A publication for Staff and Physicians of IH
A message from Chris Mazurkewich, Interior Health’s CEO.
Ways you can stay engaged in your day-to-day.
A decade of service means many milestones for Erwin Malzer.
Frank Quinn retires from his term on the Interior Health Board.
Employees and physicians awarded for years of service.
Fawcett Centre provides new opportunities for IH Simulation Program.
Health-care teams learn about culturally safe care.
Mere minutes decisive in stroke injury and recovery.
Brent Hobbs from Patient Transport, and the new CHSC in Kelowna.
Snapshots of our staff in action and trending health-care videos.
Lorne Pachara (centre), one of the Long Term Service Award recipients from East Kootenay Regional Hospital, celebrates 40 years along with presenters Dennis Rounsville, IH board member, and Mal Griffin, VP HR and Organizational Development. Story p. 10.
The @InteriorHealth magazine is a monthly publication created by the Communications Department of Interior Health. Past issues of @InteriorHealth can be found on our website under About Us/Media Centre/Publications & Newsletters. If you have story ideas for future issues, please e-mail: IHAcommunications@interiorhealth.ca Deadline for submissions to the January 2017 @InteriorHealth magazine is December 9. Editors: Amanda Fisher, Karen Hurst Designer: Kara Visinski IH Communications Contributors: Lesley Coates, Susan Duncan, Patrick Gall, Karl Hardt, Erin Toews, Breanna Traynor, Tracy Watson, Mike Youds
Every person matters
One of the milestones for IH in 2016 included bidding a fond farewell to Board Chair Erwin Malzer after a decade of service on the board. Here, CEO Chris Mazurkewich presents Erwin with a photobook as a memento of his tenure with IH.
F
inding the positive in the midst of challenging situations takes effort and practice. In our health-care world, staff and physicians must do this every day, for one another, but most importantly for our patients, clients, and residents. And sometimes it’s vice versa.
to the Public Health Overdose Emergency; planned and coordinated the provision of Medical Assistance in Dying as a new service for health authorities; added to the role and number of nurse practitioners to enhance primary care; and supported the arrival of Syrian refugees with optimized and culturally sensitive newcomer health care in IH.
to look forward – to the challenges, the realities, and the work we need to do to achieve success in the year ahead. For 2017, there are two areas in particular where I see us focusing extensive effort and energy.
The first is ensuring a safe and healthy workplace. The health and wellbeing of our We made impressive progress with our people is a priority. In IH, we say “every capital projects. In large part, this was due person matters” and we need to put those to the tremendous efforts of project teams words into action by helping our employees as well as the clinical teams who took over and medical staff be as safe as possible to operationalize the new buildings and units while at work. that opened in 2016. The list includes: the In the months ahead, this will include a Dayle Kaye was in hospital with two broken perinatal unit at Kelowna General; the ICU more concerted focus on violence prevention legs this fall. While there, she wrote poems at East Kootenay Regional; the top two to the Food Services staff praising the taste floors of Vernon Jubilee’s Polson Tower; the training and risk assessments, occupational digital mammography unit for Cariboo health and safety supervisory training, and and quality of her meals. Employees were incident investigations with corrective touched by her kind words and the chef was Memorial; the Boundary Community Health Centre in Grand Forks; the Clinical Services actions implemented as needed. But it’s even inspired to write back with a poem of Building at Royal Inland; and the Community important to know that this is ongoing work her own, ending off with appreciation and Health and Services Centre in Kelowna. and ensuring the safety of our workplace thanks. must be part of our day to day. It was kindness coming full circle. And what We have also seen exciting technology better time to share that than December – developments – from telehealth expansion, The second area of note will be the the season that brings out acts of charity to electronic charting at Royal Inland’s ED, evolution of our Five Key Strategies. One and the best of humanity. to the new MyHealthPortal now rolling out year in, we have made good progress; across IH. however, this work is evolving and there will Keeping positivity in mind, the end of the be further refining and natural shifting, year is a good time to reflect on some of On top of all that, we had several milestone which is to be expected with any large-scale celebrations. 100 Mile District General transformation like this. As a health our achievements in 2016. Hospital marked 50 years of service and authority, we are also aligning and evolving Hillside Psychiatric Centre in Kamloops with changing Ministry structure, so I expect We launched our Five Key Strategies as marked a decade. We also had the to see some changes as we move into the priority areas of work. This is part of our fifth anniversary of our first letter of new year but the goal will remain primary effort to transform the system by shifting understanding with our First Nations, an and community care transformation. I look the focus from acute care to improved and agreement that is now being renewed. forward to sharing our progress on that integrated services in the community. front throughout 2017. Congratulations to all for the roles you’ve We initiated new and expanded services – played in these accomplishments! As it is officially “the season,” I extend warm new residential, substance use, and holiday greetings and wish everyone a very palliative beds in many of our communities; For me, reflection also triggers the need happy, safe, and healthy Christmas season. expanded services as part of our response A story on our Loop website about a patient at 100 Mile District General Hospital – now known as “the wonderful lady in 17B” – defines optimism in the face of adversity and the uplifting impact it can have on others.
Farewell to IH Chair Erwin Malzer
E
Now that his term is coming to a close, Erwin says he will continue to advise at a provincial and federal level through other board opportunities and selective consulting contracts. For example he was recently appointed by the Health Minister to the provincial shared services board of directors (BC Clinical He is a champion for system transformation and a long-time business consultant with a passion for health and technology. and Support Services Society). And he will still be involved in In his first year, he led the board’s adoption of digital methods the annual Kelowna Health Summit conference where he has been a long-time organizer, moderator, and speaker. and video-conferencing technology. More recently, he has been a strong supporter of increased digital tools in health, He will keep tweeting and blogging about transformation in such as electronic health records and the use of mobile and health care, in which he believes so passionately. Follow him data exchange technology. It is no surprise that he lists on Twitter at @ErwinMalzer to keep in touch. advancements in telehealth and the introduction of Interior Health’s MyHealthPortal as important building blocks and He is also looking forward to spending more time with his wife among the highlights of his term. Rose and family, including his children (Jen, Tiffany, and Eric) and two young grandchildren. He is going to work on his golf “We are at a tipping point,” he says. “Technology, such as game – a real first for a man most accustomed integrated electronic health records and telehealth, is vital to playing on a tablet and within a health region like smart phone – and he ours, where we serve so plans to learn how to play many rural, First Nations, guitar. and remote communities.” rwin Malzer has witnessed many milestones during his 10 years with Interior Health’s Board of Directors, two of which he has served as chair.
He notes, with pride, that South Okanagan General Hospital in Oliver was one of the first in Canada to have a fully integrated health record and that Royal Inland Hospital in Kamloops now has an Electronic Medical Record in its Emergency Department and is considering expanding automated work processes throughout the hospital. It will model the way forward. Since his term as chair began on Jan. 1, 2015, Erwin has had the opportunity to visit many rural and remote communities within Interior Health. “We were able to visit many of the First Nations communities and rural sites. I considered it an honour. When you visit these communities you appreciate how truly isolated some areas are, and it underscores the importance of technology in delivering health care. Telehealth has really advanced, and tools such as MyHealthPortal, that put information in the patient’s hands, have a lot of potential to change how health care is delivered.” Above: Erwin witnessed several major capital projects, such as the expansion of Kelowna General and the opening of the Interior Heart and Surgical Centre, during his 10-year term with the board. Right: Enjoying life alongside his wife Rose is on Erwin’s list of things to do as he wraps up a 10-year term.
Erwin says he will miss his fellow board directors, the many fine executive and physician leaders he has come to know, as well as the staff that make Interior Health such a great place to work. Join us in thanking Erwin and wishing him all the best!
F
or six years, Interior Health’s Board of Directors could be sure when Frank Quinn spoke they would hear the straight goods from a guy who doesn’t waste words and is sharp as a whip.
His legal background and business acumen made him a perfect director for a board tasked with the responsibility of governing a health authority that oversees an annual budget of $2.1 billion, almost 20,000 employees, and health services to a population of about 730,000 people. Kamloops resident Frank Quinn is retiring from the IH Board after six years as a director.
Despite his experience, he admits he initially felt daunted by the span of complicated issues handled by the health authority. He will leave the board at the end of this year well-schooled in what can bring a health system to its knees or what can make it strong.
making so budgets are properly spent and shared across the health authority, particularly one that covers such a vast geographical area of B.C., much of it rural and remote.
“The most significant thing about health is the complexity of it and the number of moving parts,” says Frank. “You arrive on the board thinking you have an idea of what health care is about and you find out very quickly, even after your orientation, that you really know nothing.”
“The most important role of the board is to pick the right chief executive officer; work with him and SET to define priorities and an annual plan, within ministry guidelines, and then let them do their work. The board needs only to step in when the plan is not met.”
He advises new board members to expect to spend the first two years understanding the relationships between the health authority and its many partners, from the Ministry of Health to physician groups and community agencies. There is also the configuration of the Senior Executive Team (SET) and the various personalities on the board and within the health authority to learn about.
Frank has practised law in Kamloops for 36 years, but he is primarily a property developer now. His development company is currently working on four projects around the province, including Kelowna, West Kelowna, Sun Peaks, and Prince George.
“After two years, you have a better grasp of the substantive issues and you, hopefully, become effective in providing governance and guidance, which is the role of the board.”
It’s not surprising that while he enjoyed his six years on the Interior Health Board, he is not unhappy to be giving up that responsibility in order to spread his time fairly.
For instance, he is a director on the Thompson Rivers University Community Trust, which is at the crucial stage of For most of his term, Interior Health has worked on initiatives launching its first request for proposal (RFP) on the project to help shift the focus of health services from hospitals to the to develop campus lands – surplus to academic needs – into community. Frank agrees that from a cost-benefit analysis residences, market housing, and retail outlets. the change is the only way to go. And on the personal side, he’s enjoying spending more time “We have no choice. Health authorities have to support with his wife, Cathy, whom he met in high school and people to stay at home as long as possible.” married during his first year as a lawyer. Frank and Cathy have a son, two daughters, and three grandchildren, with However, he cautions, neither can health boards ignore the a fourth under percolation. The Quinns live half time in importance of its hospitals. “An aging population means Vancouver and half time in the Kamloops area, including at there will also be an increasing demand for acute services. their summer residence on the Shuswap Lake. It’s smart to drive resources into the community, but that demand for hospital care isn’t going to go away.” With so much of his adult life spent in Kamloops, Frank has a soft spot for Royal Inland Hospital. He wants to see RIH That’s why he is a strong proponent of careful decisioncontinue to improve as an important tertiary hospital.
Awards O
ver the last several months, employees and physicians with 25 or more years of service were invited to attend Long Term Service Awards banquets in their honour and bring with them a significant other, family member, or friend to share in the special moment.
In 2016, there were 488 employees and 51 physicians who achieved one of these significant milestones.
“ It’s great IH holds events like this. I think it’s so important to have events that recognize loyal employees, to feel appreciated, boost morale, retention, motivation and team building, so a big thank you to your team! ” - Jesse (Jasbir) Spencer, 25 year recipient (IH West), 2016 During these events, employees are individually thanked by members of our Senior Executive Team and Board of Directors and receive an award for their years of service. The events in 2016 were a great success! Thanks goes out to all the HR volunteers who helped coordinate the logistics, as well as all the details behind the scenes. Additional thanks to each of the recipients who chose to share a video clip of themselves reflecting on their years of service. Lastly, a heartfelt thank you goes out to all the family and friends who have supported the hard work of these employees over the years and the time they have dedicated to patient care in our communities. Pictured here are some of this year’s award recipients. Visit the Recognition web page on InsideNet for a full listing of recipients, event photos, the 2016 Long Term Service video, and additional resources. Congratulations everyone! Top: Al Peters from the Diagnostic Imaging Department at Nicola Valley Hospital and Health Centre was recognized for 40 years of service. Second from the top: Kamloops Mental Health Community Crisis Response RPN Jesse (Jasbir) Spencer (L) celebrated her 25 years of service with her husband. Third from the top: South Okanagan General Hospital Emergency Nurse Wanda Casorso (C) receives her award for 40 years of service from Board member Ken Burrows (L) and CEO Chris Mazurkewich (R). Bottom: Cranbrook Community Physiotherapist Elizabeth Ross (L) and her guest celebrated her 30 years of service.
Significant Service Milestones
A
patient is in cardiac arrest and a code blue has been called. Life-saving interventions are needed. What do you do?
In cases such as these, it’s preferable to have practised saving a patient’s life before actually trying it. That, in a nutshell, is why Interior Health’s Simulation Program is so vital: it provides health-care teams and medical and nursing students with invaluable hands-on experience for high-risk, rare, or complex patient situations in a risk-free environment. That’s why Shelly Koochin welcomes the opening of the Rae Fawcett Simulation Centre at Royal Inland Hospital’s new Clinical Services Building. “This gives IH a second dedicated simulation centre, and augments the education already available through the Pritchard Simulation Centre at Kelowna General Hospital and the IH Rural Mobile Simulation Program,” says Shelly, IH’s Simulation Coordinator. “Having the Fawcett Simulation Centre in Kamloops creates opportunities for
more health-care professionals to practise patient situations in a risk-free environment. That, ultimately, provides the best care for patients at Royal Inland Hospital and across IH West.” The IH Simulation Program originated with a rural focus and the intention of taking learning opportunities to health-care professionals in more remote areas of the health authority. When the Pritchard Simulation Centre was built in 2012, it opened up possibilities for staff and physicians in IH’s larger centres, and helped forge a working relationship between KGH and the UBC Faculty of Medicine. Now, with the introduction of the Fawcett Simulation Centre at RIH, just footsteps from the UBC Faculty of Medicine’s wing in the Clinical Services Building, the doors have opened to even more new opportunities. Named in honour of Rae Fawcett, a generous donor to the RIH Foundation, the centre is home to two high-fidelity simulation mannequins, one adult and one pediatric. These
life-like machines can’t move, but their “hearts” beat and they can seize and have tremors, breathe, blink, as well as have chest and bowel sounds. The mannequins are the stars in learning modules led by Regional Knowledge Coordinator Tracy Canuel. The centre is just getting up and running, she says, but already has played host to a Simulation Learning Strategies course on Nov. 3-4. The event was led by Dr. Chris Chin from BC Children’s Hospital and co-facilitated by Tracy and her KGH counterpart JoAnne Slinn, and was devised to instruct health-care professionals who want to use simulation as a teaching method. So, the Fawcett centre is not just used for learning, but for teaching others to facilitate learning. “Before, staff from IH West had the option to travel to KGH and participate in simulations at the Pritchard Simulation Centre. But this wasn’t always a viable option for our frontline staff,” Tracy says. “Now, the Fawcett Centre enables a second tertiary site in IH to have the gold standard of education – which is simulation.” Shelly says the Simulation Learning Strategies course received rave reviews from the inter-professional group of participants from across IH that included nurse educators from post-anesthetic recovery, day-care surgery, labour and delivery, mental health, trauma and medicine, and physicians both from IH and the UBC Faculty of Medicine, including those in emergency, anesthesiology, obstetrics, and pediatrics. The feedback she received included comments such as: “It really exceeded my expectations,” and “I’d rank it with some of the best CME (continuing
medical education) I’ve ever attended.” “This kind of response and enthusiasm for collaborative learning justifies having a dedicated space for simulation at RIH,” Shelly says. “It allows IH to create standardization across the health authority for training and debriefing, equipment and technical support, and for research and collaboration between IH and the UBC Faculty of Medicine.” Moving forward, Shelly says IH and the UBC Faculty of Medicine are working to establish a partnership between RIH and the Thompson Rivers University nursing program for simulation training, similar to that which is enjoyed between KGH and UBC-Okanagan nursing. “IH’s Simulation Program encourages learning and teamwork,” says Aaron Miller, IH’s Director of Strategic Initiatives and Southern Medical Program Liaison. “Nurses and physicians are able to practise their skills using familiar tools and equipment in a variety of scenarios that occur in the hospital every day and, as a result, feel confident they and their colleagues are providing the best care for their patients.” Shelly, Tracy, JoAnne, and the rest of the team are focused on incorporating more multidisciplinary education into their learning modules, which would involve both physicians and staff working together. The reality, says Tracy, is in a reallife situation such as a code blue, a physician would always be present as part of the response team. It makes sense that they would also be present in training simulations, instead of nurses alone. There are also opportunities to provide more support from the dedicated centres at RIH and KGH for regional hospitals such as Vernon Jubilee and Penticton Regional hospitals. “Because we can provide more support from the fixed centres, we can grow the whole simulation program – rural and larger sites,” Shelly says. “Eventually, we hope simulation will be incorporated into the entire learning curriculum.” To learn more about the Fawcett Simulation Centre, visit the IH Simulation Program Teamsite.
Left: Tracy Canuel, Regional Knowledge Coordinator, with her pal SimMan, one of two high-fidelity simulation mannequins used to teach health professionals at the new Fawcett Simulation Centre at Royal Inland Hospital’s Clinical Services Building. Above: A cardiac resuscitation scenario is simulated in an Advanced Cardiac Life Support (ACLS) course at the new Fawcett Simulation Centre. Right: Dr. Keith Hepburn, an IH Rural Simulation Program facilitator from Shuswap Lake General Hospital, leads a pediatric simulation alongside Tracy Canuel, Regional Knowledge Coordinator (middle), and RN Nancy Garrett-Petts, Clinical Practice Educator for RIH’s Post-Anesthetic Recovery department.
W
hen IH Community Health Services Manager Trisha Shetler began her job in 2015, one of her priorities was to hear impressions of the health-care system from local First Nations.
She listened to stories about patient care and ways in which the Tsilhqot’in, Ulkatcho, and Secwepemc Nations felt that it could be improved. Overwhelmingly, they wanted Interior Health staff to learn about their culture so they could better understand their Aboriginal patients. At the same time, IH CEO Chris Mazurkewich was touring the Cariboo-Chilcotin and also heard from community leaders that there was a need to educate health-care providers about the history of Aboriginal people. A Home Care nurse with the Splatsin band near Spallumcheen suggests that culturally safe care begins with being aware of and sensitive to the culture and background of a people. “Cultural sensitivity is only a step on the path to culturally safe care,” says Adrienne Lewis, one of several health-care providers who share their thoughts on cultural sensitivity. See page 17 for Adrienne’s full perspective. Trisha met with Aboriginal Health Director Brad Anderson, who connected her with Vanessa Mitchell, Interior Health’s Aboriginal Cultural Safety Educator.
Substance Use and residential care, as well as some people from local health agencies, seized the learning opportunity. There is also a waiting list of people who want to take the course when Vanessa can return. “The education is awesome,” says Trisha, “and I am really passionate and excited about how we are going to make this meaningful. We need to continue to work to change the perceptions that may exist and further enhance culturally safe care by working with and continuing to develop relationships with our Aboriginal partners.” Trisha is equally enthusiastic about the thirst by employees for this kind of education. “We had really great feedback so now we will look at the next steps of transferring the knowledge into culturally safe care across the spectrum of health services – acute, community, and residential.” She notes that three physicians took the one-day training session and another four physicians took a two-hour course that was also offered. “We plan to meet with Tsilhqot’in elders and council in December and have a follow-up discussion around culturally safe care.”
Vanessa brought the course, Cultural Safety – A People’s Story, to health-care providers in Williams Lake and 100 Mile at six separate sessions between Sept. 20 and Oct. 26.
Cultural Safety – A People’s Story will continue to be offered at locations across Interior Health. Most recently, Vanessa facilitated a session with community-based leaders and support staff in IH West’s Hospitals and Communities Integrated Service portfolio.
By the end of October, a total of 126 people – 70 from Williams Lake and 56 from 100 Mile House – had taken the course. Staff from acute, community, Mental Health and
Visit the Aboriginal Cultural Safety Education webpage on InsideNet for information on how to access the training for your site.
Let patient be your guide Clinicians who often work closely with Aboriginal patients and families describe what cultural sensitivity means to them.
Deb Marshall – Clinical Practice Educator In a world that is so dynamic and constantly changing it is important for one to remember that history, heritage, and culture may determine the speed at which one accepts change, if at all. In other words, we must be a society that is respectful of all cultures and how our constantly changing, technologically dynamic environment may not always be conducive to one’s cultural beliefs; hence, change happens at different rates and is accepted in different forms. To me, cultural sensitivity is our ability to accept people as they are, in whatever stage they are at within that changing environment. During my years as a Labour and Delivery nurse I had many opportunities to learn about culture sensitivity. I was honoured to support many different cultures and learn how they experience life differently than the status quo Caucasian, middle class. Our environment is often different from what that family may have either experienced or were schooled in. Personal and cultural beliefs must be respected to make these transitions as positive as we can. Bringing a baby into the world, or even the loss of a baby, is a lifechanging event and supporting that event is essential in a manner that complements the beliefs and ways of each culture. I feel fortunate to have had these experiences and empowered to be able to work with these families.
Nicola King, Acute Care Social Worker When I work with Aboriginal people, I engage with an open heart and mind. I think it helps having some understanding of the impacts of Canadian history and colonization on Indigenous people. I feel a responsibility to try and undue some of the harm that has been done. I recognize the unfair inequalities in health care and I try to create a space free of personal biases where people feel safe when receiving health care. I humbly acknowledge myself as a learner when it comes to understanding another’s experience, and honour building relationships based on mutual trust. Natalie Daniels, Social Worker Culturally sensitive care is what is required by patients, families, and communities to feel culturally safe and supported. Culturally sensitive care is best accomplished with awareness of cultural differences and similarities, and understanding of our beliefs and biases and reflecting on how those can affect our interactions. Each patient, family, and community member should be respected. For me, providing culturally sensitive care that is culturally safe means ensuring the patients direct their care and are kept apprised of everything the care team feels is necessary to reach the patients’ care and health goals in a culturally sensitive way.
Kimberly Skerritt, Social Worker Being with someone where they are at, and offering support in a way that's meaningful and helpful to them with respect to their needs and history and beliefs. Offering care in this way, I hope, helps with a positive, trusting, and safe working relationship.
Adrienne Lewis, Splatsin Home Care Nurse I will share a story about a local elder who was a patient in Vernon Jubilee Hospital, but let me preface it with a word about the value of relationships. The happy ending to this story would not have happened without the respectful relationships we have created over the past three years with hospital staff. Our collective goal has been to empower community members to self-advocate through education about VJH and create an environment for First Nations people to receive culturally safe and sensitive care. Cultural sensitivity is only a step on the path to culturally safe care. My story involves a Splatsin elder who spent five days in hospital before our community health staff realized she was there. Once we became part of the case conference, we were able to share important information that this patient was of sound of mind, but very hard of hearing. This information changed her care plan completely. With her permission, the hospital team was also able to share with us how she came to be admitted, in turn enlightening us about new risks of her impending discharge. We were able to relay some critical information about current and future plans of care already in place for this client and we moved forward together. The information circle was complete and nurses were able to develop a relevant care plan that was culturally safe. The essence of culturally safe care occurred when this patient was able to direct her own care. VJH nurses were also open to creating a plan that considered the whole patient, included our home-care staff members, and then successful discharge was possible.
Michelle Miller, Palliative Care Co-ordinator Cultural sensitivity is what you tell me it is. It is what the patient and those accompanying the patient through this journey decide it is. It is the cyclical journey in between birth and death that defines who we are and our beliefs. So when anyone is nearing the end of their journey, it is for them to decide how they choose to approach that journey. Cultural sensitivity in regards to palliative care means really listening (the words silent and listen have the same letters, just rearranged) to what you are being told about what is important to the person on the journey. It also means asking questions respectfully and without judgment, honouring the person’s beliefs and advocating for their needs and wishes. Many years ago, a dying First Nations patient was transferred to our floor during the night shift. The family requested to drum – a sacred part of their ceremony for this dying elder. The charge nurse said “absolutely not.” She was unmoved when it was pointed out to her that drumming for the family was the equivalent of last rites to a person of Catholic faith. The family never said a thing. They didn’t have to; their sadness and disappointment was written all over their faces. Things are changing slowly now as evidenced by one of my recent patients in ICU. The large family of the patient was given a room to stay close to their loved one and the rule of no more than two people at a time in the room was waived for them. Most important, with the help of the Aboriginal navigator, they were heard. I don’t need to know every ceremony or tradition of the culturally rich First Nations although I would love to. I just need to listen without judgment, respect their choices, and make sure everyone hears their voice. And the best part of all is that it is not hard to do, you just have to care.”
Marylou Givens – Registered Nurse I practise cultural sensitivity in my professional and personal life by making the effort and time to listen to people’s stories, free of personal biases and judgments, and in a friendly, empathetic way. I read body language to gauge how I am doing; the goal is to become the facilitator, guiding patients to take control over their own situations and lives. I do not have the power to know everything, but I can learn a great deal through the patients. I work in the area of mental health and substance use, and feel honoured that many patients have trusted me with their life stories. Those who choose to remain quiet are also respected, and resources explored for alternative options for dialogue. One example of how I carry myself in a culturally sensitive manner is to not make assumptions based on a patient’s ethnicity or appearance, and never start out a conversation by asking questions about the patient’s mental health or substance use. I try to meet people’s immediate needs first, such as safety, thirst, hunger, warmth, and issues that the patient identifies. I aim to communicate that I practise holistic nursing, putting safety and the needs of my patients first.
Norm Samson, who bounced back from a major stroke in September, with Stroke/TIA Nurse Noreen Spanell.
House guest lifesavers
W
hile hosting visitors from Australia – they arrived only the day before – Norm Samson suffered an acute stroke that knocked him flat in front of them.
A dreadful coincidence for all involved that September morning had it not triggered a critical sequence of events that went like clockwork. Norm believes his visitors were lifesavers, promptly summoning his wife’s help. “If they hadn’t been there, I wouldn’t be here,” says the 74-year-old Kelowna retiree.
was. When able to get to a hospital or clinic within a threeto four-hour time frame, stroke patients qualify for a thrombolytic clot buster known as tPA (tissue plasminogen activator or antiplase). That can make all the difference between rapid recovery and months of rehabilitation. Or worse – permanent, life-altering disability or even death. “The response time was phenomenal,” Norm says of the chain of events that followed his wife’s 9-1-1 call. “I can’t say any more about it; they were absolutely fantastic. When I left the hospital the next day, I was given a clean bill of health.” “You made my day,” Dr. Daryl Wile, the neurologist, told him.
The house guests first thought their host was joking around when he collapsed. His wife knew instantly this was no joke; Basically, stroke is an injury to the brain. An artery is Norm suffered a mild stroke two years earlier. Mere minutes blocked or cut off, potentially causing injury to the brain could be critical. because it can’t get oxygen or nutrients. The extent of long-term or permanent damage depends on how long the Stroke is the No. 1 cause of acquired long-term disability blockage remains. For Norm that time period was less than among B.C. adults. Numbers have climbed steadily in recent an hour, a critical determinant in his ability to recover years, yet a stroke need not be the life sentence it once quickly once treated with tPA.
When his stroke occurred around 7 a.m., the retiree lapsed into unconsciousness. He has only a vague recollection of the trip to Kelowna General, the siren wailing. A paramedic called the emergency department to advise staff that a stroke patient was en route. At 9:05 a.m., he was wheeled into the emergency department, presenting with right-side paralysis and an inability to speak. A quick assessment followed by nurses and the emergency department physician, Dr. Kevin Clark. A neurologist and stroke nurse were immediately notified, making for rapid response and treatment.
preventive care from the hospital as Norm and also excellent rehabilitation for the month she was in hospital, but when she was discharged, she felt there was nothing for her. “It was one year later that I heard about Living with Stroke through the Heart and Stroke Foundation.”
Jennifer served as a patient voice on Interior Health’s stroke collaborative and her story reflected the experience of other stroke patients as they transitioned out of hospital. Those concerns prompted the IH team to approach the Heart and Stroke Foundation with a proposal for a Stroke At 9:39 a.m. he was administered tPA, 34 minutes after his 101 pilot at KGH. arrival. Cory Bendall, Practice Lead for IH Stroke Strategy, said Norm’s experience attests to the importance of quick the Heart and Stroke Foundation has been an invaluable recognition of symptoms and the sequence that follows, partner for IH and provided funding for the program to says Noreen Spanell, stroke/transient ischemic attacks improve discharge from hospital. That initiative and another nurse. one at Royal Inland Hospital will result in a curriculum that will be spread to other primary care sites in IH for stroke The recommended time administering tPA is within 60 patients leaving acute care. minutes of patients’ arrival in the emergency department. New best-practice guidelines for stroke, set by the In Kelowna, Stroke 101 provides stroke secondary Canadian Stroke Network and the Heart and Stroke prevention and risk reduction education as well as a “warm Foundation, recommend 30 minutes. Time counts – 1.9 handover” linking patients to the Heart and Stroke’s Living million brain cells are lost every minute. with Stroke Program where, for the past three years, Jennifer has been a peer facilitator. In 10 minutes, Norm’s symptoms began to disappear. Within a few hours he was back to normal, though he While there is wide variation in the physical, mental, and remained in hospital for observation until the next day. emotional challenges in stroke recovery, Jennifer, a former A follow-up CT scan showed no damage from the stroke. lawyer, leads her groups to discover commonalities. He was able to return home and resume his active life, Sharing common experiences gives people the strength and woodturning as a hobby and planning for their new home courage to continue in what can be a long road to under construction. He was referred for followup to the recovery. stroke clinic and a Stroke 101 class. Signing up for Living With Stroke requires just a phone call: Three words sum up Norm’s best assurances of a healthier 1-888-473-4636. future. “I quit smoking,” he says. Norm has had his share of stress since his stroke, getting After his first stroke, he tried to quit his smoking habit but a new roof installed and making preparations to move gave up after three weeks. This time, using nicotine to a new home. Quitting smoking in itself is stressful, but patches, he’s determined to quit for good. That, a doctor he’s managed well so far. He also uses an app called assured him, will be the best safeguard against another Lumosity, a brain challenger that has helped him recover stroke. his speech. “I just knew I had to do it.” Had he needed additional support, Norm could have joined Living With Stroke, an eight-week program of two-hour sessions for stroke survivors in the health region. The course is offered to everyone in the community and no referrals are required to participate. “When people have had a big event, they often don’t know where to go,” Noreen said. “It’s a huge stressor. There’s lots of fear and anxiety.” The fear is palpable for Jennifer Monaghan who had a stroke at 43 in 2012. She experienced the same great
Twenty years ago, his outcome would have been dire in all likelihood. “I’d either be having someone changing my diaper or I’d be dead.” He’s glad to be able to return to his woodturning. He and his wife are looking forward to moving into their new home. “We’re both excited.” And they’ll happily host their Australian guests when they next visit B.C.
Brent Hobbs, Network Director, Patient Transport @IH: What is your role at IH? I am the Network Director for Patient Transfer Services for the region.
@IH: What services do you provide? I oversee a network of patient transportation services and related access and flow pilot projects. The IH Patient Transport Office (PTO) coordinates 25,000 routine scheduled inter-facility patient transfers a year with a variety of vendors (BC Ambulance Service and alternative service providers). We go beyond just transfers, coordinating transports to meet the operational requirements of IH facilities. The High Acuity Response Team (HART) also falls under our portfolio. Located at four regional hospitals (Kamloops, Cranbrook, Penticton, and Trail), HART supports the stabilization and transfer of complex patients to a higher level of care. When they are not transferring patients, HART provides patient care activities at their base hospitals such as outreach support to medical-surgical units. Health Connections, another program I oversee, provides rural public transit services and volunteer driver programs to support rural patients’ access to specialty medical appointments in urban centres. The IH PTO has developed a cross-facility patient repatriation planning and coordination system. The goal is to pre-plan and “pull” patient repatriations back to their home community as soon as it is appropriate. In addition, our team is involved in networking functions with BC Emergency Health Services and its counterparts in Alberta, strategic planning, heliport planning, clinical protocol development, and providing input into provincial policies.
@IH: What makes a really great day at work? For me,
Brent Hobbs (C) swam to work on his first day at CHSC with swimming friends Emily Epp (L) and Phred Martin (R).
all across rural B.C. and, in many cases, it took days not hours to transport these patients to a trauma care centre. The HART model is a manifestation of many hours of thinking about ways to bridge some of the service gaps. I also used to work as a primary care paramedic in a rural setting and I have many years of experience as a clinician in critical care and emergency care settings. HART is really my dream job as a clinician. It combines all of my clinical passions plus I enjoy supporting rural and remote clinicians for whom I have a tremendous amount of respect.
it is incredibly rewarding to see patients move seamlessly through the continuum of care – whether it is for a routine scheduled appointment coordinated by the IH Patient Transport Office, a rural citizen using the Health Connections bus service @IH: What is the best part about where you work? to access a medical specialist at a larger centre, or the I get to travel throughout IH, one of the most beautiful and deployment of the HART team to support a critically injured diverse landscapes on the planet! In my opinion, it is an patient in a rural location. absolute must to experience the challenges of transport by driving our health authority’s vast distances over rugged and I also love taking advantage of the many outdoor recreational sometimes unforgiving terrain. I can better appreciate the activities in the rural communities I visit and sometimes even challenges our rural/remote patients experience when drag my rural colleagues along. accessing specialty health services located at our regional/ tertiary care facilities. I also love connecting with the clinicians @IH: Do you have any highlights or is there a throughout the region. I believe they are the unsung heroes of particular project you have been involved in that stands our health authority. They have to be “jack-of-all-trades” out for you? The HART project, in particular, stands out for clinicians with minimal back up and support. We need to me. I used to be one of the Trauma Program managers at support these folks with responsive transportation systems like Vancouver General Hospital where we received patients from the HART team and with new innovations like telehealth.
Community Health & Services Centre, Kelowna
100,000
Weight of each wall in lbs.
20,000
140,000 Square feet
800+
80
Pieces required to complete workstations
Bike racks
Staff members
Stats gathered from 2015-2016 data. Nominate a colleague, manager, or site for a future spotlight.
400-500 Projected volume of daily patients
Oliver Submitted by: Tina Leibel
Cranbrook Submitted by: Dianne Dilts
Radium Hot Springs Submitted by: Cathleen Christensen
Kamloops Submitted by: Jennifer Maier
Where We Live & Work ... A Spotlight on Our Communities Covering more than 215,000 square kilometres, Interior Health is diverse in nature and composed of vibrant urban centres and unique rural communities. Photos are submitted by employees and posted to the InsideNet. Select photos are featured in @IH.
Submit your photos of the beautiful places that make up IH on InsideNet Spotlight Photos.
The Regional Cardiac Team is travelling to IH acute care units, educating staff about a new Heart Failure Toolkit, which includes a patient education binder. Here, at the East Kootenay Regional Hospital in Cranbrook, Regional Cardiac Clinical Nurse Specialist Jeannine Costigan (C) meets with RN Susan Pel (L) and RN Tara Bower. The education binders were developed by the BC Heart Failure Network and are an excellent resource to help facilitate patient self-care education.
Patient Dayle Kaye has been penning poetry of gratitude for the Food Services staff at 100 Mile District General Hospital. Seen here with Dayle are (left to right) Angela Walker, Monica Keogh, and Bethany Whelan. Read Dayle’s story on our “In the Loop” website.
Dexter Forbes, an anesthetic assistant at Royal Inland Hospital, oversees a lesson in intubation during the annual Take Our Kids To Work Day at the Kamloops hospital on Nov. 2. Every year, RIH welcomes Grade 9 students (sons and daughters of staff and physicians) and makes sure they are treated to some hands-on experiences in one of the hospital's ORs. This year, 50 students gathered to try their hands at suturing, intubating, drilling, and more. Thanks to the volunteer staff, physicians, and medical students who helped make the day memorable for all.
The Canadian Paediatric Society has released this video busting the top flu myths with clever analogies and witty illustrations. Learn more at www.iboostimmunity.com.
See some of the initiatives your colleagues have undertaken to reduce IH’s environmental footprint. For more information on how you can be a sustainability associate, visit The Environmental Sustainability page on InsideNet.
An important and timely message about removing the stigma of mental illness especially around the holidays.