BCNU Update Magazine Spring 2021

UPDATE SPRING 2021

M A G A Z I N E

WORTH A

THOUSAND WORDS ‘Photovoice’ research explores nurses’ lived experience of the COVID-19 pandemic

THE LONG HAUL COVID-19’s LIFE-CHANGING CONSEQUENCES

PLUS

PULL-OUT BCNU POSITION STATEMENT ON VACCINATION

PHARMACARE NURSES PUSH FOR A NATIONAL PLAN | READY TO ROLL RETIRED MEMBERS SUPPORT COVID-19 VACCINATION EFFORT | OPIOID CRISIS TOXIC SUPPLY CONTINUES TO FUEL PUBLIC HEALTH EMERGENCY

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CONTENTS

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VOL 40 NO1

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• SPRING 2021 20

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DEPARTMENTS

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PRESIDENT’S REPORT

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GUIDING LIGHTS

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MY JOURNEY

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WHO CAN HELP?

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COUNCIL PROFILE

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OFF DUTY

POSITION STATEMENT ON VACCINATION PULL-OUT p. 19

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UPFRONT

6 CHECK IN The latest news from around the province.

25 THE LONG HAUL For some members, COVID-19 has been a lifechanging illness.

42 OPIOID CRISIS Toxic supply continues to fuel public health emergency.

48 PRESCRIPTION FOR CHANGE Supporting members with substance use disorder.

51 CONVENTION 2021 Proposed Constitution and Bylaw amendments and resolutions.

68 THEY DESERVE BETTER Seniors’ advocates call for long-term solutions.

FEATURE

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WORTH A THOUSAND WORDS Photovoice research is giving nurses an opportunity to shape future pandemic response policies.

UPDATE MAGAZINE • SPRING 2021

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MOVING? NEW EMAIL?

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, Sharon Costello, Lexi Huffman, Kent Hurl, Hanif Karim, Kath Kitts, Caroline Flink, Shawn Leclair, Courtney McGillion, Cindy Paton, Christine Sorensen, Dan Tatroff PHOTOS Lew MacDonald, Dan Tatroff CONTACT US BCNU Communications Department

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

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

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

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

PRESIDENT’S REPORT ACTION LEADS TO HOPE

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PHOTO: PETER HOLST

CHRISTINE SORENSEN

PRING IS NORMALLY A SEASON of new beginnings and new possibilities. But we now find ourselves a year into the COVID-19 pandemic, and nurses, along with many other British Columbians, are exhausted and frustrated.

Nurses across BC are working incredibly hard, and I want to acknowledge your professional commitment in the face of mounting pressure, fear and anger. Over the past year you have endured extraordinary challenges that have taken an immense emotional toll.

Through it all, nurses have shown their value and strength, whether it’s caring for a patient who is newly diagnosed and scared, holding the hand of someone who is taking their last breath, or vaccinating the millions of British Columbians who are looking for hope – and we give them that hope. That’s the gift of nursing.

Now the hour is upon us as the third wave of the pandemic sees spiking case numbers and ICUs filling once more. Thankfully, vaccines will change the public-health landscape as more people are immunized. In the meantime, nurses’ collective action is needed to not only overcome the pandemic, but to call attention to a healthcare system in crisis and that relies on nurses to function.

The pandemic has shown that we need transparency from the government and health employers if we are serious about addressing the long-standing problems facing the system.

Dr. Mary-Ellen Turpel Lafond made this reality clear in her November report In Plain Sight, a powerful review of Indigenous-specific racism in health care. She said the system needs to be more transparent if it is to truly serve patients.

Nurses must be able to speak up, speak out and advocate on behalf of patients without fear of retribution.

Confronting these multiple system crises means investing in all nursing disciplines and sectors, and supporting all nurses, whether they

are working in research and education, in an ER or in community care. I’m proud of the research BCNU members have engaged in on behalf of their patients and colleagues and the perspective nurses bring to policy and decision makers.

Nurses know. We have the solutions, and we need to be at the table. We brought your voice to the provincial government recently when we met with health minister Adrian Dix this April. We reminded him that nurses’ workloads remain unsustainable and unsafe, and are leading to increased stress, burn-out and growing rates of mental and physical injury.

We said that nurses’ inability to provide basic patient care under current working conditions means they’re suffering an unprecedented degree of moral injury. They worry about jeopardizing their professional practice and being unable to meet their standards of care.

Yet nurses remain committed to providing patient care at great risk to their own health and safety. We told the health minister that your clinical judgment must be respected when determining the safety cautions precautions required for your work. And we said that the ministry and health employers must work to ensure nurses always have adequate and unfettered access to PPE, and that appropriate provincial stockpiles are maintained.

We also told him it is vital to expand timely and accessible psychological supports for nurses using dedicated clinicians.

Now it’s time for you to take action, speak up and speak out. Talk to your steward about the tools that are available in your contract to ensure safe practice and working conditions. Write a letter to your MLA or meet and tell them how the crisis has affected your working conditions and your patients.

It’s all too easy to become hopeless in the midst of this pandemic. But action leads to hope, and hope is being able to see that there is light in spite of the darkness. •

UPDATE MAGAZINE • SPRING 2021

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CHECK IN

NEWS FROM AROUND THE PROVINCE

SUPPORTING PSYCHOLOGICAL HEALTH

STUDENT NURSES

FOSTERING CULTURAL SAFETY Union launches new bursary award for Indigenous nursing students

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NEW $1,500 bursary award is now available to Indigenous BCNU student members enrolled in a BC post-secondary nursing program. The bursary is available to those studying to become LPNs, RNs and RPNs, including those currently working as employed student nurses.

The Indigenous Student Nurse Education Bursary (ISNEB) is a provincial initiative of the BCNU’s Indigenous Leadership Circle and reflects the union’s ongoing support for the Truth and Reconciliation Commission of Canada’s 94 calls to action – in particular, the call to increase the number of Indigenous professionals in health care.

BCNU President Christine Sorensen says it is critical to recognize that colonization, racism and systemic discrimination have profoundly impacted the lives of Indigenous peoples and their ability to

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access holistic, culturally safe health care.

“BCNU is committed to fostering Indigenous cultural safety, through cultural humility, and eliminating Indigenous-specific racism throughout our organization,” she says. “This commitment is framed through an ongoing undertaking to establish a genuine and just process of reconciliation with Indigenous peoples.”

In November 2020, the provincial government released a report, ‘In Plain Sight’: Addressing Indigenous-specific Racism and Discrimination in BC Health Care, which echoes the call to action by the Truth and Reconciliation Commission of Canada, and makes it clear that BC needs more Indigenous nurses to help foster a culture of safety.

The report also confirms that colonization, racism and systemic discrimination remain endemic to our care systems, while reminding us of the work that must be

SPRING 2021 • UPDATE MAGAZINE

done to remedy the many harms done to Indigenous people.

The ISNEB is awarded once per year. The 2021 recipient will be announced during National Nursing Week which runs May 10-16. The recipient will be presented the bursary at BCNU’s upcoming 2021 Convention in June. •

Read In Plain Sight on your mobile device.

Learn more about the bursary award and application process at www.bcnu.org

Canadian Mental Health Association BC Division CEO Jonny Morris says “thank you” to all of the individuals who made a contribution to the organization through BCNU’s holiday giving campaign this past December.

With help from nurses and the public, BCNU contributed over $12,000.

The funds supported two programs that are helping people endure COVID-19 fatigue.

Living Life to the Full is a mental health promotion course designed to help people deal with everyday life challenges and learn self-management skills using cognitive behavioural therapy principles, and Care for Caregivers is a free online program providing training and education resources to improve psychological health and wellbeing for workers responding to COVID-19.

For more information visit www.cmha.ca

DEFENDING MEDICARE

BCNU RECEIVES STANDING IN APPEAL IMPACTING FUTURE OF PUBLIC HEALTH CARE BCNU has successfully sought and received intervenor status in a legal appeal filed by Vancouver’s for-profit Cambie Surgeries Corporation and Specialist Referral Clinic.

Last September, a BC Supreme Court decision upheld challenged sections of the BC Medicare Protection Act that ensure patients do not need to pay out-of-pocket for medically necessary health care.

The judge in the case found that duplicative private-pay health care would benefit only the wealthy and healthy at the expense of those unable to afford to pay for their care.

BCNU-supported patient intervenors in the trial provided important evidence showing that duplicative private health care created conflicts of interest and perverse incentives for doctors working in both the public and private system.

Following a March ruling by the BC Court of Appeal on a number of applications for intervenor status, BCNU will now be joining these patients as an intervenor organization when the appeal is heard in June.

BCNU President Christine Sorensen is looking forward to participating in the appeal, and says nurses have always been concerned about private clinics’ business practices. “They’re a direct threat to the health and well-being of Canadians,” she says.

“Nurses care for all, and we believe care should be provided on the basis of need, not the size of your wallet.”

PEOPLE IN PINK BCNU’s Provincial Executive Committee members spread kindness on Feb. 24 – Pink Shirt Day. From left: President Christine Sorensen, Vice-President Aman Grewal, Treasurer Sharon Sponton, executive councillor Aida Herrera and executive councillor Michelle Sordal.

PINK SHIRT DAY

LIFTING EACH OTHER UP!

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HE STRESS that comes from living and working through the COVID-19 pandemic can test even the kindest and most resilient among us. That’s why this year’s Pink Shirt Day was so important. On Feb. 24 BCNU encouraged all members to be kind to themselves, be a model for civility and respect in the workplace and join with other Canadians in raising awareness and taking action to end bullying and harassment.

Exposure to workplace bullying – whether in person or online – can impact the physical and mental health

of workers, permeating all facets of personal and professional life. This can lead to decreased job satisfaction, motivation, morale, and can negatively affect patient outcomes.

“Bullying and harassment is prevalent in health care,” says BCNU executive councillor for health and safety Aida Herrera, “and it’s a major problem.” She notes that almost half of all nurses in BC have reported experiencing bullying at work, and workplace bullying has been associated with nurses leaving their job or the nursing profession.

However, progress is being made to address the problem.

WorkSafeBC created policies in 2013 to address workplace bullying and harassment, and in 2016 the Nurses’ Bargaining Association and provincial health employers negotiated the adoption of the CSA Standard on Psychological Health and Safety in the Workplace. The Standard has 13 factors that contribute to a safe workplace. One of these – Civility and Respect – is crucial in minimizing the risk of workplace bullying and harassment.

Contact your steward or BCNU’s health and safety department if you have any questions about bullying at your worksite. •

UPDATE MAGAZINE • SPRING 2021

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CHECK IN NEWS FROM AROUND THE PROVINCE

STUDENT NURSE CONFERENCE

CONFRONTING THE FEAR BEHIND THE CRISIS BCNU is encouraging longevity in nursing careers

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CNU HAS BEEN sponsoring student nurses to attend the Canadian Nursing Students’ Association (CNSA) national conference for over nine years. But the Jan. 19-24 event looked a bit different this year as MacEwan University, the Edmonton-based host school, ran the entire program online.

The resulting reduction in conference fees also allowed BCNU to sponsor more students to attend, says BCNU North West region council member and nursing student liaison Teri Forster who reports that 29 BC student nurses were funded to attend.

The conference theme, Devitalizing Fear by Conquering Crisis: A Focus on Crisis Intervention, addressed a growing problem within the nursing profession: rapidly declining rates of new nurse retention.

The statistics regarding new graduate nurses (NGNs) exiting the profession are alarming.

For many years now a growing number of NGNs are changing their place of employment or leaving the nursing profession within as little as two years after starting. And according to provincial health ministry researchers, a startling number of nurses claim they

FUTURE NURSE LEADERS Graciella Llagas and Katie Greentree are just two of 29 BCNU-sponsored student nurses who attended this year’s Canadian Nursing Students’ Association national conference.

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SPRING 2021 • UPDATE MAGAZINE

would actively discourage someone from going into nursing.

BCNU hopes to combat these crisis-level trends with early outreach and investment in future nurses.

Forster says that providing students with initial opportunities to connect with colleagues and resources is one way to achieve this, and it could be the lifeline new nurses need to survive possible challenges during their first years of nursing.

She notes that the feedback from BCNU-sponsored conference attendees has been overwhelmingly positive, and hopes it is an indicator of improved nurse engagement.

“It’s very encouraging to see that students are grateful for these BCNU-funded learning and networking opportunities.”

Graciella Llagas is a fourthyear Langara College BSN student who was sponsored by the union.

“I can genuinely say that this experience has contributed significantly to my time as a nursing student,” she reports. “These conferences address topics that may not often be taught in our curriculum and provide attendees the opportunity to listen to different perspectives, experiences and lessons from speakers throughout the country.

“The opportunities for networking and making friends from within the province and across the country are also very rewarding,” she adds.

Katie Greentree is a first-

year North Island College BSN student who’s interested in pursing ER nursing.

She says she liked the conference’s variety of online participation options.

“Sessions were recorded so I could still participate and listen to them, even if I had classes that conflicted at the same time that day,” she says.

“I really want to extend my thanks to the union for giving me this opportunity.”

“This experience has contributed significantly to my time as a nursing student.”

Graciella Llagas

BCNU had the most visited exhibitor booth during the six-day conference, with over 400 visits.

“We also had 25 BC students sign up to be a BCNU student member,” reports Forster. “This will help them learn about BCNU and the benefits of being employed in union workplaces.” She says it’s clear that nursing students want to know more about BCNU and the ways the union promotes the social determinants of health while advocating for social justice. • BCNU student membership is free at www.bcnu.org

THE BEAT GOES ON Prince George Indigenous and business communities support healthcare workers through pandemic

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CNU MEMBERS in Prince George couldn’t believe the love they were feeling on the evening of Feb. 22.

A group of local Indigenous drummers and members of the city’s business community had gathered outside of the University Hospital of Northern BC (UHNBC) to honour and celebrate the work of nurses and other health-care workers as the global COVID-19 pandemic wore on.

In a huge expression of community spirit, several local businesses and organizations presented health-care workers with over $30,000 in gift cards for use at local restaurants, pubs and other businesses once restrictions are lifted.

BCNU North East region lobby coordinator Tracey Jonker said the timing could not have been better. “Just as we were feeling forgotten and overwhelmed in the thick of COVID, Prince George businesses stepped up and donated so much money! They shined such a bright light for us all,” she says. “I have my gift card with me and I can see myself out with my friends in the

future, supporting local business – this just gives me such hope.”

Jonker said the event brought back memories of COVID-19’s arrival. “In the beginning of the pandemic it felt like the whole world was behind us as health-care workers – we felt such love and support.”

Prince George resident Wesley Mitchell, a drummer from the Wet’suwet’en Nation is someone who never stopped offering up this love and support.

“I’m reminded why I love this community and am so glad to call Prince George home!”

BCNU North East regional council member Danette Thomsen

The evening event saw Mitchell lead an Indigenous drum dance, where performers sang, chanted and danced as a way to honour life in a holistic ritual that is an integral part of Indigenous culture.

“UHNBC is where the magic happens, the healing,”

SPIRIT OF SUPPORT Prince George resident and Wet’suwet’en Nation drummer Wesley Mitchell leads a drum dance in support of city health-care workers on Feb.22. Inset: BCNU North East region council member Danette Thomsen and lobby coordinator Tracey Jonker join the celebration.

said Mitchell. “We drum to show respect, love and dignity and to bring comfort to all.”

Undaunted by rising COVID numbers or inclement Prince George weather – Jonker says the group of drummers showed up week after week, and soon staff and patients began to look forward to Monday evenings, standing in windows, many with their hands to their hearts, waiting to watch and dance along with the group.

“I’m in awe that a group of people would come every Monday for a year now to support us,” says Jonker. “It fills my heart with joy to see them smiling and banging drums and sending love each Monday when I’m at work.”

March 26 marked the oneyear anniversary of the first drum dance and Mitchell says the group plans to

continue drumming every Monday evening until the pandemic ends.

BCNU North East regional council member Danette Thomsen shares Jonker’s gratitude.

“We just want to say thank you from all our members for the thoughtfulness, care and generosity which went a long way to lifting the spirits of those on the front-line,” she said following the event.

“We were honoured with a song from Wesley and others who drum every Monday outside of UHNBC to bring healing energy to the workers and patients.

“My heart is humbled and full of gratitude for all the support this community has shown our nurses and frontline workers. I’m reminded why I love this community and am so glad to call Prince George home!” •

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MUNICIPAL PENSION PLAN

OUR PENSION, OUR FUTURE Governance option review continues

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HE PENSION REVIEW Committee that was established following the Nurses’ Bargaining Association (NBA) 2019-22 contract talks is continuing its work. However, ongoing delays associated with the COVID-19 pandemic, and the need for additional information to better understand the implications of the Municipal Pension Plan’s proposed rule changes, has postponed the planned NBA-member vote to approve any change in plan governance.

The pension review was negotiated in 2018 because BCNU wanted to ensure that a pension plan governance structure is in place that would allow nurses to have a meaningful say in any future changes to the design of their plan.

A new governance structure would also allow for better use of the NBA Retiree Benefit Fund, and help ensure that nurses and their employers could negotiate collective agreement changes with fewer external considerations.

The six-person review committee is considering three governance options:

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(1) maintaining the status quo; (2) creating a new nurses’ pension plan (the “NPP Option”); or (3) creating a distinct group for nurses within the MPP (the “MPP Option”).

The pension review committee is continuing to examine all options and is awaiting additional information from the MPP that it will then evaluate before making its recommendation.

“We remain hopeful that the committee will be able to make a recommendation in late spring and have the consultation sessions and member vote after that, likely in early fall,” says BCNU executive councillor for pensions Michelle Sordal. “Of course, there would only be a vote on the NPP or MPP option if the committee recommends a change from the status quo.”

Last fall, the MPP announced a major redesign that significantly changes the plan’s rules. BCNU has been investigating these changes, which are scheduled to come into effect on Jan. 1, 2022.

Based on the limited demographic information BCNU has, we know that historically more than two-thirds of nurses retire in their 60s, and those who do receive a slightly smaller pension before age 65 and a bigger pension after age 65. Under the proposed MPP redesign, these nurses would receive more pension income by the time they turn 70 than they would under the current rules. And given that most nurses live past 80, this means most nurses would be much better off under the

proposed new rules.

For those nurses retiring soon, the changes will have minimal impact regardless of age because they only affect service earned after the end of this year (see page 11 for details).

Unless a nurse has maximized their service in the MPP prior to the end of February 2022, they will have a bigger pension both before and after age 65 if they work to the end of February 2022 or later than if they stop work in 2021 and start drawing their pension.

As indicated above, for those nurses starting now and retiring in their 60s, the impact of the MPP redesign is positive. But nurses starting now and retiring 30 years from now at age 55 would potentially be worse off — and there are many nurses who think about retiring at 55. However, current evidence suggests that less than one in 10 nurses retire at 55 and more than two thirds retire at or after 60.

Regardless of the outcome of the review process, Sordal says it’s always a positive thing when members are actively involved in the governance of their pension plan.

“Nurses have a keen understanding of what we need, and having more of a say in our pension plan design will help ensure that future changes reflect the needs of the nurses.” • Visit www.bcnu.org for more information on the nurses’ pension governance review process.

THINKING OF RETIREMENT NEAR THE END OF 2021?

Carefully consider the impact THE MUNICIPAL PENSION PLAN’S ANNOUNCED REDESIGN last fall has prompted many nurses to consider retiring in 2021 – earlier than planned. Wait! There is no need to act immediately, and doing so could cost you money.

Retiring in late 2021 could cost you thousands of dollars in pension income. The following examples illustrate the consequences, but each individual should choose a retirement date that’s best for them and based on their own personal circumstances Remember, the proposed plan design changes only affect service earned on or after January 1, 2022.

EXAMPLE 1 Mary will turn 60 on October 23, 2021. She works full time and will have 30 years of pensionable service by the end of November 2021. She was thinking of working to the end of December and starting her pension in January 2022.

However, a significant and unanticipated increase in the Canada Pension Plan’s years maximum pensionable earnings announced in late November 2020 means Mary’s current plan could cost her a fair amount of money.

Mary would be better off stopping work in November 2021 and starting her pension in December 2021, or working at least three more months and starting her pension in March 2022.

Mary has a highest average monthly salary of $7,500 ($90,000 annually). The following table shows her estimated pension both before and after age 65 for different pension start dates1 : Pension Start Date

Estimated Monthly Lifetime Pension

Estimated Montly Bridge Benefit

Estimated Monthly Pension Before 65

Dec 2021

$3,473

$1,027

$4,500

Jan 2022

$3,442

$1,081

$4,523

Feb 2022

$3,464

$1,081

$4,545

Mar 2022

$3,485

$1,081

$4,566

Assumes Mary continues to work full time until the end of the month preceding the pension start date, and that her highest average salary increases slightly with more work at her current higher salary.

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Note that because of her circumstances, by stopping work in November 2021 and starting her pension in December 2021, Mary’s monthly lifetime pension is larger than it would be if she worked an extra month or two and started her pension in 2022.

Clearly, for Mary, working December 2021 and starting her pension in January means that she would receive less money from the pension plan over her lifetime than if she retired the previous month. Mary needs to carefully choose the month she chooses to stop working and start her pension.

In this example, Mary did not benefit from the MPP’s “Rule of 90” (which states that you can retire without any penalty as early as 55, and before the age of 60 if your age plus your years of service add to 90).

EXAMPLE 2 Consider the situation of Samir, who turns 57 on May 31, 2022 and will have 33 years of service on that date. Under the Rule of 90, Samir would be eligible for an unreduced pension if they worked to the end of May 2022 and started their pension in June 2022. Like Mary, Samir’s highest average monthly salary is $7,500 as of November 2021.

Samir is worried about the announced MPP rule changes, and was thinking of quitting in November and starting the pension in December 2021. But there would be significant pension consequences if they did this. The table below shows the impact on Samir’s pension under the two circumstances.

Pension Start Date

Estimated Monthly Lifetime Pension

Estimated Montly Bridge Benefit

Estimated Monthly Pension Before 65

Dec 2021

$3,649

$1,079

$4,728

Jun 2022

$3,768

$1,171

$4,936

If Samir lives to at least 71, as the vast majority of nurses will, they would collect more money from the pension plan by working the extra six months, even though they would collect for six fewer months! Further, if Samir lives to the average age a nurse lives to, they would collect about $20,000 more in pension income. Clearly, depending on Samir’s personal circumstances, it may make sense for them to work to 57 – even though five months of their service would be under the new MPP rules. •

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INTERIM PATIENT CARE ASSESSMENT PROCESS UNDERWAY Temporary nurse-driven staffing and workload assessment process to ensure all short-term staffing needs are met across the province

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AST FALL, HEALTH employers and BCNU agreed to a mediation-arbitration process to assist with the resolution of outstanding issues related to the patient care assessment process (PCAP). When mediation was unsuccessful, the arbitrator ordered the implementation of an interim process to take effect no later than Dec. 16, 2020.

Going forward, the arbitration panel will assist provincial health employers and BCNU to develop the final PCAP. Since Dec. 16, all health authorities, including Providence Health Care are expected to have implemented the interim process, one that gives union and employer reps the opportunity to evaluate the opportunities and challenges it presents over time in order to best inform a final process referenced in Article 60 (Direct Patient Care Staffing) of the 2019-2022 Nurses’ Bargaining Association provincial contract.

This interim patient care process (PCAP) is designed to allow both locallevel managers and in-charge nurses to determine staffing requirements that address short-term patient care needs, with the input of direct care nurses.

The process is to be used on a shiftby-shift basis to determine when the working short premium will be paid.

The interim PCAP may also be used throughout the shift in response to changing patient care needs.

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After the interim PCAP has been completed and a unit, program or department is deemed to be working short and no relief is found, the working short premium will be paid (see sidebar). Where there is a baseline vacancy, the employer is required to replace the absent nurse with a nurse of the same classification. The only exception is where the nurse in charge and manager both agree that circumstances have significantly reduced the workload, and that patient care needs can be met with the existing staff.

“There are a number of different considerations that need to be factored into the evaluation of patient care needs,” says BCNU President Christine Sorensen. “By having the nurses who are providing the care directly involved in the process, we are capturing and measuring the impact staffing decisions in real time.”

PUTTING THEORY INTO PRACTICE: A RESPONSIVE INTERIM PROCESS

Implementation of the interim PCAP tool began across all health-care sectors in December 2020 when BCNU and the Health Employers Association of BC published a guide to facilitate the successful adoption of the new process and support in-charge nurses and managers in their work to assess and determine patient care needs.

The interim process has two main elements: the interim PCAP form and the end-of-shift questionnaire form.

The interim PCAP form is used by the in-charge nurse and manager/designate to document the determination of patient/resident/client care needs and the appropriate staffing needed to meet the demand. It asks three questions: Is the current nurse staffing at baseline?

Are care needs as expected for the unit/ department/program? And does the nursing staff scope, competence and skills mix meet the care needs?

All three questions must be answered during every assessment.

The working short premium is payable when efforts to fully replace to baseline by designation/job code are unsuccessful. When workload is identified as being above baseline, mitigation strategies such as transferring patients or deferring clients are considered appropriate, provided they do not increase the workload of nurses.

The form is only completed by the in-charge nurse and manager/designate, but all nurses providing patient care on a unit, program or department should continue to communicate with their charge nurses or supervisors and bring forward workload concerns as soon as they arise.

The interim process also allows direct care nurses to document their perceptions regarding the adequacy of staffing on their last shift by using the end-of-shift questionnaire form, which asks them to indicate ‘yes’ or ‘no’ as to whether there was sufficient nursing staff to meet the direct care needs.

Answers can then inform staffing decisions for the next shift.

This form is an essential part of the interim process and is a documented method for direct care nurses to demonstrate their professional judgment.

WORKING TOWARD A FINAL TOOL

The SNSCs continue to meet bi-monthly and are supported by the With the interim process now underprovincial Nurse Staffing Secretariat. way, the role of the strategic nurse The work to develop a final PCAP staffing committees (SNSC) at each tool continues. This involves takhealth authority has become even more ing into consideration the feedback integral to developing solutions to staff- received and addressing the concerns ing problems. as they emerge. The intent of Article The six-person committee is com60 contract language is two-fold: prised of both union and employer it includes nurses’ professional representatives and is tasked with judgment in the determination of addressing long-term staffing needs for care needs and holds the employer the health authorities and Providence accountable for its responsibility to Health Care. SNSCs provide a forum hire enough nurses to provide care for both parties to collaborate, listen when it is needed most. and acknowledge concerns related to a Safe staffing remains a priority number of health authority-wide staff- for nurses. By taking an active and ing matters, including recruitment and vocal role in this interim assessment retention strategies and the regulariza- approach, they have the power to advotion of hours. cate for the safety and health of their The SNSCs are also charged with patients at the health authority level, reviewing organizational approaches and this in turn will help influence the to short-term staffing needs. In the final process at a provincial level. case of the interim PCAP tool, SNSCs “Nurses now have an opportunity across the province are reviewing the to use their voice to inform a process high-level trends that are emerging and that will determine proper baseline working to resolve interpretations of the and address workload,” says Sorensen. interim process as they emerge – par“This has been long overdue for both ticularly when the in-charge nurse and nurses and patients and I look forward manager do not agree that a unit, proto seeing significant improvements in gram or department is working short. the health-care system.” •

DIRECT PATIENT CARE ASSESSMENT PROCESS Nurses receive wage premiums if employers are unable to meet appropriate staffing levels.

SAFE STAFFING WILL ALWAYS BE BCNU’s number-one priority. The interim patient care assessment process now in effect will help ensure that employers adequately staff units. And a wage premium will incentivize health authorities to match staffing with patient care needs. If they are unable to do so, nurses will be compensated for working short.

WORKING SHORT PREMIUM $5.00 an hour will be paid to any nurse working short on a unit, department

or program with 10 or fewer scheduled nurses within the same baseline classification.

Nurses working short on a unit, department or program with 11 or more scheduled nurses within the same baseline classification will receive an additional $3.00 an hour.

$

5/hr $3/hr

PROFESSIONAL PRACTICE

MOUNTING PROFESSIONAL FEES UNFAIR NURSES ACROSS THE PROVINCE WERE extremely disappointed to learn they would be subjected to yet another year of rising practice licence fees despite the hardships they’ve faced during a year-long global pandemic.

LPN members saw their fees increase 11.5 percent – to $475.20 – amounting to a nearly 36 percent rise in the last three years. And RN and RPN members’ fees increased over three percent to $558.36, excluding the mandatory professional liability protection insurance they all must carry.

Recent changes to the BC College of Nurses and Midwives (BCCNM) bylaws require that RN and RPN registrants obtain their professional liability protection through the Canadian Nurses Protection Society (CNPS).

The college also announced that, effective March 1, members of the Nurse and Nurse Practitioners of BC (NNPBC) would receive a CNPS preferential group rate of $54.60 per year. Nurses who choose not to belong to the NNPBC are required to pay $164.85. The decision effectively triples the cost of nurses’ liability protection insurance.

“It is absolutely inappropriate for nurses to be forced to pay the NNPBC membership fee as the only means of accessing the preferential CNPS group rate, especially given that this rate was previously available to all RN and RPN registrants at no additional cost,” says BCNU President Christine Sorensen. “These new changes do not benefit individual nurses and instead appear designed to increase NNPBC membership numbers and revenue.”

For several years now, BCNU has supported members’ efforts to curtail rising college fees and mandatory association membership fees levied without the consent of registrants.

Sorensen and BCNU leaders met with deputy health minister Stephen Brown in February to discuss the issue and demand that action be taken to ensure that nurses are not forced to endure this unfair burden.

More information will be made available to members in the near future.

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GUIDING LIGHTS BCNU ACTIVIST PROFILE

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ARIA HEURTAS recalls the frustration she felt when her manager would not address the chronic staffing issues plaguing her neurosciences unit at Royal Columbian Hospital.

But she had just learned about the professional responsibility process at a recent BCNU regional meeting. Taking matters into her own hands, she filed the form that members then used to address staffing concerns.

Huertas says it was her first step as a union activist. “The rest is history,” she laughs.

Today, as the lobby coordinator for BCNU’s Simon Fraser region, Heurtas advocates for nurses and the public by attending community events and meeting with various MLAs and MPs.

Heurtas is passionate about community outreach and says she misses the ability to personally connect with others on account of the pandemic. “It’s frustrating not being able to do outreach because I know nurses’ services are still very much needed,” she says.

But the pandemic isn’t dampening Huertas’s activist spirit.

After witnessing a homeless person being harassed in a store for not owning a mask, she again took matters into her own hands. Huertas helped organize a group of co-workers and volunteer sewers who distributed over 1,000 masks to homeless and low-income citizens in Burnaby, New Westminster, the Tri-cities area and the Katzie First Nation in Pitt Meadows.

Huertas and other members of the Simon Fraser regional executive team

10 QUESTIONS WITH MARIA HUERTAS What is one word you would use to describe yourself?

Outgoing.

If you could change anything about yourself, what would it be?

Taking too much on at one time.

What is one thing about you that people would be surprised to learn?

I took organ lessons when I was a kid and won second place in provincial competition.

Where did you go on your last vacation?

Port Ludlow Inn, in Port Ludlow, Washington.

Name one place in the world you’d most like to visit.

The pyramids in Egypt.

What was the last good thing you read?

Wellness Together Canada, which provides resources for positive mental health.

What was the best piece of career advice you’ve received?

Nursing has so many areas you can work in. If you feel unchallenged, move on to something else. Teach, go back to school or take a course.

What do you like most about being a nurse?

I love helping people, seeing patients get better and mentoring co-workers.

What do you like least about being a nurse?

Being pressed for time, working short, and feeling like I’ve missed something.

Name one change you would like to make to the health system.

Have frontline consultation and input on everything.

also serve meals and provide essentials to people in these communities once a month by soliciting funds from local business, family and friends.

“We’ve gotten a lot of donations from friends and family and so far we have distributed masks, socks, underwear, toques, scarves, gloves, jackets, sweaters, rain ponchos, umbrellas, and hand warmers,” she reports.

Heurtas plans to involve others in her region’s efforts but says it’s important to be mindful of space limitations and the risk of COVID transmission.

“Fingers crossed that things ease up soon so we can involve the community more!” • You can connect with Maria at MariaHuertas@bcnu.org

NATIONAL PHARMACARE

THE WORK CONTINUES Although a vote for Bill C-213 – the Canada Pharmacare Act – did not pass, BCNU continues to support implementing a national program

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VERY DAY, SOMEONE IN Canada dies because they can’t afford medication. The need for a national pharmacare plan has never been greater. Before the COVID-19 pandemic, one in five Canadians, approximately 7.5 million people, were unable to afford the medication their doctors prescribe.

This means a large portion of the population must choose between expenses like groceries and rent versus getting the medication they need.

But since the pandemic began, the federal government has remained largely silent on this issue.

For many years now, nurses in BC have been joining their counterparts in other provinces and raising a national alarm in an effort to compel Ottawa to recognize the urgent need for a federally supported universal drug plan.

This winter BCNU encouraged members to join with nurses across Canada in the most recent national action in support of universal pharmacare. The union, along with over 175 national, provincial, and territorial organizations, called on the federal government to

support Bill C-213, An Act to Enact the Canada Pharmacare Act, and implement a national pharmacare program that is truly universal and comprehensive.

The bill, first tabled last year by New Westminster-Burnaby MP Peter Julian, was aimed at delivering better health care and improving the lives of millions of Canadians. BCNU members showed their support for the bill by signing a petition and emailing their local MPs. They also sent messages to Prime Minister Justin Trudeau, Minister of Health Patty Hajdu and Minister of Finance Chrystia Freeland through the Canadian Federation of Nurses Unions website, asking these key decision makers to support the adoption of a national pharmacare program.

“It’s important to have true universality in the country so no one is left behind.”

BCNU Vice President Aman Grewal

PRESCRIPTION FOR CARE BCNU has joined with nurses’ unions in other provinces in an effort to compel Ottawa to recognize the urgent need for a federally supported universal drug plan.

Unfortunately, Bill C-213 was defeated by a Feb. 24 vote of 295-32 in the House of Commons. The outcome is especially disappointing given that the Liberals campaigned on the creation of national pharmacare before the 2015 federal election. And a 2019 final report from the government’s own Advisory Council on the Implementation of National Pharmacare set up after the election and chaired by former Ontario Liberal health minister Eric Hoskins concluded that a universal, single-payer, public pharmacare system is the best option for Canada.

The report, entitled A Prescription for Canada: Achieving Pharmacare for All, recommended that the federal government work with provinces and territories to establish public pharmacare in Canada by the year 2027. The report also found that Canadians spent

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$34 billion on prescription medicines in 2018, with drugs being the second biggest expenditure in health care after hospitals.

“National pharmacare can’t be implemented overnight. This is a major part of our health-care system that affects millions of patients, hundreds of thousands of health-care providers and a broad range of dedicated stakeholders,” states the report. “We’re proposing a deliberately stepwise approach that will also enable the introduction of some fundamental and impactful changes immediately.”

Unfortunately, Ottawa appears unwilling to act on this advice, and the ruling party, with the support of the Conservatives and Bloc Quebecois, have rejected the council’s recommendations. BCNU Vice President Aman Grewal led the union’s member engagement effort and supported BCNU regional lobby coordinators in conveying the importance of universal national pharmacare. She says BCNU was signatory to a 2018 statement of consensus principles issued by a diverse coalition

of unions and health-care advocates concerned about the advisory council’s mandate of “affordability” and what that might mean for policy recommendations that would come out of its consultation process.

“What is the cost to the quality of life of an individual who can’t receive the medication they need?”

BCNU President Christine Sorensen

“Public health-care advocates developed a statement that spells out what ‘pharmacare’ means,” says Grewal. “The statement is a call for a national pharmacare program that, like Canada’s medicare, is publicly administered, comprehensive, accessible, portable, and universal,” she explains.

TAKE ACTION! Canada deserves pharmacare now Tell the federal government it is time to act Millions of Canadians have insufficient or no drug coverage and many are forced to make difficult decisions to ensure their families have the prescription medication they need. COVID-19 has made the situation worse, making pharmacare more important than ever.

Tell the federal government we need pharmacare now.

Add your voice to the petition today!

PHARMACARE OUR VISION BCNU supports the implementation of an effective national pharmacare program based on the following PRINCIPLES: 1.

PUBLIC ADMINISTRATION National pharmacare must seamlessly incorporate prescription drug coverage into the greater public health-care system.

The system must be governed by a public authority on a non-profit basis to ensure accountability exclusively to the public interest and democratic institutions.

2.

UNIVERSALITY To prevent people from falling through the cracks, everyone in Canada should be covered by the same plan on equal terms and without financial barriers. This will ensure universal coverage based on need and not ability to pay. It will nearly eliminate cost-related nonadherence to prescriptions, which contributes to the deaths of thousands of Canadians each year.

3.

SINGLE-PAYER Only a single-payer system can effectively leverage bulk-buying to bargain down prices for covered prescription medications and save between $4 and $11 billion per year. These savings could be reinvested in needed healthcare services such as seniors care, home care, mental health and Indigenous health. A single-payer system will also achieve billions in administrative efficiencies, much like our single-payer public health-care system.

4.

NATIONAL FORMULARY A common, comprehensive national formulary must be established based on evidence and administered by an arm’s length depoliticized public agency. The agency’s primary objective will be to maximize health benefits per dollar spent, using value-for-money and clinical assessments.

These four principles can only be secured in federal legislation and matched with appropriate federal transfers to the provinces and territories.

LACK OF UNIVERSAL PHARMACARE AFFECTING CANADIANS Despite the outcome of the vote, Grewal says nurses will continue to push for prescription pharmaceuticals to be covered under a national insurance plan. “BCNU has been calling on the federal government for years to expand medicare to include prescription drugs, and we’re not going to stop until we achieve this goal.”

AFFORDABILITY AT THE HEART OF THE ISSUE Canada is still one of the few industrialized countries without a national drug plan. Nurses and other health-care workers have first-hand knowledge of the human cost of not having universal prescription drug coverage, and the harm that comes from patients not being able to afford the medications they need.

BCNU President Christine Sorensen is one of those workers. “As a public health nurse, I have been involved with families many times in situations when they are telling me ‘Christine, I can’t afford to buy my medications for my son for school or my child’s epi-pen or my mother’s medication for her diabetes,’” she reports.

Sorensen, like many nurses, also has personal experiences with inadequate drug coverage.

“I had a father who had a serious heart condition and I’m very grateful that we had the coverage for many of the medications that he took,” she explains. “However, I also had a child with a very serious seizure disorder who did not have some of his medications covered, and some of those were trial medications.”

She says she feels very fortunate for the support of physicians who managed to find either pharmaceutical funding or specialty approvals through insurance programs so her son could access medications that were literally lifesaving. She realizes others are not so lucky.

“I think really when we look at this as a society, what is the measure of a society but how well we take care of our most vulnerable?” she reflects. “Many are not able to access the medications they need to have a minimum quality of life and I think that is beyond the numbers, beyond asking, ‘how much does this cost?’ What is the cost to the quality of life of an individual who can’t receive the medication they need to be a fully functioning participant in their community?” she asks.

Sorensen says the current makeshift system of drug coverage is inequitable and inefficient, and only underscores the need for a universal pharmacare plan.

Under the Canada Health Act, the federal legislation for publicly funded health-care insurance, there are criteria and conditions related to health-care services provinces and territories must follow to receive the full federal cash contribution under the Canada Health Transfer. The legislation ensures all Canadians have access to certain health services, such as hospital visits.

But when it comes to drug coverage, provincial and territorial governments are largely responsible for the administration of their own publicly funded drug plans.

Most Canadians have access to insurance coverage for prescription drugs through a patchwork of public and/or private insurance plans. Lower-income workers may be less likely to have workplace health insurance, and when they do, there may be less coverage than for higher-income workers. And with private insurance plans, there is less money for employers to invest in other areas.

“A universal plan would allow us to eliminate these inequities and set the terms for provinces and territories to receive federal funding for pharmacare,” says Grewal. “It’s important to have true universality in the country so no one is left behind – this aligns with our union’s values.” •

¼

OVER THE PAST YEAR, OF Canadians have decided not to fill a prescription or not to renew one due to cost or taken measures to extend it because they could not afford to keep the recommended dosage schedule.

¼ of Canadians say they have had to pay for half or more of their prescription drug costs over the past year. This rises to 37 percent of Canadians for households that earn less than $50,000 per year.

Canadians are twice as likely to have lost prescription drug coverage as to have gained it over the past year.

44% of Canadians are concerned about their ability to afford prescription drugs in 10 years. Just 24% feel very confident that they will always be able to pay for their needs.

72% of Canadians have most or all of the cost of their prescriptions covered by insurance and government support, but 26% must find money on their own for at least half of the cost.

Lower income households are more than twice as likely as middle income households to pay for more than half of the cost for their prescription(s) out of their own pocket – 37% compared to 15% .

86% of Canadians support the idea of a national pharmacare program while 77% say increasing coverage for Canadians should be a high priority for government. * Source: Angus Reid, October 2020 https://angusreid.org/pharmacare-2020/

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COVID-19

SLEEVES ROLLED UP BCNU members are playing a major role in the largest and most complex immunization effort the province has ever seen.

COUNTING THE DAYS Nurses welcome BC’s COVID-19 vaccination plan with cautious optimism

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RITISH COLUMBIA IS now in the third phase of a multi-pronged, multiphased COVID-19 vaccination rollout program that’s part of the largest and most complex immunization effort the province has ever seen.

The program has seen a number of logistical challenges, due in most part to supply shortages of the Pfizer and Moderna vaccines, slow approvals from Health Canada on the AstraZeneca and Johnson & Johnson vaccines and evolving research around the efficacy of the vaccine’s first dose.

The changing science prompted Provincial Health Officer Dr. Bonnie Henry to extend the interval between

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the first and second dose to fourmonths, a decision that led to a considerable amount of debate between medical professionals despite being endorsed by the National Advisory Committee on Immunization.

It’s hard to believe, as people within certain priority groups line up at immunization centres around BC, that it was not too long ago when British Columbians were waiting anxiously for the first shipment of vaccine to arrive.

It was early December when people received word that the first doses of the Pfizer COVID-19 vaccine were headed to Canada.

Soon after Health Canada announced the approval of the Pfizer vaccine, public-health officials in BC began

announcing what the immunization plan would look like in this province, and how they were planning on managing the logistical challenges that were sure to turn up in a program that comes with an ambitious target – vaccinating over four million people in an orderly, fair and consistent manner.

For many on the frontlines of the pandemic, it was hard not to feel hopeful. Dr. Henry and Health Minister Adrian Dix pleaded for patience at their first press conference held in early December where they outlined their plans.

The first 3,900 doses of the Pfizer vaccine would go to the most vulnerable, along with nurses, doctors and other health-care workers, primarily those on COVID-19 units, ICUs and emergency rooms. The vaccine was only given at two clinics in the Lower Mainland that were set up to handle the fragile Pfizer vaccine’s storage requirements. Dr. Henry was photographed getting her first shot on Dec. 22.

For nurses, the vaccine’s arrival brought both relief and concern.

“We saw the relief on the faces of health-care workers who were receiving their vaccines,” says BCNU President Christine Sorensen. “For the nurses who have been on the frontlines of the pandemic for over a year, we know that this moment is what they had been waiting for.”

While sharing many BCNU members’ optimism, Sorensen notes she’s aware of some instances of queue jumping and has relayed the union’s concerns to the health ministry for follow up. She also reports being somewhat disappointed with the level of communication coming from the government on the specifics of the rollout.

“At times, BCNU has been learning about last-minute scheduling plans and vaccine interval changes at the same time as the public, and that has made it difficult for our members.”

“We saw the relief on the faces of health-care workers who were receiving their vaccines.”

BCNU President Christine Sorensen

The fragility of the Pfizer vaccine posed significant challenges when it came to vaccinating people in rural and remote communities. Sorensen says nurses realized there was not enough vaccine to stop transmission and that the focus had to first be on saving the lives of vulnerable seniors and immune-compromised British Columbians.

“We also knew there were going to be distribution challenges that would make it hard to vaccinate point-of-care workers and those in long-term care outside of

Metro Vancouver,” she says. “The virus was impacting health- care settings in communities across this province, so we understood why members were keen to know when they would be vaccinated.”

That changed with the arrival and approval of the Moderna and AstraZeneca vaccines, which don’t require sub-zero storage and are able to be transported around the province easily.

Now, with the approval of four COVID-19 vaccines in Canada, and more shipments arriving weekly, BC has ramped up its vaccination program and is aiming to make the vaccine available to all British Columbians who want it by the end of the summer. Given the size and scale of the program, Dr. Henry recently issued a provincial health order allowing for other medical professionals to receive training to administer the vaccine. Retired nurses and physicians are also being called back to help (see story on page 24).

Sorensen says nurses share the public’s enthusiasm to get as many people vaccinated against the COVID-19 virus as possible. But she stresses the importance of acknowledging the level of exhaustion so many nurses are feeling after a year of working through the pandemic.

“Nurses are obviously ready to do everything they can to care for people and patients, but they are also tasked with following many other health ministry directives, such as meeting targets in the province’s surgical renewal plan, contact tracing and much, much more,” she says.

Phase 2 has seen thousands more British Columbians get vaccinated and there is even talk of a “post-pandemic” summer, according to Dr. Henry.

However, with the looming concern of new COVID variants, and the scheduling requirements of providing a second dose, many working on the health-care frontlines are choosing to temper their optimism. •

LEADING BY EXAMPLE NURSES LAUNCH VACCINATION CAMPAIGN COVID-19 CASES AREN’T JUST numbers on the news. They are patients nurses see every day getting sicker and sicker, with many dying. The number of patients in Canadian hospitals and ICUs is reaching record highs, even as health-care workers are reaching their breaking point.

Yet, in the midst of a pandemic characterized by unpredictability, speculation and misinformation, vaccine hesitancy remains a major issue among a significant percentage of Canada’s population.

That’s why BCNU is supporting a national campaign encouraging members of the public to get vaccinated against COVID-19.

The Canadian Federation of Nurses Unions “Trust Nurses” campaign aims to tackle vaccine myths and mistrust with facts that are guided by empathy.

The campaign features a lighthearted public service announcement, social media advertisements and a website where the public can access information, pledge to get vaccinated and easily share with friends and family.

Everyone should understand the benefits and potential risks of immunization by accessing reliable information. Nurses know that the vaccines administered in Canada are safe, tested and our best shot at getting out of this pandemic and back to the activities we’ve put on hold for a year – like seeing our loved ones.

History has shown us that viruses can be defeated with a successful vaccination effort.

Visit TrustNurses.ca, to learn more.

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COVID-19

ONCE A NURSE ALWAYS A NURSE Two veteran nurses are campaigning to help retired nurses return to work during the pandemic

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ESPITE NUMEROUS roadblocks placed in their path, two tenacious Fraser Valley nurses continue to seek solutions that will make it easier for retired nurses to participate in BC’s COVID-19 vaccination drive.

“We’ve been trying to come up with a ‘one-stop shopping’ solution to make it

easy for retired nurses to help administer the vaccine,” says Annemarie Plumridge, an RN who spent 45 years delivering care in the Fraser Valley before retiring in 2014. “We felt retired nurses should be able to find out everything they need to know with one phone call.”

“Annemarie is a real trailblazer and has always been a vocal advocate for her patients and for other nurses,” says Terry Webber, a semi-retired nurse currently working in palliative care after a 47-year career as an RN and RPN. “Now we’re advocating for retired nurses to help out with the vaccination program during the pandemic. We want to support our sisters and brothers who are working on the frontlines and are exhausted.”

TRAILBLAZER Annemarie Plumridge’s former co-workers say she has always been a vocal advocate for her patients and for other nurses.

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Plumridge says that when the first vaccine doses began trickling into BC early this year, she and Webber immediately wanted to help with the immunization campaign. And many of their retired colleagues felt the same way.

“We thought, my goodness, hiring retired nurses to help is a simple solution that is as plain as day,” recalls Webber. “Retired nurses often joke that they could do vaccinations in their sleep.”

“We want to support our sisters and brothers who are working on the frontlines and are exhausted.”

Terry Webber

But the persistent pair quickly learned there was no simple solution for retired nurses eager to join the immunization campaign. Stumbling blocks included health authorities not replying to questions from retirees, or simply sending auto replies, and government websites that offered little useful information or suggested links leading to another dead end.

But the biggest hurdle back in January and February was the BC College of Nurses and Midwives’ decision to only offer an emergency licence to retired nurses who had completed 1,125 hours of work in the past five years, or who had taken a lengthy refresher course.

DOGGED DETERMINATION Terry Webber called on Dr. Bonnie Henry and others to help ensure retired nurses are part of the province’s COVID-19 vaccination efforts.

The two nurses refused to blindly accept that short-sighted policy.

Instead, they began reaching out for information on how retired nurses could join the immunization drive.

They began by contacting provincial Medical Health Officer Dr. Bonnie Henry, health authority officials, BCNU staff and elected officials, other retired nurses and the media.

Their relentless pressure began to pay off in late February, when Dr. Henry issued a provincial health order that permitted retired nurses, midwives, dentists and some other health professionals to help with the vaccination drive. That order also allowed retired nurses to take on-line refresher courses that could be completed in a short period of time.

In March, the pair told their story in The Vancouver Sun, which led to them being contacted by more frustrated retirees. “We wanted to create awareness of the new provincial health order,” says Webber, “and support retired nurses at a more provincial level through advocacy and providing information to anyone of authority or influence who would listen.”

In mid-March, Dr. Henry expanded the list of eligible health professions to

include retired RNs, LPNs and RPNs who are not registered with the college.

“Those changes Dr. Henry made to the process empowered retired nurses to get their boots back on for the vaccination rollout,” says Webber.

Then, in late March, the pair’s persistent campaign paid off again when BCNU issued a bulletin announcing that “all retired nurse members can now participate” in the vaccination rollout.

And they are “welcome to register online with the Government of BC.”

“Retired nurses often joke that they could do vaccinations in their sleep.”

Annemarie Plumridge

“The dogged determination of Annemarie and Terry is a wonderful example of what can be accomplished by nurses when they set out to achieve a goal,” says BCNU President Christine Sorensen. “We’re grateful for all of the

work they did on behalf of retired nurses, and for all of our members who continue to deliver quality health care during this pandemic.”

“Even after retirement,” says Plumridge, “nobody can ever take away your skills, your knowledge or your compassion. Retired LPNs, RNs and RPNs who are still a valuable asset.”

“Once a nurse, always a nurse,’” adds Webber. “We’re not dead in the water yet.

We’re still very competent, and we still have value. Nursing is in our DNA. It’s in our blood. It’s important that we never lose our voices.” • Retired members wishing to assist in the COVID-19 vaccination effort are encouraged to visit the Health Provider Registry for the COVID-19 Emergency Response on the Ministry of Health website.

LESSONS LEARNED VETERAN NURSES ANNEMARIE Plumridge and Terry Webber say they’ve learned a lot from their recent experiences in speaking out for retired nurses during the pandemic. They hope those hard-won lessons will be remembered in case of another deadly pandemic. Their top three priorities are: 1. An earlier lifting of restrictions on practice hours required for retired healh-care professionals.

2. A campaign to market the idea that retired nurses are welcomed back into the workforce, regardless of practice hours.

3. A simple and easy-to-access, one-stop site for retired nurses to register to help.

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COVID-19

MAKING IT WORK Burnaby Hospital’s Leisha Marotto says she and her co-workers had to organize their own information and support networks to prepare for the COVID-19 pandemic.

RISING TO THE CHALLENGE Burnaby Hospital ER nurses demonstrated true leadership qualities during the coronavirus pandemic

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AST MARCH, DURING THE early, chaotic days of the coronavirus pandemic – when misinformation about COVID-19 was spreading faster than the disease itself – a group of Burnaby Hospital emergency room nurses decided to examine the available evidence and communicate what they learned to all of their worried co-workers.

“It’s easy to forget now,” says Philippa Lentz, who began working in the always-busy Burnaby ER in 2016, “but last year, at the beginning of this pandemic, we had no idea what was going to happen next. No one really knew how the virus was transmitted. And all the scary images we were seeing from Italy, New York and other parts of the world were very concerning. It was a really chaotic and uncertain time.”

“We went from one spectrum of chaos to another in a very short period of time,” adds Leisha Marotto, who has delivered care to ER patients at Burnaby Hospital since 2014. “We basically had to take everything we had been doing in the ER and flip it on its head.”

Prior to COVID-19, the facility’s emergency room, like ERs around the province, was often overcrowded and understaffed. “We were used to being really busy in the ER,” explains Marotto, “with people stacked up on

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top of one another, with no space for physicians to assess patients and no room for EHS crews to offload patients.

We were packed to the absolute brim, especially during flu season.

“And then,” she adds, “in the blink of an eye, it all changed. The pandemic landed on our doorstep and we had no idea how to deal with it. There were so many questions and not many answers.

We didn’t even know what we were supposed to be wearing to protect ourselves and our patients. We were literally preparing for the Apocalypse.”

“There was a lot of uncertainty,”

agrees Lentz. “Many nurses and other staff were honestly concerned for themselves and their patients.”

Adding to the confusion was the fact that Fraser Health and other government agencies kept issuing updates, sometimes daily, sometimes hourly, on everything from what personal protective equipment to wear to how many nurses could be in an operating room.

“We were being bombarded with conflicting information and changing policies and procedures,” says Marotto.

“We had a lot of questions that no one knew the answers to. So, we all looked

at each other and decided we’d somehow have to deal with the pandemic, and we’d have to rely on each other. We knew we had to pick up our socks and make this work.”

Lentz and a small group of other ER nurses began meeting in the hospital’s cafeteria to discuss how best to deal with the flood of confusing information they were receiving from the health authority. They also searched through all of the hospital’s relevant policies and procedures. “We started writing down notes and trying to summarize all of the information we were getting,” says Lentz. “Then we just decided to start putting out a daily newsletter and pulling other people in to work on different aspects of it.”

“We were being bombarded with conflicting information and changing policies and procedures.”

Leisha Marotto

The group began calling themselves “The Dukes of COVID.” “I came up with the name as a kind of dumb joke late one night,” recalls Lentz, “but people are still using it today.” The Burnaby ER nurses began emailing their newsletter with the latest COVID-19 information to all staff.

“The emails were like therapy,” say Marotto, adding that most of the newsletter work was done by Lentz and another co-worker, Sarah Bell. “They really, really stepped up. They deserve all of the credit in the world. They were our guiding light and without the two of them we would have drowned for sure.

“They would basically take all the on. For example, if a nurse learned that information that we were getting from some desperately needed N95 respiraFraser Health, summarize it on a daily tor masks were still for sale in Langley, basis and email it to all staff. Then, someone would jump in their car and when the information would change drive out to buy them. the next day, they would update us all.

Then, the ER nurses’ families and It would have been really challenging friends began to get involved. Marotto’s for us without the Dukes of COVID.” father rummaged through his garage BCNU President Christine Sorensen and found nine pairs of safety goggles says the group, like so many other that were soon being shared by numerBCNU members across our province, ous nurses. The goggles, masks and stepped up and helped lead British other protective equipment that were Columbians through the pandemic. in short supply at the hospital were “These Burnaby Hospital nurses stored in a room the nurses dubbed showed true nursing leadership during “The Armoury.” a time of crisis by ensuring that their One nurse’s mother, who is a seamco-workers were getting the most stress, made and donated over up-to-date and accurate information available,” she notes. “At a time when much of the country was isolating under public health orders, they continued to put their lives on the line and care for their patients and their co-workers.”

In addition to the must-read Dukes of COVID newsletters, the ER team created multiple simulation labs on numerous issues, including intubations, what to do if there was a code in the waiting room and other worst-case scenarios.

“We would talk through the different situations,” explains Lentz, “and one of us would take notes, one of us would type up the notes and then we would put it [simulation results] in the newsletter.”

At the height of the first wave of the pandemic last spring, when most types of personal protective equipment were in short supply in BC and around the world, the Burnaby ER nurses began heading to Home COMMUNICATION IS KEY Philippa Lentz headed up Depot and other stores to buy the production of a daily newsletter to keep nurses any available protective equipand other Burnaby Hospital workers informed in ment they could get their hands absence of information from their employer.

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COVID-19

RISING TO THE CHALLENGE continued from page 23

2020 YEAR OF THE COVID NURSE a poem In the memory of misery and treachery In the Battle score of the Crimean War

Global nursing without fail Come from matters of Nightingale so that nursing practice does not derail Health, Admin and efficiency set the path of innovation to her legacy

In the living now isolating to reduce life dying In the Battle score of the COVID War

From notes on the “craft of nursing” developed the fine art of treating and advancement of healing As nurses don and doff their protective gear to ward off this COVID year

The “Lady with the lamp” did say even in the dark lit the way to sanitize all without delay those weary hands and what demands

Nursing may have lost its lustre as those that remain try to muster not to have spirits suffer Expectation and sacrifice met empathy in so, compassion enveloped humanity

The “Lady with the lamp” even today whispers the way for nurses to convey to those leery hands and surfaces, so now society understands On a 1854 Day the path to lead the way to lift hearts and souls from fray to be caring and kind these nurses in Crimean War did find

Is it chance that COVID celebrates on the year Midwiferey and nurses commemorates 200 years through the gates Nurses will lead their voices with professional precedence in the world to make a difference

On a 2020 Day the path has to stay that way to lift hearts and souls that may stray to be caring and kind this, we in nurses and humanity do find

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Sylvia Neden, LPN December 2020

3,000 scrub caps to Burnaby and other hospitals. Many others in the community donated food or offered their heartfelt thanks to Burnaby Hospital staff for all they were doing in the early days of the pandemic.

“We all pulled each other through this,” says Lentz. “When push came to shove, we didn’t have a choice. We had to rally for our patients and our co-workers. We had to figure it out.

And we did.”

“We supported each other emotionally, especially in the early days,” agrees Marotto. “It would have been a much worse situation for me if it wasn’t for the support of my amazing co-workers.”

“We had to rally for our patients and our coworkers. We had to figure it out.

And we did.”

Philippa Lentz

“A lot of people, including other nurses and doctors, helped out,” acknowledges Lentz. “This pandemic has really showed me, in a concrete way, that when a large-scale disaster happens, we need people to stand up and be leaders at every single level.

We do need people to take care of the big picture. But we also need people attending to the small details, and they should be properly compensated. It’s all of those small details that make up the daily life of the people who actually work in the middle of a disaster.” •

THE LONG HAUL For some BCNU members, COVID-19 has brought life-changing consequences

T

HERE IS NO QUESTION that when it comes to treating the survivors of COVID-19, we are “learning as we go.” Many of the longterm effects of the disease have yet to be studied and understood.

By April 2021, there were over 100,000 COVID-19 cases in BC, with more than 5,000 requiring hospitalization and almost a third of those patients needing admission to an intensive care unit.

Most people who contract COVID19 recover without complications, but many do not.

An estimated 10 to 20 percent of patients labelled as recovered experience symptoms that last longer than six months. These are the so-called “long-haulers,” a small but growing

group of British Columbians who continue to struggle with the after-effects of the illness months after tests reveal they are virus-free.

Any one of these patients can end up with profound and prolonged conditions, including tightness of chest, fatigue, chills or sweats, body aches, dry cough, elevated temperature, headaches, “brain fog,” breathlessness or concentration challenges.

A 2020 survey of COVID-19 long-haulers conducted by “citizen scientists” in the US, Canada and UK called “Patient Led Research for COVID-19” found that only about 20 percent of respondents said they’d made a full recovery by day 50, and 65 percent said they considered themselves unrecovered and mostly sedentary.

At present, many Canadians labelled as recovered are not currently receiving adequate rehabilitation and community support upon their discharge from hospital. Canada has to-date set up only eight post-COVID-19 multidisciplinary specialty clinics to treat long-haulers.

Fortunately, three of them are in BC (see sidebar on page 32).

Health-care workers make up a significant portion of COVID-19 cases, so it’s no surprise that nurses are among this group that now finds itself facing the unknown, and on a journey that may have no end.

Update Magazine spoke with three BCNU members who contracted the virus in 2020, but who have yet to fully recover. What follows are accounts of their illness, and struggle to return to work and a life of normalcy.

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LIFE UPSIDE DOWN Before contracting COVID-19, Chilliwack’s Audrey Vanderhoek was an avid hiker and martial artist. Almost a year into her recovery process, she is unsure if she will ever again work full time.

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C

HILLIWACK’S AUDREY Vanderhoek has spent most of her 30-year nursing career working in long-term care. “I love my co-workers, my residential care coordinator is a gem and the doctors are by far the most caring compassionate and present individuals I could hope to associate with,” she says.

Until last spring, Vanderhoek worked at Abbotsford’s Cottage-Worthington Pavilion, a Fraser Health-operated single-story residence and adjoining privately run rehabilitation unit that shares a nursing station and dining area.

The COVID-19 outbreak that began on the rehab unit in the early days of the pandemic resulted in a devastating loss of life.

Vanderhoek recalls expressing concern about the possible spread of COVID-19 from the rehabilitation unit. “Letters were written, and it was widely discussed openly with higher-ups.” But after speaking to her employer about the need for better access to personal protective equipment and improved staff safety, she says she was dismissed with an “it’s all fine.”

“But it was not fine, not fine at all,” she reports, and argues that the mismanagement of the rehab unit is why she became sick – and is still sick to this day.

Vanderhoek’s COVID-19 journey began when she started to experience mild influenza-like symptoms. But it soon became evident that she had contracted much more than seasonal flu. “By day eight or nine, I had brain fog, chest pain, tightness, shortness of breath, sinus pain, weird heart palpations, dizziness, nausea,” she recalls.

Vanderhoek tested positive for COVID-19 on May 2, 2020 and self-isolated for 26 days. “I had anxiety like nothing I have ever experienced before. The exhaustion was crazy – all I did was sleep.”

Before becoming positive, Vanderhoek would have described herself as a fit and active nurse. “I practised martial arts and was an avid hiker,” she says. Now, she was off work, assigned a WorkSafeBC case manager and monitored by a public health nurse.

The illness is like nothing Vanderhoek has ever experienced before. After a brief reprieve from some of her symptoms in early June, she was soon inflicted with yet another flare up and went for multiple tests that included an electrocardiogram and blood work. Yet the results came back normal.

Vanderhoek was finally without chest pains for the first time in August.

But she sought care from a naturopath to address other lingering symptoms.

“I was looking for relief for the dizziness, neurological pain in my gums and face, nausea, general brain fog and the chronic fatigue,” she says.

The supplements Vanderhoek was prescribed led to some minor improvements, but she says she still had low energy, was unable to multi-task and had no tolerance for everyday activities like TV watching. She tried to keep life simple to aid her recovery. That meant prioritizing sleep, talking walks and doing housework only when necessary.

“I still had brain fog, fatigue and memory issues. I could not get my brain to put things together,” she recalls. “And I would become so overwhelmed by emotion under the circumstances.”

Vanderhoek’s efforts to maintain a

simple life were disrupted in the summer when her aging parents, needing care, moved from Alberta to BC, and her teenage son moved back home.

Her inability to deal with stress was exacerbated further when WorkSafeBC presented her with a graduated return to work schedule that would see her begin working on Sept. 21 and resume her full regular job duties after Oct. 16 – a decision that was made despite the several notes doctors had written on her behalf.

The exhaustion was crazy – all I did was sleep.”

Audrey Vanderhoek

She appealed the decision with the support of a BCNU WCB advocate, who arranged for long-term disability coverage pending the outcome of her appeal. Fortunately, she received a favourable result this March, when it was determined that Vanderhoek remains unable to return to work.

British Columbia has a network of three post-COVID recovery clinics connecting long-haulers like Vanderhoek with specialized care (see sidebar on page 33). It was not until Vanderhoek was referred to the St. Paul’s Hospital COVID clinic in Vancouver that she says she was told that what she’s experiencing is

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real, and not “in her head.” Before going to the clinic, she says she doubted herself, and would think, “is this really happening?” But specialists in the program made Vanderhoek feel safe. She wants others who have had COVID to know that “they should not be afraid to speak up, it’s a journey, don’t give up.”

Today, Vanderhoek is still a participant at the St. Paul’s COVID clinic, where she’s being monitored and assessed. She’s also a subject in on-going research that’s conducted by respiratory therapists and others.

WorkSafeBC is still in the process of determining whether further treatment is required, and if retraining or accommodation is necessary.

Vanderhoek continues to work on her cognitive stamina pacing and says she’s happy with her recovery process.

“There’s been improvement, albeit slow,” she reports. “I anticipate a full recovery, that is my goal. But I’m not sure I will ever have the mental or cognitive endurance to withstand the pressures of nursing as I did before.”

Every day, Vanderhoek contemplates what’s next. “If I’m not given the time, the proper job and possibly part-time hours, I will have no choice but to leave the profession.”

N

URSING IS SIMI ONO’S second career. After graduating from the University of Victoria, the RN started working as a home care nurse for Island Health and also served as a community and public health nurse in WSÁNEĆ territory on the Saanich Peninsula. When COVID first emerged onto the global stage in early 2020, Ono was involved with pre-pandemic planning, education and

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The whole thing had affected my cognitive, emotional and physical state.”

Simi Ono

COVID screening in the community.

Prior to nursing, Ono worked as a respiratory therapist in Alberta, primarily in critical care. She says she was struck by the disparity in care provided to Indigenous and non-Indigenous people, and credits her awareness in part to the fact that she is a second generation settler of South Asian descent. “I noticed a lack of cultural awareness or understanding for minorities within health care around care and particularly beliefs around death, passing and the importance of traditional ceremonies,” she remarks. “This was part of my motivation to work with the Indigenous population.”

Ono accepted a new full-time position at Victoria’s Royal Jubilee Hospital in June 2020, working on Island Health’s Indigenous Health & Diversity, Equity and Inclusion team.

Weeks later she began feeling extremely tired, but attributed it to the new role. “I was just so tired, I told myself I was overloaded from a new position,” she says. Despite not having a fever, Ono remembers having “hot breath,” feeling like a lead weight and developing a runny nose. She

decided to call in sick, get tested and then self-isolate while waiting for the result and trying to explain her symptoms away. “I have allergies and they also make me tired,” she remembers thinking.

Ono says it was her 13-year-old son who tossed the cordless phone to her in the bedroom so she could hear the results. The mother of two had tested positive for COVID-19. Ono says she was immediately concerned about whom she was in contact with. Despite being unwell and feeling lethargic, she says it was pure adrenaline that pushed her to immediately share contact tracing details with a nurse to help ensure others would be safe.

From the moment she hung up, Ono’s condition only worsened. She describes having a heavy chest, difficulty breathing, a loss of smell, gastro-intestinal pain, a low fever and nausea. But she was determined to conserve what little energy she had. “Being a respiratory therapist, I was mindful of my breathing, as even speaking would exhaust me,” she says.

“Early in my acute phase of recovery, while on complete bed rest, I was laser focused on my shortness of breath and tried to monitor my own vitals – it gave me something to focus on,” she recalls. “As my signs and symptoms progressed, changed and new ones appeared, it just never went away entirely. Today I still have trouble with random heart palpitations, random tachycardia, extreme fatigue and delayed onset muscle fatigue and weakness.”

After her diagnosis, Ono was in regular contact with a public health nurse and Island Health’s occupational health department, which had alerted WorkSafeBC. “In the beginning,

ONE DAY AT A TIME Victoria’s Simi Ono says the hardest part of her recovery from COVID19 is the unpredictability of the illness, and not knowing what her energy level will be like from one day to the next.

PHOTO: JOHN YANYSHN

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COVID-19 LONG JOURNEY Vancouver’s Katie Borrett was among the first British Columbians to fall ill with COVID-19 symptoms in the early days of the pandemic. This fact alone has made it more difficult to claim WorkSafeBC compensation while she recovers.

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you are not in your right mind, you’re at your most vulnerable. They are asking you very specific questions and there were lots of grey areas,” she recalls. At the time, WorkSafeBC was in the process of revising its claims process for workers who contract COVID19, and the legislative amendments that now make it easier for WorkSafeBC to immediately apply viral pathogen presumption for health-care workers had yet to come in to affect. Ono says she is grateful for the support of her BCNU representative who helped her navigate the cumbersome claims process.

Weeks later, after multiple trips to the ER and a battery of inconclusive tests, Ono was still not well and had added dizziness and fluctuating blood pressure to her list of conditions. “The whole thing had affected my cognitive, emotional and physical state,” she says of her illness.

To aid her recovery, WorkSafeBC referred Ono to a third-party comprehensive occupational rehab program.

She has since made gains through physical, mental and emotional work. Ono also asked her physician to arrange a referral to the St. Paul’s Hospital long-haul COVID clinic in Vancouver, the only one in BC at the time (see sidebar on page 33). Three such clinics have since opened in the Lower Mainland, but there are none on Vancouver Island. The St. Paul’s clinical team reviews Ono’s locally performed lab work ups and diagnostic tests and checks in with her every three months.

Ono reports experiencing some judgment through her ordeal, and says it's disheartening to hear others speak dismissively about COVID symptoms.

“Part of me is hesitant to speak about my experience, to be identified as that

nurse who had COVID,” she confesses.

“Some people do recover quickly, without symptoms. Some die, some barely survive – and then there are the long-haulers, like me.”

All the more reason for health-care workers to actively promote public health measures, she says. “Getting COVID is not worth the risk! All of the simple precautions we are taking everyday are vital.”

Ono says the hardest part of her recovery now is the day-to-day unpredictability. “I never thought at my age, I would have to think about my energy in terms of how much of a charge I have in a given day – I consider it a good day when my battery is at 50 percent. The trouble is, like an old cell phone battery, when you try to fully charge it, it just doesn't last, or runs out so quickly!” she explains. “I sometimes wish others could see my charge level for the day. It's not something others can view like a broken arm, or visible disease.”

Now, as Ono begins her gradual return to work, she’s extremely mindful of her energy output, and grateful that her experience has been less serious than some others’. “I know I’m lucky that I never had to be intubated and that my case would be considered moderate, that it could have been far worse,” she acknowledges, her voice cracking. “But it takes such a toll on you in every way – I wouldn’t wish a long-haul experience on anyone.”

I

N JANUARY 2020, COVID-19 WAS just emerging onto the world stage and the World Health Organization had not yet declared the disease a global pandemic. Still, Katie Borrett says she contracted the illness that month. No swabs were yet available

to verify that she had the virus, but she nevertheless ended up with the symptoms.

Borrett was working full time in the maternity ward at Richmond Hospital when her symptoms started to manifest. “Initially I presented with mild symptoms like shortness of breath and an overall fatigue,” she recalls.

What if this is for the rest of my life?”

Katie Borrett

Borrett carried on working through February, but by March her condition worsened and she felt unable to work any longer. She had a COVID-19 test, but the results were negative.

Still unwell in April, she went to the ER suffering from shortness of breath.

The doctor on duty ordered another COVID-19 test, which again came back negative. She says her doctors were baffled, and were initially telling Borrett that her condition was not related to COVID-19. A part of her wanted to agree with the assessment.

But, like other long-haul patients, Borrett knew she was not getting better.

Her co-workers were also concerned. They knew Borrett to be healthy and upbeat. The 35-year-old RN had played high-level sports and has a background in kinesiology.

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She herself had trouble wrapping her mind around how ill she felt as symptoms worsened – and she wondered if she was ever going to get better. She was dealing with a sinus infection, headaches and exhaustion to the point where her husband had to help her with almost every daily activity. “I’m young and fit, but he had to cook for me, bathe me, drive me to the ER for my tests – he provided total care,” she reports.

Borrett’s illness took a toll on her extended family as well. The youngest of five children, it was difficult for the nurse’s parents to stay distanced and not be able to help their daughter on account of public health restrictions.

Entering July and still unwell, Borrett had used up all of her sick time. She reached out for support from BCNU’s Workers’ Compensation Board (WCB) advocacy team for support, and union staff helped her complete a longterm disability application. “It is a lot of paperwork to navigate at a time when you are at your weakest.

My BCNU rep was wonderful, and it is moments like these that you’re glad if you are a member of a union.”

Borrett is part of that group of workers who became sick before changes to the Workers Compensation Act, aimed at supporting workers who contract COVID-19 on the job, came into effect last summer. Bill-23, which received royal assent on Aug 14, recognizes that a worker who contracts a viral pathogen is presumed to have been infected because of their employment whenever their risk of exposure to the pathogen is

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significantly greater than the risk to the public at large during a public health emergency.

Borrett filed a WorkSafeBC claim in October 2020, but was denied coverage in January 2021.

WorkSafeBC determined there was insufficient evidence to confirm that Borrett was exposed to COVID-19 at work. However, she believes that if tests were available when she initially became sick in January 2020, she would have tested positive for COVID-19 following an unconfirmed exposure to a COVID patient. She is now getting support from BCNU’s WCB advocacy team as she appeals the decision.

Despite the challenges Borrett has faced when dealing with WorkSafeBC, she says her care-providers agree she is suffering from post-COVID symptoms, and they have eliminated all other possible sources that could cause her lingering ailments.

Last October Borrett’s family doctor referred her to Vancouver’s St. Paul’s Hospital Post COVID19 Recovery Clinic. Staff in the program are now monitoring the nurse’s chronic fatigue, post-exertional malaise, brain fog, headaches and respiratory distress.

Borrett says she hopes for a return to work, but still struggles with the illness. “What if this is for the rest of my life?” she wonders.

“I worry that I may have permanent disabilities that impact my capacity to continue a 12-hour physical job.”

For now, however, Borrett’s recovery is trending in the right direction. •

THREE CLINICS FOR ‘LONG-HAULER’ COVID-19 PATIENTS IN BC BRITISH COLUMBIA HAS A NETWORK of three clinics connecting specialized care and follow up for COVID-19 patients still suffering from an array of ailments months after testing positive for the virus.

Vancouver General Hospital and St. Paul’s Hospital in Vancouver started operating in the fall, and the Jim Pattison Outpatient Care and Surgery Centre in Surrey opened at the end of January.

Patients must be referred to a clinic by their primary care provider. It’s hoped that findings will provide researchers evidence to better understand the long-term effects of the disease.

These clinics are interdisciplinary, integrated with primary care providers, and based on a model of supportive care co-designed by clinicians and survivors of COVID-19.

The Globe and Mail reported that most patients at the trio of BC clinics will see a doctor at the facility three months after they first feel ill and then have follow-up visits after six months and then a year.

Dr. Greiner, the internist who is in charge of the clinic at St. Paul’s Hospital, told the Globe and Mail the most important treatment to date has been educating people about how their activities can lead to their symptoms flaring. Often, people experience a worsening of their ailments two to three days after they exert themselves heavily while recovering, he said.

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WORTH A THOUSAND WORDS Researchers are exploring nurses’ lived experience of the COVID-19 pandemic and giving them voice through photography

“I

N THE MIDST OF EVERY crisis lies great opportunity.” Albert Einstein’s famous quote has never been more apt than it is today as clinicians in health-care systems work tirelessly to protect their communities during the COVID-19 pandemic.

Nurses in Canada and around the world make up the largest number of health-care providers in the system, filling roles that are committed to the prevention and treatment of disease.

There’s no question that nurses have played a decisive role during the crisis, whether as direct care providers, educators, researchers or policy makers.

So, as we begin to emerge from the pandemic, it is essential that nurses’ experience and expertise is used to shape health-care policy and develop strategies for future pandemic preparedness.

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A group of BC nurse researchers has already begun this important work, and a study is now underway that provides nurses with an opportunity to discuss the occupational and social issues that have impacted their lives and their nursing practice during the pandemic.

The research team includes Douglas College instructors Ruhina Rana and Nicole Kozak, Providence Health Care Director of Research and Knowledge Translation, Agnes Black and student assistants Megan Scott and Lauren Wittal.

“The experiences and voices of the nurses participating in the study will be communicated to health-care leaders, educators and policy-makers, and hopefully used to strengthen health-care systems,” Rana explains.

The team believes that the perspective of nurses and other point-of-care

providers needs to be included in the development of policies and strategies related to pandemic preparedness.

Rana points to recent work conducted by Saudi Arabian and Australian researchers showing that nurses are well positioned to manage and prevent communicable diseases during a pandemic.

“This research tells us that nurses have demonstrated their leadership capacity in a crisis and that they are ready to respond,” says Rana, citing findings showing how nurses are “efficiently managing limited resources, instituting infection control measures and providing safe and effective care.”

She argues that it’s imperative for nurses’ perspectives to be considered when planning the response to future health crises.

The BC study, which began in June 2020, is a collaboration between Douglas College and Providence Health Care. It uses a novel research method called photovoice, which employs photography, reflection and group discussion to help individuals share their experiences.

“Participants are seen as knowledge generators and contribute to the research

by telling stories and sharing ideas, creating rich research data, offering critical reflection,” explains Rana. “It’s a participatory action approach where the participant is seen as the expert.”

The data consists of photos and reflections submitted by participants, as well as the transcripts of online discussion sessions where participants interpreted and analyzed their photos.

The researchers were mentored

by Douglas College instructor and researcher Dr. Colleen Reid.

“She’s an expert in photovoice and has done a fantastic study looking at people in the community living with mental health challenges, where she gave them cameras to go out and photo-

“It’s a participatory action approach where the participant is seen as the expert.”

Ruhina Rana

graph their experiences,” states Rana.

The “voice” part of photovoice is especially important to the research.

“Nurses are ideally situated to provide feedback that represents the medical side and the patient side, and we liaise between them,” says Rana when recalling the planning process.

“So, we just kept asking ourselves, ‘where is nursing’s voice in all of this?’”

When reflecting on nurses’ voices, Rana says she also thought of the old adage “Why bother doing nursing notes? No one reads them.” And the general feeling that what nurses write down and put out into the world is often ignored.

“We thought, ‘what's a way to get nurses’ voices out there that can’t be ignored?’ And so photographic images seemed like a really powerful way to put that message forward.”

Rana also recalls the news coverage of the early stages of the pandemic, with the mass graves in New York and refrigerated morgue trucks, and was struck by the power of the images.

“Those things kind of came together and we thought, ‘this is the way that we can get nurses’ voices out there

because peoples’ attention is grabbed by these images and they don’t look away,’” she says.

“We thought that photovoice, as an established methodology, would be a really strong way for us to influence the healthcare system.”

Data collection has now been completed and the researchers are in the process of analyzing all the information that has been gathered. The team plans to publish the findings later this year.

In the meantime, Update Magazine is publishing preliminary research in the following pages, which reflects some of the themes that have emerged so far.

The powerful images and narratives in the following pages reflect nurses’ experiences in direct patient care during the COVID-19 pandemic. They will be shared with BCNU, researchers and health-care leaders to support nurses at the point of care and advocate for changes that will influence and improve patient care and the health-care system.

The opportunity has never been greater.

For more information on this research project please contact Ruhina Rana: ranar@douglascollege.ca

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Overwhelming anxiety, fear of the unknown and the dangers front liners are putting themselves in each day. No one was prepared for this pandemic, so self care has become huge.

It’s been hard to stay away from our loved ones and our network who help us in our daily struggles. Since we can’t hug and hand shake with friends, it’s been really challenging to stay connected.

I have felt all five stages of grief throughout this pandemic.

At first, I felt denial over how serious this was. Soon after, they declared COVID-19 as a worldwide pandemic. It all happened so fast. I started to get angry at those who wouldn't follow public health guidelines. I bargained with God. I felt anxious going into work, battling the unknown.

My anxiety spiraled down to depression, it was so exhausting. It is only now that I've started to learn how to accept things. It's the new normal for most of us.

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OCEAN BLISS (WINTER WATERS) the ocean calls to me Breathe it invites me into its waters and asks for my undivided attention Breathe It opens and offers its radiant healing powers Breathe I bow my head in respect and gratitude Breathe it beckons my presence and total submission Breathe it’s temperature wraps me in, leaving me breathless Breathe a restorative pain that turns into warmth

Community members placed a "Gratitude Garden" at the perimeter of the hospital. I walk by this garden and wonder if the rock painters ever imagined we would be so thick in the pandemic nearly one year later. Watching weather and time wear upon the rocks is a bittersweet reminder of how resilient we have all needed to be in this struggle.

Breathe it both calms me and invigorates me Breathe its waves take what they need from me and then return what I seek Breathe until nothing else remains but absolute reverence Breathe

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Majority of patients' human connections were with gowned and masked strangers; a quick FaceTime chat with family; maybe a moment of physical touch with a gloved hand in moments when words can't provide comfort. These moments felt so clinical, yet this was the closest thing they had to physical affection.

After I was suited up I gave my friend and co-worker a hug. I miss hugging my loved ones.

In our ICU teamwork has always been important but my colleagues and I have gotten even better at it since COVID-19. We rely on each other to keep each other safe.

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To wear or not wear a mask has become a political statement. It has become some sort of belief system. To some, this mask represents a hoax. A nuisance.

A hindrance to personal freedom. I have tried to listen to the perspectives of those who believe that this whole pandemic is fake But I cannot convince them. Going to work feels like trying to put a fire out while some pour gasoline.

And for that, I feel extremely helpless. "We are all in this together"... I only wish that this was true.

A peaceful-looking battlefield.

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The photograph may only show the tracks on my face, but to me these tracks have a story to tell, a story that is only truly understood by those of us in the arena. The arena where we are fighting against this disease that has already taken too many lives, fighting to keep our patients alive, fighting against our own burnout and fighting against time.

The positive energy that keeps me going.

We have to watch and support each other in the frontlines.

Without each other, our jobs and daily work will become even more difficult.

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After the first COVID vaccination, it feels one step closer for things getting back to the way they were. In a pandemic that feels like eternity, nice to make a small but important step back to resuming our lives. •

There is a light at the end of the tunnel (COVID-19).

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1,716 THE

DEADLIEST YEAR Rising numbers of preventable deaths in 2020 means more action is needed to confront the province’s worst public heath emergency

T

OMMY WAS HELPING a friend break up some cement and he popped a disk,” Deb Picco recalls.

After the back surgery that followed the injury, her son was prescribed Oxycontin to manage the pain. “But the pain never left. He ended up having two more surgeries and he was in constant pain despite the drugs that he was taking,” says Picco.

“That's what the original problem was, and then he gradually got into heavier and heavier drugs.”

Unfortunately, the treatment options available to Tommy were not enough.

“He’d been through rehab a couple of times and detox a couple times,” says Picco. “There were lots of changes in him that you would see on account of the drug use, you know, but they were not able to do anything to help that pain.”

Tommy was 36 when he died from opioid poisoning last October. It was the end of a journey with substance use that began when he was a 21-year-old young man.

His death came almost five years after the province's overdose crisis was first declared a public health emergency in 2016, after fentanyl began entering the drug supply three years earlier.

Sadly, BC continues to endure a terrible burden of death on account of the toxic drug supply. And since 2016, the number of people who have died from drug toxicity in BC has risen tragically and dramatically.

According to BCs chief coroner Lisa Lapointe, at least 1,716 British Columbians lost their lives in 2020 without access to a regulated, safe

alternative to poisoned illegal drugs.

This represents the most deaths ever in a single year in this province due to an unnatural cause, and an alarming death rate of 33.4 per 1,000 people – about five deaths per day on average.

The 1,716 number surpasses the 1,549 people who died in 2018, up until now the deadliest year, and is a 74-percent increase from last year’s 984 deaths.

As has been the pattern throughout this public health emergency, the vast majority of those dying are inside a private residence.

Fentanyl continues to drive the health crisis. The substance was found in over 86 percent of deaths between 2017 and 2020.

According to Lapointe, the toxic drug market remains the number one public health risk in BC, with deaths due to toxicity surpassing the number of deaths due to suicide, motor vehicle collisions, homicide and prescription drug deaths combined.

“People are dying in communities across BC and from all walks of life.

They leave behind broken hearted families, friends and co-workers,” she said during an April news conference to mark the five-year anniversary of the crisis.

Sadly, she also reported that in 2020 the emergency had become far worse, and there is seemingly no end in sight.

Lapointe said there is no question that harm reduction measures introduced since the public health emergency was declared have had a measurable effect of reducing deaths in 2019. The widespread provision of naloxone, the opening of overdose prevention sites and supervised consumption sites and drug checking services reduced poisonings and the number of

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TAKING ACTION NO END IN SIGHT AND MUCH MORE TO BE DONE BC HAS BEEN IN A TOXIC DRUG public health emergency for five years. In that time, we will have lost almost 7,000 people to the toxic supply of opioids.

Thousands of years of life and potential gone. We must turn this tide. Heath-care and policy leaders from all quarters – from the Coroners Service to the Association of Chiefs of Police to health-care providers and community advocates – agree that action must be taken in four broad areas: 1 PROVIDE ONGOING HARM REDUCTION MEASURES such as the widespread provision of naloxone, the expansion of overdose prevention sites, supervised consumption sites and drug checking services.

2 INCREASE ACCESS TO SAFE SUPPLY with prescribed pharmaceutical alternatives to reduce drug users’ reliance on a profit-driven illegal drug trade that depends on growing its customer base to increase its profits.

Encouraging nurses and physicians to prescribe alternatives to their patients will save lives.

3 BUILD PROVINCIAL MENTAL HEALTH TREATMENT AND RECOVERY SERVICES that are regulated, evidence-based economically and geographically accessible, and ensure this treatment is available when people are looking for it. Waiting weeks and months for access to recovery and treatment services means the difference between life and death.

4 END THE CRIMINALIZATION OF PEOPLE WHO USE DRUGS. We know that decades of stigma and punishment have brought us to the devastating place we are in today. We need to move from punishing and blaming to supporting and healing.

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deaths decreased in our province.

However, since the start of the COVID-19 pandemic, drug toxicity deaths have again been increasing at an alarming and steady rate. “With the pandemic, access to harm reduction measures was reduced, people self-isolated and the harms associated with the illicit drug market returned with a vengeance,” said Lapointe.

members, with 1,000 in BC. Most are mothers who have lost children to drug harms. Picco become involved with the group last year, after Tommy’s death.

A long-time BCNU activist, Picco retired in 2019. She worked in home care in Maple Ridge, and served on the union’s council from 2011 to 2016, as BCNU Simon Fraser region council member.

“I heard about Moms Stop the Harm A RENEWED CALL on the news one day when [group FOR ACTION spokesperson] Leslie McCain was The five-year anniversary of the health talking and I found their Facebook emergency, along with the spike in opi- page,” she says. “Right now I use the oid deaths, has prompted renewed calls group for support. It’s for parents or for action to address the crisis. loved ones of people who have died, or BCNU is one of those organizations people who use substances themselves, that’s joining with advocates in calling who can find other people who know for increased investments in harm what they're going through.” reduction services like safe consumpShe says the help she’s received from tion sites, better access to safe supply other families who have suffered loss such as prescribed pharmaceutical has been invaluable. alternatives, province-wide invest“You don't know what it’s like until ments in mental health, treatment and that happens to you. You can imagine recovery services, and ending the crim- it, but it's never quite the same,” she inalization of people who use drugs. explains. “So I’ll go on there if I’m hav“BC’s nurses see the effects of the ing certain feelings or something, and toxic drug supply every day, including other people go on and just support you, during the COVID-19 pandemic,” says and say ‘this is what it was like for me.’”

BCNU President Christine Sorensen.

Still grieving, Picco plans to turn her “They continue to work tirelessly experience into activism in the future. to provide care while this province “My intent is to eventually get into manages two public health emergenmore advocacy work for Moms Stop the cies. It’s time the government provides Harm.” more effective solutions to address this Like many people who have been epidemic.” affected by the opioid crisis, Picco BCNU, along with advocacy group believes the COVID-19 pandemic has Moms Stop the Harm, which is a shown what’s possible when there is network of families impacted by subpolitical will. stance-use related harms and deaths, is “The response to COVID-19 tells us calling for more action from all levels of that the government is not taking the government to address the crisis, and drug toxicity public health emergency for an end to the failed “war on drugs” seriously enough. They can put money approach to substance use through the and resources into pandemic emerpromotion of evidence-based policy gencies and choose to ignore other change. emergencies.”

Moms Stop the Harm has over 2,000 Picco believes that the stigma

surrounding substance use is a major factor behind governments’ uneven approach to both public health crises, and urges everyone, including nurses, to resist falling prey to many of the stereotypes surrounding substance use.

“It’s important to treat people who use substances with an awareness that it is a mental health issue,” she says. “I think most of us see people who use substances as a nuisance, as people who are choosing to be like they are.”

Picco knows this is not true.

“Just a couple months before Tommy died, he shared how hopeless he felt after struggling with pain for 15 years, seeing no end to it, and realizing he would never work again, be productive or have a family of his own. He had tried but couldn’t get away from the substance use and homelessness, and his sense of failing himself and his family.”

A growing body of addiction research is showing that people who use substances have often suffered a traumatic experience. “Usually in their childhood or in their youth,” says Picco. “We don’t always know, but we have to understand that there is usually a cause for their substance abuse.”

FROM DECRIMINAZATION OF USE TO SAFE SUPPLY

The decriminalization of people who use drugs is an important step toward removing the stigma surrounding substance use. There is now wide consensus that addiction and substance use is a health-care issue, not a criminal or a moral one, and it should not be addressed by criminalizing personal possession and consumption.

“The current war on drugs has been costly and grossly ineffective and has resulted in widespread stigma toward addiction and against those who use

PHOTO: DARRYL DYCK / CANADIAN PRESS

CALLING FOR ACTION Public health advocates say that treatment and harm reduction measures must be accompanied by improved access to safe opioids.

illegal drugs,” says Sorensen. “We need to stop treating the most vulnerable members of our society like criminals.”

Portugal decriminalized the use of all drugs, including heroin and cocaine, in 2001 and began a major public health campaign to tackle addiction. Sorensen notes that the crisis in that country soon stabilized and in the ensuing years it saw dramatic drops in problematic drug use, infection rates, overdose deaths and drug-related crime.

Portugal’s mortality rate is now four times lower than the European average.

“We've learned from countries like Portugal that when you decriminalize, people feel safe enough to ask for treatment.”

BCNU has also endorsed the Office of the Provincial Health Officer's 2018 special report that provides an analysis of the harms associated with criminal justice-based approaches to drug policy. The report, entitled Stopping the Harm, provides options for amending the province's Police Act in a manner that would guide law enforcement in its interaction with people who use controlled substances. This could include developing a new regulation that would prevent police officers from expending resources on the enforcement of simple possession offences under federal law.

While possession itself remains illegal, this approach creates alternative pathways for law enforcement to link people to supports and services they may need.

Regrettably, the provincial government dismissed the report’s recommendations, claiming the province has no jurisdiction to act because possession of illegal substances is governed by federal law, and that it can't direct police on how to conduct operations.

Legal advocates have since countered this claim, and have argued that enacting legislation to amend the Police Act is within the authority of the province, which bears responsibility for ensuring the health of British Columbians.

“We just need to ensure that they can be safe in what they are doing.”

Deb Picco

Fortunately, de facto decriminalization is already occurring in many areas of BC through the discretion of law enforcement when they interact with people who use drugs.

Last July, the Canadian Association of Chiefs of Police recognized that substance use disorder should be a health priority and not a criminal justice matter, and announced its support for the decriminalization of small amounts of illegal drugs for personal use. This

UPDATE MAGAZINE • SPRING 2021

45

position was also fully endorsed by the BC Association of Chiefs of Police.

And last year the public prosecution service of Canada developed new charging guidelines for simple possession of illegal drugs, only accepting charges where there are extenuating circumstance impacting public safety.

Despite the progress that’s been made to reduce stigma, public health advocates point to the fact that the real danger of a poisoned drug supply remains as long as the production and distribution of non-pharmaceutical opioids and other substances remain illegal.

That’s why access to a safe and regulated drug supply is so critical.

It’s also why BCNU welcomed last September’s public health order that authorizes RNs and RPNs to prescribe pharmaceutical alternatives to toxic drugs as a step in the right direction.

“Expanding nurses’ scope of practice is one part of the solution to addressing the opioid crisis, especially as deaths continue to climb,” said Sorensen when the order was announced. “However, there are many questions regarding the ‘new nursing standards’ that are included in the order, as well as what the training and education requirements will look like for nurses.”

The order is an emergency measure, and one that has taken significant time to implement. In the meantime, there is still a need for long-term investments in mental health and substance use care to build a system where providers feel supported and people get the care they need.

Picco believes that nurses are an important part of the solution. She says that with the right resources, they have the skills to help more people who are at risk from toxic substances. “They know their patients tremendously well, more so than the

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doctors often, and I think nurses are an excellent resource, and part of the solution to this problem.”

But there is still a long way to go in expanding the supply of safe opioids and treatment options that are inclusive and culturally appropriate. (The rate of opioid poisoning deaths among First Nations people in BC is over four times higher than that of other residents.)

Following last year’s order, trained nurses will first be able to prescribe Suboxone, and will later be trained on prescribing other alternatives like slow-release oral morphine and methadone.

Many harm reduction advocates argue that the new measures fall short of true safer supply, which would provide pharmaceutical-grade versions of illegal substances, such as diacetylmorphine, instead of alternatives.

Picco knows from experience how difficult it can be for substance users who cannot access a safe supply of diacetylmorphine. “Tommy went through methadone and suboxone, and despite several attempts with those, and even

with rehab, it wasn't a solution for him.”

She says that expanded treatment modalities are also critical.

“More attention needs to be paid to supporting mental health treatment.

But at the same, the expectation of total abstinence is not an acceptable goal,” she argues. “People who use alcohol are not automatically labelled alcoholics.

And likewise, not everyone who uses illegal substances is an addict with a ‘drug problem.’ We just need to ensure that they can be safe in what they are doing,”

FEDERAL LEADERSHIP NEEDED

Health-care delivery is a provincial responsibility, but the opioid crisis is national in scope, and provinces cannot adequately meet the challenge on their own.

Nationally, the number of preventable overdose deaths to date has far surpassed the total number of deaths of all other public health emergencies in the last 20 years including SARS, H1N1, Ebola and now COVID-19, yet

Drug toxicity deaths in BC 2010 – 2020 Deaths 1,600 1,400 1,200 1,000 800

Public health emergency declared

600 400 200 0 2010

2011

2012

2013

2014

2015

2016

2017

2018

2019

2020

Source: BC Coroners Service

A STEP BACKWARDS COVID-19 pandemic public health measures have been followed by a spike in the number of overdose emergencies in the province. The numbers are a tragic reversal of the progress that’s been made in recent years to reduce the rate of opioid poisoning.

the crisis has not achieved national emergency status.

And still Ottawa has refused to declare the current opioid and fentanyl poisoning crisis a National Public Health Emergency under the Emergencies Act. Such a move would unlock federal funding for evidence-based treatment programs such as the innovative program at Vancouver’s Crosstown clinic that provides access to safe opioids like prescription heroin for those most at risk for overdose and poisoning.

“The federal government has an obligation to act because it has failed to control the illegal drug supply, or keep fentanyl out of it,” Sorensen argues. “Over 80 percent of suspected opioid deaths last year involved fentanyl, and it was often combined with other drugs — most often heroin, cocaine or methamphetamine.”

“BC’s nurses see the effects of the toxic drug supply public health emergency every day.”

BCNU President Christine Sorensen

In the meantime, she says BCNU will continue the fight to reducing and eliminate preventable deaths and support the the thousands of family members like Picco who have been touched by the opioid crisis.

The pain of Picco’s loss is still raw, but she takes solace knowing her son was able to make a difference in the lives of others after he died. “Tommy was able to donate his heart, his liver and two kidneys,” she reports. “And as a nurse, that fact provides a bit of comfort.” •

BEVEL UP

CALLING FOR COMPASSION, ANTI-STIGMA EDUCATION AND POLICY CHANGE COMMUNITY NURSES KNOW THAT ONE OF THE BIGGEST PROBLEMS ASSOCIATED with the use of controlled substances is that those who use them are often reluctant to seek treatment due to the stigma they face. This exacerbates chronic health conditions, increases isolation and further adds to the complexities of the issue.

The aversion often comes from the experience of being discriminated against by the very health-care workers who are tasked with providing care.

This reality was driven home in the 2007 film Bevel Up – Drugs, Users and Outreach Nursing. The stories told and lessons to be learned are still as current and relevant as ever in the wake of today's opioid crisis.

That's why BCNU is supporting the launch of a renewed outreach campaign for Bevel Up, an award-winning documentary and learning resource that has helped health-care workers deliver compassionate care to people who use drugs.

The initiative is a timely anti-stigma campaign that’s pushing for policy change at all political levels. Producers hope to engage with many community partners and share of updated curriculum materials.

The film and accompanying educational playlists are designed to give students and instructors in the health-care field access to the knowledge and experience of pioneering practitioners. In 2018, BCNU helped sponsor a relaunch of Bevel Up in a digital format to help raise awareness of the work nurses are doing in the midst of today's ongoing opioid crisis.

The camera follows street nurses as they reach out to people working in the sex trade, and people who use substances in the alleys and hotels of Vancouver’s Downtown Eastside. Most importantly the nurses reflect on the attitudes they bring to their work—attitudes that can make or break their relationships with the people to whom they provide practical, non-judgmental health care on a daily basis.

The current opioid crisis, which has seen even more deaths than the COVID-19 pandemic in Canada, has meant that the film Bevel Up has even more relevance to commuWatch the National nities. The launch of the new educational materiFilm Board als for Bevel Up will share important knowledge to documentary nurse educators, point-of-care workers and comBevel Up on your mobile device munities dealing first hand with the opioid crisis.

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PROFESSIONAL ISSUES IN THE WORKPLACE

PRESCRIPTION FOR CHANGE BCNU co-authored report calls for reforming how nurses with substance use disorders are treated THE MEDIA HAS REPORTED on several high-profile cases of BC nurses with substance use disorders (SUDs) sounding the alarm about their employer’s one-size-fits-all treatment plans, including an over-reliance on 12-step programs and the need for total abstinence.

BCNU supports the rights of all nurses struggling with SUDs to participate in alternative, individualized treatment strategies. In fact, BCNU co-authored a 2019 report that calls for major changes to the way nurses with SUDs are treated. The report, Promoting EvidenceBased Treatment Approaches for Nurses with Substance Use Disorders: Report and Recommendations, was also authored by the BC Centre for Substance Use, Douglas College, University of Victoria and RainCity Housing.

The in-depth study describes the current regulatory approach, and delivers a series of recommendations aimed at improving the standards for addiction treatment in BC. Those long-awaited reforms include promoting evidence-based, patient-centered treatment approaches, reducing opportunities for harm and coercion and promoting individualized risk management.

CURRENT REGULATORY APPROACH

No community or profession is immune to SUDs. And nursing – with its high stress and burnout levels, heavy workloads, staff shortages and injuries – is certainly no exception.

The report reveals that BC nurses with SUDs are usually offered a cookie-cut-

“Today, in the middle of a global nursing shortage, made worse by the pandemic, it’s critical to provide nurses with evidence-based treatments.”

BCNU President Christine Sorensen

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SPRING 2021 • UPDATE MAGAZINE

ter treatment approach, “regardless of the severity of the substance use disorder, job environment and work duties … leaving nurses with SUDs at high risk of relapse.”

The BC College of Nurses & Midwives (BCCNM) gets involved after learning of a registrant’s possible addiction. The report describes how those nurses are asked to undergo an independent medical exam (IME), “which is often carried out by one of a small number of physicians, many of whom have a financial interest in a monitoring company.”

Nurses diagnosed with a SUD are then “offered a non-individualized returnto-work plan regardless of the type of SUD or severity.”

Typical plans include inpatient residential treatment in a private facility, followed by mandatory attendance in a religious-based 12-step program, abstinence from drugs and alcohol (other than tobacco and caffeine) and ongoing testing to ensure compliance.

Nurses are given little or no choice when it comes to choosing their own path to

recovery. Those who want to return to work must follow the addictions specialist’s mandatory treatment plan, or lose their job and their licence to practise nursing.

The report states that “the overwhelming majority of BC nurses with opioid use disorders are currently offered primarily non-pharmacological and abstinence-based approaches, including referral to psychosocial treatment interventions which are not evidence based, and short detox periods which, for people who use opioids, increase the risk of relapse and fatal and non-fatal overdose.”

There’s growing recognition that the status quo is not fair for nurses or their patients.

“Data indicates that the current approach is extremely punitive and coercive,” says BCNU professional practice and advocacy department coordinator Deborah Charrois.

“Treatment and recovery approaches are often outdated and can lead to a relapse. Meanwhile other evidence-based outpatient services and treatments are being withheld.”

12-STEP PROGRAMS

Charrois, one of the report’s co-authors, says that under

the current coercive system nurses can be forced into treatment plans with unsafe or ineffective modalities.

They can also be barred from using the same individualized evidence-based and culturally safe care BC nurses routinely provide to patients with SUDs. The report reveals how the current system focuses on an abstinence-only approach and punishes professionals who relapse, resulting in “negative professional, employment and reputational consequences.”

For example, the report’s authors exposed numerous inconsistencies between peer-reviewed scientific evidence and the existing practice of treating BC nurses with SUDs. Those inconsistencies include mandatory or coercive attendance at 12-step support group meetings.

Studies show those sessions may actually increase the risk of relapse. The report notes that more “high-quality research is needed in order to determine the efficacy and utility of this approach,” and calls for ending mandatory attendance in support groups like Alcohol Anonymous (AA).

Supporters of abstinence-based treatment claim that AA – founded by two recovering alcoholics in 1935, and based on Christian beliefs, not

scientific research – has saved the lives of millions of substance users around the world. They also state that many 12-step programs have been adapted for atheists and agnostics. But critics, including some nurses enrolled in AA and similar programs, say they find it extremely difficult to place their hopes for a new life on an unknown higher power.

Other studies included in the report prove that relapse after enrolling in a 12-step program isn’t just a nursing problem. Relapse is rampant among the general public, with 91 to 94 percent of participants relapsing after withdrawal from opioids and 43 to 83 percent relapsing after treatment for alcohol use disorder.

ALTERNATIVES TO THE ABSTINENCEONLY APPROACH Critics of abstinence-only treatment plans want the BCCNM to explore other options. The college had

until very recently refused to allow people to return to practice while on suboxone.

And there are concerns the college may refuse to provide nurses with extended-release naltrexone. (XR-NTX blocks the mind-altering effects of opiates and alcohol, and decreases the desire to take those substances.)

Although US studies of XR-NTX show promise in treating nurses with drug and alcohol problems, it is only offered in Canada for clinical and research purposes. The report recommends making XR-NTX available to BC nurses and their care providers, if they decide it is the best approach for them.

“Nurses deserve the same compassionate, high-quality health-care treatment options that are available to the public,” says BCNU President Christine Sorensen. “The recommendations included in this report will help us achieve that goal.

“Today, in the middle of a global nursing shortage, made worse by the pandemic, it’s critical to provide nurses with evidence-based treatments. We need nurses returning to work healthy.”

REDUCING OPPORTUNITIES FOR HARM AND COERCION

The report also emphasises the need to explore “conflicts of interest that exist, between physicians who conduct IMEs and the medical monitoring companies that are often a central component of the resulting treatment plan.” Those IMEs are “often carried out by one of a small number of physicians, many of whom have a financial interest in a monitoring company.”

The report recommends that any health-care provider who conducts IMEs not have a relationship with the monitoring company.

“Conflicts of interest in the health-care system are always a concern,”

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PROFESSIONAL ISSUES IN THE WORKPLACE

notes Sorensen. “BCNU supports full transparency from all parties who play a role in advancing the health and well-being of our members and of all British Columbians.”

LEAP SUPPORTS INDVIDUALIZED TREATMENT PLANS

BCNU’s Licensing, Education and Advocacy Program (LEAP), helps members struggling with substance and mental health disorders, regulatory complaints and other professional issues. At least one percent of BCNU members utilize LEAP services annually, with about 15 percent of those seeking help with substance use. (To learn more about LEAP, see sidebar on page 50.)

“LEAP fully supports individualized treatment plans for nurses with SUDs,” says Charrois. “The LEAP program doesn’t unilaterally assign participants to a specific healthcare provider. Instead, they’re given a list of providers to choose from.

We encourage doctors to base their recommendations for treatment on an individual’s needs, not on a

50

cookie-cutter approach.”

Charrois points out that BCNU’s LEAP staff currently ensure that nurses can choose their monitoring company and that monitors give nurses 24 hours to submit to random urine drug screens. Staff have also made sure that nurses in monitoring programs can arrange their own meetings and calls with monitors at a time that suits their schedules, and that support group attendance is not mandatory.

“Our union is totally committed to supporting nurses,” says Sorensen.

“All LPNs, RNs and RPNs who are BCNU members are eligible to apply for assistance through our LEAP program if they are concerned about their fitness to practice.”

MOVING FORWARD

Charrois says BCNU, and the other organizations that released the report, hope to work with politicians, employers and the BCCNM to educate them on best practices for treating nurses with SUDs. ‘We must encourage acceptance of individualized medical recommendations from a variety

SPRING 2021 • UPDATE MAGAZINE

of professionals,” says Charrois. “It’s time to move past the current cookie-cutter approach and give nurses with SUDs a choice in their own treatment plan.”

‘We are facing a nursing shortage in BC and across the globe,” adds Sorensen.

“That’s why it’s so critical to provide nurses with evi-

dence-based treatments.

“Imagine if – instead of stigmatizing these nurses – we partnered with BCCNM to develop individualized treatment plans that help members find a non-punitive pathway to deal with their health issues. Nurses need to have a voice in their treatment plan if there’s to be any hope of recovery.” •

SOUND RECOMMENDATIONS THE AUTHORS OF PROMOTING EVIDENCE-BASED Treatment Approaches for Nurses with Substance Use Disorders, make several recommendations for the BC College of Nurses and Midwives. These include: • Calling for the promotion of evidence-based, patient-centered treatment approaches, including pharmacotherapies shown to significantly improve outcomes of substance use disorders, and the rejection of modalities that have either proved unsafe or ineffective, such as coercive 12-step-based approaches.

• Reducing opportunities for harm and coercion, including addressing conflicts of interest that may exist between physicians who conduct independent medical examinations and the medical monitoring companies that are often a central component of treatment plans.

• Promoting individualized risk management when treating substance use disorders, and moving away from the “one-size-fits-all” approach to risk management that is often applied, regardless of severity of substance use disorder, job environment and work duties.

RESILIENT together BCNU CONVENTION 2021

DIGITAL CONVENTION JUNE 1-3, 2021 MONDAY, MAY 31 7:00 pm – 7:15 pm

Delegate Whips

7:30 pm – 8:30 pm New Delegate Session TUESDAY, JUNE 1 7:00 am – 8:30 am

Convention Login Opens

WEDNESDAY, JUNE 2 8:00 am – 9:00 am

Convention Login Opens

9:00 am – 9:05 am Call to Order 9:05 am – 9:15 am Year in Review: Part 2 9:15 am

– 9:35 am Executive Councillor – OH&S and Mental Health Report

9:35 am

– 9:55 am Executive Councillor – Pensions and Seniors Health Report

9:55 am

– 10:10 am Senior Director of Negotiations and Servicing Report

10:10 am – 10:25 am

Health Break

10:25 am – 11:05 am

Directors’ Reports

11:05 am – 11:10 am

Stretch Break

11:10 am

Questions & Answers

– 12:00 pm

12:00 pm – 1:00 pm

Lunch

1:00 pm

– 1:05 pm

Online Voting Tool Orientation

1:05 pm

– 3:00 pm

Bylaws & Resolutions

8:30 am – 8:45 am Welcome and Indigenous Acknowledgement

3:00 pm – 3:15 pm

Health Break

3:15 pm

Bylaws & Resolutions

8:45 am – 9:15 am Call to Order: O Canada, Introductions, Moment of Silence

4:30 pm – 5:00 pm Recognition of Retiring Activists, BCNU Awards Recipients and Close of Day Remarks

9:15 am

– 10:00 am President’s Opening Remarks

10:00 am – 10:15 am

Health Break

10:15 am – 10:25 am

Year in Review: Part 1

10:25 am – 10:45 am

Leadership Greetings

10:45 am – 11:30 am CEO Welcome and Report 11:30 am – 12:30 pm Lunch 12:30 pm – 12:35 pm

Online Voting Tool Orientation

12:35 pm – 12:50 pm

COO Report

12:50 pm – 1:10 pm

Vice President’s Report

1:10 pm

– 1:25 pm

Finance Report

1:25 pm

– 1:40 pm

Treasurer Report

1:40 pm

– 1:50 pm

Stretch Break

1:50 pm

– 2:45 pm

Questions & Answers

2:45 pm – 3:00 pm

Health Break

3:00 pm – 4:15 pm

Open Forum

4:15 pm

Stretch Break

– 4:20 pm

4:20 pm – 4:50 pm

Open Forum

4:50 pm – 4:55 pm Host Region and Charity Announcements 4:55 pm – 5:00 pm Close of Day Remarks 5:00pm

– 4:30 pm

5:00 pm Adjournment THURSDAY, JUNE 3 8:00 am – 9:00 am

Convention Login Opens

9:00 am – 9:05 am

Call to Order

9:05 am – 9:15 am

Year in Review: Part 3

9:15 am

Bylaws & Resolutions

– 10:15 am

10:15 am – 10:45 am

Health Break

10:45 am – 11:30 am

Bylaws & Resolutions

11:30 am – 11:35 pm

Virtual Campaign Instructions

11:35 am

Virtual Campaign Activity

– 12:00 pm

12:00 pm – 1:00 pm Lunch 1:00 pm

– 2:15 pm

Bylaws & Resolutions

2:15 pm

– 2:30 pm

Health Break

2:30 pm – 2:35 pm Introduction of Keynote Speaker 2:35 pm

– 3:35 pm Keynote Speaker

3:35 pm – 3:45 pm Evaluation 3:45 pm – 4:00 pm Closing Remarks 4:00 pm

Adjournment

Adjournment

6:00 pm – 8:00 pm Resolutions Committee Meeting

The agenda is tentative and may be adjusted prior to convention.

PROPOSED CONSTITUTION AND BYLAW AMENDMENTS AMENDMENT 1 CONSTITUTION ARTICLE 2 – OBJECTIVES CURRENT WORDING

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

Constitution Article 2

Delete 2.05

Constitution Article 2

2.05 To build relationships with government, employers, and interested parties.

2.05 To build relationships with government, employers, and interested parties.

2.05 To excel regarding compensation matters and working conditions for Members.

Replace 2.05 with 2.05 To excel regarding compensation matters and working conditions for Members.

Moved by: Christina Gower Seconded by: Michelle Barwig Costing: none provided by the Bylaws Committee

AMENDMENT 2 CONSTITUTION ARTICLE 2 – OBJECTIVES CURRENT WORDING

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

Constitution Article 2

Delete current 2.12

Constitution Article 2

2.12 To advance the professional profile of nursing.

Replace with new 2.12:

2.12 To proactively promote professional standards and to assist members in meeting their professional standards.

2.12 To proactively promote professional standards and to assist members in meeting their professional standards.

Moved by: Christina Gower Seconded by: Michelle Barwig Costing: none provided by the Bylaws Committee

52

SPRING 2021 • UPDATE MAGAZINE

AMENDMENT 3 CONSTITUTION ARTICLE 2 – OBJECTIVES CURRENT WORDING

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

Constitution Article 2

Delete current Article 2.11

Constitution Article 2

2.11 To encourage unity within the nursing profession and other allied fields through communication and cooperation.

Replace with new Article 2.11

2.11 To unite all BCNU Members in a democratic organization that acts on their behalf.

2.11 To unite all BCNU Members in a democratic organization that acts on their behalf.

Moved by: Christina Gower Seconded by: Michelle Barwig Costing: none provided by the Bylaws Committee

AMENDMENT 4 BYLAW ARTICLE 5 – ELECTIONS CURRENT WORDING

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

Bylaw Article 5

Bylaw Article 5

Bylaw Article 5

5.01(c) Eligibility requirements will be determined by the Annual Convention at least the year prior to the elections but BCNU steward experience must be a requirement.

Amend 5.01(c) – add the following:

5.01(c) Eligibility requirements will be determined by the Annual Convention at least the year prior to the elections but BCNU steward experience must be a requirement.

(i) Members who have served three (3) consecutive full terms, or partial terms thereof, in the same office, are not eligible to run for a fourth term, or partial term thereof, in the same office; and (ii) Members may run for a previously held office in (i) above, provided there has been at least one full term away from that office.

Bylaw Article 5 5.01(g) Proposed language does not currently exist.

Bylaw Article 5 – add new language 5.01(g) – Term Limits (i) The Elected Officer term limits will be three (3) consecutive full terms, or partial terms thereof, in the same office.

(i) Members who have served three (3) consecutive full terms, or partial terms thereof, in the same office, are not eligible to run for a fourth term, or partial term thereof, in the same office; and (ii) Members may run for a previously held office in (i) above, provided there has been at least one full term away from that office.

Bylaw Article 5 5.01 (g) Term Limits (i) The Elected Officer term limits will be three (3) consecutive terms, or partial terms thereof, in the same office.

continued on page 54

PROPOSED CONSTITUTION AND BYLAW AMENDMENTS AMENDMENT 4 (CONTINUED) BYLAW ARTICLE 5 – ELECTIONS (CONTINUED) CURRENT WORDING

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

Bylaw Article 4

Bylaw Article 4 - add new language

Bylaw Article 4

4.03(e)

4.03(e) Term Limits

4.03(e) Term Limits

Proposed language does not exist.

(i) The Regional Executive Committee Member term limits will be three (3) consecutive full terms, or partial terms thereof, in the same office.

(i) The Regional Executive Committee Member term limits will be three (3) consecutive full terms, or partial terms thereof, in the same office.

4.03(f)

4.03(f) Eligibility

4.03(f) Eligibility

Proposed language does not exist.

(i) Members who have served three (3) consecutive full terms, or partial terms thereof, in the same office, are not eligible to run for a fourth term, or partial term thereof, in the same office; and

(i) Members who have served three (3) consecutive full terms, or partial terms thereof, in the same office, are not eligible to run for a fourth term, or partial term thereof, in the same office; and

(ii) Members may run for a previously held office in (i) above, provided there has been at least one full term away from that office.

(ii) Members may run for a previously held office in (i) above, provided there has been at least one full term away from that office.

Article 14

Bylaw Article 14 – add new language

Article 14

Regional Executive Committee Member

(ff) Regional Executive Committee Members

(ff) Regional Executive Committee Members

Proposed language does not exist.

Each Region elects from their Membership a number of Regional Executive Members, who in turn comprise their Regional Executive Committee.

As a component of this election process, in accordance with Bylaws Articles 4.02 and 5.01 of these Constitution and Bylaws, a Regional Executive Member is elected by the Region’s Membership to also act as Regional Council Member. (ff) – (hh) renumber to (gg)-(ii)

Moved by: Paddy Kopieczek Seconded by: Michael Young Costing: none provided by the Bylaws Committee

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Each Region elects from their Membership a number of Regional Executive Members, who in turn comprise their Regional Executive Committee.

As a component of this election process, in accordance with Bylaws Articles 4.02 and 5.01 of these Constitution and Bylaws, a Regional Executive Member is elected by the Region’s Membership to also act as Regional Council Member.

AMENDMENT 5 BYLAW ARTICLE 4 – BCNU REGIONS CURRENT WORDING

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

Bylaw Article 4

Bylaw Article 4

Bylaw Article 4

Proposed language does not exist.

4.03(f) Eligibility

4.03(f) Eligibility

(i) Eligibility requirements for Regional Executive Committee Members will be determined by the Annual Convention at least the year prior to the elections but BCNU steward experience must be a requirement.

(i) Eligibility requirements for Regional Executive Committee Members will be determined by the Annual Convention at least the year prior to the elections but BCNU steward experience must be a requirement.

Bylaw Article 14

Bylaw Article 14

Bylaw Article 14

Regional Executive Committee Member

Bylaw Article 14 – add new language

(ff) Regional Executive Committee Members

Proposed language does not exist.

(ff) Regional Executive Committee Members Each Region elects from their Membership a number of Regional Executive Members, who in turn comprise their Regional Executive Committee.

As a component of this election process, in accordance with Bylaws Articles 4.02 and 5.01 of these Constitution and Bylaws, a Regional Executive Member is elected by the Region’s Membership to also act as Regional Council Member.

Each Region elects from their Membership a number of Regional Executive Members, who in turn comprise their Regional Executive Committee.

As a component of this election process, in accordance with Bylaws Articles 4.02 and 5.01 of these Constitution and Bylaws, a Regional Executive Member is elected by the Region’s Membership to also act as Regional Council Member.

(ff) – (hh) renumber to (gg)-(ii) Moved by: Shannon Sluggett Seconded by: Tracey Jonker Costing: none provided by the Bylaws Committee

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PROPOSED CONSTITUTION AND BYLAW AMENDMENTS AMENDMENT 6 BYLAW ARTICLE 12.07 – DISCIPLINE CURRENT WORDING Bylaw Article 12 12.07(a) Discipline Committee Hearing: ix. If the Respondent is found guilty of any breach

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

Amend 12.07(a)(ix)(3): strike “or return to membership;”

Bylaw Article

Delete 12.07(a)(ix)(4) Delete 12.07(a)(ix)(5) Housekeeping amendments

of duty, impose a penalty which may include:

12.07(a)(ix)(2) add “or”

1. a reprimand;

12.07(a)(ix)(3) add “.”

2. a fine; 3. terms on continued membership or return to membership; 4. suspension or termination of membership; or 5. any other penalty it considers appropriate in the circumstances.

Moved by: Tristan Newby Seconded by: Jereme Bennett Costing: none provided by the Bylaws Committee

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12.07(a) Discipline Committee Hearing: ix. If the Respondent is found guilty of any breach of duty, impose a penalty which may include: 1. a reprimand; 2. a fine; or 3. terms on continued membership.

AMENDMENT 7 BYLAW ARTICLE 8.02 – CONVENTIONS CURRENT WORDING

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

Bylaw Article 8

Bylaw Article 8.02 – add new language

Bylaw Article 8

Proposed language does not exist.

(d) Wherever possible, the Convention agenda will prioritize BCNU business as outlined in the Policies and Procedures.

8.02 Annual Convention: (a) The date and time of the Annual Convention will be determined by Council. (b) While in session, the Annual Convention will be the governing body of the BCNU. (c) The Annual Convention will make decisions and take actions to further the strategic directions of the BCNU. (d) Wherever possible, the Annual Convention agenda will prioritize BCNU business as outlined in the Policies and Procedures.

Moved by: Roy Hansen Seconded by: Ann-Marie Charbonneau Costing: none provided by the Bylaws Committee

AMENDMENT 8 BYLAW ARTICLE 5 – ELECTIONS CURRENT WORDING

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

Bylaw Article 5

Article 5.01(c) add the following to the end:

Bylaw Article 5

Article 5.01(c) Eligibility requirements will be determined by the Annual Convention at least the year prior to the elections but BCNU steward experience must be a requirement.

, unless the Member has been denied BCNU steward experience.

Article 5.01(c) Eligibility requirements will be determined by the Annual Convention at least the year prior to the elections but BCNU steward experience must be a requirement, unless the Member has been denied BCNU steward experience.

Moved by: Christina Gower Seconded by: Joanne Hamberg Costing: none provided by the Bylaws Committee

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PROPOSED CONSTITUTION AND BYLAW AMENDMENTS AMENDMENT 9 BYLAW ARTICLE 5 – ELECTIONS CURRENT WORDING

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

Bylaw Article 5

Add to Article 5.01

Bylaw Article 5

Proposed language does not exist.

5.01(g) Term Limits

5.01(g) Term Limits

(i) Elected Officer term limits will be two (2) full terms, or partial terms thereof, in the same office.

(i) Elected Officer term limits will be two (2) full terms, or partial terms thereof, in the same office.

Moved by: Christina Gower Seconded by: Joanne Hamberg Costing: none provided by the Bylaws Committee

AMENDMENT 10 BYLAW ARTICLE 10 – FINANCE CURRENT WORDING

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

Bylaw Article 10

Add new to Article 10

Bylaw Article 10

10.04 Council may appoint additional signing officers of the BCNU.

10.04 To make the financial records available to BCNU Members.

10.04 To make the audited financial records available to BCNU Members.

Renumber existing 10.04 to 10.05

Moved by: Christina Gower Seconded by: Michelle Barwig Costing: none provided by the Bylaws Committee

AMENDMENT 11 BYLAW ARTICLE 1 – MEMBERSHIP CURRENT WORDING

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

Bylaw Article 1

Add new language to Article 1.01:

Bylaw Article 1

Proposed language does not exist.

1.01(b) Focus new membership on those with nursing designations.

1.01(b) Focus new Membership on those with nursing designations.

Renumber current 1.01(b) to 1.01(c)

Moved by: Christina Gower Seconded by: Michelle Barwig Costing: none provided by the Bylaws Committee

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AMENDMENT 12 BYLAW ARTICLE 1 – MEMBERSHIP CURRENT WORDING

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

Bylaw Article 1

Add new article to 1.03(b)

Article 1.03

Proposed language does not exist.

(b) Review Council and PEC Meetings on demand, as outlined in the Policies and Procedures;

1.03 Members may (subject to any restrictions under Articles

Housekeeping – renumbering (b) and (c)

1.04, 1.05, 1.10, 1.11, 1.12, 1.13, 1.14, or 12): (a) Attend Meetings; (b) Review Council and PEC Meetings on demand, as outlined in the Policies and Procedures; (c) Hold an Elected Position; and (d) Receive the benefits of BCNU benefits.

Moved by: Christina Gower Seconded by: Michelle Barwig Costing: none provided by the Bylaws Committee

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PROPOSED CONSTITUTION AND BYLAW AMENDMENTS AMENDMENT 13 ARTICLE 1 – MEMBERSHIP CURRENT WORDING

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

1.12 Within thirty (30) days of notification of a declaration under Article 1.10, a Member declared no longer a Member in Good Standing may apply to the Chief Executive Officer or designate to request that the Discipline Committee establish a Hearing Board in accordance with Article 12.06 to hear the merits of Council’s declaration as

To insert (iii)

if it were a Complaint by Council:

1.12 Within thirty (30) days of notification of a declaration under Article 1.10, a Member declared no longer a Member in Good Standing may apply to the Chief Executive Officer or designate to request that the Discipline Committee establish a Hearing Board in accordance with Article 12.06 to hear the merits of Council’s declaration as if it were a Complaint by Council:

(a) The Hearing Board may, in addition to its powers and discretion set out in Article 12.07:

(a) The Hearing Board may, in addition to its powers and discretion set out in Article 12.07:

i.

Uphold or set aside Council’s declaration; and

i.

ii.

In the event that the Member is guilty of a breach of duty, impose any penalty that it considers appropriate in the circumstances.

ii. In the event that the Member is guilty of a breach of duty, impose any penalty that it considers appropriate in the circumstances; and

“All decisions and determinations of the Hearing Board regarding Article 1.12 are within the Hearing Board’s sole discretion and will be final and binding.”

Uphold or set aside Council’s declaration;

iii. All decisions and determinations of the Hearing Board regarding Article 1.12 are within the Hearing Board’s sole discretion and will be final and binding.

Moved by: Sara Mattu, Bylaw Committee Chair (on behalf of Council) Seconded by: Teri Forster Costing: none provided by the Bylaws Committee

AMENDMENT 14 ARTICLE 1 – MEMBERSHIP – TEMPORARY LEAVE CURRENT WORDING

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

1.16 Provincial Executive Officers and Regional Council Members filling a temporary Staff position will take a leave of absence from their Elected Position:

To replace “Provincial Executive Officers and Regional Council Members” with “Any Member in an Elected Position”

1.16 Any Member in an Elected Position filling a temporary Staff position will take a leave of absence from their Elected Position:

(a) A leave of absence will not alter the term of office.

Moved by: Sara Mattu, Bylaw Committee Chair (on behalf of Council) Seconded by: Teri Forster Costing: none provided by the Bylaws Committee

(a) A leave of absence will not alter the term of office.

AMENDMENT 15 ARTICLE 12 – DISCIPLINE CURRENT WORDING

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

12.04 Complaints

To insert, “such as mediationarbitration.” after, “whether it is appropriate to initiate an early alternative dispute resolution process.”

12.04 Complaints

(d) The Chief Executive Officer, or designate, will consider the merits of the Complaint, for the purpose of determining, in their sole discretion, whether it is appropriate to initiate an early alternative dispute resolution process. (e) All decisions of the Chief Executive Officer, or designate, to initiate or not initiate the early alternative dispute resolution process will be final and binding. (f) Where a matter is determined to be suitable for an early alternative dispute resolution process, the Chief Executive Officer, or designate, will appoint a Neutral Third Party to assist the parties in resolving the dispute. (g) If the Neutral Third Party determines that attempts at consensual resolution have been unsuccessful, they will advise the Chief Executive Officer, or designate, and the matter will be referred to the Complaints Investigation Committee under Article 12.05.

To insert a new clause (e) “The initiation of mediationarbitration will be conducted in accordance with the Policies and Procedures.” to To re-number existing clauses (e-g) to (f-h).

To insert, “either: (i) arbitration with the same Neutral Third Party; or (ii)” After, “and the matter will be referred to”

(d) The Chief Executive Officer, or designate, will consider the merits of the Complaint, for the purpose of determining, in their sole discretion, whether it is appropriate to initiate an early alternative dispute resolution process such as mediation-arbitration. (e) The initiation of mediationarbitration will be conducted in accordance with the Policies and Procedures. (f) All decisions of the Chief Executive Officer, or designate, to initiate or not initiate the early alternative dispute resolution process will be final and binding. (g) Where a matter is determined to be suitable for an early alternative dispute resolution process, the Chief Executive Officer, or designate, will appoint a Neutral Third Party to assist the parties in resolving the dispute. (h) If the Neutral Third Party determines that attempts at consensual resolution have been unsuccessful, they will advise the Chief Executive Officer, or designate, and the matter will be referred to either: (i) arbitration with the same Neutral Third Party; or (ii) the Complaints Investigation Committee under Article 12.05.

Continued on page 62

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PROPOSED CONSTITUTION AND BYLAW AMENDMENTS AMENDMENT 15 (CONTINUED) ARTICLE 12 – DISCIPLINE (CONTINUED) CURRENT WORDING

PROPOSED AMENDMENT

IF ADOPTED, WILL READ

12.05 Complaints Investigation Committee and Complaints Investigation Sub-Committee:

To delete, “be appointed to mediate a settlement” and insert, “initiate mediation-arbitration”

12.05 Complaints Investigation Committee and Complaints Investigation Sub-Committee:

(f) While discharging its functions under subsection (d) above, the Complaints Investigation Sub-Committee will, subject to applicable rules and procedures, determine its own process and will have the power and discretion to:

(f) While discharging its functions under subsection (d) above, the Complaints Investigation Sub-Committee will, subject to applicable rules and procedures, determine its own process and will have the power and discretion to:

i.

Convene a settlement conference and assist to negotiate a settlement between the parties;

i.

Convene a settlement conference and assist to negotiate a settlement between the parties;

ii.

Request that a Neutral Third Party be appointed to mediate a settlement; or

ii. Request that a Neutral Third Party initiate mediationarbitration; or

iii. Require the Complainant, the Respondent, or any other Member who may have information relevant to the investigation of the Complaint:

iii. Require the Complainant, the Respondent, or any other Member who may have information relevant to the investigation of the Complaint:

1. To communicate with and provide information to the Committee;

1.

2. To produce to the Committee potentially relevant documents; and

2. To produce to the Committee potentially relevant documents; and

3. To attend at meetings convened by the Committee

3. To attend at meetings convened by the Committee.

To communicate with and provide information to the Committee;

Moved by: Sara Mattu, Bylaw Committee Chair (on behalf of Council) Seconded by: Teri Forster Costing: none provided by the Bylaws Committee

PUBLICATION DISCLAIMER The inclusion of proposed bylaw amendments is not intended to reflect the opinions or views of the Bylaws Committee, or the BCNU and its employees, unless otherwise expressly stated.

Changes in circumstances after the time of publication may impact the accuracy of the information published, and the information may change without notice. The Bylaws Committee or the BCNU and its employees are not in any way liable for the accuracy of any information provided.

RESOLUTIONS RESOLUTION 1 Social Media Focused LRO Whereas,

BCNU members are frequently asking questions on social media platforms, such as Facebook and other platforms;

Whereas,

BCNU values excellence and integrity;

Whereas,

BCNU servicing staff will help avoid confusion, conflicting contract interpretation, and misinformation;

Whereas,

there may be a need for an interactive online resource to provide timely and accurate contract interpretation to BCNU members; and

Therefore be it resolved,

that BCNU create a full time Social Media focused Labor Relations position to provide members with a rapid, detailed and accurate interpretation of the contract language, and allows members to engage in respectful dialogue and discussion, in a safe space free of non-members; and

Be it resolved,

that the Social Media LRO answers questions posed by BCNU members in a re-established BCNU Facebook page that vets membership that are dues paying members.

Submitted by: Moved by: Seconded by: Costing:

Peggy Holton Peggy Holton Rekha Vashisht $194,667

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RESOLUTIONS RESOLUTION 2 Elder Nurses Whereas,

negative stereotypes about age (ageism) creates problems which may lead to unfair and/ or discriminatory treatment of younger and elder workers. Ageism has three foci: 1) the aging process 2) limitations and accommodations arising from the aging process, and 3) specifically, the experience of workers in relation to age and work;

Whereas,

Section 15 (1) of the Canadian Charter of Rights and Freedoms states that "every individual is equal before and under the law and has the right to equal protection and equal benefit of the law without discrimination and, in particular, without discrimination based on ... age";

Whereas,

age discrimination is embedded in industrial relations of regional labour markets;

Whereas,

age discrimination can take many forms, including prejudicial attitudes, discriminatory practices, or institutional policies and practices; from peers, coworkers, clients, and employers;

Whereas,

a report from the Conference Board of Canada notes that the required number of nurses will more than double by 2029;

Whereas,

Canada is facing a growing nursing shortage, and projections indicate Canada will be short almost 60,000 full-time equivalent nurses in 2022;

Whereas,

if retention strategies designed to eliminate ageism and mitigate rates of retirement are implemented, the estimated loss of nurses retiring early could be reduced significantly;

Whereas,

in 2015, the percentage of seniors working almost doubled between 1995 and 2015. One in five Canadians aged 65 and older, reported working during the year, the highest percentage since the 1981 Census;

Whereas,

seniors with a bachelor’s degree or higher, and seniors living in rural areas were more likely to work than seniors living elsewhere;

Whereas,

the importance of identifying effective retention strategies may be critical to sustaining an experienced workforce and to the efficient use of health human resources; and

Therefore be it resolved,

that BCNU Council establish a working group of 3-5 members and determine the membership.

At least one member will be an Elected Officer;

Be it further resolved,

that the Working Group will explore through quantitative and qualitative research the actions and attitudes, workplace characteristics, and relevant accommodations of aging workers in the workplace. The goal is to address retention and ageism;

Be it further resolved,

that the Working Group will meet every two weeks for 12 months. The Working Group will follow internal operational processes to develop the charter, deliverables, timeline, and milestones. The Working Group will produce a summary and financial report which will be presented to Council within 12 months of forming; and

Be it further resolved,

that the Working Group will produce a detailed report to Council. An approved summary will be presented to the membership at the BCNU 2022 Annual Convention, as recommended by the Working Group and approved by Council.

Submitted by: Moved by: Seconded by: Costing:

Adrian Mulholland Adrian Mulholland Leslie Zinger $50,000 maximum

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RESOLUTION 3 BCNU Death Benefit Whereas,

BCNU’s mission is to protect and advance the health, safety, social and economic well-being of members;

Whereas,

BCNU members and their families may experience financial stress as a result in the death of the member, the member’s spouse, and/or their dependent children;

Whereas,

BCNU members must demonstrate eligibility for the BCNU Death Benefit;

Whereas,

other union(s) provide financial assistance to their members and members’ families when there has been a death; and

Therefore be it resolved,

Submitted by: Moved by: Seconded by: Costing:

that the BCNU establish a fund to provide active members, or their families, with a death benefit.

Tanja Bergen Tanja Bergen Lara Renehan $50,000 maximum annually

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RESOLUTIONS RESOLUTION 4 Mental Health and Substance/Addictions for Nurses Whereas,

this education is not to replace the RPN program but to expand general nursing knowledge in an area that is fast becoming in high demand;

Whereas,

in the present RN/LPN nursing curriculum it is very limited in its education deliverable to the present changes and new approaches to Mental Health plus Substance/addictions education;

Whereas,

new approaches and changes in Mental Health plus Substance/addiction use have been made available mainly to staff working in psychiatry and Mental Health but are inconsistent, fragmented and scattered as to accessibility;

Whereas,

statistics for physical and or mental injury are at an alarming increase for nurses dealing with an ever increasing population with Mental Health, substance/addictions issues which are increasing in intensity and acuity;

Whereas,

there is limited knowledge in the legalities of the Mental Health Act;

Whereas,

Knowledge and education aids nurses to create a safer environment for their practice and as result for their patients and the public; and

Therefore be it resolved,

that the BCNU investigate educational resources, clinical supports and third party initiatives in the fields of Mental Health and substance/addictions use for nurses;

Be it further resolved,

that BCNU created an easy and accessible catalogue of these materials for nurses; and

Be it further resolved,

that BCNU do an information rollout of this information.

Submitted by: Moved by: Seconded by: Costing:

Sylvia Neden Sylvia Neden Katy Flory $3,100

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RESOLUTION 5 Pandemic Pay Whereas,

the COVID 19 pandemic presents a unique and exceptional workplace challenge and demand to British Columbia Nurses’ Union members;

Whereas,

the federal government issued funding to provincial governments to be used as temporary pandemic pay, which has now ceased as per the program. BCNU members continue to face challenges and hardships related to the pandemic;

Whereas,

BCNU members deserve compensation at an increased level for the extraordinarily increased labour and unique hazards they face related to the pandemic for its entire duration;

Whereas,

BCNU protects and advances the health, safety, social and economic well-being of the members; and

Therefore be it resolved,

that the BCNU supports increased financial compensation from the provincial or federal governments for the duration of the pandemic for nurses in the form of a specific “pandemic pay” or similar mechanism and shall lobby relevant government partners.

Submitted by: Moved by: Seconded by: Costing:

Arjun Gill Arjun Gill Arman Gill Maximum $10,000

PUBLICATION DISCLAIMER The inclusion of resolutions is not intended to reflect the opinions or views of the Resolutions Committee, or the BCNU and its employees, unless otherwise expressly stated.

Changes in circumstances after the time of publication may impact the accuracy of the information published, and the information may change without notice. The Resolutions Committee, or the BCNU and its employees are not in any way liable for the accuracy of any information provided.

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FEATURE

SENIORS' CARE

THEY DESERVE BETTER Advocates call for long-term solutions to address the crisis in residential care THERE IS LITTLE QUESTION that BC’s long-term care sector was in desperate need of attention long before the COVID-19 pandemic struck.

Beyond the unending staffing shortages that already existed, care providers were regularly managing unsustainable workloads

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in overcrowded facilities in need of repair, while caring for residents with a wide variety of acute needs, including dementia, mental health issues, substance use disorders and psychiatric illness.

Over the years, calls for help have come from those

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working in the system, from family members with loved ones living in care facilities and from numerous healthcare advocates, including the BC Nurses’ Union, demanding that both provincial and federal governments take immediate action to help a residential care sector in serious need of repair.

BCNU is one of many organizations demanding that policy makers and governments take action to address multiple challenges in this province’s long-term care sector. But it has been an uphill battle.

Long-term care, along with

assisted living and home health care are critical parts of BC’s public health-care system. Yet BC seniors today have less access to these services than they did in 2001.

Almost 20 years of underfunding, privatization and fragmentation of the system have left many seniors, their families and communities patching together care – and even going without.

Between 2001 and 2016, access to long-term care and assisted living spaces declined by 20 percent (measured as beds relative to the population of people 75 and over).

The crisis has also affected the special bond that staff have with the residents in their care.

Unfortunately, years of negligence and the government’s unwillingness to maintain and strengthen seniors’ care meant that BC’s long-term care sector was no match for the first wave of the COVID-19 pandemic that took hold last spring, and the far more devastating second wave that came in the fall.

Staffing levels at these care facilities have also been dangerously low, and the government’s quick fixes and Band-Aid solutions have not provided long-term relief for health-care workers. What’s worse, all of this has had a direct, negative impact on quality patient care.

In the absence of an effective long-term care sector health human resource plan, and with the added new stressors of a pandemic, it is little wonder that the health and safety of the sector’s chronically shortstaffed workforce has been impacted.

COVID-19 IN BC’s LONG-TERM CARE SECTOR

On March 7, 2020, BC’s Provincial Health Officer, Dr. Bonnie Henry, told reporters that two residents and one health-care worker at North Vancouver’s Lynn Valley Care Centre had tested positive for COVID-19. The next day, one of the residents would die, becoming the first person in Canada to succumb to the virus.

Since that dreaded week, the COVID-19 death toll in seniors’ residences has been hard to comprehend and the pandemic has proved to be deadlier in provinces that failed to learn from the

first wave and prepare for a resurgence of the virus. BC is one of those provinces, where last fall’s second wave saw 567 resident deaths compared to 120 resident deaths the previous spring, a more than four-fold increase.

In total, 392 care homes in BC have been affected by COVID-19, with the province reporting a 29 percent resident fatality rate.

BCNU executive councillor for seniors Michelle Sordal says that as infection numbers climbed, it quickly became obvious that nurses and those working in the facilities didn’t have access to appropriate personal protective equipment, and there were numerous reports of communication breakdowns about outbreaks and concerns that infection control protocols were routinely being missed.

“We had members send us photos of themselves in painting gowns and masks because that was all they could get their hands on,” she reports. “Nurses were going out and purchasing what they could find as there was very little effort on the part of their employers to ensure they would be kept safe.”

To make matters worse, COVID-19 outbreaks on

floors where residents live with dementia proved almost impossible to contain.

Nurses were then getting sick themselves, which meant fewer staff were available to work.

BCNU was among many health-sector unions and organizations that assisted in helping to implement the provincial health office’s single site order last April. It restricted the movement of workers employed in longterm care, assisted living and private mental health facilities. The union also ran a province-wide occupational health and safety campaign to educate members on the importance of practising the precautionary principle when caring for residents in the pandemic.

MAJOR REFORMS ARE NEEDED

The COVID crisis has brought the long-standing problems with seniors’ care into stark relief.

BCNU is one of a number of health-based organizations that has endorsed

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several recommendations in a new report

by Action for Reform of Residential Care (ARRC), a non-partisan voluntary citizens group.

One of these recommendations is the call for a “person-centred care model” that consists of a stable, well-trained and well-supported work force, including on-site RN leadership and organization of work.

“It’s time that we get registered nurses back into long-term care facilities and onto health teams in order to provide a well-rounded, adequate amount of patient care that is needed,” says Sordal. “What we have seen is a drastic reduction in the number of RNs in the longterm care setting, which has led to a lack of support for both the health teams on the ground, and negative outcomes for patients.”

Sordal also points to the risks associated with for-profit ownership and financialized corporate chains, and the large body of research showing how staffing levels and the care provided in for-profit longterm care facilities is generally inferior to that provided by public and non-profitowned facilities. High staff turnover, which is linked to lower wages and the heavy workloads demanded by inadequate staffing levels, is associated with lower-quality care in large for-profit facilities.

The BC government’s longstanding practice of relying on private finance capital to build new facilities means that corporate chains now control over one-third of all publicly subsidized and private-pay long-term care and assisted living spaces in BC, while two-

“The pandemic has had devastating consequences for both residents and staff in the long-term care sector.”

BCNU Executive Councillor Michelle Sordal

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thirds of units are owned by either non-profit agencies or health authorities.

“As outlined in the BC Seniors’ Advocate’s report, A Billion Reasons to Care, for-profit care homes failed to deliver 207,000 funded direct care hours in fiscal year 2017–18, even while receiving the same level of public funding,” says Sordal, noting that for-profit homes spend $10,000 (24 percent) less per year than for-profits on direct care for each resident.

She says the deadly coronavirus pandemic that has swept through nursing homes across BC and Canada has made it clear that for-profit facilities aren't delivering a safe level of care to their vulnerable residents.

BCNU’s WORK AHEAD

It is vitally important to recognize the important contribution that long-term care nurses are making to the province’s healthcare system. And calling for improvements to the long-term care sector is a top priority for BCNU – especially as COVID-19 continues to put pressure on staff, increase workload and expose gaps in patient care.

The union’s seniors’ strategy working group, which consists of elected

members and researchers, continues to meet monthly to discuss priorities in long-term care and how the union can best support the nurses working in the sector, all of whom remain committed to providing the best patient care despite the harrowing year that’s passed, and the uncertainty the future brings.

When the pandemic has passed, BCNU expects that the government will conduct a comprehensive review of BC’s long-term care system and do more to improve working conditions for long-term care nurses and providers – all in the name of patient care.

Sordal says there is no question that nurses should have a seat at the table once that review begins.

“Years of budget cuts, shrinking resources and a lack of attention to a chronically short-staffed workforce have collided with the unprecedented demands of the pandemic, and that has had devastating consequences for both residents and staff in the long-term care sector,” she says.

“The coronavirus has shown us that we don’t have time to waste – the system is broken and we must do all we can to fix it, so that it’s strong enough to meet the needs of all residents now and in the future.” •

IT’S TIME FOR BETTER LONG-TERM CARE STAFFING THE COVID-19 PANDEMIC’S devasting impact on the long-term care sector has led to renewed calls for legislated nurse staffing requirements to ensure that staff and the residents in their care can safely live and work with dignity.

BCNU has endorsed the recommendations contained in Improving Quality of Life in Long Term Care – A Way Forward, a new report by the advocacy group Action for Reform of Residential Care (ARRC).

The report’s call for a “person-centred care model” is based on the recognition that a stable, well-trained and well-supported work force, including on-site RN leadership and organization of work, is critical for the provision of quality care.

But this vision cannot be realized until governments make critical investments in nurse staffing.

Unfortunately, over a 10-year period, the number of RNs working in BC’s long-term care facilities has dropped significantly compared with numbers of LPNs. Currently, BC has no legislation governing the staff-

ing of long-term facilities, whether that be minimum numbers of staff or the type of staff providing care.

Indeed, in BC, unlike most other provinces, there is no requirement that long-term care facilities have an RN on duty 24/7.

The provincial government’s residential care staffing guidelines recommend that each resident receive 3.36 worked hours of direct care per day, and no less than 20 – 25 percent of those hours should be professional care (i.e., provided

by RNs and LPNs).

Studies that have explored the relationship between resident care and

RN staffing have found that higher levels of RNs result in fewer trips to the emergency room and achieve positive health outcomes overall. The health teams, consisting of LPNs and care aides, also benefit from having more RNs present, as this allows nurses to perform within their scope of practice. It also provides for the critical and often “hidden labour” of the nurse’s job, which is the emotional component that is such a large part of a long-term care nurse’s role – a role that has evolved from caregiver, to “family member” as so many relatives of residents have been denied visiting rights due to the risk of bringing the virus into care facilities.

“The government must take into account our calls for onsite RN leadership in long-term care facilities,”

says BCNU executive councillor for seniors Michelle Sordal. “Over the years, we’ve seen the reduction of staffing resources and limited access to quality of life supports. The system was not strong enough to adapt to this pandemic, and we’ve seen the devastating consequences that have resulted from it. We must all work hard to make the system stronger than it was before.”

BCNU supports the ARRC report recommendation that the Ministry of Health set a standard of actual direct care nursing hours worked per resident per day at 4.1 hours, and that facilities be funded and monitored effectively to ensure they meet this standard.

BCNU is also calling on the government to develop a clear definition of direct care hours. •

ACT NOW FOR BETTER LONG-TERM CARE! APPALLING CONDITIONS, OVERWORKED STAFF, RAMPANT profiteering, devastating loss of life. Canada’s long-term care is in crisis.

Point-of-care health-care workers have been sounding the alarm on conditions for years, but governments have failed to take responsibility and act. Vulnerable nursing home residents, and the workers who are struggling to care for them, are suffering.

They deserve better.

Don’t look away. Conditions will only get worse if we don’t act.

Join Canada’s nurses and email Prime Minister Trudeau, Minister of Health Patty Hajdu and your Member of Parliament. Tell them we need better long-term care now!

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IN THE WAKE: PANDEMICS + PUBLIC HEALTH Human Rights and Equity Conference focuses on social determinants of health

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VERY YEAR, BCNU’s annual Human Rights and Equity Conference brings hundreds of members together for a day of presentations and discussions on social and political issues that are at the heart of nursing.

But the union’s most recent conference was different. The public health restrictions that were enacted in response to the global COVID-19 pandemic upended most in-person events. As a result, BCNU adapted its delivery method and produced the union’s first entirely digital conference for members.

Over 200 nurses joined the one-day event, logging in from around the province to explore social justice issues affecting the nursing profession.

In the Wake: Pandemics + Public Health centred on several issues that have arisen in the midst of COVID-19 and offered members an opportunity to engage in dialogue and reflect on how to shape the future as health-care workers and union activists.

Since the start of the pandemic, the mantra “we are all in this together” has been adopted by people around the world to remind each other of our shared humanity, and to help stay connected during the long and often lonely battle against COVID. BCNU President Christine Sorensen’s opening remarks touched on themes of isolation, oppression and social fault lines that call into question the popular catchphrase.

VIRTUAL WELCOME BCNU President Christine Sorensen addresses members at the opening of the union’s first member-wide virtual conference.

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“Can we really say we are ‘all in this together’ with those who are living in long-term care, bereft of family and loved ones and ever-more reliant on the health-care workers who have become like family to them?” she asked conference participants.

“We watch as even the most robust social safety nets are frayed – as isolation overwhelms us or our loved ones –as rumours spread like wildfire,” she remarked.

“Even a simple mask becomes a symbol of sound public health practice for some and a marker of state oppression for others.”

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or many, social isolation invokes feelings of imprisonment, and wreaks havoc on our mental health as we yearn for freedom, connection and a sense of shared vulnerability.

No stranger to the effects of forced isolation, speaker Dr. Shokoufeh Sakhi began her presentation by sharing her experience as a political prisoner in Iran from 1982 to 1990.

An independent scholar

and researcher, Sakhi is currently a member of the Pathologies of Solitude research network, a project hosted at Queen Mary University, London. She has a doctorate in political science from York University, with a specialization in political theory and philosophy.

Born and raised in Iran, Sakhi was a high school student during the country’s Islamic revolution and found herself swept up by the 1979 rebellion. She was detained for her political views and consequently interrogated, put on trial and handed a five-year sentence. At the time of her arrest, Sakhi was just 18 years old: leaving behind her freedom and her one-year-old son.

She spent over eight months in solitary confinement, spending 15 hours per day in “Haj Davood coffins” – cells the equivalent of grave-like chambers. Not allowed to move or speak out loud, she learned the depths of forced human isolation and quickly developed a yearning for justice and freedom.

“In prison, our vulnerability is exaggerated and

exploited,” she told conference participants. “We are helpless, hopeless, vulnerable to our cores.”

In the early '90s, Sakhi was granted leave along with a number of other prisoners.

She escaped to Canada with her son and was granted political asylum.

STRENGTH THROUGH EXPERIENCE Former political prisoner Dr. Shokoufeh Sakhi believes the pandemic can help people relate to others’ feelings of confinement.

Sakhi remarked that, prior to COVID-19, people perceived stories of isolation and oppression as stories of others – others’ problems, others’ pain. She said that historically it is free people that turn their backs on the imprisoned – a fear-based numbing towards the realities of others.

However, she believes that living in a pandemic

has created tiny bridges into these other realities because we are all constrained to our homes and find ourselves vulnerable - with the ability to better imagine the experiences of peoples across the globe.

“We are now locked down in our homes, in our apartments, with the keys in our hands,” Sakhi observed. “And even though it appeared to be impossible at the beginning, we are learning to live with social isolation for the greater good while finding ways to stay connected with each other.

“We live with the fear of catching and passing on this sickness unwittingly – we become victims, vulnerable to our core and yet guardians of the vulnerable at the same time.”

Sakhi believes the virus has brought about the potential for meaningful change as people can better relate to others’ feelings of imprisonment. And that it is through this socially distanced solidarity that we have gained an opportunity to collectively advance and improve living conditions globally.

T

he COVID-19 pandemic has raised awareness about the relationship and interaction between humans and animals, and the impor-

We become victims, vulnerable to our core and yet guardians of the vulnerable at the same time.”

Dr. Shokoufeh Sakhi

tance of this bond during a time of widespread social distancing and isolation measures.

For many, it is a very lonely time. A lot of people are living alone, isolated from friends and family.

Studies show that the bond between humans and animals can ease some of the negative psychological effects of the COVID-19 public health restrictions.

Early on in the pandemic, animal shelters around the world reported struggling to keep up with the demand for adoptable animals.

Speaker Dr. Kendra Coulter examined this relationship. Chancellor's Chair for Research Excellence and chair of the Department of Labour Studies at Brock University, Coulter is also a fellow of the Oxford Centre for Animal Ethics and a member of the Royal Society of Canada's College of New Scholars, Artists and Scientists. Her work primarily focuses on animal labour and protection, humane jobs, and how to

foster sustainable multispecies associations. She fosters an approach to labour that takes human and animal well-being seriously.

During her presentation, Coulter challenged delegates to think deeply about animals, their work and humans’ multi-faceted connections to them. Examining the work done by, with and for animals, she spoke about the complexities of multispecies and interspecies existence.

“When we are thinking about human and animal issues, it’s really important to acknowledge the historical patterns of colonialism, but also how things are still ongoing and playing out today with respect to the relationships between humans and animals,” she stated.

Coulter reminded conference participants that the term “animals” itself is an umbrella term covering distinct groups. Breaking down these distinctions helps define the differences and similarities in how we

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HUMAN RIGHTS & EQUITY STRONGER TOGETHER

view – and value – these groups.

Companion animals are the most commonly protected given their close daily relationship with humans, she noted. These are the animals that live with us and are often viewed as family members. A quick search online shows there are around 16 million companion animals in Canada alone, with 57 percent of Canadian households – 7.5 million – owning at least one pet.

WE ARE ALL ANIMALS Dr. Kendra Coulter talks about the importance of fostering sustainable multispecies associations.

Coulter contrasted the number of companion animals with that of captive animals, those creatures that should be roaming free but which are now kept in human-controlled

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environments like circuses, zoos, aquariums and – most startlingly – people’s homes. Thanks in part to the glamourization of exotic animals in captivity, Coulter reported that in the state of Texas there are more tigers being kept by people than there are wild tigers in all of Asia.

Moving to farmed animals, Coulter informed participants that the largest group of vertebrates in Canada are farmed animals. “These animals used to all be wild but have now been domesticated and their movements, reproduction, lives and deaths are now all under the control of humans,” she said.

Coulter reflected that too often animals are prevented from caring for their own offspring in order to create products for human consumption.

She also spoke about the factory farming living conditions of dairy cows, kept endlessly impregnated for milk; of animals hunted to a point of almost extinction so that humans may have a pelt, shell, horn or fin; of pigs kept in pens in which they are unable to turn around; and of chickens whose legs are too weak to support the weight of their hormone-fueled growth.

Coulter reported that more than 834 million farmed animals are killed every year in Canada alone, and suggested that the per-

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Whether the next pandemic is viral or bacterial, it’s very likely to come from some kind of interaction with animals.”

Dr. Kendra Coulter

sistence of the often-horrific conditions these animals endure depends on humans determined to be oblivious of where our meat, poultry, eggs and milk actually come from.

All of this comes with risk to us. “It’s estimated that there are millions of viruses in animals’ bodies,” Coulter said. “These viruses are not harmful to us if these animals are left alone, but the danger emerges through zoonotic transference when we consume and interact with animals.”

She cited statistics showing that family farms are rapidly declining in Canada, being replaced by sprawling industrial animal agriculture with an eye to maximizing profits to the detriment of animals’ well-being.

“We know this,” Coulter remarked. “Whether the next pandemic is viral or bacterial, it’s very likely to come from some kind of interaction with animals.”

She stressed the need to pay

attention to the trade of wild and farmed animals and awareness about where our food comes from.

Coulter believes the concept of solidarity invites us to recognize animals, their rights and their suffering.

“We need to engage in global action that recognizes they too are interested in living lives without suffering and the ability to care for their young and do the work they were meant to do.”

She concluded her presentation by asking participants to reflect on what they can do as health-care workers to recognize the furry, feathered and finned and to create space for solidarity for all.

Sorensen echoed both speakers’ messages and signed off the day by reminding all conference participants that, united, nurses have the power to address all of the determinants of health – and by doing so they can change the world. •

WHAT IS TO BE DONE? Conference panel discussion tackles nursing practice during a pandemic THE FINAL SESSION of BCNU’s annual Human Rights and Equity Conference brought together six guests for a panel discussion entitled What is to be Done? Nursing Through a Pandemic. Nurses Danielle Bourque-Bearskin, Keisha Jefferies, Haniely Pableo, Martha Paynter and Connie Paul joined union president Christine Sorensen to talk about the key challenges facing nursing practice during the global health crisis.

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biggest assets in responding to the pandemic has been a swift and aggressive approach taken by community elders and leaders to ban travel on and off reserve in order to lessen the chances of exposure.

But she recognized that these kinds of measures also exacerbate many of the health problems Indigenous communities already face across Canada, particularly mental health.

Unfortunately, she said nurses have bare minimum access to resources in these remote communities and need greater supports to be able to advocate for their patients against systemic

medical racism.

“The pandemic didn’t discover the health inequities in health care,” she said.

“It’s just brought them to the surface making it harder for the public to ignore the unequitable health care that Indigenous peoples receive.”

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hD candidate Keisha Jefferies spoke to the panel about the underrepresentation of Black women in the nursing profession. Through her scholarly and advocacy work, Jefferies aims to influence institutional and organizational policies that would increase Black nurses’ presence and participation

in our health-care system.

She shared her work on an equitable admissions policy for Dalhousie University that would address inequities faced by historically marginalized groups, including Indigenous, Black, queer and those with altered abilities.

The policy is designed to address gaps in recruitment, representation and retention of Black nurses.

Jeffries highlighted the reality that Black nurses are underrepresented in advanced practice, leadership and speciality care, and reported that Black nurses are too often practicing on

alling in from Beaver Lake Cree Nation in Treaty 6 Territory, Danielle Bourque-Bearcontinued on page 77 skin opened the discussion by sharing the ways her remote, northern Ontario community has been battling the pandemic since it began.

She spoke of the socio-economic challenges of nursing in small communities and dealing with limited access to health care and told of the common overcrowding of families living on reserve – sometimes with as many as 10 family members living in a small space.

SHARING KNOWLEDGE A six-member panel discussion among nursing leaders and activists was a key highlight Bourque-Bearskin of BCNU’s 2020 Human Rights and Equity Conference. Clockwise from left: Danielle Bourque-Bearskin, Keisha said one of the Jefferies, Haniely Pableo, Martha Paynter, Connie Paul and BCNU President Christine Sorensen

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HUMAN RIGHTS & EQUITY STRONGER TOGETHER

HOW TO CONTACT YOUR HUMAN RIGHTS AND EQUITY REPS BCNU Human Rights and Equity Committee Aman Grewal, Chair E amangrewal@bcnu.org C 604-813-7208 Indigenous Leadership Circle Sherry Ridsdale, Interim 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 Gurvir Sekhon, Interim Co-Chair C 604-603-5097 E m eninnursing@bcnu.org Graham Olds, Interim Co-Chair E p rmin@bcnu.org

Walter Lumamba, Council Liaison C 604-512-2004 E walterlumamba@bcnu.org Mosaic of Colour Caucus Tessy Chalissery, Interm Chair C 778-960-5681 E moc@bcnu.org

Workers with Disability Caucus Kelly Woywitka, Chair C 250-715-5752 E disabilities@bcnu.org Teri Forster, Council Liaison C 250-615-8077 E teriforster@bcnu.org Young Nurses’ Network

Parveen Gill, Council Liaison C 604-615-6815 E parveengill@bcnu.org

Melissa Vannerus, Interim Chair E ynn@bcnu.org Hardev Bhullar, Council Liaison C 778-855-0220 E hardevbhullar@bcnu.org

MEMBERS’ TAKEAWAY Conference participants share their views

MORGANA LAWLOR-WHITE

I was so grateful for the virtual format. Due to issues with ADHD, I have never enjoyed a full-day conference as much as this one. I was able to keep my body physically busy while giving my full mental attention to the amazing speakers. I have to admit I cried a bit after the conference was finished because it was such an amazing experience.

STEPHANIE SPINNEY

I loved this year's HRE conference. It was just the shot I needed to rejuvenate and feel good about my work as an activist!

TRACEY HULME

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LINDSAY MANNING

I have learned about so many more perspectives and opinions as it relates to human rights and equity that I can incorporate into my nursing practice. I very much enjoyed the pandemic presentation at the beginning of the day. I also enjoyed the videos and the virtual booths.

Great job BCNU!

Walidah's talk and exercise of envisioning the future was incredible, and charged my batteries to continue to strive for a more equitable future. Centering Black and Indigenous voices was needed and so appreciated.

WHAT IS TO BE DONE? continued from page 75 the margins of the profession and feeling disconnected from the nursing core.

However, even in the midst of a pandemic, she said we must continue to advocate for social justice for all. “I believe the idea of racism is in itself a pandemic – one that has been going on since the arrival of the first Black people in Canada,” she stated. “And of course, prior to that, the grotesque treatment of Indigenous peoples on this land.”

Jefferies hopes that her work will be shared across multiple institutions to improve access for all potential new Black nurses in Canada.

I

nternationally educated nurse and Filipina-Canadian performance artist Haniely Pableo works as an operating room nurse specializing in cardiac surgery at Toronto General Hospital.

During the first wave of the pandemic, Pableo volunteered to be part of the emergency response team conducting intubation procedures for COVID-19 patients. Speaking to the challenges of working on the front lines of the health crisis, Pableo stressed the importance of self-care and using the arts as a means of expression through difficult times.

Pableo uses music and

lyrics to deal with significant topics like the immigrant experience in Canada, being a woman of colour, and fighting for social justice and equality. She told conference participants about her mother’s work as a live-in caregiver, and how the strife felt by migrant workers is very close to her heart.

She noted how the COVID-19 pandemic has highlighted the disparities faced by already racialized groups. Many in her community have families back in the Philippines who remain dependent upon remittances from family in Canada to survive, she said. But with the massive loss of jobs and family income, many can no longer afford to support their extended families abroad, causing further economic stress.

H

aving worked in rural and remote First Nations communities for 32 years, Connie Paul is no stranger to the issues affecting so many Indigenous people today. Born into the Tsartlip First Nation, Paul spoke to conference participants about the historically segregated health care her people experienced, such as the “Indian hospitals” that existed until 1965.

She said it’s imperative that nurses know the history of how care was delivered to Indigenous peoples in order to hold each other accountable for our standards today. “We cannot stand by

and accept that unhealthy behaviour such as racism is okay,” she remarked.

COVID has shone a light on the health disparities between Indigenous and non-Indigenous people in Canada, noting that the life expectancy of an Indigenous person on reserve is five to 10 years shorter than the average Canadian. “We have so few elders left and we must do everything we can to protect them,” she said.

Referencing a recent story about a grade six student tasked with finding five positive things about the residential school system, Paul said, “we desperately need to hold our educational systems accountable about how they teach the history of the Indigenous peoples in our country.”

Paul is committed to making change through mentorship. For the past 10 years, she’s offered to have nurses walk with her for a day to see the work that is being done. Her goal?

To teach young healthcare providers about the importance of a culturally informed and sensitive practice.

Paul hopes to see cultural competency and sensitivity training be mandatory for every nurse, doctor and health-care worker and said she wants all of us to take part in the conversations that are needed to implement solutions, and not just identify problems.

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artha Paynter spoke to conference participants about her research on reproductive health outcomes for women, transgender and non-binary people. For over eight years, she has done advocacy work related to reproductive health and its intersection with the justice system and criminalization.

A registered nurse practicing in abortion and postpartum care, Paynter is a PhD candidate in nursing at Dalhousie University. In 2012, she founded Women's Wellness Within (WWW), a non-profit organization that works to advance reproductive health and justice for people experiencing criminalization while pregnant or parenting young children in Nova Scotia.

Paynter suggested that incarceration is a preventable threat to health in a pandemic and noted that is nearly impossible to practice social distancing in prison.

She reported that she and other abolitionists have called for compassion and care in this crisis and the release of prison inmates Paynter said her work is “a lot of advocacy, a lot of fear, a lot of real disgust at the choices that our public sector makes with respect to people’s lives.” But then, she continued,“there are moments of hope, and real inspiration from the resilience of those that are persisting despite the healthcare threats all around.” •

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MY JOURNEY

INTERNATIONALLY EDUCATED NURSES

PURSUING HER DREAM

nurse. “I didn’t know what nursing was, the scope of the profession, anything,” she Saima Hirani’s love of nursing remembers. and teaching has taken her That conversation sparked around the world her curiosity.

“I ended up going to an SAIMA HIRANI REMEMBERS the expanded horizons it open-house event at the Aga the celebratory sweets – biteoffered her.

Khan University’s Faculty sized geometric pieces of For most Pakistani of Nursing and liked what creamy decadence, flavoured children who score well on I saw, not only in terms with saffron and cardamom their grade 10 exams – and of the practice of nursing and covered in a layer of whose families have the but also what was possible edible silver – that her mother financial means to supacademically – that I could, handed out to her cousins and port them – the academic if I wanted to, reach for the aunts, elders and neighbours path is toward medicine or highest levels in the profeson the day she had come home engineering. Initially, Hirani sion,” she says. As it turned and announced her grade 10 thought that she might out, the university entrance examination scores. “I had pursue medicine. But one exam for medicine and nurspassed with flying colours, day, at a family event, she ing was scheduled for the Hirani recalled, “and I knew met a relative who was a same date and time. “I spoke then that my dream of going to university was one step closer.

“I grew up in a middle-class family in one of the oldest commercial areas of Karachi, Pakistan,” says Hirani. “Most of my extended family used to live in the same area, so we all had a strong connection with each other – and my brother and I were considered the favourite kids of our family.”

As a young child Hirani found herself drawn to her studies – eager for knowledge and an understanding of her place in the world. “One of my favourite childhood memories is when I was in grade 5 and I started participating in debate and speech competitions, representing my school at several city-wide events.” It’s a recollection that arrives with a hint of wistfulness for the FROM HEART TO MIND Saima Hirani recently began teaching at UBC’s delights of grade school and school of nursing after a nursing career that began in Karachi, Pakistan.

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with my father and he said it was up to me to decide, and so I chose nursing.”

Hirani graduated from the university’s three-year nursing program in 1999 and took a job at the adjacent Aga Khan hospital where she worked in ICU and Cardiac ICU. In 2002 she began the university’s BSN program.

It was there, while doing a mental health rotation and working with women – some of whom were incarcerated, or who were survivors of domestic or sexual violence – that Hirani realized she wanted to continue doing this kind of work. “A switch from heart to mind,” as she succinctly puts it.

In 2009, Hirani completed a master’s degree in nursing, her thesis focusing on mental health promotion for women living in an impoverished neighbourhood in Karachi. “I felt like I had found my calling,” she says.

Hirani then taught mental health nursing and nursing research at the university and was also asked to coordinate the BSN program. “I loved it, loved the teaching and mentoring, but I knew that I wasn’t done with school and that much more needed to be accomplished.”

In 2012, Hirani applied to the University of Alberta to do a PhD in nursing and travelled to Edmonton with her husband and son in tow.

She completed her doctorate in 2017.

Although the family had decided to stay permanently in Canada, Hirani felt an obligation to return to the Aga Khan University for a period of time. “And anyway I had signed a memorandum of understanding that I would go back to do some work there,” she notes. “But also, anyone who has studied and worked at the university feels a pull – a desire to go back because of the place and what it means to be a part of it.”

“I could, if I wanted to, reach for the highest levels in the profession.”

Saima Hirani

In the summer of 2019 Hirani returned to Canada and completed a postdoctoral research fellowship at the University of British Columbia. In July 2020 she joined UBC’s school of nursing as an assistant professor.

Her research continues to focus on mental health and mental health promotion, particularly for priority and high-risk populations while also teaching about research methods and evidence-based practice.

It’s been a remarkable journey – one that began through a chance conversation with a family member in a pleasant middle-class neighbourhood in Karachi.

As Hirani reflects on her accomplishments, she notes with some irony that, “even though I have spent my entire adult life immersed in the practice and theories of nursing I am not able to call myself a nurse.” Indeed, despite Hirani’s extensive education and career as a bedside nurse, nursing instructor and nursing researcher, she is not yet able to use that title after her name because she does not have a licence to practise nursing in BC. “I began the process in 2018, applying to the National Nursing Assessment Service, and received my report in May 2020,” she says, “but now the process is on-hold.” The hold is due to the fact that the BC College of Nurses and Midwives would not grant Hirani a waiver for the English language exam requirement, despite the fact that her entire nursing education was taught in English. As Hirani puts it, “I just haven’t been able to find the time to prepare for the language exam. I will do it, of course, because I have to – I am a nurse and I would like to be able to call myself a nurse, so I will do it.”

And you know she will. •

RESEARCHING THE PANDEMIC SAIMA HIRANI, LIKE MANY NURSE RESEARCHERS, HAS turned her attention to the COVID-19 pandemic and is working to ensure that policy makers have the information needed to fully understand the lasting impacts of the public health crisis. These are two of Hirani’s recently published articles:

A portrait of the early and differential mental health impacts of the COVID-19 pandemic in Canada: Findings from the first wave of a nationally representative crosssectional survey This monitoring study highlights the differential mental health impacts of the pandemic for those who experience health, social, and structural inequities.

These data are critical to informing responsive, equityoriented public health, and policy responses in real-time to protect and promote the mental health of those most at risk during the pandemic and beyond.

Co-authored Preventive Medicine Volume 145, April 2021

Examining the impacts of the COVID-19 pandemic on family mental health in Canada: findings from a national crosssectional study This study identifies that families with children 18 years or younger at home have experienced deteriorated mental health due to the pandemic. Population-level responses are required to adequately respond to families’ diverse needs and mitigate the potential for widening health and social inequities for parents and children.

Co-authored BMJ Open 2021, Volume 11 Issue 1

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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 Judy McGrath C 604-970-4339 jmcgrath@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 Christine Sorensen C 250-819-6293 christinesorensen@bcnu.org

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

VICE PRESIDENT Aman Grewal C 604-813-7208 amangrewal@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 Lynnda Smith C 778-977-6315 lynndasmith@bcnu.org

NORTH EAST Danette Thomsen C 250-960-8621 danettethomsen@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 Rachel Kimler C 250-816-0865 rachelkimler@bcnu.org

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

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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 Shalane Wesnoski C 250-231-8468 shalanewesnoski@bcnu.org

COUNCIL PROFILE HERE’S WHO’S WORKING FOR YOU

“We’re all union members and we all need to work together,” says South Fraser Valley regional council member Hardev Bhullar.

CONNECTING WITH MEMBERS SOUTH FRASER VALLEY COUNCIL MEMBER HARDEV BHULLAR QUICK FACTS NAME Hardev Bhullar GRADUATED 2015 Athabasca University UNION POSITION South Fraser Valley council member WHY I SUPPORT BCNU? “We are member centric and provide a variety of services for those truly in need and continue to work towards providing a brighter future for our members.”

HARDEV BHULLAR IS feeling good about his work as BCNU’s South Fraser Valley regional council member. “This is important work to me. It’s a great opportunity to hear directly from members about what’s important to them,” he says. “I also get to report to members on what the union is working on and have important conversations about direction and priorities, and how those things affect our work.”

Bhullar’s council duties keep his schedule full now, but there was a time when his studies were the only entry in his calendar.

“My nursing career began in 2008 – that’s when I became an LPN,” he says.

“After a while, I decided to complete my RN.” Bhullar then graduated in 2015 from Athabasca University in Alberta. “It was distance learning, and I had to go there three times for clinical trials, but I’m from here.”

Bhullar has spent his professional career in the Lower Mainland, nursing in a variety of areas including an Alzheimer’s unit in longterm care in Aldergrove, and in rehab units at New Westminster’s Queen’s Park Care Centre and Laurel Place

in Surrey. He also worked in the Acute Care for Elderly unit at White Rock’s Peace Arch Hospital, helping frail patients with complex concerns return to independent living at home.

A couple of years into his work as a RN, Bhullar grew increasingly interested in union activism. He became a steward in 2017 and was later elected as a South Fraser Valley regional council member.

Bhullar’s experience in long-term care has helped inform his contributions to BCNU’s Seniors Strategy Working Group. He also has a keen interest in helping to shape the rules that govern how BCNU operates, and has served on the union’s Constitution and Bylaw Renewal Working Group, the Regional Bylaw and Policy Working Group and the Election Review Working Group.

Bhullar also served as council liaison to the BCNU Young Nurses’ Network, which connects nurses and nursing students under 35 to share experiences and become more involved in the union.

Concerned about BC’s nursing shortage, Bhullar

hopes to see more young nurses fill the growing number of vacancies in the province. “It needs to be fixed, starting at the foundation,” he says of the staffing crisis.

“It has to start with putting more money into educational institutions and creating more nursing seats.”

Nurse retention is just as important, he says. “When nurses graduate, we must provide good support for their transition into the workforce, especially given that we are currently losing 51 percent of nurses within their first five years.”

Bhullar also points to the world of skilled workers beyond our borders who could help address the crisis.

“Internationally educated nurses need to be recognized and added to our workforce at a faster rate,” he says. “It shouldn’t be such a hurdle for them. It should be a smoother transition, especially at a time when we’re in dire straits and needing nurses on the units.”

So how do nurses stay together and focused in such challenging times? “We’re all union members and we all need to work together,” Bhullar says. “That’s the only way we’ll be successful.” •

UPDATE MAGAZINE • SPRING 2021

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OFF DUTY CALCULATED RISK KAYLA BROLLY USES HER NURSING SKILLS TO RESCUE WILDERNESS TRAVELLERS KAYLA BROLLY’S LIFE before nursing may have been considered hazardous by some. The North Vancouver resident helped injured skiers as a full-time professional ski patroller at Grouse Mountain, and in the summer, she fought wildfires in the Interior for the province’s Firefighter Rappel Program — where she was trained to rappel from a helicopter into inaccessible areas during a wildfire.

Brolly has since added North Shore Rescue (NSR) volunteer to her resume, which takes her directly into the depths of the Lower Mainland’s North Shore mountains to find

lost, injured and sometimes deceased wilderness travellers.

Brolly did a stint in the medicine unit at North Vancouver’s Lions Gate Hospital after graduating from UBC's school of nursing in 2014. Within the year she had completed her ER training at BCIT and began working full time. “I love it.

I love the people there and it’s always interesting,” she says enthusiastically about her job.

That energy and passion clearly translates to Brolly’s volunteer work at NSR. “The commitment is massive. It consumes a lot of your free time,” she says happily.

LIFE SAVER Lions Gate Hospital’s Kayla Brolly is one of only seven women who volunteer for the Lower Mainland’s 50-person North Shore Rescue team.

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Founded in 1965, NSR is an all volunteer-run community-based search and rescue team of approximately 20 volunteer support staff and 50 full-time members who are expected to be on-call 24/7 and respond to calls if they are available. Because of its proximity to a major metropolitan area, NSR is one of the busiest search and rescue services in Canada.

Applicants go through a rigorous acceptance process, which emphasizes time commitment. Brolly was told to give at least 300 hours a year when she applied in 2013.

According to NSR, the organization performs approximately 120 search and rescue operations annually, with some lasting multiple days.

“Our call base is seasonal, with summer being our busiest,” says Brolly. “We might get five calls in a weekend and then in the fall you might not get a call for three weeks.

I volunteer about 500 hours a year on average.”

Like all new members to the rescue team, she was a designated member-in-training for her first two years, which required continual preparation, practical and written exams and regular evaluations.

Being at the ready to respond to calls quickly and safely is what Brolly and her NSR colleagues prepare for, and just like nursing, she says there’s a lot of training and preparation behind the scenes that the public doesn’t see.

Brolly headed up NSR’s education arm for a couple

of years. The organization emphasizes public education to help reduce critical incidents. Team members provide talks to community groups and staff booths at outdoor shows to help educate the public about outdoor safety. “You never want to see someone lost or injured, so getting that preventive messaging out is really important,” she says.

Brolly says she gets a lot of benefit from her volunteer work despite the potential risk and hours.

“Even though it’s work, it doesn’t feel like it – there’s camaraderie and the rescue team is like family,” she explains. “I also enjoy being able to help someone out of a tricky situation and it really means a lot when you can bring loved ones home.”

In a hospital setting Brolly says she can work her 12-hour shift and sometimes not see a patient improve.

But it’s different in the field.

“We’re with people for a shorter period, but it’s a significant moment when we approach people who’ve been awaiting a rescue. It’s energizing and feels really good to get them back.”

Members can watch Brolly on Knowledge Network’s five-part original series: Search and Rescue: North Shore. The series follows the members of Canada’s busiest volunteer search and rescue team as they set off by foot and helicopter to rescue people from the rugged wilderness of Vancouver’s North Shore. •

PHOTO: GRANT BALDWIN, PEG LEG FILMS

MEMBERS AFTER HOURS

Social Media Can Hurt you and others

What you share on social media reflects on you professionally. Your employer and college both have expectations for online conduct.

Before you post, consider, is it:

T RUE? H ELPFUL? I NSPIRING? N ECESSARY? K IND?

To celebrate our nurses, BCNU is pleased to present an exciting week of virtual sessions including inspiring presentations that focus on resilience and self care, as well as interactive fitness classes.

International Nurses Day May 12 Indigenous Nurses Day May 13

All members are invited to submit an expression of interest to attend Nursing Around the World, the International Council of Nurses Congress 2021, taking place virtually November 2-4.

Watch for more details on BCNU’s social media channels, at bcnu.org and in Member eNews.

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