BCNU Update Magazine July-Aug 2016

JULY/AUGUST 2016

WATER IS A RIGHT: MEMBERS SIGN ON TO BLUE COMMUNITIES PROJECT

RUN FOR THE CURE: BCNU GEARS UP TO BEAT BREAST CANCER

MENTAL HEALTH SERVICES: THE CALL FOR CARE CONTINUES

UPDATE BRITISH COLUMBIA NURSES’ UNION

BARGAINING SUCCESS

NEW PROVINCIAL CONTRACT RATIFIED “NOW THE REAL WORK BEGINS”

THE FUTURE OF MEDICARE NATIONAL SENIORS’ STRATEGY NEEDED

CONVENTION 2016

WWW.BCNU.ORG

The

POWER of UNITY

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JULY 31, 2016

VANCOUVER PRIDE PARADE

MORE INFORMATION Frances Beswick f.m.beswick@gmail.com FACEBOOK EVENT BCNU Marches With Pride 2016

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Walk with the BCNU bus and/or volunteer at the BCNU pride booth at Sunset Beach where we will be doing community outreach, health promotion and trivia games.

Come on out, have fun and show your BCNU pride!

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UPDATE MAGAZINE July/August 2016

UPDATE

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CONTENTS vol 35 no3

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uly/August 2016

PROUD TO BE NURSES BCNU members Barbara Taylor (East Kootenay region), Mildred Vicente (RIVA region) and Jessy Dame (Thompson North Okanagan region) were just three of the more than 500 delegates attending this year’s convention in Vancouver.

UPFRONT

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Check In

News and events from around the province.

12 Bargaining Success

BCNU is working to ensure full implementation of new provincial contract.

16 The Call for Care Continues Nurses demand action to address the province’s mental health crisis.

18 Efficiency vs. Care

Practice conference 2016 tackles the logic of productivity and its effect on patient care.

20 Water is a Right

BCNU members sign on to the Blue Communities Project.

36 The Future of Medicare

Leadership needed to protect public health care and invest in the needs of seniors.

DEPARTMENTS

5 PRESIDENT’S REPORT 22 YOUR PENSION 42 PRFs WORK 44 WHO CAN HELP? 45 COUNCIL PROFILE 46 OFF DUTY FEATURE

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THE POWER OF UNITY

Members from across BC came together at Convention 2016 to celebrate their profession and plan for the year ahead.

Are you ready to run for the cure?

Find your region’s team captain on page 11 Sunday, October 2

ON THE COVER Okanagan-Similkameen region’s Wendy Imhoff and Central Vancouver region’s Jenny Ng are united for safe patient care.

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BC Nurses’ Union

STAY CONNECTED

UPDATE MAGAZINE

MISSION STATEMENT The British Columbia Nurses’ Union protects and advances the health, social and economic well-being of our members, our

MOVING? NEW EMAIL?

When you move, please let BCNU know your new address so we can keep sending you the Update, election information and other vital union material.

Send us your home email address and we’ll send you BCNU’s member eNews.

profession 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, David Cubberley, Gayle Duteil, Gary Fane, Kath Kitts, Tarya Laviolette, Shawn Leclair, Michelle Livaja, Courtney McGillion, Catherine Pope, Patricia Wejr PHOTOS Sharon Costello, David Cubberley, Kath Kitts, Shawn Leclair, Courtney McGillion, Lew MacDonald, Catherine Pope

CONTACT US BCNU Communications Department 4060 Regent Street Burnaby, BC, V5C 6P5 PHONE 604.433.2268 TOLL FREE 1.800.663.9991 FAX 604.433.7945 TOLL FREE FAX 1.888.284.2222 BCNU WEBSITE www.bcnu.org EMAIL EDITOR lmacdonald@bcnu.org MOVING? Please send change of address to membership@bcnu.org Publications Mail Agreement 40834030 Return undeliverable Canadian addresses to BCNU 4060 Regent Street

Please contact the Membership Department by email at membership@bcnu.org or by phone at 604-433-2268 or 1-800-663-9991

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Burnaby, BC, V5C 6P5

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PRESIDENT’S REPORT

GAYLE DUTEIL

OUR MOST VALUED TREASURE

PHOTO: ALEXIS SULLIVAN WALTERS

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S THE CANADA DAY LONG WEEKEND COMES TO A CLOSE, AND the annual sea of red and white slowly disappears, I find myself reflecting on my own Canadian citizenship. It’s all too easy to take for granted what so many others, particularly new Syrian refugees, are experiencing for the very first time: a day full of hope and new beginnings in a country known for its tolerance, inclusiveness and generosity.

And as we celebrate “all things Canadian,” I can think of no other program that better reflects our country’s values than our publicly funded health care system. Medicare is our most valued treasure, but we have had to fight to keep our health care safe from private sector promoters who are more interested in taking profit than providing patient care.

This September, barring any further delays in legal proceedings, BCNU will again be standing up for public health care in BC Supreme Court and supporting a number of patients who have been unlawfully billed for surgeries that were already covered by public health insurance.

BCNU took the lead on blowing the whistle when private surgical clinics began setting up shop in BC. In 2005, we called attention to the unlawful activities of Cambie Surgeries Corporation (CSC) and other for-profit clinics. We filed a petition to compel the province to enforce our public health care law, audit the clinics and stop the extra-billing. In response to our advocacy, leading for-profit medicine promoter and CSC founder Dr. Brian Day – aiming to have the audit quashed – took the province to court, claiming that BC’s health care law violated the Canadian Charter of Rights and Freedoms.

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UPDATE MAGAZINE July/August 2016

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Dr. Day and his supporters claim to act on behalf of patients, but their real motive is profit. This reality was made clear when Day’s Cambie Surgery Centre was finally audited in 2012. Auditors found physicians working at the private facility illegally billed patients almost half a million dollars in the three months selected for the audit. This is an offence to the very foundation of our public health care system, which is based on the principle that care be provided on the basis of need, not on the ability to pay.

Despite Dr. Day’s arguments, the evidence is clear that for-profit clinics do not reduce surgical wait times. They are a drain on the public health care system. The physicians and nurses who work at these facilities can’t be in two places at once, and the more they work in for-profit clinics, the longer the wait times in public facilities.

All of this is occurring while we face one of the greatest shortages of operating room nurses in the past decade. This shortage has resulted in OR closures across the province including at Vancouver General Hospital’s Jimmy Pattison Pavilion and BC Children’s Hospital.

Nurses have an ethical obligation to care for all. This court challenge is a direct threat to public health care and the health and well-being of all Canadians. BCNU will continue to stand up for public health care and I encourage all of you to stay informed on this very important issue.

With summer upon us, it is certain that wherever you work, the shortage of nurses on your unit will be magnified. No doubt, many of you are working short or on your second overtime shift this week. Many nurses have been denied summer vacation due to new leave quotas. But you must remember to care for the most important patient: yourself. Turn the phone off, stop taking calls from the hospital or clinic and enjoy an afternoon at the lake with your friends or family. All members of BCNU strive to provide safe patient care. However, we need safe and rested nurses in order to fulfill this goal!

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CHECK IN

NEWS FROM AROUND THE PROVINCE

SAFETY ALERT! NURSING WEEK 2016

OUR NURSES MATTER

IS YOUR LANYARD SAFE?

All BCNU members are urged to immediately check their safety lanyards to ensure that break-away clasps are working properly. Plastic clasps should release immediately when the lanyard is subject to forceful pressure.

No member should be using a lanyard without three quick-release clasps. If you are using an old lanyard without a three-point release, please discontinue use immediately and ask your steward for one of BCNU’s new berry-coloured lanyards.

If you test your lanyard and it does not release as it should, do not continue to use it. Periodic re-checking of the quick-release clasps is also advised.

COMMUNITY OUTREACH JOIN BCNU AT THE PNE!

BCNU’s big blue bus will be spending a few days at this year’s Pacific National Exhibition, and you’re encouraged to come out and spend some time at the fair with other BCNU member-volunteers.

Members will be interacting with the public, checking blood pressure and glucose levels, and talking about health care from August 25 – 28.

Volunteers are required to commit to a minimum fourhour time block. You’ll get free admission on the day of your shift, meaning you can enjoy the PNE before or after you volunteer. Email BCNU Vancouver Metro region Lobby Coordinator Brooke Raphael for more information: brookeraphael@bcnu.org NEW VIDEOS BCNU members participated in the creation of a series of new Our Nurses Matter videos that were released during National Nursing Week.

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CNU MARKED NATIONAL NURSING WEEK WITH the release of a series of new videos produced by the unions’ professional practice and advocacy department that feature interviews with a variety of BCNU members from around the province.

The union also ran a province-wide, week-long radio campaign with advertising that acknowledged nurses’ daily effort to provide safe patient care at the bedside and in their communities.

Nursing Week took place May 9 to 15. The event is celebrated throughout the world honour the nursing profession.

You can watch the new Our Nurses Matter videos on BCNU’s YouTube channel. update

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STANDING UP FOR HEALTH CARE Some of the fantastic BCNU member-volunteers who participated in last year’s community outreach effort at the PNE fair.

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UPDATE MAGAZINE July/August 2016

PRINCE GEORGE VAISAKHI BCNU members attended annual Vaisakhi celebrations across the province. In Prince George, the union’s North East region provided blood pressure and glucose monitoring as well as health promotion tips at the community’s May 21 event. Photo: BCNU’s Jassi Varaich (left) and student nurse Priya Badial (pink scarf) with a local family.

MAKING NEWS iHEALTH ON THE ISLAND

BCNU in the headlines

tion requesting use of the When emergency room system be suspended until staff at Nanaimo Regional its issues are addressed.

General Hospital stopped Concerns have primardirectly inputting informaily focused on how iHealth tion into Island Health’s new has reduced the pace of iHealth system, and returned treatment in the ER and to using pen and paper, intensive care unit at NRGH, BCNU Pacific Rim region and turned caregivers into chair Rachel Kimler spoke highly-paid data entry clerks. to BC Local News about the Kimler is among the few controversial health care new paperless professionals record-keeping speaking publicly system. on this issue and “Nurses still acknowledged continue to raise she has peers concerns about who say they patient safety are reluctant to and workload,” speak out. said Kimler on Kimler said the June 14. “Island nurses remain Health does in support of Rachel Kimler seem to be the concept of motivated, but the solutions electronic records, they are not coming as fast as just haven’t been convinced doctors and nurses would that this system is ready. like. People don’t trust the “We’re struggling with the system and we are going on implementation. We want 10 or 12 weeks now.” to work with the employer The $178 million system to address the issues. All marks a fundamental change parties have patient care in the way diagnoses and first in mind. We’ll get there. treatments are recorded.

Hopefully it will be a linear More than 100 health care progression, not having to providers have signed a petitake a step back.”

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STEWARD ELECTIONS

MAKING A DIFFERENCE: MEMBERS ACROSS THE PROVINCE CHOOSE THEIR ADVOCATES

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VERY THREE YEARS, BCNU STEWARDS ACROSS the province must stand for election. This year, members voted on June 9 to select those leaders who will represent them at their worksites. Stewards are the backbone of BCNU. They are the individuals making a difference at their worksite, and who make sure members get the respect they deserve so that patients can receive the care they need.

BCNU places a high priority on steward recruitment and retention efforts and invests significant resources in steward development.

Steward elections are where an individual steward’s leadership path begins, and an important opportunity to encourage the participation of all union members and increase the diversity of BCNU’s leaders.

Interested in the steward role? Talk to a member of your regional executive today. update

POSTER SERIES Several BCNU stewards were profiled ahead of this year’s steward elections.

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CHECK IN

HUMANITARIAN AID

NURSES COME TOGETHER FOR FORT McMURRAY FIRE VICTIMS

In addition to dropping off 40 boxes of scrubs pre-sorted by size, Laird brought postscards from her son’s school with words of encouragement to hand out to Fort McMurray residents. She also drove to a campsite with over 400 evacuees and distributed 500 pairs of brand new underwear, along with many other items.

“I really used my nursing skills for this project,” reflects Laird. “I was planning, documenting and leading.” She says she was struck by the number of people behind the scenes who contributed to the effort. “This was a family of nurses all coming together.”

BCNU helped Fort McMurray residents cope with this environmental disaster by contributing $5,000 to UNA and $5,000 to the Canadian Red Cross. update

ELECTORAL BOARD BCNU's new Nominations Committee members were announced at this year’s convention. From left: Okanagan-Similkameen's Vince Manfre (out-going), Pacific Rim region's Carol Rocker, Cindy Webster and Michelle Nelson, and Thompson North Okanagan region's Kevin Barry.

DEVASTATION BCNU members acted quickly to assist nurses and other residents affected by Fort McMurray’s deadly wildfires.

PHOTO: MICHEL CHAMBERLAND/CBC NEWS

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HEN SEVERE WILDFIRES RAVAGED THE northern Alberta city of Fort McMurray this May, nurses in BC took immediate action to assist the devastated community.

Sam Laird’s husband works in Fort McMurray.

As soon as she heard the news, the Victoria nurse felt compelled to help.

Laird started the “With Love, Victoria” Facebook page, a grassroots effort that connected her with hundreds of others who wanted to help.

This included fellow Victoria nurse Cherrie Curry who had already started to collect scrubs for delivery to the United Nurses of Alberta (UNA), BCNU’s sister union in that province.

Fort McMurray is located in the middle of the Athabasca oil sands.

The entire community was mandatorily evacuated as a result of the wildfires. Homes, businesses, and family pets were all abandoned, and more than 100,000 residents and people living in surrounding areas were forced to flee the area with little to no warning.

Curry, who is from Fort McMurray, collected scrubs from the staff at Esquimalt Westshore and Royal Oak health units. And she received almost 240 scrubs from the Compassionate Resource Warehouse, a local volunteer-based humanitarian organization that specializes in shipping materials to underdeveloped countries. The effort helped the over 300 nurses who were displaced as a result of the fire, many of whom worked at the evacuated Northern Lights Regional Health Centre, the area’s major acute care facility.

For her part, Laird began collecting items that her family would personally deliver to areas surrounding Fort McMurray. She left for Alberta on May 19 in a pickup truck towing a full U-Haul trailer.

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SHIFT SCHEDULES – KNOW YOUR RIGHTS! WHEN EMPLOYERS CREATE permanent vacation relief or float lines, they are addressing the need for replacement in the workplace while providing regular permanent employment for BCNU members. And that’s a good thing.

But the union is now aware that some employers are frequently changing the schedules of these lines, or using them for other types of coverage, and doing so while only giving members 10- to 15-days’ notice.

This is unacceptable.

The union had agreed that vacation relief-line schedules could be changed from the master schedule under

Article 25 of the Nurses’ Bargaining Association collective agreement in acknowledgment of the fact that vacation backfilling can be challenging as regular employees’ time off varies from year to year. However, BCNU expects that a vacation relief-line schedule will not be changed once they are made and presented, and considers them no different than the schedule of any other nurse on a master unit.

If you have a vacation relief line that is constantly changing, please contact your steward to assist you in discussing the problem with the employer.

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UPDATE MAGAZINE July/August 2016

BCNU DAY AND THE WINNER IS…

BCNU Vice President, Christine Sorensen presents Lions Gate Hospital nurse and BCNU Day Quiz winner Kathleen Labelle with an iPad mini on June 10. Labelle, along with over 700 other BCNU members, participated in the annual quiz, which focused on BCNU’s steward elections. Labelle said her husband has a few iPads, but she is claiming this one for her own! BCNU held its founding convention on June 11, 1981. The union celebrated its 35th anniversary on June 11.

CANADA DAY The BCNU bus was on hand in Osoyoos for the community’s 66th annual Cherry Fiesta held July 1. BCNU President Gayle Duteil and other Okanagan-Similkameen region members participated in the celebration, which saw thousands marching in the town’s parade.

IN MEMORIAM

Former BCNU labour relations officer Angela Towner passed away on June 30, 2015. Towner worked at Vancouver General Hospital before her employment with BCNU in the mid1980s. Her dedication to the union and nurses’ rights will not be forgotten.

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NEW STUDY

VIOLENCE AGAINST HEALTH CARE WORKERS STILL GOING UNADDRESSED

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NEW STUDY PUBLISHED IN THE NEW England Journal of Medicine this May contains findings that reveal how much work remains to be done until nurses and other health care providers can go to work and know that they will come home safe at the end of their shifts.

Violence against health care professionals in the workplace continues to be under-reported and understudied, according to the study published May 2.

Researchers found the health care industry is statistically the most violent non-law-enforcement industry in the US. The study also found that violence in the health care sector is under-reported by as much as 70 percent, meaning the true impact is estimated to be significantly higher.

The US research findings echo the experiences of many health care workers in BC and the rest of Canada.

The study’s authors focused not just on the risks to health care providers, but also on the issues around why these risks continue unabated. According to the researchers, providers often feel assaults against them are not taken seriously. And health care workers themselves often excuse patients’ violent behaviour because they are coming from a position of compassion and realize the behavior may stem from issues including mental health and substance misuse problems, the researchers noted.

“We don’t want to treat patients like they’re criminals or the enemy,” study author Dr. James Phillips told the Reuters news agency. “So we probably make excuses when we shouldn’t, and we overlook patients who are intoxicated or on drugs, and other patients who have altered mental status because of chronic dementia or acute delirium.”

Here in BC, nurses are taking a lead role in addressing violence in their workplaces. BCNU negotiated the creation of a violence prevention framework as part of the recent Nurses’ Bargaining Association contract talks. The union also continues to work with health employers to evaluate and improve safety conditions at high-risk worksites in the province. update

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MEDICAL ASSISTANCE IN DYING

Employer policy and practice supports are needed

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AST YEAR, WHEN THE working group, which includes representatives Supreme Court of Canada struck from all health authorities, regulatory colleges down provisions of the country’s (including nurses’ colleges) and the Ministry Criminal Code that have long made of Health is now developing standard guideassisted dying illegal, uncertainty lines and decision support tools to support a ensued for nurses and other health care providconsistent approach to nursing practice when ers who were later left in a legislative vacuum aiding in the provision of MAiD. The union has after the government failed to pass new legislaalso been informed that health authorities have tion before a court-mandated deadline. established working groups that meet regularly A new law – Bill C-14 – that addresses medito develop policies and procedures for MAiD. cal assistance in dying (MAiD) was eventually While a positive step, the union has not been passed in Parliament on June 17. While the bill provided with any timelines for completion of was being debated and finally passed, regulatory this work. colleges – including the College of Registered In the meantime, uncertainty surroundNurses of BC (CRNBC) – issued revised scope ing assisted dying will be sure to continue. A of practice standards for nurses aiding in the BC woman with spinal muscular atrophy is provision of MAiD. However, health employers joining the British Columbia Civil Liberties in the province have yet to provide nurses with Association to challenge Bill C-14. Julia Lamb of clear policies, procedures and practice support Chilliwack launched the constitutional chaltools related to MAiD. lenge in Vancouver only 10 days after Bill C-14 BCNU President Gayle Duteil wrote to health was passed. authority CEOs on June 10 to raise concerns Whatever the outcome of this case – likely about the fact that employers have not develthe first of many – nurses and other health care oped policies to explain what nurses can do in workers who find themselves involved with their workplaces. This was particularly trouMAiD as part of their employment will expect bling as BCNU members in certain facilities and demand that employers provide clear were being asked to participate in MAiD in policies, procedures and practice support tools the absence of these supports. BCNU advised related to assisted dying. update members not to participate until health authoriTHE REGULATORY PYRAMID ties have clarified the process.

Controls on nursing practice is a shared responsibility between professional regulators, Registrant’s competency employers and nurses themselves, and all should work together to ensure the public Employer policy receives safe, competent and ethical care ACTION NEEDED HERE (see box: the regulatory pyramid). “It is important that employers now do Regulatory College Standards, their part,” says Duteil, “especially Limits and Conditions REVISED JUNE 23 given that BCNU members are not independent practitioners, and will only find themselves Health Professions Act involved with MAiD as part of their employment.”

The Health Employers MISSING LINK Nurses are still waiting for health employers to provide Association of BC has advised adequate policies and decision support tools since new legislation was BCNU that a provincial MAiD passed allowing for the provision of Medical Assistance in Dying (MAiD).

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ASSISTED DYING In January 2015, the Supreme Court of Canada struck down existing laws prohibiting medical assistance in dying. New legislation passed this June changed the Criminal Code to allow physicians and nurse practitioners to prescribe a self-administered drug or to directly administer a drug that causes death to patients who qualify for medical assistance in dying, without facing criminal repercussions. In order to qualify under the new legislation, a patient must: • Be eligible for health services funded by the provincial or federal government; • Be at least 18 years old and capable of making health care decisions; • Suffer unbearably as a result of a “grievous and irremediable medical condition” (a serious illness, disease or disability in an advanced, irreversible state of decline that makes death reasonably foreseeable); • Not be pressured or influenced by others into making their decision; and • Give informed consent after receiving information about their diagnosis, available treatment and palliative care.

But the legislation has been criticized in part because it is limited to those facing a “reasonably foreseeable” death.

Critics say that excludes people with a non-terminal illness, including Kay Carter, the North Vancouver woman who launched the original court challenge with against the ban on assisted dying before her own assisted death in Switzerland in 2010. update

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RUN FOR THE CURE

GRATEFUL TO BE CANCER-FREE

For Kamloops nurse, this year’s run is personal in Moorhouse’s family. “I had not at all entertained the idea that I had cancer, even as I was going through the tests,” she recalls, acknowledging that the diagnosis came as a shock to her and her family. “I just burst into tears as I wasn’t prepared for the test results.”

That summer Moorhouse started on a plan that included 16 one-anda-half minute radiation treatments.

“It took longer to get undressed and into the gown than the length of the READY TO RUN BCNU’s Run for the Cure Kamloops treatments,” she jokes. Moorhouse team pictured at an event in 2012. From left: Kay Gienow says that she was extremely for(retired), Kathy Moore (retired), Debra Moorhouse and BCNU Thompson North Okanagan region chair tunate to be able to stay in New Tracy Quewezance.

Westminster with her parents for the duration of her radiation sesAVE YOU HAD YOUR sions that took place at Surrey Cancer Clinic. mammogram this year?”

Six months after her radiation treatments, That was the question Debra Moorhouse was tested again and told she Moorhouse’s husband Jay was cancer free. Now, she gets checked began asking his work colannually and says she counts her blessings leagues after he learned that his wife of 10 every day. She knows a cancer-free diagnosis years was diagnosed with breast cancer. is not something everyone is lucky enough Moorhouse admits it’s not the kind of questo receive. “I had early detection, a very small tion you hear every day. lump and my prognosis was good since there In January 2013 she noticed she had an was no infiltration of the cancer cells into the inverted right nipple and knew enough lymph nodes.” about the symptoms to take immediate Even before her diagnosis, Moorhouse action. She went through a battery of tests was a BCNU team member participatover a six-month period that included a ing in the annual Canadian Breast Cancer mammogram, ultrasound, MRI and a biopsy. Foundation’s (CBCF) Run for the Cure.

The mammogram also exposed a small lump “Since my diagnosis it has become a lot on her right breast. more emotional for me. I am a survivor and Moorhouse has been a nurse for 24 years the Run for the Cure invites us to stand up and is no stranger to the challenges of illas one at the run, she says. “But I also see ness. She works at the Phoenix Centre in individuals who are scared after being newly Kamloops, a detox facility where she helps diagnosed, and countless families standing individuals who have self-referred or been up for the loved ones they lost to cancer.” referred by their alcohol and drug counselMoorhouse wants to emphasize the imporlor, physician or community agency. tance of regular mammograms, and says early Still, there was no history of breast cancer detection likely saved her life. update

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TEAM CAPTAINS AND RUN LOCATIONS Mike Goerzen Abbotsford michaelgoerzen@bcnu.org Debra Moorhouse Kamloops debramoorhouse@bcnu.org Lorna Thomas Kelowna mickeythecat@hotmail.com Rachel Kimler Nanaimo rachelkimler@bcnu.org Tish Trevelyan Prince George pgrccstewards@gmail.com Michelle Sordal Surrey michellesordal@bcnu.org Brooke Raphael Vancouver brookeraphael@bcnu.org Lauren Vandergronden Vancouver (Council Liaison) laurenvandergronden@bcnu.org Amanda Hackman Vernon ajhackman@hotmail.com Lynnda Smith Victoria lynndasmith@bcnu.org

TAKE ACTION Support Moorhouse, and the other 25,000 women and 220 men in Canada expected to get a breast cancer diagnosis this year. Contact the Run for the Cure team captain in your region (see above) to join BCNU at the October 2 event. This will be BCNU’s ninth year as a lead provincial sponsor. There will be BCNU representatives at all nine Run for the Cure locations around BC.

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NURSES RATIFY NEW PROVINCIAL CONTRACT

Historic agreement unites LPNs, RNs and RPNs across all sectors BCNU President Gayle Duteil: “Now the real work begins to make sure nurses and their patients benefit from new provisions designed to advance the nursing profession and provide safe patient care.” attended bargaining town halls to review the terms of the proposed settlement and heard directly from members of the provincial bargaining committee about the details of the settlement. For the first time, they were able to vote at mobile polling stations set up at these meetings.

NURSES VOTE Janis Wensley and Brianne Rollins vote at Lions Gate Hospital May 5. For the first time, members around the province had a choice of casting ballots at advance polls or on voting day, May 10.

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N MAY 10, BC NURSES’ Union members across the province voted 85 percent in favour of accepting the contract negotiated the previous month by the Nurses’ Bargaining Association (NBA) and the Health Employers Association of BC (HEABC).

This new comprehensive five-year agreement improves benefits, compensation and working conditions for nurses and addresses major issues surrounding staffing and workload that directly impact the safety of patient care.

BCNU President Gayle Duteil believes the new provincial contract is something

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to be proud of. “We can celebrate our enormous collective success in securing a comprehensive agreement that unites our nursing family under one agreement,” she says. The ratified contract means that licensed practical nurses are no longer bound by their old Facilities and Community Bargaining Association contracts and for the first time will be covered under the NBA agreement with registered nurses and registered psychiatric nurses.

“We can also celebrate an amazing voter turnout of BCNU members for our ratification vote, the largest number of members ever,” says Duteil, who notes that throughout the month of April, nurses

“We can celebrate our enormous collective success in securing a comprehensive agreement that unites our nursing family.”

BCNU PRESIDENT GAYLE DUTEIL

More than 19,000 BCNU members also joined in two bargaining telephone town halls – another first. Dozens of important questions were brought forward by members and addressed by Duteil and the union’s senior management team. As a result of this engagement, more than 20,000 members cast ballots.

Highlights of the 2014–2019 NBA agreement include access to Blue Rx, a customized drug plan (see sidebar) with an expanded formulary that will greatly improve nurses’ access to prescription drugs and address the Pharmacare tie-in issues that so many members faced after the last contract settlement.

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UPDATE MAGAZINE July/August 2016

The agreement also greatly advances the profession of nursing by giving nurses a stronger voice in the shaping of health care policy. There are new funds for nurses’ education and opportunities to optimize scope of practice and increase career development.

Very importantly, progress will also be made in establishing a culture of safety with an agreement for a new provincial framework for violence prevention and commitments to safety

improvements at every worksite in the province (see story on page 13).

This contract will also provide opportunities for nurses who are off work and injured to be accommodated more quickly so they can return to their profession. And key job security provisions will keep nurses in acute care, community or long-term care on the job and caring over

CREATING A CULTURE OF SAFETY A NEW AGREEMENT TO ESTABLISH A PROVINCIAL VIOLENCE PREVENTION framework that makes health authorities more accountable to nurses and responsive to the working conditions they face has seen BCNU host meetings with employer reps to begin the important work of contract implementation.

Under the terms of the 2014–2019 Nurses’ Bargaining Association contract, the parties have until September 2016 to establish a violence prevention framework and conduct a review of the safety plans, including implementation status at 50 high- and medium-risk worksites identified during the bargaining process.

“We are more than happy to take the lead in getting this important work done,” said Adriane Gear, BCNU Executive Councillor for health and safety, during a June 29 meeting at BCNU’s provincial office. The gathering brought together frontline nurses from across health care sectors and professional designations along with representatives from the Ministry of Health and the Health Employers Association of BC. Issues discussed included the use of security officers and code white responses, setting admission and exclusion criteria, communication and alert protocols, personal safety equipment and the physical environment, critical incident stress support and education requirements.

Gear says that meetings between employer reps and BCNU regional Mental Health Advocates and OH&S reps hosted by the union on June 13 and 21 also provided valuable input for the violence prevention framework.

“Health authorities have committed to establishing a culture of safety at every worksite in BC, and nurses are committed to ensuring that these agreements are honoured.” update

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DRUG PLAN CHANGES TAKE EFFECT NEXT JANUARY Some changes already implemented RATIFICATION OF THE Nurses’ Bargaining Association provincial contract means that the drug plan will change from the Pharmacare tie-in (current plan) to Blue Rx, effective January 1, 2017.

BCNU is now working closely with Pacific Blue Cross to develop a comprehensive implementation and communication plan to ensure a smooth transition to the new drug plan. Detailed communication about plan changes will be sent out to all members in the coming months.

Members with drug-specific questions should call Pacific Blue Cross where specialized pharmacy services staff will advise how drugs are covered.

BENEFIT PLAN CHANGES ALREADY IMPLEMENTED

New coverage The newly ratified provincial collective agreement also includes an increase in hearing aid coverage. Effective May 11 coverage for hearing aids has been increased to $1,000 per ear, per person every five years.

Coverage added for LPNs LPNs will also see a number of changes to their benefit plan as of May 11, as coverage levels are brought up to match those provided for RNs/RPNs under the current provincial collective agreement.

Among these is the addition of contraceptive coverage and a reduction in the annual deductible. coverage for clinical psychologists and clinical counsellors has also been added.

For more information regarding your extended health benefits, please contact Pacific Blue Cross at 1-888-737-5696, or via email at pharmacyservices@pac.bluecross.ca.

SHARING EXPERIENCE Frontline nurses and health employer reps met at the union’s offices to begin development of a new provincial violence prevention framework.

July_2016_v5.indd 13

For further assistance, please email extendedbenefits@bcnu.org. update

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for patients, while providing new job opportunities, education, earnings and benefits protection.

Most importantly, the new agreement has seen the Ministry of Health and provincial health employers acknowledge the need for a comprehensive health human resource management framework, and commits them to better achieve critical health service delivery objectives that include hiring more nurses. BCNU will be at the table to help realize these goals, and a series of innovative committees and secretariats has been established to ensure nurses’ concerns are heard by key decision-makers.

TALLYING THE VOTE BCNU Treasurer Mabel Tung, BCNU Vice President Christine Sorensen and BCNU President Gayle Duteil work on compiling vote results at the BCNU office May 10.

CHANGES COMING TO GRIEVANCE PROCEDURE BCNU’S FIGHT FOR SAFE PATIENT care saw union members file thousands of grievances to compel health employers to follow through on the staffing commitments they made to nurses during collective bargaining.

This effort resulted in an arbitrated provincial grievance settlement for improved staffing that was reached in April 2015 after BCNU successfully called out employers for not living up to the terms of the staffing language contained in the 2012–2014 contract.

That settlement established a new expedited dispute process, where stewards and members completed notices of complaint (NOCs) in lieu of grievance forms to address replacement and staffing issues. This process will now be phased out, as BCNU begins to update the grievance procedure as agreed to in the recently ratified 2014–2019 Nurses’ Bargaining Association collective agreement.

Disputes previously filed as NOCs must now be filed as regular grievances and should continue to follow

July_2016_v5.indd 14

the current three-step grievance procedure. For those NOCs that have already been filed, they will now be referred directly to the new Nurse Relations Committee (NRC) and/or Nurse Staffing Secretariat (NSS) for a final decision.

As always, it is critical that members continue to gather relevant data such as call logs and keep detailed notes from meetings with management, as these will help to expedite the process.

It is important to have open and full discussions in these meetings, as this too helps to prevent disputes being referred back and forth for further discussion, resulting in delays in resolving the issues.

BCNU is no longer seeking monetary damages related to staffing issues as the focus has now shifted to fixing the underlying problems. However, any grievances filed on behalf of individual members who were not called in despite being eligible and available for shifts will continue to be subject to monetary remedies. update

USE EXISTING PROCESS:

STEP 1 Grievor talks to manager

(with or without steward present)

NO RESOLUTION?

STEP 2 NOCs

Steward attends meeting with grievor and management/HR NO RESOLUTION AT MEETING? GRIEVANCE FILED

COMING SOON:

A NEW, SIMPLIFIED PROCESS FOR ALL GRIEVANCES (as per the new 2014–2019 NBA PCA)

STEP 3 Labour Relations Officer conducts meeting with HR manager

(Steward and member present)

RESOLUTION or ARBITRATION GRIEVANCE PROCESS CHANGES A new, simplified grievance process is forthcoming under the terms of the 2014–2019 provincial collective agreement.

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UPDATE MAGAZINE July/August 2016

BCNU and provincial health employers also agreed to the creation of an expedited grievance and arbitration process to quickly resolve disputes, and which builds on the historic workload and staffing language negotiated in the previous NBA agreement. Union staff and HEABC representatives are now in meetings to work on the details for the creation of a new BC Healthcare Office of Arbitration that will oversee the dispute resolution process. The current three-step grievance procedure will soon also be phased out (see story on page 14).

“It has not been easy to achieve all that we have, especially when other unions settled for so much less,” says Duteil, adding that a “me-first” clause in the new agreement makes sure nurses lead the way in future public sector negotiations. “But now the real work begins to make sure nurses and their patients benefit from new provisions designed to advance the nursing profession and provide safe patient care,” she says.

Duteil tells members that employers will need to be held to account in order to ensure that contract language aimed at reducing their inappropriate use of on-call, and addressing their inability to educate and hire adequate nursing staff, is implemented at all worksites.

“We must remain vigilant,” warns Duteil. “We must hold the health authorities to account in order to realize the gains made in this collective agreement.”

Duteil is calling on all members to monitor their employers, and call them out if they try to close beds or facilities or ignore these hard-won contract provisions. “We must make clear and assertive demands and we must be relentless in our determination – for the sake of our patients and all nurses,” she says.

“So as we go into the next two years I am counting on every member to be the eyes and ears in the workplace,” says Duteil. “We need nurses to be involved at every level, and file those grievances and PRFs, lobby their MLAs and hold the government accountable to the agreement they have made with the nurses of BC.” update

15

COMMUNITY NURSES EYE NEXT ROUND OF BARGAINING THE INK HAS BARELY DRIED ON THE NEW 2014–2019 PROVINCIAL collective agreement, but this hasn’t stopped community nurses from identifying key issues ahead of the next round of negotiations. From care delivery model changes to point of care needs, everything was up for discussion during a day-long community nurses’ meeting held at BCNU’s Education Centre on June 10.

The community nurses, who were elected by their peers to attend this year’s annual BCNU convention, work as LPNs, RNs and RPNs in regions around the province and have job experience that ranges from seven to 25 years. BCNU Vice President Christine Sorensen, Executive Director Gary Fane and Director of Legal Services Umar Sheikh were on hand to listen to the group’s concerns around changes to patient care delivery, technology needs and community grievances. The nurses discussed the Ministry of Health policy paper on primary and community care in BC and reviewed the results of Fraser Health’s community work survey.

“It was great to have this group, which is a wide representation of nurses in regions around the province, spend the day with us,” said Sorensen.

“They each brought first-hand experiences to the table, as well as important perspectives from those who work in community nursing around BC.” A list of identified issues was drafted that contains a variety of important considerations for community nurses, including workload and staffing, safety, rural and remote nursing, advocacy and scope. Nurses also took part in a brainstorming activity on how to improve community health care delivery.

“It’s important to hear directly from our community nurses as we move forward in bargaining discussions and mobilize towards the next round of bargaining in 2018,” said Sorensen. update

Want more details about the NBA contract? Please review the summaries, terms of settlement and wage grids behind the BCNU member portal.

RETRO PAY Some nurses have yet to receive the retroactive pay owed to them as part of the new NBA agreement.

BCNU is pushing health employers to rectify this, and members should receive their retro pay no later than September (dates vary by health authority).

July_2016_v5.indd 15

PLANNING AHEAD Community nurses from across the province gathered to identify key issues ahead of the contract negotiations that begin in 2018.

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16

MENTAL HEALTH

NURSES CALL FOR IMPROVED SERVICES NOW Auditor general uncovers gaps in services for the seriously mentally ill

can access the services they need,” she said.

The report found that vulnerable patients needing urgent care may be forced to wait for days to get into a psychiatric unit due to overcapacity problems and later, when ready to be discharged, can’t leave because there are no supports or housing available in the community.

Bellringer’s audit also found that one unnamed facility had an average length of stay of 1,677 days because there was nowhere else for discharged patients to go. “It puts a lot of pressure on the system.

Those beds are being filled and they can’t bring other people in,” said Bellringer.

“Getting people out with the right supports is critical.”

PART OF A GROWING PROBLEM

CALLING OUT FOR CARE Clockwise from left: Abbotsford nurse Tristan Newby addresses supporters at March 19 rally to save the Mountain View Home from closure. BCNU Fraser Valley region chair Katherine Hamilton stands outside the closed adolescent psychiatric unit at Abbotsford Regional Hospital. Hamilton talks to the media about Mountain View Home’s unique care model.

Fraser Health’s closure of these facilities underscores the need for a provincial strategy to address the crisis in mental health.

O

N A RECENT DAY AT the Royal Inland Hospital in Kamloops, seven patients suffering from severe mental health problems were placed in the hallway outside the emergency room because the psychiatric unit was full.

In Kelowna, psychiatric patients who are ready to be discharged must wait two to three months for supported housing. And in Abbotsford, children with serious mental health issues are placed alongside adults in the ER and psychiatric unit.

Every day in BC, nurses and other health care workers are challenged to provide safe patient care under these conditions, and it

July_2016_v5.indd 16

is a growing problem. Now, a new report paints a disturbing picture of the lack of services for people with serious mental health issues, and underscores the need for a provincial strategy to address the crisis.

Carol Bellringer, BC’s auditor general, authored a report in May which found that adults with complex mental health or substance use problems – including brain injuries, developmental disabilities or a history of extreme violence – may not be receiving the services they need at some facilities.

“The health system, as a whole, needs to do more to ensure that people with serious mental health or substance-use problems

The auditor general’s report focuses on access to adult tertiary care, which is the highest level of service for people who are extremely vulnerable and have substantial, complex needs.

But BCNU President Gayle Duteil says gaps in services are not only limited to adults, and the problem can be particularly distressing for youth in crisis.

“Nurses see youth struggling with serious mental health issues every day,” says Duteil. “They come into the hospital in crisis and there aren’t enough beds, or nurses to take care of them. Youth in trouble need ongoing supports and services and we know they’re often not receiving them.”

In the Fraser Valley, like many other regions in the province, mental health patients are often forced to wait in emergency rooms.

Recently, a ten-year-old spent three days in the Abbotsford Regional Hospital ER. There were also two teenagers, aged 16 and 17, who spent one-and-a-half days in reclining chairs in a pod in the ER, next to four adult mental health patients – all waiting to be admitted to the psychiatric ward.

There is a solution to this problem: the onsite facility specifically built to provide safe patient care for youth – the Adolescent Psychiatric Unit (APU) – that was closed six years ago. The unit now serves as

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UPDATE MAGAZINE July/August 2016

“The health system, as a whole, needs to do more to ensure that people with serious mental health or substance-use problems can access the services they need.”

BY THE NUMBERS

MENTAL HEALTH

1

IN

BC AUDITOR GENERAL CAROL BELLRINGER

administrative office space while also being used for a youth day program.

“It’s totally unacceptable,” says BCNU Fraser Valley region chair Katherine Hamilton. “Youth with mental health issues can access the day program, but there is nothing to help kids who are in a serious crisis who need urgent, safe, overnight care,” she reports. “Demand is higher than ever and yet Fraser Health continues to ignore our calls to re-open the APU and use it for its original purpose.”

The number of children and youth hospitalized for mental health issues in the Fraser Health Authority has more than doubled in four years. Some 1,200 individuals needed urgent care last year.

BC’s Representative for Children and Youth, Mary Ellen Turpel-Lafond, has repeatedly warned that the mental health system for children is failing. And a Simon Fraser University report prepared for the Ministry of Children and Families concluded that only one third of children who need help are getting it.

CUTS MADE DESPITE RISING DEMAND

Despite rising demand among youth and adults with mental health issues, Fraser Health is also closing Abbotsford’s Mountain View Home after the last resident leaves. Some 25 adult patients live at the facility and the average stay is 10 years.

At a March rally in support of Mountain View, nurse Tristan Newby told a crowd of protesters, “Mountain View is not a facility where people are placed. Mountain View provides a home for 25 people who become a community.”

“Eventually there won’t be enough people here to sustain the services,” says

July_2016_v5.indd 17

17

Hamilton of the closure through attrition.

“It’s a slow starvation.”

BCNU is continuing to pressure Fraser Health to keep Mountain View open. An email campaign has targeted health authority board members, and at a recent public meeting, BCNU members reminded Fraser Health board members of the facility’s importance to patients with complex needs who require residential care.

A new mental health facility is slated to open in Abbotsford this summer. But only 30 licensed care beds are being created. The rest of the building will provide assisted and independent living.

Bellringer made 10 recommendations in her report, including more collaboration between the health ministry and health authorities in order to track wait lists and determine the needs of the mentally ill population.

In responding to the report, the Ministry of Health admitted that more needs to be done to “enhance” services and gaps in supports. So far, there is little evidence to show that any action has been taken. update

5

people experience a mental health disorder each year.

BY AGE

40

nearly half of us will have/have had a mental health condition.

714,000 people in BC have mental health and substance use needs.

$51

BILLION/YEAR

economic impact of mental health illnesses and/or substance abuse problems in Canada.

Source: Mental Health Commission of Canada

Access to Adult Tertiary Mental Health and Substance Use Services This report by BC’s Auditor General focuses on how BC’s health care system manages access to adult tertiary mental health and substance use services.

Read the report on your mobile device

7/14/2016 11:06:49 AM

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PROFESSIONAL ISSUES

EFFICIENCY vs. CARE

Practice conference 2016 tackles the growing shortage of time that’s needed to provide care

She had been diagnosed with an aggressive form of breast cancer, and had only a limited support network to rely on.

“When the pathology report came back and the doctor told me that I had breast cancer, I realized that not only was this a crisis of health, but I was about to live through a crisis of care,” she explained.

“This profession is complex but I think nurses handle complexity better than most people.”

NATIONAL LEAGUE FOR NURSING CEO DR. BEVERLY MALONE

“I THINK WE ARE A PRETTY FANTASTIC GROUP” Keynote speaker and National League for Nursing CEO Dr. Beverly Malone addresses BCNU nursing practice conference participants.

T

HIS YEAR’S NURSING practice conference, called Knowledge Work: Nursing, Professionalism and the Labour of Care offered the more than 150 BCNU members in attendance an indepth look into the way care is delivered in a health care system often driven by a growing need for efficiency and productivity, and the impact these imperatives are having on patients and health care workers alike.

The conference, which took place between Feb. 29 and March 1 in Richmond, boasted an impressive agenda with eight guest speakers from a variety of backgrounds.

Following an indigenous welcome from

July_2016_v5.indd 18

Roberta Price, BCNU President Gayle Duteil opened the conference by reminding members how nurses can use the bargaining process to further their professional aims. [Ed: a provincial contract was ratified May 11.]

“Nursing isn’t just a profession. It’s a way of life. We do what we have to do,” she told the room. “I believe in this round of bargaining we can identify key actions that need to be taken in order to demand respect for our profession,” she added.

T

he first guest speaker was poet, visual artist and author Anne Boyer who described what it was like to be on the receiving end of the health care system.

Boyer told the audience she quickly realized after she was diagnosed that her “experience of medicine” would be very different from those who have partners to care for them. A single parent, she didn’t have many friends and family members to help her while she underwent treatment.

She relied on those close to her to take her to appointments, biopsies and procedures and she explained how one of her friends even lost her job as a result of taking time off work to transport Boyer to and from the doctor.

“My friends and I had to scramble to care for me in a world in which single mothers who work for a living do not fit into the social scheme of care,” she recalled.

A

presentation by University of Alberta nursing professor, Christine Ceci titled “Nursing with Care”, further explored the conference’s theme.

Ceci explained how problems arise when efficiency is considered the most important skill when treating patients, and good care is often associated with increased time and costs.

“We are experiencing a crisis of hurry,”

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UPDATE MAGAZINE July/August 2016

she said. “The way of thinking [today] is that health care practitioners don’t have time to slow down. But, in fact, we need to take more time to look at our practice.”

Ceci argued that describing good patient care is more than just a technical question. She said nurses should take a minute to ask themselves if the care they are providing should be done quickly or if they should be paying more attention to the patient they are treating.

Mills Memorial nurse Sonja Comerford took the stage on the second day of the conference,

presenting her research paper “Family Presence During Resuscitation: Nurses’ Opinions and Perspectives.” Her contribution to the discussion around the meaning of care included sharing nurses’ thoughts on allowing family members to be present during resuscitation.

She said that while conducting her research, she found that many nurses were in favour of allowing family members in the room and she hopes her paper will encourage health authorities around the province to develop policies on the issue, and give family members a voice.

1

2

3

THE PEOPLE 1. BCNU President Gayle Duteil welcomes guest speaker, poet and cancer survivor Anne Boyer. 2. UBC PhD Student Farinaz Havaei and Chantelle Bailey, UBC Post Doc Fellow in Emergency Medicine. 3. Conference participant Sabrina Wong talks about her breakout session entitled “Increasing the quality of primary health care in BC: opportunities for nurses.”4. BCNU North West region members (from left) Nancy Levesque, Kathy Buell, Sonja Comerford (presenter), Lisa Abel and Carmen Doyle.

4

19

TWO BCNU NURSES HEADED TO LONDON BCNU celebrated the nursing profession during National Nursing Week (May 9-14) by selecting two members to attend the upcoming Royal College of Nursing* International Centenary Conference on November 22–23 in London, England.

The opportunity was offered as part of BCNU’s new Professional Practice & Advocacy department activities. Winners were selected from over 100 expressions of interest received during a competition which ran from April 1–22. The high calibre of submissions made the decision very difficult.

Congratulations to the two nurses who will be headed to London in the fall: Melissa Furst, an RN from St. Paul’s Hospital, and Sarah Tobin, an LPN from Saanich Peninsula Hospital. Watch for an account about their learnings from the conference in a future issue of Update magazine. *The RCN is the world’s largest nursing union and professional body, representing more than 435,000 members.

July_2016_v5.indd 19

7/14/2016 11:06:56 AM

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T

he final guest speaker was Dr. Beverly Malone, CEO of the National League for Nursing (NLN) in the United States. Malone has also served as general secretary of the Royal College of Nursing in the United Kingdom and was the former president of the American Nurses Association.

She addressed the theme of the conference by listing the core values of the NLN, the first of which is “caring.”

“Caring is the baseline of nursing. We take care of you regardless. We treat everyone unconditionally,” she said. “The second is integrity, the third is diversity and the fourth is excellence. Excellence is something you are always in pursuit of. It isn’t something that you hold in your hand.”

“Health care practitioners don’t have time to slow down. But, in fact, we need to take more time to look at our practice.”

PHOTO: MARTINE LABERGE, CBC NEWS

CHRISTINE CECI

Malone told the room about her years as a psychiatric nurse who climbed the ladder to her role as CEO for the NLN. She encouraged members to strive towards bringing change even though it can take time and dedication. And lastly, she explained the importance of having a vision.

“A vision without action is a hallucination.

Remember that it is never how you fall, but how you get up. This profession is complex but I think nurses handle complexity better than most people. I think we are a pretty fantastic group,” she told the room.

This year’s conference closed with a standing ovation. For many who attended, the opportunity to take a critical look at the meaning of care and draw upon their professional identity and unique training was both inspiring and motivational. update

July_2016_v5.indd 20

HR&E HUMAN RIGHTS AND EQUITY

WATER IS A RIGHT JOINT PROJECT REACHES OUT TO COMMUNITIES ACROSS CANADA the Blue Communities Project, an initiative led by the Council of Canadians, a national non-profit advocacy group. The Blue Communities Project is a growing global movement that encourages municipalities and community leaders to adopt a water commons framework that includes the following three principles: recognition ACCESS DENIED Longstanding boil-water advisories in aboriginal of water and sanitation as communities underscore the lack of political leadership needed to human rights; the comensure access to an important determinant of health. plete phasing out of the sale of bottled water in MAGINE THE STRESS OF municipal facilities and at municipal events; having to sterilize your baby’s milk and the promotion of publicly financed, bottles for an hour every day, just owned and operated wastewater services. to be sure to avoid contamination.

An awareness campaign is now being led Or spending hours preparing water by activists from each of BCNU’s equityto bathe your child, only to have their skin seeking caucuses who sit on the union’s break out in lesions and rashes that leave Human Rights and Equity Committee. scarring on their young bodies. This is Speakers from the Mosaic of Colour caucus, the reality for many families living in First the Aboriginal Leadership Circle and the Nations communities across the country, Workers with Disabilities caucus spoke who are routinely exposed to water so full about the campaign at this year’s BCNU of contaminants that they face an increased convention and encouraged members to risk of serious negative health outcomes support the Blue Communities Project. including gastrointestinal disorders and “The project calls on communities and even cancer. The infrastructure is so broken municipalities to recognize water and sanidown that entire generations of people have tation as human rights, to ban or phase out been raised on boil-water advisories, never the sale of bottled water, and to promote knowing the ease and security of drinking publicly financed, owned and operated clean, safe water from a faucet. water and wastewater services,” says Mabel To help address this crisis, a group of Tung, chair of BCNU’s Human Rights BC Nurses’ Union members is supporting and Equity Committee. “These actions

I

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UPDATE MAGAZINE July/August 2016

closely align with issues the caucus groups promote, and so supporting the Blue Communities project was a natural fit.”

There is a growing global awareness of the importance of access to clean water.

In 2010, the United Nations General Assembly passed two resolutions: one recognizing the human rights to water and sanitation, acknowledging that clean drinking water and sanitation are essential to the realization of all human rights, and the other calling on governments to take concrete action by developing plans of action, establishing monitoring and accountability mechanisms and ensuring affordable services for everyone. In 2012, the Canadian government adopted these decisions at the Rio+20 UN Conference on Sustainable Development. But despite these commitments, it is clear that the country still has far to go in securing access to water for its own citizens.

“Water is not just an Aboriginal issue, it’s a basic human right. It needs to be protected, and it’s up to the government to step up and do something.”

SHERRY RIDSDALE, BCNU ABORIGINAL LEADERSHIP CIRCLE ACTING CHAIR

A quick Google search of the terms “drinking”, “water” and “Canada” brings up news story after news story of boil-water advisories for First Nations communities across the country. According to the Blue Communities report, at any given time, there are more than 100 drinking water advisories in First Nations, where people cannot drink water straight from their tap.

In May of this year there were 26 drinking water advisories in BC alone, and 23 of those were in First Nations communities.

Responsibility for systemic failure lies squarely with the federal government. The federal Indian Act grants the government

July_2016_v5.indd 21

jurisdiction over First Nations peoples and the land reserved for them. But the government has downloaded much of its responsibility to administer these communities onto the shoulders of First Nations themselves without providing the needed assistance to ensure the communities remain healthy.

The federal department of Indigenous and Northern Affairs has considerable authority over water and wastewater on reserves, including funding and management of the infrastructure required to build water and wastewater systems. But when these systems fail, First Nations communities are left hanging. The Neskantaga First Nation, a fly-in community in northern Ontario, has been under a boil-water advisory for more than 20 years – the longest-standing boil-water advisory in the country – after their water treatment plant failed one year after it was built. An entire generation of children has grown up drinking bottled water.

But for Sherry Ridsdale, the environmental impact of bottled water is also unacceptable. Ridsdale is acting chair of BCNU’s Aboriginal Leadership Circle, and she is keen to reach out to local communities and encourage them to endorse the Blue Communities Project’s ban on bottled water. “We have to get away from the fact that we’re drinking bottled water,” says Ridsdale. “We need to take a strong stance on it. We can stop buying plastic water bottles and go back to drinking tap water,” she says. “BCNU needs to educate people on why it is so important to take on human rights issues such as this because we have a strong voice, we are a strong community and we can make a difference.”

The Blue Communities Project is ongoing, and to-date, some progress has been made in drawing attention to the water crisis affecting First Nations and other Aboriginal communities. This year’s federal budget includes nearly $2-billion for water and wastewater infrastructure over five years to end boil-water advisories.

This is a positive move, but much more needs to be done at the local level in all communities to safeguard universal access to clean water. update

21

SUPPORT THE BLUE COMMUNITIES PROJECT TAKE ACTION Encourage your local schools, municipalities, and other public institutions to ban the sale and purchase of bottled water on their premises.

RAISE AWARENESS The bottled water industry works hard to undermine public confidence in our safe, public tap water. Inspire your friends, family, neighbours, and co-workers to discuss what actions everyone can take to promote public water.

CHOOSE TAP WATER Switch to non-toxic re-usable bottles you can fill at the tap for free. Refuse bottled water at restaurants and demand to be served tap water instead.

DEMAND STRICTER REGULATION FOR THE BOTTLED WATER INDUSTRY Bottled water companies currently don’t need to identify their sources although in many cases their pricey product is nothing more than filtered tap water. Write, phone and fax the federal government to lobby for tough protections for our threatened water supplies.

SUPPORT THE COUNCIL OF CANADIANS AND ENCOURAGE OTHERS TO JOIN There’s strength in numbers! Join the citizens’ movement to help win a bottled water ban in all Canadian municipalities, and keep up the fight for a national water policy to protect water for generations to come.

Visit: www.canadians.org/bluecommunities

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Your Pension SECURING YOUR FUTURE

A LOOK AT PLAN MEMBERSHIP Active Membership by Gender:

CHANGES COMING TO POSTRETIREMENT GROUP BENEFITS ACTIVE BCNU MEMBERS NOT AFFECTED

A

SERIES OF CHANGES IS coming to the post-retirement group benefits currently provided to retired workers enrolled in the Municipal Pension Plan (MPP). The changes, which take effect Jan. 1, 2017, were announced by the Municipal Pension Board of Trustees on April 20. The changes are relevant to retired members only, as working members continue to be covered by benefits negotiated in their collective agreements.

Group benefits include Medical Service Plan (MSP) coverage, extended health care (EHC) and dental coverage with Pacific Blue Cross.

The changes (see table “What is changing?”), which will affect the more than 70,000 retirees enrolled in the MPP, were

July_2016_v5.indd 22

announced following an intense two-year review of the extended health and dental programs that was conducted by the plan’s Board of Trustees. The review, which included an in-depth analysis of usage and trends, concluded that these group benefits are not sustainable in their current form.

Deb Ducharme is BCNU Executive Councillor (Pensions) and serves as a trustee on the Municipal Pension Board. “These were very difficult decisions for the board,” she says, noting that no one likes changes, particularly when they will cost retirees more.

It’s a fact that Canadian retirees are living longer than ever before – and that’s a good thing. But this also means that retiree benefit groups are getting larger and costlier as a result. Costs within the MPP group

PENSION STATEMENT ERROR? Employers provide the MPP and PSPP with their information.

Remember to check with your employer if you think your pension statement is in error.

27% male

73

% female

As at December 31, 2014 TOTAL: 184,943 The Municipal Pension Plan had 184,943 active members who worked for 931 employers as at December 31, 2014.

The total membership is 299,167.

There are three types of members in the plan: ACTIVE Those currently contributing, on a leave of absence or receiving benefits from an approved long-term disability plan. There are 184,943 active plan members.

INACTIVE Those who terminated their employment but left contributions in the Plan. They may or may not be eligible for a pension in the future. There are 34,442 inactive plan members.

RETIRED Those receiving a pension, including a survivor or disability pension.

There are 79,782 retired plan members.

The majority of BCNU members are enrolled in the MPP. Some members are enrolled in the Public Service Pension Plan or the Canadian Blood Services Defined Benefit Pension Plan.

REMINDER: Pension Statements come out in the months of May and June. Contact your Human Resources Department if you have questions and don’t forget to check to see if you have reached your maximum contribution limit of 35 years’ pensionable service.

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benefit program are rapidly increasing, primarily as a result of pharmaceutical cost increases. This has put significant pressure on the program and changes had to be made to keep it within the funding limits.

All pension plan trustees have an obligation to act in the best interests of every member in the plan, whether they be new entrants in their 20s, members in the middle of their careers, or retirees. The MPP Board of Trustees recognizes the value of benefits to retirees, and its goal is to provide the best possible programs within the funding limits set out by the plan’s governing documents.

GROUP BENEFITS NOT FUNDED BY PENSION CONTRIBUTIONS

Municipal Pension Plan members contribute throughout their careers for their basic post-retirement pension – and this remains well funded and secure. Postretirement benefits, on the other hand, are not guaranteed. They are paid for through the Inflation Adjustment Account, which was established to provide cost of living increases for retired members and is jointly funded by employers and employees.

Each group contributes one percent of its total plan contribution to this account. A maximum limit of 0.8 of the employers’ contribution can be used to fund the cost of post-retirement group benefits each year.

Unused amounts remain in the inflation account.

NURSES’ BARGAINING ASSOCIATION MEMBERS ASSISTED

Ducharme believes BCNU has demonstrated a strong commitment to protection of benefits. “When the last round of MPP benefit cuts were announced in 2004, BCNU initiated a legal challenge but was not successful in the courts” she says. “That was the driver behind the union negotiating terms that have seen one percent of employer payroll cost set aside for benefit protection since 2008.”

The retiree benefit program was set up from that funding and currently pays to qualified Nurses’ Bargaining Association retired members 50 percent of their MSP premium that the pension plans no longer cover.

Ducharme reports that BCNU’s Retirement Benefit Program Committee is aware of the announced changes and will be working over the summer to review all aspects of the program and analyze current and future costing for potential improvements.

In the meantime, all of the changes announced by the MPP Board of Trustees are outlined on the MPP website. And BCNU members are encouraged to review them at www.pensionsbc.ca. update

GROUP BENEFITS FOR RETIRED MEMBERS: WHAT IS CHANGING?

Current

Effective January 1, 2017

Open formulary with low cost alternatives and Pharmacare pricing limits

Blue Rx drug formulary

Annual deductible is $100 per family

Annual deductible will be $100 per person

Co-insurance is 80 percent on first $1,000

Co-insurance will be 70 percent on first $1,000

Lifetime maximum payable is $100,000

Lifetime maximum payable will be $200,000

Dental is subsidized

No dental subsidy; unsubsidized voluntary dental plan available

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Municipal pension plan aGM 2016 OctOber 13 10am – nOOn anvil centre new westminster

plan on it OctOber 13

mpp.pensionsbc.ca/agm

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MENTAL HEALTH MATTERS! Over 500 BCNU members fill Vancouver streets on May 19 and march to the steps of the Vancouver Art Gallery to call for investments in youth mental health services.

The

CONVENTION 2016

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BC Nurses’ Union President Gayle Duteil opened the union’s 35th annual convention with a congratulatory message for the more than 500 delegates who attended the May 16 – 19 gathering in Vancouver.

“It is my greatest pleasure to be here this morning as your president, one week after celebrating an overwhelmingly positive ratification vote of 85 percent on our new contract,” she said, informing members that the 50 percent voter turnout was also the highest in the union’s history.

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Duteil said she was especially proud of the historic importance of the 2014-2019 Nurses’ Bargaining Association contract. “As a result of everyone’s efforts here today, we have secured our first-ever agreement uniting and advancing the profession and family of nursing,” she said. “Now LPNs, RNs and RPNs are finally under one contract!”

Duteil acknowledged the many challenges that came with the previous contract, from the Pharmacare tie-in to employers’ broken promises to create 2,125 new nurse positions by 2016. But she believes the achievements made in the most recent round of bargaining have allowed the union to turn an important corner, and spoke to the exciting potential of the new contract language.

“I believe we have delivered a strong, meaningful contract for the nurses and the patients of BC and have overcome significant challenges,” said Duteil. “This contract delivers on all three areas of our union’s mission statement, by advancing the health, social and economic well-being of our members, our profession and our communities.”

Duteil pointed to the improved benefits plan (Blue Rx), the new expedited grievance process to resolve workload and staffing disputes, the new framework that will give nurses representation at the higher levels of

OPENING REMARKS BCNU President Gayle Duteil welcomes over 500 delegates to this year’s convention.

provincial policy making, and commitments on violence reduction and nurse safety as bargaining achievements all BCNU members should be proud of.

ADDRESSING THE CRISIS IN SENIORS’ CARE

Duteil chose to spend much of her opening address focusing on the growing crisis in seniors’ care funding now affecting communities across BC. She told delegates that a provincial

seniors’ strategy is urgently needed to ensure that safe, quality care is available to a rapidly swelling demographic – and she pledged that BCNU would take a lead role in advocating for that care.

“There’s a lot of talk about supporting seniors to live and be healthy in the community, and we agree with the Seniors Advocate, Isobel Mackenzie, that this is where they should be,” she said. “But resources, including nurses, must be in place.”

She told delegates there are not enough resources to provide the care seniors need to live independently or in residential care, and that too many care decisions are taken out of the hands of seniors today. “The bottom line is that our system is not based on the choices and preferences of seniors,” she said.

“But instead, people are strong-armed into accepting whatever is available – even when it doesn’t meet their needs.”

Duteil called on the government to ensure that communities have enough resources to care for seniors before they arrive in acute care in crisis, and she reminded delegates that BC sits at the very bottom in Canada when it comes to spending on home nursing care and number of residential care beds.

“Our nurses lack the time to spend with residents and clients because our health authorities chronically understaff residential care and community care,” she said.

Staffing in residential care is currently so inadequate that nearly half the residents are being over-medicated with anti-psychotics or made to suffer neglect of their basic care needs, such as clean bed sheets.”

Duteil also noted that

THINK PINK BCNU Thompson North Okanagan region delegates chose to embrace kindness and wear pink at this year’s convention.

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the underfunding of care homes by health authorities is leading more operators to contract out, and pointed to Burnaby’s 300-bed George Derby Centre as an example of this when it recently pink-slipped 54 full-time nurses. Management at the facility recently announced budget-cutting measures that nurses says will directly impact safe resident care.

“We will not stand for the erosion of care for our seniors and our veterans,” said Duteil. “Today we will stand up for the residents of George Derby and I am counting on each of you to help us do so.”

BARGAINING REPORT

BCNU Executive Director of Negotiations and Strategic Development Gary Fane took to the stage on day one of the convention to thank the union’s provincial bargaining committee for the work it did over several months to secure the new provincial contract. He said that the bargaining environment during this round of negotiations

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gaining table as one of the most frustrating obstacles facing nurses. “You all deserve more than 5.5 percent,” Fane told delegates, referring to the fixed fiscal envelope that the provincial government successfully forced on all public sector bargaining associations.

Fane reported that preparations are already under way for the next round of NBA contract negotiations, and that talks will take place according to BCNU’s schedule, not those of the government or other unions.

BARGAINING REPORT BCNU Executive Director of Negotiations and Strategic Development Gary Fane congratulates the union’s bargaining committee for its work in securing a new provincial contract.

was especially difficult, and pointed to the “me-too” clause negotiated by the Health Sciences Association at the Health Science Professionals Bargaining Association bar-

CANDLELIGHT VIGIL FOR GEORGE DERBY SENIORS The first day of convention wrapped up with a candlelight vigil for the George Derby residents affected by management’s cuts at the facility. Over 350 BCNU members donned black clothing and lit candles to honour the veterans and seniors living at the home.

“Increasingly, we see care homes trying to cut costs on the backs of vulnerable seniors,” said Duteil. “At the George Derby

FIRST-TIME DELEGATES’ VIEWS WHY DID YOU ATTEND CONVENTION THIS YEAR?

ANGELA ACHOBA Kamloops “I’ve been a steward for just about a year, and through that time I’ve seen a lot of work the union has been doing on our behalf. I thought that coming to convention would help me to learn what the union stands for, and I could bring that knowledge and information back to the members.”

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FRED PANGAN Surrey “It’s a privilege to be part of a union that has such an impact on the community of nursing. This participation is new for me, but I have been working for a while.

I started as a care aide 20 years ago, then I transitioned to LPN. There is so much on offer at convention. It will be good to see and hear it.”

LANA WASYLKIW Kelowna “I’ve never been to convention before and I was intrigued with the terms of the new contract. I’m also interested in the rules that govern the union, and being here is a great way to find out.”

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FEATURE

Centre, veterans are being used as pawns in an attempt to save money by laying off all the nurses. We will fight tooth and nail to defend safe patient care for seniors – and all British Columbians in the health care system.”

Duteil said that BCNU will hold health authorities accountable for hiring adequate nursing staff, and added that the crisis will continue unless there is a long-term funding commitment.

KEYNOTE SPEAKER DR. DEBRA BOURNES

The highlight of the convention’s second day was a keynote presentation by Dr. Debra Bournes. The former Chief Nursing Officer of Ontario and recognized expert on professional nursing leadership called for greater collaboration between nurses, doctors and governments.

Bournes is the Chief Nursing Executive and Vice-President of Clinical Programs at The Ottawa Hospital, a 1,100-bed teaching hospital with over 4,200 nurses. An advocate of innovative change, Bournes spoke directly to convention delegates, explaining how she believes nurse leaders have to harness the power, knowledge and passion of the nurses

KEYNOTE SPEAKER Former Chief Nursing Officer of Ontario Dr. Debra Bournes said BC’s new nurse secretariats will create opportunties for positive change.

doing direct care in order to create a better nursing environment. “When nurses are engaged and feeling supported and valued, they have a better work experience and you get better patient outcomes,” she said.

She also stressed the need for greater doctor and nurse collaboration. “A lot of what happens with patient experience depends on how the nurses and doctors interact with

one another,” she said. “Innovation comes out of working together”.

Here in BC, collaborative relations between nurses and government is one avenue with major potential to improve working conditions. Bournes said that BC’s new nurse secretariats and Chief Nursing Officer position will create a window of opportunity for policy to come out of the mixing of visions, ideas and priorities.

Getting all of these forces moving in the same direction will always be challenging, admitted Bournes, but she told delegates she believes that formalizing relationships and ensuring that a nurse is inside the walls of government creates new opportunities for positive change.

“You need to get the right person in the role, a person who can walk that fine line down the middle – someone well-enough connected to the nursing community, but who also understands how government works,” said Bournes of the Chief Nursing Officer role.

“But you can’t just establish it and walk away. You’ve got to stay with it. Your job is to hold them accountable, make sure the continued on page 30

OUR HOPE FOR THE FUTURE BCNU leaders host a panel discussion focused on the future of nursing. From left: BCNU Vice President Christine Sorensen; Dr. Maura MacPhee, Associate Professor and Associate Director of Undergraduate Programs, UBC School of Nursing; BCNU President Gayle Duteil; BCNU Director of Communications Systems and Policy Advisor Patricia Wejr and Canadian Federation of Nurses Unions President Linda Silas.

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TECH TABLE BCNU’s education department engages members BCNU’s education department showed its love of technology and teaching when it debuted a number of new projects at its tech table. Enticing delegates with a draw-to-win candy machine full of M&Ms – in BCNU’s colours no less – education officers were on hand with cell phones loaded with a mobile learning prototype that will allow members and stewards to access information about the provincial contract and other labour relations tips.

Members who visited the tech table were also invited to colour in a personal infographic about their convention experience and have their photo taken by an education officer who then tweeted the photo with the member’s quote. The photos were projected onto a large Tweetwall that showed pictures of over 100 members who’d stopped by the tech table to chat, colour, and find out about the education department’s programming.

Members also tried out a personalized e-learning module that leads stewards through the selection grievance process with the help of “Stu Ward” – one of the education department’s e-characters.

Also showing at the tech cable was a new animated video about the union’s Leadership and Labour Relations (LLR) program, featuring highlights of its first year.

Between the candy, the colouring and the numerous computer screens, the tech table became a hub of activity, and members had the opportunity to see first-hand some of the creativity and excitement behind the e-learning projects available to them.

TWEETWALL Convention delegates share their enthusiasm at this year’s education department table.

MENTORING NEW AND YOUNG ABORIGINAL MEMBERS Members of BCNU’s Aboriginal Leadership Circle met over lunch during convention to discuss ways of mentoring new and young members in communities across the province. ALC acting chair Sherry Ridsdale also took the opportunity to describe her experience volunteering at this year’s “Gathering Our Voices” youth conference in Victoria. The annual event is hosted by the BC Association of Aboriginal Friendship Centres. Back row, from left: Simon Fraser region’s Sherry Ridsdale, West Kootenay region’s Erin Roulette and Shaughnessy Heights region’s Scott Ramsay. Front, from left: East Kootenay region’s Lori Pearson, Nurse Practitioner Tania Dick, North East region’s Leona Clark, South Islands region’s Louise Laroche and Thompson North Okanagan region’s Diane Lingren.

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FEATURE

office is doing what you want it to do,” she cautioned. “In the past these roles really worked across Canada – it’s a powerful place to have a nurse.”

The new nurse secretariats were negotiated as part of the recently ratified Nurses’ Bargaining Association provincial contract, and are expected to be in place later this year.

OUR HOPE FOR THE FUTURE

The final day of convention saw BCNU leaders host a panel discussion focused on the future of nursing. With an increasing population and a surge in seniors in the coming years, the panel considered the ways in which expanding capacity in acute and community care will affect nursing.

Duteil predicted health authorities will be looking at ways to increase capacity in a publicly funded system in the future, and that could mean operating rooms may be open 24-7 in order to accommodate more surgeries and reduce waiting lists.

Duteil said nurses require support in pursuing recognized specialty roles such as RN First Assist, and that more LPNs need to be trained to work in the operating room theatre. She also stressed the need for “homegrown education,” so that nurses don’t have to travel out of province for specialty OR training.

BCNU Vice President Christine Sorensen said fragmentation of care is a key problem that needs to be addressed in the future. She pointed to new, team-based continuity-ofcare models where patients are treated by a

SPIRITED RALLY Project Backpack founder Cara Sinclair thanks BCNU members for their donation to the organization and talks about the difference the supplies would make in the lives of homeless youth.

range of health care professionals, including nurses. “The aim is to keep them out of acute care. Keep them in their communities and allow them to stay at home,” she said.

RALLYING FOR YOUTH MENTAL HEALTH SERVICES

Delegates capped their annual convention in Vancouver with a spirited rally in support of homeless youth in the city. Over 500 BCNU members filled city streets, chanting “mental health matters!” while marching to BCNU CONVENTION 2016

Watch the Video on your mobile device Highlights include comments from a silent vigil at George Derby Centre and a rally with nurses from across the province in support of Project Backpack for homeless youth.

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the lawn of the Vancouver Art Gallery.

“Nurses see youth struggling with serious mental health issues every day,” said Duteil from the steps of the gallery. “They come into the hospital in crisis and there aren’t enough beds or nurses to take care of them.

Youth in trouble need ongoing supports and services and we know they’re often not receiving them.”

Duteil told members that the need for improved mental health services for youth is province-wide, and she reminded them of BCNU’s repeated calls for the Abbotsford Regional Hospital psychiatric unit to be reopened to youth in crisis.

Duteil was joined by Canadian Federation of Nurses Unions president Linda Silas, who spoke about the growing need for mental health services across the country, and the fact that services for the most vulnerable are often the first to be cut when governments implement austerity measures.

BCNU partnered with Project Backpack for the event. Project Backpack is a non-

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profit organization that helps homeless youth in Vancouver. The union donated 260 backpacks that nurses filled with essential supplies and wore to the rally. Project Backpack founder Cara Sinclair thanked BCNU members for their support of the organization and told them about the difference the supplies would make in the lives of homeless youth. “There are hundreds of at-risk youth who are homeless or couch surfing in Vancouver,” she said. “Many of these youth live with mental health issues

that only make it harder for them to find help and support.”

The rally wrapped up once members filled a waiting truck with the backpacks for delivery to youth in need.

BYLAW AMENDMENTS AND RESOLUTIONS

Delegates at this year’s convention debated proposed bylaw amendments and resolutions that were brought to the floor over three days of business.

MEN IN NURSING CELEBRATE WIN BCNU’s Men in Nursing Caucus chair Walter Lumamba (front row, second from right) invited group members to celebrate the recently won five-day paternity leave language negotiated in the new Nurses’ Bargaining Association contract as a successful example of what can be accomplished by understanding process, working together and showing persistence.

The 2014–2019 NBA contract contains a provision for 37.5 hours of paternity leave, up from the 7.5 hours contained in the 2012-2014 agreement.

First put together as an idea for negotiations in 2012, it took until the most recent round of bargaining before the idea of expanded paternity leave was sufficiently acknowledged to see it become a reality.

“It takes participation to make change,” said Lumamba. “You have to communicate and connect with people. We succeeded through continued effort this time around.

It’s a historic achievement.”

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Article 3 (Officers of the Union), Article 4 (Election of Officers) and Article 7 (Term of Regional Council Members and Vacancies) were amended to make the language consistent with the switch to concurrent 3-year terms of office for all elected positions in the union. Delegates also voted to amend Article 4.06, so that in the event of a tie vote a run-off election will be held between the tied candidates.

Convention delegates passed an amended resolution submitted by Central Vancouver members calling on BCNU to endorse the Leap Manifesto and urge its members to add their names to the document. Delegates voted against union endorsement of the manifesto, and instead voted to encourage the union to ask members to read the document and consider signing it.

Members from BCNU’s Pacific Rim region submitted a resolution to extend the Supplemental Employer Benefits (SEB) Plan in Article 38.01 of the NBA collective agreement attached to EI maternity benefits to include non-biological mothers.

Delegates voted in favour of this resolution which read that “this matter be considered at the next contract negotiations, in order to include parents/mothers who use gestational surrogates and adoptive parents.”

Fraser Valley region members brought forward a resolution to provide single-chair regions with two weeks’ vacation backfill annually by a current executive officer within the same region. The motion was amended to increase vacation backfill to three weeks. However, the motion was ultimately defeated.

Delegates defeated a resolution brought

by Simon Fraser region members that called on the union to fund up to four steward planning days per region each year.

Convention delegates passed an amended resolution submitted by the West Kootenay region which read “that BCNU Council consider funding the Building Union Strength (BUS) or a similar day that is provided by the BUS Member Educators and fully funded and salary-reimbursed for members.” update

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CONVENTION POSTCARDS 1. Simon Fraser region’s Mina Nasiri spins the wheel of fortune with BCNU LGBT Caucus chair Cynthia Reid at the LGBT booth. 2. Thompson North Okanagan region’s Jessy Dame takes to the mic to remind delegates of the importance of using gender-neutral language. Tuesday, May 17, was the International Day against Homophobia, Transphobia, and Biphobia. The importance of LGBT rights is outlined in BCNU’s recent gender-affirming care position statement.

3. President Gayle Duteil speaks to reporters following her opening address.

4. North East region's Jessie Varaich and Bal Badial get ready for the photo booth at the Convention banquet. 5. South Fraser Valley region's Annie Lee and North West region's Priscilla de Medeiros catch up on a health break.

6. Okanagan-Similkameen region delegates, from left: Linda Partington, Joanne Bayley, Toni Royer, Wanda Remfert and Rhonda Croft. 7. Simon Fraser region's Anna Douglas speaks at the microphone about the need to engage frontline staff on innovative projects. 8. Pacific Rim region’s Catherine Nieman and BCNU education officer Mycal Barrowclough shake hands and talk steward elections at the BCNU education booth. 9. South Fraser region’s Danna Marica Cattermole, Vancouver Metro region’s Noemi Guevarra, Coastal Mountain region’s Yolanda Cutanda Dela-Cruz and Shaughnessy Heights region’s Ida Chan stop for a smile at the Finding a Fit booth. 10. BCNU education department coordinator Ann Bradbury joins member educator Ann Chin at the education booth. 11. 50/50 draw winner Rebecca Bell (North West region) receives her winnings from Pacific Rim region's Brenda Hill.

12. BCNU Vancouver Metro region executive members Andrea Rauh and Brooke Raphael stop for a smile. 13. RIVA region's Len Vaness consults with BCNU occupational health and safety officers Georgina Hackett and Michele Chase while taking the OH&S workplace safety hazard quiz. 14. Pacific Rim region's Geraldine Miller gets her picture taken at the BCNU education department Tweet Wall that features nurses' personal infographics. 15. South Islands region members dress up in flashing lights for the Convention banquet hosted by the Fraser Valley region. This year's theme was "Health Care 2125 – The Future is Here.” 16. Members show their BCNU nursing colours during the convention photo shoot. 17. North West region's Laura Marko and Ellen Christison.

18. Thompson North Okanagan region’s April Ferguson enters a draw and chats with Coastal Mountain region Mental Health Advocate Paddy Treavor at the Mental Health Matters booth. 19. BCNU's LGBT Caucus gathers for a lunch meeting. Back row, from left: North East region's Brenda Edwards, Pacific Rim region's Richard Bernier, West Kootenay region's Ron Poland, Central Vancouver region's Rae Wooffindin, Simon Fraser region's Jereme Bennett, Central Vancouver region's Keith Gingerich, East Kootenay region's Tyrel Hawke, Thompson North Okanagan region's Jessy Dame and OkanaganSimilkameen region's Carla Winchell. Front row, from left: North East region's Hanna Embree, South Islands region's Cynthia Reid, South Islands region's Robert D'Andrea and Fraser Valley region's Mike Dirk. 20. Pacific Rim region's Colleen Dhami and South Fraser Valley region's Diana Henson visit Thompson North Okanagan region's Diane Lingren and Simon Fraser region's Sherry Ridsdale at the Aboriginal Leadership Circle booth.

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THE FUTURE OF MEDICARE An aging population and strained provincial budgets means a new federal health accord is more important than ever

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WELVE YEARS AGO, Canada’s first ministers signed a historic accord reaffirming their collective commitment to the country’s universal public health care system.

The 10-year federal-provincial health accord, signed in 2004, provided for a six percent annual increase in the federal Canada Health Transfer (CHT) to the provinces, and first ministers agreed to tie the federal dollars to national standards to help reduce surgical wait times.

The health accord also reaffirmed the provinces’ commitment to the principles and criteria of the Canada Health Act that ensures all medically necessary care be publicly administered, comprehensive, accessible, portable, universal and delivered without user fees or extra-billing.

Two years ago that health accord expired.

And today, there are many troubling violations of the Canada Health Act across the country.

In BC and Alberta, private clinics are charging illegal membership fees and billing patients for access to necessary health services.

In Saskatchewan, Bill 179 will lead to the opening of private MRI clinics and allow those who can pay to jump the queue ahead of others.

In Ontario there have been multiple cases of extra-billing and user charges, especially for cataract patients.

And in Quebec, Bill 20 forces patients to pay for medically necessary treatment.

In the past year alone, the provinces have failed several times to abide by the Canada Health Act. It is up to the federal government to ensure that the provinces and territories are delivering health care according to the Act.

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For many Canadians, the future of medicare has appeared bleak. The last federal government had turned its back on health care leadership, and abandoned Ottawa’s historic funding and policy role. And in 2012, it announced cuts to the CHT that will amount to $36 billion over the next 10 years.

“Now it’s time for the federal government to follow through and make sure Ottawa continues to provide the health care leadership nurses, and all Canadians, expect.”

BCNU PRESIDENT GAYLE DUTEIL

A NEW HEALTH ACCORD The dark clouds looming over public health care lifted with last year’s election of the Trudeau Liberals, who won a majority in the House of Commons after running a campaign that placed a high emphasis on support for medicare and seniors’ care.

The current federal-provincial health accord, which was extended by five years by the previous Conservative government, is set to expire in 2017, and annual increases to health care funding will then be tied to GDP growth rates. A slow economy means that the amount of money transferred to the provinces will be restricted – unless a new deal is struck.

New federal health minister Jane Philpott expressed her desire to draft a new health accord as soon as she took over her portfo-

lio, and has said she wants the federal government to start the transfer of new funds to help provinces deal with the mounting costs of care.

Philpott and her provincial counterparts have been in negotiations throughout 2016 in the hopes of reaching a new multi-year health accord by 2017.

Philpott has indicated that any deal negotiated with the provinces will address home care, improved mental health services and a commitment to expanding palliative care.

And the federal government has already agreed to join the provinces and territories in the bulk purchase of pharmaceuticals, a move aimed at making medication cheaper for Canadians. But many public health care advocates – including the BCNU and other unions – have called for a national drug program to properly address the rising costs of prescription drugs.

The federal government’s willingness to negotiate with the provinces is no more than a complete 180 degree turn from the position of its predecessor, who refused to sit at the same table as provincial health ministers. But Ottawa’s plan for targeted health care spending, versus straight increases in the CHT, has meant that the negotiations won’t necessarily be all blue skies.

TARGETED FUNDING INADEQUATE Philpott is arguing that targeted funds are what the health care system and Canadians need now, and has said that any new additional federal funds for health care would be paid through targeted funds rather than through the CHT mechanism.

But provincial health ministers unanimously disagree, and have emphasized that only an increase in the CHT can adequately

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support provincial priorities and ensure the long-term sustainability of provincial health care systems.

Targeted funds are temporary by definition, and generally conditional on the achievement of new initiatives that do not always correspond to the priorities of provincial governments.

Experience has also shown that, when targeted funds run out, the provinces must take up responsibility for the expenses related to the new initiatives, which can further increase any financial pressures their health care systems face.

The best way to transfer federal money for health care to the provinces, they say, is one that dates back to the Liberal governments of Jean Chrétien and Paul Martin: predictable CHT funding.

Philpott disagrees. “We can show Canadians what we’re doing with that new [targeted] money and Canadians can see new spending through the federal government’s support into health care will actually deliver the kinds of things Canadians want,” she told CBC News in an interview this June.

WHERE IS THE SENIORS’ CARE? Federal health care investments were a high-polling issue during last year’s election

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campaign. And Trudeau made frequent promises on the campaign trail about ensuring there would be immediate investments in home care if the Liberals were elected.

The party’s election platform says that, as an immediate commitment, a Liberal government will invest $3 billion in home care over the next four years to deliver more and better home care services for all Canadians.

Fast-forward to the release of the federal budget this March, and we find that there is no money for home care. It’s a shocking omission, especially given that, in 2014, more than 5,000 hospital beds were occupied by patients waiting for residential care placement. A 2012 Statistics Canada study also found that 461,000 patients aged 51 and older could not access needed home care for their chronic health conditions.

“Investments in home and community care are what’s needed for the future of health care,” says BCNU President Gayle Duteil. “It’s considerably more cost effective, and – if it were more widely available – would free up space in costly acute care facilities for patients who need a higher level of care.” Unfortunately, with no commitment in this year’s budget, the federal government will have to spend $1 billion in each of the next three years to meet its commitment.

The issue of seniors’ care funding, combined with Ottawa’s resistance to revisit the CHT, has the potential to de-rail current talks. With an aging population and the costs of health care rising, many provinces have said an increase of more than three percent is needed. Philpott has expressed resistance to this call, and has said the government plans to honour its commitment to targeted home care funding.

“I’m not convinced that putting more money in through the transfer is the most effective way for us to transform the health-

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care system in the way that it needs to be done,” Philpott told CBC News this June.

But Terry Lake, BC’s health minister, has said the federal government needs to increase the amount of money it’s paying for health care across the country if it wants to see an agreement on home care.

“I think it would be difficult to come to any agreement on other priorities [like home care], because the federal government needs to increase the amount of money it’s paying for health care if they want to have more of a say in the kinds of programs that are delivered,” Lake told the CBC. FEDERAL LEADERSHIP STILL NEEDED The federal budget did allocate $290 million over two years to various health initiatives, including expansion of a nutritious food program in the North, improving food safety and fighting cancer. These are important initiatives. But leadership is about more than targeted funding. It’s about sectorwide investments in areas such as home and community care, metal health care or prescription drug coverage that respond to Canadians’ evolving needs. It’s also about enforcing the Canada Health Act to ensure that hospital and physician services continue to be equally accessible to all Canadians, regardless of income.

The provinces will always be responsible for the majority of health care funding, but Ottawa’s role is critical for the future health of the health care system itself. It’s a shared commitment, and a partnership that has come to define some of Canada’s most important values.

“Nurses know that when we are facing staffing cuts or unhealthy work environments that it’s not just a problem with an individual employer,” says Duteil. “It also means there are problems at the top.” In the last federal election, Canadians voted for change at the top, and for candidates who were committed to improving health care for all. Now it’s time for the federal government to follow through and make sure Ottawa continues to provide the health care leadership nurses, and all Canadians, expect. update

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FUTURE OF MEDICARE

THE LEGAL ASSAULT ON UNIVERSAL HEALTH CARE For-profit health care trial to go ahead in September

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CONSTITUTIONAL challenge that could change the future of Canadian health care is scheduled to resume in BC Supreme Court this September, and patients supported by the BC Nurses’ Union will have an important role in the proceedings.

At the centre of the story is Vancouver doctor Brian Day, founder of the Cambie Surgeries Corporation (CSC) and leading promoter of for-profit health care in Canada.

Dr. Day is a self-styled champion of patients, but BCNU and other public health care advocates have argued that his true motive is profit and a desire to see a private, US-style insurance system for hospital care in Canada.

For years, Dr. Day has railed against medicare laws that protect patients’ access to necessary care, regardless of their income. Day has fully admitted to breaking the law and charging patients thousands in illegal fees. He has been litigating since 2008 in order to prevent the province from enforcing the BC Medicare Protection Act in the interest of all British Columbians.

Day used the courts to delay a government audit of his clinic for three years, and when the audit was finally conducted in 2012, it showed that CSC illegally billed patients almost half a million dollars in the three months selected for the audit.

BCNU has supported patients who are interveners in the case. They were set to bring important affidavit evidence to trial in September 2014, attesting to their negative experiences with for-profit health care in BC. As the trial was set to begin, CSC legal counsel said that it wished to delay trial proceedings yet again in order to allow for settlement

discussions with the provincial government. A settlement was not reached, and another trial date was set for March 2015. But the case was put off again when disclosure issues surfaced, and since then the trial has been postponed three times.

As the defendant in this case, the provincial government is expected to be arguing that a parallel, private health care system does not reduce wait times for patients using the public system because physicians have incentives to delay surgery in public facilities, forcing patients to use private health care. The province will also point to the ethical problems that arise when doctors have ownership interests in the private clinics to which they refer privately insured and higher paying patients.

There are also a number of other interveners in this case, including the BC Health Coalition and Canadian Doctors for Medicare. They, along with the BCNU-supported patients, will be providing evidence attesting to the high costs and negative impacts that for-profit health care and private insurance would have for Canada.

And this year, the government of Canada entered the fray and will provide evidence about its health roles and responsibilities. The government has yet to provide the court with information on what positions it will be taking.

Despite its for-profit business model, CSC has always claimed that its actions are motivated by a desire to rescue patients on surgical wait lists in the public health care system. The company’s legal strategy has involved telling the “horror stories” of individual patients who have suffered while waiting for surgery. A number of patients joined Day as plaintiffs in 2012, in order to attest to the harm they claim to have suffered while waiting in the public system.

Some of these patients received services at the

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UPDATE MAGAZINE July/August 2016

Cambie Surgery Centre and had their fees reduced or waived.

An individual’s suffering should be a concern, and improvements to the management of surgical wait lists are always welcomed. But the facts themselves contradict Dr. Day’s scaremongering.

The evidence tells us that, by and large, surgical wait lists are being managed effectively, and there is certainly no case for the elimination of the single-payer insurance system that is the basis of Canadian medicare.

The Canadian Institute for Health Information has published analyses year after year that consistently show how approximately 80 percent of Canadians receive priority-area procedures – including hip and knee replacements, cataract surgery, hip fracture repair and radiation therapy – within medically acceptable time frames. Unfortunately, BC happens to have some of the longest lists in the country – a fact that may very well be attributable to the high number of private surgical facilities in this province.

Yes, there is room for improvement, but public innovation and provincial policy leadership are the key to reducing surgical wait times (see sidebar on page 38). It is unfortunate that, instead of working with his colleagues to improve medicare, Dr. Day’s solution is two-tiered medicine that would pull the public system down. update

37

FOR-PROFIT HEALTH CARE

DANGEROUS MOVE

Government report recommends extending the length of stay in private surgical facilities

M

ANY BCNU MEMBERS are aware of the private surgical clinics that operate in the province. But did you know why these businesses only perform day surgeries?

It’s because provincial legislation does not allow overnight stays in non-hospital facilities. This effectively means that all major surgeries must be performed in public hospitals.

Now, the government has suggested making changes to the Hospital Act to allow private clinics to perform surgeries that require up to a three-day stay.

Allowing three-day stays would be a massive step toward health care privatization – a move the College of Physicians and Surgeons of BC recognizes would lead to a private hospital sector.

The proposal was announced as part of a comprehensive report outlining the province’s plan for tackling surgical wait times. The government is pitching the idea as a way to shorten our long waiting lists – but what does the evidence say?

Wait lists won’t get any shorter

There is a huge body of research from the US, the UK and here in Canada showing that shifting surgeries into private hospitals doesn’t cut wait times, it actually makes them longer and more difficult to manage. We don’t have enough nurses or anesthesiologists to properly staff the operating rooms we have now. Draining the public system of its human resources is no way to improve access to care.

Costs will go up

CLINIC TODAY, HOSPITAL TOMORROW Proposed changes to the province’s Hospital Act would result in a massive step toward health care privatization.

July_2016_v5.indd 37

The evidence here is clear as well.

Surgeries performed in private facilities are more expensive and taxpayers will pay the extra costs: higher administration fees; the cost of setting up and enforcing new regulations to cover private hospitals; managing contracts with individual surgery centres; and the extra costs incurred

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FUTURE OF MEDICARE

when patients who develop complications after surgery in private care must be treated in public hospitals. On top of that, private facilities are duty-bound to generate profit for their investors.

Patient safety will be put at risk

More expensive care doesn’t necessarily buy better care. To stay competitive despite the extra costs, private hospitals often cut corners – usually on nursing hours. Opening the door to 3-night stay surgeries means that we would be trusting private surgery centres with more complex procedures even though our public hospitals are better resourced to deal with complex cases, putting patient safety at further risk.

Transparency and accountability will be at risk

We know that costs will go up, but it will be difficult to measure by how much, or where the extra money is going. Because private facilities are protected by commercial confidentiality, they don’t have to release the same detailed information that public hospitals currently do. Transparency and accountability, hallmarks of the public system, don’t apply.

Nurses will pay the price

One of the ways that private hospitals cut costs is by choosing not to contribute to nurses’ pensions. As a result, any hours worked in the private sector aren’t counted toward nurses’ pensions.

Once we open the door, it stays open

This isn’t something we can try out and then decide to reverse.

Because of international trade commitments, once we allow international investors access to the private surgery market in Canada, we can’t go back. Large for-profit hospital chains operating internationally are eager to break into the Canadian market, and we need to ask ourselves if that’s where we want our public health care dollars being spent.

If the evidence is so overwhelming, why is the government trying to sell this plan to British Columbians as a good idea?

It comes down to short-term versus long-term thinking.

Innovations supporting long-term solutions to our surgical wait list problems would require up-front investments in infrastructure and human resources, which can be difficult to sell to the public. Unfortunately, a balanced budget in the short-term makes for a better headline.

The government’s proposal to make BC a “leader” in private, for-profit care – the only province to consider private hospitals profiting from three-night stay surgeries – is unacceptable.

Public health care dollars should be invested into delivering the best possible care for British Columbians, not to generate dividends for investors seeking to profit from our ills. update

July_2016_v5.indd 38

REDUCING SURGICAL WAIT TIMES The Case for Public Innovation and Provincial Leadership BC’S SURGICAL WAIT times are among the longest in the country. The provincial government recently released a policy paper, Future Directions for Surgical Services in British Columbia, that discusses the need for more provincial leadership to reduce wait times. Unfortunately the policy paper also recommends extending the length of stay in private surgical facilities for up to three days – a direction that the College of Physicians and Surgeons of BC recognizes would sanction a for-profit hospital sector.

A new study by the Canadian Centre for Policy Alternatives assesses the provincial government’s policy paper and provides an extensive review of research on the problems with

private, for-profit surgical delivery.

Reducing Surgical Wait Times presents detailed policy recommendations that build on best practices from BC and Saskatchewan as well as Scotland – a global leader in public sector waittime solutions.

“There are some very fixable problems in the public health care system that are contributing to longer waits,” says study author Andrew Longhurst.

“Almost 20 percent of operating rooms in BC aren’t used to full capacity.

We don’t have adequate home and community care for seniors, so they end up in hospital, which contributes to bed shortages and longer waits for surgery.

We have pilot projects that reduce wait times but they aren’t being scaled up province-wide.”

Read the report on your mobile device

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UPDATE MAGAZINE July/August 2016

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SILENT VIGIL BCNU members gather at Burnaby’s George Derby Centre last May. Nurse layoffs at the residential care facility underscore the crisis facing home and community care at a time when investments in the sector should be made to save money throughout the public health care system.

WHERE IS THE CARE?

Seniors’ care is the future of public health care, but leadership is needed to address BC’s foundering home and community care system

I

T WILL TURN INTO ANOTHER geriatric warehouse, and that’s what they’ve got all over the province.”

That’s how long-time resident Dave Peacock reacted to management’s decision to fire the full-time nursing staff at George Derby Centre. Deathly ill upon entering the 300-bed residential care home in Burnaby, Peacock recovered there due to the quality of care he received. “I needed extended care, and I got the best. These guys saved my life.”

George Derby Centre is the latest victim of BC’s systemic under-funding of residential care. When Executive Director Ricky Kwan issued pink slips to 54 RNs and LPNs in May, he pointed to a funding shortfall of over $1 million a year. Kwan claims the deficit arose because Fraser Health mandated an increase in direct care

July_2016_v5.indd 39

to 2.87 hours per day without providing additional funding.

“Contracting out has dire consequences for residents,” says BCNU President Gayle Duteil. “It replaces family-like relationships and continuity of care with strangers and high turnover.” To prevent this from happening, Duteil says that government needs to ensure it fully funds its target of 3.36 direct care hours per day. And it should eliminate funding inequities between facilities owned and operated by health authorities and those at for-profit and notfor-profit providers.

Fraser Health asked Kwan to delay the firings until it completed a review of George Derby’s books, which in the end made no difference when the company went ahead with the layoffs. It’s now clear that the impetus to contract out won’t be

curtailed by finding more corners to cut.

The real problem remains systemic underfunding of the residential care sector by the provincial and federal governments.

C

anada as a whole faces a mounting crisis in seniors’ care, due largely to the absence of federal leadership during the Harper era. Tailoring health care services to the specific needs of a growing seniors’ population is now the single biggest challenge facing the system.

With the 2015 election of the Trudeau Liberals, hopes rose that a national strategy on seniors’ care would finally be forthcoming. The Liberals promised to renew the federal health accord and inject $2.1 billion over four years into expanding seniors’ care.

But the first federal budget was silent on seniors, offering neither money nor timing for any strategy.

This is troubling news for British Columbians. Our province is the greyest in Canada, but it supplies the least residential care per capita. According to the Canadian Centre for Policy Alternatives, before 2002 BC was among the top provinces in per capita expenditures for residential care. But by 2012, the province was “dead last by a huge margin.”

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FUTURE OF MEDICARE

BY THE NUMBERS

SENIORS IN CANADA

24%

The proportion of Canadians aged 65 and older in 2012 who had unmet home care needs.

1

4

IN

The proportion of Canadian seniors, aged 75 and over, who received help at home in 2012.

89%

The proportion of Canadian seniors in 2009 who had at least one chronic condition. Arthritis and rheumatism were identified as among the more common chronic conditions, affecting 44% of seniors aged 65 and over.

81.7

YEARS

The average age of a Canadian senior in 2011, an increase of almost 25 years since 1921.

July_2016_v5.indd 40

There are over 27,000 elders living in BC’s publicly subsidized care facilities.

While BC’s Seniors Advocate has reported a modest 3.5 percent bed growth since 2012, the over-75 seniors’ population grew by 10 percent in the same period. An earlier Ombudsperson’s study noted that BC actually shed 1,748 residential beds between 2005 and 2011.

Having too few residential care beds means many seniors get stuck in $1,100a-day hospital beds waiting for space in care homes that, if available, would only cost $200 a day. In 2014 for example, 12.6 percent of all hospital stays in BC were for alternative level of care (ALC) patients waiting for space in an appropriate nonacute facility.

Many seniors suffer declines in their health, mobility and well-being while parked in acute care. But the sad reality is that many of these so-called bed blockers would not need to be in hospitals if they had better access to home and community care services.

Too few hospital beds and too many ALC patients also means that hospitals routinely run over-capacity, an approach that generates hallway medicine and backs up waits for admission in emergency rooms.

N

ot only are there too few residential spaces to meet rising demand, there aren’t enough nurses or other health care workers to supply the safe, highquality care frail residents need.

One sign of understaffing is the overmedication of seniors in residential care.

According to the Seniors Advocate, only 4 percent of residents are diagnosed with psychosis, but 34 percent are on anti-psychotics. And while 24 percent are diagnosed with depression, some 47 percent are on anti-depressants. “Let’s be honest here – this is a result of inadequate staffing,” says BCNU President Gayle Duteil. “If these facilities were appropriately staffed, maybe our seniors wouldn’t have to be sedated so much of the time.”

Under-mobilization is another sign of

understaffing: only 12 percent of BC residents receive weekly physiotherapy, compared with 25 percent in Alberta and 58 percent in Ontario. And only 22 percent of residents in this province have access to recreational therapy compared with 42 percent in Alberta.

In 2016, the Seniors Advocate reported that 232 of 292 funded residential care facilities in BC failed to meet the government’s guideline of 3.36 direct care hours per day. In response, Health Minister Terry Lake has called for an in-depth review of direct care hours and staffing in residential care – a much overdue step.

“It will turn into another geriatric warehouse, and that’s what they’ve got all over the province.”

GEORGE DERBY CENTRE RESIDENT DAVE PEACOCK

There’s no question that additional money is also needed for improved home and community care to meet the needs of a steadily rising seniors’ population. This care must begin in the home – long before individuals are ready to live in a residential care facility. Just as investment in residential care services reduces pressure on the acute care sector, investment in home health services relieves demand for residential care. Unfortunately, BC seniors face the most restrictive access to home health services in Canada. Analysts note that, between 2001 and 2014, there was nearzero growth in the number of BC seniors receiving home support services despite a 49 percent increase in seniors over 80 years of age during the same period.

Failure to supply enough home health services to meet government’s commit-

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ment to enable aging in place for seniors has resulted in care being skewed towards only the sickest of the sick. This defeats using these services preventively to help seniors age stably in place. In practice, it means signs of decline are not picked up early and acted on before crisis, resulting in avoidable episodes of acute care in overtaxed hospitals.

For those delivering home health services, underfunding has also meant fragmentation of work, higher turnover, more agency nurses and care aides, and the loss of social relationships with clients.

BC also relies heavily on unpaid caregivers to offset the lack of available home care and support. According to the Seniors Advocate, over 97 percent of BC’s home support clients have an unpaid caregiver in their lives, and over a third of these are in distress due to providing over 30 hours of care weekly. Some 54 percent of caregivers now care for seniors with complex needs and would benefit from access to respite, which is in short supply.

T

he sorry state of seniors’ care in British Columbia underscores the need for renewed federal leadership in developing a pan-Canadian strategy and targeting new investments to key areas, like home and community care.

Leadership in policy and funding is required if BC is to reverse this negative spiral. Both the Canadian Medical Association and Canadian Federation of Nurses Unions have proposed seniors’ strategies based on funding care as a relationship, delivered by teams of providers at the community level.

BC’s new policy direction signals the transfer of care from hospitals into the home and community sector. This is a goal BCNU agrees with, but it must come with new investments in home and community care to support the strategy. So far, there is little evidence of this happening.

Improvements to home and community care cannot simply be funded through the cutting of acute care beds. Doing so

July_2016_v5.indd 41

would cannibalize one overtaxed part of the health care system to feed another.

The transfer of care into the community should be funded directly by long-overdue additional investments in home and community care. At the same time, the delivery of home and community care should be redesigned to better and more fully accomplish the objective of aging in place.

BCNU’s new collective agreement extends job security to nurses in residential care, ensuring that any nurse who’s displaced will get another job in their health authority. That’s a good first step in protecting nurses from job loss, but it doesn’t protect their residents. The move to contract-out care at George Derby will only mean further downgrading of the amount and quality of care provided to the frail elderly.

BY THE NUMBERS

SENIORS IN CANADA The main factors behind the aging of Canada's population are the nation's below-replacement-level fertility rate over the last 40 years and an increasing life expectancy.

79

Life expectancy for men in 2009.

83

Life expectancy for women in 2009.

69

Life expectancy for men in 1970.

76

Life expectancy for women in 1970.

YEARS

YEARS

YEARS

“If these facilities were appropriately staffed, maybe our seniors wouldn’t have to be sedated so much of the time.”

BCNU PRESIDENT GAYLE DUTEIL

A necessary next step must be to increase funding to the residential care sector so that enough direct care hours are supplied in-house rather than being contracted out.

If, as the literature suggests, care of seniors is optimally provided as a relationship, then it needs to be designed and funded as such. “The risk if we don’t see renewed leadership and funding, federally and provincially, is that seniors’ care will literally become mere ‘geriatric warehousing,’” says Duteil. “And that’s something nurses will not stand by and allow to happen.” update

41

YEARS

1

IN

7

The number of Canadians over the age of 65 in 2011.

1

4

IN

The projected number of Canadians over the age of 65 in 2036.

Source: Statistics Canada

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PRFs IN THE WORKPLACE

FIRST-TIME SUCCESS SENIORS’ HOME NURSES EMBRACE PROFESSIONAL RESPONSIBILITY PROCESS TO IMPROVE CARE CONDITIONS

LOOKING FOR LONG-TERM SOLUTIONS Nurses working at Burnaby’s St. Michael’s Centre successfully used the PRF process to address long-standing workload concerns. From left: Inna Nagey, Samanthi Rodgrigo, Jennifer Gan, Gianne Paez and Sameer Arora.

TODAY, MORE NURSES than ever are aware that professional responsibility forms (PRFs) are an effective way to safeguard their practice and protect their patients and residents. Despite the progress that’s been made, many nurses working in long-term care facilities have still been less likely to use the professional responsibility process. But a recent success at Burnaby’s St. Michael’s Centre shows that this is changing.

Inna Nagey, an LPN who works at the seniors’ facility, says staff had raised concerns about workload for over five years, but management still made no

July_2016_v5.indd 42

changes. “We were concerned about the complexity of the patients and the staffing ratio,” says Nagey. “But we were always told the same thing: management couldn’t make changes to staffing because of the budget.” In April 2015, Nagey was appointed as a steward and attended one of BCNU’s steward education workshops.

There, she learned about the professional responsibility process and how it could make a difference at her workplace.

Soon after, Inna and co-worker Sameer Arora began educating their colleagues about how the process could help them, and how to file PRFs.

BCNU Simon Fraser region PRF Advocate Cam Ward is pleased that members working in a long-term care facility are now actively filing PRFs. “We know that our acute settings tend to be more active,” says Ward. “That St. Michael’s Centre staff is stepping up to ensure safe patient care demonstrates that BCNU is reaching LPN members about the importance of filing PRFs.” According to Fraser Health’s own policies, the ratio of nursing staff to residents in its longterm care facilities should be no greater than 1-to-25. Arora says the ratio is now closer to 1-to-45. “Ten years ago that

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might have been passable in a long-term setting,” he says. “But so much has changed now.”

Both Nagey and Arora note that resident acuity has increased during this time, making their work much more demanding.

Arora adds that family members are on the Internet now more than they were ten years ago. They often come in with a list of questions they want answered, and staff are required to assist them in addition to their daily tasks.

“There was a lot of apprehension at first – people were worried about losing their jobs.”

ST. MICHAEL’S CENTRE NURSE SAMEER ARORA

Once Nagey and Arora got started, they embraced the professional responsibility process as a way to achieve their goal of a better working environment. “We were very persistent every day in documenting our workload,” explains Nagey, who created a timetable to track every one of the tasks she was expected to complete in her 420-minute work day. She was able to document that a regular workload required 627 minutes to complete, not including any unforeseen delays, questions from families or emergencies.

The initiative was not without its hurdles. “There was a lot of apprehension at first,” says

July_2016_v5.indd 43

Arora. “People were worried about losing their jobs.” He admits that it was a challenge to educate his co-workers about their own job security, and about the fact that there was no risk of a poor job performance review or being disciplined for participating in the professional responsibility process.

Nagey says she’s thankful for the support of her union, and notes that Ward was incredibly helpful in supporting St. Michael’s staff throughout the process. She observed that once her co-workers were educated about PRFs as a support tool to help them find professional practice solutions versus being a confrontational exercise, they were all on board. Nagey believes that the decision to file one collective PRF with over 25 signatures also helped to allay fears.

In response, managers agreed to a meeting with Nagey last December. There, she presented information from the Canadian Nurses Association as well as BCNU’s position statement on mandated nurse-patient ratios to illustrate the impact of working short before sharing her own report that showed the extra time needed to finish her regular daily duties. Nagey says they ended up being at the table for two hours brainstorming ideas on mutual solutions to resolve the workload problem.

A resolution was reached, and Nagey, Arora and their co-workers now applaud management at the facility for being open to hearing nurses’ concerns around unsafe conditions for both staff and residents. As a starting point, in April 2016, a permanent part-time position

was added to float between each of the existing three wards to assist with the volume of work.

Starting in September 2016, management will reorganize the facility from three wards up to five, which should limit LPNs’ workload to an average of 26 residents. Nurses will also be assigned to a specific ward to promote continuity of care and

43

help build rapport with their patients.

Nagey’s final words for others? “There is no harm in raising your concerns. The professional responsibility process is not confrontational.

It is a mechanism for bringing issues forward, discussing them and finding solutions together.” update

HOW TO CONTACT YOUR REGIONAL PRF ADVOCATES If you need help, please contact your current PRF advocates listed below.

Pacific Rim Ray Hawkes rayhawkes@bcnu.org

South Fraser Valley Catherine Clutchey catherineclutchey@bcnu.org

South Islands Daphne Wass daphnewass@bcnu.org

Simon Fraser Cameron Ward camward@bcnu.org

Vancouver Metro Andrea Rauh andrearauh@bcnu.org

Okanagan Similkameen Heather Picklyk heatherpicklyk@bcnu.org

Coastal Mountain Pauline Barlow paulinebarlow@bcnu.org

Thompson North Okanagan Chauni Johnson chaunijohnson@bcnu.org

RIVA Sara Johl sarajohl@bcnu.org

East Kootenay vacant

Shaughnessy Heights Manpreet Mann manpreetmann@bcnu.org

West Kootenay Glenna Lynch glennalynch@bcnu.org

Central Vancouver vacant TBD

North East Barbara Erickson barbaraerickson@bcnu.org

Fraser Valley Janice Young janiceyoung@bcnu.org

North West Louise Weightman louiseweightman@bcnu.org

TBD

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44

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 Adriane Gear C 778-679-1213 adrianegear@bcnu.org

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

July_2016_v5.indd 44

SIMON FRASER Lynn Lagace Co-chair C 604-219-4162 lynnlagace@bcnu.org

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

Wendy Gibbs Co-chair C 604-240-1242 wendygibbs@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 Chair C 250-816-0865 rachelkimler@bcnu.org RIVA Lauren Vandergronden Chair C 604-785-8148 laurenvandergronden@bcnu.org

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

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

Marlene Goertzen Co-chair C 778-874-9330 marlenegoertzen@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 Margo Wilton Co-chair C 250-818-4862 mwilton@bcnu.org Lynnda Smith Co-chair C 250-360-7475 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

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Council Profile

45

HERE’S WHO’S WORKING FOR YOU

COMMITTED ADVOCATE FRASER VALLEY CHAIR KATHERINE HAMILTON

EMPOWERING MEMBERS

“There’s a real diversity in BCNU members’ needs but it’s important to me that we are united,” says Fraser Valley region chair Katherine Hamilton.

QUICK FACTS NAME Katherine Hamilton.

GRADUATED Langara College 1987.

UNION POSITION Fraser Valley chair.

WHY I SUPPORT BCNU? “I believe in the power of collectivity.”

July_2016_v5.indd 45

IT’S CLEAR WHEN SPEAK­ ing with BCNU Fraser Valley region chair Katherine Hamilton that being a nurse isn’t just a career choice, it’s a lifestyle.

Hamilton was elected chair of her region in September 2014, replacing long-time chair Linda Pipe. Now she works tirelessly to improve working conditions for her colleagues, speaking out against unsafe workloads, attending organized rallies, hosting this year’s BCNU convention and taking part in demanding union business.

Hamilton’s busy schedule benefits from the strong leadership skills she’s developed over years working as a neonatal

and perinatal nurse. Her career began after she graduated from Vancouver’s Langara College in 1987. Since then, she’s worked in the surgical unit at Surrey Memorial Hospital, the neonatal intensive care unit at BC Children’s Hospital, and the perinatal unit at Abbotsford Regional Hospital and Cancer Centre (ARHCC). She has fond memories of her time in NICU and gets emotional thinking about her experiences, especially with new moms and dads.

“It was such a privilege to watch a couple become parents,” she says.

Running for the position of regional chair seemed like the best next step for Hamilton. An

active steward at ARHCC since 1993, she has held positions as a member communicator, PRF steward, contract interpretation steward and grievance steward.

Hamilton says the learning curve since being elected has been massive.

“I’ve realized how diverse nursing is and I’m committed to learning more about community nurses, long-term care nurses and LPNs,” she says.

“There’s a real diversity in their needs but it’s important to me that we are united.”

In addition to her role as regional chair, Hamilton also sits on BCNU’s Member Engagement and Steward Recruitment and Retention Committee, PRF Review Committee, and participates on BCNU’s Run for the Cure team.

Hamilton was raised by a father who was a strong union supporter, and she says the word “solidarity” was used a lot in her childhood home. In her spare time, the mother of three sings in a band called, No Code Blue, which consists of doctors and nurses. Over the last 14 years the group has played hundreds of charity events.

Hamilton’s busy schedule is fueled by her desire to help those who don’t always have the tools to support themselves.

“It’s an honour to be regional chair and I believe it’s important to stand together. While it’s hard to be away from the bedside, the work I’m doing in this role fills me up.” update

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UPDATE MAGAZINE July/August 2016

Off Duty MEMBERS AFTER HOURS

THE PERSONAL IS THE POLITICAL PENNY COULSON RAISES FUNDS FOR WOMEN ESCAPING DOMESTIC ABUSE PENNY COULSON KNOWS what it’s like to experience domestic violence first-hand.

When she was younger, the Victoria nurse escaped an abusive relationship in the back of a police car. Today, she volunteers as a board member for the Victoria Women’s Transition House Society.

For more than 40 years, the Victoria Women’s Transition House and Women’s Sexual Assault Centre has offered emergency shelter, support, counselling and education to women of all ages, with or without children, who are fleeing domestic abuse. Coulson has been a volunteer for the past five years, and her duties include the planning of fundraising activities and board recruitment.

When speaking with Coulson, it’s clear that the issue of violence against women is important to her. “I believe women deserve a better life,” she says. “Our whole goal is to keep the transition house running to provide counselling and services for women and children. I’ve been down that path. I know what support services did for me and I know what they can do for women who are affected by violence.”

Coulson, a registered nurse,

July_2016_v5.indd 46

has worked for BC Corrections for the past nine years. Prior to this, she worked at Royal Jubilee Hospital for 31 years. Coulson recalls treating women in hospital who had been assaulted before a women’s sexual assault centre was established. Now she is both grateful and proud to be supporting a much-needed service. “If you are a victim of violence, the transition house is there for you,” she says. “There are many different services available to help women who need them.”

Coulson also brings years of community experience to her board position. Her volunteer commitment over the years has been focused on her children’s schools and sports programs.

She has also volunteered with Victoria City Police Victim Services, helping women prepare for court when facing their accused assaulters.

Despite the serious nature of the Transition House Society’s mission, Coulson makes sure she has fun in her fundraising role. This year she volunteered to be the society’s “Charity Champion” in the Victoria Goddess Run that took place June 5 in Langford. Now in its fifth year, the annual run is a celebration of women.

This year, runners wearing tutus, boas, tiaras and sashes raced a 5K, 10K or halfmarathon. At the finish line, participants were greeted by local firefighters, given medals, and treated to a buffet of gourmet treats donated by local businesses. Coulson, along with transition house development

manager Joanna Verano, raised $3,400 at this year’s run. “I absolutely love it! The empowerment for women is amazing,” said Coulson after completing the race.

Coulson says community fundraisers like the Goddess Run are critical for the continued operation of non-profit societies. And fundraising is an important function of a board of directors. “Once again we are partnering with a golf tournament, and we get a portion of the money that’s raised,” she says. “Last year it was $70,000.

It’s a huge fundraiser for us.”

Coulson plans to retire in December. But that likely won’t put a dent in her volunteer work.

She encourages other nurses to consider doing similar volunteer work in their own communities.

“If you have the opportunity to get on a board like this, any kind of board, it’s fantastic,” she says. “I love it. I’ve become very good friends with other people on the board and we work really hard together on many different projects.” update

CHARITY CHAMPIONS Victoria Women’s Transition House Society development manager Joanna Verano (l) and board director Penny Coulson participated in this year’s Victoria Goddess Run to raise funds for women’s support services.

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Join BC NURSES’ UNION in participating in the First Cause Ride 2016 – a first responders’ ride for PTSD and mental health.

Supporting occupational stress injury treatment for all first responders.

To ride or volunteer on behalf of BCNU contact: shawnleclair@bcnu.org

SATURDAY, AUGUST 20, 2016

www.firstcauseride.ca #UnitedWeRide Colin Thompson, 2015 First Cause Ride Founder

START TIME: 9:00am – Jack Poole Plaza FINISH: Central City Centre, Surrey 32km Rookie Ride July_2016_v5.indd 47

82km Summit Ride

140km Elite Challenge 7/14/2016 11:08:10 AM

JOIN US Sunday October 2, 2016

Visit cibcrunforthecure.com to register

You are invited to be part of the BC Nurses’ Union’s Run for the Cure team as a runner, walker and/or volunteer in your community*.

Click “Join a Team” and choose the team name “BC Nurses Union” (no apostrophe).

Click “Find a run site” and choose your community location.

*choice of 9 locations

PROUD PROVINCIAL SPONSOR:

PM 40834030

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