BCNU Update Magazine Spring 2022 by BC Nurses' Union

UPDATE SPRING 2022

M A G A Z I N E

WAITING GAME LICENSING WOES SIDELINE INTERNATIONALLY EDUCATED NURSES

PLUS

TOXIC DRUG CRISIS AN INTERVIEW WITH BC’s CHIEF CORONER LISA LAPOINTE

MANY HANDS MAKE US UNITED BCNU members are coming together ahead of this year’s steward elections. Are you ready to join them?

STAFFING CRISIS NURSES HAVE THE SOLUTIONS | NEW DIRECTIONS NEEDED TIME TO IMPROVE WORKERS’ COMPENSATION SYSTEM | CALLING FOR ACTION TAKING MEMBERS’ VOICES TO BC DECISION-MAKERS

Update Magazine Digital Edition Now it’s easier than ever to stay connected. Try it today at bcnu.org

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CONTENTS

VOL 41 NO 1

• SPRING 2022 20

DEPARTMENTS

PRESIDENT’S REPORT

GUIDING LIGHTS

VITAL SIGNS

HUMAN RIGHTS & EQUITY

MY JOURNEY

WHO CAN HELP

COUNCIL PROFILE

OFF DUTY

UPFRONT

6 CHECK IN

The latest news from around the province.

20 WAITING GAME

Qualified US-educated nurse is sidelined by licensing woes.

22 FULL SCOPE

Shannon Sluggett shares her passion for education.

24 TOXIC DRUG CRISIS An interview with BC’s chief coroner Lisa Lapointe.

40 NEW DIRECTIONS FOR WORKSAFE BC? Improvements to workers’ compensation system are long overdue.

42 EQUITY MEANS ACCESS

Advocates are calling for an end to three-month wait period.

FEATURE

MANY HANDS MAKE US UNITED

BCNU members are coming together ahead of this year’s steward elections. Are you ready to join them?

UPDATE MAGAZINE • SPRING 2022

UPDATE M A G A Z I N E

MISSION STATEMENT The British Columbia Nurses’ Union protects and advances the health, safety, social and economic well-being of our members, our profession and our communities. BCNU UPDATE MAGAZINE is published by the BC Nurses’ Union, an independent Canadian union governed by a council elected by our 48,000 members. Signed articles do not necessarily represent official BCNU policies. EDITOR Lew MacDonald CONTRIBUTORS Juliet Chang, Tina Cheung, Laura Comuzzi, Neil Fisher, Jim Gould, Aman Grewal, Lexi Huffman, Kent Hurl, Hanif Karim, Kath Kitts, Caroline Flink, Shawn Leclair, Courtney McGillion, Moninder Singh,

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PRESIDENT’S REPORT NURSES ARE INSPIRING LEADERS

PHOTO: PETER HOLST

AMAN GREWAL

PRING FLOWERS ARE STARTING to bloom, and the brighter days bring a much-needed sense of hope and renewal. Our members have endured so much these past few years, and we want and need to see a brighter future for all nurses. The province is slowly emerging from the pandemic and BCNU regions are again starting to host member engagement and outreach events. I recently had the chance to participate in such an event at Vancouver General Hospital. The steward team, regional council members and I were able to connect with hundreds of members on this bright sunny day to answer their questions and provide information on BCNU’s steward elections. BCNU places a high priority on steward recruitment and retention, and we invest significant resources in steward development. Steward elections are where an individual steward’s leadership path begins. This is an important opportunity to encourage the participation of all union members and increase the diversity of BCNU’s leaders. Speak with a member of your regional executive team if you are interested in becoming a steward. Or take our online Building Union Strength course to learn more. I would like to acknowledge our stewards for their invaluable and all-too-often thankless work, especially during the pandemic. The amazing leadership they provide to members every day is inspiring, and we hope more members step forward to take up the challenge. It’s not always an easy job, but it truly is rewarding. Stewards are the heart of BCNU. I’m inspired by Catherine Tanski and other members of the Indigenous Leadership Circle, who took the initiative to partner with a number of nursing and post-secondary organizations to recognize BC’s inaugural Indigenous Nurses Day on April 10, the birthday of Edith Monture, the first Indigenous nurse in Canada. Promoting human rights and equity (HRE) has never been more important, and the first provincial HRE Bargaining conference held this January

was a step in the right direction. The Nurses’ Bargaining Association collective agreement expired on March 31. That means nurses across the province are positioned to take action and advance their interests ahead of provincial bargaining. Rest assured you are still covered by the existing agreement until a new, clear, concise and enforceable contract is negotiated and ratified by our members. Other health-sector unions have begun negotiations with employers and the government. That means it’s time for all nurses to learn more about what job action means if another union puts up picket lines, and how to report to strike headquarters to learn whether you’re deemed essential or on the picket line. Our education department has been diligently creating an asynchronous online module on provincial job action that will assist members with the process. Next month, members will be heading to Victoria for National Nursing Week. This will be an opportunity to let the government know we are serious about safe staffing and ending workplace violence, to name just two of our asks. Contact your regional council member to find out about National Nursing Week activities at your worksite. Now is the time to come together, united with one voice and the goal of achieving a collective agreement that supports nurse recruitment and retention, safe staffing levels, increased wages and premiums and many of the other priorities members highlighted at this winter’s regional bargaining conferences and town halls. We’ve just launched a new provincial advertising campaign to highlight the enormity of the nurse staffing crisis and call the public’s attention to the burdens our members have borne during the pandemic, toxic drug crisis and climate-related disasters. Tell your friends and family to visit www.helpbcnurses.ca and send a message to their MLA demanding action. Together, in solidarity, we can achieve great things. Become informed and involved. This is your contract and your union.•

UPDATE MAGAZINE • SPRING 2022

CHECK IN

NEWS FROM AROUND THE PROVINCE

OHS

DANGEROUS DESIGN Vancouver General Hospital members secure needed safety upgrades to nursing station

HE JOSEPH and Rosalie Segal Family Health Centre is a new, eight-storey mental health and addictions facility located on the Vancouver General Hospital site. With 100 private rooms, it is one of the largest purpose-built facilities of its kind, and brings a variety of mental health services under one roof, including inpatient and outpatient care, outreach programs and addiction services. Great anticipation surrounded the construction of the facility given the shortage of mental heath services and treatment options in the province. The building itself is impressive in its design, and earned many architectural accolades when it opened in 2017. But almost as soon as the ribbon was cut, staff at the facility raised concerns about the nursing station – or care team base – and the fact that it lacked the safety features common on other nursing stations. After several serious vio-

lent incidents, VGH stewards Maria Olivero and Sandra Ramos and other members took action and addressed their concerns through their worksite Joint Occupational Health and Safety (JOHS) committee. After a concerted two-year effort that came to a head in 2020, members were able to compel a resistant employer to make the needed renovations, which included enclosing the area so patients could not throw things at staff, access weapons of opportunity or jump over the counter and attack them. WorkSafeBC regulations required Vancouver Coastal Health to complete a pre-occupancy violence risk assessment before the building opened. JOHS committee members learned that managers were aware that the care team base counters would need to be elevated to comply with provincial safety regulations, but the facility was opened regardless. Oliverio and Ramos are both committed to developing effective JOHS committees where the employer and staff can work collaboratively to

SPRING 2022 • UPDATE MAGAZINE

DETERMINED ADVOCATES Vancouver General Hospital stewards Sandra Ramos and Maria Oliverio successfully worked to secure much-needed safety improvements to the nursing station at the hospital’s main mental health and addictions facility.

solve problems and ensure that health-care workplaces are safe for workers and patients. But they say the Segal Centre experience illustrates the challenges that can come with advocating for workplace OHS rights, and the reality that managers are often resistant to change. “The WorkSafeBC regulations, the provincial collective agreement and our nursing standards together make a powerful combination,” says Ramos, who encourages all members to learn more about the role of the JOHS committee at their worksite. “The potential for change is exciting,” she says. “We’ve seen what we can accomplish, but it’s not an easy road.” Ramos and Oliverio credit

the support of BCNU OHS department staff in helping to secure the success. “They gave us the confidence and the backbone to speak up,” says Ramos. “Without their coaching, support, and expertise, we wouldn’t have been as effective as we were,” adds Oliverio. The care team base renovations were completed last year over a four-week period. BCNU Central Vancouver region council member Kelly Zander says the efforts of Ramos, Oliverio and others in her region are an example of what can be accomplished when nurses work together toward a shared goal. “It was a lengthy and arduous process, but tenacity prevailed,” she says. •

BUILDING ON-BRAND Commuters on the Trans Canada Highway were greeted with a new landmark following the March 24 installation of a large sky sign on the union’s education centre in Burnaby. The five-storey building has been visible to highway travelers since it’s construction 2015, but it had no signage on its south side. Now, a large energy efficient BCNU sign reminds travellers daily of the union that stands up for health care in the province.

DUES AND TAXES If you are contacted by the Canada Revenue Agency (CRA) regarding the union dues amount you have claimed on your 2021 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 the BC College of Nurses and Midwives as proof of payment of your annual membership fee. Please visit the CRA website for information regarding union dues and professional fees claimed on your tax return: Home > Individuals and families > Tax return > Completing > Deductions> Line 212 Annual union, professional, or like dues This should help you satisfy CRA investigation audit requirements if you undergo one. 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 2021 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.

PEOPLE IN PINK BCNU members across the province donned pink attire on Feb. 23 to celebrate diversity and promote respect in their workplaces.

PINK SHIRT DAY

LIFT EACH OTHER UP!

CNU MEMBERS joined with other Canadians on Feb. 23 to promote civility and respect in their workplaces. The event was Pink Shirt Day, and this year, BCNU regional OHS and mental health reps focused on celebrating our diversity and promoting acceptance and inclusion. BCNU executive councillor Aida Herrera says diversity and inclusion have never been more important – especially given the stressors of the global COVID-19 pandemic. “Bullying in the workplace is often the result of multiple drivers such as increased workload, complex cognitive demands, role conflicts, and unclear leadership direction – conditions all exacerbated

by working through the pandemic,” she explains. “Pink Shirt Day seeks to reduce bullying by celebrating diversity in all its forms. While all people can be the target of bullying, some equity-seeking groups or individuals encounter more bullying than others.” Bullying and harassment are prevalent in health care, says Herrera, and workplace bullying is associated with nurses leaving their job or the nursing profession. Exposure to workplace bullying – whether in person or online – can impact the physical and mental health of workers and permeate all facets of personal and professional life. This can reduce job satisfaction, motivation, morale, and negatively impact patients.

Herrera reminds members that BC workplaces are required to have prevention strategies for bullying and harassment. “If you witness, or are the recipient of bullying, report it!” she says. “Talk to your supervisor, contact your local BCNU Joint Occupational Health and Safety Committee representative or BCNU steward. It’s also important to be an ally to those subjected to discrimination, oppression or bullying and harassment in the workplace.” Pink Shirt Day was started by two Nova Scotia students who organized a protest to support a Grade 9 boy who was bullied for wearing a pink shirt. Since then, Pink Shirt Day has become an international event to express solidarity through acts of kindness.•

UPDATE MAGAZINE • SPRING 2022

CHECK IN

NEWS FROM AROUND THE PROVINCE

PROFESSIONAL PRACTICE

COLLEGE CLARIFIES INDEPENDENT MEDICAL EXAMS AND CONFLICT OF INTEREST

BACK IN THE FOLD BCNU to rejoin Canadian Federation of Nurses Unions

CNU MEMBERS MAY SOON BE JOINING their union counterparts in other provinces. The news comes following a March 15 statement from Canadian Federation of Nurses Unions president Linda Silas announcing that the national organization is working to formally welcome BC nurses back to Canada’s largest community of unionized nurses. This announcement followed a unanimous decision of CFNU’s national executive and comes more than 10 years after BCNU left CFNU following the successful Nurse+Nurse campaign that united BC’s provincially employed LPNs, RNs and RPNs in one union. BCNU President Aman Grewal expressed gratitude following the announcement. “A staffing crisis is plaguing nurses across the country,” she said. “Now is the time for nurses to be fiercely united from coast to coast in our effort to secure the changes that are needed to protect nurses, our patients and the future of health care.” In her statement, Silas said CFNU expects to work alongside the British Columbia Federation of Labour and the Canadian Labour Congress throughout the reunification process. CFNU represents about 200,000 nurses and student nurses. Since 1981 it has provided advocacy on key health issues and promoted federal engagement in public health care.• NEWS FROM AROUND THE PROVINCE Learn more about CFNU at www.nursesunions.ca.

SPRING 2022 • UPDATE MAGAZINE

Concerns among nurses and other health-care workers receiving treatment for substance use disorders became heightened last year following media reports about doctors referring patients to monitoring companies they own. In response, the College of Physicians and Surgeons published a clarification statement on real or perceived conflict of interest with respect to independent medical evaluation (IME) and a financial interest in a

medical monitoring business. The statement “Potential for real or perceived conflict of interest in business ownership” makes it clear that a doctor should not conduct an IME and then refer the examinee to a biological monitoring company in which the doctor has a financial interest. The statement also requires doctors who conduct IMEs and perform monitoring services to inform examinees of the potential conflict of interest, including that they have a financial interest in a monitoring company.

AND THE WINNER IS... BCNU congratulates Cranbrook’s Avneet Gill – the winner of our 2021 Update Magazine readers’ survey draw. The first-year University of Victoria nursing student received an Apple iPad in the new year. Thanks to all Avneet Gill of those individuals who took time to participate. Your survey feedback is invaluable and helps ensure Update Magazine is meeting the needs of our members.

FACES NEW AND FAMILIAR BCNU has seen more than a few changes in its senior leadership team over the past six months following leaves, retirements and special elections. From left: President Aman Grewal, Vice President Adriane Gear, Interim Chief Executive Officer Jim Gould, and Chief Operating Officer Moninder Singh

LEADERSHIP UPDATE

CHANGES AT THE TOP

HE UNION HAS seen a series of changes and shifts in its senior leadership team over the last six months. During this period, all have been committed to faithfully serving BCNU’s membership and effectively advocating for nurses in every health sector and region of the province. In accordance with BCNU bylaws, Aman Grewal became president following the resignation of Christine Sorensen in September 2021. Grewal was elected BCNU Vice President in a 2019 special election and re-elected in 2020. A nurse for over 35 years, Grewal lives in Surrey at Surrey Memorial Hospital, where she held a variety of positions, including clinical care coordinator, patient care coordinator, diabetes nurse educator, and shift coordinator. BCNU Council then elected North East region

council member Danette Thomsen as interim vice president, a role she held from September and into the new year while a special election took place for the position. The election was won by South Islands region council member Adriane Gear, who took office on Jan. 27 and will hold the vice president position until the end of the current Council term next year. Gear previously served as BCNU Executive Councillor, OHS and Mental Health from 2015 to 2020. A registered nurse since 1993, she has worked in long-term care and general surgery at Saanich Peninsula, Royal Jubilee, and Victoria General hospitals. She most recently worked in case contact management and surveillance. In mid-January, BCNU welcomed Jim Gould as Interim Chief Executive

Officer following a leave taken by CEO Cody Hedman. As interim CEO, Gould will lead upcoming Nurses’ Bargaining Association contract negotiations. An experienced labour lawyer and mediator, Gould brings a wealth of experience to this role. This year the union bid farewell to Chief Operating Officer Colleen McFadden who, after 16 years of dedicated service, retired from her role in March. McFadden was an integral member of BCNU’s senior staff team and worked tirelessly to support all aspects of the organization. She will be deeply missed. Moninder Singh is BCNU’s new COO. Prior to his appointment, he held the position of Executive Lead, External Relations & Communications and served as the union’s director of occupational health and

safety. Singh joined BCNU staff in 2019, and in his new role he is committed to fostering leadership, building relationships, and supporting a positive working environment for all BCNU staff. BCNU’s current leadership team began the new year engaging with members across the province. In February, Grewal, Gear, Gould and members of BCNU Council hosted six virtual town halls. Nearly 1,500 members and stewards attended for an opportunity to share their concerns directly with senior union leadership and learn more about BCNU’s priorities for 2022. All members are encouraged to stay connected and take advantage of future opportunities to engage with senior elected leaders and staff. •

UPDATE MAGAZINE • SPRING 2022

CHECK IN

NEWS FROM AROUND THE PROVINCE

HEALTH & SAFETY

VICTORY AGAINST VIOLENCE New federal legislation protects health-care workers’ occupational health and safety

URSES IN BC and across the country had a welldeserved reason to celebrate this holiday season with the adoption of Bill C-3 in the Senate. The law amends the Criminal Code to recognize violence against health workers as an aggravating factor during sentencing. The Dec. 17, 2021 legislation represents the culmination of a long campaign to protect nurses and other health-care

workers from the violent physical and emotional assaults that are all too common at work. Similar federal legislation already exists to safeguard workers in other sectors who perform highrisk jobs, including peace officers and transit workers. “Nurses in BC can applaud the fact that the federal government has finally listened to our call to hold those who perpetrate violence against health-care workers accountable for their actions,” says BCNU President Aman

Grewal. “We look forward to working with health employers and the provincial government to ensure union members benefit from the legislative amendments.” BCNU was one of the first unions to call for Criminal Code amendments to help keep nurses safe. Our Violence. Not Part of the Job. campaign that launched in 2017 influenced public perception of nurses’ workplace violence, and our message was taken up by nurses’ unions across the country. “I want to thank every member who took the time to send messages to the government or talk to family

and community members about the workplace violence they’ve experienced,” says Grewal. “This is a well-deserved victory for nurses in BC and across Canada.” •

SAVE THE DATE

2022 provincial-level union meetings confirmed THIS FEBRUARY BCNU COUNCIL ANNOUNCED OCTOBER AND NOVEMBER DATES for the union’s provincial bargaining conference and annual convention • The provincial bargaining conference will take place October 3 to 5, 2022 at the Vancouver Convention Centre. • The annual BCNU convention will be held November 1 to 4, 2022 at the Hyatt Regency Hotel in Vancouver. The scheduled dates were confirmed following the provincial health officer’s February 15 announcement of the gradual reopening of the province. Both events will take place in-person. The needs of the entire membership remain the union’s top priority. The decision to move these meetings to later in the year recognizes the staffing pressure and instability that has landed directly on members. For more information, please contact your local steward or regional council member.

SPRING 2022 • UPDATE MAGAZINE

PROFESSIONAL PRACTICE

THE HIGH COST OF DOING BUSINESS LPNs hit especially hard by rising professional fees

ICENSED practical nurses across BC were extremely disappointed to learn that the BC College of Nurses and Midwives (BCCNM) had yet again raised its registration fee for LPN members. In October 2021, the college announced that the fee for 2022-23 would increase by 10 percent. The hike follows an 11.5 percent fee increase charged for 2021-22. The latest bump is part of a troubling pattern that has seen LPNs subjected to registration fee increases of nearly 46 percent over the last four years. Today, an LPN pays $521.95 for the 2022-23 registration year – the same amount a registered nurse or registered psychiatric nurse pays – despite the wage difference between the designations. “It is absolutely unfair that LPNs are seeing yet another increase in their professional fees,” says BCNU Treasurer Sharon Sponton. “The union continues to advocate for LPNs in an effort to curtail rising costs for these members.” In February 2021, BCNU leaders met with deputy health minister Stephen Brown to discuss the issue. They noted that registration

fees for RNs, RPNs and nurse practitioners rose by 1.5 percent this year, making the 10 percent hike to LPN fees especially concerning. BCNU also called on Brown to intervene on behalf of nurses facing rising professional liability protection fees they pay annually to the Canadian Nurses Protection Society (CNPS). A March 2021 BCCNM bylaw change now requires RNs and RPNs to join the Nurse and Nurse Practitioners of BC (NNPBC) to be eligible for a reduced preferential CNPS rate. Nurses who choose not to belong to the NNPBC are required to pay $92.40 for liability protection, while those who become NNPBC members only pay $71.40. Regardless of the choice they make, nurses are being hit with unprecedented liability protection fee increases on top of the other professional fees they must pay. This year CNPS fees rose by more than 30 percent. Sponton says the ongoing additional costs and fees for nurses run counter to the province’s efforts to retain and recruit nurses in the face of a critical staffing crisis. By the government’s own projections, more than 26,000 nurses will be needed by 2031 to staff the health-care system

at its current level. “We understand the financial impact that rising fees and insurance costs are having on our members,” says Sponton. “That’s why we negotiated a partial reimbursement of registration fees during the last round of provincial bargaining.” The contract improvement means most nurses no longer

have to bear the full cost of registration renewal, and now receive a partial reimbursement that is paid by their employer. “This has certainly helped relieve the burden,” says Sponton, “but nurses shouldn’t be subjected to continually rising professional costs they must pay for out of their own pocket.” •

EASY UPDATE New dashboard allows quick access to reimbursement application status BCNU STRIVES TO CONTINUALLY IMPROVE EASE of access to member services. New for 2022 is a reimbursement dashboard on the BCNU Member Portal that allows members to check the status of their college fee reimbursement application and quickly upload any required supporting documents. BCNU members covered by the 2019-2022 Nurses’ Bargaining Association provincial collective agreement can apply for the $215 reimbursement from April 4 to June 30 via the Member Portal. The reimbursement application form was streamlined last year for those members who provided consent to BCCNM allowing it to share their registration renewal confirmation with BCNU. The union receives this information under the terms of an information sharing agreement reached with the college in 2021. Eligible members applying for reimbursement through BCNU will once again have access to a form that takes only a few minutes to submit. In 2021, over 6,500 forms were successfully submitted within 24 hours of opening. The streamlined process also means staff can process reimbursement payouts more quickly. In future, the reimbursement dashboard will be expanded to allow members to view the status of their union leave and expense submissions.

UPDATE MAGAZINE • SPRING 2022

CHECK IN

NEWS FROM AROUND THE PROVINCE

NURSES’ BARGAINING ASSOCIATION

COMING TOGETHER Bargaining consultation process continues with online regional strategy conferences

CNU MEMBERS in regions around the province gathered at virtual meetings at the beginning of the year discuss opportunities for contract language improvements that best reflect what nurses need now. The online regional bargaining strategy conferences replaced the in-person meetings scheduled for last November and December. These events were postponed following renewed public health restrictions and rising hospitalization rates driven by the COVID-19 Omicron variant. BCNU President Aman Grewal hosted this year’s meetings, where she, explained the bargaining process, and talked about the importance of lobbying elected officials ahead of contract negotiations. The events featured virtual breakout sessions where groups of attendees discussed potential job action activities and brainstormed ideas on how to retain nurses. Attendees also elected members from their region to represent them at BCNU’s provincial bargaining confer-

ence scheduled for Oct 3. In her opening remarks, Grewal commented on the difficulties so many nurses have faced in the last year, and with many prepared to leave the profession, she said the government must take nurses’ concerns seriously. Grewal introduced members to BCNU Interim CEO and chief negotiator Jim Gould, who took the opportunity to share his background and talk about the challenges and opportunities facing nurses during the next round of bargaining. Gould acknowledged the diversity that exists in a bargaining unit of over 40,000 people. “That’s why it’s important to hear from as many of you as possible,” he said. Gould stepped into the role on Jan. 17. No stranger to the Nurses’ Bargaining Association collective agreement, Gould has led successful litigation battles against the government and health employers to win nurses tens of millions of dollars in damages over previous breaches of the contract’s staffing language. Gould said he has little

SPRING 2022 • UPDATE MAGAZINE

patience for the blatant disrespect that nurses have received. “A collective agreement is a contract,” he said. “This is your contract of employment that sets the ground rules. Yet this government, and past governments, have breached it

SOMETHING TO TALK ABOUT As BCNU looks ahead to this fall’s provincial bargaining conference, your regional executive members will be connecting with members to talk about important issues like the role of stewards, bargaining, job action and occupational health and safety. A series of online leaning resources dubbed “NU Connections” will help kick off the conversations. It’s going to be a busy year. We want to make sure you feel supported and are empowered – and an active part of your union. Watch BCNU member eNews and visit your worksite’s BCNU bulletin board for information on upcoming events.

time and time again.” Gould assured members that BCNU is in a strong negotiating position given the staffing needs of the health-care system and the high levels of public support nurses enjoy. He also said it’s important to build nurses’ collective voice before negotiations with the government and health employers begin next year. “Members from BCNU regions around the province need time to come together, hear from each other, and appreciate where their power lies,” Gould advised. “It comes down to solidarity. When all nurses come together as a unified voice, you have unbelievable power.” Member input and partic-

ipation is crucial for success at the negotiating table. The online regional bargaining strategy conferences were just the latest step in a provincial bargaining process that has allowed nurses to shape the direction of negotiations between the union and health employers. That process began last year with a membership-wide survey conducted by Mustel Group, a BC-based market research company, that solicited input from more than 14,000 respondents on a number of key issues, including

health and safety, wages and staffing constraints. Results of this survey will be presented in full at the union’s October provincial bargaining conference. Conference attendees will also elect BCNU’s provincial bargaining and job action committees. Led by Gould as chief negotiator, the committee is made up of member-representatives from all health-care sectors (large and small-sized worksites) including long-term care, acute care and community/public health care. Meanwhile, BCNU con-

tinues to turn up the heat on government by calling on the public to support nurses and email their local MLAs to demand that they make the nursing shortage a priority (see story on page 15: “Nurses Call for Action”). Public polling shows that more than 85 percent of British Columbians recognize the nursing shortage is a problem that government needs to be addressed. More events are planned throughout the year where members can meet with provincial union leaders, ask questions and share their

suggestions for what the future could hold (see sidebar: Something to Talk About). “BCNU members have endured a tumultuous two years, and our priority now is to continue listening to them,” says Grewal. “We encourage every member to stay engaged with the union. Every voice matters, and when thousands of voices are united in solidarity, there’s nothing we can’t achieve.” The current Nurses’ Bargaining Association collective agreement expired March 31.•

STRUGGLING THROUGH A NIGHTMARE Provincial ad campaign puts spotlight on nurse staffing crisis

NURSE ON A BUSY UNIT IS PULLED IN MULTIPLE directions. She quickly turns a corner, only to find herself staring down an eerily quiet hallway with a lone patient laying in a dimly lit bed. She reacts and quickly walks to reach the patient, but the bed recedes further and further out of reach. In desperation, she looks over her shoulder, only to find the hallway now full of patients. The sound of desperate pleas for help multiply and alarms grow louder and louder, creating an overwhelming crescendo of pressure and fear. This is just one of the nightmare scenarios portrayed in BCNU’s latest public advertising campaign. The dramatic imagery drives home the burnout and overcrowding that is causing nurses to consider leaving the profession. The ads also highlight the staggering fact that 82 percent of nurses say their mental health has worsened over the past two years. The campaign encourages British Columbians to put pressure on their MLAs and demand change. “We need the public to come away from this ad campaign thinking, ‘if we don’t take action to tackle the nursing shortage in BC now, we will not have the health care we and our loved ones need,’” says BCNU President Aman Grewal. The advertisement is airing on all major television stations in the province as well as digital streaming platforms, social media and transit shelters until May 15, 2022. • For more information, visit www.helpbcnurses.ca.

UPDATE MAGAZINE • SPRING 2022

GUIDING LIGHTS BCNU ACTIVIST PROFILE

URVIR SEKHON says he became a union activist to better understand his rights and make his workplace the best it could be. He recalls one weekend shift which focused his intentions. “Instead of five nurses on shift, I was one of only two. Our workload significantly increased and patient care was directly affected,” Sekhon remembers. “When I asked the on-call director for support, she told me they’re not to be blamed. I filled out a PRF (Professional Responsibility Form) which she encouraged me not to do, but I did anyway.” The professional responsibility process protects members’ professional license and should allow them to quickly address practice concerns as they arise. It took a few weeks for Sekhon to meet with his director – but instead of collaborative problem-solving, the BC Children’s Hospital nurse was told there was no problem working three nurses short. “If something had happened that shift, it would’ve been my licence on the line,” he says. “That was the moment I realized I needed to be more involved with BCNU.” Since 2017, Sekhon has served as the mental health rep on BCNU’s Shaughnessy Heights regional executive. In this role he is able to advise members on how to create a safe, healthy workplace. “Members are heavily impacted by workload, and they continue to use the patient care assessment process to address staffing. I admire their strength and dedication so much,” he says. Sekhon believes that no one should ever come to work feeling undervalued. His call to other members? “It’s time to find your voice and be courageous.” •

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10 QUESTIONS WITH GURVIR SEKHON What is one word you would use to describe yourself? Courageous.

management. We’re on the floor every day, but when we speak up our opinion is tossed aside.

If you could change anything about yourself, what would it be? Be more assertive.

Name one change you would like to make to the health system. Spend more on prevention and early education. Obesity, diabetes, and heart disease are rising but our system is reactive, not proactive. We need youth invested in their health, otherwise it’ll cost billions later and our system may crash.

What is one thing about you that people would be surprised to learn? I used to be a high school teacher. Where did you go on your last vacation? Palm Springs in 2019. It’s really nice there, like if Hawaii and Mexico had a baby. Name one place in the world you’d most like to visit. Austria. The capital city Vienna was previously the top-rated city in the world to live. What was the last good thing you read? A Piece of Cake by Cupcake Brown. It’s the author’s amazing memoir of her childhood journey of teenage prostitution, sexual assault, drug addiction and the foster care system. Later she became a lawyer. What was the best piece of career advice you’ve received? Fancy titles aren’t all they’re cracked up to be. A nurse may strive to be an educator or manager, but those positions often have little autonomy so, the position with a fancy title may be less than hoped for. What do you like most about being a nurse? First is the opportunity to work in so many areas – community, neuro, emerg – it’s never boring. Second is there’s truly a sense of family at work because nurses always step up when you need help. What do you like least about being a nurse? A lack of validation and respect by

NURSES CALL FOR ACTION BCNU takes members’ voices directly to decisionmakers in Victoria

HIS FEBRUARY BCNU leaders from every region in the province engaged directly with their local members of the legislative assembly (MLAs) to bring home the urgent issues facing nurses and the patients in their ridings. The nurses’ messages were personal, poignant accounts of what it’s like to provide care in BC today. And the stories from the MLAs’ own backyards weren’t easy to ignore. BCNU council members gathered numerous emotional anecdotes from members in their regions and called on their elected officials to stand up for nurses in the legislature. Unsurprisingly, nurses across the province cited the worsening staffing shortage as their primary concern. “MLAs heard about the harsh reality faced by nurses and patients who reside and work in their constituencies,” says BCNU President Aman Grewal. “They were told about serious overarching issues throughout the health-care system, such as a critical shortage of nurses, continued exposure to workplace violence, and a worrying decline in nurses’ mental and physical health.” Grewal says the outreach effort also aimed to give patients a voice. “The messages made our province’s elected officials intimately aware of the serious impacts the nursing shortage is having

on patient care.” MLAs heard heartbreaking stories of constituents not receiving a basic level of care, such as failing to have their teeth brushed, or suffering the embarrassment of incontinence after not receiving assistance to a bathroom.

being choked and – if not for another patient intervening – would most likely have died. COVID-19 pandemic working conditions figured prominently in many of the stories, but the campaign was focused on pre-existing systemic problems that have only been exacerbated by the pandemic. “The goal was to show MLAs that, although COVID-19 has made caring for patients more challenging, the province’s health-care system had already been floundering for quite some time – and nurses have been without adequate supports for even longer,” explains Grewal.

“We made elected officials intimately aware of the serious impacts the nursing shortage is MESSAGE TO having on patient MINISTERS care.” The union also put pressure on the govBCNU President Aman Grewal

Provincial legislators were also given first-hand accounts of nurses being told to contact local law enforcement when feeling unsafe in their workplace. The stories shared clearly illustrated the severity of violence that members face. These included a bedpan full of urine thrown into a nurse’s face, homophobic comments and threats, an incident of death threats from a patient and their family towards the nurses, nurses being spat on, scratched, kicked and punched and kneed in the groin. And an account of one nurse who was

ernment using open letters to provincial cabinet members. Key ministers were called out on their lack of meaningful action to address the challenges facing nurses and other health-care workers. The union called on health minister Adrian Dix to address a number of concerns related to the risks associated with the COVID-19 Omicron variant. Of particular concern was BCNU members’ inability to consistently access appropriate personal protective equipment (PPE), even when performing a patient care risk assessment. “Today, health employers continue to demand that our members conduct

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THIS MESSAGE HAS HIGH PRIORITY Connecting with decision makers THIS WINTER’S MLA OUTREACH INITIATIVE SAW BCNU REGIONAL LEADERS sharing members’ stories with local MLAs about patients experiencing avoidable delays for care, and about nurses consistently working short and being exposed to violence in their workplaces. “A nurse recently reported that their unit was short-staffed, and the admitted patients were above census. Two nurses were left to care for 22 patients on a night shift. Normally, the nurses would be caring for five to six patients each.” East Kootenay region council member Denise Waurynchuk “Mackenzie made the national news as it was on diversion 16 times in December alone. This is putting members of these communities in danger.” North East region interim council member Tracey Jonker “Our unit now utilizes tele-sitters. Instead of providing in-person care, we are resorting to computer monitoring our patients. When patients need a one-on-one caregiver they need someone to physically help them, they don’t want to speak to a camera on a pole.” Okanagan Similkameen region council member Candi DeSousa shares a member’s concern. “Nurses in Nakusp shared that they do not feel unsafe at night, as there are instances when only three staff members are present. Interior Health’s response directed nurses to call the RCMP.” West Kootenay interim regional council member Dennis Senft “Self-defence is not something our nurses learn at school.” North West region council member Teri Forster

a point-of-care risk assessment to be allowed access to an N95 respirator. This, despite the established evidence of aerosolized transmission of the virus,” wrote Grewal. “Your ministry continues to adhere to outdated prevention measures based on droplet precautions. We insist that the current provincial PPE allocation framework be updated to list aerosolized spread as the primary method of spread for this virus rather than droplet spread,” she added. Anne Kang, Minister of Advanced Education and Skills Training, was asked to provide stronger leadership to advance the recruitment and retention strategies so desperately needed to meet the government’s own health-care system staffing targets. The union called on Kang to do everything in her power to help increase the number of nursing seats in the province’s post-secondary education system. Grewal cited a 2018 report from the Canadian Association of Schools of Nursing that shows BC as having the second-lowest average number of students enrolled in a nursing program per capita, out of all 10 provinces. “In 2019, before the pandemic was even on our radar, the average number of total vacant nurse positions that year was 2,238. In 2020, however, we only graduated 1,505 registered nurses into the system,” reported Grewal. “Yet, despite the addition of these new graduates, by 2021, the average number of total vacant nurse positions during that same time period had more than doubled to 5,108.” Grewal told Kang that the province’s

TAKE ACTION! Now, it’s your turn! Use your mobile device and join the thousands of nurses who are calling on MLAs across BC to stand up for their constituents and make health care a priority. Share your personal experience working in the current healthcare system with your local MLA. A copy will be sent to the premier, health minister, leader of the official opposition, and the opposition health critic. When united around a cause, nurses are an effective voice for real change and a better public health-care system for all!

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ability to recruit and retain nurses is critical to improving staffing levels, and that her ministry is uniquely positioned to foster the kinds of improvements necessary to give our health-care system a fighting chance. BCNU also called on labour minister Harry Bains to fulfill his stated mandate of “putting people first through the enhancement of public services.” To accomplish that mandate, Grewal told Bains to create safer workplaces for nurses while simultaneously increasing the number of nurses at the bedside. BCNU also called on Bains to work directly with WorkSafeBC to immediately increase safety levels for nurses currently at the bedside. “Our members are continuing to tell us their safety is not prioritized, and that violence in health-care workplaces remains rife,” wrote Grewal. “Even more alarmingly, nurses continue to tell us that WorkSafeBC officers are conducting an inadequate number of inspections, despite the fact that health care is a key part of both the 2018-2020 and 20212023 High Risk Strategies and Industry Initiatives, which seek to reduce workplace injuries.” In the weeks since the outreach effort began, several BCNU regional council members have been successful in opening a dialogue with their MLAs, and members of the union’s Provincial Executive Committee have participated in productive meetings with ministers holding key cabinet portfolios. Grewal says the campaign highlights the need to maintain open communication with elected officials. “We need to work harder to ensure they are always aware of the challenges nurses face – and that nurses’ inability to provide safer patent care directly affects their constituents.” •

COVID-19

OUR SAFETY IS NON-NEGOTIABLE Health-care workers’ frustration over limited access to PPE has become a defining issue of the COVID-19 pandemic – and employers’ lack of respect for nurses’ professional judgment is an ongoing source of frustration and uncertainty

N THE MONTHS BEFORE THE COVID-19 outbreak was officially declared a pandemic by the World Health Organization (WHO) in March 2020, BCNU was already raising the alarm about the coronavirus’s risk to members’ health and safety This advocacy began when the union was made aware of BC’s first case of COVID-19 in January. In the absence of definitive science to confirm the transmission of COVID-19, the union called on health employers and governments to ensure point-of-care nurses had access to the highest level of personal protective equipment (PPE) as they worked to confront the global public health crisis. In those early days, elected BCNU leaders met with health employers and government officials daily, and they insisted that the precautionary principle be applied to all of its occupational health and safety planning. This approach begins by recognizing that reasonable actions to reduce safety risks should not await scientific certainty, and that workers should be afforded the highest level of precaution in the face of uncertain hazards. “The precautionary principle supports nurses’ ability to conduct point-of-care risk assessments and use their clinical and professional judgment to determine their own risk and PPE requirements,” explains BCNU President Aman Grewal.

The union also voiced concerns for pregnant, vulnerable, or immune-compromised members, and fought to ensure they were provided with medical accommodations during the pandemic. BCNU labour relations officers helped more than 550 nurses make duty-to-accommodate requests to their employers, upholding nurses’ right to work free from discrimination based on their medical status. “The first few months in 2020 were unprecedented for the union,” recalls Grewal. “The information around the novel coronavirus seemed to be changing daily. And as the crisis in the province grew, so too did our response for our members.” Grewal says that even with its staff working remotely, the union was able to ramp up member services and provide support for a 24/7 phone line to respond to members’ health and safety concerns.

ACCESS CHALLENGES

In March 2020, the province updated its PPE allocation framework to advise that, when at particular stages of supply, health-care workers would be required to wear the same surgical mask and eye protection for their entire shifts, despite having close contact with patients. The scientific community remained divided on how the virus was spread, yet the provincial framework stated that droplet-based precautions were sufficient to protect health-care workers.

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Grewal says the allocation framework became a tool in the hands of employers who could use it to deny nurses access to higher levels of PPE, including N95 respirators – the standard when managing aerosol-based transmission. Government officials came under greater media scrutiny as more nurses began reporting that their employers were locking up PPE at worksites to ration products. Nearly 25 percent of nurses surveyed by BCNU reported PPE being held under lock and key at their worksite, despite health ministry reports that tens of thousands of pieces of PPE had been purchased. “The reports from our nurses on the ground differed greatly from the information provided in daily media briefings from health minister Dix and provincial health officer Dr. Bonnie Henry regarding the availability of PPE in this province,” Grewal recalls, noting that one in four nurses polled in a BCNU telephone town hall in May 2020 indicated that they did not have sufficient access to PPE at their worksite. “We knew the truth – and it was unacceptable.” The union continued its call for properly fit-tested N95 respirators and training and supports for health-care workers to effectively manage the challenges of working in an overloaded health-care system that was already critically understaffed. Unfettered access to PPE was the union’s line in the sand. “Protecting those on the front lines who are risking their health, and those of their families, to provide care for sick British Columbians should be non-negotiable,” states Grewal. As the pandemic wore on, the scientific evidence for aerosolized transmission of the virus was growing. In October 2020 the WHO acknowledged that the COVID-19 virus could spread via short-range airborne transmission and inhalation of infectious particles. And the following November the Public Health Agency of Canada revised its guidelines

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“Access to appropriate PPE should not be another challenge.” BCNU President Aman Grewal

on how COVID-19 spreads to include the risk of transmission from aerosols. The agency advised that aerosols could remain suspended in the air or travel farther than conversational distance, especially in poorly ventilated and/or crowded indoor settings. In December 2021, as BC entered the fifth wave of the pandemic that was driven by the rapid spread of the new Omicron variant, the union reached out again to Minister Dix raising concerns about safety and risks to members. “The international scientific community, including BC’s Centre for Disease Control, have acknowledged aerosolized spread as a primary mode of transmission of the Omicron variant,” Grewal told Dix. “Yet we continue to hear directly from members who are not able to consistently access appropriate PPE.” The union also called on Dix to update the province’s outdated PPE allocation framework to include aerosolized spread in addition to droplet-based transmission and precautions. To support its position that the framework was not good enough to protect health-care workers, BCNU cited 2020 WorkSafeBC reports showing that workers in the nursing occupation registered the highest number of COVID-19 illness claims. Nurse aides, orderlies, and patient service associates account for the second highest number of registered claims.

SYSTEM LEVEL CONSEQUENCES

BCNU conducted a member survey in the spring of 2021 during the height of the pandemic’s third wave, and it found that nearly two-thirds of respondents

felt like the government was not doing enough to ensure their safety. Thirty-six percent reported that their employers continued to restrict access to PPE in their worksite. Of those, a staggering 73 percent said that PPE was placed under lock and key. “Our nurses are already working under increasingly difficult working conditions – and access to appropriate PPE should not have been another challenge,” states Grewal. Grewal notes the changes to the Point of Care Risk Assessment process announced in February that make it easier for nurses to access N95 respirators, but she says this may be too little too late, especially when coupled with crushing workloads and inadequate staffing levels that nurses are experiencing. BCNU’s November 2021 report, The Future of Nursing: Impacts of the COVID-19 Pandemic and the Nursing Shortage in British Columbia, found that 82 percent of members reported that their mental health had worsened during the pandemic and 65 percent said their physical health had worsened. Just as worrying, 35 percent of respondents indicated the pandemic experience has made them more likely to leave nursing in the next two years. The figure rises to 51 percent of nurses working in ICU and ER care settings. “These numbers are heartbreaking,” says Grewal. “The government needs to act now to mitigate the devastating impact these conditions are having on our health-care system. Without immediate investments and swift action, we fear that patients and nurses will continue to suffer.” • TAKE ACTION! BCNU is actively recruiting and supporting Joint Occupational Health and Safety Committee members to help address worksite safety issues, including access to PPE. Talk to your steward today.

COVID-19

MAKING HEADLINES BCNU provides commentary on the state of BC’s health-care system

HESE DAYS, FOR MEMBERS of the public seeking to understand BC’s health-care system, staying abreast of the seemingly endless media coverage has never been more difficult. Whether it’s the latest numbers on COVID-19 hospitalizations, the government’s response to the chronic nurse shortage, increased violence in health care, the toxic drug supply, or large organized protests targeting healthcare facilities, the daily news cycle is now a mix of overwhelming and complex story angles – the majority of which involve nurses. The media coverage means BCNU has become a leading voice in the discussion of health-care related stories and topics that lead the nightly newscasts. Reporters now make it a priority to speak to the union representing the tens of thousands of nurses providing care in communities across the province, and under the most challenging circumstances. But the union’s media status didn’t happen by accident. “Through hard work and relationship building, BCNU has established itself as a ‘goto’ for the media when it comes to the state of the health-care system,” says president Aman Grewal. “We get calls almost every day from reporters asking us to explain what things are really like in our health-care system

– and what we’d like to see in the way of improvements for nurses and their patients.”

“The relationship we’ve built with the media over the last couple of years has led us to become a solid, trusted voice.” BCNU President Aman Grewal

Being a sought-after media source is an essential part of the union’s advocacy role. A recent example of this work was seen following the government’s annual tabling of the provincial budget, which took place this February. The day-long event is one of the biggest opportunities for organizational leaders to weigh in on what is – and isn’t – in the government’s fiscal plan for the year. BCNU attended the budget announcement and was a key media commentator, outlining where it felt the government had fallen short on funding for nurses and the province’s health-care system, and where it could improve. “Just as we have in years past, we took a firm stand in our media work and made it clear that while this year’s budget

included money for continued pandemic response, it lacked anything for nurses in regard to workplace safety or recruitment and retention efforts,” notes Grewal. “In our media interviews, we made sure to highlight the reasons why, two years into the pandemic, the government must make nurses’ needs a priority.” The COVID-19 Delta variant-driven wave that hit last fall also put BCNU in the headlines, as the number of people admitted to hospital spiked, and with it the pressure on hospitals and staff. The union, speaking on behalf of exhausted and burnt-out members, held lobby meetings with MLAs, issued news releases, and was active in the media in an effort to get decision makers and government to pay attention. There’s no question that BCNU’s advocacy on behalf of nurses around the province has made the union a primary fixture in newscasts. “Whether we are in the midst of a devastating COVID-19 wave, pushing government for resources, or calling for safer workplaces, the relationship we’ve built with the media over the last couple of years has led us to become a solid, trusted voice,” says Grewal. “We will continue to do this important work with the goal of securing improvements for working nurses in BC.” Catch up on some of BCNU’s latest media appearances and interviews at BCNU.org/InTheNews. •

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COVID-19

WAITING GAME Qualified US-educated nurse finds herself sidelined by glacial applications process

READY TO SCRUB IN Natalie Nelson can’t wait to care for patients again. But the US nurse has found herself in “a black hole of paperwork and bureaucracy.”

ETWEEN THE unrelenting pressures of COVID-19, the ongoing opioid crisis, the lack of available seats in nursing schools and the rapidly aging healthcare workforce, it’s becoming ever more clear that we’ll need “all hands on deck” if we hope to address Canada’s worsening nursing shortage. But a big part of the solution is in our midst. Today there are scores of internationally educated nurses (IENs) who could and should be working, but who are prevented from doing so. Natalie Nelson is one of those nurses. The US-educated RN lives across the street from Vancouver General Hospital. She is qualified, skilled, and ready to begin a career in Canada, but she’s been sidelined by licensing and regulatory red tape. An experienced critical care nurse, Nelson received her nursing degree in Utah, where she worked before moving to Oregon and later to Alaska. She

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lived there for over two years prior to arriving in Vancouver so her partner could attend graduate school at UBC. Nelson understood that getting a nursing licence in Canada could be time-consuming and frustrating, so she began the application process prior to moving to Vancouver. “It’s an elaborate process to navigate,” she says. Any nurse who wishes to work in Canada must first apply to the National Nursing Assessment Services (NNAS), the organization that assesses international qualifications to ensure they meet Canadian standards. NNAS also helps determine if an IEN requires further education or training before they can be licensed. Nelson began collecting details of her education, training and work experience to support her application and submitted the required paperwork to NNAS in February 2021. The organization’s website states applicants that can expect to wait up to 12 weeks to move from the “ready to

review” phase to the phase when a licence is ready to process. Nelson says she waited while the 12-week mark came and went without any communication from NNAS. She then contacted NNAS in mid-August 2021 to request a status update as she and her partner were due to arrive in Vancouver at the end of that month.

“I feel a lot of guilt, being able to see the hospital from home and not being allowed to work, to help.” Natalie Nelson

The move from rural Alaska to downtown Vancouver is not inexpensive, and the couple first had to make ends meet

on a small university stipend. Thankfully, Nelson quickly managed to find a serving job at a well-known Vancouver restaurant. It was there that she first met Sara Mattu, council member for BCNU’s Vancouver Richmond region. “When I first met Natalie and she told me she was a critical care nurse who had worked in ICUs in the US, I was surprised and disappointed that she was unable to be registered in BC.” Mattu remembers. “Of course, I am familiar with challenges nurses coming from other countries face, but I never imagined US-educated nurses were also going through the same struggles.” Nelson says she didn’t realize how many nurses were in the same situation until she started doing research and discovered just how many IENs are unable to work in Canada due to the strict application process. “I learned that less than half of the IENs in Canada are working as nurses due to issues with application processes, and that it can take as many as three years and as much as $20,000 for IENs — including

Canadians who studied abroad — to clear all the hurdles,” she says. Mattu took Nelson’s case to heart. “Her story made me feel disappointed and angry at the system for creating unnecessary barriers,” she says. “We are in midst of the worst nursing crisis in history, yet here we have nurses working in restaurants instead of helping in health care.” After Mattu’s offer to assist, BCNU advocated on Nelson’s behalf, and was able to help her secure a temporary licence to work until June 2022. “But the catch is that I can’t apply to nursing units because those are not temporary positions, and managers are not looking to hire someone only until June,” Nelson sighs. “I feel a lot of guilt, being able to see the hospital from home and not being allowed to work, to help.” She concedes that it’s been a challenge supporting herself and her partner with her restaurant earnings and admits that if her situation does not resolve soon, she may have to return to the US and work there.

“It’s been over a year since my first submission to NNAS with multiple contacts and information exchanged,” Nelson reports. “I know that I’m qualified and ready, but yet I’m stuck in a black hole of paperwork and bureaucracy.” Are there solutions? Nelson says the current application system is paperbased, archaic, and she believes it should be streamlined. “I don’t understand why there isn’t an online system to coordinate this,” she says. “Yes, there’s a lot of information that needs to be assessed but I feel an online system could present applicants with a more informed reality on steps and timing.” Nelson’s future is still uncertain, but her optimism shines through, and she remains steadfast in her desire to nurse in Canada. “I have to say that the BC Nurses’ Union advocacy in my case has been so helpful and amazing,” she remarks. “I’ve belonged to unions in a couple of previous positions, but BCNU has been extraordinary, especially as I’m not even a member yet!” •

LENGTHY PROCESS

2 APPLY TO BCCNM British Columbia College of Nurses and Midwives has a mandate to protect the public through the regulation of nurses. This includes setting standards of practice, assessing nursing education programs and addressing complaints about BCCNM registrants. IENs must provide an NNAS registration number, an NNAS application number and an NNAS advisory report.

will then advise applicant on the next steps they must take.

Getting your licence in BC Internationally educated nurses must pass a series of hurdles before they are allowed to practice in BC. 1 APPLY TO NNAS National Nursing Assessment Service (NNAS) assesses nursing credentials obtained outside of Canada. It determines if an IEN needs to supplement their education/training before becoming licensed. Once confirming an application and payment, NNAS provides an IEN with an ID number to track their application status. After all forms are submitted, NNAS reviews an applicant’s files and provides access to an advisory report that contains their evaluation. A copy of this report is sent to BC College of Nurses and Midwives (BCCNM).

3 COMPETENCY ASSESSMENT Nursing Community Assessment Service (NCAS) provides a three-part competency assessment for internationally-educated health practitioners — including nurses — who hope to practice in BC. 4 REPORT OUTCOME Applicants can expect to receive an assessment email from BCCNM 8 – 10 weeks after it has received a report from NCAS. BCCNP

5 CRIMINAL RECORD CHECK Applicants are asked to consent to complete a criminal record check. The consent and fee must be submitted before writing the national nursing exam. 6 WRITING THE NATIONAL NURSING EXAM All applicants seeking BCCNM registration must write and pass a national exam to become a: • LPN – Regulatory Exam - Practical Nurse (REx-PN) (formerly CPNRE) • RN – The National Council Licensure Examinations for RNs (NCLEX) • RPN – The Registered Psychiatric Nurses of Canada Examination (RPNCE)

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PROFESSIONAL ISSUES

EXPANDING CAREER PATHWAYS

PHOTO: GILES PALMER

BC LPN helps create new orthopedic program

LEARNING LEADER Prince George LPN Shannon Sluggett encourages other nurses to take advantage of the opportunities available to advance their careers with the support of the Nurses’ Bargaining Association nursing scope of practice fund.

HANNON SLUGGETT has a passion for education. The Prince George acute care LPN was a member of the BCNU bargaining committee that negotiated the current Nurses’ Bargaining Association collective agreement – and she wanted to make sure education opportunities for nurses were a priority in the 20192022 contract. “One of the things I fought to get in the collective agreement was more education and more specialties for licensed practical nurses,” she says. Sluggett knows first-hand how challenging it can sometimes be for nurses who want to expand their scope of practice. For the past 10 years, the LPN has worked an as orthopedic technician at the University Hospital of Northern British Columbia. It’s a specialty designation she loves, but the education that she needed to qualify for the job required her to travel to

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“I absolutely love teaching. I like to assess students’ needs and learning styles.” Shannon Sluggett

NorQuest College in Alberta. For years, LPN orthopedic technicians like Sluggett had to make this journey. “There were a few barriers, Sluggett says, “with our practicums being here in BC and also having to travel to Alberta for a one-week clinical before our practicum.” That’s now about to change. Starting this year, BC LPNs will have a learning option for advanced orthopedic knowledge and skills that keeps them closer to home.

A new LPN Orthopaedic Certificate at Okanagan College launched this January is the first of its kind in BC – and Sluggett is one of three instructors in the program. With support from BCNU and others, Sluggett was part of the team that developed the online certificate program, and she says she’s proud to help increase access to advanced orthopedic education for nurses throughout the province while reducing travel requirements. The advanced education program covers specialized learning for a range of topics, including anatomy and physiology, orthopedic pathology and casting skills. Nurses will be prepared to work in team-based environments along with physicians and nurse practitioners to assess and manage nursing care for conditions and injuries of the musculoskeletal system. The program was first conceived in 2019, after BCNU was approached

by one of the medical advisors for NorQuest College’s Advanced Education in Orthopaedics for LPNs, regarding the required clinical placement for completion of this program and the difficulties faced by students outside Alberta. BCNU was included in the discussions because of previous conversations about keeping nurse education local. Sluggett says Heather Straight, BCNU’s executive nurse lead, reached out to inform her that Okanagan College was considering developing an orthopedic certificate program in BC, and asked her to join a working group involving the Ministry of Health, health authorities, BCNU and other interested parties. The goal was to help Okanagan College develop a program that would conform to the LPN orthopedic competencies within the LPN scope of practice in BC. Sluggett was more than excited to participate. She says she helped develop the Orthopaedic Pathophysiology and Nursing Interventions course for the program, and took additional courses herself to become one of the three Okanagan College program instructors. “I absolutely love teaching,” she says. “I like to assess students’ needs and learning styles,” noting the LPN Orthopaedic Certificate has room for 20 students per intake, which runs once a year. “This program is not easy. It is very intense,” Sluggett says. “You are looking at every muscle in the body, every nerve in the body, every vessel in the body and it’s a lot of memory.” Only seven students applied for the first intake this year, she reports, adding that some nurses had already started with the Norquest program. “From this point forward, we expect a much higher intake of LPNs to be coming through the course.” While the course is a huge benefit to LPNs, Sluggett notes that the price of

the course ($7,620 for tuition and fees for the 2021-2022 Okanagan College year) can be a barrier without paid support from an employer. That’s why she’s glad to see the nursing scope of practice funding that’s been negotiated in the NBA contract (see sidebar: Supporting Professional Practice). Sluggett encourages other LPNs to consider taking advantage of the opportunities that are available to gain advanced competencies.

She says LPNs who complete the Orthopaedic Certificate program will be working in areas such as cast clinics, plastic clinics, and emergency departments, and assisting with closed reductions, assessing radiology, X-rays, traction, casting, and splints. “I would like to see a lot more ortho LPNs, especially in the smaller communities we have in the north,” she adds. “That would definitely benefit our patients.”•

SUPPORTING PROFESSIONAL PRACTICE BCNU IS COMMITTED TO HELPING members gain the skills and competencies required to maintain rewarding careers – and ensuring our members get the best professional practice support and access to education remains one of our highest priorities. That’s why the union negotiated the establishment of the Nursing Policy Secretariat (NPS) during 2014-19 Nurses’ Bargaining Association collective agreement negotiations. The NPS is tasked with reviewing current legislation, regulation and other standards, limits and conditions and other types of practice restrictions and looking for opportunities to expand nursing practice. When negotiating the NPS, BCNU, health employers and the Ministry of Health all agreed that a robust career pathway for nurses will enhance recruitment and retention and support the delivery of safe patient care. In accordance with Appendix JJ.3 (Nursing Career Pathways), the NBA can help nurses access education funding to expand their scope of practice through advanced competencies while strengthening LPN, RN and RPN nurse leadership roles and skills across the health system. These opportunities include pro-

grams such as LPN Ortho Tech, RN First Assist, RN First Call and Integrated Primary Care Nursing. NURSING SCOPE OF PRACTICE FUND (APPENDIX JJ.3) As part of the 2019-22 NBA contract, BCNU recently secured up to $700,000 from this fund to support LPN to RN and LPN to RPN education and placement. The funding can be used to provide tuition and related costs to support educational upgrades. More information will be forthcoming. An additional $700,000 of the fund has been allocated to establish and support LPN, RN, RPN nurse leadership roles and skills across the health system, including but not limited to, advanced competencies. EDUCATION FOR NURSES LINKED TO STRATEGIC PRIORITIES FUND (APPENDIX JJ.1) BCNU, health employers and the Ministry of Health recently agreed to allocate $1,000,000 of this fund to financially assist nurses wishing to upgrade their skills and competencies including, but not limited to, LPN bridging, specialty training in gerontology, mental health and substance abuse, critical care specialties and rural nursing. This work is in its initial phase.

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OPIOID CRISIS

SAFE SUPPLY SHORTAGE

Chief coroner’s expert panel urges safer supply, evidencebased system of care to reduce deaths from toxic drugs TELLING IT LIKE IT IS For the past six years, BC’s chief coroner Lisa Lapointe has been making recommendations to the province about the actions needed to confront the deadly drug toxicity and poisoning crisis.

PHOTO: CHAD HIPOLITO. Republished with the express permission of Vancouver Sun, a division of Postmedia Network Inc.

HE NUMBERS FOR 2021 are in. And the numbers are not good. BC saw 2,224 suspected illegal drug toxicity deaths – the most ever recorded in a year and a 26 percent increase over the 1,767 deaths seen in 2020. Lisa Lapointe says it’s hard to think of anything else happening in this province resulting in the deaths of six or seven people every single day that would not elicit a massive, coordinated response. Lapointe is BC’s Chief Coroner, and she is speaking to her most recent report Illicit Drug Toxicity Deaths in BC January 1, 2011 – December 31, 2021 released this February. Her reports have become grim, annual reminders not only of failed drug prohibition policies, but of the institutional inertia and shortage of political will that continues to protract the crisis. The COVID-19 pandemic has shown British Columbians what a robust response to a public health emergency

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can look like, with provincial testing, provincial vaccination sites and provincial data. But none of this has been brought to bear on the opioid crisis even though toxic drug deaths in BC have far outpaced those from COVID19. Poisoned opioids and other drugs killed 3,000 people in BC between January 2020 and July 2021, compared to the 1,800 who died from COVID-19 in the same period. The crisis is national in scope. Some 25,000 Canadians have died from unintentional toxic drug poisoning since 2016 – an average of 19 Canadians died every day in 2021 according to the Public Health Agency of Canada, and there are no signs that 2022 will be any different. In her role, Lapointe oversees the independent investigations of approximately 10,000 deaths reported to the Coroners Service annually, including all children’s deaths, and deaths reviewed at inquest. Coroners establish the circumstances of unexpected deaths for the public record and may

make recommendations to prevent similar deaths in the future. The chief coroner has the discretion to establish death review panels to review the facts and circumstances of deaths and provide advice on medical, legal, social welfare and other matters that impact public health. In the wake of February’s grim drug toxicity report, Lapointe convened a panel of subject matter experts to provide advice and recommendations on how to stem the unrelenting death rate. The panel’s report, A Review of Illicit Drug Toxicity Deaths, was released in March and is the second such report since the public health crisis was declared in 2016. The first Death Review Panel report was published in 2018. The latest report contains several findings and recommendations (see sidebar: The Deadliest Year Ever), which Lapointe has forwarded to relevant ministries and organizations. Update Magazine sat down with Lapointe to discuss the report and her views on the crisis.

UPDATE The Death Review Panel

findings show that deaths are increasing both in number and in rate and the drug supply has become increasingly toxic. What explains the persistence of toxic supply and deaths? How does this make you feel considering the significant efforts to expand harm reduction services and options over the past six years? LAPOINTE The numbers of people dying is truly heartbreaking. As coroners we are very close to this crisis. Our coroners go to the scene of death. They examine the person who died. They talk to the family members at the scene. Then they follow up with the family members calling them to ask what happened and to share information. So, it’s very personal to those working in the Coroners Service. It’s also heartbreaking for families and communities. And it’s not just families. It’s friends, co-workers and friends of friends that are suffering when someone dies. Most of the people who die have had long-term substance dependencies and not as many casual users die. Which makes sense because the more often you use, the more you are at risk from the toxic market. A challenge we are facing has been the increasing toxicity of drugs over time. In 2012, when somebody purchased heroin, it was heroin and normally, if somebody purchased what they felt was cocaine, it was cocaine. Then fentanyl arrived, which is much cheaper to manufacture. But then people started becoming accustomed to fentanyl. However, we now see fentanyl in more extreme concentrations, making it much riskier to use. And now we are finding increasingly benzodiazepine in the drugs today, which, as a sedative and not an opioid, does not respond to naloxone. The unpredictability of the drug supply is a huge, huge factor. It really

means that people can’t protect themselves very easily unless there are substantial drug checking services, which there aren’t, there are some. Overdose prevention sites are extremely valuable. But not every community has one. Or if it does, it’s maybe not where people want to go. Someone living in a suburban neighborhood may not want to go to a different area of town to use their substance. We need more drug checking, more overdose prevention sites. I know efforts are underway to initiate safe supply, but it is still extremely limited across the province. A few hundred people can access safe supply and there are estimates that there are 200,000 substance-dependent, opioid-dependent people in our province. So the access to safe supply is really, really minimal. And treatment and recovery options are, again, very, very minimal. Few physicians are willing to prescribe a supply. There are long waits for publicly available treatment. Private options are out of the reach of many people and we don’t have data to know if they work because there are no reporting requirements. Something my office has been asking for since the previous Death Review Panel back in 2018 is regulations around treatment and recovery services, and making sure there are reporting requirements so we have some sense that what’s happening out there is evidence-based and actually effective. There are still so many service gaps. As long as these gaps remain while we have an increasingly toxic drug market, people are going to continue to die, and that’s what we have been seeing over the past six or seven years. UPDATE BC could become the first province to decriminalize personal possession of some illegal substances. Instead of arresting people, or seizing their drugs, law enforcement would

direct people who use substances to health and social service resources. But some critics and advocates say BC’s proposal and submission to the federal government won’t solve the deadly problem. They argue the 4.5-gram limit is too low. Many people carry multiple days’ worth of substances with them that would tip them easily over the total limit. The City of Vancouver’s proposal, which also contains quantity limits, has received similar criticism. Is the quantity-limit approach to decriminalization the way to go? LAPOINTE I do feel very strongly, as do members of the death panel, that we need to be listening to the people who are directly impacted and who have lived experience. It seems very logical to me that we would permit people to carry substances they are going to consume or that a family member or friend is going to consume. I know there are concerns about trafficking, but trafficking is an offence, and that is not going to change. So, no matter what a person is carrying, if they are trafficking, they still are liable to sanction. The assumption has been if somebody is carrying over a certain amount [they are a trafficker]. Law enforcement all have different ideas – and that’s one of the challenges. We do hear from some of the major police departments like Vancouver and Victoria about how they don’t arrest people for possession. And we know from Federal Crown direction is that they will not prosecute for possession. But, in smaller communities, we hear loud and clear that people are often stopped, and their substances are taken away no matter how much they have. And, even in Vancouver and Victoria, currently it is not lawful to have controlled drugs in your possession and they will be taken away. I think we need to be really clear that if people have drugs that they are

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using for their personal use, then just because the quantity is more than a police officer might feel comfortable with, doesn’t mean they are trafficking. I don’t think that it is reasonable to assume they are, or that it is even lawful. That’s where the line is. Is it for personal use or are they trafficking? And the line shouldn’t be an amount, it should be active evidence of trafficking. UPDATE In terms of greater action on safe supply, last year the province issued a directive expanding programs to provide users with safe, non-poisoned drugs, and where nurses could prescribe “pharmaceutical alternatives.” Some critics, including nurses, have said it is too restrictive and it does not include access to heroin. Community advocates have also said the province is not moving fast enough on the safe-supply front. Is access to pharmaceutical alternatives safer supply? LAPOINTE Yes, absolutely. There are varying definitions of safe supply and there are some who say safe supply is people being able to access a drug of their choice when they need it. While others are saying it’s broader, that it includes access when needed in addition to receiving opioid agonist therapy, or being treated for substance dependency. The real focus needs to be acknowledging that substance use is a choice for many people. Sometimes it becomes a dependency. Sometimes it becomes a disorder. But in any of those cases, ensuring that people have access to safe regulated drugs is the only way that we are going to prevent the number of deaths we are seeing. Currently, access is only by prescription and it clearly needs to be broadened. The Death Review Panel was pretty explicit about that. There needs to be much greater access to safe supply much more quickly across the province. That’s the only thing

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that is going to prevent these deaths because the illicit drug market is toxic. We know there is no quality control. Clearly, it’s a profit driven market. Safe supply is ensuring that people can access the drug they need and that it’s regulated and safe – whether they are looking for treatment or whether they are looking for personal use. And, as the panel pointed out, there will probably need to be more models. A prescriber-only model is probably not going to be sufficient to meet everybody’s needs. UPDATE Discussion about the drug toxicity crisis almost always leads to a discussion about addiction, substance use disorder and the need for treatment. But most people who use drugs are not addicted, and are not needing prescriptions. They don’t want to have contact with the health-care system. They just want to purchase some cocaine on a Friday evening after work just like somebody else might want to go get a six-pack. Are policy makers too focused on treatment at the expense of analyzing the broader toxicity crisis? LAPOINTE As a coroner service, the population we encounter most often are people who are substance-dependent because they are more at risk. But clearly, if we want to keep people alive, then we need to ensure that the drugs that the people are accessing are safe. Whatever they might be accessing them for, because as long as we allow the illicit market to flourish and be this sole provider of these substances, then lives are at risk. If we want to keep people alive then all substances need to be regulated and safe. What does that regulation look like? That’s a policy issue. How substances are dispensed to people is another question. But that is what will keep people alive. For decades we have been socialized into believing that drugs are bad and people who use drugs are bad, and the stigma associated with that is going to

take time to undo. But so many people are recognizing now that drugs can be used safely if there are safe drugs. Make sure the drug is safe. UPDATE You and the Death Review Panel have reported that deaths are occurring throughout the province, yet so much of the focus and coverage of the crisis quickly turns to Vancouver’s Downtown East Side. This community needs significant mental health support and treatment, but does this clarify or obscure the nature of the crisis? Adjusted for population, death rates in rural and northern BC are almost double the death rate of Vancouver. How do you deal with this challenge? LAPOINTE It’s frustrating because it reinforces this idea among many that “that’s not me” and that it only concerns other people who are using drugs. And my family and my community are not at risk. In fact, we know that every community in the province is at risk and many, many family members are at risk. The fallback notion that it’s a Downtown Eastside problem is really unfortunate. It is people from all walks of life and, as you know, we often see media images of somebody using intravenous drugs in a lane. That is a stereotype and it’s so inaccurate. Many, many people struggle with substance use. UPDATE The Death Review Panel recommends developing a Comprehensive Continuum of Substance Use Care. However, the panel also noted that the majority of those who died had accessed the health care system recently and many for a reason related to substance use and or mental health. That’s concerning. Do you think that there were unrealized possibilities in that encounter that might have resulted in a different outcome for the person using drugs? LAPOINTE The panel didn’t go into it, but certainly we coroners hear often from families that there is still a great deal of stigma, even in the health-

care system, towards people who come in having suffered an adverse drug event or who are known to be substance-dependent. One of the hopes of decriminalization is that, over time, that stigma around drug use – it’s illegal and therefore people who use drugs are criminals and therefore they are bad

people – will go away. But also, a real frustration for medical practitioners is not having resources available. We’ve heard from practitioners who’ve treated someone who’s suffered an adverse drug event or come in for another reason, and they’re really motivated to access safe supply or some kind of treatment

THE DEADLIEST YEAR EVER A PANEL OF 23 subject-matter experts convened by the BC Coroners Service is calling for increased access to a safer supply of drugs and creation of an evidence-based continuum of care to better support substance users and reduce the number of illegal drug-related deaths in BC. The panel was convened in the wake of the deadliest year in BC’s toxic drug crisis, which saw 2,224 suspected drug toxicity deaths in 2021 – a 26 percent increase over the number of deaths seen in 2020. Findings reviewed by the panel show: • the drug supply has become increasingly toxic • deaths are occurring throughout the province • deaths are increasing both in number and in rate • people had frequently accessed medical services prior to an illegaldrug-related death • death rates are higher in rural and remote communities • more drug toxicity deaths occur among younger adults

Read the report BC Coroners Service Death Review Panel: A Review of Illicit Drug Toxicity Deaths on your mobile device

• Indigenous peoples are disproportionately represented in drug toxicity fatalities • in addition to fentanyl, other substances were also detected in most deaths • smoking is the most common method of illegal drug consumption The panel’s advice includes three recommendations: 1. Ensure a safer drug supply to those at risk of dying from the toxic drug supply 2. Develop a 30/60/90-day Illicit Drug Toxicity Action Plan with ongoing monitoring 3. Establish an evidence-based continuum of care The chief coroner has forwarded each of the panel’s recommendations to the relevant ministries and organizations.

program. But there are huge gaps in available services, no options for them and nowhere to refer them because anything publicly funded is so oversubscribed that we’ll put you on a list and hope that sometime in the next few weeks we’ll be able to link you up with a safe supply or get you into a treatment or a detox program. The panel also identified the importance of having a consistent assessment protocol so everybody is really clear that, when somebody comes in, medical practitioners are able to assess their dependency, where they are in their journey, what they might need, and then have evidence-based options in terms of referring them. That currently just doesn’t exist. It’s a huge gap. And we know that medical practitioners are like everybody else. Sometimes they don’t want to treat somebody experiencing substance use. They are nervous about how it might reflect on their practice. My read on the panel’s recommendations is that this is about making substance use a health-care issue that has all of the same training and protocols as any other health-care issue. When someone comes in with certain symptoms, we go through the options, there’s a protocol assessment, and depending on what the protocol says, this is how they are treated. And currently that just doesn’t exist. For so long the investment and energy has been focused on law enforcement and it hasn’t been directed to providing support for people who are substance dependent. UPDATE The Death Review Panel recommends rapidly expanding the safer drug supply throughout the province and in all communities, including rural, remote and Indigenous communities. Where will the supply come from? continued on page 29

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NURSE STAFFING CRISIS What creative solutions are out there to address this chronic problem?

OW OFTEN DO NURSES in BC use the term “working short” each week? “Too often,” says BCNU President Aman Grewal who, before running for a senior leadership position at the union, worked as a site leader at Surrey Memorial Hospital. She knows first hand what it’s like to work in a unit with soaring overcapacity and minimal staffing. “Having to ‘work short’ is embedded into nurses’ experiences in most healthcare facilities these days,” she reports, “and it’s having a devastating impact on our members across the province.” Grewal says BCNU is fully committed to addressing this systemic crisis.

“That’s why we always aim to bring creative solutions to the table in our meetings with government and health authorities,” she reports. “Our proposals include short- and long-term ideas.” The province’s staffing crisis is not new. In fact, the union has been sounding the alarm for years, speaking out in the media and raising public awareness through advertising campaigns. Today, the COVID-19 pandemic has shown that the nurse shortage isn’t just impacting individual nurses and patients, but health-care teams across the entire system. There’s no denying the problem is complex – and one that involves issues of both supply and demand.

VITAL SIGNS

IENs CRITICAL TO NURSING WORK FORCE SUPPLY ACCORDING TO THE SUPPLY FORECAST CONTAINED IN THE MOST recent BC Labour Market Outlook, the province will see a sharp increase in immigrant supply compared to previous forecasts, reflecting an increase in federal immigration targets. About 346,000 new immigrant workers are expected over the 2021-2031 period. This includes both permanent and temporary immigrants. Across industries, immigrants’ share of job openings will increase from 31 percent to 34 percent.

Nurses openings for immigrants and migrants through 2031 Immigrants Migrants from other provinces

RN/RPN Supply 5,190

LPN Supply 1,120

3,080

1,000

Immigration drives higher labour demand as well as labour supply. Immigrants are a vital part of communities across the province. They bring fresh perspectives and new ideas, and contribute to making our communities vibrant, diverse and prosperous. Source: British Columbia Labour Market Outlook 2021 Edition

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Nursing schools are seeing interest soar. In 2021, UBC’s school of nursing received 860 applications for 120 available spots. Douglas College had a one-year waitlist. BCNU welcomed the government’s February announcement of 602 new nursing education seats at 17 post-secondary institutions around BC, but the union also called it a drop in the bucket. “It’s a promising step to tackling the problem, but it’s not near enough seats to accommodate the demand,” says Grewal. “We must also look at retaining nurses in the system right now – and recruiting those who are waiting to bring their skills to the bedside.” The Nurses’ Bargaining Association Employed Student Nurse Program is a good example of what can happen when all parties come to the table to tackle the nursing shortage. Launched in 2001 following negotiations between BCNU, student nurses, employers, educators and the Registered Nurses’ Association of BC, the program is a paid practicum that enables students to gain valuable clinical experience in health care facilities, in either special paid part-time or part-year positions. “The third-and-fourth year nursing students get valuable experience and are an extra set of skilled hands on that shift, supporting patients and providing patient care.” says Grewal. “The program is being well-received because everyone wins.” BCNU has also spent time advocating

“BCNU is fully committed to addressing this systemic crisis.” BCNU President Aman Grewal

for internationally educated nurses (IENs), asking that the government streamline the current, complicated process many must go through before they are licensed to work in BC (see page 21: “Lengthy Process”). Grewal says she’d like to see the province embrace the skills, diversity, and richness of IENs and recognize what they could bring to the healthcare system. “I heard someone say the other day that varied backgrounds, training and skills should be judged as advantages, and I couldn’t agree more,” she remarks. “We know that many of these nurses would be a welcome addition to health-care teams across the province.” Keeping new nurses in the profession is another priority, says Grewal, who notes that BCNU would like to see changes at the health authority level to improve workplace culture, which can sometimes include unexpected redeployment, little orientation, and a barrage of non-nursing duties that take up a nurse’s precious time while on shift. “We have to provide relief and incentives to the thousands of nurses who are close to the brink and considering leaving the profession two years into this pandemic,” adds Grewal. “This could come in the form of more health care support workers, hiring bonuses, pay incentives, and housing subsidies.” The nurse shortage is a crisis being felt across the entire country and globe. As BC manages two public health emergencies, extreme weather events, and a growing and aging population, Grewal says it’s time to come together to preserve the health-care system for the future. “Nurses want to be part of the solution and are ready to come to the table to work with all parties to figure out a way through this crisis,” she says. “This isn’t something that can be fixed overnight – but we must work hard to come up with creative solutions that are focused on improving staffing levels and taking the burden off nurses who are providing care today.” •

the harm. I do hear the colleges saying we need to evaluate, and we need to take time. Ideally, it would be Could there possibly be a recoma slower process. But, in a crisis, mendation about how to access there isn’t a lot of time with six or that supply? seven people dying every single LAPOINTE It’s really going to be day – so it’s about reducing the up to the folks that the panel’s harm and trying to fix supply recommendations were directed for as many people as quickly as to: the Ministry of Mental Health possible. and Addictions, the Ministry of And it means moving from Health and the CEO’s of the health the traditional law enforcement authorities. They need to look model – which has not been at available models and see how effective – to a medical model. quickly we can ramp this up in Or perhaps it’s a compassion terms of meeting the needs of as club model. Maybe that’s the many people as possible. recommendation that needs to We know there have been some come back, with the recognition groups like the Vancouver Area that the health-care system can’t Network of Drug Users and others possibly facilitate all of this. that have been purchasing subMaybe we need a broader model stances on the internet and having and make some recommendathem tested and then providing tions to government about how them to substance users. So, we that might look. Like government know that it’s possible to get subliquor and cannabis stores – who stances on a large scale and it is knows? Maybe that’s what it is. possible to distribute them. But it’s about getting those minds The panel drew a lot of parallels to the table and asking, how do to the COVID crisis, noting how we quickly put together somethat was a crisis which presented thing that is really meaningful to new obstacles weekly, but there prevent death? was an ability to be flexible and I’m so appreciative of the say we want to reduce harm, we work that nurses do, and the want to save lives, and what do we nurse practitioners in particular need to do? Something else has right now, around safe supply come up, what do we need to do because what I’ve heard is that now? where many of the physicians are What came through loud and unwilling, the nurse practitioners clear in the panel’s report was are stepping up and ensuring that this is a crisis. We are losing that safe supply is available, and thousands of people. We will soon sometimes being criticized for it. probably hit 10,000 deaths since We all know that this is a change the public health emergency was that will happen over time and declared in 2016 – and we know there’s a certain nervousness that it was declared because of the around it, in particular with some growing number of deaths before of the regulators. It takes courage that. So, in a crisis, you respond and I appreciate that nurses have by doing what needs to be done the best interests of their patients to prevent the deaths and prevent at heart.•

SAFE SUPPLY SHORTAGE continued from page 27

UPDATE MAGAZINE • SPRING 2022

PROFESSIONAL ISSUES IN THE WORKPLACE

STUDENT NURSES

EXPANDING THEIR HORIZONS BCNU sends students to ‘think outside the box’ at national nursing conference

ERI FORSTER IS a busy nurse. The BCNU North West region council member’s days are spent advocating for a predominantly rural and remote nursing workforce that’s been hit especially hard by the COVID-19 pandemic. Forster knows first-hand how important it is to ensure that new nurses are ready to assume the important work of caring for northern communities – especially with the numbers of current nurses nearing retirement. “Nursing students are the future of our profession and our union,” she says. Forster serves as BCNU council liaison for student members of the union. Every year, she’s proud to help student members attend the

Canadian Nursing Students’ Association (CNSA) national conference. The annual event has become a popular networking and educational event for attendees across the country. BCNU sponsored 21 student members to attend this year’s virtual conference, entitled Nursing Outside the Box. “It’s important to give nursing students opportunities like this that provide extra professional development before they enter the workforce,” says Forster. “We were really pleased to see students engaged in expanding their knowledge even before they reach the bedside,” she said after the Jan. 21-23 event. “For me, their experience reinforces the importance of the union’s role in supporting BC nursing students.” Many of the BCNU-

sponsored conference participants would seem to agree with this sentiment. arcy Sellars is finishing her first year at Langara College. “Do it!” is her advice to other BCNU student members who may be considering applying for a union sponsorship to future CNSA conferences. “This conference was a great opportunity to learn about the different areas of nursing practice, and I really appreciate the support BCNU provided that allowed me to attend,” she says. Sellars grew up on a small reserve in the BC interior and has seen first-hand the health-care inequities experienced by Indigenous communities in rural areas. She has two close-family members who are registered

READY TO LAUNCH This year’s Canadian Nursing Students’ Association national conference inspired more than 20 BCNU-sponsored participants. From left: First-year Langara College student Marcy Sellars, fourth year UBC student Jacquelyn Wang and second year Vancouver Island University student Megan Branch.

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nurses and was drawn to the profession through following their careers, but she says her passion for nursing really grew when her grandparents became terminally ill.

“This was a great opportunity to learn about the different areas of nursing practice.” Marcy Sellars

“They were residential school survivors, and despite their own efforts to improve their health, their lack of trust towards health-care professionals and the system was a real barrier,” says Sellars. “I chose nursing to help address the high demand for Indigenous nurses and build trusting relationships between Indigenous patients and practitioners of western medicine,” she explains. Sellars is also interested in increasing awareness for culturally safe learning environments in both the nursing classroom and clinical settings. Surprisingly, her favourite session at the CNSA conference was a panel on military nursing, which featured, perioperative nursing

officer Adam White, and nursing officers Marissa Hsu and Mathew Wilson, all with the Canadian Armed Forces. “I had very little knowledge of this part of the nursing profession, and the possibilities seem endless,” remarks Sellars. “Nothing is ever the same – you are going to different parts of Canada or internationally, I find that exciting.” acquelyn Wang is in the fourth year of her nursing program at UBC and is actively involved in her student community. “I was a teaching assistant, a nursing student peer mentor, and student orientation leader,” she says. The CNSA conference was Wang’s first, and she admits getting much more than expected. “The line-up included speakers on nurse advocacy, travel nursing, leadership, and other topics beyond the bedside,” she reports. Wang says her “hands down” favourite presenter was The Adventurous Nurse CEO Brennan Belliveau, who hosted a session on travel nursing. “I was born and raised in Vancouver and I have stayed relatively close to home,” says Wang. “It wasn’t until this past year, when some of my Vancouver born-and-raised friends and family moved abroad, that I thought, ‘why not join them too?’ Belliveau’s session gave me more insight on the flexibility and ease of working abroad. I’ve been inspired to venture and see what else

“I’ve been inspired to venture and see what else the world has to offer.”

CANADIAN NURSING STUDENTS’ ASSOCIATION

Jacquelyn Wang

the world has to offer.” Wang encourages other students to adopt the same mindset. “You’ve chosen a truly dynamic profession and you are the narrator of your nursing journey,” she exudes. “Be curious and explore all of the opportunities beyond what’s available through your school.” egan Branch is in the second year of her LPN program at Vancouver Island University. She says that since becoming a BCNU student member, the union has provided her with many learning opportunities that have allowed her to network with nurses around the world and access resources to further her nursing practice. “I apply for every conference we receive information on and want to be an advocate for patients and classmates,” she says. “These conferences are perfect for nursing students,” says Branch. “Having the ability to network with other nurses of various ages, areas, and specialties helps us learn from each other and expand our horizons!” Branch says the pediatric nursing panel, which included several nurse clinicians and practice leaders from major hospitals across Canada, had a significant impact on her. “My goal is to specialize in emergency med-

icine and the panel indicated that pediatric education would help tremendously, as many emergency patients are children.” Branch said all the panelists were extremely knowledgeable, answered many student questions and provided tips for such things as dosage calculations when working with children. “I really enjoyed hearing the amazing experiences they shared and the beauty of the nurse-client relationship, as kids are quite different from adults in terms of care.” One presentation that proved extremely popular was conducted by BCNU manager of professional practice and advocacy Rhonda Croft. Students said Croft’s session, entitled Civility Matters: Self-Care and Choosing Kindness, provided them with valuable insights on how to face workplace incivility and the importance of practicing self-care when enduring challenging working conditions. “Rhonda’s presentation will be offered to student members at an upcoming BCNU province-wide Zoom presentation,” says Forster, who encourages all student nurses to read their BCNU student eNews, so they don’t miss future sponsorship opportunities. •

A bilingual and panCanadian organization advocating for the needs of all nursing students THE CANADIAN NURSING Students’ Association is the national voice of Canadian nursing students. Its goal is to increase the legal, ethical, professional, and educational aspects which are an integral part of nursing. It is actively dedicated to the positive promotion of nurses and the nursing profession as a whole. Since 1971, it has represented the interests of nursing students to federal, provincial, and international governments and to other nursing and health care organizations. CNSA members have the opportunity to interact with other nursing students on educational, professional, and social levels. Members connect with each other through annual national and regional conferences, member forums, and social media. With nearly 30,000 members, the CNSA is an affiliate member of the Canadian Nurses Association and an associate member of the Canadian Federation of Nurses Unions. It also has a reciprocal relationship with the Canadian Association of Schools of Nursing. Interested in becoming a member? Contact the Director of Membership Development at membership@cnsa.ca or visit www.cnsa.ca

UPDATE MAGAZINE • SPRING 2022

FEATURE

MANY HANDS MAKE US UNITED BCNU members are coming together ahead of this year’s steward elections

HEART OF THE UNION Every day, hundreds of BCNU stewards support members in worksites across the province. Are you ready to join them? All BCU stewards stand for election every three years and endorsed by the members they represent.

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F YOU’VE EVER ENCOUNTERED A PROBLEM AT WORK you couldn’t resolve on your own, there’s a good chance you’ve been helped by your steward. Stewards are the heart of BCNU. They’re there to defend contract rights and professional practice standards, and assist in improving workplace health and safety conditions. They also guide members through the grievance process or defend them in disciplinary proceedings. Your fellow co-workers who’ve stepped up to the steward role are a diverse bunch. Some have been nursing for over 30 years, while others are brand new. They are your colleagues from all over the province in every designation and in every health sector, who work to keep employers accountable. But they can’t do it alone. Did you know there are some 1,000 BCNU stewards supporting the union’s work to protect and advance the health, safety, social and economic well-being of our members, our profession, and our communities? It’s an impressive number. But BCNU needs more active stewards. “It is no secret that employers have not been respecting nurses or the collective agreement they signed,” says

BCNU President Aman Grewal. “Keeping an employer accountable is a daunting job for any single steward.” That’s why Grewal is calling on members to join the steward team. She want’s everyone’s work to becomes a little lighter. “Many hands make us united,” she says. “And collectively, if we do our part, we will always achieve positive change.” Every three years, members across the province choose the steward who will represent them – a process that embodies the member-driven values and democratic principles BCNU is founded on. Are you ready to lend a hand? This year, nominations are open May 16 to 30. See page 37 or download the nominee checklist at www.bcnu.org for more information.

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FEATURE

HELPING HANDS

E ASKED SOME BCNU STEWARDS WHY FIGHTING FOR THEIR CO-WORKERS AND workplace is worth it. Are you ready to join them? The responses in the following pages provide insight on what motivates your co-workers to stand up for members like you. Nominations for BCNU steward elections close May 30 and voting takes place June 7 - 10. Consider nominating yourself or a colleague today. And, of course, talk to your steward if you have any questions.

Cory Allen West Kootenay region

LPN, Community and Long-term Care Years nursing: 10 Steward years: 7

I see nurses giving everything they have physically, emotionally, and mentally to care for hurting, lost, scared and fragile people every day. Giving back to fellow nurses who are always giving to others before themselves is rewarding.

Caitlin Jarvis

South Island region LPN, Community Care Years nursing: 12 Steward years: 6

My colleagues give all of themselves to this profession. More time is spent at work than at home with our families and friends. My nurse colleagues are now friends and people whom I admire greatly. Nurses deserve respect, acknowledgement for their commitment, safe workplaces and appropriate staffing. I’m proud to have a small part in advocating for these things and so much more.

David MacVicar

East Kootenay region LPN, Community and Long-term Care Years nursing: 12 Steward years: 8

The nurses in my workplace are not only a part of my community, but as nurses, they support my community. I want to support my fellow nurses as their steward, so they can better focus on nursing.

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Duniya Maiwand

Richmond-Vancouver region LPN, Acute Care Years nursing: 18 Steward years: 5

I consider my workplace my second home. Nursing is an extension of who I am and how I strive to help others. My steward work has become a platform for me to speak on behalf of my colleagues and it allows me to raise awareness about injustices against BCNU members at my workplace. In solidarity, we can overcome any obstacle because a steward’s work is not a ME thing, but a WE thing.

Frank Martens Simon Fraser region RN, Acute Care Years nursing: 8 Steward years: 4

For too many years the employer has acted in bad faith. They have not done enough to ensure the contract language we bargained will be respected. I’m proud to represent and stand up for my workplace colleagues as a steward and ensure nurses are treated fairly. I take pride in the accomplishments I have had in ensuring colleagues receive their due compensation and that their livelihoods are protected.

Rajni Bala

Fraser Valley region RN, Acute Care Years nursing: 3 Steward years: 6

Nurses are the backbone of any health-care system. No system can survive without

nurses. I see my co-workers struggling every day and night and not getting enough support from management. Nurses are working short-staffed and getting physically and mentally injured. Many are not aware of their rights. I came forward to advocate, educate and support them. I’m proud to be a BCNU steward.

Sandeep Dhaliwal

Simon Fraser region LPN, Long-term Care Years nursing: 10 Steward for less than a year

I believe knowledge is power. I became a steward to empower my co-workers by educating them about their rights. They are worth standing up for because I have seen them working very hard to make a difference during the pandemic. They work short-staffed and long hours, sometimes with no breaks!

Adelaide Vinthers

Simon Fraser region RN, Acute Care Years nursing: 34 Steward years: on and off since the 90s

Despite the various challenges we face – especially in the last two years – nurses have continually shown resilience, professionalism, integrity, dedication, and compassion by doing their best in caring and advocating for our patients. They have shown repeatedly how pulling together as a team and supporting each other can get us through the most challenging days and times.

Betty Thomsen

John Brown

RN, Community Care Years nursing: 26 Steward years: 19

RPN, Community Care Years nursing: 5 Steward years: 4

I want my co-workers to be safe on the job and have their rights protected. A safe and happy nurse means better patient care and outcomes.

Brian Stewart

My colleagues work extremely hard, and under great stress to provide exceptional care. It is good to have the opportunity to help those of us who support others. It’s important to me to stand up for nurses and the profession, as it has provided me with a career which supports my family.

LPN, Community Care Years nursing: 6 Steward years: 4

Josselyne Mensah-Wilson

North West region

North East region

My nursing team – Rapid Mobilization Prince George – is worth standing up for because we are out in the community everyday helping people transition back home after being in the hospital. We perform an important role that helps people get home sooner.

Canan (Janan) Duru Coastal Mountain region

LPN, Long-term Care Years nursing: 8 Steward for less than a year

No one was protected from management and members felt left alone. I wanted to change this and ensure that member concerns and problems were heard. Nobody is alone! We are advocates for our patients, and residents, but also for ourselves and colleagues!

Janice Mason

Shaughnessy Heights region RN, Community Care Years nursing: 35 Steward years: 6

I have worked at the bedside for over 25 years and in clinical informatics for the past seven years. In both roles I have been more than honoured to work alongside so many hard working and professional nurses. I’m very proud to call myself a nurse. Nurses deserve a union to support them, I became a steward to represent and support my amazing nursing colleagues.

Pacific Rim region

Fraser Valley region

RN, Community Care Years nursing: 13 Steward years: 2

A lot of nurses, including myself, need education on contract interpretation and application. We don’t always know our rights. I like fairness in the workplace. There are opportunities as we continuously strive for improvement. Far too many times I have experienced and witnessed disciplinary inconsistencies at the workplace. I have watched co-workers stress because they did or didn’t do something. I want to bridge that gap by educating myself and advocating for others.

Brenda Dowell South Fraser Valley region RN, Acute Care Years nursing: 28 Steward years: 3.5

I believe in advocating for my co-workers, ensuring a safe work site. My colleagues are the backbone of the health-care system.

Kassandra Racine

Thompson North Okanagan region LPN, Acute Care Years nursing: 14 years Steward years: 6

I wanted to understand our collective agreement and share that knowledge and understanding with my co-workers. I wanted

my colleagues to have onsite support available to them as they navigated through concerns, issues, and ideas. I wanted to help build a positive environment for my co-workers and between the worker and employer.

Kyla Dres

Thompson North Okanagan region LPN, Acute Care Years nursing: 11 Steward years: 6

I stand up for nursing and my colleagues because they are more than just that – they are my friends and family. Working in a small rural town, we have seen each other at our best and worst moments, and I could not get through each day without the love and support we share with each other. I care about the nurses working now so that nurses will be there to care for us in the future. We all deserve it!

Lily Osekre

Fraser Valley region RN, Community Care Years nursing: 20 Steward years: 4

I went into nursing to help others. Working as a community dialysis nurse is hugely rewarding and fulfills my reason for becoming a nurse. Watching my dedicated colleagues give their all to provide quality care for the vulnerable has driven me to become BCNU steward and fight for both my colleagues and our patients.

Lindsay Willoner

North West region RN, Community Care Years nursing: 16 Steward years: 10+

I’ve worked in public health my whole nursing career. Public health nurses in the north are scarce, and hard to recruit and retain. I have the pleasure of working with brilliant colleagues who bring a wealth of knowledge from diverse backgrounds across the health authority. The pandemic has shown how truly important the leadership role of public health nursing is, and how we strive for upstream health and well-being.

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FEATURE

Lisa Yaremy Vancouver Metro region RN, Acute Care Years nursing: 7 Steward years: 2

We all work together as a team and help each other out. Whether it’s patient care or our own mental health and wellness, we are there for each other and that is worth standing up for! I’ve always felt supported by my co-workers, whether I’m new on the unit or back from maternity leave. I love to return the favor by supporting them when I can!

Michael Pluegge

Fraser Valley region RN, Community Care Years nursing: 7 Steward years: 1

Nurses are worth standing up for as we have a crucial role in the health-care system. Yet, we are not always valued.

Miranda Nichol East Kootenay region LPN, Acute Care Years nursing: 12 Steward years: 1

We have a small but bustling rural hospital where everyone from new babies to people over 100, both local and non-local, rely on us for care and treatment. With an influx of yearround tourists to our beautiful community we need to a strong, well trained, and capable team. Go Invermere!

Mona Hinds Thompson North Okanagan region RN, Acute Care Years nursing 25 Steward years: 5

The nurses at Royal Inland Hospital are so committed to patient care and advocacy, I became a steward to be able to do the same

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for them. My goal is to use the knowledge I have gained as a steward to support my fellow colleagues through the many challenges that arise within our work environment, whether it’s a health and safety issue, a contract issue, or other concern.

Scott McCaughran

to be proud of who they are and to join the BCNU Human Rights and Equity caucuses. Supporting fellow nurses is a passion of mine.

Vanessa Chong Central Vancouver region

Pacific Rim region

RN, Acute Care Years nursing: 4 years Steward for less than a year

RN, Acute Care Years nursing: 6 Steward years: 3

As a nurse, I have always been an advocate for my patients. Now, as a steward, I can be an advocate for my fellow colleagues too!

My nursing colleagues are my work family, a team of close-knit people that form the foundation of our unit’s culture. It is worth standing up for our team who consistently rise to the occasion to overcome significant challenges in our profession and workplace.

Shanaz Ali

South Fraser Valley region RN, Acute Care Years nursing: 30 Steward years: 15+

Advocating for my colleagues and patients gives me a sense of fulfillment. The nurses at Surrey Memorial Hospital are passionate and have the drive to make positive changes. I’m confident we can empower one another as we stand together.

Treena Sinclair

North East region RN, Acute Care Years nursing: 12 Steward years: 10

I enjoy being a steward so I can support new nurses and fellow co-workers. I try to be a person people can talk to, and I encourage my colleagues to take part in our union. I work hard to empower all nurses to be the best they can and give them information on how to say no to such things as workplace violence or bullying. I encourage people

Vienna Kan

Central Vancouver region RN, Acute Care Years nursing: 7 Steward years: 1.2

I really want everyone to know that nurses are not just nurses. We are everyday lifesaving heroes who have been relentlessly battling every second at work, even pre-pandemic. Why does it take a pandemic to realize how essential nurses are and that we deserve the most basic and fundamental respect? I know I only live life once, and standing up for nurses makes it meaningful, worthwhile, and fulfilling.

Wanda Remfert

Okanagan Similkameen region RN, Acute Care Years nursing: 28 Steward years: 14

I stand up for nurses because I believe we must speak collectively and elevate each other professionally. We care for humanity, and we must also take care of each other so that we can continue supporting public health care, our patients, and our communities.

WHY BECOME A BCNU STEWARD? You will help secure a safe, healthy and respectful workplace AS A STEWARD, YOU WILL BE ABLE TO WORK proactively with management and advocate for BCNU members. You will gain knowledge and develop skills to help you use BCNU’s problem-solving tools (grievances, PR process, JOHS committees, and union-management meetings) and resolve workplace concerns. You will feel the satisfaction of doing important leadership work that directly benefits you and your colleagues.

YOU WILL CREATE A FAIRER AND MORE EQUITABLE WORKPLACE As a steward, you have the power to make a real difference in your workplace. Our collective agreements are powerful contracts that set the rules for fair and equitable practices. Stewards are the leaders who make sure these rules, and other rules related to fairness and equity (like human rights legislation), are respected in the workplace. YOU WILL UNDERSTAND YOUR RIGHTS — AND HELP OTHERS UNDERSTAND THEIRS Your union has fought to include hundreds of rights in your collective agreement. Throughout the career of any member, these rights can make a big difference, at work and beyond. As a steward, you will come to understand these rights and learn how to advocate effectively for others.

YOU WILL ACT AS A STRONG ADVOCATE FOR PATIENTS Good working conditions for nurses and other health care workers help to ensure patients receive the care they need. As a steward, you do work that directly impacts patient care – from monitoring safety concerns and ensuring staff get the breaks and leaves they deserve, to speaking out on staffing issues.

These educational opportunities are accompanied by multiple opportunities each year to gather with other stewards from across your region and the province to share ideas, support one another’s efforts and build strong relationships that often last a lifetime.

YOU WILL RECEIVE SUPPORT, MENTORSHIP, AND OPPORTUNITIES TO GROW Stewards are asked to commit to a three-year term. Over the first year you will learn the basics of the steward’s role. During the second year you may discover a passion and choose to specialize in a particular area of steward practice, growing your skills and knowledge in new directions. By the third year, you will have mastered many skills and be ready to take on new roles and mentor others. As you map out and travel on this journey, you will receive support and mentorship from others on your team, and from the labour relations officer (LRO) assigned to your worksite. LROs bring a wealth of experience with grievances and any issues that are proving hard to resolve, so stewards know they can seek support in the work they take on.

YOU WILL CONTRIBUTE, WHATEVER YOUR STRENGTHS There is no one type of person who makes the perfect BCNU steward. Every steward contributes their own experience and skills, and steward teams benefit from this diversity. Some of our most effective stewards are quiet people, with strong listening skills or creative minds. They are very powerful in grievance meetings. Others are very social – they are great at networking, and keeping their finger on the pulse of the worksite. What is required of those who step up to the steward role is a strong desire to grow and learn, to be a role model and leader at the worksite and to advocate for yourself, your colleagues and for safe patient care.

YOU WILL RECEIVE VALUABLE EDUCATION AND TRAINING As a steward, you will receive a wide variety of training that prepares you for the work you do. This high-quality education, reinforced by the leadership experience you will gain, will increase your competence and confidence in a number of areas that go well beyond your steward work – from effective advocacy and presentation skills to the ability to handle conflict and communication well.

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MEMBER EDUCATION

TURNING TEACHING ON ITS HEAD BCNU supports stewards and members with innovative approaches to learning

AVE YOU EVER SAT through a classroom lecture, however engaging, and forgotten much of what you learned after leaving class? You’re not alone. Traditional classroom settings often regard learners as passive. Students take notes quietly and leave to work through assignments on their own. And without help, they may submit projects based on ideas they haven’t fully absorbed or understood. This teaching method can have significant negative impacts. Learners are often at risk of falling behind, and if they do, some become hesitant to ask questions and withdraw from discussions to mask their knowledge gap. Engaged class participation then declines. Flipped classrooms seek to solve this problem by moving from instructor-led and lecture-based learning to ones where students review information beforehand, and then learn with a facilitator in the classroom. Unlike the conventional classroom, a flipped class sees facilitators pre-recording presentations on the skills they want to teach, and then helping participants learn these skills in a live setting. This flip means the facilitator is no longer a straight-up provider of information, but a coach who supports skills development, and who challenges participants to test new ideas and consolidate information. “We are very pleased with the success of the flipped classroom,” says BCNU President Aman Grewal.

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“When workplace leaders and stewards get support that’s accessible and caters to diverse learning needs it means they are more confident in their roles as member advocates.” BCNU began to use blended and flipped classroom offerings to support learners at the onset of the COVID-19 pandemic. Members and stewards learn asynchronously (working independently at own pace) and synchronously (facilitator-led real-time classes). In this style of learning, students take the time they need to understand the material before coming to a group setting, where they join cohorts on a learning path that’s designed to build community, increase retention, and foster engagement. Having self-paced, on-demand pre-learning means the many nurses who work long and varied shifts can access educational opportunities when it suits their schedules. BCNU’s online events calendar offers a variety of workshops, skill labs, classes and multiple day courses for members and stewards in topics such as Pensions, Occupational Health and Safety. The union also provided focused offerings to help stewards build skills required for their union role. One recent graduate of the two-day blended Steward Essentials course appreciated the flexible format. “I

loved the hybrid delivery model,” they wrote in an anonymous post course evaluation. “Online modules and working from home on my schedule allowed me to feel focused, engaged and totally prepared for the in-person sessions.” BCNU members are becoming accustomed to using information technology in a learning environment. In recent BCNU post-class evaluations, members reported enjoying the interactive elements and group activities via Zoom. For example, skill lab participants are required to review an asynchronous online learning module (AOM) and prepare thoughts before attending a live session, which expands on the knowledge base through group discussions, breakout room activities and live engagement exercises. “The activities and interaction helped keep me engaged and focused” says one former student. “I really loved the platform and how the course was laid out with a wide variety of reading, videos and quizzes.” Whether in person, online or a combination of both, BCNU classes, workshops and skill labs offer learners a chance to connect with colleagues and problem solve common workplace issues, which fosters solidarity and strengthens stewards’ ability to advocate for members in the workplace. • FLIPPED CLASSROOM New BCNU education offerings help members learn new skills in a live setting.

THE HANDS THAT UNITE BCNU acknowledges and honours the invaluable work of our steward team – especially during the COVID19 pandemic. The daily leadership and support they provide to members is vital for our success. Aaron De La Espriella, Adelaide Vinthers, Alana Eberts, Alana Williams, Alexa Caton, Alexis Ingham, Alfredo Pangan, Alison Alldritt, Amanda Friesen, Amanda Watt, Amandeep Turre, Amber Kravontka, Amrita Alexiev, Amy Gee, Amy Riley, Andrea McKinnon, Andrea Schulte, Andrew Lamb, Angela Crawford, Angela Falk, Angela Lamoureux, Angela Merrick, Anissa Roadhouse, Anita Dickson, Ann Chin, Ashana Ramsay, Ashley Henry, Ashley McLoughlin, Ashley Nyberg, Ashley Schuhmann, Benjamin Woywitka, Bobbie-Jo Allen, Bonnie Balam, Bonnie Snesar, Bonnie Lynn Meharey, Brandy Selluski, Brenda Dowell, Brenda Neufeld, Brian Stewart, Brittany Carroll, Brooke Kallen, C O’Donnell, Caitlin Jarvis, Cameron Rose, Canan Duru, Candace Maines, Carelle McKellan, Carlene Jenkinson, Carol-Ann Lonsdale, Carrie Tamblyn, Catherine Casey, Catherine Collicott, Catherine Nocente, Catherine Saretske, Catherine Tanski, Celeste Young, Cesar Balce, Chenoalyn Le Gresley, Christa Maguire, Christina Poirier, Christine Green, Christine Smith Zakrzewski, Christine Svendsen, Christopher Burnett, Cindy Gaita, Cindy Merrett, Cindy Webster, Claire Jaenen, Cody Gregg, Colette Thucydides, Colin Spangl, Colleen Clow, Cory Allen, Courtney Carroll, Crystal Andrew, Crystal Ferreira, Crystal Jodouin, Crystal Sheridan, Cynthia Dumont, Dalia Loewen, Daniel Gitaari, Danielle Semple, Danielle Westwick, Danika Butcher, Dari Bennett, David Callahan, David MacVicar, Dawn Terrill, Deandra Grist-Cormier, Deanna Waslewsky, Deborah Bradshaw-White, Dianne Fowlie, Dolores Gwerder, Dolores Nohr, Donna Seva, Doreen Konno, Dulce-Corazon Myles, Duniya Maiwand, Dustin Mackay, Eduard Armeanu, Elaine Walker, Elizabeth Caines, Elizabeth Gignac, Elizabeth Thomsen, Erin Hay, Erin Roulette, Eugenia Diogo, Eva Wiercinski, Evgeniya Liferovich, Evie Lastovicka, Farana Munif, Faranak Amouei, Farideh Bozorg, Feruza Abdjalieva, Florentina Agpalo, Frances Chan, Francis Kopieczek, Frank Martens, Frederick Smith, Gerald Dyer, Gordon Wilson, Hanna Embree, Harleen Nijjar, Harpal Birdi, Harwinder Dherari, Heather Davis, Heather Lawrence, Helen Goodwin, Honeylette Abesamis, Huy Nguyen, Jacquesline Goodman, James Mowry, Jamie Birch, Jamie Schumacher, Jane Straker Gray, Jane Violet Beech, Janice Mason, Janice Stevens, Janille Wingson-Gore, Jasmin Pinto, Jason Kent, Jaspal Sidhu, Jay Hamilton, Je Punzalan, Jennifer McPhee, Jennifer Nelson, Jennifer Powell, Jennifer Price, Jennifer Ruel, Jennifer Turner, Jennifer Waterhouse, Jeremy Hudson, Jesse Wuerch, Jessica Byrne, Jill Howarth, Jillian Christjansen, Jin Yu Liu, Joanne Hamberg, Joanne Ord, JoAnne Ratchford, John Brown, Jolene Cowden, Jordanne Ru , Joseph Andrian Siriban, Josselyne Mensah-Wilson, Julie Markovic, Julie Mathieu, Kaila Ingram, Kamini Gounder, Karen Everitt, Karen Winters, Kari Walker, Karishma Sekhon, Kassandra Racine, Katelyn Newell, Katey McLellan, Katherine Hamilton, Katherine Morgan, Kathleen Haberlin, Kathleen Ibbetson, Kathryn Larden, Katie Rosa, Kelly Williams, Kent Fourneau, Kerrie McHugh, Kimberly Magnant, Kimberly Thompson, Krisha Dodds, Kristin Kidd, Kristina Schwenning, Kristy Dunham, Krystal Fergus, Kuljeet Bains, Kyla Dres, Lanie Fajardo, Laura Campbell, Laura Dion, Laura Morgan, Laureen Engelmyer, Laurie Schmidt, Leah Trudeau, Lee Frederick, Lesley Johnson, Letitia Trevelyan, Lilibeth Colet, Lily Osekre, Linda Mitton, Lindsay Willoner, Lisa Yaremy, London Vaughan, Lori Fredin, Lori Schaefer, Lorna Crooks, Lynden Lehman, Lyndini Lasdoce, Lynn Goodman, Mabel Walcott, Maddy Steventon, Madison Beedller, Magali Krische, Mandy Kohinsky, Manpreet Kajla, Marcelina Lidiard, Marcia Wright, Maria Buchmann, Maria Wort, Maria Lyanne Lamanilao, Mariam Saqib, Marianne Pitt, Maribeth Ito, Marilia Cordeiro, Marlee Emery, Marlene Albutra, Marlon Miguel, Martin Lapaire, Martin Leonard Quero, Mary Dexter, Mary Beth Wells, Mary-Anne Leader, Mary-Jeanne Tremblay, Marylin Daet, Mary-Louise Lazatin, Meenakshi Sareen, Megan Butler, Meghan Valouche, Melanie Simpson, Melissa Clint, Melody Pawlo , Michael Pluegge, Michelle Malabuyoc, Michelle Robertson, Michelle Rodriguez, Michelle Schnittker, Mildred Vicente, Miranda Nichol, Mirian Hanninen, Mitchel Perepalkin, Moi Tan, Mona-Lynn Hinds, Morgan Manchip, Myra Noga, Nasrin Khanmohamady, Neelya Krikke, Nicholas Landstrom, Nicole Abbott, Nicole Burnett, Nicole Eustis, Nicole Ong, Nieves Velasco, Pamela La2eur, Parminder Bagri, Patricia Cameron, Patricia Sladecek, Patsy Grund, Patti Myroniuk, Paula Gilberd, Pei Shiang Lo, Penny Suen, Peter Gill, Peter Herd, Prabhdeep Grewal, Priscilla de Medeiros, Qi Ling Wu, Rachael Hodgson, Radhika Khosla, Rafael Chicopa, Rajni Bala, Ramona Ludwar, Randi Hill, Raquel Sandoval, Ravinder Singh, Ravneet Grewal, Reanne Laurie, Rebecca McTavish, Rebecca Miller, Rebecca Shardlow, Reynaldo Antonio Ortiz, Richard Massey, Rise Ford, Robert Blatchford, Robert Davis, Robert Fitch, Robert Labelle, Roberta Peterson, Rochelle Neid, Roger Normandeau, Romy Durand, Ronald Pachet, Rosaline Kennedy, Rupinder Dhaliwal, Ryan Kean, Ryan Thomas, Sabrina Mattson, Saeed Atashband, Sally Chiu, Samantha Martin, Sameer Arora, Sandeep Dhaliwal, Sandra Dessau, Sandra Meeres, Sandra Ramos, Sara Homer, Sara Kilburn, Sarah Flello, Sarah Pelow, Sarah-Kaye Gabel, Sarah-Zoe Pichette, Scott McCaughran, Scott Smith, Seone Fuller, Shalini Sudhakar, Shanaz Ali, Shannon Andruchiw, Shannon Buhler, Shaunice Brown, Shelby Gustafson, Shelley Amos, Shelley Knowles, Shelley Lynn Davies, Shelly Cousineau, Sherri Ng, Sherry Roberge, Shirley Balzarini, Shirley McCallum, Shiva Mehrzad, Simmi Parmar, Siobhan Williams, Sonia Tamblin, Stephen Russell, Steven Cli e, Sukhwinder Jagpal, Susana Lawton, Tamara James, Tanja Bergen, Tannis Keteca, Tanya Karateew, Tanya Olsen, Tara Green, Tara Jantzen, Taryn O’Genski, Tashnumaity Minwalla, Tatjana Bosche, Teresa Christo ersen, Terra Christison, Tessy Chalissery, Ti any Bellerive, Tova Edwards, Tracey Bellows, Tracy Ross, Treena Sinclair, Ugochi Ibediro, Valerie Williams, Vanessa Chong, Vanny Mei Kwan Ngai, Vicki Montgomery, Victoria MacDonald, Victoria Staples, Vienna Kan, Vivien Simons, Wanda Remfert, Wen Wang, Wenjun Gao, William Chambers, William Glaspey, William Howe, Xuemei Su

MANY HANDS MAKE US UNITED Stewards are BCNU members like you. They’ve stepped up to help ensure members’ rights are respected as they deliver safe patient care. But they can’t do it alone! Join your colleagues who’ve already become active BCNU stewards by nominating yourself or encouraging a co-worker you respect to consider this role. Together, let’s ensure the employer respects and honours the collective agreement. Download the nomination checklist at www.bcnu.org Nominations period opens at 12 pm noon on Monday, May 16 and closes at 12 pm noon on Monday, May 30. A worksite can have more than one steward.

Steward elections take place online June 7-10, 2022 Every effort has been made to ensure the list on the left is accurate as of March 31, 2022. If there are errors or omissions, please accept our apologies and contact the BCNU membership department UPDATE MAGAZINE • SPRING 2022 with the necessary corrections.

HEALTH & SAFETY IN THE WORKPLACE

NEW DIRECTIONS FOR WORKSAFE BC?

More than two years after landmark report, nurses hopeful the province will act on recommendations to improve BC’s workers’ compensation system

IT WAS OVER TWO YEARS ago, just prior to the COVID19 pandemic, that a formal, independent review of BC’s entire workers’ compensation system was released. Led by Janet Patterson, a labour lawyer with a history of representing workers, the review would be a comprehensive look into the WorkSafeBC’s compensation process. The submitted report, entitled New Directions: Report of the WCB Review 2019, was seen by BCNU and other unions as a positive, significant step in the right direction for thousands of people who’d suffered injury at work and had struggled through a complicated and often discriminatory compensation process. The Patterson Report is unique. Its terms of reference required an open, public consultation process, unlike previous reviews that heard primarily from regular stakeholders and insiders familiar with WorkSafeBC processes. The review involved a wide range of persons using a number of methods, including public hearings, written submissions, online responses and a range of party consultations. The report drew on numerous first-hand accounts

from nurses and other workers, and presented a number of significant recommendations on how to best improve the compensation system so that it better serves the needs of employees around the province. The Patterson review was years in the making, and widely seen as an ambitious undertaking. It was the first major review since the 2002 Winter Core Review and the legislative changes that followed under the previous Liberal government. Now, three years after its release, BCNU President Aman Grewal says it’s time to enact the Patterson Report recommendations. “We want to see the recommendations, especially the legislative recommendations, be enacted,” she says. “It is well known that nurses and health-care workers have among the highest injury rates in the province. The report is

aimed at reflecting the needs of all injured workers.” After consulting over 200 presenters, the reviewers found that the existing WorkSafeBC process was extremely complex and often left out workers whose injuries or recovery fell outside the board’s “pre-determined” guidelines. They also raised concerns that WorkSafeBC often disregarded medical evidence, discriminated against workers who had difficulty understanding the board’s legalistic decision letters, and made it hard for people who didn’t speak English as a first language. Reviewers also found that there was little communication between WorkSafeBC and an injured worker before a decision was made, that WorkSafeBC showed an overall lack of respect toward claimants, and that a complicated claims process often meant

“I’m sharing my story with the hope that government is listening, and things will change.” BCNU President Aman Grewal

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workers required legal counsel to help them navigate it. When it came to return to work (RTW) and vocational rehabilitation issues, the report recommended that WorkSafeBC adopt best practices RTW guidelines that include providing established training for staff whose disability was being accommodated or who were receiving disability management services. It also recommended that WorkSafeBC initiate vocational rehabilitation programs for immigrants, older workers and younger workers. Recognizing workers’ long-standing lack of confidence in WorkSafeBC, the report’s authors recommended that a Fair Practices Commission independent of the WorkSafeBC board be created to address both individual complaints and systemic issues. The report addressed workers’ mistrust in WorkSafeBCarranged medical exams by recommending the creation of a Medical Services Office that would look at individual cases and arrange medical exams from a roster of approved physicians. By and large, the review process validated what many injured workers have known

for years – that a more “worker-centric” delivery system would provide injured claimants with the services and assistance they need and with the respect and dignity that they deserve.

PANDEMIC MEANS REFORM MORE URGENT THAN EVER

In the more than two years since the COVID-19 pandemic began, it’s been hard to miss the devastating toll the crisis has taken on nurses who’ve been on the frontlines of the health-care system, and providing care under challenging circumstances. The stress and strain of COVID-19 has only been compounded by crushing workloads, fear of violence, dangerous working conditions, and a crippling staff shortage. The spike in nurses’ mental health claims is proof to this unfortunate reality. WorkSafeBC claims rose 58 percent over the last two years, to 784 during the height of the pandemic in 2021. “Nurses have been working incredibly hard throughout this pandemic and they have reached a breaking point,” says Grewal. “In fact, our latest internal survey conducted last spring found 83 percent of nurses said their mental health had suffered because of the pandemic.” Grewal says supporting nurses’ mental and physical health remains BCNU’s top priority, and it’s one of the main reasons she wants the government to implement the legislative changes recommended in the New Direction report. For Grewal, the report hits close to home. During the review process, she lent her own, personal story as a worker with a disability – one of several BCNU members

who took part in consultations. Grewal told Janet Patterson about the difficulties she faced when trying to make a WorkSafeBC claim after suffering a serious back injury at work. “I injured my back in 2009 and again in 2012 and had to undergo multiple surgeries after that as a result,” says Grewal. “I was off work for a number of months and was in pain and unable to walk. On top of all that, I found myself having to deal with the complicated, frustrating and demoralizing task of having to navigate the WorkSafeBC process.” Grewal says explaining her traumatic experience to Patterson made her feel acknowledged, and she was pleased that her story was included in the final report. “I felt listened to,” she says. “When you’re an injured person and facing financial hardship because of your condition, the last thing that should happen is for WorkSafeBC to treat you as a case number and not as a human being.” BCNU has a particularly good track record when it comes to WorkSafeBC advocacy and has spent years speaking on behalf of nurses who’ve suffered injury at work. In the summer of 2019, the union was invited to Victoria to participate in an in-person hearing while the Patterson Review was underway to give an impassioned presentation on the union’s commitment to keep nurses safe through increased awareness, violence prevention measures, and ensuring the principles, tools and guidelines that make up the National Standard for Psychological Health and Safety were implemented in workplaces across the province. BCNU had recently been successful in its hard-fought win to have nurses included in the list of eligible occupations that have the presumption of a workplace mental injury. This was a big gain for the continued on page 43

RETURNING TO A WORKERCENTRIC APPROACH THE PATTERSON REVIEW OF WORKSAFE BC’s practices and culture found that the organization has not adequately considered injured workers’ circumstances while seeking to fully maximize their recovery. The report calls for a shift away from WorkSafeBC’s current “insurance” model to one that is worker-centric, where people are treated with dignity and offered effective returnto-work services. To make this shift, WorkSafeBC requires improvement in three essential areas: 1. RESPECTFUL COMMUNICATIONS All stakeholder communications should occur through the use of email, plain English decision letters, and supported on-line multilingual services, and with an established code of conduct for fairness and service. 2. CONSIDERATION OF INDIVIDUAL CIRCUMSTANCES AND EVIDENCE BC Decisions should be made on the “merits and justice” of a case. Clear guidance should exist on the use of embedded disability guidelines for consistency in decision-making. There must be improved internal processes for the collection and weighing of evidence, including the use of individualized assessment and case management for concussion injuries. Injuries from violence in the workplace cannot be dismissed as “part of the job.” 3. PATIENT-CENTRED MEDICAL CARE Medical evidence must be accessible and credible, and medical disputes resolved quickly, ideally through collaboration. This means: • The worker is treated by the caregiver of their choice who delivers a treatment plan that is minimally supervised by WorkSafeBC Clinical Services. • WorkSafeBC Clinical Services is re-established as a separate division. • WorkSafeBC medical advisers will consult and collaborate with treating physicians but not provide opinions on adjudicative matters. • Medical disputes will first be addressed informally before involving an independent medical examination.

UPDATE MAGAZINE • SPRING 2022

HUMAN RIGHTS & EQUITY STRONGER TOGETHER

EQUITY MEANS ACCESS

of individuals coming to BC for the purpose of receiving health-care services at public Advocates fight to end BC’s three-month health expense. Blair disagrees with the govcoverage wait period for people arriving or returning ernment’s rationale. A BCNU from outside Canada member and nurse practitioner student who has worked in the NURSES AND OTHERS three provinces – the others are a collective of health-care and community for over 10 years, welcomed the provincial Ontario and Quebec – that deny community workers who advo- she’s seen the harm the policy government’s elimination of up to three months of health cate for access to services for has caused. Medical Service Plan (MSP) coverage to people arriving all, regardless of immigration She knows that most new monthly premiums at the or returning from outside of status or documentation. immigrants, temporary beginning of 2020. It was a pos- Canada. This exclusionary “The journey of migraforeign workers and even itive step to provide barrier-free wait period prevents new tion puts people in a place of returning Canadians will access to health care in the immigrants, temporary foreign significant vulnerability,” says delay accessing care. This province, replacing a punitive workers, returning Canadians Sanctuary Health collective is evidenced by the spike in and regressive tax on care. and even some newborn member Natalie Blair. “And to physician billings in the fourth But advocates say further Canadian babies from receiving then be barred access to care month of an immigrant’s stay, improvements are needed to needed health-care coverage. means they delay seeking help demonstrating that delaying ensure that the delivery of health Sanctuary Health is one for their health concerns.” care leads to greater potential care in BC is truly fair. One of organization that’s urging the According to the BC govern- system-wide costs as illnesses these would be the removal of the provincial government to end ment, the wait period protects progress and advance. three-month wait period. the mandatory wait period. The the province’s health-care sysBCNU member Sarah At present, BC is one of only grassroots community group is tem by reducing the likelihood Reaburn is a nurse who’s working to improve health access for migrant, immigrants and refugees who may be unsure or fearful of accessing health care in a new country. She has worked at Vancouver’s Elizabeth Bagshaw Clinic, BC Women’s Hospital and the BC First Nations Health Authority. During the course of her nursing and midwifery work, Reaburn reports seeing people without MSP coverage struggle to access preventive care during their pregnancy due to an inability to pay or a fear of deportation. Often clients delay accessing care until later in their pregnancy or illness, or they may opt out of tests they can’t afford. She says this is stressful for both patients and nurses, many of whom are already experiencing high rates HEALTH CARE FOR ALL Sanctuary Health collective volunteers Maria Paralta and Natalie Blair believe all people, regardless of legal status, have the right to access health care without fear. of burnout.

SPRING 2022 • UPDATE MAGAZINE

“There is moral injury and moral distress that’s put on nurses, physicians and midwives and all of the front-line health-care workers who are trying to patch together what they know is insufficient care,” says Reaburn. “Providing lessthan-standard care to people causes a huge amount of burnout and also costs the system a lot more.” Blair explains that if immigrants and migrants from other provinces do choose to access care before their MSP coverage starts, they are encouraged by the government to purchase private health insurance. But she says that is unaffordable for most. “All people, regardless of immigration status, deserve dignified access to care and a place in the community,” she argues. Blair reports that Sanctuary Health recently submitted a policy study and letters supporting the organization’s position to the BC Medical Services Commission, the statutory body tasked with ensuring that all BC residents have reasonable access to care. And in December 2021, the organization partnered with UBC’s the Centre for Gender & Sexual Health Equity to send an open letter to the BC government sharing new research supporting the immediate repeal of the wait period. The research evaluated the impacts of a residency-based wait period for health insurance coverage on lived experiences of health and settlement for immigrant and migrant women in BC. Conducted in

NEW DIRECTIONS FOR WORKSAFE BC? continued from page 41

“All people, regardless of immigration status, deserve access and dignified access to care and a place in the community.”

union and for nurses as it finally recognized that the predominant cause test that had been applied to mental disorder claims discriminated against workers suffering from psychological injuries.

Natalie Blair

the Metro Vancouver area from July 2018 to January 2020, researchers collected data from community focus groups made up of service providers, and racialized immigrant and migrant women. According to the study, the wait period resulted in mistrust and internalized stigma for the research subjects, who reported feeling undeserving of care. The study also found that participants were confused as a result of being uninformed about the wait period prior to arriving in Canada, and they struggled with the paperwork. This led to the delay of care, particularly related to sexual and reproductive health and children’s health. Community-based organizations could provide support in many areas but could not fill all gaps produced by the wait period, the report found. BCNU was one of the organizations that endorsed last December’s open letter to the government. The union supports the call to end the wait period as part of its belief that all people in the province deserve access to high quality health-care services whenever they need them. “By removing the wait period, the government could help ensure all people in the

province are treated equally and with respect, no matter when they arrived,” says BCNU Vice President Adriane Gear. Blair says there is a precedent to remove the threemonth wait period, noting that in 2007 BC waived the wait period for MSP coverage for Canadian military families moving to BC from overseas. She also points to the principles that are the foundation of the Canada Health Act, and which govern provincial public health insurance systems. One of those principles – accessibility – is clearly breached by the wait period, she argues. In the meantime, Blair and Reaburn encourage other nurses to be vocal about their commitment to their patients and want to remind them about the importance of nurse advocacy and focusing on the social determinants of health. The two are exploring opportunities to host workshops on issues surrounding the provision of care to for people without health coverage. Reaburn says it’s a complex and nuanced topic and admits there is a range of opinions. “Part of our role as nurses is to encourage systemic change that will ensure the best quality of care for all patients,” she says. •

THE PUSH CONTINUES

Today, it is more important than ever that the New Directions recommendations be enacted. To this end, BCNU’s senior leaders met with Labour Minister Harry Bains this April to reaffirm the union’s position that workers be listened to and that the report recommendations be enacted. During the meeting, Grewal brought the perspective of both a union president and a worker with a disability who is committed to speaking for others who don’t have the platform to bring about change. “It’s very difficult having to jump through all the hoops you have to go through to fight for yourself, when you are already injured,” says Grewal. “I realized that there must be thousands of nurses that have gone through the same thing, so I’m sharing my story with the hope that government will listen, and things will change.” Grewal has a simple message for those injured nurses who are dreaming of one day returning to the job they love – but are currently wading through a WorkSafeBC process that lacks empathy. “Involve BCNU as much as you can and just advocate, advocate, advocate.” •

UPDATE MAGAZINE • SPRING 2022

HUMAN RIGHTS & EQUITY STRONGER TOGETHER

EQUITY AGENDA Caucus chairs share their advocacy goals for the year ahead BCNU’s STORY IS ONE OF BRINGING ALL MEMBERS together to face our shared challenges and achieve the fairness and respect we would not be able to attain individually. Fairness is a value we can all relate to. But we must also be aware of the ways that discrimination and injustice are present in our union and work to make space for marginalized members. To that end, BCNU proudly supports six human rights and equity groups as we strive to make our union a safe and welcoming place for all. Four are equity-seeking caucuses, including the Indigenous Leadership Circle, the Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) Caucus, the Mosaic of Colour Caucus and the Workers with Disabilities Caucus. Two are non-equity seeking groups: the Men in Nursing Group and the Young Nurses’ Network. All of these groups operate under the auspices of the BCNU Human Rights and Equity Committee. BCNU Vice President Adriane Gear chairs the committee, a role she says she’s proud to play since being elected this February. “From a values-based perspective I have always believed that silence is complicity,” she says. “I need to use my voice to advocate for others and to use the power of our union to amplify that voice.” Gear admits it’s been difficult to come to terms with how rampant systemic racism and bullying are for some members and stresses the need to move from performative to authentic allyship “I feel like we need to lead by example,” she says. “I’m motivated to use the benefits of my position to advocate for our members.” Gear says the equity groups were established according to the principles of the BC Human Rights Code and work to support members who may feel less welcome and find participation more difficult by giving them a space to speak freely about issues that matter to them. Members often identify with more than one caucus, and they frequently seek opportunities to productively engage with each other out of a profound and sympathetic commitment to justice and equity. Update Magazine asked the chairs of each group to share their advocacy and activism agenda for the year ahead. Here’s what they told us. •

SPRING 2022 • UPDATE MAGAZINE

SETTING PRIORITIES

Update Magazine asked BCNU Human Rights and Equity Committee members about the issues they are focused on in 2022. Here’s what they told us.

Catherine Tanski

Chair, Indigenous Leadership Circle

Catherine Tanski says there is a general feeling among members of the Indigenous Leadership Circle (ILC) that the voices and perspectives of many First Nations, Métis and Inuit nurses are missing from important conversations that affect them. “Indigenous peoples continue to fight for their rightful place in Canadian health care,” she says. “The resilience and resourcefulness of Indigenous nurses can make a significant impact on nursing, and we should have opportunities to contribute routinely to our areas of expertise.” She says ILC members are concerned about the lack of support and education for cultural safety and would like to see health employers include Indigenous nurses in the development of mandatory training for their nursing colleagues. The ILC is also calling for the creation of an employer policy to address workplace racism, with clear-cut consequences for those who are bullying or harassing others. Tanski says the ILC will continue calling on all BCNU members to stand with their Indigenous colleagues to end racism in the workplace.

Jessy Dame

Chair, LGBTQ Caucus

Confronting phobias and discrimination based on gender and sexual expression is an ongoing task – and LGBTQ caucus chair Jessy Dame believes BCNU can take a leadership role on the issue by listening to the voices of caucus members. “For so long we were kind of tokenized. Now our issues are being brought to the forefront and respected.” Gender discrimination is a serious issue that can have devastating effects on an individual’s personal and professional security, Dame notes. He says the LGBTQ caucus wants to see a memorandum of understanding negotiated with employers that includes a complaint reporting process and a framework of zero tolerance for macro and micro aggressions – and with consequences clearly stated.

Melissa Vannerus

Chair, Young Nurses’ Network

A recent BCNU survey revealing the decline of young nurses’ mental health – and the high likelihood they will leave nursing altogether – underscores the importance of new nurse retention. “This is a huge priority for our caucus,” says Young Nurses’ Network chair Melissa Vannerus. The network represents nurses with less than five years of nursing experience and/or those younger than 35-years of age. Vannerus says a universal new grad orientation initiative would help address the discrepancies that currently exist between health authorities. She believes this would encourage young nurses to consider working throughout the province, including rural and remote locations most in need of health-care workers. Young Nurses Network members also want to see the union put support behind their call for preceptorship/mentorship premiums and retention bonuses that would be paid every five years.

Tracia Batson-Dottin Interim Chair, Mosaic of Colour Caucus

A vision of equity and inclusion is at the heart of the Mosaic of Colour caucus’s drive for systemic change. Part of this work involves helping BCNU members understand the effects of racism and discrimination against people of colour who work in health care. “As an African-descendant nurse, I have personally experienced it all,” says caucus chair Batson-Dottin. “It’s important that I’m treated fairly and with respect. I want to be given equal opportunity for career advancement and not be judged on the colour of my skin or my accent.” The Mosaic of Colour caucus is calling for employer-created mandatory training on cultural sensitivity, diversity, and inclusion – something Batson-Dottin says should also be added to core nursing competencies. The caucus sees internationally educated nurses (IENs) as one solution to the nurse staffing crisis and the aging-out of a large portion of the nursing workforce. Batson-Dottin believes BCNU can play an important role in helping these nurses begin work in BC. “If we have our caucus reps supporting this effort, we could provide voice, experience and accountability to encourage action,” says Batson-Dottin, noting that many caucus members are IENs themselves.

Matthew LeGresley

Interim Chair, Men in Nursing Group

Men in the nursing profession can face challenges that stem from the prevalence of outdated gender biases. Matthew LeGresley is working to change this through education and advocacy. Ahead of Nurses’ Bargaining Association negotiations this year, the Men in Nursing Group is calling for expanded access to parental leave allowance for non-birthing parents. “Currently there is lack of acknowledgment of anything other than the cis gender birth mom for (financial) top ups.” The group says existing language is not reflective of the needs of BCNU’s diverse membership, which includes non-binary persons and adoptive parents. LeGresley stresses the importance of ensuring that a diversity lens is applied throughout the organization and reflected to the wider membership through campaigns and initiatives. “We believe that if we stand strongly together and learn to push not only for ourselves but for those around us, we can accomplish great things.”

Kelly Woywitka

Chair, Workers with Disability Caucus

It’s not easy working with a disability, visible or not – and even colleagues can be judgmental and unforgiving. It’s for this reason that Kelly Woywitka stresses the need for solid, respectful workplace policies that are developed with union involvement. “Oftentimes members are not treated fairly and are left out in the process during a respectful workplace complaint. Stewards are not allowed to speak and there is no appeal for outcomes. Our caucus would like to see mandatory sensitivity training with clear language on appropriate communications.” Woywitka also hopes to see increased funding for caucus groups so they can expand their own awareness and advocacy efforts. This includes promotion of the Enhanced Disability Management Program (EDMP), which is designed to support members suffering from an occupational or non-occupational illness or injury. “Our EDMP reps create valuable holistic case management programs, but many reps have large caseloads and people are not always getting the attention, medical interventions and accommodations required to help them.” Woywitka says the Workers with Disability caucus also plans to push for the hiring of more float nurses so staff can take their breaks on shift. “It’s alarming the number of nurses who don’t feel they can take a break because there is no one around to cover their workload.”

UPDATE MAGAZINE • SPRING 2022

MY JOURNEY

INTERNATIONALLY EDUCATED NURSES

COUNTRY ROADS Benito Tuyor’s nursing journey has taken him from rural Philippines to rural BC ON HIS INFREQUENT DAYS off, Benito Tuyor likes to cook and sing. These twin pursuits offer a relaxing and creative counterpoint to the often frantic pace of the licensed practical nurse’s working life at Ridge Meadows Hospital (RMH) in Maple Ridge. “I really love music. I play a number of musical instruments, and I used to be in a band,” Tuyor notes with a hint of nostalgia, as if he’d rather be on stage in a crowded venue than talking about his life as a nurse. “But now, when I have some free time, I like to sing karaoke,” he says with a knowing grin. Growing up on Catanduanes, an island province located in the Bicol region of Luzon in the Philippines, Tuyor had never imagined himself as a nurse. Indeed, he had never imagined leaving that island idyll. “I had always thought that when I grew up, I would become a journalist. I had a passion for the news – for stories – and there were so many interesting stories to tell about the island and the people living there,” he recalls. Growing up, Tuyor says life was simple and basic. “We were a rough, five-hour ride from anywhere major. Most of the people were farmers, and there was a local rice mill and bakery.” The bakery was run by Tuyor’s aunts, and on many occasions he found himself there – helping out – learning the trade.

SPRING 2022 • UPDATE MAGAZINE

AT HOME IN THE COUNTRY Ridge Meadows Hospital’s Benito Tuyor is a practising LPN with a wealth of experience gained from his work in the Philippines.

It was only when the government of the Philippines initiated what Tuyor described as a “doctors to the barrios” program – recruiting and providing health-care training to young adults from underserved communities – that he began to consider a new career path. “The town councillors selected the students and I was fortunate enough to be chosen,” he says. “I received a government scholarship and that was how my nursing journey began.” Tuyor went to school in Lagazpi, the largest city in Bicol. “It was a very big adjustment”, he recalls, “but I enjoyed it a lot. There was a laddered curriculum. The first year was care-aide training, the second, midwifery, then two to three years of nursing, and after that pre-med, and so on.”

Tuyor had planned on completing the entire program but when the funding dried up, he was obliged to stop. In 2002, after five years of school, he returned home. “I volunteered in the very deprived district hospital for one year – providing basic nursing care.” In early 2003, Tuyor travelled to Manila to write his licensure exam before returning to Bicol, where he was hired by a private nursing agency to work in one of the regional hospitals – though not as a direct employee. “The agency paid better wages and offered benefits – and my partner and I had a young child, he explains. “This shaped my decision.” In the fall of 2003, Tuyor’s wife was sponsored by her sister to come to Canada to work as a caregiver. “It was a good

HOW TO CONTACT YOUR HUMAN RIGHTS AND EQUITY REPS BCNU Human Rights and Equity Committee Adriane Gear, Chair E adrianegear@bcnu.org

opportunity for us – for our family – and for me to nurse in Canada,” Tuyor recalls. But as it turned out, Tuyor wasn’t able to join his wife, and he had to wait five years until she was able to sponsor him. “So, it was me with our children in the Philippines and my wife in Canada.” Tuyor and the children arrived in Canada in the spring of 2008. “We were excited to be here, together, and I had heard that there were lots of nursing jobs,” he says.

“After all these years of practising I still feel like an RN inside” Benito Tuyor

The family settled in Pitt Meadows. “It was strange. When I imagined Canada, I had images of Los Angeles and New York in my mind,” Tuyor admits. “But here I was in a place that looked like the one I had left behind – I’d gone from a rural area to a rural area.” Tuyor worked at a warehouse while initiating an application to obtain his RN licence. “After a year I was hired as a care aide and porter at Ridge Meadows Hospital.” In the meantime, Tuyor’s attempt to get his nursing licence had stalled. “I was informed by the regulatory college that I didn’t meet the criteria”, he explains, noting the assessment was based mainly on a lab simulation test that he feels is not

an accurate tool to assess the competency of international nurses. “I came to Canada as a nurse, not as an actor,” he remarks. “In the real world, I would know exactly how to deal with a code blue situation, for example, but a simulation is very far from that reality.” Tuyor then took a practical nurse refresher course in November 2010, and in June of the following year received his LPN license. He continues to work at RMH. “Even after all these years of practising as an LPN I still feel like an RN inside,” he notes with an existential weariness. “Don’t get me wrong, I love to work as an LPN,” he says, “but the system could utilize my skills much more effectively, especially during a pandemic.” Despite his long-standing dream of obtaining an RN licence, Tuyor has recently decided to abandon the effort after a more recent experience with the National Nursing Assessment Service (NNAS). “I’d already applied to NNAS some years ago, and now they’re requiring me to submit the same nursing credentials previously verified by the regulatory college – the same credentials that allowed me to work as LPN for more than 10 years,” he stresses, noting that NNAS will simply submit its report back to the college. Tuyor’s lament is a familiar one – and it highlights the frustrations of a process that is both costly and time consuming. “It doesn’t make sense,” Tuyor laments. “It’s so frustrating that I’ve given up challenging this RN process, and quite honestly, I’m considering leaving nursing all together.” •

Indigenous Leadership Circle Catherine Tanski, Chair E Indigenous@bcnu.org Candi DeSousa, Council Liaison C 250-488-9232 E candidesousa@bcnu.org LGBTQ Caucus Jessy Dame, Chair E lgbtq@bcnu.org Tristan Newby, Council Liaison C 604-313-1308 E tristannewby@bcnu.org Men in Nursing Group Graham Olds, Chair E m eninnursing@bcnu.org Walter Lumamba, Council Liaison C 604-512-2004 E walterlumamba@bcnu.org Mosaic of Colour Caucus Tracia Batson-Dottin, Interim MOC Chair E moc@bcnu.org Parveen Gill, Council Liaison C 604-615-6815 E parveengill@bcnu.org Workers with Disability Caucus Kelly Woywitka, Chair E disabilities@bcnu.org Danette Thomsen, Council Liaison C 250-960-8621 E danettethomsen@bcnu.org Young Nurses’ Network Melissa Vannerus, Chair E ynn@bcnu.org Hardev Bhullar, Council Liaison C 778-855-0220 E hardevbhullar@bcnu.org

UPDATE MAGAZINE • SPRING 2022

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. Regional Council Members if your steward can’t help, or for all regional matters. Provincial Executive Committee for all provincial, national or union policy issues.

PROVINCIAL EXECUTIVE COMMITTEE

REGIONAL COUNCIL MEMBERS CENTRAL VANCOUVER Marlene Goertzen C 778-874-9330 marlenegoertzen@bcnu.org Kelly Zander C 778-222-3756 kellyzander@bcnu.org COASTAL MOUNTAIN Kath-Ann Terrett C 604-828-0155 kterrett@bcnu.org EAST KOOTENAY Denise Waurynchuk C 250-919-2178 denisewaurynchuk@bcnu.org

PRESIDENT Aman Grewal C 604-813-7208 amangrewal@bcnu.org

TREASURER Sharon Sponton C 250-877-2547 sharonsponton@bcnu.org

VICE PRESIDENT Adriane Gear C 778-679-9968 adrianegear@bcnu.org

EXECUTIVE COUNCILLOR Michelle Sordal C 604-445-2003 michellesordal@bcnu.org

FRASER VALLEY Parveen Gill C 604-615-6815 parveengill@bcnu.org

RICHMOND VANCOUVER Sara Mattu C 778-989-8231 saramattu@bcnu.org

SOUTH ISLANDS Stephanie Spinney C 250-883-6593 stephaniespinney@bcnu.org

NORTH EAST Tracey Jonkers (interim) C 250-960-8621 traceyjonker@bcnu.org

SHAUGHNESSY HEIGHTS Claudette Jut C 604-786-8422 claudettejut@bcnu.org

Leanne Robertson-Weeds C 778-222-7997 leannerobertsonweeds@bcnu.org

NORTH WEST Teri Forster C 250-615-8077 teriforster@bcnu.org

SIMON FRASER Tristan Newby C 604-313-1308 tristannewby@bcnu.org

OKANAGAN SIMILKAMEEN Candice DeSousa C 250-488-9232 candidesousa@bcnu.org

Wendy Gibbs C 604-240-1242 wendygibbs@bcnu.org

PACIFIC RIM Kelley Charters C 250-816-0865 kelleycharters@bcnu.org

SPRING 2022 • UPDATE MAGAZINE

SOUTH FRASER VALLEY Hardev Bhullar C 778-855-0220 hardevbhullar@bcnu.org Walter Lumamba C 604-512-2004 walterlumamba@bcnu.org

EXECUTIVE COUNCILLOR Aida Herrera C 604-612-8871 aidaherrera@bcnu.org

THOMPSON NORTH OKANAGAN Scott Duvall C 250-241-5952 scottduvall@bcnu.org VANCOUVER METRO Meghan Friesen C 604-250-0751 meghanfriesen@bcnu.org WEST KOOTENAY Dennis Senft (interim) C 250-231-7083 dennissenft@bcnu.org

COUNCIL PROFILE HERE’S WHO’S WORKING FOR YOU

“Caring for patients and making sure they get what they need is such an important part of what we do.” says Simon Fraser regional council member Wendy Gibbs.

FIGHTING FOR FAIRNESS SIMON FRASER REGIONAL COUNCIL MEMBER WENDY GIBBS

QUICK FACTS NAME Wendy Gibbs. GRADUATED 1983, Vancouver Community College. UNION POSITION Simon Fraser region council member. WHY I SUPPORT BCNU? “There’s safety in numbers and you want to be part of those numbers.”

WENDY GIBBS RECALLS her first days on the job like it was yesterday. The year was 1983 and the young LPN had begun working on the dementia unit at North Vancouver’s Beacon Hill Lodge. “Wow, this is overwhelming,’ I thought. The first month was really hard.” The difficult working conditions Gibbs encountered, and her desire to change them, set her on a path of advocacy and activism that continues to this day. “I want things to be fair,” says the BCNU Simon Fraser region council member. “And I’ve always felt like there’s room for improvement.” In the years since, Gibbs has spent her 38-year career working in community hospitals and tertiary care, on medical and rehab units, and finally in the ER at Ridge Meadows Hospital in Maple Ridge. Gibbs began her steward work while working at Maple Ridge Community Hospital in the 1990s, when she was a Hospital Employees’ Union member. She says her attraction to the steward role came from a curiosity about what nurses were entitled to as a group, and how the collective agreement affected those rights. And then there was that little detail about fairness. “The employer just kept making me

angry all the time because they did not want to follow the collective agreement,” she reports. “They were always trying to find loopholes and doing things to save money; it was never about patients.” Later in her career, Gibbs decided to go back to school and graduated from Douglas College with her RN designation in 2001. She earned her BSN in 2007. “I had to take Grade 11 math again and that was rough,” she laughs. “Probably the hardest part of the whole thing.” The new RN became a BCNU member and continued her steward role. She was later elected to her regional executive 2015, serving as communications secretary. Gibbs credits former BCNU Simon Fraser region council member Deb Picco for taking her leadership path to the next level. “She had a personal touch and I guess she realized I had some leadership potential I didn’t know I had,” says Gibbs, when recalling how Picco approached her to serve as regional council member. “She was realistic and honest about the challenges of the work but felt I would be a good addition to the team.” Gibbs was appointed regional council member in 2016 before she was elected by members the following

year and re-elected in 2020. “Disgruntled” and “Frustrated” are the words Gibbs chooses when asked how members in her region are feeling today. “They enjoy nursing, but the conditions are horrible and they can’t do their nursing work in the way that they want to,” she reports. “Caring for patients and making sure they get what they need is such an important part of what we do as nurses, and it’s really hard to do that right now because it takes time and there’s just not enough nurses.” She says the nursing shortage is the top-of-mind issue in her region, and the biggest source of member dissatisfaction. “Retention is a real problem; people keep leaving so that’s hard.” Gibbs served on BCNU’s Member Engagement and Steward Recruitment and Retention Committee for several years and recently moved to the Human Resources Committee. Her goal on BCNU council? “I just want to leave the place a better place than when I found it,” she says. Whether in the workplace or the union, Gibbs believes nurses should look for opportunities to make things better. “There’s always room for improvement,” she says. •

UPDATE MAGAZINE • SPRING 2022

OFF DUTY MEMBERS AFTER HOURS

FULL STEAM AHEAD PAULINE KONG FINDS ADVENTURE IN THE WORLD OF BOARD GAMES

offering a delicious cultural experience,” says Kong. Steam Up is also the name of an award-winning dim sum restaurant in the game. PAULINE KONG HAS idea of using dim sum as a “Players travel from afar to worked in critical care cultural theme for a game. Steam Up where they play as nursing at Surrey Memorial “And that’s how Steam Up one of 12 Chinese zodiac aniHospital for over a decade. was born!” mals,” Kong explains. “The She performed as a magician Steam Up: A Feast of Dim player who devours the most in her off-time. But after Sum is the board game dim sum and leaves the table retiring from magic in 2018, Kong co-developed with with the fullest stomach is the ICU nurse found that friend Marie Wong. The two the winner!” she needed a new hobby. launched Hot Banana Games Dim sum is a large range of “I started playing more a couple of years ago and small Chinese dishes that are board games!” Kong says. Steam Up is the company’s traditionally served in bam“My friends and I play at my first project. boo steamers and enjoyed in house because I have the Kong says the game’s restaurants for brunch. “The most games,” she explains. design began as an idea she steamers are on a turntable “One day I said, ‘wouldn’t and Wong steamed dreamed that spins around so the food it be cool if we had our own up and spun around in their can be shared with family board game?’” minds – like a dim sum and friends,” Kong explains. As they explored the idea, turntable – until it evolved to “In Steam Up, we serve Kong says that her elemena family-friendly format for the five most popular dishes: tary school drawing of dim 2-5 players. shrimp dumpling, meat sum dishes happened to be “Steam Up is a competitive dumpling, BBQ meat bun, on the table. This led to the dim sum collection game sticky rice wrapped in lotus leaf, and the exotic phoenix claw.” In the game, miniature steamers are filled with replica dim sum, then stacked and placed on a turntable. The game is played in rounds – each player takes a turn performing different actions like gaining food tokens, drawings or playing fortune cards, and that allows the player to turn the table. Kong says it’s GAME ON! Pauline Kong and Marie Wong developed the board game important for a player Steam Up: A Feast of Dim Sum as a bridge to understanding Asian culture.

SPRING 2022 • UPDATE MAGAZINE

to spend food tokens to purchase dim sum within your feast zone (i.e., within their reach). As in real life, instead of reaching over the table for more food, you take food in your feast zone. It’s game over when there’s no dim sum left. “For players who have eaten dim sum, we hope that playing Steam Up brings back delicious memories of their favourite dishes,” says the entrepreneurial nurse. “And for players new to this Chinese cuisine, we hope our game will spark their interest to go on a food adventure to try traditional dim sum.” Eating food is a universal experience that connects families, communities and perhaps the global community, too. Kong sees great potential impact for her board game. “We hope Steam Up is a positive bridge to understanding Asian culture,” she says. “Gamers can experience the culture and customs through a fun, immersive board game. The greater your knowledge becomes, the greater your cultural understanding becomes too.” Steam Up launched on Kickstarter in October 2021 and to date has raised nearly $600,000 with over 8,200 backers. While the fundraising campaign has officially ended, pledges are still being accepted via Kickstarter.com (search “Steam Up: A Feast of Dim Sum”). •

APRIL 28

NATIONAL DAY OF MOURNING FOR WORKERS INJURED OR KILLED ON THE JOB

Let’s honour their memory by committing to work together to prevent injuries, illnesses, violence, and fatalities in the workplace. DELIVERING QUALITY CARE MEANS WORKING IN A SAFE AND HEALTHY ENVIRONMENT

www.bcnu.org

82% of nurses say their mental health is suffering Critically short-staffed, nurses are struggling through a nightmare. Ask the government to take action, today.

HelpBCNurses.ca PM 40834030