Nurses’ Notes
September 2007
Newsletter of the Yukon Registered Nurses Association
MESSAGE FROM THE PRESIDENT
"Each time a man stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, he sends forth a tiny ripple of hope, and crossing each other from a million different centers of energy and daring, those ripples build a current which can sweep down the mightiest walls of oppression and injustice." Robert F. Kennedy These words struck a chord with me particularly as I had recently reviewed previous messages from YRNA leaders. Over the years, thought provoking and informative pieces have been delivered with unique personal touches that say so much about the individual author, and resonate with passion and wisdom. And many of the topics remain true today. tice); diminishing workforce; retention & recruitment; collaborative practice; nurse practitioner role; SelfRegulation; Ethics; impact of trade agreements; and the burden that comes with the financial impact of the Residential Schools Abuse settlement. As president of YRNA, I will continue to champion nursing; best practice; and healthy public policy – not below the radar screen, but whenever I have the opportunity to do so. Thank you to everyone who has contacted me personally over the past few months to discuss nursing issues. You are true leaders, and it is evident that the profession is in ‘good hands’. It is imperative that we work together so that ‘those ripples build a current’ and that we as the largest group of health care professionals in the territory, demand a healthy quality work environment to move us out of the 20th Century, for the benefit of all.
Respectfully submitted, Paula Bilton, RN
One has to question why progress on many fronts has been so limited or even non-existent. For example, eviChallenges that face nursing are dence based research supports delivmany, and over the past year we have ery of patient care through a collabobeen drawn into the arena of nursing rative practice model, so that patients health human resources – a fitting receive the most appropriate care by journey indeed given the implications the most appropriate provider in a for nursing in Yukon, and heightened timely fashion. What’s really at stake by the reality of current practice envi- here? Is it quality patient care delivronments. Focus has been on complex ery? Or is it ye olde ‘resistance to topics that affect nursing practice envi- change’, and the inability of stakeronments – quality of work life holders to dare to challenge the ‘status (includes safety; aging workforce; quo’ when it is clearly in the best interworkloads; balance with personal/ ests of all. family roles; as well as scope of prac-
Tuesday, October 16th
Join your nursing colleagues for a presentation and discussion on the potential challenges for health care workers resulting from compensation settlement for Former Residential School Students which will be paid out to Yukon First Nation individuals in the next few months.
7:00 p.m. at the YRNA office
Fragrance-free please.
Research Participants Needed
RNs are invited to participate in a research study conducted by Simone Arbour from the Department of Psychology at the University of Windsor. The purpose of the study is to examine the relationship between person-environment fit (the match between an employee and his/ her work environment) and occupational outcomes such as work attitudes and behaviours in a sample of Canadian nurses. The ultimate goal of the research is to use personenvironment fit theory to help explain some occupational outcomes related to the nursing crisis in Canada (i.e. the current nursing shortage and high turnover rates). Volunteers will be asked to take approximately 15 minutes to complete an anonymous and confidential online survey. For more information about the study and to access the survey go to: www.uwindsor.ca/users/a/ arbours/main.nsf If you have any questions or concerns about the research, please contact Simone Arbour at arbours@uwindsor.ca or Dr. Catherine Kwantes at ckwantes@uwindsor.ca or 519-253-3000 ext. 2242.
Yukon Advisory HONOURARY MEMBERSHIP Committee on Nursing CALL FOR NOMINATIONS
The Yukon Advisory Committee on
Nursing (YACN) is an advisory committee to the Minster of Health and Social Services and is responsible for making recommendations to the Minister on improving the planning and management of nursing human resources, including retention and recruitment. YRNA has three positions on this committee, two of whom must be registered nurses. This allows YRNA the ability to also nominate a member of the public. One of these positions is currently vacant and a second one will become vacant at the end of the year. The one currently vacant must be filled by an individual from a rural community. The other one has no stipulation regarding residence. If you are interested in either of these positions, or know of someone who would be a good candidate, please contact the YRNA office. Appointments to YACN are made by the Minister based on nominations from the participating organizations.
Do you know a current or former Yukon nurse who rendered distinguished service or valuable assistance to the nursing profession territorially, nationally and/or internationally? YRNA’s Honourary Membership category was established as a way to recognize outstanding contributions to the nursing profession by colleagues. Members are invited to submit Honourary Member nominations to the YRNA Board for consideration prior to December 31st. Presentations will be made at the 2008 Annual General Meeting. Honourary Membership criteria and nomination forms are available at the YRNA office or on the website at www.yrna.ca. Don’t delay—–do it now!
Looking for Invigilators
On an increasing basis, YRNA is asked to accommodate transfer candidates from other jurisdictions to write the Canadian Registered Nurse Exam (CRNE) in Whitehorse. We are always happy to do so provided we can find someone to invigilate the full day exam. There is an honorarium paid for this work. If you are interested, please contact the YRNA office and we will establish a contact list for future CRNE sittings.
YRNA BOARD MEMBERS
Paula Bilton Peggy Heynen Antonia Manolis Jackie MacLaren Maureen Crill Andrea Mainer Diane Kirchgatter Public Representative: Bob Lorimer President President-Elect Secretary Treasurer Members-at-Large:
Tobacco Cessation Course
After attending the BCCA conference last year, Mary McAvoy brought back with her three copies of the reference materials for an online tobacco cessation education program for nurses. Anyone interested in pursuing this on-line course is encouraged to contact Mary in the Chemo Suite at 3938882.
YUKON iPOD WINNER
Congratulations to Jackie MacLaren who was the lucky winner of an iPOD through the NurseONE promotion in May. Happy listening Jackie! NurseONE is an amazing personalized interactive web-based resource for nurses. You can access up-todate, accurate information on a wide range of topics which has been vetted by CNA and its review committees. Go to www.nurseone.ca to check it out.
www. yrna.ca
Check it out!
Page 2
The YRNA newsletter is published four times a year. Publication dates are February 28th, May 31st, August 31st and November 30th. Deadline for submissions is the 1st day of the month of publication. Articles and letters are welcome and should be addressed to the Editor. Inclusion of items in the newsletter does not imply endorsement or approval by the YRNA. Yukon Registered Nurses Association 204—4133—4th Avenue, Whitehorse, Yukon, Y1A 1H8 Phone: 867-667-4062 Fax: 867-668-5123 E-mail: yrna@yknet.ca Web: www.yrna.ca
If you would like to receive e-mail notification of YRNA events (Coffee Talks, etc.) please let YRNA know: yrna@yknet.ca.
YRNA Nurses’ Notes
September 2007
FROM THE EXECUTIVE DIRECTOR
The effects of a nursing shortage have been apparent in the rest of Canada for some time now. In the Yukon, we have not experienced the symptoms as severely, however there are signs that we are heading in the same direction. Despite all the information that has been produced nationally and locally and despite the warnings that YRNA has been giving for at least ten years when we first realized that a problem was looming, a comprehensive, preventative strategy has not been put in place. In 1997 the Canadian Nurses Association published a report that predicted a worrisome shortage of nurses in Canada. Since then, calculations have been updated and the latest predictions are that we will be 116,000 short by the year 2011. bers of nurses that the system needs. Locally, mentoring new graduates seems like such a simple solution, however that means freeing up experienced staff with already heavy workloads to provide the support. These hurdles should not prevent us from initiating these strategies, but they mean that we need to be willing to put the energy and some creative thinking into it. YRNA has the mandate to regulate the registered nurse profession, to
Patricia McGarr, RN
It doesn’t matter what state of the art equipment we have on hand or how many beds are ready to be opened, without adequate numbers of health care workers to provide care, that equipment and those beds are irrelevant.
promote standards of nursing practice and to advance nursing excellence in the interest of the safety of the public. As part of that mandate, YRNA has been very active in providing information about a national nursing shortage, the consequences for the Yukon and issues related to retention and recruitment. Not only have we provided information, we have also made numerous, related recommendations to try to safeguard the quality of patient care in the territory. It doesn’t matter what state of the art equipment we have on hand or how many beds are ready to be opened, without adequate numbers of health care workers to provide care, that equipment and those beds are irrelevant. It is obvious that no one government or employer can tackle the situation
YRNA Nurses’ Notes
alone and that collaboration is required between federal/provincial/ territorial governments, professional organizations, employers and others. YRNA has stressed the need for solid planning in retention and recruitment in this time of an aging workforce and a global shortage of health care professionals. Although some strategies have been initiated, a comprehensive plan has not been put in place either nationally or locally. Without a timely, coordinated approach, it has been apparent for some time that the shortage cannot be avoided. However, in a closely linked jurisdiction like the Yukon, it could have been better managed. The people of the Yukon have watched the deterioration of health care in the rest of Canada. YRNA fears that we are now catching up. At this time, most Yukon health care workplaces are facing great strains from the perspective of the staffing levels of nurses. Nurses are booking overtime weeks ahead; some units are consistently short staffed every shift; nurses are being phoned at home to come in on days off – four phone calls a day is not unheard of. While some of these issues have been around for some time, they have become more evident and troublesome in the last months. We have recently seen admitted patients being housed in the emergency room of the hospital for a number of days. The symptoms of the shortage that has hit most of Canada are now apparent in our territory. In the Yukon there are various reasons why we have been able to hold off the more serious signs of trouble
Page 3
In the Yukon, our registration figures have not fallen but this is because many of our members come for term assignments and the numbers do not reflect the reality of the workplace. A truer indication of what we are facing is the advancing age of nurses here (55% are over 45) and the accounts from nurses about staffing problems and shortages within individual health agencies. The nursing shortage is a very complex issue and, while some solutions would be simple to initiate, others are not so simple. For example, at the national level, the call to increase university nursing seats (one may think an easy solution to increase the number of nurses) was matched with the realization that there was just not enough faculty to educate the numSeptember 2007
and it is largely due to the dedicated people who are providing clinical care. In our health care agencies there has been a community of health professionals and allied health workers who have worked together over many years to provide an environment of safe care to the public of the Yukon. In the territory, as elsewhere, there is an increasing demand on the system, often by sicker patients, at a time when there is an increasing shortage of health care professionals. The community of health care professionals and allied staff in the Yukon have collaborated more closely, picked up extra shifts and duties, and have worked overtime in order to continue to provide the same standard of care to the people of the Yukon. It is this level of professionalism and dedication to each other and the people of the Yukon that has caused them to go to work daily and allowed our health care system to continue to function at the high level it does.
ideal but allows them to use those skills that cannot be used in any other agency. They care about the ongoing provision of safe care to the Yukon public and they would not leave their co-workers high and dry. They do not want to cause a breakdown of the health care system in the Yukon. YRNA is worried that we have left it too late to initiate some of the strategies proposed over the last ten years—strategies and ideas that have
nent positions would provide benefits and stability—a great retention strategy and also a recruitment strategy for new graduates and experienced nurses. In addition, revised staffing patterns which result in the reduction of sick time and overtime costs would also be financially efficient. The studies are there to prove this. Another staffing proposal relates to hiring support staff to do clerical and cleaning duties so that nurses can nurse. An issue that is particularly worrisome is that of the loss of leadership within the profession. When we look at the age of registered nurses in the Yukon, we know that we will be losing clinical and administrative nurse leaders in the next few years. It is crucial to have nurses ready and willing to step into those roles. Research has shown that professional nursing leadership has a direct impact on quality of care, patient health outcomes and patient safety. It has also shown that nurses are more satisfied in a workplace that puts emphasis on nursing leadership because they are more likely to be supported in their professional capacity. Satisfaction with work and good morale are not just about keeping nurses happy, they are directly related to encouraging nurses to stay in a workplace and to encourage others to join them there. Nurses have been clear that it is not good wages and benefits that keep them in a particular job, although these are also important; it is the quality of the work environment. They want to work in a quality professional practice environment that includes effective nursing leadership, a realistic workload, support to work as responsible and accountable professionals, good communication and respect. In this time of shortage it is imperative for stakeholders to pull together and aim high. Yes, it takes time, energy and resources but the alternative will be more onerous in the long run.
September 2007
Our members and others have been covering short falls in the system . . . and this is beginning to take its toll.
been researched by health human resource experts and professional organizations. However, we continue to meet with stakeholders to offer suggestions at the broadest level as well as specific ideas that could have immediate benefit. At the broader level, we have suggested that there must be a strategy that looks at health care providers overall. This strategy would take into account the health needs of Yukoners and the skills of the various providers we already have here. It would examine more efficient ways of deploying providers to provide better access to care and to avoid overlap of services. A more formalized method of collaborative practice would be a part of this system change. More specifically related to nursing, we suggest that there be a review of staffing levels throughout the Yukon. This would include, but not be limited to, looking at how many nurses are employed on a casual basis, how many hours are those nurses actually working and calculating which of those casual positions should be turned into permanent positions. Those permaYRNA Nurses’ Notes
Our members and others have been covering short falls in the system for a period of time already and this is beginning to take its toll. Nurses are concerned that they are no longer able to provide appropriate care to patients and regularly go home at the end of the day feeling guilty that they did not spend enough time with a patient or family that needed support. This leads to moral distress and low morale, yet nurses continue to live and work here. They choose to do this because this is their home and they love the Yukon and the lifestyle. They have raised, or are raising, their children here—an ideal place to do that. Their spouses have jobs here. Many nurses are specialized in a specific field and because of limited professional opportunities in the Yukon, stay in a work environment that is not
Page 4
Residential School Common Experience Compensation
by Jackie MacLaren RN, B.Sc.N. CAIRS Society Secretary/Treasurer As many of you are aware, the Former Residential School Students will soon be receiving financial compensation for their years of attendance. The final date for acceptance of the government package is August 20, 2007. If it is accepted, former students will then be able to apply for their compensation. Applications will likely be available in September/October. There will be a lot of information in the media and on the website listed below. It is expected that the financial compensation will be distributed in November/December 2007 and will range between $10,000 -$55,000 per former student. At CAIRS Society, we have done some rough calculations based on Yukon statistics and we anticipate approximately $92 million coming to Yukon former students. While we strongly believe that there is a need for the government and churches to make amends for the harm done to First Nations people through the residential schools, we are concerned about the influx of money and the potential harm it could do. We want to encourage frontline workers to be aware of the potential challenges and begin discussions at the community level. While some individuals are well prepared to handle their finances, some are not and they will be easy targets for fraud and abuse. Increased access to alcohol and drugs is a major concern and all workers are encouraged to have safety plans if dealing with individuals under the influence. CYFN hosted an information session for community workers and information packages have been developed. For those of you in rural settings, these can be accessed through your community Health Commissioner. The staff at CAIRS can be contacted by email at cairs@northwestel.ca or 867-667-2247 if you have questions. The Indian Residential Schools Resolution Canada (IRSRC) website: http://www.irsr-rqpi.gc.ca/ Frequently Asked Questions (FAQ) page. English - http://www.irsr-rqpi.gc.ca/english/questions.html French - http://www.irsr-rqpi.gc.ca/francais/questions.html
Editor’s Note: See the notice on page 1 about the YRNA Coffee Talk scheduled for October 16th at which Jackie will present information related to this issue.
September 2007
CNA Centennial Awards
CALL FOR NOMINATIONS
The Canadian Nurses Association (CNA) will marks its 100th anniversary in 2008. As part of the celebrations, CNA will present one-time awards, the CNA Centennial Awards, to 100 Canadian registered nurses to recognize their contribution to nursing in Canada. The Yukon Registered Nurses Association (YRNA) has the opportunity to nominate two individuals for these awards. To assist with identifying potential nominees, YRNA is inviting members to submit names and supporting information. The CNA Centennial Awards will: · recognize living registered nurses (or former registered nurses): - whose personal contribution has had a positive impact on the nursing profession and/or the practice of nursing in Canada and/or abroad that brings credit to nursing in Canada - who have contributed in one or more of the areas of nursing – practice, education, administration, research, policy and regulation - who have made consistent contributions over time · represent the geographic diversity of Canada, as much as possible. For more information about eligibility criteria and nomination requirements, please contact the YRNA office (6674062 or yrna@yknet.ca). The deadline for submission to YRNA is October 5th, 2007. A final decision on YRNA’s two nominees will be made by the YRNA Board and forwarded to CNA.
April 25-26
Page 5
AGM 2008
YRNA Nurses’ Notes
At the Annual General Meeting in April, three new members joined the YRNA Board. Peggy Heynen became the President-Elect; Antonia Manolis took on the role of Secretary, and Diane Kirchgatter is a Member-at-Large representing rural members. Two of the new Board members are introduced here. The third will follow in the next newsletter.
Meet YRNA’s New Board Members
Peggy Heynen, RN
My name is Peggy Heynen (nee McNeil) and I work at Whitehorse General Hospital on the West unit. I have lived in the Yukon for 14 years, coming here from Nova Scotia, and have worked in several jobs in that time. I started out working for "Nursing Options," then moved to the Thompson Center and the hospital. I have worked in almost every aspect of the hospital including doing medivacs and covering a "float" position that entailed working whatever unit was short staffed or the busiest. Needless to say I’ve had lots of new and exciting experiences and have learned a lot in my years of nursing in the territory. The Yukon certainly has been a land of opportunity for me and I feel being President-Elect of YRNA is just another great opportunity to learn and grow and contribute to a profession that I truly love and am in because I feel I can help make a difference to people's lives, including those of my colleagues.
Antonia Manolis, RN, B.Sc.N.
Hello, my name is Antonia Manolis and I am the new Secretary on the YRNA Board. I moved to the Yukon in 1997, just after finishing my diploma program in Victoria where I lived for 7 years. My formative years were spent in Toronto. Since moving to the Yukon, I spent a year working at the Thompson Centre and then began at Whitehorse General Hospital where I currently work on the Maternity Ward. I decided to get some first-hand experience and my son is now 4 months old! I have a passion for travel and have done a little nursing overseas. I also continued my nursing studies and, in December 2005, I completed my B.Sc.N. through University of Victoria. I am excited to be a member of the YRNA Board to gain a greater understanding of nursing issues and to be part of an organization dedicated to the nursing profession.
President-Elect
Secretary
Page 6
YRNA Nurses’ Notes
September 2007
My Experience with the Community Health Nursing Association of Canada (CHNAC)
by Heather Johnson, RN Thank you YRNA for funding my CNA Community Health Nursing Certification in 2006 and for funding me to attend the National Conference for Community Health Nurses that was held in Toronto last May. CHNAC is composed of community health nurses— home care nurses, public health nurses, out post nurses, and street nurses). Presently there are 2,150 members. Membership to CHNAC is $30.00/year. CHNAC unveiled their new website at their AGM and it can be seen at www. chnac.ca. During the AGM I was nominated and accepted the Yukon position on their Board of Directors. While CHNAC has been around for 25 years, their first conference occurred in May and was entitled “Mapping the Future for Better Health – Innovation, Leadership and Integration.” Similar to Michael Villeneuve’s paper “Toward 2020: Visions for Nursing”, CHNAC wants to create a position paper on its vision of community nursing in the future, including identifying themes that will be significant in the future of community health nursing. In 2003 CHNAC developed the Canadian Community Health Nursing Standards of Practice. There is now a toolkit available to help implement these standards. Many jurisdictions across the country have adopted these standards, and as well they have been translated into Japanese and are used in some Japanese communities.
I encourage community health nurses to work toward getting CNA Certification in Community Health Nursing. At the conference two nurses spoke about their experience in pursuing Certification. They stressed how useful the learning process was and found building relationships with community health nurses from different areas of community nursing valuable. Once certified there are opportunities to become a mentor for this exam, write future exam questions and become a member of the CNA Community Health Nursing Exam Committee. The conference included pre-conference workshops, large group sessions, many small concurrent sessions and poster presentations. The following list is a small sample of some of the topics presented at the conference: · community based mental health promotion programming for women, · political advocacy for nurses, · responding to disclosures of intimate partner violence in home visitation, · developing best practice guidelines for suicide prevention, · negotiating relationships in home based palliative care, · implementing life skills programs for vulnerable teens, · health care needs from the perspectives of homeless persons, · Aboriginal women caregivers of the elderly in geographically isolated communities, · Aboriginal nurses’ perspectives on community health nursing (by Gaye Hanson the only Yukon presenter), · the impact of raising postpartum women’s knowledge of postpartum depression. CHNAC’s next conference, entitled Shaping the Future: Practice, Power and Politics, will be May 29, 30, and 31 2008, in Toronto. I hope to see you there!
Update on the Registered Nurse Education Funds
As I write this in the last few days before the August 31 application deadline, the number of applications coming in indicate September will see a busy review for the Education Fund Management Committee. As you will know from previous notices, the last two years have brought a significant increase in member requests for funding, in both number and dollar amounts. YRNA and the Committee faced a situation where demand quite clearly exceeded money available through our Contribution Agreement with the Yukon Government Department of Health & Social Services. YRNA submitted a number of documents
September 2007
to demonstrate the situation to government representatives and, when we met with Health & Social Services staff in May, we were able to obtain a commitment for a three year increase in funding. For the three years covered by the current agreement, we have an additional $75,000 to support ongoing education for our approximately 350 practising members. The Committee will, in its September meeting, consider how policies and practices should be updated to reflect current funding. We are also working to revamp all forms and policy statements for clarity and consistency (something I have wanted to do for
YRNA Nurses’ Notes
a few years, but have been too occupied with the day to day workload associated with the education-hungry population of nurses I am delighted to serve!) If you have ideas or suggestions, please feel free to let me know by phone (867667-4062) or email (registrar@yrna.ca). And remember that deadlines for submission of applications has been increased to 5 per year: the last day of January, March, May, August and November. Catherine Bradbury, RN, B.Sc.N.
Coordinator of Regulatory Programs Page 7
Yukon Registered Nurses Association
204—4133—4th Avenue Whitehorse, Yukon Y1A 1H8 Phone: 867-667-4062 Fax: 867-668-5123 E-mail: yrna@yknet.ca Web: www.yrna.ca
MAIL
POSTE
Postage Paid Publications Mail Registration #40017695 Y1A 1H8
Coming Events . . .
Oct 11-13, 2007 Family Medicine Forum 2007. All family practice nurses or other nurses who may benefit from attending this national forum to learn and network are invited to attend. For more information contact: www.cfpc.ca Western Nurse Leaders Forum. Leading the Way – the Challenge of Leadership. Co-sponsored by the CRNM, SRNA, CARNA, CRNBC, and YRNA. Winnipeg. Contact: www.crnm.mb.ca/westernleaders.php Oct 15-17
Loca l
Oct 16, 2007
YRNA COFFEE TALK—Learn about the potential impact on health care workers and others of the compensation payout related to the Former Residential School Students Settlement. YRNA Office. 7:00 p.m.
“Seven Humour Habits for Workplace Wellness” with Paul Huschilt. Promoted by WOW (Working on Wellness Team) Whitehorse General Hospital. 1:00 p.m. Westmark Whitehorse. $50 per person. Contact Maureen Turner 867-3938791 ; maureen.turner@wgh.yk.ca Critical Care Consultants presents “Surgical C A N C E L L E Workshop. Whitehorse. Contact Borealis Birth Services —————————————————Emergencies/PACU D——————————————————– at 867-456-2959. National Forum on Cancer Care for All Canadians: Improving Access & Minimizing Disparities. Coast Plaza Hotel & Suites, Vancouver. Sponsored by Interprofessional continuing Education, UBC and BC Cancer Agency. Contact: 604822-0054; lpconf@interchange.ubc.ca ALARM Obstetrical course. Whitehorse. Contact Borealis Birth Services at 867-456-2959. INFACT CANADA 6 day Advanced Lactation Management Workshop. Whitehorse. Contact: Borealis Birth Services at 867-456-2959. 5th International Nurse Practitioner/Advanced Practice Nursing Network Conference. Leadership in Advance Nursing Practice: Maximizing Health, Celebrating Collaboration and Promoting Innovation. Toronto. E-mail: inpapnn2008@meetics.com Web: www.inpapnn2008.com
Oct 26, 2007
Loca l
October 2007
Nov 1—3, 2007
Early in 2008
Loca l
February 2008
Sep 17-20, 2008
Page 8
YRNA Nurses’ Notes
September 2007