conference atmosphere allowed for open discourse between various groups and participants, finding common ground and, in a sense, belonging,” said Nombrado. “Often we forget, make assumptions, and close ourselves off from truly relating and understanding others on a human level. I would encourage other BCNU members to attend this conference because it’s an opportunity to be oneself, and relate to others on a level which is human at its core.” update

Allies across borders Below from left to right: BCNU Executive Councillor Marg Dhillon, Ali Kazimi, Simon Fraser Region co-chair Debbie Picco. Right: Dr. Jack Halberstam.

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PRFs

in the workplace

PRF SUCCESS: PERSISTENCE PAYS OFF AT POWELL RIVER GENERAL HOSPITAL

final straw ER nurse Andi Hagen’s PRF was one of dozens filed at Powell River General Hospital since 2006.

Persistence is key when it comes to using Professional Responsibility Forms to address nurses’ safety, professional and practice concerns.

This fact was made evident with Vancouver Coastal Health Authority’s recent approval of funding for a second fulltime critical care nurse in the Powell River General Hospital Emergency Room. The decision was the result of years of concerted effort on the part of frustrated nurses working there.

ER nurse Andi Hagen’s PRF was the proverbial straw that broke the camel’s back. His was the culmination of at least 26 PRFs that have been presented

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to hospital administrators since 2006 regarding the ongoing large volume of high acuity patients being cared for in the ER due to low staffing.

When Andi filed his PRF, both the ER and the ICU were overflowing with admitted critical care patients. There was only one nurse in each department – and both needed assistance to safely care for patients with their workload.

Unfortunately, that assistance wasn’t forthcoming.

“A lot would be going on at night,” says Hagen. “The float nurse would often be pulled to maternity – so we had no one to call. We couldn’t stop and leave the bedside to go and call for

help from anyone. We couldn’t even call the bedside alarm button because no one would come and answer it.”

According to BCNU Steward Coordinator Liz Young, ER nurses were sharing a hospitalwide float nurse with the hospital support staff for meal break coverage – but breaks were not possible because this nurse was so busy attending to workloadrelated needs they were unavailable to provide relief in ER. The hospital’s initial attempts to address these workload challenges were not adequate.

Administrators responded to initial PRFs by posting an evening shift in the ER that would add coverage to address high demand times. Unable to fill the position, they converted it to a daytime acute care educator position.

Untenable workload condi-

improvement, and they did a great job,” says Hagen. “But clinically things were still not great – we were spending a significant amount of our time at the computer, sending faxes and doing orders when the whole point was that things were getting so busy there was a danger of us getting overrun and missing things.”

Hagen’s PRF was heard in Committee in 2010 and a meeting with hospital COO Wendy Hansson was held in 2011. At the time management was resistant to considering putting a second nurse in ER and Hagen recalls that it was difficult to get them to acknowledge the challenges that one nurse was facing working nights.

“The ER was difficult to quantify for management,” he says. “They’d look at acuity and hours and traffic times and say

We were spending a significant amount of our time at the computer, sending faxes and doing orders. There was a danger of us getting overrun and missing things.

”

tions remained and nurses persisted in filing PRFs. The hospital’s next attempted solution came in 2009 – when it hired ambulance attendants to staff the ER with the RN during the day and keep a second RN on duty for an additional four hours in the in the evening.

This did ease the situation somewhat, but in the end the conditions Hagen described still occurred. “Having the ambulance attendants was an

that only six people were coming in after midnight. But what they weren’t seeing were the four or more people who were there all day and also staying overnight in ER.” According to Hagen, managers were not paying enough attention to these issues and simply looking at acuity. They were initially not willing to hire a second 24/7 nurse and argued that budget constraints were limiting their ability to act.

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“We anticipated this and approached the issue on the basis of standards of care that we were not meeting,” says Hagen. “We said that in BC employers cannot run an open gas station at night with only one person because it’s deemed unsafe. We asked them how they can run an ER that’s the front door of the hospital, where the doctor is sleeping in a different room, and they’ve got patients on beds and one solitary nurse with a truckload of narcotics in a cupboard with a little key on it? That simply will not stand. ” Hospital administrators conferred with VCHA management later in 2011 and announced that a second nurse 24/7 in the ER would be hired in November 2012. As this issue of Update goes to press, the second position will have been in place for 10 weeks.

Young and Hagen say that the decision is a victory that needs to be reviewed and monitored.

“This change is the result of the perseverance of all the nurses who presented these PRF’s,” says Young.

“At times it was very discouraging when the plans for improvement were vague and lacking timelines.”

Young is optimistic that the stronger PRF language in the new Nurses Bargaining Association provincial contract means the future PRF processes will result in faster outcomes.

“We got a positive result and showed the PRF process can work,” says Hagen. But he warns that decisions like this one can also result in restructuring in other areas of the hospital, and says it’s necessary to be vigilant.

“Don’t forget to file your PRF,” is Hagen’s message to other nurses.

“Keep chipping away at problems.

It’s a standard of care issue. We all know this. It’s something we should be doing as an advocacy measure.” update

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taking the mystery out of prf committees This is the fourth instalment of a five-part series aimed at helping members demystify the Professional Responsibility Form process. “Ensuring A Respectful PRF Committee Process” explains how to ensure a respectful collaborative problem-solving committee process. The ongoing PRF series explores a wide range of topics including “My Role On The PRF Committee”, which will appear in the next Update. For more PRF information, visit bcnu.org or contact your BCNU worksite steward or regional chair.

ensuring a respectful prf committee process

Usually our PRF Committee meetings go fairly well, but occasionally, there are problems with disrespectful behaviours.

Sometimes nurses talk over managers, or the manager interrupts the nurse in the middle of her presentation. How can we ensure things stay respectful and productive at the meetings?

Sometimes the work you do before the meeting is as important as the meeting itself.

Co-chairs should work at developing their own relationships first through the adaption of Terms of Reference (TORs) for the committee, setting of climate goals, clarifying expectations of roles and

exploring assumptions.

Co-chairs should educate members and managers about the process in advance. They need to focus on the principles (what the forum is for) and process (how things will go) to set expectations for all involved.

At the beginning of the meeting the Co-chairs need to orient everyone present to those same expectations. Review the TORs, climate goals and the agenda and check in that everyone is comfortable before proceeding.

If disrespectful behaviours begin to emerge, anyone in the meeting can and should “call” the behaviour. It is also the Co-chairs’ responsibility to do this. This should be done in a direct but respectful way.

If you anticipate a highly charged environment, consider meeting with the individuals in advance to discuss the process and expectations. In the meeting, acknowledge that the topic is controversial or emotional and reframe the conversation around the issues, not the people. update

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Learning & Development

education for members

communicating at work LINKING EFFECTIVE COMMUNICATION WITH STRONG PROFESSIONAL PRESENCE Internationally educated nurses practise skills to overcome barriers In the workplace

“A reflective practitioner… demonstrates confidence, integrity, optimism, passion, and empathy, in accordance with professional standards. This includes…verbal and nonverbal communications and the ability to articulate a positive role and professional image.”

CRNBC definition of professional presence

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Professionals present Communicating at work participants, from left to right: Nazanin Barati, Ju (Judy) Xiao, Julia Gilaev, Pannarasee Wishit, Chungung (Greg) Li, Balwant Grewal, Zenaida Ong, Pei Hong (Enya) Xu, Michelle Omengan, Qian (Jenny) Zhang, and Maria Corazon Asiain.

The twelve enthusiastic internationally educated nurses who found themselves at BCNU’s Burnaby office last November for the union’s six-week Communicating at Work course, had not given much thought to the concept of professional presence. They were there to improve their communication, to hone a few techniques, improve their pronunciation and use filmed role-plays to simulate the challenges of communicating effectively in an increasingly hectic workplace.

As the weeks unfolded and

the role-playing became more challenging, what became clear to all the participants – whose countries of origin ranged from Israel to Iran to China – was that effective communication was intimately linked to the strength of their professional presence.

If you plug the words “professional presence” into a search engine you’re likely to discover a thriving world of life coaches, self-help books, business articles and workshops, all of which appear to suggest that a polished “professional presence” can accelerate a career path.

Add the word nurse or nursing to your search and you’ll encounter various standards of practice documents put out by colleges of nursing across Canada. In its document on “Competencies in the Context of Entry-level Registered Nurse Practice in British Columbia”, the College of Registered Nurses of British Columbia (CRNBC) notes that nurses’ competency of professional responsibility and accountability can be achieved if they “demonstrate a professional presence and model professional behaviour”.

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Easier said than done.

For the newly minted nurse about to step through the doors of the hospital on her first day of work, professional presence might look like a nicely ironed uniform, a new stethoscope, and a name tag that identifies her as an employee. But the learning curve is steep: There are a thousand new policies, procedures, protocols and techniques to learn and new scenarios to make sense of.

Judy Boychuk-Duchscher, author of “From Surviving to Thriving: Navigating the First Year of Professional Nursing Practice”, describes this stage of the nurse’s career as “transition shock”, and notes that the first three to four months of a new nurse’s work experience is “An exercise in adjusting and adapting to, as well as accommodating what they find in the realities of their new work, professional and life worlds. For the new graduate, there is little energy or time to lift their gaze from the very immediate issues or tasks set before them, and their “shock” state demands a concerted focus on simply “surviving” the experience without revealing their feelings of overwhelming anxiety or exposing their self-perceived incompetence.

The workplace experience of an internationally educated nurse (IEN) closely approximates that of the newly graduated nurse. For the IEN the adjustment and adaptation is not only to the unique culture of nursing and healthcare within their work environment, but also an ongoing process of acclimation to the culture of a new country and the grammar, syntax and vocabulary of a new language.

Communicating at Work participants were able to reflect critically on the strength of their professional presence during the course. Viewing video clips of themselves in various clinical role-playing exercises and receiving feedback from their peers and instructors is one example of this six-week iterative process that gives the course its transformative potential. update

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OVERCOMING BARRIERS IN THE WORKPLACE Three IENs who participated in BCNU’s recent Communicating at Work course share their thoughts.

What has been the most challenging part of the transition from working in your country of origin to working in Canada?

Having to prove yourself as a professional and gaining the respect of your colleagues is a challenge – as was adjusting to different nursing procedures. Working through the CRNBC registration process helped prepare me for working in BC – but it also comes with its own challenges for IENs. Nazanin Barati, RN

Country of Origin: Iran Graduated: 2003 Working in Canada since 2010 Workplace: Vancouver General Hospital (Critical Care Unit)

Why would you recommend this course to other internationally educated nurses?

Words are just one part of language. When we communicate it’s with our whole body. The filmed roleplaying exercises are really helpful for developing this awareness. This was a valuable personal experience that helped me become more aware of my strengths and what I can improve.

What has been the most challenging part of the transition from working in your country of origin to working in Canada?

The language barrier – communication is the key to an easier transition – for example accent is challenging. We are a multicultural team with workers from many different countries and sometimes it’s hard to understand each other.

Julia Gilaev, RN

Country of Origin: Israel Graduated: 2002 Working in Canada since 2011 Workplace: Palliative Psychiatric Unit Richmond Hospital

Why would you recommend this course to other internationally educated nurses?

It’s important to share your fears with other participants and meet people facing the same challenges.

It is important to see that you are not alone and that there are many other IENs facing the same issues that you can build relationships with.

What has been the most challenging part of the transition from working in your country of origin to working in Canada?

English is not my first language and pronunciation is a challenge – particularly telephone communication.

I will use face-to-face communication whenever possible to ensure that my colleagues understand me.

Why would you recommend this course to other internationally educated nurses?

Jenny Zhang, LPN

Country of Origin: China Graduated: 2006 Working in Canada since 2006 Workplace: Madison Care Centre (Residential Care), Coquitlam

It’s important to learn about and appreciate cultural differences. For example, in Western culture eye contact is very important. Eye contact shows respect.

In my culture, making direct eye contact can be seen as disrespectful. You’ll also learn valuable skills. For example, good listening skills are important in helping reducing workload stress.

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BCNU Strategic Plan October 2012 for the year 2013 The Planning Document The Planning Context The Planning Context section provides a ‘snapshot’ description – or an ‘environmental scan’ – of the organization. A process called the ‘SWOC’ (Strengths, Weaknesses, Opportunities and Challenges) Analysis was used to situate the organization within the current strategic planning process by identifying internal strengths and weaknesses, and external opportunities and challenges. The outcome of this process was the articulation of the organization’s current state of affairs.

In 2011, the Balanced Scorecard Perspective was introduced to determine how the Objectives defined by the organization measured up in four areas – Financial, Members, Union Processes and Learning and Growth. As well, emphasis was placed on establishing measurables (i.e. what would demonstrate that success was reached) and measures (how could that evaluation be made).

It was recognized that the top two priorities for 2012 were: 1) Collective Bargaining and 2) the LPN initiative. The length of both efforts continued through to October 2012. As a result, many other items on the Operation Plan were deferred until their completion and are re-introduced in the current plan.

BCNU made significant gains in bargaining 2012 specifically

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in workload language, and a required increase in nursing FTE’s positions. Those gains will impact nurses’ work life in a positive way. It will be up to us to rigorously enforce these gains.

An historical vote bringing the majority of British Columbia’s LPN’s into our union will change the face of our union. We eagerly embrace this opportunity.

Nurse + Nurse One province. One profession. One union

Vision An organization’s vision is a short, inspirational and futurefocused statement of where the organization sees itself in the future. The statement must reflect an ideal based on what is realistically achievable and typically reflects a 5-10 year time frame.

Mission The mission statement reflects the current mandate of the organization.

Values The organizations’ values – and corresponding statements – provide members, staff and Council with behavioural descriptions of how the organization’s core values may be lived within the BCNU.

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Strategic Directions The strategic directions reflect the main priorities of the organization. Strategic directions are formulated with input from the SWOC Analysis and Council and support the mission.

Objectives Objectives are statements that articulate – at a high level – how the strategic directions will be realized throughout the organization.

Desired Organizational Outcomes The desired organizational outcomes are broad, high-level statements that reflect what the organization (Council) would like to see as result of the implementation of the objectives.

Measurables How would we know success was reached?

Measures How can we evaluate our successes?

The Planning Context As we continue to grow and succeed, our capacity is the foundation for this work. Our members are our number one priority, and we must ensure our internal capacity is adequate to meet their needs. To advocate and bargain successfully, to represent more members effectively, and to campaign with impact, we must have the human and financial resources required. And moreover, we have a duty to live our values: to build effective and collegial working relationships with each other, with staff and with partners; to serve with honesty, integrity and compassion; and in all things, to be driven by the priorities and needs of our members. Our working environment challenges us to achieve these goals in many ways, including rapid technological change; ever-increasing workload; an increasing shortage of skilled workers; and an ever more culturally diverse population. To succeed, we must not only adapt; we must anticipate, learn, innovate, communicate and regularly attend to the relationships that are at the heart of our success.

The British Columbia health care workplace is increasingly characterized by changing work roles, new models of care delivery, and a decrease in registered nursing jobs. At the same time, the health care workforce is aging, and demographic trends indicate that even with significant reliance on internationally educated professionals, we will be increasingly challenged to retain an appropriately trained and equipped workforce. For BCNU to survive, thrive, and excel at representing the interests of its members and their communities,

Feb2013_v6.indd 29

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it must ensure that it not only includes an increasingly diverse membership, but that it engages, educates and serves them.

To do so requires a larger membership and a more engaged membership, both of which will also contribute to Strategic Directions 2 and 3 by strengthening our collective voice.

Changes in licensure in BC health professions have created a gap in support for professional practice maintenance and enhancement. This gap represents a continuing opportunity for BCNU to expand its services and appeal not only to our members but to other colleagues in the health care workforce through organized drives and campaigns.

Poor working conditions will not be tolerated, and despite considerable gains made by BCNU during the past year, significant challenges remain in areas of workload, work-life balance and workplace safety. Systemic budget pressures result in displacements, layoffs, demands for excessive overtime, assignments without adequate education and training, and similar challenges that put both nurses and their patients at increased risk. Our members continue to report alarming threats to their personal health and safety while at work, and violence is being experienced at an increasing rate. BCNU must continue to act, and must equip members to take action as advocates and activists.

We also recognize that resolution of these issues requires renewed government commitment, the support of employers, assertive bargaining objectives, and implementation of new contract language. As the scope of certifications grows to include more non-nurse members, we must also recognize that the system still often fails to compensate health care workers commensurate with the value of their work. Thus we must continue to bargain for enhanced wages, benefits and working conditions for all our members, and then be vigilant to ensure that the full benefits and intentions of new contract language are achieved and safeguarded.

Canada’s publicly funded and publicly delivered health care system is known to be one of the best in the world, but it continues to be eroded. There is a growing proliferation of private health services, some of them entirely privately funded and others offered within public settings. Continuing to be impacted by the 2008/09 global economic downturn, pressures are increasing to offload delivery of publicly funded services to this growing sector. These trends represent an erosion of the Canada Health Act and compromise the values and social safety net that Canadians consider so important. These trends also are fundamentally at odds with BCNU mission and values.

Given our analysis of the policy platforms and priorities of the current provincial and federal governments, it is imperative

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30 that BNCU continues to act effectively to protect the public and BCNU members from efforts to further erode public health care. To be successful, we must ensure that we are recognized and effective as a significant voice in the public policy arena with respect to health care issues.

and accomplished for the betterment of the whole.

•

the BCNU demonstrates Democracy by actively engaging our membership through egalitarian processes where equal rights to both representation and involvement are guaranteed.

•

the BCNU demonstrates Equality by ensuring that each member has access to all services of the BCNU.

•

the BCNU demonstrates Excellence by incorporating best practices throughout the organization when responding to and supporting our members.

•

the BCNU demonstrates Integrity by being honest, respectful, accountable and transparent.

•

the BCNU demonstrates commitment to Social Justice by advocating and promoting that the social determinants of health be equally accessible to ensure the dignity of every human being.

•

the BCNU demonstrates Solidarity by promoting unity of our members based on shared goals and values.

Vision The BCNU shall be recognized as a champion for improved work life, health and economic status for our members, and as a leading advocate for the publicly funded health care system.

Mission The BCNU protects and advances the health, social and economic well being of our members and our communities.

Values The seven Core Values listed below support the vision and mission of the BCNU and reflect key behaviours that guide our daily actions.

As a member-driven organization: •

the BCNU demonstrates Collectivity by acting together to make certain that all activities and decisions are inclusive

Strategic Direction One Increase BCNU’s capacity to respond to our number one priority, our members.

Objectives

Desired Organizational Outcomes

1.1 Increase knowledge of, and response to members priorities

Increased member satisfaction

1.2 Enhance member participation in the electoral processes of BCNU

Stronger member participation

1.3 Implement best practices across the BCNU organization

Enhanced effectiveness and efficiency in responding to our member.

1.4 Provide consistent, high level representation of members (from staff and stewards)

Increase in member satisfaction.

1.5 Increase member engagement in BCNU

Increase in member understanding of what the Union is doing and empowerment to take action for themselves and others

1.6 Increase involvement of our diverse membership in BCNU

Increase connection with our diverse members

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Adherence to Collective Agreement language and gains

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Strategic Direction Two Enhance the socio-economic status, work-life balance, and workplace safety of our members.

Objectives

Desired Organizational Outcomes

2.1 Ensure that BCNU members remain employed as BCNU members in unionized health care jobs.

Retain the members we have employed in BCNU worksites

2.2 Implement bargaining gains

Educated members Educated members on Collective Agreement changes Active stewards monitoring and enforcing collective agreements Committees established as required by Collective Agreement

2.3 Improve members’ personal health and safety in the workplace and promote improved work-life balance

Safe worksites and healthy members

2.4 Safe staffing for safe patient care.

Implementation of ratios and other solutions as identified in bargaining priorities

2.5 Achieve substantial bargaining gains for new members

Move members into the NBA

Strategic Direction Three Engage the public and members to champion and improve our publicly funded and delivered health care system and protect it from further erosion.

Objectives

Desired Organizational Outcomes

3.1 Increase members and public knowledge of the benefits of publicly funded health care delivery.

Members and the public engaged in successful campaigns to maintain services

3.2 Enhance public recognition of BCNU as a respected voice on issues affecting social determinants of health

Increased voice, opinion and input into discussions and decisions on healthcare

3.3 Ensure the voice of nurses has a unified message regarding public healthcare delivery

Consistent strong messaging supporting public healthcare

Strategic Direction Four Increase our Membership.

Objectives

Desired Organizational Outcomes

4.1 Organize more nurses and more non-nurse members

Increased membership

4.2 Promote our professional profile and outreach to nurses and other healthcare workers and professionals

Greater union density

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Council Profile Here’s Who’s Working For You

LIFELONG ACHIEVER interior health LPN REP janet ELIZABETH van doorn Empowering Members

Nurses make a huge of difference. It’s important to take pride in nursing and be proud of helping others,” says Interior Health LPN Representative Janet Elizabeth Van Doorn.

quick facts Name Janet Elizabeth Van Doorn.

Graduated College of New Caledonia in 1977. Union Position Interior Health Authority LPN Representative Why I support BCNU Because of its strong member advocacy and promotion of professionalism in nursing.

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Janet Elizabeth Van Doorn hadn’t always planned on becoming a nurse. The newly-elected Interior Health LPN Rep on BCNU Council was studying to be a teacher when she caught the nursing bug.

“I was living in Prince George and friend told me about a year-long nursing course I could take that would allow me to work as a nurse during the summer – I liked it so much I never went back to teaching.”

The decision was a good one.

Van Doorn has been a strong advocate for nurses since the beginning of her career. Her commitment to advancing the professional profile of licensed practical nurses was recognized last year when she received the College of Licensed Practical

Nurses of BC’s 2012 Excellence in Lifetime Achievement Award.

Van Doorn became active in the Licensed Practical Nurses Association of BC early in her career after moving to Peachland with her young family.

She served as President of LPNABC from 1995 to 2000 and says she spent a lot of time travelling the province during this period reaching out to other LPNs. The LPNABC grew from 150 to 1,000 active members under her leadership.

Van Doorn also served two three-year terms on the Board of the CLPNBC. Her work on CLPNBC’s Nursing Practice Committee allowed her to advance policy recommendations promoting the skills,

expertise, and utilization of LPNs in healthcare.

Van Doorn says she enjoys developing policy and using her leadership position to influence lawmakers. While at the LPNABC she was responsible for preparing submissions to the BC Health Profession’s Council and Saskatchewan’s Dorsey Commission on union jurisdiction in healthcare.

It was during her time on the Kelowna General Hospital Nursing Practice Committee that Van Doorn realized the importance of moving LPNs into the Nurses Bargaining Association. “LPNs didn’t have success convincing the province that they needed to move to the NBA until we started working with BCNU,” she says, noting that her union at the time was also opposed to the move.

Van Doorn has enjoyed working with other nurses on professional issues throughout her career and feels it’s important for nurses to provide leadership to one another and their profession. “You have to know the rules, have your information and come prepared to speak up while respecting others’ opinions,” she says when asked what makes an effective Council member.

Van Doorn is excited about her new position on BCNU Council. “I’m hoping to help all LPNs get to know their new union and get enthusiastic, involved and proud of their profession,” she says. update

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Who Can Help?

BCNU is here to serve members

regional reps Vancouver Metro Colette Wickstrom Chair C 604-789-9240 cwickstrom@bcnu.org

BCNU CAN. Here’s how you can get in touch with the right person to help you.

Coastal Mountain Kath-Ann Terrett Chair C 604-828-0155 kterrett@bcnu.org

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.

Central Vancouver Judy McGrath Co-Chair C 604-970-4339 jmcgrath@bcnu.org

executive committee

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

PRESIDENT Debra McPherson C 604-209-4253 dmcpherson@bcnu.org

executive councillor Marg Dhillon C 604-839-9158 mdhillon@bcnu.org

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

executive councillor Deb Ducharme C 250-804-9964 dducharme@bcnu.org

LPN reps

Diane LaBarre Co-Chair C 604-341-5231 dlabarre@bcnu.org Shaughnessy Heights Claudette Jut Chair C 604-786-8422 claudettejut@bcnu.org RIVA Lauren Vandergronden Chair C 604-785-8148 laurenvandergronden@bcnu.org Simon Fraser Liz Ilczaszyn Co-Chair C 604-785-8157 lilczaszyn@bcnu.org Debbie Picco Co-Chair C 604-209-4260 dpicco@bcnu.org

fraser health Jonathan Karmazinuk C 604-312-0826 jonathankarmazinuk@bcnu.org

providence Steven Roth C 778-870-7328 stevenroth@bcnu.org

interior health Janet Elizabeth Van Doorn C 778-214-4798 janetvandoorn@bcnu.org

vancouver coastal Marlene Goertzen C 778-874-9330 marlenegoertzen@bcnu.org

South Fraser Valley Cheryl Appleton Co-Chair C 604-839-8965 cappleton@bcnu.org

northern health Louise Weightman C 250-639-6436 louiseweightman@bcnu.org

vancouver island Barry Phillips C 778-679-9737 barryphillips@bcnu.org

Lisa Walker Co-Chair C 604-880-9105 lisawalker@bcnu.org

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Fraser Valley Linda Pipe Chair C 604-793-6444 lpipe@bcnu.org West Kootenay Lorne Burkart Chair C 250-354-5311 lorneburkart@bcnu.org East Kootenay Patt Shuttleworth Chair C 250-919-4890 pshuttleworth@bcnu.org North West Sharon Sponton Chair C 250-877-2547 sharonsponton@bcnu.org North East Jackie Nault Chair C 250-960-8621 jacquelinenault@bcnu.org Okanagan-Similkameen Laurie Munday Chair C 250-212-0530 lmunday@bcnu.org Thompson North Okanagan Tracy Quewezance Chair C 250-320-8064 tquewezance@bcnu.org South Islands Adriane Gear Co-Chair C 778-679-1213 adrianegear@bcnu.org Margo Wilton Co-Chair C 250-361-8479 mwilton@bcnu.org Pacific Rim Jo Taylor Chair C 250-713-7066 jtaylor@bcnu.org

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Off Duty members after hours

GIVING BACK BURNABY HOSPITAL OR NURSES kathy bonitz and shelley mceachern ARE JOINING A MEDICAL MISSION TO ECUADOR Kathy Bonitz is fulfilling a dream. This winter the Burnaby Hospital OR nurse is travelling to Ecuador to help perform hip replacements for the poor.

Bonitz has joined the Canadian Association of Medical Teams Abroad 2013 mission to the South American country. She is part of a cohort volunteering there from February 22 to March 4.

CAMTA was formed in 2001 by a small group of Edmontonbased healthcare practitioners and lay people who had been on previous medical missions to Ecuador. They provide orthopaedic surgery to pediatric and adult patients and to provide continuing education on detection and treatment practices for medical personnel in Ecuador.

This year the CAMTA team will perform at least 80 surgeries over 20 days.

Ecuador has a high incidence of hip dysplasia, a birth defect that can cripple a person by age 30. Poverty and limited access to medical assistance often means people with this condition live with pain and limited mobility their entire lives.

CAMTA has sent growing numbers of volunteers to

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Ecuador. The teams include pediatric and adult orthopaedic surgeons, anesthesiologists, family doctors, physiotherapists, nurses, residents, nursing and medical students, lay people and translators.

This year’s mission will be Bonitz’s first time participat-

ing in CAMTA, but she has been aware of the group’s work for some time. “I first heard of CAMTA about 10 years ago at an OR conference in Banff.”

She says a speaker presented on a CAMTA mission and she thought, “I would love to do that.”

She was reminded of CAMTA’s work again at last year’s BCNU convention when Canadian Federations of Nurses Unions Secretary-Treasurer Pauline Worsfield mentioned that she just returned from Ecuador. “I thought the time was right [to participate]. I’m coming to end of my career and if I don’t do this soon I’m never going to do it,” says Bonitz.

TEAM EFFORT Burnaby Hospital OR nurses Kathy Bonitz and Shelley McEachern are looking forward to participating in the Canadian Association of Medical Teams Abroad 2013 mission to Ecuador.

On learning the 2013 mission was short of OR nurses, Bonitz encouraged one of her colleagues to join her. Shelley McEachern recently retired from her position as Assistant Head Nurse of Orthopedics at Burnaby Hospital. “I’m thrilled we are both going,” says Bonitz.

“It’s a real plus to get Shelley to come. She’ll be fantastic with her many years experience as charge nurse of Orthopaedics.”

CAMTA team members volunteer their time and expertise and raise the necessary funds to cover their travel and living expenses. Everything they raise above that amount helps pay for medical and surgical supplies and equipment needed for the mission.

Bonitz’s participation in CAMTA is a reflection of her values. “I really value the accessibility of Canada’s healthcare system and I am staunch defender of it,” she says. “These Ecuadorian patients would likely not have access to surgery if we weren’t going.”

She also likes the idea of sharing her knowledge and expertise with other health professionals – especially in a country as poor as Ecuador.

However, she’s quick to note that the experience is reciprocal. “We can also learn from them. I don’t just think I’m going there to give them something – I know I’ll get tons back.”

“CAMTA is an amazing organization,” says Bonitz. “I encourage other nurses to consider participating in a mission.”

For more information visit: www.camta.com. update

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