BCNU Update Magazine July-Aug 2015 by BC Nurses' Union

JULY/AUGUST 2015

ADVOCATING FOR COMMUNITY NURSES: CDMR SUCCESS: MOBILE TECHNOLOGY CAN ADOLESCENT NANAIMO NURSES REACH PSYCHIATRIC SERVICES STAFFING AGREEMENT IMPROVE PATIENT CARE

UPDATE BRITISH COLUMBIA NURSES’ UNION

BCNU RALLIES FOR SAFE PATIENT CARE ASBESTOS: THE HIDDEN KILLER

NURSES’

VOTES WWW.BCNU.ORG

COUNT There’s a lot at stake in this year’s federal election. Nurses have the votes – and the voice – to make a difference.

VANCOUVER

PRIDE PARADE

AUGUST 2, 2015

Walk with the BCNU bus or volunteer at the BCNU Pride booth at Sunset Beach where we will be testing blood pressure and blood sugars after the parade.

Contact Frances Beswick for more information: f.m.beswick@gmail.com Facebook event: BCNU Marches With Pride 2015

UPDATE MAGAZINE July/August 2015

UPDATE

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CONTENTS vol 34 no3

july/august 2015

UPFRONT

Check In

News and events from around the province.

12 Adolescent Psych Unit Crisis

Fraser Valley youth are in desperate need of mental health services.

14 Back to the Bedside

Nanaimo nurses reach breakthrough staffing agreement.

18 The Hidden Killer

Asbestos in old and aging facilities is a growing concern.

32 Disconnected Care

Paperwork has community nurses calling for mobile technology to improve patient care.

34 PRFs Work

St. Paul’s Hospital Coronary Intensive Care Unit nurses secure better baseline staffing.

DEPARTMENTS

GRAND OPENING BCNU Vice President Christine Sorensen and President Gayle Duteil cut the ribbon to officially open BCNU’s new member education centre on June 11. Read about the big day on page 9.

5 PRESIDENT’S REPORT 36 HUMAN RIGHTS & EQUITY 39 MEMBER PROFILE 40 WHO CAN HELP? 41 COUNCIL PROFILE 42 OFF DUTY

FEATURE

NURSES’ VOTES COUNT

Health care is the number one issue ahead of this year’s federal election. Nurses’ have the votes, and the voice, to make a difference

Before you vote Read about key issues in the federal election on p. 31

MOVING? NEW EMAIL?

BC Nurses’ Union

UPDATE MAGAZINE

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 43,000 members. Signed articles do not necessarily represent official BCNU policies. EDITOR Lew MacDonald CONTRIBUTORS Juliet Chang, Laura Comuzzi, Sharon Costello, David Cubberley, Monica Ghosh, Gayle Duteil, Gary Fane, Hanif Karim, Shawn Leclair, Piotr Majkowski, Michelle Livaja, Robert Macquarrie, Amanda Marley-Clarke, Catherine Pope, Shirley Ross, Patricia Wejr PHOTOS David Cubberley, Hanif Karim, Shawn Leclair, Lew MacDonald, Catherine Pope

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PRESIDENT’S REPORT

UPDATE MAGAZINE July/August 2015

GAYLE DUTEIL

STANDING TOGETHER GLOBALLY FOR SAFE PATIENT CARE

PHOTO: ALEXIS SULLIVAN WALTERS

O VIOLENCE,” “MORE NURSES FOR SAFE PATIENTS” AND “Take a Break!” Sound familiar? I learned of these current campaigns from Korean nurses. Nurses from across the globe recently gathered in Seoul, South Korea for the International Council of Nurses Conference. While there, I met the president of the Korea Health and Medical Workers’ Union (KHMU), a union comprised mostly of nurses and about the same size as BCNU. She handed me a brochure written entirely in Korean and went on to explain, through an interpreter, about KHMU campaigns: “No Violence,” “More Nurses for Safe Patients” and “Take a Break!” So, although we didn’t speak the same language, we understood each other perfectly. All over the world nurses are facing almost identical issues. From Dubai to Australia, nurses are talking about safe staffing and the shortage of professional nurses, problems felt just as strongly by nurses in our province. Yet, according to new information from the Canadian Institute for Health Information (CIHI), full-time registered nursing jobs in BC have declined in the last five years. At the same time, casual nursing jobs have doubled. Casualization of LPNs’ work remains unacceptable at 30 percent. Our RPNs have the highest casualization rate in the western provinces, at 19 percent. While the system needs some casuals, BCNU strongly advocates for full-time, permanent jobs for our members and for safe patient care. There shouldn’t be a new nursing grad in this province without a nursing job!

We shouldn’t have to fight day in and day out for safe patient care either. However, BC’s nurses who refused to work short and filed thousands of grievances will be seeing some benefits from their labour. We are now distributing the monies BCNU received from this successful staffing grievance campaign. Members who said “no” to working short will receive compensation. Thank you for making a difference. In the coming months some nurses will participate in BCNU’s resiliency workshops, with the goal of overcoming the moral distress nurses feel every day. These initiatives are all part of our bargaining strategy. We’ll continue monitoring health authorities’ compliance with our 2012-2014 collective agreement safe staffing language. BCNU will not move forward with our next contract until we see progress on the last one. In the words of Marie Currie: “I was taught that the way of progress is neither swift nor easy, but it is always worth it.” During the summer, staffing shortages will no doubt get worse, so I am asking you to please, stand up for yourself. By standing up for yourself, you are standing up for your profession and your patients. You are standing up for safe patient care. Don’t work excessive overtime hours, take the breaks you are entitled to and enjoy a guilt-free day off. Don’t tolerate violence in your workplace. Insist on baseline and appropriate overcapacity staffing. Every unit, every shift, every vacancy! And remember to also take time to care for yourself this summer. The next three months are pivotal in the road to achieving our bargaining goals. The fact there is a global shortage of nurses will no doubt be reflected in some of your shifts. Be strong. Be assertive about your rights that we have fought so hard for. When nurses stand united, in Dubai, Korea or Victoria, we are a powerful voice! update

CHECK IN

NEWS FROM AROUND THE PROVINCE

BCNU RESPONDS TO PROPOSED NURSES’ REGULATIONS

CNU SUBMITTED comments to the Ministry of Health in June regarding proposed changes to the current Nurses’ (Licensed Practical) and (Registered Psychiatric) regulations. Nurses in BC have been working without role clarity for too long, and BCNU welcomes the enactment of this new regulation as a positive step toward standardized, autonomous practice for both LPNs and RPNs. BCNU is pleased to see an expanded list of activities that LPNs may carry out without an order and expects the process for RNs/RPNs issuing orders for patients, clients and residents who are being cared for by LPNs will be identical to that of a physician issuing an order, i.e., an RN/RPN will not be expected to assess an individual LPN’s ability. However the proposal generally speaks to entry-level competencies that will be challenging for LPNs who have additional education and are carrying out activities that will be viewed as beyond the scope of practice articulated in the regulation. Standardized, credentialed postbasic education for LPNs is sorely lacking in BC, and LPN practice suffers as a result. BCNU has advocated strongly for education in the areas of mental health, LPN orthopaedic technician, dialysis, peri-operative, peri-natal and

DON’T FORGET TO CHECK YOUR CHEQUE!

The on-the-job diligence required of nurses and other health care workers can mean that, after a long week, it’s all-too-easy to forget to check the accuracy of your paycheque. However it’s not uncommon for employers to fail to properly record overtime or on-call premium pay, to give just two examples. Please, don’t forget to “check your cheque” and if you have any doubts or concerns, talk to your steward, manager or human resources department. NEPAL EARTHQUAKE RELIEF

learning related to expanded roles in community nursing. Regarding the proposed RPN regulation, BCNU expressed concern over the limits to standardized and credentialed post-basic education that would support career pathways. For example, Psychiatric Nurse Practitioners could provide a useful service, but there is no direct entry to a Nurse Practitioner program for a degreeprepared RPN. BCNU also reiterated its position that RPNs should be given access to any entry level position, and the proposed regulation could be interpreted to restrict this access. RPNs already work in a variety of settings, including medical-surgical units and longterm care. New regulations should not restrict service delivery, and any restriction imposed by a new regulation is unacceptable. Notwithstanding these and other concerns, BCNU generally supports bringing the proposed RPN regulation in line with other nurse regulations. We hope that health authorities will embrace the new regulations and support LPNs and RPNs in working safely to their full potential. A full summary of BCNU’s submission can be found on the BCNU website. update

The massive earthquake that struck Nepal on April 26 has caused widespread destruction, leaving more than 5,000 people dead and millions more in urgent need of help. BCNU has donated $5,000 to the Canadian Red Cross to assist with the humanitarian efforts following this devastating earthquake. Individual members and regions are also encouraged to donate. Turn to page 20 to read about one North Vancouver nurse’s efforts to provide assistance in the wake of this tragic disaster.

SPECIAL ELECTION The BCNU Nominations in April. Committee is pleased to The voting period for the announce that Adriane special election ran between Gear is the winner of the June 15 and June 26, 2015. It special by-election that was was open to all members who held in June. Gear served voted electronically or by as South Islands telephone. region co-chair and The BCNU has been active in Nominations BCNU’s campaign Committee also to raise awareness wishes to thank of the dangers of South Fraser the Island Health Valley region’s Authority’s care Walter Lumamba, model restructuring Adriane Gear Fraser Valley that has pulled nurses region’s Beverly from the bedside. Pudwell and Simon Fraser Gear will assume the role region’s Sherry Ridsdale for of Executive Councillor – putting themselves forward Health and Safety, and takes as candidates and parover from Will Offley, who ticipating in the democratic resigned from the position process.

UPDATE MAGAZINE July/August 2015

AND THE WINNER IS…

BCNU Executive Councillor Dan Murphy presents Surrey Memorial Hospital nurse Shingirai Makaye with an iPad Mini. Makaye, along with more than 1,500 other BCNU members who participated in the contest, had 11 days to complete 11 questions in honour of June 11, BCNU Day. Contestants were then entered in a random draw. Congratulations Shingirai!

MAKING NEWS

BCNU in the headlines

BURNED OUT IN COWICHAN

ing harder day by day. After reading about the Our hospital is already burstfederal government’s cuts to ing at the seams. Cowichan health transfers, Cowichan Valley does not have enough District Hospital nurse Abi nursing home facilities to Nielsen wrote the following accommodate our fast-expandletter that was published in ing seniors’ community. Nor the Cowichan Valley do we have enough Citizen. mental health and I love nursing and addiction facilities to it saddens me to accommodate our think I may need to young, middle-aged find another job. I and senior citizens. am a hard-working, Nurses are retiring caring RN, just like all early and seeking new the other hard work- Abigail Nielsen ventures with less ing, awesome nurses stress and demand at CDH, fighting for you, our on our mental and physical community. But our stamina, well-being. It is not unusual for a our drive, our daily FIGHT nurse to finish their exhausting to keep you and ourselves 12-hour shift only to go home safe (because nurses still are and think about their patients wives/husbands, mothers/ and what more can be done for fathers, who need to be there them while our own families for our own families) is growsuffer.

UNITING FOR REFUGEE CARE

CNU MEMBERS JOINED WITH HEALTH CARE workers across the country on June 15 in a show of solidarity in support of refugees in this country. The day was the occasion of the fourth, and to-date largest, National Day of Action against cuts to the Interim Federal Health (IFH) program. Health care workers and allies in at least 20 Canadian cities staged protests against the sweeping changes to the IFH. A rally was held in Vancouver in front of the CBC building on Georgia Street. When cuts to the IFH were announced in 2012, all refugees except government assisted refugees lost access to medication coverage, vision and dental care. Many lost all health coverage, including urgent and essential care except in cases of specific infectious diseases. These cuts were challenged in federal court and in July 2014 the court ruled the changes “cruel” and “unusual” – and unconstitutional. The government has appealed the ruling, and while some categories of refugees have had their benefits restored, others have not, in direct violation of the court order. “In addition to flouting the law, the federal government continues to spend citizens’ tax dollars fighting the court decision,” says BCNU Treasurer and Humans Rights and Equity Caucus chair Mabel Tung. Tung says it’s vitally important for health care workers to protest the federal government’s continuing efforts to deny health care to some of the most vulnerable people in our society. update

HEALTH CARE FOR ALL! Vancouver Coastal Health nurses (from left) Annette Floyd, Hadassah Moes and Sonja Rietkerk show their support for refugee health care at a June 15 rally in Vancouver.

CHECK IN

WEARING WHITE BCNU Fraser Valley and South Fraser Valley regional executive members are joined on the steps of the provincial legislature by BCNU President Gayle Duteil and Vice President Christine Sorensen during the union’s May 14 rally for safe patient care.

NURSING IN BLACK AND WHITE

STANDARDIZED LOOK IS DESIGNED TO HELP NURSES STAND OUT

HE PUSH FOR NURSES TO adopt standardized work wear has come to BC. It’s been many years since nurses were required to wear a uniform, and today it’s common for all health care workers to wear a variety of garb while on the job. However both unions and employers, for different reasons, are increasingly asking nurses to consider the value of returning to a more formal standard of attire. Nova Scotia introduced a policy in 2012 requiring most nurses to wear a standard uniform – white scrub top and black pants or skirt – in an effort to immediately identify registered nurses from the assortment of other health care workers. It was a move that had the full support of the Nova Scotia Nurses’ Union, which has reported receiving complaints from the public about not being able to pick out nurses in a hospital setting from other unregulated health care providers. BCNU Vice President Christine Sorensen agrees that it’s important for patients to be able to identify nurses when they visit a hospital. “If nurses are clearly identified by their uniform – white tops and black bottoms – then the public will be able to see how few nurses are actually working.”

She says that increasing nurses’ visibility can only help the union’s efforts to raise awareness about the need for improved staffing for safe patient care. For employers, uniforms make it easier to implement professional image policies that they hope will improve the perceptions and satisfaction of patients, families and visitors. Several provincial nurses unions have endorsed the black and white standard, and it’s now common to see nurses wearing black and white in New Brunswick and Newfoundland. The Canadian Federation of Nurses Unions is also encouraging its member organizations to join in the push for a standardized appearance. Meanwhile, BCNU Fraser Valley and South Fraser Valley regional executive members have been leading the call in this province for nurses to wear traditional nursing white. Their “Wear White Wednesdays” campaign is designed to assist the union’s effort to implement the terms of the recent provincial grievance settlement for improved staffing while showing support for the nursing profession. Sorensen says that the black and white initiative has been discussed by BCNU Council, and that any health employer professional image policy would be implemented in consultation with the union. update

HUMAN RIGHTS AND EQUITY

PRESERVING THE LEGACY OF RIGHTS STRUGGLES

Record of BCNU’s involvement in groundbreaking legal case yet to be digitally archived SOME SENIOR AND RETIRED BCNU members may remember Beverly Holmwood. The Royal Jubilee Hospital OR nurse died in December 1991 of hepatitis C resulting from a needlestick injury she received at work. Holmwood’s partner, Shirley Petten, forced a landmark legal ruling on samesex rights, and was the first person in Canada to receive same-sex benefits from the Workers’ Compensation Board (now WorkSafeBC). The case is regarded as one of the important legal precedents of the 1990s for people in same-sex relationships. BCNU provided legal support to Petten during this case. In memory of Holmwood, Petten gave over the announcement of the win to the BCNU. The union also provided continued legal support during the hospital's appeal of the decision, which was also decided in favour of Petten. Petten died on May 22. She was 73. In the final months of her life, Petten requested that records of the case be donated to the Archives of Lesbian Oral Testimony at Simon Fraser University so that the story could be preserved and more Canadians in same-sex relationships could know of their right to benefits in the event of their partner's death. Researchers are currently raising funds to have the records digitized. BCNU has contributed $500 toward the project and encourages individual members to contribute too. It’s an opportunity to help preserve the union’s legacy of support for social justice and human rights struggles. If you’d like to contribute to the Shirley Petten Digitization Project, please email Cameron Duder at cameron.duder01@gmail.com update

UPDATE MAGAZINE July/August 2015

BCNU DAY

A PROUD HISTORY, AN EXCITING FUTURE 3 2

JUNE 11 – BCNU DAY – WAS AN EXTRA SPECIAL occasion this year. The date marked the grand opening of the union’s new Education Centre. The proceedings started under sunny skies with a welcome from First Nations Elder Margaret George from the Tsleil Waututh Nation. President Gayle Duteil then welcomed the over 150 guests. “This Education Centre belongs to the membership of the BC Nurses’ Union,” she said. “It is your centre – a place that is symbolic of your profound commitment to the values and ideals of your union – a union that in turn recognizes that members are at the heart of everything we stand for.” Burnaby Councillor Sav Dhaliwal, provincial opposition leader John Horgan and other elected officials were on hand to congratulate BCNU members on their new facility. Guests got a chance to tour the building and learned about its high energy efficient standards and facilities for hosting the union’s extensive educational programs on-site and via teleconferencing province-wide. Construction of the Education Centre was approved by BCNU Council in 2011. The project stayed on budget, and now the facility will allow for the delivery of services in-house, saving money on events and meetings that were previously held off-site. “It is my sincere hope that this Education Centre will become a hub of learning, and the sharing and generation of ideas and knowledge about professional nursing, labour and human rights and workplace health and safety,” said Duteil at the closing of the event. update TAKE A TOUR!

Members are welcome to drop in to see the new building anytime between 9:00 a.m. – 5:00 p.m. on Tuesday’s until the end of August. Visit www.bcnu.org for BCNU Education Centre virtual tour videos.

THE PEOPLE 1. BCNU’s Council gathered for its inaugural meeting in the new fifth floor boardroom. 2. BCNU President Gayle Duteil, Executive Councillor Deb Ducharme, Vice President Christine Sorensen, Treasurer Mabel Tung and Executive Councillor Dan Murphy buried a time

capsule that will not be opened for 25 years. 3. Senior citizen Eva Webb celebrated her 100th birthday and was saluted by all in attendance. She was accompanied by her granddaughter and BCNU professional advocacy officer Suzie Ford. 4. Five former BCNU

presidents were on hand. From left: Cathy Ferguson, Debra McPherson, Colleen Bonner, Ivory Warner, Gayle Duteil and Wilma Buckley. 5. Tsleil Waututh nation Elder Margaret George told guests of her experience in the residential school system.

VICTORIA RALLY HIGHLIGHT OF NURSING WEEK 2015

3 4

HE SEA OF RASPBERRY BCNU banners and umbrellas covering the lawn of the BC legislature on May 14 was a sure sign that nurses were in town to deliver their message to BC politicians. The occasion was National Nursing Week and the cause was safe patient care. Many of the members in attendance travelled from the lower mainland, where they attended BCNU’s annual leadership conference the day earlier. “It’s a sad fact that today, we just don’t have enough nurses to deliver safe care by meeting the staffing mandated by our collective agreement,” BCNU President Gayle Duteil told the assembled group. “Not enough nurses to backfill vacancies and absences, not enough nurses to meet daily spikes in acuity, and not enough nurses for safe patient care.” Duteil also reminded members about the recently-negotiated provincial staffing settlement that was the result of thousands of grievances triggered by health employers’

refusal to replace nurses and staff at capacity under the terms of the Nurses’ Bargaining Association collective agreement. Nurses’ efforts forced employers to admit that they fell short on their end of the deal, and the health ministry-initiated talks that took place earlier this year are a testament to the value of coordinated group efforts in solving individual member’s workplace problems. “We’re grateful to the ministry for creating an expedited process to deal with safe staffing grievances, and we’re very pleased that funds are now in place to begin training larger numbers of specialty nurses to meet critical shortages, be they ER nurses, OR nurses, ICU nurses, or gerontology nurses,” said Duteil. “They are sorely needed and this is a great first step.” Duteil also spoke to the so-called nursing shortage the government claims is responsible for unfilled vacancies. “If there’s a shortage, why hasn’t every new BC nursing

graduate over the past three years found a job?” she asked. “Recruit those nurses first! Advertise for them! Ensure that every new graduate nurse – whether RPN, LPN or RN – gets a job, a real nursing job supporting safe patient care.” Opposition leader John Horgan, along with several other MLAs, took the opportunity to welcome nurses to the legislature. Horgan promised to hire more nurses if elected in 2017 and thanked the group for their tireless advocacy on behalf of all BC patients. National Nursing Week 2015 was celebrated May 11-15. In addition to the Victoria event, nurses across BC and Canada celebrated their professions and role in advancing the health and well-being of their communities. update

UPDATE MAGAZINE July/August 2015

THE PEOPLE 1. Members get ready to rally in Victoria on May 14. From left: Simon Fraser region’s Mary Jean Power, North West region lobby coordinator Kathy Buell, Fraser Valley region OH&S rep Heather Weins, North West region chair Sharon Sponton and Coastal Mountain region chair Kath-Ann Terrett. 2. Members take to the lawn of the BC legislature May 14. 3. Leader of the Official Opposition John Horgan addresses nurses on the steps of the BC legislature May 14. 4. BCNU President Gayle Duteil “rallies the troops” at BCNU’s Rally for Safe Patient Care in Victoria May 14. 5. BCNU members take their message of safe patient care to the streets of Victoria May 14. 6. Burnaby Hospital nurses don helmets and pose with a Burnaby firefighter in front of the department’s vintage fire truck. The firefighters were on hand to barbeque burgers for the hundreds of nurses who attended the hospital’s Nursing Week event. 7. Burnaby Hospital nurses enjoy lunch at a May 12 Nursing Week barbeque at the facility. 8. Burnaby Hospital nurses raised money for Nepal earthquake relief at their May 12 Nursing Week event. 9. Full-time community steward Judith Raymer and South Islands region lobby coordinator Jayne Yearwood talk about safe patient care with Oak Bay-Gordon Head MLA Andrew Weaver on May 11. 10. The BCNU bus rolled by Richmond General Hospital to celebrate Nursing Week May 12. From left: RIVA region PRF advocate Sara Johl, Janet Carver, Dorothy McKune. Fiona Dib, Suman Prasad, Gloria Friesen, Devinder Gill, Felix Chow and Kar Chan.

MENTAL HEALTH

CALLING OUT FOR CARE Nurses say spike in demand and dearth of beds calls for the reopening of Abbotsford Regional Hospital’s adolescent psychiatric unit

HE FULL-SIZED BASKETball court is surrounded by greenery and bathed in the warmth of the Fraser Valley summer sun. It’s the kind of place that’s perfect for a young person wanting to spend some time addressing their important mental health concerns with a trained professional. The amenity is part of Abbotsford Regional Hospital’s (ARH) adolescent psychiatric unit. Unfortunately, most of this state-of-the-art facility is gathering dust. Inside, four patient rooms are now used as ad-hoc offices and storage spaces. It’s the result of a Fraser Health Authority decision five years ago to close the unit as a costcutting measure. At the time, the health authority argued the unit was underutilized. However, since 2011, ARH’s youth mental health admissions have more than doubled. And today, adolescents with men-

“If it were my child, I would want them to receive care in a safe adolescent unit streamlined for their age and needs and within their own community.” BCNU FRASER VALLEY REGION CHAIR KATHERINE HAMILTON.

tal health crises wait – some longer than 100 hours – in the hospital’s emergency department. “We desperately need this unit,” says BCNU Fraser Valley region chair Katherine Hamilton. “These kids wait days in our busy emergency department, receiving minimal care and witnessing violent events in cramped quarters.” In response to the growing concerns Fraser Health has announced plans to open 10 new adolescent psychiatric beds

at Surrey Memorial Hospital (SMH) in the fall of 2016 to augment the existing 10 beds at the facility. Unfortunately, it’s still not enough. Fewer than half of the almost 400 youth mental health admissions to SMH last year were able to be admitted to the existing youth mental health unit. The numbers clearly show that even if the 10 new beds were added today they would not cover current rates of admission. Even more alarming is treatment given

UPDATE MAGAZINE July/August 2015

to individual kids who don’t have access to a specialized unit. Teenagers aged 15 and older are sent to the adult psychiatric unit. “Vulnerable youth end up being placed alongside adult patients who may have sexually inappropriate behaviour or aggression,” says BCNU President Gayle Duteil. “This is not safe patient care.” Duteil notes that children under the age of 14 are treated on the pediatric unit, which has an open fourth floor balcony. Aside from the obvious suicide risk, these young patients receive their treatment alongside babies and toddlers, in a setting that’s not suited to their needs. “Treatment is very limited,” says Duteil of the care in this environment. RAPIDLY GROWING DEMAND

Last year ARH saw 220 mental health cases of children under 18, more than double the number from the previous year. The growth is region-wide. Fraser Valley hospitals in Abbotsford, Chilliwack, Langley, and Maple Ridge saw some 450 youth mental health cases last year. There are many reasons for the rapid increase in demand. The main culprit, however, is total population growth in the region. According to Statistics Canada, the city of Abbotsford grew by 7 percent between 2006 and 2011, and is now home to 124,000 residents. The city projects that by the end of the decade its population will exceed 170,000. With this kind of growth, it’s easy to see why new services are needed. And those 10 new adolescent psychiatric beds planned

for SMH? The city of Surrey predicts that its population will grow by some 54,000 people between 2011 and 2021. Given that SMH also accepts admissions from surrounding municipalities, the likelihood of there being a bed available for someone from Abbotsford in need of care means that transfers will be unlikely. The complexity of cases is growing too, and hospitals are seeing a wider age range in admissions. Where admissions of children aged five and under was previously quite rare, the treatment of children as young as two for mental health concerns is now becoming more commonplace. CALLING FOR SOLUTIONS

Despite the urgency of the current situation, ARH’s Adolescent Psychiatry Unit remains mothballed. “These kids are our future,” says Hamilton. “If [their mental health issues] are recognized and treated appropriately, these kids can go on to lead healthy and productive lives,” she argues. “If it were my child, I would want them to receive care in a safe adolescent unit streamlined for their age and needs and within their own community.” BCNU is preparing for a campaign to reopen the unit. It will include a petition from the community, as well as efforts to educate families and politicians about this very dire situation. “This is an important campaign,” says Hamilton. “The petitions will be circulated, please sign one and join us in the quest to provide our youth the care they deserve.” update

REPORT CALLS ON BC GOVERNMENT TO MAKE FUNDAMENTAL CHANGES TO CARE SYSTEM THE BRITISH COLUMBIA government should begin providing appropriate care for children and youth who have multiple vulnerabilities – including developmental, psychological and medical needs. That’s the recommendation of the province’s Representative for Children and Youth, Mary Ellen Turpel-Lafond. The representative’s latest report Who Cares? B.C. Children with Complex Medical, Psychological and Developmental Needs and their Families Deserve Better shows that young people with complex needs in this province continue to be placed in inappropriate residential placements, with negative and sometimes tragic outcomes. “These children and their families who need the most support are often the least well served by the province’s care system,” says Turpel-Lafond. “The Ministry of Children and

Family Development (MCFD) must make fundamental changes in order to ensure that all children have their needs met in a loving, permanent setting that includes, wherever possible, input and involvement of their families.” The report finds that most children and youth with complex needs in residential care lacked the assessments, plans and access to treatment and services necessary to meet their needs. The results, illustrated in eight case examples, are life experiences marked by frequent moves, lack of stability, unaddressed medical and developmental needs, and a general drift towards aging out of care without proper supports or planning. “The lack of a continuum of care means not only poor outcomes for these young people, but also a staggering loss of potential,” says Turpel-Lafond. “Children and adolescents are remarkably resilient, and with strong emotional, cultural and behavioural supports and a fully funded and staffed system of services, much more positive outcomes are possible.” update

Read the report

Forms (PRFs) were about to be introduced as evidence of unsafe care. The PRFs were filed as part of a strategy to document SAFE PATIENT CARE lapses in safe care under CDMR, in order to protect nurses’ licences and challenge the employer’s right to force them to work in conflict with their professional standards. The parties also agreed that all PRFs filed during the CDMR era will be reviewed and that they will mutually agree which ones are resolved by the process of restoring lost nursing hours. RECENT SETTLEMENTS SET POSITIVE TONE BCNU’s campaign against CDMR included multiple rallies in Nanaimo and FOR FUTURE BARGAINING TALKS Victoria, public advertising that included billboards and newspapers, a petition that T WO-YEAR DISPUTE received over 30,000 signatures, letters to over a risky care model the editor and opinion pieces, freedomintroduced at Nanaimo of-information requests, and asking quesRegional General Hospital tions at every Island Health board meeting has been resolved in a from the time CDMR was first announced settlement agreement with Island Health, in 2013. substantially restoring the 48,000 annual The campaign was also bolstered by nursing care hours cut from four medical overwhelming public support for nurses’ and surgical units at the facility. concerns. This was made clear in a BCNUCare Delivery Model Redesign (CDMR) commissioned Mustel Group survey that was introduced in NRGH in September found more than 95 percent of respondents 2013, then extended in modified form agreed with the statement that “Island to Victoria General and Royal Jubilee Health should have to provide evidence hospitals in 2014. that any changes in care delivery are safe for The settlement is being hailed as a major patients.” victory by Nanaimo nurses, who camThe CDMR settlement applies to paigned tirelessly against the replacement of NRGH. BCNU intends to initiate a full 26 RNs and LPNs with care aides. The net review of the quality and safety of care on effect of CDMR was to roughly double the CDMR units at Victoria-area hospitals, number of patients for each nurse, putting beginning with a survey of nurses working patient safety at risk and placing nurses in under CDMR. conflict with their professional standards. “Island nurses have done BCNU proud, The May 20 agreement was negotiated as and their efforts should inspire us all as we A VOICE FOR SAFE PATIENT CARE BCNU a binding resolution to a Single Employer prepare to bargain a new provincial conSouth Islands region co-chair Adriane Gear Policy Dispute (SEPD) filed by BCNU tract,” says BCNU President Gayle Duteil. addresses members during the May 14 rally at the BC legislature. The efforts of Gear and other shortly after CDMR was introduced in “The agreement is also a reminder that Vancouver Island activists have been critical in Nanaimo. As a result, Island Health will member engagement and public support ensuring that staffing levels are maintained. increase RN baseline staffing at NRGH by are critical to stopping the erosion of nurs10 FTEs. Best use of the added RN hours ing and safe patient care.” is to be determined following a joint review will also increase the current LPN float pool The NRGH agreement, along with of patient acuity and intensity to identify “by an average of 30 hours per day, by regu- the recent provincial staffing grievance where they would be “most effective for larizing casual relief hours and adding those settlements, sets a positive tone ahead of patient care and staff needs.” hours to existing float pool positions.” negotiations for a new Nurses’ Bargaining Island Health has also agreed to “regularIn return for these gains BCNU has Association provincial collective agreeize” into baseline staffing two temporary agreed to drop the SEPD grievance, which ment. Both Island Health’s decision to 12-hour night shifts added back prior to had proceeded to an arbitration where move ahead with CDMR despite nurse’s this agreement (4.3 FTEs). Island Health hundreds of Professional Responsibility concerns, and all provincial health employ-

NANAIMO HOSPITAL AGREEMENT RESTORES STAFFING LEVELS

UPDATE MAGAZINE July/August 2015

ers refusal to implement new staffing language in the 2012–14 contract, had been major obstacles to progress. The months ahead will be crucial in showing whether the health authorities have turned over a new leaf and are now committed to meeting their contractual obligations to replace and hire nurses. The provincial staffing grievance arbitration panel noted that its

“The agreement is a reminder that member engagement and public support are critical to stopping the erosion of nursing and safe patient care.” BCNU PRESIDENT GAYLE DUTEIL

recommendations for change were intended “to repair the trust that has been damaged and to create a constructive environment for moving forward in the next round of collective bargaining.” In the meantime, all members are encouraged to use the grievance settlement’s new fast-track process to ensure compliance with nurses’ contract rights requiring that vacancies be filled, absences be replaced, vacations by community nurses be backfilled, and that additional nurses be called in when demand and acuity spike. update

PROFESSIONAL ISSUES

COLLABORATION THE BEST WAY TO PROTECT NURSES’ INTERESTS Who is the voice for nursing policy and professional practice in BC? RECENT ACTIONS BY THE COLLEGE OF Registered Nurses of BC (CRNBC) seem to suggest that the provincial licensing body believes the Association of Registered Nurses of BC (ARNBC) is the only organization that should take the lead in representing RNs’ professional practice interests. In 2013, the CRNBC arbitrarily and without any consultation with its members gave startup monies to the fledgling ARNBC – an undemocratically elected body that had been lobbying the CRNBC since 2010 to be anointed as the policy and professional voice for nurses. The funds in question include $1.5 million derived from nurses’ over-contributions for liability insurance they had paid to the college. The CRNBC also committed to transferring a portion of all future registrant fees to the ARNBC. BCNU initiated a legal challenge in response to the transfer, arguing that the funds are assets held in trust for BC nurses and cannot be used for other purposes. Who effectively represents the professional interests of RNs in British Columbia? Was it legal and ethical for the CRNBC to distribute funds for purposes other than strictly regulatory ones? Shouldn’t CRNBC members have had some say in what was done with those assets derived from members’ own registration fees? These are the questions at the heart of BCNU’s lawsuit. After its establishment in 2005 with the passing of the Health Professions Act, the CRNBC transitioned from an association to a regulatory college, and became the sole licensing body for RNs working in BC. BCNU then assumed a greater professional advocacy role and has since been successfully involved in nursing education, research, policy administration and other initiatives, including meeting with the government monthly to discuss a wide range of issues related to nursing practice. BCNU has always acknowledged that nurses

not represented by the union, for example managers and academics, would need a professional voice and is prepared to enter into dialogue with all RN organizations to determine how best to achieve this. Unfortunately, this offer has not been taken up. In 2010 the CRNBC rejected a BCNU proposal to establish a Council of Nurses for BC that would have been inclusive of all nurses including RNs, RPNs, LPNs, midwives and nurse practitioners. This would have allowed all nursing organizations to be part of a body that could provide a single, powerful professional voice for BC’s nurses. Meanwhile, leaders of the ARNBC board continue to lobby for ongoing funding to become the policy arm and professional voice of BC’s RNs, and have only been successful in this effort by accessing nurses’ contributions and fees paid directly to the CRNBC. BCNU is always interested in working collaboratively to protect the rights of nurses. Unfortunately, ARNBC has not shown a willingness to include BC nurses in important decisions. In February 2015, the group scheduled an extraordinary general meeting in Kamloops at the same time that the BCNU was holding its annual convention in Vancouver, and then denied the voting rights of BCNU members who travelled to Kamloops in an attempt to ensure that the interests of BC nurses were fairly represented. Such actions do not reflect a willingness to collaborate. Some of these members have since filed a petition in BC Supreme Court in order to hold ARNBC accountable for an admitted failure to follow its own bylaws and to ensure that all RNs in BC have the right to participate and vote in the business of the ARNBC. The BCNU will continue to support the efforts of our members who have stood up and demanded that the CRNBC and ARNBC hear and respect the voices of all BC nurses. update

Health & Safety IN THE WORKPLACE

SAFETY AND HEALTH WEEK 2015

MAKING SAFETY A PRIORITY

BCNU OCCUPATIONAL HEALTH AND SAFETY REPS AND STEWARDS GET CREATIVE TO ENGAGE MEMBERS ACROSS THE PROVINCE CONNECTING WITH MEMBERS St. Vincent’s Hospital worksite steward Alex Palacol, BCNU Vancouver Metro region OH&S Regional rep Frankie Salvador and St. Paul’s Hospital worksite steward Arlie Gilhousen were on hand at St. Paul’s Hospital during Safety and Health Week. Members who stopped to chat were treated to free massages provided by a registered massage therapist.

SAFETY FIRST East Kootenay Regional Hospital nurses participated in creative games that helped reinforce safety rules that are critical for their well-being. From left: Aryn Driedger, Debbie Brown, Megan Bursey, Heidi Fox, Kathleen Straub.

AFETY AND HEALTH ISSUES WERE FRONT AND CENTRE FOR BC Nurses’ Union members during North American Occupational Safety and Health (NAOSH) Week May 4 – 11. It was all thanks to the creative efforts of the union’s regional Occupational Health and Safety reps and stewards who organized outreach events and activities around the province. Nancy Silzer is the OH&S rep for BCNU’s East Kootenay region and a member of the East Kootenay Regional Hospital Joint Occupational Health and Safety ( JOHS) committee. Her engagement methods included the creation of a “No Blame” game, where she and her alternate Carrell Fitzgerald travelled the hallways delivering information, asking members to place a candy in a jar labelled with the topic of the safety issue they discussed.

These included issues such as repetitive strain injury, violence, exposure to bodily fluids and others. “After each question and candy drop,” explains Silzer, “I told the member I was using this ‘highly scientific experiment’ as a tracking tool to offer education around OH&S and support for reporting systems.” The activity allowed Silzer and Fitzgerald to raise awareness about the opportunities that exist to keep workplaces safer. Silzer reports that this year’s NAOSH Week was also a great opportunity to emphasize the obligation of reporting to their workplace call centre. “Most of the staff that I talk to don’t know there is a call centre, so this was an opportunity to talk about what gets reported, where to report and exactly where those reports go.” “I know the current reporting system is not user friendly,” admits Silzer. “But right now it’s all we have.” As a member of her regional violence prevention committee, she remains hopeful that members can overcome the reporting challenges. “If

UPDATE MAGAZINE July/August 2015

HEALTH AND SAFETY CHAMPIONS East Kootenay Regional Hospital Joint Occupational Health and Safety (JOHS) committee members Carrell Fitzgerald (l) and Nancy Silzer (r) used a range of creative engagement methods to help raise awareness about the importance of reporting events to WorkSafeBC.

you would go to the ends of the earth to keep your child’s school safe, why would you not make a phone call to report a near or actual incident if it ensures your safety and the safety of your colleagues?” she asks. In the Lower Mainland, BCNU Vancouver Metro region OH&S rep Frankie Salvador teamed up with St. Paul’s Hospital worksite steward Arlie Gilhousen and St. Vincent’s Hospital worksite steward Alex Palacol to promote NAOSH week. The group was positioned in a high volume location during peak hours, enabling them to reach members and engage in conversations related to worksite safety at one of BC’s busiest hospitals. The Van Metro team also created a Safety

HOW TO CONTACT YOUR REGIONAL OH&S REPS

READY TO HELP If you have any occupational health and safety concerns, always remember to talk to your steward. You can also contact your regional executive OH&S rep. Here they are, pictured above. Their contact information is listed on the right. Front row (kneeling) l-r: Wendy Onofrechuk, Frankie Salvador, Gerrie Miller and Heather Wiens. Back row (standing): Danette Thomsen, Susan Crawford, Tasneem Buksh, Judy Surkon, Annelise Henderson (standing in for Paula Lameiro), Natalie Mark (standing in for Lynne Eross), Nancy Silzer, Ken Giles, Rajnish Ramdoyal, Sherry Lucchesi (standing in for Ryan Kean), Sherry Ridsdale and Andrea Noronha.

and Health Q&A pegboard wheel game that helped them broach a wide variety of topics. The option of a free massage from a registered massage therapist was an added wellness bonus for members who stopped by. Regional executive members and stewards in many other BCNU regions also hosted NAOSH week events. Across the province members were able to raise safety concerns they face at their worksite and speak with their ( JOHS) committee reps. NAOSH Week began in 1997 when Canada, the US and Mexico agreed to dedicate one week a year to raise awareness about the importance of safety at work, at home and in the community. update

Central Vancouver Andrea Noronha andreanoronha@bcnu.org

RIVA Paula Lameiro paulalameiro@bcnu.org

Coastal Mountain Rajnish Ramdoyal rajnishramdoyal@bcnu.org

Shaughnessy Heights Ryan Kean ryankean@bcnu.org

East Kootenay Nancy Silzer nancysilzer@bcnu.org

Simon Fraser Sherry Ridsdale sherryridsdale@bcnu.org

Fraser Valley Heather Wiens hwiens@bcnu.org

South Fraser Valley Tasneem Buksh tasneembuksh@bcnu.org

North East Danette Thomsen danettethomsen@bcnu.org

South Islands Ken Giles kengiles@bcnu.org

North West Wendy Onofrechuk wendyonofrechuk@bcnu.org

Thompson North Okanagan Judy Surkon judysurkon@bcnu.org

Okanagan Similkameen Lynne Eross lynneeross@bcnu.org

Vancouver Metro Frances Lynn Salvador frankiesalvador@bcnu.org

Pacific Rim Gerrie Miller gerriemiller@bcnu.org

West Kootenay Susan Crawford susancrawford@bcnu.org

REGISTERING EXPOSURE TO A HAZARDOUS SUBSTANCE

Due to the latency and long period of exposure required for the onset of some occupational diseases, WorkSafeBC has developed an Exposure Registry Program as a way for workers, employers, and others to register a worker’s exposure to a harmful substance at work. The information obtained through the registry will be kept as a permanent record of a worker’s exposure and will assist WorkSafeBC in the adjudication of any future claim for occupational disease caused by the workplace exposure. Reporting an injury or work-related illness Follow these steps if you are injured at work or have symptoms of a work-related illness: Step 1: Report it to your employer immediately. Step 2: Seek medical attention and tell your doctor your injury is work-related. Your employer is responsible for your transportation costs from your workplace to a doctor’s office or hospital. Step 3: Start a claim by reporting it to WorkSafeBC as soon as possible. If you miss work time as a result of your injury, call their Teleclaim Centre Monday to Friday between 8 a.m. and 6 p.m.: 1-888-WORKERS (1-888-967-5377), or #5377 for Telus, Rogers, and Bell mobility customers. SOURCE: WORKSAFEBC

OH&S

HIDDEN KILLER

BC’S AGING, ASBESTOS-CONTAINING HEALTH CARE FACILITIES CALL FOR ONGOING DILIGENCE

HEN WORKERS AT the Port Coquitlam health unit got the news last October that they and their clients had been exposed to asbestos for years, it was both a shock and a wake-up call. It was a shock because provincial health and safety regulations had not been followed. Dust and debris falling from crumbling walls had been an ongoing issue in the health unit since as far back as 2002, and verbal complaints to management resulted in periodic cleaning and patching. But when a subsequent materials analysis of the debris revealed that vermiculite insulation in the building contained one percent asbestos, the Fraser Health Authority admitted to having been told about the toxic substance in 2009, but did not disclose it to workers at the facility and did not take the required steps to remediate the situation. BCNU is supporting the nurses who worked at the facility and the union’s occupational health and safety department is now helping them work with their Joint Occupational Health and Safety ( JOHS) committee to review WorkSafeBC’s orders and compliance plan to ensure the employer adheres to its regulatory requirements. The Port Coquitlam incident should also serve as a wake-up for employers and health care workers in BC who operate and work in facilities that were constructed when asbestos was commonly used in many building materials. And ongoing research into this silent health hazard should give pause to planners and the public alike. Asbestos is far and away the number-one workplace killer in Canada today, accounting for some one third of the 15,000 workplace death claims approved since 1996, according to a Globe and Mail investigation published last year. The figures are a reflection of Canada’s historic role in asbestos production – the industry

employed thousands and once produced about 40 percent of the world’s supply – and the 20- to 40-year latency period before the effects of exposure are manifested. As a result, health experts warn that deaths from asbestos will climb further despite that the last Canadian asbestos mine closed in 2011. According to the Association of Workers’ Compensation Boards of Canada, many victims die of mesothelioma, an aggressive form of cancer caused almost exclusively by exposure to asbestos, and asbestosis, a fibrosis of the lungs. The workers’ compensation numbers don’t fully capture the total number of fatalities in Canada as not everyone is covered by workers’ compensation and not every claim is successful. Separate Statistics Canada data show almost 4,000 people died of mesothelioma alone in the decade to 2011. And while miners and those working in construction may be the primary group now succumbing to the effects of prior asbestos exposure, there is new group of workers who find themselves at risk of accidental asbestos exposure every day. The material was widely used in everything from attic insulation to modelling clay in schools

UPDATE MAGAZINE July/August 2015

and car parts. It was also used in a variety of construction materials such as cement, tiles and shingles. It is this latter application that is the greatest cause for concern. Health Canada reports that asbestos is a problem when its fibres become airborne and are inhaled after being disturbed, such as during building maintenance and renovation of older buildings. Unfortunately, this kind of accidental exposure is exactly what does occur, on a regular basis in BC and across Canada. It is not uncommon to read about public facilities, like the Port Coquitlam health

“Any time construction work is being done the nurses immediately want to know if asbestos containment procedures are being followed.” BCNU EAST KOOTENAY REGION OH&S REP NANCY SILZER

unit, being closed, or their operators being fined, for failing to inform workers about the toxic material. Where does this leave the thousands of BCNU members who work in buildings that contain asbestos? The union’s OH&S stewards and regional reps have a keen awareness of the dangers of asbestos exposure in older buildings. They’ve passed on this vigilance by reminding nurses and other members about the risks. This was seen during a recent renovation begun at the Creston Valley Hospital and Health Centre “Any time construction work is being done the nurses immediately want to

know if asbestos containment procedures are being followed,” says BCNU East Kootenay region OH&S rep Nancy Silzer. According to Silzer, the work had begun without employees being given the appropriate notice. However, nurses were able to quickly assess the risk. “The Joint Occupational Health and Safety committee met in January, and we are able to confirm that Interior Health had done the right paperwork and ensured that qualified people were doing the work,” she reports. “There was a lack of communication initially regarding workplace OH&S during construction, but there are no concerns now that we know the paperwork is in place and WorkSafeBC regulations are being followed.” All employers are required to have a process for reporting hazards in the workplace, and a well-functioning JOHS committee is certainly critical for maintaining awareness and ensuring that workers are protected from accidental asbestos exposure. However members who have any concerns should check with their manager and JOHS committee representative or steward about reporting procedures at their workplace and how to register with the WorkSafeBC Exposure Registry in case of future occupational illness. BCNU strongly recommends that members contact their local steward or JOHS representative about suspected hazards. They in turn will contact the BCNU OH&S department if unsure about a situation. If there’s any doubt, members can also notify WorkSafeBC directly. Asbestos research is ongoing, and new evidence continues to shed light on the dangers of this hidden killer. In the meantime, BC’s aging health care infrastructure demands diligence and long-term planning to ensure that workers are no longer exposed to this once common construction material that remains in the walls of workplaces and public buildings across BC. update

PREVENTING ASBESTOS EXPOSURE: WHO IS RESPONSIBLE?

EMPLOYERS Both the health employer and contractor hired to perform the work have specific obligations before and during renovation or maintenance work that may disturb asbestos containing materials. • Employers must ensure that an inspection has been conducted by qualified persons to identify the location of hazardous materials, including asbestos. • Employers must make the results of these inspections available at the worksite, with appropriate drawings, plans or specifications to show the location of these materials. • Contractors must ensure these materials are removed or safely contained, prior to commencing work that may disturb them. • Contractors must ensure that a qualified person has conducted a risk assessment and that work procedures acceptable to WorkSafeBC have been developed to eliminate or minimize the exposure risk. SUPERVISORS Supervisors must ensure the health and safety of all workers under their direct supervision, which includes ensuring that work procedures developed by the employer are effectively implemented. WORKERS Workers – both nurses and other health care providers working in a facility and those doing the construction or maintenance – have responsibilities for their own health and safety and the health and safety of other workers. That means that they must: • Follow the exposure prevention procedures that have been developed. • Refuse work that they believe creates an undue exposure hazard. • Report to their supervisor any defect or exposure hazard that they think may endanger the worker or any other person. SOURCE: WORKSAFEBC

HUMANITARIAN AID

NEPAL EARTHQUAKE HITS CLOSE TO HOME BC Nurse on the ground during second quake

HE WORLD WATCHED IN horror when reports of Nepal’s devastating April 25 earthquake were broadcast around the globe. Estimates have put the numbers of dead at 9,000, with some 23,000 injured. For Lions Gate Hospital nurse Prabina Dahal, the news was especially chilling. The Nepalese-born Canadian immediately feared for the safety of her extended family living in the country. For the past 10 years, Nepal had been receiving notice that a major earthquake was due, and Dahal knew that preparedness was weak. Dahal was in the Post Anesthetic Recovery Room, where she has worked for the past eight years, when she first heard the news of the 7.8-magnitude quake. The hours following were worrisome as she and her Nepalese husband were unable to make contact with their families. Several hours later she was relieved to hear that, despite her mother having an injured knee, everyone was safe. Dahal, who also is a nurse instructor at BCIT, made immediate plans to go to Nepal

EARTHQUAKE RELIEF Lions Gate Hospital PAR nurse Prabina Dahal was assisted by her colleagues before she left for Nepal to assist her community. From left: Cristina McKean, Caitlin Hennecker, Allison Dunn, Dahal, Christina Rice and Jessica Foster Knape.

to help her family. “I asked my five-yearold daughter’s preschool classmates and parents to help provide donations,” she says. Dahal left Vancouver on May 9, her luggage weighed down with toys and books for the children. “My sister said the schools were completely damaged and these supplies would help bring some smiles to the children during this crisis.” After arriving, Dahal teamed up with four doctors and a pharmacist to help provide basic medical assistance to residents of Sundarijhal, a town 30km outside of Katmandu. The doctors had used their own funds

to stock a van full of water and supplies and the team set up under a makeshift Tarpaulin. “Many Nepalese were grateful just to be alive, so they wouldn’t pursue medical care,” reports Dahal, “They needed x-rays and had infections that could become worse without attention.” However, with some of word of mouth, community members started to visit their makeshift medical stand to seek care and advice. Unbelievably, a second 7.3-magnitude earthquake hit on May 12 while Dahal was helping local patients. “There were screams, crying and significant damage immediately,’ she recalls. “People were scared, and running towards an open space that had live electric wires above, and I was yelling, ‘please don’t go there, they can fall on you.’” Over the following couple of days Dahal says she and the medical team provided more of a counseling role to people who were suffering from shock. The Nepali army also arrived and provided medical support. Dahal left five days later, once she was sure her sisters and parents were safe. However, the quake had rendered their home unsafe and they were now stationed in the family garage. Once back in Canada, Dahal teamed up with the Nepal Cultural Society of British Columbia (NCSBC) in order to assist her family and others. “The distribution of supplies is uneven, and it’s monsoon season soon,” she explains. “Though Katmandu is faring slightly better, the remote villages still need so much help. “NCSBC have been doing so much collectively to help with immediate concerns at a grassroots level. We have managed to arrange temporary shelter for a village school and secured a sitting mat for the children to study on.” Dahal says that the rebuilding effort will be a continuous process, and ongoing help will be needed in coming months. “There are no words for the gratitude I have towards my fellow Canadians and their support of the Nepalese people – and when the BC Nurses’ Union contributed $5,000, I was overwhelmed.” update

UPDATE MAGAZINE July/August 2015

MENTAL HEALTH

A PASSIONATE NURSE

Farida Bano Ali is committed to ending the stigma of mental illness in BC’s Muslim community

T’S A BEAUTIFUL SPRING Saturday and Farida Bano Ali is standing in the prayer space of the Masjid al Haqq on Welwynn Street in Vancouver. She’s in deep conversation with Sgt. Tahir Humayun of the Vancouver Police Department. The room is suffused with morning light, and the people seated on the assembled chairs are waiting for the town hall meeting on mental health and suicide prevention services to begin. The lightness of the spring air seems at odds with the weightiness of the subject to be discussed, but around the room people are in quiet conversation, with smiles and warm greetings extended to newly arrived attendees. Shortly after the scheduled start time the acting Imam of the masjid stands before the gathering, and after a brief recitation from the Qur’an and a few words on the subject of mental health, he welcomes people to the event. What follows is a remarkably diverse collection of Muslim voices. From Sgt. Humayun’s description of the role of Car 87 (a joint service of the VPD and Vancouver Coastal Health that responds to calls involving people with apparent mental illness or in acute distress) to social worker Sana Siddiqui’s highlighting of the impact of the events of September 11, 2001 and the ongoing “war on terror” on the overall mental health of the Muslim community, all of the speakers highlight a

COMMUNITY ADVOCATE Retired nurse Farida Bano Ali says more mental health education and awareness is needed in the Muslim community.

critical facet of mental health care in British Columbia. But it is the heartbreaking words of Nessima Nastosh, whose young son Hamed took his own life after years of relentless homophobic bullying at the hands of his school peers that brings home the sobering reality of the subject before the group. In a tremulous voice she reads Hamed’s suicide letter that’s filled with tender words for his family coupled with the angst of misunderstood adolescence. Many people in the room are crying. It’s no small achievement to have convened a meeting like this in a community

that has, in a real sense, only just begun to talk about mental health. And yet Bano Ali – a retired RN/RPN and tireless community and social justice activist – appears to take it all in stride. Bano Ali was born in Fiji, where she spent a pleasant childhood surrounded by a supportive and loving extended family. At the age of 17, in search of new horizons and experiences, she travelled to England where she began her nursing career. It was, she says, one of the best decisions she made. Bano Ali remains passionate about nursing, and mental health nursing in particular. “I feel mental health is not being addressed properly,” she says, when asked why she continues to be such a strong advocate for the health of all British Columbians. “More education and awareness is needed,” she says, stressing that this is what she is committed to providing. Bano Ali is the Director of Social Services for Women’s Affairs of the BC Muslim Association. In September 2013 she encouraged the Muslim community to host a fundraiser in collaboration with Vancouver General Hospital & UBC Hospital Foundation. The event raised $40,000 for the new Joseph & Rosalie Segal Family Health Centre which will provide much needed support services to people in need of mental health care. For Bano Ali, the overwhelming success of the event has served as a reminder that the good intentions and hard work of a few committed individuals can go a long way towards improving the lives of the most vulnerable and marginal amongst us. Bano Ali’s future projects include highlighting the mental health challenges of refugees and older adults, and ensuring they receive the compassionate and loving care that all British Columbians deserve. update For more information on the Joseph & Rosalie Segal Family Health Centre, visit: www.vghfoundation.ca/news/bc-muslimassociation-makes-mental-health-matter

FEATURE

NURSES’

VOTES

COUNT

There’s a lot at stake in this year’s federal election. Nurses have the votes – and the voice – to make a difference.

Health care. It’s Canadians’ number one issue this federal election. Most of us are proud of the health care system we have, but we’re also concerned for its future.

These were the findings of an Ipsos poll released this June. Health care regularly beats out jobs and the economy as the top-of-mind issue come federal election season. Whether it’s protecting medicare, investing in seniors’ care or creating a national prescription drug program, voters are looking to Ottawa for leadership to protect their health and the well-being of their families. But there’s more at stake this year. Canadian health care is at a crossroads. The federal government has turned its back on health care leadership, and has abandoned Ottawa’s historic funding and policy role in the area, with health transfer rates being cut to provinces, amounting to $36 billion over the next 10 years. The government has repeatedly claimed that health care is a provincial responsibility. However, the recent Ipsos poll clearly indicates that most Canadians don’t agree. Health care is a shared responsibility, and the system we have today only exists because the federal government committed to being a partner with the provinces almost 50 years ago. This bargain has now been broken with federal governments transferring an ever-decreasing percentage of health care costs. The consequence of this, if allowed to con-

tinue, will mean our health care system will descend into chaos with 13 patchwork systems that are all struggling. Currently, nurses are facing funding cuts, staffing cuts, unhealthy work environments and extreme demands for overtime hours. This inadequate approach threatens their ability to deliver safe patient care. Tackling this and developing a plan for nurses that creates safe staffing standards across the country will require national leadership. Nursing is a highly demanding job, and we are constantly trying to give our patients the best possible care. Unfortunately, we are finding this increasingly difficult because of federal, provincial and local health care cuts. Nurses, like all Canadians, need to recognize how politics and elections impact the care we provide. Nurses across the country will be speaking up to ensure the health and well-being of Canadians is at the forefront of government’s priorities. Your vote, and your voice, can make the difference in this federal election. Talk to your friends and neighbours about the kind of health care system you want to see, and ask them to vote for a candidate who’s committed to improving health care for all.

NURSES’ V TES COUNT

BY THE NUMBERS

MEDICARE

2.1%

MEDICARE

Annual rate of growth of Canadian health spending in the last three years, the slowest rate of growth in 17 years.

18%

The push for for-profit health care is all about private health insurance

The federal government’s direct share of overall health spending (Canada Health Transfer), with provinces covering the rest.

45%

Amount the Canada Health Transfer covered in 1974.

OUT OF

Number of Canadians getting treatment within the timelines for priority medical procedures established by the 2004 Health Accord.

$36

BILLION

The amount that Ottawa will cut from health transfers to the provinces between 2017 and 2027, without a renewed health accord.

$16.5

BILLION

Additional reduction in federal transfers between 2014 and 2019 due the removal of the equalization portion of the CHT.

“There are very few people who can afford to pay out-of-pocket for a $40,000, $50,000, or even $100,000 procedure, but when you have insurance that would cover it, that's a whole different story.” ZOLTAN NAGY, FORMER EXECUTIVE DIRECTOR OF THE CANADIAN INDEPENDENT MEDICAL CLINICS ASSOCIATION

n the debate around for-profit health care, proponents like Dr. Brian Day like to talk about ideas like freedom of choice. They argue that patients should have the right to spend their after-tax income to access care for their pain and suffering. They are also keen to portray Canada’s health care system as an inefficient “monopoly” that unfairly rations care. However, a word we rarely hear the for-profit health care advocates mention is “insurance.” Strange, because health insurance is really what their fight is all about. Canadian provinces already have a health insurance system. It’s called medicare. In BC, individuals and families, through their

taxes and health care premiums, pay the Medical Services Plan, and all physician services covered by the plan are billed to the MSP, as the so-called “single-payer.” Under medicare rules, private health insurance companies are not allowed to sell coverage for those services already listed by the MSP. These prohibitions on the charging of user fees and “extra-billing” for insured services are what keep our health care system public. Nevertheless, health care businesses like Cambie Surgeries Corporation continue to allow doctors working in their facility to extra-bill patients in violation of provincial law, and will likely continue to do so until the company’s Charter challenge is heard by

UPDATE MAGAZINE July/August 2015

the Supreme Court of Canada. Now, surgery is expensive, and the number of patients who are willing or able to pay the thousands required for care in a private surgical clinic is actually quite small. Cambie Surgeries’ lawsuit has been long and costly, and it will probably drag on for several more years. Why go to all this effort to service a relatively small market of wealthy queue-jumping patients? It’s because Dr. Day and company are not simply trying to get into patients’ pockets. They are attempting to re-establish a private insurance model for primary and acute hospital care that Canadians rejected some 50 years ago. Dr. Day and his allies want access to more patients who are insured under a US-style private health insurance model – allowing them to earn more money than doctors who only work in the public system. But the word “insurance” rarely passes Dr. Day’s lips. One reason for this was Michael Moore’s acclaimed 2007 documentary Sicko, that shed light on the nightmare that is the US insurance-industry driven health care system. Viewers saw patients ensnared in a bureaucratic and legal nightmare, fighting for the coverage they assumed they had been paying their insurance premiums for in the first place. Cambie’s lawsuit is an attempt to take Canada backwards, and is part of a concerted effort to destroy medicare – a social program valued and supported by the majority of Canadians. If the lawsuit succeeds, and prohibitions on user fees and extra-billing are deemed unconstitutional, then the doors to hospital care will be flung open to an already robust US and domestic private health insurance industry all too eager to sell policies to worried Canadians. Most of us can’t afford the thousands required to pay for a procedure

in order to jump the queue. But if Dr. Day and other promoters of a private health insurance business model succeed in their attack, we could all find ourselves paying expensive premiums for hospital and physician services no longer covered by medicare. Canadian’s value their single-payer insurance system, and many are aware of the financial consequences of embarking toward privatized health insurance. But all patients have their limits. If the public system is not supported through adequate taxation and funding, then surgical wait lists will grow and the temptation to dip into personal savings to pay out-of-pocket – if one is able – for a publicly-insured procedure will only grow. Ottawa’s health care retrenchment and refusal to negotiate a renewed health accord that would allow for adequate provincial health funding and planning means that the stress on our public health care system will grow, leaving the future of health care uncertain and aiding privatization proponents in their efforts. A federal government committed to building a cost-effective and universal health care system will make the difference between having coordinated and effective services for all, or fragmented and uneven care that delivers increasingly poor health outcomes. But regardless of the outcome of this October’s election, one thing is certain: the push for for-profit health care is not about the rights of patients. It’s about the right of physicians to earn more money from patients, and the means to this end is the establishment of a US-style private insurance industry in Canada. update

CAMBIE CORP. GOES TO COURT Report highlights the stakes of the for-profit legal assault on medicare A new report by the Canadian Centre for Policy Alternatives examines recent attempts by private sector advocates to challenge the right to universal public health care in the courts, with a focus on the current Charter challenge before the BC Supreme Court, led by Brian Day's Cambie Surgeries Corporation. It reviews the evidence on the impact of for-profit providers and payers on wait times and looks at the potential consequences a successful bid could have on Canada's most valued and cherished public program. As early as November 2015, the BC Supreme Court will begin hearing a challenge to the provincial Medicare Protection Act (MPA) that, if successful, will impact all Canadians in every province and territory, Dr. Day argues that if two-tier care is allowed, wait times will improve. However, the report demonstrates that countries with a two-tier or multi-tier health care system do not experience shorter wait times due to the participation of a parallel private tier. In fact, private payment options increase wait times for those who rely on the public system and increase costs overall while providing poorer patient outcomes. "The plaintiffs are asking the Court to legalize extra-billing, user fees and private insurance,” says report author Colleen Fuller. “If they are successful, it will affect the ability of the Canada Health Act and every provincial health insurance plan to allocate access to physician and hospital services according to need rather than ability to pay.” update

Read the report

NURSES’ V TES COUNT

SENIORS’ CARE Non-profit funding crisis in long-term care bad for nurses and residents

arksville is a sleepy Vancouver Island community of about 10,000 residents. Its sandy beaches and quiet, suburban streets draw small crowds of tourists. The town is also an inviting retirement community. Nestled along one of its tree-lined streets is Arrowsmith Lodge, a 75-bed residential long-term care (LTC) facility. As far as LTC facilities go, it’s exactly what you might expect. Outside, the grounds are manicured with paths, lawns, and fruit trees. Inside, the steady hum of residents and nurses, moving about in wide, bright hallways, completes the setting. To the untrained eye, Arrowsmith Lodge looks like any other LTC facility. So why is Joanne Ord, a nurse and BCNU steward coordinator who works at the facility, frustrated by what she sees as unfair treatment of her residents? Because, when it comes to health policy, there’s often more than meets the eye. Debates and discussion on health funding often revolve about how a system is

financed. Should taxes go up? Should the federal government transfer more money to the provinces for health care? Are MSP premiums or direct taxes a better way to pay for health care? But revenue is just one side of the financing equation. The other, equally important funding question is how health care systems pay the providers who deliver the services. Until recently, Arrowsmith Lodge was an “affiliate” facility. Run by a not-for-profit organization, it was built before the Island Health Authority existed, and later contracted to provide its services to the authority. There are 15 affiliate LTC facilities on Vancouver Island, and 93 province-wide. These non-profit homes operate alongside public facilities that are owned and operated by the health authorities themselves. “We have been struggling with underfunding from Island Health. Because we are an affiliate, we are funded significantly less than the model Island Health uses to fund its own facilities,” explains Ord. She says that the health authority expects the lodge to make do with the funding it

receives. But in the context of a small facility in a small community, this can be very difficult, or even impossible. The Lodge’s size means it can’t easily take advantage of benefits available to a large organization. “Island Health has their own resources for payroll, scheduling, administration and education,” explains Ord. “At Arrowsmith Lodge, we have to find money for this out of our own budget, which is less than that of the [public] facilities.” Ord reports that the lack of funding has prompted the lodge to “disaffiliate” and withdraw from the Health Employers’ Association of BC, a group which bargains collective agreements on behalf of BC health authorities and other employers. “We are now in a position to have to negotiate an independent collective agreement,” she says. As an independent employer, Arrowsmith Lodge will be looking to save money by making cuts to its collective agreements. This has Ord concerned. “It will be harder to attract and retain health care staff, and this will have a negative effect

UPDATE MAGAZINE July/August 2015

on resident care,” she says. “A familiar face goes a long way for our residents. For some, the staff are the only family they have.” It’s clear that Ord is just as concerned for her residents as she is about her paycheque. “Our residents deserve the same level of care as that provided in other facilities,” she says. “The government and Island Health need to be held accountable in providing adequate funding for long-term care so that we can provide safe and appropriate care for our residents.”

“

The government and Island Health need to be held accountable in providing adequate funding for longterm care so that we can provide safe and appropriate care for our residents. JOANNE ORD

”

UNEVEN CARE

The challenges at Arrowsmith Lodge are a reflection of the precariousness of care provided outside the medicare umbrella. Unlike hospitals and doctors’ offices, LTC is not required to be publicly insured under the Canada Health Act. And services, by comparison, are uneven and inequitable. A 2007 report from the Women and Health Care Reform group notes that federal funding was earmarked for LTC prior to 1996. Today, the provinces are required to juggle a smaller amount of funding between increasingly diverse priorities. Given the current economic context and

budget restrictions, it’s easy to see why Island Health would direct its current funding to public beds, and lower the funding rate to non-profit affiliates. By maintaining a higher level of funding in their own facilities, health authorities can point to successes in their own public operations. It looks good on administrators, but what does it mean for residents in non-profit affiliate facilities? To answer this question, we need only ask nurses. “There’s less one-to-one time,” says Ord. “Our residents get mobilized less frequently, and sometimes things get missed.” The research confirms Ord’s observation. According to the most recent Statistics Canada numbers, non-profit facilities provide 2.48 hours of nursing time per resident-day, while public facilities provide 3.3 hours. (Research shows that staffing levels should provide at least four hours of direct care per resident per day in order to ensure appropriate quality of care.) Similarly, non-nursing allied health professionals, such as activity aides, occupational, physical, and recreational therapists, make do with 0.18 hours per resident-day in non-profit facilities, while public facilities have 0.22 hours. “We strongly believe that what is happening with funding in long-term care is very wrong. Our residents deserve the same level of care as those in other Island Healthfunded facilities,” says Ord. Unfortunately, this is not the case. “We do not even have 24-hour RNs seven days a week because the employer says that they cannot afford it,” she reports. The situation is a no-brainer for anyone who’s ever worked in clinical practice: fewer staff means care is going to be less effective and less safe. Current research shows that residents living in for-profit and stand-alone non-profit facilities have a higher relative risk of hospitalization when compared to facilities that are a part of a health authority or hospital. This means that, while reducing funding to non-profit LTC facilities may save money in the short term, the increased cost of hospitalization makes care more expensive in the long run.

BY THE NUMBERS

SENIORS’ CARE

35%

Amount of all long-term care beds in Canada that are for-profit.

22%

Increase in for-profit LTC beds in BC between 2001 and 2009.

12%

Decrease in the number of nonprofit beds over the same period.

Number of Canadian provinces with meaningful legislated minimum LTC staffing levels.

2.6 2.7 TO

Average number of direct care hours per resident per day in BC LTC facilities.

28%

Increase between 2001 and 2010 in the number of BC seniors over age 75.

NURSES’ V TES COUNT

Before the funding crunch, Arrowsmith Lodge had aspired to implementing elements of the Eden model, an approach to care which seeks to eliminate what it calls the three plagues of LTC: loneliness, helplessness and boredom, Unfortunately, it the lodge no longer able to meet this goal with fewer staff available to engage with residents. Regardless, Ord is proud of the lodge’s commitment to provide high quality care. The nurses’ frustration lies with Island Health. “It’s not my employer – they’ve been fighting tooth and nail,” she says. “It’s the government and their funding model.”

seniors’ housing including market rental and ownership, LTC facilities, assisted living units, and others. It found that, in general, affordability, appropriateness and availability of housing were major concerns for seniors. Regarding LTC, the report found that availability and appropriateness were the greatest issues of concern for seniors.

BRINGING IT HOME

Equitable access to LTC has clearly become a looming health care policy issue in BC and across the country, and solutions COMMITTED TO CARE Parksville’s Arrowsmith Lodge steward need to be found and impleteam members Helene Smithson, Mary Wort and Joanne Ord are mented. For Ord, it’s a simple frustrated by a funding model that sees non-profit care facilities receive less than their public counterparts. LARGER matter of ethics. “Our residents ACCESSIBILTY are not second class citizens.” CRISIS LOOMS It’s also clear that whatever The financial crisis facing Arrowsmith for Policy Alternatives has shown that it is the political or policy trends within the Lodge and other affiliate non-profit facilibecoming increasingly harder to get into health care system, residents and nurses are ties will no doubt have an impact on quality LTC, and the number of residents waiting the first to see the effects. In Ord’s words: of care. But what about those seniors who in hospitals for placement continues to “It’s time that the public was made aware have yet to access care? grow, displacing other, more acute patients of what’s happening in long-term care. The When we divide the amount of availfrom those beds and creating larger probinequities in funding levels are incredibly able LTC beds by the amount of people in lems for the rest of the health care system. unfair. Why is it okay for the health authorthe province aged 75 or older, we find that In May of this year, the Office of the ity to fund its own sites at a certain level between 2001 and 2010, the accessibility of Seniors Advocate of BC added its voice to but give inferior funding to its affiliates?” LTC in BC fell by 21 percent. the accessibility issue. Its report, Seniors she asks. “Families deserve to know what is Recent research by the Canadian Centre Housing in BC, reviewed all aspects of really happening.” update

THE SHIFT TO FOR-PROFIT CARE Since 2001, the BC government has required that all new publicly-funded long-term care facilities be tendered through a request for proposals (RFP) process. This favours private corporations and a few large non-profits with the infrastructure to participate in a bidding process. Not surprisingly, since 2001, there has been a more than 20 percent increase in the number of for-profit long-term care facilities and a decline of more than 11 percent in non-profit facilities. Most new long-term care facilities

are now private and for-profit. International and BC studies have shown that private for-profit facilities provide a lower quality of care than non-profit facilities. There are higher rates of hospitalization for conditions like anemia, pneumonia and dehydration, and more substantiated complaints from residents and families. In 2002, Bill 94 gave employers unlimited rights to contract out direct care and support services in long-term care facilities. Employers also gained the right

to terminate and re-tender contracts for these services with just 60 days’ notice. Employers have taken advantage of this provision, and terminated contracts in cases where staff advocated for higher wages and better working conditions. High turnover in long-term care staff has a significant impact on residents, who consider the facility to be their home. Research has shown that residents have better health when they are able to form strong, stable connections with staff. update SOURCE: CCPA

UPDATE MAGAZINE July/August 2015

BY THE NUMBERS

MENTAL HEALTH CARE Nurses are part of the solution

MENTAL HEALTH CARE

$20

BILLION

The cost of lost productivity each year in Canada due to mental illness.

127

Number of Canadian health professionals working in the mental health sector per 100,000 population. Number in Norway: 258.

ealthy citizens are the foundation of a healthy society. But too often, mental health is not given the priority it deserves. Mental health is essential to physical health and personal well-being, but mental health care systems in British Columbia and other provinces are in crisis. Patients and their families lack support in dealing with mental illness, and nurses in community, residential and acute facilities work in unsafe conditions under impossible workloads. The current system where the police and criminal justice system have become the default care provider for many seriously mentally ill people has a great human and financial cost. The Mental Health Commission of Canada is clear that provincial mental health care systems are underfunded and fragmented and need to focus on promotion and prevention not only in the health care system but also in schools and workplaces. The commission reports that the total cost of addressing mental-health problems and illnesses over the next 30 years is expected to exceed $2.5 trillion. Yet some of these costs could be prevented.

An estimated 70 percent of mental-health problems emerge in childhood or adolescence and evidence shows the earlier they’re tackled, the better the chances of positive outcomes. It’s a big problem that requires federal coordination, especially as more young people speak out and seek help. While there has been increased attention and funding from various levels of government (from community boards to federal agencies), Canadians are still left with a patchwork of initiatives, and few concrete steps are taken to improve access to diagnosis and provide funding for treatment. Nurses can and should be part of the solution in the development of a patientcentred, pro-active approach to mental illness through expansion of the mental health nursing scope of practice, and embedding mental health nurses in the school system, emergency departments, ambulance service, police and other community services. And as the population continues to age, dementia will continue to grow as a key mental illness. Attention will also need to be paid to this population as part of any robust mental health strategy. update

30%

Amount of all short- and long-term disability claims that are due to mental health problems and illness.

34 IN

Ratio of Canadian children who don’t access mental health services and treatments.

$200

BILLION

Estimated long-term cost of childhood mental health disorders in Canada.

CENTS

Amount of every public health care dollar that goes to mental health .

NURSES’ V TES COUNT

BY THE NUMBERS

PRESCRIPTION DRUGS

$33

BILLION

Amount that Canadians paid for prescription drugs in 2012, either directly, through insurance plans or by provinces

NATIONAL DRUG PLAN

universal access to safe and appropriate care. A national drug plan has many advantages. It would provide equal We can afford it access to prescription drugs and we need it for all Canadians, replacing our uneven patchwork of provincial programs and private insurance at work. It would also control costs by allowing providers to negotiate good prices and reducing anadians pride ourselves administrative costs. on our universal Medicare Because there is no national drug plan, system. Unfortunately, we there are over three million Canadians also have an American-style who are uninsured or under-insured for system of paying for drugs, prescription drugs. Our patchwork of and it yields American results –inequity, provincial programs and work-based plans waste and high costs. means that access to drugs depends on The growing cost of prescription drugs where you live and where you work. For is one of the biggest problems facing example, a couple aged over 65 with an Canadians today – and it’s an issue income of $35,000 who need $1,000 of that demands action from the federal drugs per year would pay the entire cost in government. New Brunswick and Newfoundland, twoCanada is the third most expensive thirds of the cost in Quebec, one-third in country in the world for brand-name drugs. Ontario and B.C., but nothing in the Yukon Studies have shown that a national univeror Northwest Territories. sal public drug plan would save billions By far the major driver of rising costs is of dollars for Canadians, improve health the use of new, more expensive and most outcomes and reduce suffering. often inferior drugs instead of existing, lessMedicare’s founder, Tommy Douglas expensive products. The problem is, when didn’t intend for health insurance to cover a drug is newly released onto the market, only hospitals and doctors. These services there is intense promotion by drug comwere supposed to be just the beginning, panies to both the public and to doctors, with coverage of drugs and other services encouraging them to request and prescribe to follow. But despite repeated proposals the latest expensive brand name. As a result, and pledges, Canada remains one of the few drug costs escalate, threatening both proindustrialized countries without a national vincial and work-based drug plans. drug plan. In addition to saving administrative costs There is a growing chorus for change and choosing safer, less-expensive older that’s coming from many quarters, that drugs, national drug-insurance plan could includes employers, unions and provincial bargain with the pharmaceutical companies governments. The call for a national drug to pay lower prices for drugs. strategy is growing. What does this look Like so many other industrialized counlike? tries, Canada can afford a national drug A national publicly funded and adminisplan. We already pay for our drugs – but tered insurance plan for medication would a plan would let us do so more effectively, cover essential drug costs the way medicare more economically and more fairly. We’ll covers hospitals and physicians, providing be able to do more for less. update

30% C Amount that Canadians currently pay above the OECD average for lack of a national drug program to negotiate lower drug prices.

13%

Additional increase that Canadians will pay for drugs under the terms of the recently-negotiated Canada-European Union freetrade agreement (CETA).

14 OUT OF

Ratio of Canadians without supplementary insurance who can’t afford their prescriptions.

BILLION

Amount that a national drug plan could save each year while covering virtually all prescription drugs.

UPDATE MAGAZINE July/August 2015

ISSUES AT STAKE Making Canada a better place for everyone

urses know that strong communities are healthy communities. That means social determinants are just as important as direct patient care when it comes to developing and implementing effective social policies. There are a range of issues related to health care that require action from Ottawa. They are wise investments that benefit workers, their families and their communities.

CHILD CARE

The cost of quality child care is prohibitive, and an increasing strain on family budgets. Across Canada, parents work hard and make sacrifices to ensure that their children get the care and early childhood education the need for a good start in life. Women pay the highest cost, and are often forced to miss work or delay their careers because they can’t find reliable child care. Canadian parents have waited too long for affordable child care they can trust. It’s time to establish a national child care program.

PENSIONS

Canada is facing a pension crisis. Some

11 million Canadians don’t have a workplace pension, and less than 25 percent of Canadians contribute to RRSPs. Expanding the Canadian Pension Plan is the most efficient, effective and affordable way to address this crisis. All Canadians have a right to retire in dignity with a secure income. Expanding the CPP and protecting the pensions we’ve got is the best way to ensure that we are safe in our retirement years.

HOME AND COMMUNITY CARE

As the provinces assume a greater share of health care financing, Canada’s health care system is becoming increasingly stressed and fragmented, and at risk of more privatization – especially in those areas not covered by medicare, such as home and community care. It’s time for renewed federal leadership to ensure that Canadians get the quality care they need, when they need it. Ottawa’s cuts to provincial health transfers must be reversed to allow for needed investments in health human resources. Canada’s population is aging at a time when fewer nurses are graduating and more than five million Canadians are without a family doctor.

We need immediate action. It’s time for targeted investments in long-term care, home care and mental health, so that caregivers get the support they deserve and seniors can have affordable, quality care in the comfort of their home.

GOOD JOBS AND PUBLIC SERVICES

The country’s slow economic recovery has left 2.8 million Canadians unemployed or underemployed. Nearly three quarters of the jobs created in the past six years have been precarious (part-time, temporary or in the self-employed sector). With limited job prospects, household debt is at an all-time high. All the while families are struggling to make ends meet and the public services they depend on everyday are being cut. Canadians need high-quality, secure jobs instead of short-term, temporary positions. Our economy needs to benefit the majority of Canadian workers, not simply the few. Decent paying jobs, strong public services that fuel our economy and a taxation system where everyone – including corporations – pays their fair share will ensure the good health of the communities that nurses serve.

LEARN MORE

Visit the federal parties’ websites to find out where they stand on these issues

Conservatives www.conservative.ca

Greens www.greenparty.ca

NDP www.ndp.ca

Liberals www.liberal.ca

COMMUNITY NURSING

DISCONNECTED CARE THE LACK OF INTEGRATED PATIENT RECORDS HAS NURSES SPENDING TIME ON UNNECESSARY PAPER WORK SMART PHONES, TABLETS, phablets and laptops are now commonplace devices that keep busy professionals productive and connected to their clients and organizations. When BlackBerry integrated email with cell phones in 2003, it launched a revolution in mobile computing that’s evolving at a dizzying pace. Today it seems like there’s a mobile app for almost every human activity, and people under 25 find it difficult to comprehend a world where they’re not wirelessly connected to their friends, families and workplaces. But community nurses in British Columbia don’t share the connected universe of 25-year-olds. And because they’re not supplied with integrated mobile technologies it’s tough for them to provide modern, high-quality health care to patients. Roni Lokken has been a community nurse since 2004 and has also worked in acute settings in both urban and remote areas of northern BC. “Community nurses will typically see between three and seven patients a day,” says Lokken. “They’re mostly clients needing assessments, wound care, palliative care, and blood pressure or blood sugar monitoring.” Lokken says one of the biggest frustrations for community

CONNECTED CARE Community nurses across BC say that the use of mobile computer technology such as tablets would reduce the enormous amounts of time they currently spend to re-create patients’ health records that already exist on non-networked computers.

nurses is the lack of integrated patient records and the amount of unnecessary work that creates. “When I’m assigned a patient I should be able to access all of their health information like medications, notes from their doctor, or charting from the discharging hospital,” says Lokken. “Community nurses shouldn’t need to build new health records for every community care patient.” Lokken explains that within a health authority there’s a mixture of unconnected computer

systems. Hospitals, community care, doctor’s offices and other health providers keep patient records on different computer systems, and most of these don’t share information. To make matters worse, electronic record systems between different health authorities are even more disconnected. This lack of connectivity causes enormous amounts of lost time whenever nurses have to re-create patients’ health records that already exist in other computers. “On a typical day I’ll spend

about two hours doing ‘rework’ like re-charting information or rummaging through multiple computer systems trying to find patient information,” reports Lokken. “If you add that up across the whole province, it’s likely tens of millions of dollars every year that’s lost to unproductive activities.” Amanda Halliday is a public health nurse in Fort St. John and has patients who would also be well served by integrated mobile technologies. “In public health the patient populations we see outside of our office are post-partum moms and children who need vaccinations at school,” says Halliday. “We also support people with communicable diseases.” Halliday says public health nurses don’t have wireless access to clients’ charts so they have to print and carry paper charts with them into each home. Then they chart on paper and redo that work when they enter it in the public health computer at their office. “It’s a very time consuming duplication of effort,” she says. “If I have wireless access to patient records I can chart at the client’s home and that’s a much more efficient use of my time.” Halliday believes mobile technologies would also help her connect clients with community resources and provide

Secure your 33 retirement from the starting line

UPDATE MAGAZINE July/August 2015

information on medications. Currently, providing clients with that kind of information means doing research from her office and then calling the client back. Halliday says the lack of integrated health records and mobile technologies also causes frustration for parents when their children need vaccinations.

“On a typical day I’ll spend about two hours doing ‘rework’ like re-charting information or rummaging through multiple computer systems trying to find patient information.” RONI LOKKEN

“If parents don’t bring vaccination records to school clinics then we have to check three different systems to see if the child is eligible for a vaccination because a record could exist in any one of them,”

explains Halliday. “Often I have to ask the parent to come to my office so I can check vaccination records and then give the shot – it’s very frustrating and time consuming for everyone.” Lokken serves as chair of BCNU’s North East region. Her position allows her to listen to members’ concerns on a range of issues, and the lack of integrated mobile technology is one of the biggest frustrations for community nurses. “I hear comments like Amanda’s all the time,” says Lokken. “Northern Health covers a huge area and a lot of it is remote so we have unique needs for mobile and satellite technologies. We also need things like GPS tracking and satellite alert systems to keep community nurses safe when they’re in remote areas.” BCNU president Gayle Duteil says it’s not only northern nurses who are asking for these technologies. “Across the province community and public health nurses want integrated patient records and mobile technologies to access them.” “Community-based nurses should know when a client has been to the hospital, a walk-in clinic, a pharmacy or a doctor,” says Duteil. “And integrating that information for all health providers will give better care to patients and lower costs to our public system.” update

Learn more at the

Municipal Pension Plan AGM October 15, 2015 10 am – noon Anvil Centre Third floor theatre 777 Columbia St. New Westminster

PROVINCE-WIDE COMMITTEE EXPLORES NEW TECHNOLOGIES FOR COMMUNITY NURSES BCNU has representatives on the province-wide Community Nursing Technology/ Resident Assessment Instrument Working Group committee that’s looking at new technologies to improve community health care. And as part of this April’s grievance settlement for improved staffing, BCNU was awarded $2 million that’s being used as seed money to provide technology to community-based nurses. The committee’s goals are to: 1. Determine the appropriate use of the short form Resident Assessment Instrument. 2. Identify and implement technology applications that improve patient care delivery and enhance safety for community health nurses. 3. Address staffing, workload and ways to increase patient interaction.

The Municipal Pension Plan AGM Doing it right mpp.pensionsbc.ca

PRFs

IN THE WORKPLACE

PERSISTENCE PAYS FOR ST. PAUL’S HOSPITAL CORONARY INTENSIVE CARE UNIT NURSES

“It took 100 years of combined critical care experience to make our nursing voices heard and get the solutions we wanted.” HAROLD MCCARTHY, BCNU STEWARD AND CLINICAL NURSE LEADER

would be reduced from seven RNs and one clinical nurse leader (CNL) down to six RNs and one CNL. Staff were told the changes were the result of provincial funding being redirected to the recently opened Kelowna Regional Heart Centre. But the reductions in St. Paul’s cardiac program budget didn’t come with any changes in the actual number of CICU beds at the hospital, which remained at 11. This number stood contrary to the assumption that, because the CICU had, on average, two patients from Kelowna, there would be fewer patients at St. Paul’s once the Kelowna patients could be treated in their own community. Harold McCarthy is a BCNU steward and CNL at St. Paul’s. The nurse of 32 years has worked on the CICU for 13 years, and his experience told him that management’s decision would have a detrimental impact on the staff ’s ability to FOCUSED ON POSITIVE CHANGE St. Paul’s Hospital coronary intensive provide safe patient care. care unit clinical nurse leaders Aurora Verzosa and Harold McCarthy say He says that staff repeatedly the PRF process was essential for ensuring their patients get the safe and professional care they deserve. raised their concerns with managers. However, without the Professional Responsibility St. Paul’s cardiac program Form (PRF) process he feels VANCOUVER’S ST. PAUL’S is made up of four units that they likely would not have been Hospital is one of the busiest include the coronary intensive able to effect the changes they in the province, and its worldcare unit (CICU), cardiac surgi- called for. “No matter how many renowned cardiac program cal intensive care unit (CSICU), respectful conversations we had makes the facility BC’s primary cardiac surgical unit and cardiac with our operations leader or heart centre. The hospital medical unit. senior management, it was only receives the most critical and In the fall of 2012, hospital by engaging in the formal PRF complicated cardiac patients, management announced that process that worked in the end,” and it’s impossible to divert baseline staffing for the CICU says McCarthy. them, even when overcapacity.

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“Even though it took some time, we recognized that the PRF process was the best route to create positive change.”

HAROLD MCCARTHY

Even before the cut was implemented in 2013, staff in the CICU found that, with their seven RN and one CNL baseline staffing complement, they were unable to meet their standards of practice due to the unanticipated nature of changes in patients’ acuity and inability to adequately control admissions. Before filing any PRFs, they met with management in an attempt to brainstorm ways to anticipate ongoing surge activity and capacity. “We had many discussions over and over again about our issues,” recalls McCarthy. “Everyone admitted there was a problem, even in 2012, but there seemed to be an unwillingness to do anything about it.” McCarthy said that issues remained unresolved, and in the fall of 2012 a number of staff started to file PRFs. Using the PRF process, they reported numerous dangerous incidents and patient safety concerns. These included two critical admissions within a half-hour period, resulting in a tripled assignment; a cardiac arrest requiring three to four RNs, which resulted in minimal

coverage for the rest of the unit; patients who required one-toone nursing care being put into a double assignment; and the frequent inability to secure staff on short-call. In response to the nurses’ concerns, management developed an action plan that included policies, guidelines and a staffing decision algorithm. It also agreed to provide acuity staffing when surge occurred, but given the nature of the CICU, calling someone in hours after a critical event had occurred did not help to ensure the safe care of unstable and unpredictable patients. The solution didn’t allow staff to meet unanticipated acuity. The reality was that, to be effective, an algorithm needed to include a review of the entire cardiac program and on-going collaboration and consultation with all critical care departments. The staffing issues remained unresolved despite management’s temporary fix. As a result, 16 PRFs were filed between October 2012 and December 2014. “I lived the PRF process

every day. I felt it was my job as a CNL to advocate for the staff,” says McCarthy. “I got a lot of input from the staff about their frustrations and we all soon realized how important it was to support each another throughout the process.” McCarthy credits the support and guidance of Andrea Rauh, BCNU Vancouver Metro region PRF Advocate and St. Paul’s PRF committee co-chair, for ensuring that some progress was finally made. “I can’t say enough about the work that Andrea did on our behalf,” he says. “It’s important to have a PRF co-chair who is focused, collaborative, acknowledges the problems and investigates every possible solution. She was critical to our success.” In June 2014 the CICU nurses decided to advance their PRFs to the Senior Review Committee (SRC), the joint union-employer committee that’s tasked with finding solutions that are unanimous and binding. While waiting to present their concerns to the SRC, the group filed four additional PRFs in late 2014, and these

were heard at a regularly scheduled PRF committee meeting this spring. Then, in May, the nurses were surprised to find that their persistence and tenacity had finally paid off. Hospital management informed them that the employer agreed to restore baseline staffing back to seven RNs and one CNL. A new rotation will be posted within a month and in the interim the employer will continue to staff to this level. There will also be a review in six months to determine if this change is meeting patient care needs. The employer also agreed to undergo a critical care staffing review that includes the hospital’s intensive care unit (ICU) and post-anesthesia recovery (PAR) unit. A clinical nurse specialist will be hired to complete this review as soon as possible. “We’ll continue to watch and observe and articulate any issues that don’t get resolved from the PRF process,” says McCarthy when asked about his mission in the wake of the success. “I will have to be proactive regardless of what unfolds to get what we need to ensure our patients receive the safe and professional care they deserve,” he says. “Even though it took some time, we recognized that the PRF process was the best route to create positive change.” update

Q&A

HUMAN RIGHTS AND EQUITY

AN INTERVIEW WITH BCNU ABORIGINAL LEADERSHIP CIRCLE ACTING CHAIR SHERRY RIDSDALE

IN MAY OF THIS YEAR, the Truth and Reconciliation Commission of Canada released its final report, entitled Honouring the Truth, Reconciling for the Future, along with 94 calls to action that, if implemented, could go a long way to address the racism and discrimination that Aboriginal people have experienced in this country. The Commission spent the past six years documenting the experiences of Aboriginal people whose lives, and those of their loved ones, were torn apart by the residential school system. The report has sparked a national dialogue on the need for all Canadians to take meaningful action to rectify historic injustices. It has also raised questions about the federal government’s commitment to make reconciliation a reality. Update magazine sat down with BCNU Aboriginal Leadership Circle acting chair Sherry Ridsdale to talk about the current political reality facing Canada’s First Nations, Inuit and Metis peoples. UPDATE Since its election in 2006, the Harper government has refused to acknowledge within Canada that indigenous peoples’ collective rights are human rights. And for years, it has refused to consult

indigenous rights-holders on crucial issues, especially when it involves international forums. For example, last year at the World Conference on Indigenous Peoples, a historic two-day meeting at the UN General Assembly in New York focused on developing steps to implement the United Nations Declaration on the Rights of Indigenous Peoples, Canada was the only country in the world that objected to the commitment to uphold the principles of the declaration, arguing that they are incompatible with Canada’s constitution. Critics have said that this repeated failure to consult Aboriginal people violates Canada’s duty under Canadian constitutional and international law. How does this make you feel? RIDSDALE Every day in the news we read about international human rights violations and groups like Amnesty International are talking about the amount of racism that exists today. But here in Canada the history books have hidden the native history, and the fact that there was the genocide of 3,000-plus native children who went missing at residential schools and were

buried in mass graves. The numbers could be higher but we’ll never know because they never kept records. Canada doesn’t want to acknowledge this in the history books because we would no longer be seen to be holding up human rights. We would be no better than China, South Africa or any other country that committed genocide. We would be classified in there. Canadians pride ourselves on human rights and Harper’s

UPDATE MAGAZINE July/August 2015

making a joke out of that. It comes down to the government not wanting to give Aboriginal people the rights that they deserve. He doesn’t want to give them land rights. He doesn’t want to give them anything. So this is not a surprise. What is shocking is how he is making Canada look internationally. Canada is committed to defending human rights and yet we’re not even acknowledging our indigenous people – that sends a huge message and not a good one. UPDATE Prime Minister Harper has said that the security of Aboriginal women is not something that requires a federal inquiry and that the RCMP can deal with the deaths of hundreds of murdered and missing Aboriginal women as criminal investigations. Then we have Bill C-51, the government’s controversial anti-terrorism bill that was quickly passed into law following the shooting deaths of two soldiers on Canadian soil. Suddenly, security seems to be at the top of the government’s agenda. What’s your reaction to that? RIDSDALE The murdered and missing women issue shows how systemic the problem is, because Harper won’t even acknowledge it – it’s not on his radar. The numbers of Aboriginal people are so low that he doesn’t care, because they’re not going to have an impact when it comes to voting. So he’s not interested in us.

Bill C-51 is a personal attack on any Canadian who goes out and protests the government. It makes them into “terrorists” so they silence our voices, and then we can’t speak. For Aboriginal people, the law means they won’t be able to protect their land. Even though the Supreme Court of Canada has ruled they have the right to control their own land, with Bill C-51, they will be arrested, they will be labelled terrorists and they will be put in jail. When the law passed it was a huge slap in the face not just for Aboriginal Canadians but every Canadian. BC is known for protests. Look at Burnaby Mountain: there were hundreds of protestors up there trying to stop the Trans-Mountain pipeline survey. The law is designed to protect investors who are there to make money, not the average Canadian. UPDATE The Truth and Reconciliation Commission has made quite a few calls to action. One of these is a call for the federal government to appoint a public inquiry into the causes and remedies for the disproportionate victimization of Aboriginal women and girls. Now that the TRC has made that explicit call to action, are you optimistic about the possibility of justice being served? RIDSDALE I’m not really optimistic. There have already been 700 recommendations made over the past 20 years on the issue of missing and murdered Aboriginal women and none

have been implemented. It’s easy to lose hope. Maybe the TRC’s call to action will be a wake up call for Harper, but I think Canadians are going to have to start speaking up more. This is not acceptable and they have to start looking at what brought us here and why we are in this situation now. And it all comes down to government policies and government programs that removed people from the reserve so there would be no native Indians or Aboriginal people in Canada. Basically that’s what it comes down to. Aboriginal programs and everything that the government put in place was meant to annihilate the Aboriginal people – make them extinct. If all the Aboriginal people could be removed then there would be nothing for the government to worry about, and it would cost them zero money. They wouldn’t have to provide housing, school and education – things that most Canadians take for granted. Aboriginal people have to argue for

TAKE ACTION Indigenous women are going missing and being murdered at a much higher rate than other women in Canada – a rate so high it constitutes nothing less than a national human rights crisis. Amnesty International is calling for a comprehensive, coordinated, and well-resourced National Action Plan, created in collaboration with Indigenous women and girls, to stop the violence. The plan should include a national public inquiry into missing and murdered Indigenous women and girls – focused on exposing the nature of this violence and on ensuring government and police accountability for an effective and coordinated response.

SIGN THE PETITION AND ADD YOUR VOICE TODAY!

Q&A

HUMAN RIGHTS AND EQUITY

these things. Until these issues are fixed, it’s just going to be the same old, same old, and it appears that Harper doesn’t want to admit that Canadian governments screwed up. UPDATE The TRC issued six specific calls to action regarding health. Overall, the message is that there’s a huge disparity in health outcomes that the government needs to address in consultation with Aboriginal peoples. The last recommendation calls on medical and nursing schools in Canada to require all students to take a course dealing with Aboriginal health issues including the history and legacy of residential schools, the United Nations Declaration on the Rights of Indigenous Peoples, treaties and Aboriginal rights, and indigenous teachings and practices. That’s a call to action that is fairly specific about the situation right now when nursing students are being trained, and the BCNU Aboriginal Leadership Circle has also

raised this issue recently. RIDSDALE It’s all good for nursing schools to teach about native history in nursing school, but the history has to be correct in order for students to understand what the native people have been through. There’s no ability to move forward if nobody can understand why these people are in this position they are now. Until you fix the history so that it reflects exactly what happened to the Aboriginal people, you can make every recommendation you want. If people don’t understand the history, they’re not going to understand the people. Everybody understands the holocaust and what happened to those people – how horrible it was. Well, they need to understand that went on in Canada too. They need to understand that the reason Aboriginal people today live in the places they do and the reason there are no schools, no health care and no housing or running water is because of the government pro-

grams that were put in place. It’s basic stuff. But unless we fix the social economic legacy and put those murdered and missing women back to being the centre of their communities, there will be no change. UPDATE You’ve mentioned the holocaust. The TRC concluded that the treatment of Aboriginal people constituted cultural genocide. Was it simply cultural? RIDSDALE It was an actual genocide. It was more than simply cultural. They wanted to make sure there were no native Canadians left in this country. That’s the genocide of a whole race. They wanted to wipe out the Aboriginal people of Canada so that nobody could say, “this is what you’ve done.” And they wouldn’t have to settle land claims, worry about education or housing, and they wouldn’t have to honour any of the treaties they signed because they wanted to make sure no native people were left. update

READ THE TRUTH AND RECONCILIATION COMMISSION’S SUMMARY REPORT “Land is seized, populations are forcibly transferred and their movement is restricted. Languages are banned. Spiritual leaders are persecuted, spiritual practices are forbidden, and objects of spiritual value are confiscated and destroyed. And, most significantly to the issue at hand, families are disrupted to prevent the transmission of cultural values and identity from one generation to the next.” So begins the summary report of the Truth and

Reconciliation Commission’s account of the destruction of Aboriginal social structures and practices that allow a people to exist, in what amounted to cultural genocide. Required reading for all Canadians, young and old, who wish to truly appreciate Read the report here their country’s history.

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

UPDATE MAGAZINE July/August 2015

Member Profile

YOUR COLLEAGUE CLOSE-UP

PHOTO: EAGLE RIDGE HOSPITAL FOUNDATION

ICING ON THE CAKE EAGLE RIDGE HOSPITAL NURSE SANDI SAUNIER PERFORMS AREOLA TATTOOS FOR SURVIVORS OF BREAST CANCER

SANDI SAUNIER IS ONE of very few nurses working in Western Canada who has the sub-specialty of being allowed to tattoo for medical purposes. Since 2009, the Eagle Ridge Hospital nurse is called on to perform this specialty when plastic surgeons refer their patients to her postmastectomy. “Once the breast reconstruction is almost complete and the nipples have been formed, they come to see me and I tattoo the nipples on them,” explains Saunier, who says she also does the occasional lip tattoo for patients treated for cleft lips. When working as a surgical nurse, Saunier says she had frequent contact with plastic surgeons who had no tattoo nurse to refer their patients to post-mastectomy. Saunier was

CREATIVE CARE Nurse Sandi Saunier uses her unique talents as a tattoo artist to help women recover from breast cancer.

asked if she was wanted to take the specialized training required of a tattoo artist, and she gladly accepted. Saunier received her training from a private school that teaches cosmetic tattooing. Afterwards she hung out with a tattoo artist at a tattoo parlour. “I wanted to learn as much as I could, because there are no other nurse tattoo artists I could train with,” she says of the unique learning experience. Saunier now spends one day each week tattooing patients at Eagle Ridge Hospital, where she has the use of a minor OR that she describes as “nice, clean,

new, with bright lights that are perfect for me to do my work.” The hospital’s areola tattoo program has been running since 2012 and will be able to offer the service free of charge to about 250 women in the coming year through the generous support of donors. (Areola tattoos are not covered by MSP since it is still considered a cosmetic procedure.) Saunier sees patients from all over BC. “All the plastic surgeons from Abbotsford to North Vancouver refer to me when their patients are ready.” Saunier explains that for women who have gone through

numerous surgeries to create the reconstructed breast and nipple, getting the areola tattoo is the final step that makes the reconstruction look like a normal breast. And for women who don’t have nipple reconstruction, Saunier can create a 3-D look just by using different coloured inks. “I get to put the final icing on the cake for these ladies,” she says. She says her interaction with patients during the process is an opportunity that they wouldn’t get using a cosmetic tattoo artist. Saunier spends about two hours providing nursing assessments and care related to her patients’ current health status, both mental and physical. The process allows her to focus on the patient’s healing process in a safe and confidential environment. Saunier estimates that she has tattooed about a thousand patients now. In doing so, she has learned about her patients’ specific needs, and if she finds that a patient is struggling, she’s able to refer them to the appropriate interventions and supports. “Almost every one of us is affected by knowing someone with breast cancer,” says Saunier, who notes that since starting this work, one of her best friends was diagnosed with breast cancer. “So there I am tattooing one of my best friends,” she recalls. “I listened to her story too, and she was no different from anyone else, opening up and sharing her journey.” update

Who Can Help?

BCNU IS HERE TO SERVE MEMBERS

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

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

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

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

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

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

EXECUTIVE COUNCILLOR Adriane Gear (Transition date to be determined)

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

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

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

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

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

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

FRASER VALLEY Katherine Hamilton Chair C 604-793-6444 katherinehamilton@bcnu.org NORTH EAST Veronica (Roni) Lokken Chair C 250-960-8621 veronicalokken@bcnu.org NORTH WEST Sharon Sponton Chair C 250-877-2547 sharonsponton@bcnu.org OKANAGAN-SIMILKAMEEN Rhonda Croft Chair C 250-212-0530 rcroft@bcnu.org PACIFIC RIM Rachel Kimler Acting Chair C 250-816-0865 rachelkimler@bcnu.org RIVA Lauren Vandergronden Chair C 604-785-8148 laurenvandergronden@bcnu.org SHAUGHNESSY HEIGHTS Claudette Jut Chair C 604-786-8422 claudettejut@bcnu.org

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

UPDATE MAGAZINE July/August 2015

Council Profile

HERE’S WHO’S WORKING FOR YOU

CAPACITY BUILDER OKANAGANSIMILKAMEEN CHAIR RHONDA CROFT

EMPOWERING MEMBERS

“Building new relationships means we all have to work together, nurses and the employer. It’s OUR workplace,” says OkanaganSimilkameen chair Rhonda Croft. QUICK FACTS NAME Rhonda Croft. GRADUATED Okanagan College, 1993. UNION POSITION Okanagan-Similkameen chair. WHY I SUPPORT BCNU? The strength of this organization is the voice and opportunities that it gives members.

RHONDA CROFT WAS A stay at home mom, who one day decided on a whim to go into nursing. “A friend said she was going to nursing school and that sounded like something I would like to do as well,” she recalls. Croft graduated in 1993 from Okanagan College with a nursing diploma and says it’s the best decision she ever made. As a new graduate, Croft first worked at Penticton Hospital, then moved to an extended care facility where she specialized in treating patients with dementia. Croft says she has always enjoyed working with older people and the focus on the whole person that the work requires. “It takes a lot of kindness, and I feel really blessed to have worked there,” says Croft of the experience. When the facility closed,

Croft decided to get her nursing degree from Okanagan University College, with a focus on community nursing. Croft’s instructors urged her to further her studies, and she enrolled in the University of British Columbia Master of Nursing program. In response to what she experienced personally in the workplace, Croft’s thesis explored bullying and horizontal violence. “Bullying is prevalent everywhere, even in nursing. Nursing is hierarchical, we experience oppression, and nursing is not the dominant culture in our workplaces,” explains Croft. “Nurses are ordered to care for patients in a system that doesn’t value caring,” she says. “The stress of being overcapacity or understaffed causes good people to do bad things,” she

continues. “There’s a responsibility by the organization to create and maintain safe and respectful workplaces.” Croft says she loves working in community nursing, but that it has its unique challenges. “Community has it tough these days, with ‘invisible overcapacity’. You can count the patients in an ER, but decanting the hospitals means that community nurses have to try and keep patients safe at home, which is really difficult when the resources don’t follow.” Croft first became a BCNU steward in 1996 because her worksite “needed the nurses’ voices to be heard,” she recalls. Motivated with upholding nurses’ collective agreement, Croft served on her BCNU regional executive in several capacities, and was elected Okanagan-Similkameen regional chair in 2008. She currently serves on BCNU’s Bargaining Committee, where she represents community nurses. Croft also worked as a fulltime organizer, encouraging LPNs to join BCNU. “The strength of this organization is the voice and opportunities that it gives members,” says Croft. “We’re so democratic. I loved being able to tell LPNs it would be one member, one vote to determine their leadership.” Croft is now focused on building capacity within her regional executive, mentoring future leaders, and creating space for diverse voices. “I campaigned on calm, thoughtful leadership so I aim for that in my style.” update

UPDATE MAGAZINE July/August 2015

Off Duty MEMBERS AFTER HOURS

BACK TO THE LAND LAURA DICKINSON IS FINDING HAPPINESS IN HER COWICHAN VALLEY PRODUCE FARM IT’S 5:30 ON A SATURDAY morning at the Romney Farm on Vancouver Island and Laura Dickinson is picking strawberries. She has just enough time to harvest them for the weekly farmer’s market before heading to work at the hospital for an 8:00 a.m. shift. Dickinson has been an OR nurse at the Cowichan District Hospital for ten years. It’s a small facility, with only 104 beds. But like so many other BC hospitals, it’s constantly overcapacity. There aren’t enough nurses to meet an ever increasing number of patients and Laura is often called in overnight. As a union steward and nurse educator for BCNU’s Pacific Rim region, she is passionate about nursing. But the overwhelming burden of trying to provide basic, safe patient care while working short every day played a large part in a life-changing decision. Recently, Dickinson gave up full-time nursing and now works as a casual at the hospital. “I’m sick of fighting, so I’m going to do something that makes me happy.” Happiness, to this energetic 55-year-old, means devoting herself to the farm she and

her husband Bruce own in the Cowichan Valley. The couple emigrated from the United Kingdom 11 years ago. They discovered the Cowichan Valley when they were touring Vancouver Island and came across Cobble Hill. Dickinson says they fell in love with the bucolic setting, and decided to put down roots – literally. In addition to working full time at the hospital, Dickinson toiled on the land with her partner to help build their “all

natural” produce farm into a successful small business. Romney Farm is six-and-a-half acres and filled with fruits and vegetables. Last year the couple added three greenhouses. During peak growing season, the farm produces up to 200 pounds of salad greens per week. While the Romney Farm is not certified organic, it uses only organic principles – no chemical sprays or pesticides. All food grown is 100 percent natural and local. The venture has not been without its challenges. Unwanted bugs can cause havoc for small operators. An infestation can wipe out an entire crop and six months’ work. To fight back while still maintaining organic practices, Dickinson has turned to natural predators. For example, last year when aphids were chewing on the blueberry bushes, she brought in 60,000

ALL NATURAL Laura Dickinson’s Cowichan Valley produce farm uses only organic principles – no chemical sprays or pesticides. Inset: some of this season’s tasty bounty.

ladybugs. The ladybugs disappeared and eventually, so did the aphids. The Dickinsons have also tried diversionary tactics, such as planting radishes next to the lettuce, because wire worms – if given the choice – prefer eating radishes. While consumer demand for fresh, local produce is surging, there is also plenty of competition in the natural and organic farming business. Still, the Dickinsons have managed to carve out a niche market. Romney farm berries and salad greens are now being served up at some of Vancouver Island’s top restaurants and the future looks promising for this hard working couple. As with nursing, the days are long and physically demanding. But nursing, says Dickinson, is definitely the tougher job. “Although farming is labour intensive, it’s a different sort of work than in the OR. The mental stress at the hospital is harder.” With their three children now grown, the pair can focus on the farm and enjoy their time off – although they rarely take more than one day off a week. With a bright future ahead, Dickinson looks forward to life after nursing – growing and harvesting fruits and vegetables – and spending time with her family, three dogs and the latest additions – six baby piglets. It seems she is living her dream. update

SEPTEMBER 13, 2015 2.5 KM OR 5 KM WALK BCNU is encouraging members to participate in Ovarian Cancer Canadaâ&#x20AC;&#x2122;s Walk of Hope on September 13.

Participate as an individual, register as a team captain or join a team. You can even start a walk in your own community!

Your fundraising efforts will help raise awareness, offer hope and support to women diagnosed with ovarian cancer and fund research on early detection and improved treatments.

Visit ovariancancerwalkofhope.ca to view a cross-country map of communities participating in the Walk of Hope and encourage your family to join!

REGISTER TODAY AT: OVARIANCANCERWALKOFHOPE.CA BC WALKS: Abbotsford > Chilliwack > Duncan > Kamloops > Kelowna > Nanaimo > Vancouver > Victoria

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