BCNU Update Magazine May-June 2015

MAY/JUNE 2015

BURNED OUT: WORKLOAD STUDY REVEALS HIGH LEVELS OF EMOTIONAL EXHAUSTION

SPECIAL PULL-OUT REPORT: GRIEVANCE SETTLEMENT SETS PATH TO IMPROVED STAFFING

UPDATE BRITISH COLUMBIA NURSES’ UNION

CONVENTION 2015

BCNU IS

FOR SAFE

PATIENT CARE

PROUD TO BE NURSES Central Vancouver region’s Jeana Dagasdas and Okanagan Similkameen region’s Celine Smith are committed to safe patient care.

H SP SAEA ECI IS FELTH AL SU T & E Y

WWW.BCNU.ORG

UNITED

NATIONAL NURSING WEEK MAY 11–17, 2015

With you every STEP of the way

> INTERNATIONAL NURSES DAY MAY 12

> LPN DAY MAY 13

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UPDATE MAGAZINE May/June 2015

UPDATE

•

CONTENTS VOL 34 NO2

MAY/JUNE 2015

OH&S CHAMPIONS University of BC Hospital nurse Jocelyn McCord and Vancouver General Hospital nurse Dallas Gogal both worked to successfully ensure that Vancouver Coastal Health Authority implement an enforceable surgical smoke evacuation policy for its operating rooms.

UPFRONT

6 8 9

Check In

News, updates and current events.

Birthing Unit Crisis

Surrey Memorial Hospital nurses ring the alarm on chronic understaffing.

Care Model Changes

Island nurses document the risks to safe patient care.

10 Committed to Their Work Long-term care nurses address their unique challenges ahead of bargaining.

12 Burned Out

BCNU workload survey reveals high levels of emotional exhaustion.

13 Convention Report

A virtual rally for safe patient care was one of the highlights of this year’s gathering.

DEPARTMENTS

5 PRESIDENT’S REPORT 32 YOUR PENSION 34 PRFS WORK 36 WHO CAN HELP? 37 COUNCIL PROFILE 38 OFF DUTY Special Pullout Report

FEATURE

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SAFETY FIRST

Read about how BCNU members are making their workplaces safer for themselves and their patients.

Learn about the recent staffing grievance settlement that sets the tone for productive bargaining in the year ahead. p. 13

Special Re

port

STAFFING GRIEVANCE SETTLEME NT www.bcnu.org > Message From Your President > NEW Fast-T rack Staffin g Dispute Process In Specialty Education Funding

> $5 Million

APRIL 2015

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BC Nurses’ Union

MOVING? NEW EMAIL?

UPDATE MAGAZINE

MISSION STATEMENT BCNU protects and advances the health, social and economic well-being of our members and our communities.

BCNU UPDATE is published by the BC Nurses’ Union, an independent Canadian union governed by a council elected by our 42,000 members. Signed articles do not necessarily represent official BCNU policies.

EDITOR Lew MacDonald CONTRIBUTORS Juliet Chang, Laura Comuzzi, Sharon Costello, David Cubberley, Monica Ghosh, Gayle Duteil, Gary Fane, Shawn Leclair, Michelle Livaja, Robert Macquarrie, Sherry Parkin, Cindy Paton, Catherine Pope PHOTOS David Cubberley, Lew MacDonald, Catherine Pope

CONTACT US

STAY CONNECTED

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. Give us your home email address and we’ll send you the latest BCNU bulletins and news releases. And if you’ve changed your name, please let us know.

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

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

Canadian addresses to BCNU 4060 Regent Street Burnaby, BC, V5C 6P5

PRESIDENT’S REPORT

UPDATE MAGAZINE May/June 2015

5

GAYLE DUTEIL

SAFE NURSES EQUALS SAFE PATIENT CARE

PHOTO: ALEXIS SULLIVAN WALTERS

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S YOU READ THIS, CHANCES ARE THAT A NURSE TODAY somewhere in BC has been assaulted while on the job. Nurses everywhere, every day, are subjected to physical, verbal or emotional abuse while trying to provide safe patient care.

Violent attacks on health care workers have increased 70 percent in the last ten years. This is unacceptable, and definitely not part of the job. No nurse should ever have to suffer because of a lack of safety officers, personal alarms or adequate training.

Over the last number of months, we have worked hard to convince provincial health authorities that they must make worksites safer. The BCNU team has presented our demands in countless meetings with the health minister and senior officials from the government and health employers. We have also raised public awareness by engaging the media.

Finally we seem to be getting somewhere.

The government has now agreed to move forward with a plan to address some of BCNU’s concerns. Four sites out of the twelve we identified as needing immediate attention are now being reviewed by the health ministry. Hillside Psychiatric Centre in Kamloops, where many nurses have been injured by patients over the years, is first on

the list. As this issue of Update went to press, another Hillside nurse was assaulted, and Interior Health has finally posted a safety officer at the facility 24-7. (Turn to page 23 for the full story and learn more about BCNU’s new policy on violence protection.)

I am also very pleased that BCNU has won a major settlement which resolves thousands of safe staffing grievances. The details can be found in the special pull-out insert on page 13. BCNU has secured $2 million for breaches of the contract, which will be distributed to individuals and groups of members who filed grievances. Another $5 million in funding has been secured for specialty education and there is now a fast-track process to resolve nurses’ staffing issues. It won’t solve every staffing issue at every site, but it improves the process and makes health authorities more accountable.

This significant achievement could not have happened without the dedication and perseverance of our members. You rose to the call for collective action, took the time to file thousands of grievances demanding safe patient care and made change happen!

Occupational health and safety is the focus of this month’s magazine. In addition to violence prevention, there are stories about rural transport nurses’ work to secure safety management systems and Vancouver Coastal Health OR nurses’ successful push for an enforceable smoke evacuation policy.

As always, members are making a difference on many of these issues by speaking up and working with union reps to defend their right to a safe and healthy workplace.

I want to thank each and every one of you for your hard work and dedication. The recent grievance settlement and health ministry commitments are just the beginning, and one more step on our path to a new and better contract for all BC nurses. update

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CHECK IN

NEWS FROM AROUND THE PROVINCE

HARM REDUCTION

OTTAWA THREATENS INSITE – AGAIN

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HOUSE OF COMMONS BILL THAT PASSED last month will impede the operations of supervised consumption sites such as Vancouver’s Insite and endanger severely addicted Canadians, according to nurses and other community health professionals.

Bill C-2, the Respect for Communities Act, consists of a host of new regulations that will make it much more difficult for a community service provider to open a harm reduction site. The new legislation will also complicate the process by which existing sites have to apply annually for an exemption from the Controlled Drugs and Substances Act to operate.

The move flies in the face of a 2011 Supreme Court of Canada ruling where the court found that supervised injection sites save lives and that the federal health minister’s failure to provide an exemption was in violation of drug users’ constitutional rights to life and security of the person.

Under Bill C-2, facilities that wish to run a supervised consumption site must meet a lengthy list of requirements, including: a letter from the head of the local police force; statistics and other information on crime, public nuisance and inappropriately discarded drug paraphernalia in the vicinity of the site; and a report on consultations with “a broad range of community groups.”

The Canadian Nurses Association says it is “disappointed” that the bill was passed in the House and “concerned” by the Conservative government’s so-called “tough-on-crime” position.

“A government truly committed to public health and safety would enhance access to prevention and treatment services instead of building more barriers,” the association, which represents 135,000 registered nurses, said in a statement last month. update

SAFE INJECTIONS SAVE LIVES BCNU and other organizations are working hard to support the continued operation of Vancouver’s Insite – Canada’s only stand-alone supervised drug injection facility. But the federal government has consistently opposed the harm reduction strategy on which Insite is based.

DUES AND TAXES

If you are contacted by the Canada Revenue Agency (CRA) regarding the union dues amount you have claimed on your 2014 income tax return you should provide them with the following: 1. Your T4 (or T4s if more than one was received) – this shows the amount of union dues your employer has deducted from your salary and submitted to BCNU for the tax year indicated.

2. The receipt you received from CRNBC or CLPNBC as proof of payment of your annual membership fee.

In most instances this

should satisfy any CRA investigation audit regarding your union dues and professional fees.

If the CRA requests proof that the union dues noted on your T4 were paid to BCNU you should contact the payroll department of your employer and request a brief letter noting that they remitted the dues to BCNU in tax year 2014 on your behalf. BCNU does not issue receipts for proof of union dues noted on your T4.

More information on annual union and professional dues claims can be found on CRA’s website.

CNSA ELECTIONS

Several BC nursing students were recently elected to top positions in this year’s Canadian Nursing Students’ Association elections. North Island College’s Dawn Tisdale was elected president, Langara College School of Nursing’s Terrace Desnomie was elected vice president and Langara College School of Nursing’s Tonie Castro was elected director of communications.

VITAL SIGNS

Numbers that matter

NURSES’ JOB SATISFACTION

Recently surgical BCNU members reported only moderate levels of satisfaction when it came to working in their current job. Nurses cited workload and management practices as the primary reasons for intent to leave their current positions. Nurses were satisfied overall with their career choice despite the working conditions.

44% CURRENT JOB The percentage of nurses who reported that they were “moderately satisfied” with their current job.

25% INTENT TO LEAVE The percentage of nurses who reported that they were “somewhat likely” to leave their current job within the next year.

40% CAREER CHOICE The percentage of nurses who reported that they were “very satisfied” with being a nurse.

Source: BC Nurses’ Workload Impact Study (2014) MacPhee, M, et al. Published by the University of British Columbia and the BC Nurses’ Union

UPDATE MAGAZINE May/June 2015

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INDEPENDENT BARGAINING

FIRST CONTRACT Ayre Manor Lodge employees see improved wages, benefits and holidays

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#SAFEPATIENTCARE BCNU’s North East region held a mini rally during its March 27 regional meeting in Prince George. Members pictured, from left: University Hospital of Northern BC steward Victoria MacDonald, UHNBC steward Shannon Sluggett, UHNBC steward and Joint Occupational Health and Safety committee member Jen Coleman and UHNBC full-time steward Judi Dindayal.

MAKING NEWS MAKING HEALTH CARE LEADERSHIP AN ELECTION ISSUE

BCNU in the headlines

funding contribution.

“The [Harper] government will not negotiate a When the federal governnew health care agreement ment announced cuts to between the federal and health care funding in 2011, provincial governments. many Canadians vowed to The private sector is lobbymake sure that voters would ing our governments, sucnot forget the cessfully it seems, decision. to allow it more Duncan Home access to our and Community public health care Centre nurse Ted system. This issue Gamble reminded needs to be at the people of the forefront of the Harper governfederal election, ment’s polices and I encourage when he wrote to all constituents Ted Gamble the Vancouver Sun to question all on the one-year the political party anniversary of the March 31, candidates on this issue,” 2014 expiry of the federalwrote the BCNU Pacif ic Rim provincial health accords region member in a letter that had secured Ottawa’s published April 2.

FIRST CONTRACT COVERING 65 BCNU members at Ayre Manor Lodge in Sooke was ratified on March 31 by 100 percent. The three-year agreement, retroactive to July 2014, improves wages, paid leave, and benefits, and establishes strong new language on bullying and harassment.

Under the contract that has now been ratified by the Sooke Elderly Citizens Housing Society (SECHS), housekeepers, servers and prep cooks will receive a $1.00 per hour increase, while wages for all classifications will rise by 2.5 percent on July 1 and another 2 percent on July 1, 2016. Members will also receive a signing bonus of $250 for full-time, and $125 for part-time. Casuals who have worked more than five shifts since July 1, 2014 will receive $75.

Statutory holidays have been increased from 10 to 12 per year, with Christmas paid as a super stat at twice regular pay. The contract also increases sick leave to up to eight days a year, accrued fully in January (under a former independent contract it had to be accrued month-by-month).

BCNU was certified to bargain on behalf of all the workers on July 15, 2014. The four-member bargaining committee, led by BCNU negotiator Laura Anderson, showed patience and determination throughout long negotiations, which also included mediation.

“I think members are really happy with the gains in this contract,” said bargaining committee member Janice Leask. “They like the harassment language, and the night shift are happy they’re going to get paid for their meal breaks.”

Since 2008 Ayre Manor Lodge has provided 25 assisted living apartments and 32 residential complex care suites. The lodge was initially operated on contract by Beckley Farm Lodge Society, but SECHS assumed direct control in 2014 and BCNU now represents all classifications at the facility, including housekeepers, cooks, servers, care workers and nurses. update

GOOD DEAL Ayre Manor Lodge workers (from left) Anna Campbell, Terri McKinty, Linda Quigley and Janice Leask are happy with the first collective agreement they signed on March 31.

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SURREY MEMORIAL HOSPITAL

BIRTHING UNIT CRISIS

STAFFING NIGHTMARE SEES EXODUS OF 30 NURSES OVER THE PAST 2 YEARS

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MAGINE A SITUATION WHERE you work an entire shift running from medical event to medical event with no time for mental or physical breaks, being unable to complete your charting until after the shift ends, and finally being reduced to tears before heading home due to the overwhelming workload.

Now imagine that, instead of being a oneoff event, this is considered part of a normal shift at your worksite. This is the reality for the more than 100 regular nurses who work at Surrey Memorial Hospital’s Family Birthing Unit (SMH FBU).

Every year, some 4,200 babies are born here.

The SMH FBU is the busiest mater-

nity ward in the province. The unit is also a non-refusal site with its own operating room designed to accept high-risk pregnancies. It’s not a place for the faint of heart.

But despite the unit’s size and importance to the region, nurses here are constantly overworked, and patients aren’t getting the care they deserve.

Nurses have been ringing alarm bells for the past two years due to chronic understaffing, and report that managers regularly staff the unit with only 14 to 15 nurses on the night shift when the baseline staffing requires 21. RN absences are regularly not replaced.

Janet Cooley is a 17-year nurse and patient care coordinator at SMH. She’s proud of the work she and others do under the circumstances. “We have an amazing team and everyone works really hard and really well together,” she says. But Cooley also knows that staff are experiencing physical and mental stress, burnout and sometimes provide sub-standard care to their patients.

Nurses have responded by filing several grievances over the employer’s refusal to properly staff for patient demand and to baseline levels. At a recent arbitration hearing, Cooley testified that the level of acuity and patient demand can change at any moment, with up to 10 patients coming to the unit

SARE CARE NOW! Surrey Memorial Hospital patient care coordinator Janet Cooley and former full-time steward Nicole Ng are seeking concrete solutions to remedy the chronic staffing problems in the hospital’s maternity ward.

in active labour and needing immediate one-to-one nursing care. She also noted that the unit is expected to deal with many high risk deliveries requiring multiple nurses to provide appropriate care and monitoring. But short staffing has led to admission delays and incomplete assessments, and an inability to provide patients with adequate post-partum education.

SMH doctors joined nurses in testifying at the hearing about their concerns for the safety of their patients.

Cooley is also worried about her employer’s ability to recruit and retain staff for a ward that has seen an exodus of some 30 regular nurses in the past two years.

“We’ve lost so many amazing nurses and we now have a lot of junior staff on the unit – and it’s hard to support them when it’s such a busy place,” she says. “So it’s very hard on new people as well.”

She says it feels like managers are more focused on the budget than meeting guidelines and following the contract.

“Many of the nurses don’t feel supported,” says Cooley. “They don’t see more nurses being trained and educated. They don’t see the lines and shifts being filled, so working short just places extra workload on them – and they choose to go to other obstetrical units in the lower mainland where working conditions are better.”

This only compounds the problem, she says. “You can work in a different birthing unit in Fraser Health and it’s way less busy and better staffed.”

In the meantime, Cooley is doing her best to support her team. “Always ask for help, always fill out PRFs and always tell your PCC when you’re feeling your practice or patient care is being affected,” is her message to nurses working short.

Fixing the problems at the FBU is now a top priority as the BCNU works with provincial health employers to resolve all outstanding safe staffing grievances related to the 2012 provincial collective agreement (see the special pull-out report on p. 13).

The progress made so far is a testament to nurses at SMH and other worksites who continue to fight for safe patient care every day. update

UPDATE MAGAZINE May/June 2015

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CARE MODEL CHANGES

NURSES DELIVER STRONG MESSAGE TO ISLAND HEALTH BCNU has documented more than 100 instances where new care model prevented nurses from meeting their professional standards

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HE TWO SCHOOL BUSES that pulled up outside Victoria’s Royal Jubilee Hospital on March 26 were filled with nurses determined to send a strong message to Island Health Authority board members during its public meeting.

Led by BC Nurses’ Union South Islands region co-chairs Adriane Gear and Lynnda Smith, some 100 nurses outside the hospital carried signs that read “Safe Patient Care.”

Once inside, nurses presented the board with 2,000 petitions demanding an independent review of the deeply flawed care model (dubbed Care Delivery Model Redesign, or CDMR) which has caused so many problems for nurses and patients on Vancouver Island. The latest batch of petitions come in addition to the 27,000 signatures already given to Island Health over the year-and-ahalf since CDMR was introduced.

Each board member was also given a personally addressed letter reminding them of their own vision statement in which they

“aspire to the highest degree of quality and safety.”

“How can you endorse replacing nurses with care aides in a context of rising patient acuity?” read the letters. “How can less nursing care be a safe response to more complex patient needs? And how can cutting over 48,000 annual nursing hours in Nanaimo (26 FTEs) and up to 186,000 annual hours (100 FTEs) in Victoria be said to improve care for patients whose complex illnesses require more – not less – nursing attention?”

Gear told the board that when nurses tell Island Health leadership that they can’t meet their professional standards, they’ve been told to “lower their standards.” Island Health CEO Brendan Carr dismissed these concerns, claiming management would never ask people not to comply with professional standards.

However, BCNU has now documented more than 100 instances where the new care model has prevented Vancouver Island

nurses from meeting their professional standards and providing safe patient care.

This information will be presented in affidavits during upcoming arbitration hearings where the union will provide evidence of specific instances of lapses in patient safety due to excessive workloads, including: • The inability to provide medications in a timely manner.

• The inability to complete patient assessments and adequately monitor patients.

• The inability to complete charting and care plans.

Nurses have reported that these types of situations are all associated with an increased risk of adverse patient outcomes.

“Island Health has repeatedly said there is no evidence of serious problems with the care model,” says BCNU Pacific Rim region chair Jo Salken. “But nurses at Nanaimo Hospital deal with problems in providing safe patient care every single day.”

The union is hoping that the sched-

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uled arbitration will resolve key issues in Nanaimo, including: • A ruling on the extent to which an employer can cut nurse staffing levels without impacting their professional standards.

• A ruling that will require the employer to re-establish nursing positions on CDMR units where professional standards aren’t being met.

• An acknowledgement that Island Health changed its care model without seeking nurses’ input.

• An acknowledgement that CDMR has impacted nurses’ work-life balance, resulting in decreased job satisfaction and increased mental health problems, such as moral distress.

Unfortunately, Island Health continues to deny that the care model has serious flaws, and nurses say that problems providing safe patient care while understaffed persist.

According to Salken, Nanaimo Regional General Hospital’s floor five is a heavy medical and stroke floor that is often short four nurses.

“Nurses just don’t want to work any ‘extra’ in an environment where it puts them into moral distress because they’re unable to provide quality care,” she explains, noting that professional responsibility forms are being used in response to the situation. “PRFs continue to be filled out by nurses who are not meeting their standards.”

Salken points to Island Health’s creation of a Critical Care Outreach Team (CCOT) as evidence that CDMR isn’t working.

CCOT is supposed to “provide early intervention to prevent a patient from going into cardiopulmonary arrest,” she says. But she believes it’s recognition that there have been poor outcomes for patients on CDMR units. update

LONG­TERM CARE MEMBERS PREPARE FOR BARGAINING MEETINGS HIGHLIGHT THE UNIQUE CHALLENGES FACING MEMBERS WHO PROVIDE SENIORS’ CARE ACROSS THE PROVINCE

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CNU MEMBERS WHO WORK in long-term care facilities across the province have been meeting to prepare for contract negotiations so employers and policy makers clearly understand their issues at the bargaining table.

This winter, the BCNU wrapped up a series of dinner meetings organized to hear first-hand about the challenges that the more than 6,000 BCNU members working in long-term care face. More than 300 members participated in 18 meetings across the province. And for many of the participants it was their first BCNU meeting.

BCNU Vice President Christine Sorensen, Treasurer Mabel Tung and BCNU long-term care Bargaining Committee rep Liz Ilczaszyn facilitated many of the dinners. They were joined by other BCNU regional chairs and staff.

The lack of accessible long-term care services is a serious issue, and it’s one that policy makers cannot afford to ignore as BC’s population ages and more people require full-time home and community health care services. Seniors’ advocates have been speaking out about the issue on behalf of patients (see sidebar: BC Seniors’ Advocate calls for improved home and community care services).

No one is more aware of the challenges facing the long-term care sector than the nurses and other health care workers who provide care daily, and BCNU members raised many common themes in the course of the meetings.

These included: • Chronic underfunding: nurses report that government neglect and the lack of a provincial/national long-term care strategy has led to the problems they are experiencing in their workplaces.

CALLING FOR ACTION Victoria nurse Ariel Allen says the lack of staff in every classification is the biggest problem facing the long-term care sector.

• Increasing resident acuity: nurses report facing daily challenges and obstacles as they provide care to an increasingly complex resident population.

• Short staffing and heavy workload: longterm care nurses have heavy workloads and high nurse-to-patient ratios. They often feel they are doing little more than “putting out fires” and don’t have the opportunity to build relationships with residents, and this puts health outcomes at risk.

• Communication challenges: heavy workloads cause communication problems with

UPDATE MAGAZINE May/June 2015

residents, managers and families.

Nurses want more education to create positive environments that combine clinical care with family engagement. Many also said that managers aren’t connected to frontline employees and don’t understand nurses’ experiences.

• Fair compensation: long-term care nurses have a wide body of knowledge and provide health services to residents with multiple issues. But they feel that their work and their unique body of nursing knowledge is neither valued nor appreciated by managers, other members of their profession or co-workers. LPNs in particular felt that they should be fairly compensated for their nursing work.

A

riel Allen is a Victoria RN who works at two long-term care facilities. She’s also worked in oncology and in end-of-life care. Allen attended one of the BCNU bargaining meetings for long-term care members.

“I love having the same resident day after day and getting to know them and their family,” says Allen. “I want to help residents maintain the best possible quality of life for the time they have.”

She says that when she worked in acute care facilities she liked the patient acuity but didn’t like having four to six new patients every day. “In residential [long-term] care I have the best of both worlds,” says Allen.

“Patient acuity is high so I get to expand my nursing knowledge, and I also get to build caring relationships with residents and their families that are so important to my practice.”

Allen says that long-term care nurses need broad knowledge about different fields of health care like oncology, renal, palliative, emergency, cardiac, neuro and mental

health because the acuity is so high.

For Allen, the rewards of the job are overshadowed by what she sees as the biggest problem in long-term care today: the lack of staff in every classification. In addition to needing more nurses, residents also need more physical and occupational therapy to keep them active and socially stimulated, she explains.

“The lack of staff actually pushes up costs to the health care system,” says Allen. “More physical occupational therapy would reduce falls and injuries, and more recreation would reduce depression and patient outbursts. Better recreation would also reduce the amount of medication residents take.”

Allen points to visionary seniors’ care policies in countries like Holland that keep seniors stimulated and active. “It astonishes me that we’re not following models like that,” she says. “They’re doing things the right way and it’s the kind of setting I want for my parents and grandparents if they need residential care.”

The information gathered during the course of the BCNU long-term care dinner meetings makes it clear that members working in this sector need more resources, and that message will be delivered to employers and policy makers in contract negotiations. Our system needs to prepare for – and can easily accommodate with appropriate planning – the growing number of baby boomers who will need long-term care services.

Allen says that baby boomers and those who don’t yet require care should demand better services to ensure they are available when they need them too. “The boomers that are approaching the system need to say ‘this isn’t the way we should be treated in our golden years – this system needs to change.’” update

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BC SENIORS’ ADVOCATE CALLS FOR IMPROVED HOME AND COMMUNITY CARE SERVICES The BC Seniors’ Advocate has just released a report about improvements that are urgently needed in seniors’ health care services. The advocate’s recommendations echo the suggestions of many long-term care nurses who attended the BCNU’s dinner meetings recently.

The advocate made three key recommendations: 1. More community supports are necessary to keep seniors in their homes longer. Up to 15 percent of long-term care residents were prematurely admitted and should have stayed at home with community support.

Supporting healthier seniors in their homes will improve their health and free more space in residential facilities for those who really need it. Then, less complex patients can move out of acute care facilities into appropriate placements. This would reduce costs and lower hospital congestion.

2. Better use of medication in residential care. Drugs are over-used, especially antipsychotics and antidepressants.

In BC long-term care, the following statistics are troubling: • 34 percent of residents have been prescribed antipsychotic drugs, while only 4.1 percent have been diagnosed with a psychiatric disorder.

• 47.1 percent of residents have been prescribed antidepressant drugs, while only 24.5 percent have been diagnosed with depression.

3. More physical, occupational, speech and recreational therapy are needed. BC lags behind Alberta and Ontario in these areas by a significant margin.

Alberta provides almost double the amount of recreational therapy and Ontario provides almost five times more physical therapy.

Read the full report at www.SeniorsAdvocateBC.ca

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MENTAL HEALTH

BURNED OUT

BC NURSES’ WORKLOAD IMPACT STUDY REVEALS HIGH LEVELS OF EMOTIONAL EXHAUSTION

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AST YEAR, OVER 2,000 BCNU members responded to a comprehensive survey conducted by researchers from UBC’s School of Nursing. The objective was to build on existing research on nurses’ perceptions about their work environments.

The research unequivocally supports BCNU’s call for increased staffing. Nurses across sectors believe there has been a deterioration in quality and safety standards within their organizations. The report finds that staffing is insufficient and there is simply too much work to do. On average nurses leave three to four essential tasks undone on their shifts.

BCNU will certainly be bringing these findings to the bargaining table in the coming months, and Nurses’ Bargaining Association negotiators will cite this research to assist in the larger campaign for safe patient care.

However, an equally troubling finding is the survey’s insight into nurses’ mental health. High levels of emotional exhaustion were reported in every sector, as well as reports of post-traumatic stress. Many nurses also reported sleep disturbances and panic attacks.

And instead of using professional help as a way to deal with work-related stress, the majority of respondents’ coping strategies involved the use of informal supports, such as friends, family, exercise and hobbies.

Dr. Maura MacPhee is the study’s principal researcher. She says that when nurses are consistently unable to carry out essential tasks, while also perceiving a real compromise to their professional standards, they get burned out.

MacPhee notes that over 45 percent of survey respondents reported high levels of emotional exhaustion, while 40 percent indicated that they intended to leave their jobs within the next year – and that’s a problem.

“Employers need to take note, because there’s a big correlation between nurse burnout – when they say they’re emotionally exhausted – and their desire to leave,” she says. “Sometimes they leave their current job, and sometimes they will

leave the whole nursing profession – so it is important that health care administrators look at those things and try to do what they can to improve nurses’ work environment so that they don’t get burned out and they don’t leave.” Over 50 percent of nurses cited burnout as the main reason for their intent to leave, according to the report.

Not surprisingly, over 40 percent of survey respondents reported that they were dissatisfied with their current job. When asked to identify the particular workload factors associated with their dissatisfaction, nurses cited emotional exhaustion, short-staffing, and a lack of time to complete necessary nursing tasks as primary culprits. They also cited interruptions during care delivery and documentation as factors influencing their job satisfaction and levels of emotional to U are partnering with BCN UBC nurse researchers ical, phys es’ exhaustion. nurs of workload on document the impact nt safety. health as well as on patie Health employers who are findemotional and mental you are invited om sample of nurses, Together with a rand ing difficulties filling regular fully. to take part in the stud time positions should also note .bcn wis.net ial online survey at: www that of those respondents who Complete the confident ___ Your password is: ____ worked part-time or casual, over one-third stated that they chose PARTIC IPATE! win a to work fewer hours because they to draw a in red will be ente Survey part icipa nts gift card s. felt that full-time work was too 100 5 of 1 or iPad Mini .bcn wis.net study, please visit: www demanding.

To learn more about the The report should serve as a wake-up call for policy-makers and health employers. There’s no question that nurses are committed to COMPREHENSIVE FINDINGS The detailed safe patient care, but there is clear evidence information on nurses’ work environments that, without the necessary support, they gathered in last year’s survey provides are sacrificing their own well-being in the invaluable insight into the factors affecting process. update BCNU members’ job satisfaction. $

UNITED CONVENTION 2015

FOR SAFE

PATIENT CARE Social media networks lit up last month with the message “United for Safe Patient Care.” The occasion was BCNU’s first ever “virtual rally” that took place during this year’s convention. The action succeeded in getting convention delegates to really make some online noise about nurses’ commitment to safe patient care.

MEMBERS WITH A MESSAGE BCNU’s virtual rally saw hundreds of nurses broadcasting their call for safe patient care.

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Duteil thanked delegates for their unrelenting advocacy on behalf of their patients, and in the face of an employer who does not want to listen. “But these are the stories that matter, she said, “and we will tell them with our voices because we must tell them.”

She reported that the ministry of health finally appears to be listening to nurses’ BRINGING NURSES TOGETHER BARGAINING REPORT BCNU’s WELCOME ADDRESS BCNU BCNU President Gayle Duteil kicks Executive Director of Negotiations Executive Councillor Dan Murphy voices, and told delegates off this year’s convention with a and Strategic Development Gary addresses delegates for the first that the provincial governstrong message of unity and hope Fane gives delegates an update time since BCNU’s merger with ment and health employers for all nurses who are fighting for on preparations for provincial the Union of Psychiatric Nurses. met recently to address the safe patient care. bargaining in 2015. workload and patient care issues that BCNU stewards and activists have been conNurses used social media to reach tinually raising. thousands of people with their message Duteil congratulated delegates on the without ever leaving the convention floor. filing of over 4,200 grievances in just six The action involved the mass uploading of weeks – a coordinated effort that should pictures and pre-recorded video clips proleave no doubt nurses are indeed united for moting the message to Facebook sites for safe patient care. “You folks did this – you sharing with friends, family and beyond. helped get employers’ attention to get them Rally organizers primed the pump durto do what they should have done two ing the week with teaser pics of BCNU years ago: implement a fairly negotiated BCNU PRESIDENT GAYLE DUTEIL executive members holding Safe Patient agreement.”

Care signs, posted to Our Nurses Matter – The government has since indicated that BCNU’s popular Facebook site with over it now plans to work constructively with 17,000 followers. nurses to resolve outstanding issues contion, which ran from Feb. 23–25. BCNU Photo and video booths were set up tained in the 2012–2014 contract. “I’m so President Gayle Duteil kicked off the event very pleased that we’re finally making progat convention to generate individual and with a powerful message for the over 500 group photos and video clips for uploadress, that nurses’ and patients’ voices will be delegates gathered in Vancouver for the ing to the Our Nurses Matter page, and for heard.” (See special pull-out report on p. 13 event. sharing with members’ personal networks that provides highlights of the grievance setShe said that when it comes to talking from there. tlement reached with the government and about conditions in BC’s heath care faciliDelegates launched a clear message in health employers following convention). cyberspace that nurses are indeed united for ties, it’s nurses’ voices that tell the real story.

Duteil also reminded delegates that – “All of you know that the patients linsafe patient care. despite the ongoing advocacy and effort ing the hallways, the tub rooms and the of the union to advance the occupational PRESIDENT’S MESSAGE emergency departments, and the elderly in health and safety of its members – employThe virtual rally marked the final day of the community who are waiting for assessers are still not getting the message when BCNU’s thirty-fourth annual convenments – they are not statistics.” it comes to protecting nurses from violent

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I’m so very pleased that we’re finally making progress, that nurses’ and patients’ voices will be heard.

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UPDATE MAGAZINE May/June 2015

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

RYAN UNGER Thompson North Okanagan “I’m hoping to learn about how BCNU performs its business. I went to the firsttime delegates’ session and learned a lot about how meetings are done.”

HUMAN RIGHTS & EQUITY The BCNU Human Rights and Equity Caucus met during convention to discuss current issues and prioritize its work in the year ahead. One urgent issue on their agenda was the federal Bill C-279, which is being delayed in the Senate. Bill C-279 incorporates transgender rights in the Canadian Human Rights Code and in the Hate Crimes provisions of the Criminal Code of Canada. Passed in the House of Commons in March 2013, the bill could die on the order paper if senators continue to delay its passage. Committee members, from left: Walter Lumamba, Mabel Tung, Catherine Clutchey, Kath-Ann Terrett, Kelly Woywitka, Jessica Celeste, Lori Pearson, Cynthia Reid, Jonathan Karmazinuk, Roni Lokken and Sherry Ridsdale.

and aggressive patients.

“We have waited too long for the government and health authorities to take action, and our nurses have the broken jaws to prove it,” she said, before announcing that BCNU has created a new policy which will provide a range of supports for nurses who are physically or psychologically hurt. This includes the option of support for legal action taken by a nurse who has been injured on the job and who wishes to press charges against the attacker.

Duteil took the opportunity to welcome members of the Union of Psychiatric Nurses into the BCNU family, and noted that nurses are all too aware of the mental health challenges facing health care workers and their patients.

She said BCNU’s leadership in the

development of mental health strategy informed by the voice and experience of frontline nurses will go a long way to addressing this pressing social problem.

“We will create solutions and offer ideas as we help to address this overwhelming problem for patients with mental health issues.”

Duteil called on delegates to keep building on their successes as they advance the profession of nursing and continue to provide some of the most complex and compassionate care available.

“Because at the end of the day we will find strength in unity,” she said, “one voice – united for safe patient care.”

PROVINCIAL LOBBY REPORT

On the second day of convention del-

DEANNA ROMM Simon Fraser “I’m actually quite proud to be a BCNU member, and that’s why I came. I feel support coming from everywhere, from my co-chair to the president – from the top on down.”

CAROLYN HUTTON Pacific Rim “I wanted to learn about the decision making process and the running of the business – to be able to bring that back to my colleagues in public health in Campbell River, where vacation backfill has been an issue.”

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ing results,” she said.

Sorensen also blasted the Association of Registered Nurses of BC (ARNBC) for pretending to be “our voice” while being run by “management and educators” and avoiding engaging with working nurses.

Speaking defiantly, Sorensen said, “BCNU has over 42,000 members and we are proud to be the true voice of professional nursing in this province.”

RETIRING ACTIVISTS THANKED PATIENT’S VOICE Keynote speaker Margaret Trudeau speaks candidly about her life-long experience with mental illness.

egates heard from union vice president and provincial lobby coordinator Christine Sorensen, who remarked that a huge bonus of her many responsibilities is the time she gets to spend “working with members, hearing from members, and meeting with members.”

A highpoint for such contact was this year’s community bargaining outreach that saw Sorensen travel to 11 sites across BC and meet with some 880 community nurses. This consultation process identified issues from safety, violence and posttraumatic stress, to vacation backfill, job security and technology, all of which are being fed back into the community bargaining table.

Sorensen also praised the many local campaigns undertaken by the union’s 16 regional lobby coordinators. She mentioned BCNU’s rural and remote health care postcard (where over 3,500 cards calling for improvements were sent to Christy Clark) and support for the Single Mothers’ Alliance of BC’s child support clawback campaign as examples of lobbying success.

“Small grassroots efforts can make for amaz-

Several retiring activists were recognized this year for their dedication and commitment to the union. Members also bid fond farewell to former BCNU President Debra McPherson, who served the union for over 18 years. Other outgoing activists thanked included East Kootenay region’s Patt Shuttleworth, Okanagan Similkameen region’s Laurie Munday, Fraser Valley region’s Linda Pipe, Interior Health LPN rep Janet Van Doorn, North East region’s

Jackie Nault, Central Vancouver region’s Margaret Dhillon, South Islands region’s Margo Wilton and South Fraser Valley region’s Lisa Walker. Duteil extended them best wishes on behalf of all BCNU members.

KEYNOTE SPEAKER MARGARET TRUDEAU

Delegates attending this year’s convention were treated to Margaret Trudeau as the event’s keynote speaker.

Best known as the former wife of the late Prime Minister Pierre Elliott Trudeau, today the 66-year-old mother of five speaks about her experiences living with bipolar disorder as her way of encouraging others to better understand mental illness and to get help.

Trudeau spoke candidly about her lifelong experience with mental illness. She recalled her healthy childhood in North Vancouver, and the changes she first began to notice as a young student. She told dele-

ACTIVISTS’ FAREWELL Several retiring activists were recognized this year for their dedication and commitment to the union. Members also bid fond farewell to former BCNU President Debra McPherson, who served the union for over 18 years. From left: Patt Shuttleworth, Laurie Munday, Linda Pipe, Janet Van Doorn, Jackie Nault, Margaret Dhillon, Margo Wilton and Lisa Walker.

UPDATE MAGAZINE May/June 2015

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STUDENT NURSES MEET BCNU student members from seven BC nursing programs met during convention’s Young Nurses’ Network luncheon to discuss issues such as bursaries and the new National Council Licensure Examination (NCLEX). Back row: (l-r) Kelsey Hollett, Joseph Zeller, Gina Neumann, Diana Henson, Holly Gale.

Middle row: (l-r) BCNU Council student liaison Sharon Sponton, Nadine McGinity, Jessica Wakeling, Catherine Miller, Regina Leung, Sarra Smeaton, BCNU education officer Lois Pierik. Front row: (l-r) Fiona Chiu, Autumn McIvor, Wendy Chan.

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BCNU has over 42,000 members and we are proud to be the true voice of professional nursing in this province.

again in 2001, when she was first diagnosed with bipolar disorder, and of the benefit of the medical treatment she received that has given her new happiness and balance.

“It was the kindness and care of the nurses who helped me get back on my feet, who helped me recover, and who gave me the ability to want to live,” she said.

Trudeau noted the value in being proactive to ensure a successful recovery.

“You have to make the decision that BCNU VICE PRESIDENT CHRISTINE SORENSEN you want to be better,” was her message to other individuals struggling with mental illness. “Don’t dismiss the idea that you can have a beautiful, wonderful, productive and gates about the lack of support she received purposeful life.” when experiencing her first bout of depresThroughout her talk, Trudeau stressed sion after the birth of her second child, and the importance of self-care and nurturing the onset of her episodes of mania. the mind and the body with a healthy diet, Of all the ups and downs in her life, exercise and sleep.

Trudeau told the convention that her lowest point came with the accidental death of BYLAWS AND RESOLUTIONS her third son in 1998.

Delegates to this year’s convention spent The tragedy sent her into deep depression and isolation. “I was finished, I had no significant time debating proposed bylaw amendments and resolutions that members hope. I was physically ill, I was mentally brought to the floor. destroyed,” she said.

Delegates defeated a motion that Trudeau spoke about how she emerged proposed limiting the number of confrom the darkness after being hospitalized

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secutive terms an officer could serve in the same position to no more than two.

Delegates also voted against approving a bylaw amendment that would change the composition of the Nomination Committee from five regular members to three standing members and two auxiliary members.

Delegates rejected a resolution that called for an end to BCNU’s organizing of psychiatric nurses who are members of other unions and turned down a resolution that would reduce the president’s severance allowance to one week’s pay for every one year of service.

Delegates voted in favour of an emergency resolution calling for the continuation of salary reimbursement for members taking the Building Union Strength (BUS) course.

An emergency resolution calling on the BCNU to push for the federal government’s adoption of the United Nations Outcome Document upholding the rights of indigenous people was referred to Council for consideration, as was an emergency resolution calling for BCNU to support family work-life balance by allowing all employees fair and reasonable vacation leave during school holidays. update

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CONVENTION POSTCARDS

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1. BCNU Young Nurses’ Network provincial chair Catherine Clutchey and Central Vancouver region’s Isabelle Bertrand chat at the YNN booth. 2. East Kootenay region’s Nancy Silzer calls for extended OH&S call centre hours. 3. BCNU President Gayle Duteil presents LPN survey winner and Central Vancouver region member Catriona Busutil with an iPad Mini. 4. Delegates Manjit Bains, Harwinder Gill, Bernie Wright and Jessica Celeste. 5. 50-50 draw winner Georgina Lapointe receives prize from retired member Teresa Meierhofer. All funds raised went to BCNU’s Nurses’ Education Fund. 6. BCNU LGBT caucus chair Cynthia Reid smiles with Coastal Mountain chair Kath-Ann Terrett. 7.

Delegates wear pink shirts to celebrate Anti-Bullying Day on Feb. 25. 8. Simon Fraser region’s Sherry Ridsdale and South Islands region’s Louise Laroche at the Aboriginal Leadership Circle booth. 9. BCNU’s Workers of Colour caucus met over lunch on Wednesday to talk about priorities in the year ahead. 10. Shaughnessy Heights region members rock it ‘80s style at the convention dance night hosted by the East Kootenay region. From left: Anne Shields, Eve Seto and Merissa Lacsamana. 11. Retired Pacific Rim region member Brenda Hill sells 50-50 draw tickets to Central Vancouver region’s Gulzar Hassan. 12.

South Islands region’s Lenny Balaiah speaks to the need for more mental health resources in long-term care facilities.

13. North East region’s Cynthia Marquez participates in convention photo shoot. 14. Delegates Desta Azale, Sharon Sharp, unidentified member, Malou Cordero, Menchie Rosales, Cedric Soriano and Christina Isidro take a break at the BCNU Communications Department booth. 15.

Coastal Mountain region’s Amy Orodio poses with keynote speaker Margaret Trudeau. 16. South Fraser Valley region’s Cathy Robinson spins the Wheel of Fortune with Central Vancouver region’s Rae Wooffindin at the LGBT caucus booth. 17. South Fraser Valley region’s Rod Isidro and RIVA region’s Romy de Leon join BCNU Men in Nursing group chair Walter Lumamba at the MiN booth.

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SPECIAL FOCUS ON SAFETY

NO SMOKING VANCOUVER COASTAL OPERATING ROOM NURSES PUSH FOR ENFORCEABLE POLICIES TO PROTECT THEM FROM TOXIC SURGICAL SMOKE

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The days of smoking in hospitals, or any workplace for that matter, are long gone. The health risks of tobacco are well-established, and the overall awareness of the importance of air quality and proper ventilation has made buildings much safer work environments than they were in the past.

Now imagine working in a modern hospital in BC and being expected to routinely inhale a toxic plume of smoke, live viruses, live bacteria, toxic gases and human tissue in the course of your duties.

This is the reality facing many operating room nurses and other health care professionals working in BC hospitals today.

The toxins, which include things like the Human Papillomavirus, are produced when a heat-generating procedure is performed on human tissue. This includes electrocautery and laser surgery. The plume is a part of the environment during operative and invasive procedures. And as lasers and electrosurgery become commonplace, the health of nurses and other perioperative practitioners is increasingly at risk.

Yet, since the mid-1970s, the body of evidence documenting the hazardous components of surgical plume has continued to grow. Plumes are now proven to be carcinogenic, mutagenic and fetogenic, and since 1996 there have been requirements mandating surgical plume evacuation in BC’s occupational health and safety regulations.

However, it wasn’t until March of this year before the Vancouver Coastal Health Authority – home to some of the busiest ORs in the province – implemented an enforceable smoke evacuation policy that obligates managers to provide smoke evacuation on all of its units. And it likely would not have happened without the diligence and determination of BCNU members.

Vancouver General Hospital OR nurse Dallas Gogal is a member of the hospital’s Joint Occupational Health and Safety Committee. A nurse for the past 14 years, he joined the committee in 2013. Gogal says he’s seen a lot of surgical smoke in his time, and inhaled a lot of it too.

“I’ve known for a decade that this stuff wasn’t good for you,” he says of the surgical smoke that he was exposed to. “What I didn’t know was there were laws to ensure that we shouldn’t be breathing this.”

Gogal says he learned more about surgical smoke at a BCNU OH&S workshop.

“I and the other members [of the JOHS committee] were quite upset when we learned about the actual law and found out we’ve been here completely unprotected,” he says. “And that’s pretty unacceptable – that’s when we had to move forward.”

Members learned that the only way to eliminate surgical plume as an occupational health hazard is to ensure that facilities consistently use smoke evacuation systems with special air filters. N95 respirators used alone are not effective.

Gogal and other nurses on the VGH JOHS committee discovered that, while their employer had a policy that instructed using smoke evacuators for all surgeries, it was deemed “non-enforceable” on the grounds that there were either not enough available units to cover all ORs, or that there were legal obstacles in the procurement process required to install additional machines.

Undeterred, the BCNU JOHS committee members, with the support of union staff, worked on a proposal for an enforceable policy that the committee would send to management for a response.

Workplace JOHS committees are made up of employee and employer reps, and it’s not always an easy task to reach the consensus needed to make a policy recommendation to management. But that’s what Gogal and his colleagues were able to achieve, and in January the JOHS sent a 21-day letter of official recommendation to VGH management for a response.

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nbeknownst to Gogal, operating room nurses at UBC Hospital were addressing similar concerns, and the VGH nurses’ efforts to establish a policy, if successful, would apply to all workplaces in the

Vancouver Coastal Health Authority (VCHA). The timing could not have been better.

Jocelyn McCord is the operating room nurse coordinator at UBC Hospital and has worked in ORs for the majority of her 35-year career.

She says that nurses were not taught about the perils of surgical plumes when she was in school and it wasn’t until she joined the Perioperative Registered Nurses’ Association of BC in 2006 that she received formal education about surgical smoke and became more aware of the risks.

UBC Hospital is a major surgical daycare centre, with eight operating rooms and 800 staff, including 270 physicians and 450 nurses. Approximately 1,600 hip and knee replacement surgeries are performed each year, and surgical plumes are a daily reality at the facility.

When McCord began to advocate for consistent smoke evacuation, she discovered that the primary barriers she faced were technological and financial.

She says that surgeons and nursing staff were not comfortable using the existing old, noisy and bulky smoke evacuation equipment designed to attach to their surgical tools, and which could block their view while working.

“The physicians felt that they didn’t have proper visualization in their surgical field with the smoke evacuation equipment provided,” she explains, adding that surgeries went ahead with no smoke evacuation whatsoever. “But surgeons said they would evacuate smoke if they were given a proper cauterizing pencil that provides smoke evacuation while allowing adequate, safe surgical field visualization.”

In 2012 McCord spoke with equipment vendors and discovered that a range of cauterizing pencils are available, and that these were already being used

HAVE YOU BEEN EXPOSED TO SURGICAL PLUME? While most commonly encountered in operating rooms, surgical plume can be produced anywhere heat generating procedures are employed on human tissue, including day surgery, labour and delivery, ICU/PICU/NICU, interventional radiology, emergency departments, outpatient clinics, etc.

If you work in any of these settings, you may have experienced plume-related symptoms, including: • Nausea • Sore throat • Nasal/sinus congestion • Bronchospasm • Asthma/allergy • Headache • Ocular irritation • Excessive fatigue While these symptoms can be transient, and may clear when you leave the workplace, however they are indicative of an exposure.

If you have concerns: • Inform your manager/supervisor and the Joint Occupational Health and Safety steward or representative at your worksite.

• Report the hazard as soon as possible using the employee incident reporting process at your worksite, e.g. Employee Call Center, electronic, or paper employee incident report.

• Participate in the incident investigation process with the Joint Occupational Health and Safety steward/representative at your workplace.

• You can also file a lack of safe workplace grievance.

• You may follow the steps for Refusal of Unsafe Work.

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SPECIAL FOCUS ON SAFETY

in other hospitals within the health authority and the the province. McCord then approached hospital management who initially agreed to the trial use of the new equipment.

However, it was not long before equipment managers decided that the product was too expensive, and could not be provided to some hospitals without offering to all.

“It was denied on that basis,” she says.

McCord raised the issue with her workplace JOHS committee and received support from OH&S CHAMPIONS University of BC Hospital nurse Jocelyn BCNU staff on how to corMcCord and Vancouver General Hospital nurse Dallas Gogal rectly document concerns and both worked to successfully ensure that Vancouver Coastal Health Authority implemented an enforceable surgical keep them on the employer’s smoke evacuation policy for its operating rooms. agenda.

She’s not surprised that the momentum for changes at Meanwhile, the members at VGH had UBC which picked up last year happened met with success. In February, VGH independently from the initiative that management announced a new policy and nurses were taking at VGH. brought 16 new smoke evacuator machines “A lot happens in isolation,” she says, on site so that all operating rooms have indicating that many policies are applied adequate evacuation. The policy came into inconsistently across the health authority.

“I found out that Lions Gate and Richmond effect March 2.

“It was more challenging than I expected,” Hospital have been using a smoke evacuconfesses Gogal on the JOHS committee’s ation pencil for the past four years,” she efforts to establish the policy. “But I’m glad recalls, “so I suspected that this was just it’s over. However hard it was to get it going, [UBC] management not wanting to spend everybody walks away as a winner because the money – because the other sites apparof it.” ently seemed to have managed it without McCord sent the new VCHA policy out to requiring a [formal enforcement] policy.”

EXPERIENCING SYMPTOMS? DO THE FOLLOWING:

• Report the exposure as soon as possible using the employee incident reporting process at your worksite, e.g. employee call center, electronic, or paper employee incident report.

• Register on the WorkSafeBC exposure registry if you have experienced an exposure.

• If you develop surgical smoke-related illnesses file a WSB claim in case of required treatment and/or time loss.

staff at UBC as soon as she learned about it.

“UBC Hospital was one of the last hospitals in the country to get on board to finally implement a policy and make equipment available,” she says. “And that didn’t happen until March 2.”

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ogal and McCord’s experiences illustrate that it’s possible to effect change with diligence and perseverance.

In both cases management initially resisted their initiatives, but chose to work with staff through the JOHS committee to achieve a resolution. Both nurses also had to work with colleagues – both BCNU members and other health care workers – and get their support in helping achieve their goals.

The new policy has been in place for two months, and Gogal says he is pleased with its implementation so far.

“As far as I am aware, we are at 100 percent compliance now,” he says. “I’ll give credit to management. They’ve brought another company in and expanded their range of [smoke evacuation] options that can be used by the surgeons – and that addressed a lot of the surgeon group’s concerns.”

He also notes that the available range of smoke evacuation tools means there is no longer an excuse for a surgeon or anyone else to avoid using one of the products.

Gogal’s message to other members who have an occupational health and safety concern? “Find your JOHS committee, meet your rep and realize that you can work through the committee,” he says. “It’s your venue for working together with the employer to solve something.”

Gogal is also happy for his team to serve as an example for others. “If there are members in other parts of the province suffering from surgical smoke issues, they should know that there are many places like Vancouver General that have successfully solved the problem,” he says. “You can be protected and still be in surgery, and everybody can be winners, right?” update

UPDATE MAGAZINE May/June 2015

BREAKING POINT

HEALTH AUTHORITIES MUST IMPROVE NURSES’ SAFETY NOW

BCNU CALL FOR VIOLENCE-FREE WORKPLACES FINALLY GETS GOVERNMENT’S ATTENTION

SAFE NURSES = SAFE PATIENT CARE The BCNU bus was on hand for a March 10 news conference at Abbotsford Regional Hospital to call for action after an ER nurse at the facility was savagely attacked, suffering serious trauma and injury. Back row: Chilliwack General Hospital steward Mike Goerzen, Fraser Valley region PRF advocate Janice Young, BCNU President Gayle Duteil, Abbotsford Regional Hospital full-time steward Elvira Martens, ARH nurse Robin Price, former BCNU Executive Councillor Will Offley and ARH steward Doris Rettich. Front row: ARH stewards Kathi Dempsey, Heather Quayle and Ravi Kochar, and Fraser Valley region chair Katherine Hamilton.

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he chronic levels of preventable workplace violence that BCNU members have been consistently reporting is a clear indication that serious action is required on the part of the provincial government and health employers to address this occupational health and safety issue. And the BC Nurses’ Union has made violence one of its top priorities as it prepares for collective bargaining in the year ahead.

“We will not have a new collective agreement signed until the issue of violence is

addressed,” said BCNU President Gayle Duteil at a March 10 news conference organized in response to the problem. She indicated that unsafe staffing levels are at the root of much of the violence that nurses are experiencing, and until health authorities begin honouring their 2012 contract commitments to maintain baseline staffing levels and replace nurses when required, it will be very difficult to move forward.

The union’s warning got the attention of the government, and now, after numerous meetings with government and health

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officials, Duteil has received a letter from Deputy Minister of Health Stephen Brown committing to address the problems: “…the government will commence work linked to your proposal on ensuring the safety and security of nurses working in high risk mental health care services with a view to taking some practical concrete steps to make real improvements in the sites you have identified.”

Duteil says any changes can’t come soon enough for nurses on the front lines. “Nurses put themselves at risk every day while trying to provide safe patient care. Many violent attacks can be prevented by increasing safety officers, and providing personal alarms, specialized training and appropriate staffing levels for the patients’ care needs, especially those who are aggressive or violent.”

Health Minister Terry Lake reiterated the government’s commitment at a recent violence prevention summit of health care leaders in Richmond that was attended by BCNU. “We can’t accept that violence is part of the job – it’s a huge challenge and we’ve got lots of work to do,” said Lake.

(Sadly, as Update went to press, another nurse was viciously attacked at Hillside Centre in Kamloops. Duteil called for immediate action, and after meeting with Lake and Interior Healthy Authority manangent, a 24-7 safety officer was posted to the worksite.)

The Ministry of Health has promised to consider all of the solutions that BCNU has proposed and has committed to a plan that will begin by gathering information from four sites out of the 12 that BCNU has identified as needing immediate attention.

These include: • Forensic Psychiatric Hospital, Coquitlam • Hillside Centre at Royal Inland Hospital, Kamloops • Seven Oaks Tertiary Mental Health Facility, Victoria • Abbotsford Regional Hospital Abbotsford is one of many sites in BC where nurses have felt unsafe at work. In March a nurse was assaulted while triaging a continued on page 25

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SPECIAL FOCUS ON SAFETY

COLLABORATIVE SUPPORT

ENHANCED DISABILITY MANAGEMENT PROGRAM HELPS ILL AND INJURED MEMBERS RETURN TO WORK

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wen Herrington began studying to become an RN shortly after graduating as an LPN in 2002. The Dawson Creek nurse wanted more knowledge – and a life-changing diagnosis of kidney disease in 2005 gave her the motivation to finish the RN program as soon as possible. “As an LPN, the work was too physically demanding,” she explains. “But as an RN I could work part-time as a liaison nurse while still having enough kidney function to be an effective nurse.”

However, in 2012 Herrington needed to go on long-term disability as her kidney function decreased to the point that she needed dialysis and could no longer work as a liaison nurse at Dawson Creek Home and Community Care due to the fatigue.

Herrington was on dialysis for over two years before receiving a transplant in July 2014. “A wonderful friend, who is also a nurse donated to me,” she says. “The transplant is a gift of life, but more specifically it is the gift of MY life back – I would encourage people to donate.”

Last February Herrington received the good news from her physician that she was approved to return to work. But the transition came with challenges. Herrington’s decreased immune system required that she work in an environment where she wouldn’t be exposed to very sick patients.

“My position was eliminated in my absence,

CUSTOMIZED ASSISTANCE Dawson Creek nurse Gwen Herrington took advantage of the Enhanced Disability Management Program to help her transition back to work after a long-term disability. She encourages any nurse needing support returning to work to contact the program.

so that added an additional obstacle of placement,” she notes.

It was Herrington’s steward who suggested she make contact with the BCNU Enhanced Disability Management Program (EDMP) representative from her region.

Jointly administered by the employer and the union, the EDMP is a pro-active, customized disability management program designed to help members off work or

struggling at work due to an occupational or non-occupational illness or injury.

The regional BCNU EDMP representative works collaboratively with the employee and disability management professional to address all barriers to a return to work through the development of an individualized case management plan.

The plan may include medical intervention, transitional work, a graduated return to work, workplace modifications and vocational rehabilitation and/or retraining.

Herrington says she was vaguely aware of the program, but admits that she made some assumptions about what it was. “I didn’t ever think it would apply to my own needs.”

After meeting with Wanda Veer, the BCNU EDMP rep for her region, and employer representatives, Herrington says that options opened up for her, and she found herself pleased with how quickly things progressed. “A teleconference was set up immediately, and when we ended the call a plan of action and schedule for future meetings was in place,” she recalls. The manager and EDMP team reviewed options where there were vacancies and identified those that would suit Herrington’s abilities.

From start to finish it took Herrington less than six weeks to know that she would be returning to work in public health on a part-time basis, although she notes that it can often take several months to accommodate members in the program. She says that on her first day back to work, her manager and co-workers could not have been more supportive.

Herrington says the approach of both her employer and union was cooperative and

EDMP COMING TO AFFILIATE WORKSITES IN 2015

EDMP has been fully implemented for all BCNU members who are employees of a Health Authority. Starting in May 2015 EDMP will be implemented into affiliate worksites through a graduated roll-out. Watch your email and bulletin boards for more details of when it is being implemented at your affiliate worksite.

UPDATE MAGAZINE May/June 2015

supportive. “I could tell that everyone was seeking the best for me.” She encourages any nurse needing support returning to work to contact EDMP. “It can make a difference.”

If you are struggling at work with occupational or non-occupational illness or injury, contact your steward or regional EDMP representative about selfreferring to EDMP. update

EDMP HIGHLIGHTS • All regular employees who are off work for one day with a workrelated illness or injury, or five consecutive shifts with a non-work related illness or injury, participate in the program.

• Casual employees and regular employees who are struggling but continue to work may self-refer.

• Case Management Plans are developed collaboratively between the disability management professional, the employee and BCNU EDMP representative.

Plans reasonably address all barriers to return to work including medical, personal, vocational and/or workplace.

• All confidential medical information is protected.

BREAKING POINT continued from page 23

patient in the ER. Without warning, the patient lunged across the desk and attacked the nurse, who was left with stitches and an eye injury requiring surgery.

Following extensive media coverage about the incident, a third safety officer was finally hired to protect staff in the ER. In addition, new safety barriers have been put in place in the triage area.

Nurses at the facility say it’s been a long battle just to obtain these few necessary protections. “We have been asking for increased security since 2011,” says BCNU Fraser Valley region chair Katherine Hamilton. “The situation had become so bad nurses were afraid to come to work. We were so frustrated, we contacted the media and after that a few changes were finally made.”

The progress in Abbotsford and the recent commitment from the government are promising, but the risk of violent attacks and injury remains, and all members are reminded to use existing tools to address the problem.

“BCNU members need to know that there are many supports available to address their safety concerns,” says Duteil, who reminded nurses that Joint Occupational Health and Safety Committees, grievances and professional responsibility forms (PRFs) are just some of the ways that members can work together to improve safety for themselves, their co-workers and their patients.

“We will continue to advocate for improved staffing levels and demand that BC health authorities and affiliates take responsibility for safety and follow through on their legal requirements,” she says. update

BY THE NUMBERS VIOLENCE IN HEALTH CARE How does health care compare to other sectors?

Transportation and Related Services 5%

Other 11%

Retail 6%

Health Care and Social Services 56%

Public Administration 6% Hospitality and Leisure Service 6% Education 10%

Source: WorkSafeBC

WorkSafeBC claims

• There has been a 70% increase in health care claims in the past ten years.

• 42% of all injured worker claims in health care are in longterm care.

• 70% of claims are made by women over the age of 35.

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NEW BCNU POLICY OFFERS HELP FOR NURSES INJURED ON THE JOB DUE TO VIOLENCE

In response to the ongoing lack of support for injured nurses, BCNU is developing a policy to provide assistance to members who have been hurt on the job due to violence. This includes both physical and psychological harm caused by workplace violence.

BCNU will support members in a variety of ways in their time of need. The draft policy, which Council has approved in principle, will: • E stablish a 1-800 hotline for nurses injured on the job.

• Defend and assist all members – including casuals – who are injured on the job due to workplace violence according to the provisions of the collective agreement.

• P rovide limited financial support for employment income lost while awaiting WorkSafeBC claims to be processed (to be reimbursed by member once claim processed).

• P rovide support for mental and physical health.

“The purpose of this policy is to assist members in their time of need and to ensure that employers adhere to their obligations,” says BCNU President Gayle Duteil. “Nurses need and deserve better protection from violent and aggressive patients.”

Duteil also reports that BCNU intends to assist nurses who wish to pursue legal action against an attacker. update

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SPECIAL FOCUS ON SAFETY

MOST DANGEROUS HOSPITAL IN BC

THE

A LAX SAFETY CULTURE AND A RECENT SPATE OF INJURIES HAVE NURSES WORKING AT THE PROVINCE’S MAJOR PSYCHIATRIC FACILITY RINGING THE ALARM ABOUT WORKPLACE HEALTH AND SAFETY

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magine what it’s like working with the most clinically challenging patients in British Columbia while wondering that if things go sideways, management will not have your back.

Or what it’s like to head home at the end of each shift feeling lucky that you didn’t get injured on the job that day.

That’s the grim reality faced by some 190 registered psychiatric nurses and registered nurses at BC’s Forensic Psychiatric Hospital (FPH) in Coquitlam. These BCNU members, along with about 250 other health care workers, care for unpredictable, potentially violent patients at the 190-bed facility.

FPH is where people who have committed serious crimes, but deemed unfit to stand trial due to mental illness, are sent for treatment. Nurses and other health care workers play a key role in the therapies designed to enable these patients to eventually return to society. But the nature of this population means the potential for violence and risk of injury to staff is ongoing. According to WorkSafeBC, the hospital’s injury rate is 75 percent higher than other acute care hospi-

tals in BC, with 7 percent of staff reporting injuries versus 4.1 percent in other facilities.

Like every employer in BC, FPH is obliged by law to take comprehensive steps to eliminate or minimize the risks of injury to its workforce. But FPH’s management, despite seeing a much higher-than-average ratio of violent incidents and being ordered repeatedly by WorkSafeBC to comply with occupational health and safety regulations, appears reluctant to make safety its top priority.

In fact, staff have said it feels like their employer’s concern with budgets has trumped its commitment to provide quality care to clients, optimize the therapeutic relationship between nurses and patients, and protect nurses from assault on the job.

A new staffing model in place since 2013 that reduced baseline staffing and scrambled shifts is widely felt to have seriously compromised the continuity of care.

“Regular shift patterns lead to safe care by supporting therapeutic outcomes,” says FPH nurse and BCNU steward Ron Morley. “Familiarity has a therapeutic value, and therapeutic rapport leads to safety

because the patients trust you.”

Staff report that the switch to a scheduling structure that sees nurses working different shifts on different units, and with absences filled from a float pool of nurses who are often not adequately oriented – has led to instability in therapeutic relationships, with negative implications for workplace safety.

“Back when we had four-on, two-off, there was always continuity of care and people knew what was going on,” says 20-year nurse Carole Anne Pominville. “Now we’re exhausted, we’re swinging shifts too much, we’re always with different people.”

“When it was ward-based, you knew every patient on your unit, and their history,” she explains. “Now, with the number of on-call and relief [staff ], it’s a whole different story.”

Staff say the recent staffing model changes have only served to aggravate stress levels and feelings of insecurity in a workplace where safety training remains erratic and when violent incidents occur all too frequently. And tensions have been compounded by the fact that repeated orders, warnings and a major fine issued by WorkSafeBC to address health and safety have largely been ignored.

“There appears to be fundamental problem with the way this facility is being managed,” says BCNU President Gayle Duteil. “The employer needs to start listening to nurses’ safety concerns and taking WorkSafeBC orders seriously.”

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he Forensic Psychiatric Hospital falls under the administrative jurisdiction of the Provincial Health Services Authority (PHSA), but the operational and clinical management is provided on contract by the Forensic Psychiatric Services Commission (FPSC). Responsibility for ensuring a safe, healthy workplace thus falls on two parties, yet neither appears to be taking the role as seriously as provincial legislation requires.

Systemic neglect of safety at FPH first came to light after a serious stabbing incident in September 2012, where a patient with a known history of violence was alone with a

UPDATE MAGAZINE May/June 2015

therapist and allowed access to a large unsecured knife. A subsequent WorkSafeBC investigation revealed just how lacking the culture of safety was at FPH. Morley, first on the scene following the stabbing, says the incident reveals management’s blatant disregard for worker safety.

Ultimately, WorkSafeBC found FPH in total breach of its obligations to eliminate or minimize the risk of violence to its workforce.

In April 2014, it issued four orders setting out detailed measures to ensure compliance with provincial regulations.

Despite being directed to implement the measures without delay, Morley reports that only some of the required steps have been taken, and nearly a year later FPH is still resisting coming into full compliance.

A December 2014 WorkSafeBC investigation report on subsequent incidents identified further violations of provincial regulations. FPSC was then assessed a fine of $75,000 because the employer: • “failed to take sufficient precautions for the prevention of work-related injuries” • “[had] not maintained a safe workplace or safe working conditions” • “did not exercise due diligence to prevent these circumstances” Dr. Johann Brink, Clinical Director of Psychiatry at the facility, disputed the basis for the fine, claiming in a letter that the report “does not take into account changes made since the incidents,” which he listed.

However, WorkSafeBC had closely assessed those changes and found that many were inadequate or incomplete.

WorkSafeBC then issued an administrative warning, this time to the PHSA, regarding management’s failure to bring FPH into compliance. Noting it had established grounds to assess another fine, WorkSafeBC opted instead for a formal warning as “the appropriate course of action to motivate your firm [PHSA] to comply with the Act”.

Finding motivation to proactively protect its workers appears to be an ongoing challenge for FPH management, and PHSA is still silent on the matter. In response to the employer’s delaying tactics, BCNU filed a

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Occupational Health and Safety Committee (JOHS) formally asked the employer to install passthrough food slots on seclusion room doors to avoid individual contact with unsettled patients.

Management rejected this request on grounds that shielding workers from violence in this way would somehow be “detrimental to creating a positive therapeutic milieu for assessing, treating and rehabilitating persons with severe mental illness.” They MAKING SURE SAFETY COMES FIRST Forensic Psychiatric proposed instead that a set of Hospital Joint Occupational Health and Safety Committee secondary controls to reduce risk members (from left) Philip Oosterman, Carole Anne Pominville and Ron Morley say recent staffing model be explored, which the JOHS changes have increased stress levels and feelings of declined because they don’t insecurity in their workplace. address risk, and opted instead to bring WorkSafeBC back in to resolve the issue.

Single Employer Policy Dispute (SEPD) A subsequent WorkSafeBC inspection grievance on Jan. 12 over PHSA’s continuing and incident review endorsed the viability of failure to minimize the risk of violence to pass-through food slots as an interim control staff at FPH. The dispute alleges that PHSA while dismissing management’s arguments is: against this solution. WorkSafeBC’s report • Not providing appropriate staffing for also reminded FPH of its obligation to patient acuity. eliminate or minimize the risk of violence • Failing to ensure that seclusion/postseclusion work practices are done in a safe and ensure that its current practices do not contravene OH&S regulation 4.29 and appropriate manner. (b). WorkSafeBC ordered FPH to review • Failing to address particular weapons and revise procedures accordingly and to infractions (Plexiglas, rope, X-ACTO prepare a Notice of Compliance report by blades, lamp parts) appropriately.

March 31. ractices relating to the use of secluThe date has come and gone. Neither sion rooms at FPH provide some BCNU, worksite stewards nor the JOHS of the clearest examples of how committee have received the report as management continues to stubbornly required by law. And to date, the employer resist changes that would remove or greatly appears to have taken no action to bring diminish safety risks. Seclusion rooms are FPH into compliance. It would seem that used to isolate and settle patients who pose stalling, delay or outright refusal to minian immediate risk to themselves or others, mize risks to workers continues to be the so there is a heightened risk of violence entrenched mindset at FPH. towards staff especially if they are alone “Nurses’ occupational health and safety is with patients. a major priority for the union,” says Duteil.

In just over a year, five workers have “The failure of this employer to protect their been injured providing food to patients in workforce when dealing with dangerous seclusion, and there were 26 reported cases patients is shameful. We will be supporting of aggression that did not result in injury. our members in this dispute and advocating In September 2014, the hospital’s Joint strongly for safe patient care.” update

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SPECIAL FOCUS ON SAFETY

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DANGER ZONE THE

NURSES WORKING ON BC AMBULANCES ARE CALLING FOR A CREW SAFETY MANAGEMENT SYSTEM TO PROTECT THEMSELVES AND THEIR PATIENTS

UPDATE MAGAZINE May/June 2015

H

igh Acuity Response Team (HART) nurses attend to acute patients in rural and remote health sites, either stabilizing them to avoid transfer or transporting them by ambulance to a higher level of care.

Nurses like Kim Brown have tons of experience saving lives in ambulances. But a 2014 ambulance crash switched her role from HART nurse to ambulance patient in a terrifying vehicle rollover that happened in the blink of an eye.

The July 2014 accident that could have killed Brown and the crew was entirely preventable because the risks that preceded the crash were clearly visible at the time.

Brown started her night shift on July 23 in the high-acuity unit at Trail’s Kootenay Boundary Regional Hospital. At about 2:00 a.m. the BC Ambulance Service (BCAS) dispatched her and a paramedic crew to Nelson’s Kootenay Lake Hospital to move a critically ill patient to Kelowna. Just before they left Nelson one of the paramedics told BCAS they were fatigued. The crew was sent anyway.

They left Nelson for the two-hour drive to Grand Forks where they planned to meet a Penticton-based crew who would take the patient to Kelowna. But that plan would change along the way.

“Just outside of Grand Forks, BCAS told us we had to drive another hour and meet the Penticton crew in Midway,” says Brown.

“That adds another two hours to our shift by the time we get home.”

BCAS knew that some of the crew felt very tired, but still extended the transport.

And during the journey one paramedic radioed BCAS three times to report that they felt fatigued.

Brown’s crew made it safely to Midway and handed over the patient to the next crew. Then they started their three-hour journey home to Trail. But three hours of driving on an already long day can create a dangerous situation.

“We were about 10K from Trail when I felt the ambulance veer right and leave the

road,” says Brown, who was sitting in the back of the ambulance. “It happened so fast that all I remember is rolling around uncontrollably, and equipment was crashing around me.”

The ambulance skidded off the road and rolled down a 50-foot ravine. The battered vehicle lodged against a tree that stopped it from rolling further.

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It happened so fast that all I remember is rolling around uncontrollably and equipment was crashing around me.

HART NURSE KIM BROWN

”

“I didn’t lose consciousness and when the ambulance stopped rolling I smelled fuel and smoke,” says Brown. “The back exits were crushed, and the driver was unconscious and blocking the exit window into the front cabin. I was trapped in the ambulance, and didn’t know if the fuel would explode.”

A passing motorist arrived at the scene and removed the unconscious driver from the cab. Then Brown crawled to safety through a window into the cab. The rollover had scattered their equipment and cell phones so they couldn’t call for emergency services.

The motorist used his cell phone to call for help, and a fire truck and two ambulances arrived quickly at the accident scene.

In less than 15 minutes, Brown’s role switched from being a high-acuity transport nurse to an ambulance patient. She was off work for almost eight months because of spinal fractures she sustained in the rollover. There were no shoulder harnesses in the ambulance’s back seats that could have prevented this injury.

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Brown says that in hindsight she sees a whole chain of events that conspired to create an unsafe situation for the crew. There were clear warning signs at the beginning of their journey and at points along the way that the transport was becoming unsafe.

A crew safety management system (see sidebar p. 30) would have mitigated some of the following danger signs: • Before the crew left Nelson one of the paramedics reported they were feeling very fatigued. Currently, crews don’t have the safety protocols to collectively monitor their safety or the authority to change plans if circumstances are getting unsafe.

• On three separate occasions a paramedic reported they were getting more fatigued. A safety management system would empower the crew to pull over and rest until another crew is found to finish the transport.

• The paramedics had transported a critically-ill patient earlier that day which increased their fatigue. That should have been considered before they were sent on a lengthy transport.

• Transferring the patient in Midway and refueling in Grand Forks were natural points for a crew safety discussion.

Those discussions didn’t happen because there’s no protocol for the crew to assess safety at enroute points.

Clear standard operating procedures that focus on crew safety could have prevented this accident at multiple points along the way. And 10 months after the accident the Interior Health Authority still hasn’t implemented a safety management system for HART nurses.

“We need to be very careful not to blame individual staff members for events like this because nurses, paramedics and BCAS staff are all working hard in tough conditions,” says Brown. “The problem is systemic. IHA and BCAS need to implement protocols to keep us safe and help us make alternate plans when circumstances are getting unsafe.”

Scott Lamont is a Trail-based HART

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SPECIAL FOCUS ON SAFETY

nurse with more than 20 years of experience transporting critically ill patients in Canada and the U.S. He’s also flight board certified as a Certified Flight Registered Nurse (CFRN) in the U.S. to provide emergency and critical care in an air transport environment.

Lamont’s experience as an emergency transport nurse in northern Canada and New Mexico gives him a broad perspective on what safety should look like for BCAS staff and the nurses who work with them.

“In New Mexico we used standardized protocols to assess crew and patient safety before we left the sending facility and at points along the transport route,” says Lamont.

NARROW ESCAPE The wreckage of a July 2014 ambulance rollover near Grand Forks that nearly claimed the life of trans“It’s inconceivable that airline crews wouldn’t have safety protocols to fol- port nurse Kim Brown highlights the need for improved crew safety management systems. low at every point in their journey, and ambulance crews shouldn’t be any different.”

Lamont is unequivocal in his demand for Lamont says employers must implement action. “We need a comprehensive safety safety protocols that reduce risks for transport management system that brings HART nurses and paramedics. Industry-standard nurses, hospital staff and BCAS employees safety management systems would fix many of onto the same page to focus on crew safety. the problems they see every day.

Until we have that, the risks to crews and Some of the protocols Lamont suggests patients will keep multiplying,” he says. include: BCNU has advocated for Kim Brown’s acci• Using pre-departure briefings where factors dent investigation to be finalized, so that the like patient safety, road conditions, equipvoid in the overall safety regime can be fixed. ment checks and transport duration are all “If IHA won’t do the right thing and implediscussed in advance. ment a transport safety management system • Establishing a clear decision-making then nurses need to know they have a legal authority about who gets to make “go or right to refuse unsafe work,” says BCNU no-go” decisions, or when plans need to be President Gayle Duteil, who is watching the adjusted during transport.

BCAS/IHA accident investigation carefully.

• Implementing a minimum equipment list “If nurses believe there are risks along the that says “no-go” if important items are transport route they can simply refuse to go, damaged or missing. or refuse to continue,” she says. “The law is • Assessing when it’s safe to leave the hospital clear – no one is required to put themselves whenever hospital management pressure in unsafe conditions and BCNU will support staff to transport patients as quickly as posour members’ right to refuse all unsafe work.” sible (transporting patients right away isn’t Lamont stresses that what happened to Kim always the best decision because weather Brown could happen to any nurse in BC who’s conditions, roads, crew fatigue and equiptransporting a patient. “We need to be sure that ment failures might mean it’s better to keep safety measures are in place for all nurses travelthe patient where they are). ling in ambulances.” update

KEEPING SAFE ON THE ROAD Crew Safety Management Systems are industry benchmarks in the US The Commission on Accreditation for Medical Transport Systems (CAMTS) sets industry-leading benchmarks for safety standards in the U.S. It also accredits medical transport systems in Canada, the UK and South Africa.

Patient transport systems cannot be CAMTS accredited unless they have clearly defined crew safety management systems.

Employers should include the following procedures and equipment in crew safety systems: • Structured protocols to evaluate road conditions, weather forecasts, crew fatigue/rest, equipment status, transport duration and patient acuity before leaving the hospital, and at points during the transport.

• Clear roles and responsibilities on the crew and with BCAS dispatch to collectively make safety decisions and adjust plans when dangers emerge.

• Training on the right to refuse unsafe work.

• Training HART nurses, BCAS staff and hospital management to focus on transport crew safety as well as patient well-being.

• Up-to-date safety equipment in ambulances such as fixed satellite phones in the back of the ambulance, GPS or satellite tracking systems, ‘black-box’ recordings, helmets and adjustable seats so nurses can treat patients while they’re in lap and shoulder restraints.

UPDATE MAGAZINE May/June 2015

MEDICARE

NATIONAL DAY OF ACTION BCNU MEMBERS ACROSS BC RALLY IN SUPPORT OF PUBLIC HEALTH CARE, CALL FOR FEDERAL LEADERSHIP MARCH 31 MARKED THE one-year anniversary of the expiration of the 2004 – 2014 Health Accord – an important deal that set funding and health care service delivery agreements between the federal and provincial and territorial governments.

The Harper Conservatives’ refusal to negotiate a new deal

with the provinces has signaled a historic shift away from the federal government’s leadership role in health care policy and financing. This was an unfortunate decision, especially considering that the 2004 deal was designed to rectify years of federal underfunding during the 1990s.

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BC Nurses’ Union members joined with public health care supporters across the country in a national day of action to remind the federal government that Canadians will not forget Ottawa’s betrayal, which will see $36 billion worth of health care cuts come into effect after this year’s federal election.

Nurses and others are concerned that the lack of federal leadership in health care will lead to 14 different health care systems, with access depending on where patients live and their ability to pay.

“Canada is facing an important next step in our medicare history,” says BCNU President

Gayle Duteil. “We need to tell Ottawa that that everyone – provincial and territorial governments, First Nations and the federal government – should come together to negotiate a health care accord that delivers better, more efficient, quality public health care.

“We have an aging population and demand for health care is increasing – unless federal funding is stable and adequate, our cherished public system is in danger.”

This year’s federal election is currently scheduled for October 19, but the government may call an election at any time before this date. update

STANDING UP FOR MEDICARE BC Nurses’ Union members joined with public health care supporters across the country March 31 in a national day of action calling for federal leadership in health care.

1. South Fraser Valley region lobby coordinator Walter Lumamba at a rally of health care workers at Surrey Memorial Hospital. 2.

Dawson Creek Hospital nurse Connie Schmakeit. 3. Nanaimo Regional General Hospital Nurse Sharon Fulton (l) is joined by a retired vacationing nurse from Alberta at a rally in Nanaimo.

4. West Kootenay region members joined a rally in Nelson. From left: Sarah Crossley, Jessie Renzie, Colleen Driscoll, Angela Falk and Chantal Robert. 5. Thompson North Okanagan region members Diane Lingren, Tracy Musey and Brenda Boynton rally at Royal Inland Hospital. 6. North West region lobby coordinator Kathy Buell is joined by Wendy Onofrenchuk and Ingrid Overbeek in a visit to the Terrace offices of Skeena-Bulkley Valley MP Nathan Cullen. 7. Dawson Creek Hospital nurse Amanda Chmelyk and UNBC student nurse Sheena Muir.

8. Dawson Creek Hospital nurse Shallyn Kocis shows her support for public health care. 9. South Fraser Valley regional executive members Michelle Sordal, Melissa Lee and Jonathan Karmazinuk visited the office of SurreyFleetwood MP Nina Grewal.

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Your Pension SECURING YOUR FUTURE

ANSWERS TO YOUR PENSION QUESTIONS If you’ve been working in BC’s public health care and social services system (health authorities and affiliates, and community social service agencies) chances are you’re part of the Municipal Pension Plan (MPP) or the Public Service Pension Plan (PSPP).

Even if retirement is the furthest thing from your mind, it’s a good idea to have an understanding of how your pension plan works, and make sure you are getting the most of this important benefit.

Here are the answers to some of our members’ most frequently asked questions about the MPP and PSPP, the two plans to which most BCNU members belong.

How is my retirement benefit calculated and how do I know how much I will receive when I retire?

Your actual pension benefit at retirement is not based on contributions. It is based on a formula that takes into consideration your age and your spouse’s age (if any) at retirement, your Highest Average Salary (HAS), your years of pensionable service and the pension option you choose at retirement.

Section 2 of your Member Benefit Statement provides an estimate of your monthly pension benefit at retirement.

Once you become vested – after two years of contributory service – the plan will give you a lifetime pension, starting when you retire. After your death, depending on what kind of pension option you chose, the plan may continue to pay pension benefits to your spouse (if you have one) for his or her life time or to another benefi-

ciary for a set period, or it may pay a lump sum payment to your estate.

To increase your pension, you can increase your salary and/or your pensionable service.

Your Member Benefit Statement also notes your pensionable earnings (Section 5) and your pensionable service for the previous calendar year (Section 4). If you want to review your pensionable service history or estimate what your pension might be, based on your current personal information, you can access the “My Account” page on the BC Pension Corporation website and use the General Pension Estimator tool.

Not all earnings are pensionable. For example, straight time earnings are pensionable, but overtime is not.

If you’re a member of the MPP and the PSPP and work for more than one employer, you will contribute on all earn-

ings but will not accrue more than 12 months of pensionable service in one year. However, the total salary will be used to calculate your five year highest average salary.

Why does my Member Benefit Statement show less than 12 months of pensionable service when I work full time and never take unpaid leaves?

If you work the full number of shifts assigned to you in a year, or contribute for the first 20 unpaid leave days (150 hours), your pensionable service should be 12 months if you are full time.

There are legitimate reasons why you may be short pensionable service such as: you took more hours off than what was in your bank (such as vacation or sick leave bank); you swapped shifts and didn’t complete the swap; you really did take an unpaid leave; or you had a change in rotation

mid-year and lost time. The fact that you are paid in January for shifts worked in the previous year should not result in a shortfall in service.

If you feel that your pensionable service is not reported correctly, contact your employer.

If you disagree with the report from your employer, contact your steward for assistance.

I take time off without pay (Leaves of Absence – LOA) during the year. Can I contribute to my pension when I am on an LOA and is my employer required to contribute?

Article 37 of the Provincial Collective Agreement (Leave – General), or Article 34 (Leave – Unpaid) under the Facilities Collective Agreement, requires employers to continue paying pension contributions for the first 20 days (150 hours) of an unpaid leave of absence provided you continue to pay your contributions. The 20 days is pro-rated for part-time employees.

If you don’t continue your contributions, the employer isn’t required to pay their portion.

If I take an LOA, must I inform my employer in writing that I wish to continue paying my portion of pension contributions?

Yes, you must advise the employer you wish to continue your pension contributions with each unpaid LOA. Before leaving, complete a purchase of service application form and submit it to your employer.

UPDATE MAGAZINE May/June 2015

Keep a copy of the purchase of service application form for your records.

For any unpaid leaves over 20 days, you must apply for a purchase of service if you want to include them in your years of pensionable service. Your employer is not required to pay a portion of the purchase cost.

I work part time at one facility and started casual in another. Do I have to contribute to the pension plan as a casual?

If you are a member of the Municipal Pension Plan with one employer and start working with another employer, the second employer must enroll you in the Plan at the date of hire.

I am quitting my job and starting to work with another employer who offers the MPP. Do I have to wait another three months to be eligible for enrolment if I take a regular job or meet the criteria again if I take a casual position?

No. As long as you are hired within 30 days from your termination date, your new employer must enrol you in the plan as a new regular or casual employee.

I belong to the MPP now and want to take a casual job with another plan employer. What happens to my pension at the second employer?

As you are already a contributing member of the Municipal Pension Plan, your new employer is required to enrol you in the Plan immediately.

I plan to quit my job and get a job with another Plan employer. What happens to my pension?

Your contributions remain in the plan. Under the MPP, if you get a job with another plan employer within 30 calendar days, your employer is required to enrol you in the Plan immediately.

Under the PSPP, if you get a job with another plan employer and kept your seniority rights, you will be enrolled immediately.

If you don’t get a job with another Plan you’ll be provided with a number of options. You can always keep your funds in the plan and apply for a pension later on.

Can I defer my pension?

Yes. If you terminate employment prior to being able to start your pension, you can defer the benefit until a later date. For example, if you terminate employment at age 50, you can leave your funds in the plan

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and begin to draw your pension as early as age 55.

I chose a Single Life Pension, guaranteed for 15 years and have a dependent child that is on my Post Retirement Group Benefits.

What happens to the benefits if I die prior to the guarantee period?

Your dependent can remain covered by PRGBs until the end of the guarantee period only. If your beneficiary is not listed as a dependent with benefit coverage, they will not be able to enrol.

What is the Retiree Benefit Program and how do I apply?

The RBP is for members who belonged to the Nurses’ Bargaining Association (NBA) collective agreement at the time of their retirement.

Since 2009, the program has reimbursed up to 50 percent of the MSP premiums that pension plan retirees pay for this benefit. Twice yearly, enrolled program members receive a cheque from BCNU which reflects 50 percent of out-ofpocket costs of MSP premiums that are no longer covered by public pension plans. This amount is adjusted yearly based on the MSP monthly premiums.

Eventually, the union hopes to negotiate all BCNU members into this program.

For more information on eligibility and how to apply, email retireebenefit@bcnu.org or phone 604-433-2268 (toll free 1-800-663-9991). update

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PRFs

IN THE WORKPLACE

JOINT EFFORT NURSES AND MANAGERS AT CAMPBELL RIVER HOSPITAL ARE IMPROVING HEALTH CARE

BY BUILDING RELATIONSHIPS IN THE PRF PROCESS

problems to the Senior Review Committee.”

Hilsden, an LPN, says that the PRF process was unfamiliar to her and her colleagues before they joined BCNU. However, she soon became an advocate of the PRFs when she learned how effective they could be. “I had to encourage my colleagues at first,” she says. “But early successes impacted them and helped them trust the process.”

One of those early PRF successes was the creation of a checklist for patients admitted to the transitional care unit that helped define which patients were suitable for the hospital’s LPN and care aide unit. “The checklist keeps patients safe, avoids risks to LPNs’ licences and teaches others about LPNs’ PRFS WORK Campbell River Hospital stewards Nancy Boulet and Devon scope of practice,” says Hilsden.

Hilsden say a strong focus on patient safety has led to a healthy working The CRH nurses are also relationship with managers. proud of another PRF success that improved everyone’s safety almost overnight. “We’re CAMPBELL RIVER HOSPITAL ing a strong working relationship with hospital management. a small hospital with only one nurses have successfully used “Management is eager to hear secure ER room,” says Boulet. the Professional Responsibility nurses’ feedback because we all “One weekend we were very Form process to improve staff want the best patient outcomes short-staffed and after a safety and patient safety and build and higher patient safety,” incident we discovered that solution-focused relationships. says Hilsden. “They take the security guards could be called BCNU members’ PRFs are PRF process seriously and we in to help. Now, calling them even informing safety and all want to make this a good is a standard practice at the design decisions for the new workplace.” hospital.”

95-bed hospital that is being “When just one nurse fills out To keep the process on track constructed in the city. This a PRF it can encourage others Hilsden supports all LPNs level of collaboration turns to do the same – then issues who fill out PRFs. “I’m there the process into a gold mine get identified and resolved, and to help my peers when they of both clinical and process people learn that PRFs are not need it,” she says. “Before LPNs information. a punitive process,” explains joined BCNU I was hesitant Nancy Boulet and Devon Boulet. “Solving PRFs locally to get involved with my union.

Hilsden are nurses and BCNU But when LPNs moved to the stewards at CRH who are build- avoids escalating workplace

UPDATE MAGAZINE May/June 2015

nurses’ union I became a steward and I’m enjoying the experience. It’s so important for our union to support LPNs’ practice issues, and now that we’re in BCNU we should use that support.”

The steward team at CRH discusses PRFs regularly.

BCNU stewards, clinical coordinators and the site director all attend PRF Committee meetings where discussions are structured to reduce stress. “The director thanks each nurse who fills out a PRF and that makes people feel comfortable and supported instead of nervous,” says Hilsden.

The stewards keep detailed information about all PRFs, and the data is shared with the facility director who uses the information to make good decisions for nurses and patients.

Boulet and Hilsden say it’s a joint effort to find solutions in PRF meetings.

Patient safety is always at the front of everyone’s mind.

And when management really hears workload or staffing concerns it’s a winwin for everyone.

“Patient safety is the reason for every PRF that nurses have submitted,” says Boulet. “When we’re over census or the flu hits then PRFs come in fast and reflect those critical situations. The collaborative approach we have with management means nurses feel they have a voice and aren’t just numbers in the system.”

For years Boulet didn’t know a lot about the RN contract or her union. “I’ve worked at CRH for 28 years now and I’m in my 35th year of nursing,” she says.

“After 25 years of nursing, I took a keener interest in BCNU because I wanted the contract followed and nurses treated fairly. I like it when nurses have a say in things and the PRF process gives them a structured way to do that and to protect their licence.”

Hilsden says that Boulet has been her mentor and go-to person for any PRF questions. “We remind members who approach us that they’re not alone – we take calls 24-7 and are always there for our members.” update

For more details on the PRF process and information on how to use PRFs at your worksite visit the BCNU website.

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FINDING SOLUTIONS Senior Review Committee is an important step in the PRF process MANY PROFESSIONAL concerns that members address using the PRF process are resolved at the local level. This is a good thing – and it shows that PRFs can be an effective tool to address patient care and other practice issues.

But if nurses and managers are unable to find a solution, a PRF can be forwarded to the Senior Review Committee (SRC) for a final recommendation. The SRC was created in 2012 and hears presentations at worksites province-wide. This joint committee’s goal is to find solutions that are unanimous and binding.

BCNU Pacific Rim region’s Rachel Kimler is one of the union’s representatives on the SRC. While relatively new to the role, she’s been involved with PRFs for many years as a worksite steward at Cowichan District Hospital in Duncan.

The SRC consists of one union and one employer rep: it’s either Kimler or BCNU West Kootenay region’s Paul Moffat, and the chief nursing officer of the health authority for the worksite in question.

BCNU professional advocacy officers on staff provide Kimler or Moffat with the background and history of a unit before they meet with members. The BCNU reps use this information to help members prepare a presentation

that they will make to the SRC. “I’ll go to the nurses’ worksite and spend a few hours with them. Basically, I’m making sure I have clarity and that I have a full appreciation of the issues they’re dealing with,” explains Kimler.

She says the SRC is also beneficial for health authority managers who may not have a full appreciation of the workplace issues from the distance of their offices.

“When the chief nursing officers are hearing nurses’ presentations, they’re hearing from the frontline workers how these issues are impacting them on a daily basis,” says Kimler. “And I think it can really hit a nerve with them.”

After hearing from nurses firsthand, the SRC meets and aims to find mutual ground for a recommendation that, if unanimous, becomes binding. “There’s a lot of push to find that mutual ground,” says Kimler. “Binding recommendations have a lot more teeth because the union signs off on it and so does the employer – so in many respects it’s very much like contract negotiations, but at a much more local level.”

The SRC plays an important role that Kimler is proud to be a part of. “I see PRFs as a positive way to engage nurses and to make positive workplace changes – the SRC is just the next level in that process.” update

36

Who Can Help?

BCNU IS HERE TO SERVE MEMBERS

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

CONTACT YOUR STEWARDS For all workplace concerns contact your steward. REGIONAL REPS If your steward can’t help, or for all regional matters, contact your regional rep. EXECUTIVE COMMITTEE For all provincial, national or union policy issues, contact your executive committee.

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

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

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

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

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

EXECUTIVE COUNCILLOR Vacant

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

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

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

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

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 Adriane Gear Co-chair C 778-679-1213 adrianegear@bcnu.org Lynnda Smith Co-chair C 250-361-8479 lynndasmith@bcnu.org THOMPSON NORTH OKANAGAN Tracy Quewezance Chair C 250-320-8064 tquewezance@bcnu.org VANCOUVER METRO Meghan Friesen Chair C 604-250-0751 meghanfriesen@bcnu.org WEST KOOTENAY Lorne Burkart Chair C 250-354-5311 lorneburkart@bcnu.org

UPDATE MAGAZINE May/June 2015

Council Profile

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HERE’S WHO’S WORKING FOR YOU

BRINGING NURSES TOGETHER CENTRAL VANCOUVER CO-CHAIR MARLENE GOERTZEN

EMPOWERING MEMBERS

“BCNU is there to help you be the best nurse you can be,” says Central Vancouver co-chair Marlene Goertzen.

QUICK FACTS NAME Marlene Goertzen.

GRADUATED Vancouver Community College 2002.

UNION POSITION Central Vancouver co-chair.

WHY I SUPPORT BCNU? The union looks after members the way a nurse looks after their patients.

WHEN MARLENE Goertzen decides she wants a challenge, she really knows how to choose them. The BCNU Central Vancouver region cochair was at the forefront of the union’s historic organizing campaign that successfully allowed over 7,000 of the province’s licensed practical nurses to move from the Facilities Bargaining Association to BCNU in 2012.

“I felt so strongly that nurses needed to be together,” she says.

Goertzen has learned a lot about nurses’ rights and benefits since becoming a BCNU activist.

“Like a nurse looking after your patients, that’s how we look after our union members,” is how she describes her role as a regional chair.

“Before I became involved with BCNU I knew some parts of my contract, but not all of

it, and not in depth,” she says.

“When I became a steward, I felt that members counted on me to know the contract. And I understand how they feel because I was in their place once, so now I’m here for them with the information they need.”

Goertzen says she wanted to continue her leadership role after the successful LPN campaign.

“By the time we were part of BCNU, I felt I needed to see things through,” she explains.

“We convinced a lot of LPNs that it was important to join BCNU, so I had to take responsibility for members that followed us.”

In 2012 Goertzen was elected as an LPN representative on BCNU Council, and she says it was natural progression to run for a regular Council position when her term expired last year.

Currently on leave from her

position at a Richmond longterm care facility, Goertzen first completed her nursing education at the Vancouver Vocational Institute (the precursor to today’s Vancouver Community College (VCC)) in February 1977, and received her nursing upgrade certificate at VCC in 2002.

After working in maternity, pediatrics, orthopaedic and medical-surgical wards, Goertzen says she found her “right place” working in palliative care.

Goertzen is a member of BCNU’s Bursary Committee, which provides funding for nurses who want to advance their education. She also sits on the Member Engagement, Steward Recruitment and Retention Committee, which works to ensure that future leaders are supported in their roles within their union.

Goertzen also sits on BCNU’s Bargaining Committee. As one of the LPN reps tasked with comparing both the Nurses’ Bargaining Association and Facilities Bargaining Association contracts line-by-line, her knowledge now informs BCNU’s provincial bargaining objectives.

“BCNU cares about health care and about nurses,” says Goertzen when asked about what keeps her motivated. “The union is there to help you be the best nurse you can be. It supports our education and our practice, and binds all nurses together with a common goal for health care in BC and in Canada,” she says. “I’m amazed to be given this opportunity and responsibility – and I’m using it to improve the lot of all nurses.” update

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UPDATE MAGAZINE May/June 2015

Off Duty MEMBERS AFTER HOURS

with some of the same people for hours at a time, you forge MARATHON RUNNER some really strong bonds,” she RACHEL KIMLER IS FOCUSED says. “The running commuON HEALTH AND WELLNESS nity is very supportive of one another.”

This fact was evident to WHEN MANY OF US HIT a week. Often she will run by Kimler during the 2013 Boston our mid-forties, we start to herself, but she also enjoys the marathon. A major race that ease up on our fitness efforts. company of her local running requires runners to qualify to Our aching bodies usually tell store club. participate, Kimler completed us that it’s time to change our “Besides the safely factor of the infamously hard course routines. running with a group, the social just three minutes shy of her For Nanaimo’s Rachel element has been a big part of personal best time and was Kimler, however, the transimy life. When you’re running elated to be part of this incredtion to middle-age became the ible marathon motivation to ramp-up her experience. exercise regime.

However, just as Five years ago, the Cowichan she and a fellow District Hospital nurse decided Nanaimo racer to complete a marathon. To were collecting tackle the goal, she started post-race clothtraining for a half-marathon. It ing they heard was difficult at first. “I would two large bangs build up to the distance, and that sounded then get injured or sick,” she like canons. recalls. “I would be side-lined Because Boston for a while and need to start all was celebrating over again.” But eventually, her Patriot’s Day, perseverance paid off. the noises didn’t In May 2010, Kimler crossed alarm them. But the finish line of her first halfmoments later, marathon. “It was a feeling of chaos erupted relief and satisfaction,” she says with police run“I knew that if I could accomning in differplish this, I could move forward ent directions, with my ultimate goal of comhelicopters above pleting a full marathon.” and subways Kimler completed several shut down. They, more half-marathons that year along with the including an event in Las Vegas. rest of the world, CROSSING THE FINISH LINE BCNU Pacific Rim She says that training to run a soon discovered region nurse Rachel Kimler says her community marathon’s distance of 42.1 km that bombs had of marathon runners supports her in achieving her fitness goals. requires her to run five days been planted on

the route, killing three people and injuring an estimated 264 others.

After several heart-stopping hours, Kimler was re-united with her husband. She says the experience was surreal. People from her running community in Nanaimo were texting back and forth, fearing for their loved ones’ safety. Before the tragedy unfolded, Kimler had been impressed with the number of Bostonians who came out to support the runners.

And the way people responded in the wake of disaster has made her proud of the running community.

Despite her accomplishments, Kimler admits she can be unmotivated, and that without goal setting, she could easily slip into couch potato mode. She says that being surrounded by a fit healthy group of co-workers keeps her on track. “We are supportive of one another and have likeminded ideas on health and wellness.”

Kimler has now completed 10 half-marathons and five marathons including Boston and Chicago. So what’s next?

In the running community there are six major events around the world that are thought to be the ultimate accomplishments in marathons.

With Boston and Chicago under her belt, she says she has New York, London, Berlin and Tokyo to go. update

BC NU

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NATIONAL ABORIGINAL DAY JUNE 21, 2015

MAY 3–9, 2015

SAFETY & HEALTH WEEK Delivering safe patient care means working in a safe and healthy environment.

PM 40834030