A Healthier You November 2014
TEACHING TO LIVE ACTIVELY page 10
COOKING WITH KIDS page 6
Presented by Northern Health and Glacier Media
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contents NOVEMBER2014 30
Hand Washing: Flu Season and Beyond!
Cooking with Kids
4 5 8 9 10 11 12 14 16 18 20 22 23 24 26 28 29
CEO Welcome Showing “Spirit” Junior Volunteer Program Connecting Across the Generations Healthier Youth: Teaching to Live Actively Physical Activity should be a Delight! Cuystwi Indigenous Youth Wellness Project Capital Update A Community Health Star: Myles’s Mindcheck Staff Profile: Karen Wonders Active Living: Every Day, Your Way! Keeping Young Men Healthy Healthy Living Program for Youth in Prince George How Can We Help? Foundation Update Health: There’s an App for That Youth Urged to Use Common Sense and Practice Safe Sex Proud supporter of Northern Health
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Fall is upon us and winter isn’t far behind. You know what that means for northern B.C. residents: dusting off jackets, pulling out the sweaters and boots, and finding ways to stay warm and healthy in the cooler months. This time of year can also be one of renewal: a new routine, a way to look at where and how we spend our time and make some adjustments to focus on our health. Keeping a focus on the family is important, too. As adults, we can model healthy behaviours for kids, but – an emerging trend – is that our kids can model healthy behaviours for us, too. Many initiatives are happening all over northern B.C. that support the health of youth, or are spearheaded by youth to support health in their community. Northern Health is very proud to dedicate the twelfth edition of A Healthier You to youth and youth health. Healthy youth are important to the future health of northern B.C. residents. Stories included in this edition showcase the great work that is happening all over our region to support health and wellness for youth. From focusing on mentorship for youth mental health by Myles Mattila, Northern Health’s first Community Health Star in this new program, to reduced rates of tobacco use among Canadian youth, to raising awareness of risk-taking behaviour, this issue brings into focus some of the great initiatives that support youth health in communities. The articles also provide adults with tips and tricks on how we can support youth health today and for future generations. I hope you enjoy this edition of A Healthier You! As always, for more great articles on health and wellness, please be sure to regularly check our Northern Health Matters blog at blog.northernhealth.ca.
Cathy Ulrich | President and chief executive officer Cathy has held her position of president and CEO of Northern Health since 2007. From 2002 to 2007, she was the organization’s vice president, clinical services and chief nursing officer. Before the formation of Northern Health, Ulrich worked in a variety of nursing and management positions in northern B.C., Manitoba, and Alberta. Most of her career has been in rural and northern communities, giving her a solid understanding of their unique health needs.
A Healthier You is published by A product of
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Your Daily Dose of Health and Wellness November • • • •
“Movember”: Men’s cancer awareness month Nov 6-12: National Seniors Safety Week Nov 17-23: National Substance Use Week Nov 29: Sports Day in Canada
All across Canada, specific dates are set aside to bring awareness to various aspects of your health. Here are some dates you might be interested in! Stay tuned to blog. northernhealth.ca and our Facebook page (facebook.com/northernhealth) to learn more about these important events as they get close.
December • • • •
Do you have a community event coming up that promotes health? Tell us about it!
Lung Association’s Christmas Seal Campaign Dec 1: World AIDS Day Dec 1-7: National Safe Driving Week Dec 1-7: BC Buy Local Week
January • • • • •
Alzheimer Awareness Month Perinatal Depression Awareness Month Jan 18-24: National Non-Smoking Week Jan 21: Weedless Wednesday Are you making health-related resolutions for the New Year?
Join the #healthynorth conversation!
For more information, visit Health Canada’s Calendar of Health Promotion Days online at: www.hc-sc.gc.ca/ahc-asc/ calend/index-eng.php
Showing “Spirit” – Introducing the Northern Health Mascot! By Jessica Quinn, health promotions and community engagement manager, Northern Health
Northern Health would like to introduce northern B.C. residents to our new healthy living mascot, Spirit the caribou. Spirit was designed by Prince George resident, 12-year-old Isabel Stratton during the May 2014 contest that called for idea submissions from people in our region. Spirit will be attending some of the events during the 2015 Canada Winter Games torch relay this winter, a great opportunity to highlight health in an innovative and exciting way for children and youth in the north. The mascot will help in our
goals to raise awareness and promote healthy living in the north, including healthy eating, active living, injury prevention, tobacco reduction, and more! We hope that having a mascot present at events and functions will help make health more accessible to a wider, younger audience, in a fun and engaging manner. The winning concept for “Spirit” the caribou, Northern Health’s new mascot. Designed by Isabel Stratton.
Thank you to Spirit of the North Healthcare Foundation for sponsoring the development of the mascot costume (note: the name is pure coincidence!). Watch for Spirit at an event near you soon!
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Cooking with Kids By Flo Sheppard, registered dietitian, Northern Health
While it may seem more like work than fun, cooking with kids at any age is a great way to spend quality family time together while teaching important life skills. Cooking with kids can be a gift that keeps on giving, now and in the future. When kids cook at home they are: • Exposed to healthy foods, which may positively shape their lifelong food preferences. • Given opportunities to build reading, math, chemistry and problem solving skills. • Provided opportunities to develop self-confidence and creativity. Here are a few things to remember: Provide age-appropriate opportunities to grow cooking skills. Kids as young as two years of age can help in the kitchen with simple tasks like washing fruits and vegetables and adding ingredients to a bowl. By age 12, kids can have the skills to do independent meal planning and preparation. Be safe. Supervise kitchen time and demonstrate safe food handling practices, including hand washing and keeping cooked and raw foods separate, as well as safe practices like working with knives and what to do in the case of a fire. Keep it simple. Choose recipes that have fewer steps and ingredients and/or take a portion of a recipe and let your child help. For example, your child may be able to whisk and scramble the eggs while you complete the other pieces to make breakfast burritos. Make it interactive. Especially in the beginning, cooking may mean letting kids choose from a variety of prepared ingredients to make their own version of the meal. In my home, “build your own meal” recipes have always been winners with all ages – our favourite being build your own pizza where everyone chooses from bowls of diced veggies, fruit and meat, grated cheeses and sauces like pizza sauce, pesto and hummus to top whole grain pita, tortilla or pizza dough.
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To get you started, try this recipe for “build your own grilled cheese sandwich”: • Bread (any kind you like) • Cheese (try mozzarella, cheddar, brie, gouda, or another favourite) • Toppings (sliced pears, apples, avocado or tomatoes; caramelized onions, cooked sliced potatoes, grilled vegetables like peppers or zucchini, spinach leaves, sliced meats, etc.) • Condiments (pesto, honey, mustard, jalapeno jelly, jam, etc.) Lay the ingredients out and let your family pile all their favourite cheeses and toppings on the bread. Brush each side of the bread with a little vegetable oil and then bake, broil or grill until the bread is golden brown and the cheese is melted. To make a balanced meal, serve with a green salad or a bowl of tomato soup!
For more healthy eating ideas and recipes like this, visit the recipes section on the Northern Health Matters blog at blog.northernhealth.ca!
For more information on age-appropriate food skills, see nutritiontoolsforschools.ca/assets/ guides-attachments/Food_skills_Fact_Sheet_ Final_Sept._2013.pdf
Check your local library or online for cookbooks with simple recipes.
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Volunteer in your Community
Junior Volunteer Program at the University Hospital of Northern BC Northern Health Junior Volunteers are young people, aged 16 to 19, who have a passion for patient care. Junior Volunteers commit to a two-hour shift per week plus optional special projects at the University Hospital of Northern BC in Prince George, under the direction of a supervisor. What do Junior Volunteers do? • • • • • •
isit patients V Read to children Change water jugs Play instruments and sing for Jubilee Lodge residents Set up meal trays ...and much, much more!
What do Junior Volunteers gain? • Many opportunities for learning and personal growth as you fulfill meaningful tasks in the hospital setting • A positive component for your resume • Potential for future reference letters • Important experience for future health care professions • Insight into and knowledge about health care careers • …and much, much more!
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This September, approximately 40 new volunteers joined the existing cohort of returning volunteers. A one-day orientation and training session included presentations from several departments of Northern Health including: Aboriginal Health on cultural safety, Education Services on respectful workplace policy, and the Jubilee Lodge on working with community care patients. The online application for the 2015-16 season will begin in early May 2015. Applications are accepted online from early May until July 31st at northernhealth.ca.
Connecting Across the Generations By Christine Hinzmann, Prince George Citizen
It’s been at least 20 years of seniors and youth coming together at Simon Fraser Lodge in an intergenerational program. About 40 children from Highglen Montessori school visit residents at the complex care facility every other Tuesday from 10 to 11:15 a.m. “They come in and do a craft, sometimes it’s a seasonal craft, something for anti-bullying, or an international recognition day, they’ll sing a song and interact with our residents,” said Cecelia Osmond, recreation coordinator for the Simon Fraser Lodge contracted through the YMCA of Northern B.C. “Sometimes the residents will sit back and observe, and just enjoy the company of children.” Some students reach out to the residents and they become friends, said Osmond. It’s a good lesson for students to know the natural progression of life, she added. The Montessori program gets a city grant for transportation so the children are bused to and from the Lodge. The children learn to appreciate their elders while the program continues to bring energy and enthusiasm - and noise - into the common area of the care facility.
“It’s so interesting when the children come to visit,” said Osmond. “People who usually stay in their room can’t resist the excitement in the air and make a point of coming out to be with the children.”
Each year the students turn the tables on the residents and invite them to a tea at the school where the message is a big thank you for allowing them to be part of the program.
“It’s really a grassroots learning program and always brings smiles to the faces of residents,” said Osmond.
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Healthier Youth: Teaching to Live Actively By Jodi Penttila, child and youth recreation supervisor, YMCA of Northern BC
In their 2014 report, Active Healthy Kids Canada revealed some alarming stats: • 84% of kids aged 3-4 meet the Canadian Physical Activity Guidelines • 7% of kids aged 5-11 meet the guidelines • 4% of kids aged 12-17 meet these guidelines Such a staggering drop in physical activity has been cited as a result of several factors including the rise in sedentary living and screen time, the decline of active transportation, and our growing culture of convenience. The report also states that 75% of 5-19 year olds participate in an organized activity or sport, indicating that we rely heavily on organized activities and infrastructure to provide enough physical activity for our children. Making activity a priority Communities across Canada have increased their commitment to focus on physical activity as a priority to manage overall health. In Prince George, the YMCA of Northern BC provides programs for youth that emphasize participation and active living. From organized sports, such as Basketball Kids and Toddler T-ball, to innovative activities, such as Zumba Kids and Aikido, the overall focus of programs is to get kids moving and having fun. Learn a little, too There is also room for a little learning here, too! The YMCA strives to incorporate strategies for physical literacy that allow children to grow and continue to stay active. Teaching kids age-appropriate fundamental movement skills gives them the confidence and competence to continue participating in physical activities throughout their lives. Engaging youth in physical activity not only benefits overall health, but can also contribute to increased academic performance and provide
HEALTH TIPS FOR YOUTH Less screen time is associated with more health benefits! A Healthier You | 10 | November 2014
opportunities for community involvement. The value of unstructured activity It doesn’t end here either. The Active Healthy Kids Canada report identified the value of both unstructured physical activity and organized pursuits in having a positive effect on children’s health. The report recognizes that in addition to organized activities, children also need time for free play. At the YMCA in Prince George, the Recreation Room boasts two large play structures and a rock climbing wall, in addition to the full-sized gymnasium, all of which offers the space needed to let children explore, get creative, and stay active. It will take a balanced approach and a collective effort to get our youth living actively!
Physical Activity Should Be A Delight! By Stephanie Mikalishen, camp and events coordinator, YMCA of Northern BC
In a world where troubling statistics are everywhere about the high amounts of inactivity among youth (and adults!), we have lost sight of the importance of the fun in physical activity! Our physical activity can be driven by fear more than fun.
This unique experience not only allows youth time for selfreflection, but it also develops their body and mind. Perhaps even more importantly, the program fosters an appreciation for movement and health. It gives youth an opportunity to fall in love with active hobbies while enjoying all the beauty that northern B.C. has to offer.
What happened to throwing a football or taking a paddle because it was something that you loved to do? We seem to be now living in a culture of being active “because-youneed-to-accomplish-your-30-minutes-of-physical-activityevery-day.” Our physical activity is driven by fear more than fun; we don’t want to fall into the ‘scary statistics.’ We have forgotten the value of enjoying activity and time spent outdoors for both the physical and mental wellness benefits.
If you take pleasure in it, you are much more likely to stick with it!
The YMCA’s Aurora Leadership Program is an outingbased initiative to promote enjoyment for the outdoors and alternative modes of physical activity. Youth spend the first half of the program acquiring wilderness skills such as paddling technique, t-rescues, shelter construction, and trip planning. The latter portion of the program is dedicated to an out-trip adventure where youth have the option of a hikingor canoe-based adventure in their backyards: to Mount Robson, Carp Lake, or the Bowron Lakes (West Side Circuit).
Teaching youth the importance of health goes far beyond showing them the statistics; it’s about giving them opportunities to discover life-long active hobbies that keep their bodies moving and their minds free of stress. I challenge youth to try something new: find something you enjoy that keeps you active. If you take pleasure in it, you are much more likely to stick with it!
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Cuystwi (“Let’s Go!” in Stl’atl’imx) Indigenous Youth Wellness Project By Tysun Tallman, First Nations Health Authority
Cuystwi facilitators from the nine community partners of Nisga’a, Gitsegukla, Lake Babine, Nak’azdli, Okanagan, Squiala, Cowichan Tribes, Carrier Sekani Family Services, and Urban Native Youth Association pose in the Cuystwi ‘decolonized’ toques at the first facilitators gathering in November.
The Indigenous Youth Wellness project, now known as Cuystwi (“kwee-stwee”), began as a conversation between First Nations communities in northern BC who were working with Provincial Health Services Authority (PHSA) Aboriginal Health on a chronic disease prevention program highlighting the importance of traditional food. The idea was to create an online resource specifically for Indigenous youth to promote wellness and prevent suicide. A reduction in the First Nations youth suicide rate is one of the seven key performance indicators identified in the Transformative Change Accord: First Nations Health Plan. Therefore, developing a resource for upstream suicide prevention relevant to Aboriginal and First Nations youth would meet a need identified by the community. Indigenous youth were engaged on the idea of an online resource for wellness and what this might look like for them. World café style workshops were held in communities in 2011 followed by a think tank in Vancouver in early 2012 bringing together 65 youth representatives from 20 communities. These conversations made it clear - more youth wanted to learn about their culture! A partnership was formed between the Nisga’a Nation, the A Healthier You | 12 | November 2014
community of Gitsegukla, Nak’azdli First Nation, Lake Babine Nation, Urban Native Youth Association, BC Mental Health and Substance Use Services and PHSA Aboriginal Health. By early 2013, Carrier Sekani Family Services, Okanagan Nation Alliance, Squiala First Nation and Cowichan Tribes also joined the project. What makes Cuystwi unique and significant is that it gives Indigenous youth an opportunity to participate in the creation of an online wellness tool made specifically for them. Cuystwi continues to evolve in the scope of activities offered and the team is committed to building capacity with youth from First Nation and Aboriginal communities. Indigenous youth have had involvement since the creation of Cuystwi, in the design, implementation, and review process. The Youth Advisory was led by ‘Namgis youth Gabriella Emery and Stl’atl’imx Elder Gerry Oleman. The youth on the committee received training in leadership, public speaking, facilitation, data gathering, and filmmaking, utilizing Telehealth technology to connect from across the province. Youth Advisory members vetted the curriculum for the online program with youth in their communities and at the Gathering Our Voices 2013 conference in Penticton, BC. Youth from all over the province were asked to provide feedback on the project videos and
activities to ensure relevance and suggest modifications if it did not meet their approval. The Cuystwi quest is designed for youth (ages 10 to 12) to be led through the training by a community facilitator. In the pilot phase, youth and youth workers were provided training, and were given the skills and knowledge to facilitate and provide evaluation documentation for the program. Some of the facilitators were originally members of the Cuystwi Youth Advisory committee. These youth have been with the program since the beginning, and are now facilitating, teaching, and helping youth navigate through the program and understand the material. This is truly inspiring to witness! The Cuystwi quest guides youth through a series of online activities and videos that are meant to be paired with activities in their existing community-based youth groups. The modules include: • Identity: Building on the interconnections of family, community and the land. • Culture: Introduction of the concept with videos sharing cultural activities from different Nations across the province. Culture is food, art, song, respecting the land, and living in balance. • Colonization: Introduction to the concept, historical context, major elements and the ongoing cumulative effects on Aboriginal people. Youth become aware of how it affects them. • Racism: Addressing racism experienced by Aboriginal people, youth learn skills and tools to deal with racism. • We are all Warriors: Emphasizing personal and collective strengths and values with themes of culture,
interconnection and community, including inspiring video stories of youth who have overcome challenges. The youth are then invited to become Cuystwi Warriors. Cuystwi is currently developing phase 2 for youth ages 1315, including topics such as: enhancing cultural identity, selfregulation and healthy relationships. In addition, Cuystwi now has a sister program, Ask Auntie, that is currently being developed by BC Women’s Aboriginal program. It is an upstream suicide and violence prevention program for girls ages 10 to 18 delivered in a similar online and community partner format. Cuystwi opened up my eyes to new and old challenges of First Nations youth. I was able to picture what they were seeing online and feel better about youth learning about a history that affects our people in many negative ways, but how knowing where we came from is going to help us see where we need to go and how we can help each other to get there. For more information on Cuystwi please check out our website www.cuystwi.ca.
This article originally appeared in the Summer 2014 issue of Spirit Magazine, the magazine produced by First Nations Health Authority. To view the entire article online, please visit: www.fnha.ca/wellness/spirit-magazine
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Learning and Development Centre to Help Develop Future Medical Professionals By Jonathon Dyck, public affairs and media relations lead, Northern Health
It’s exciting to see the Learning and Development Centre taking shape at the University Hospital of Northern British Columbia (UHNBC) site in Prince George, B.C. The $10 million facility, funded by the Province of BC, will be a place for students and residents that are currently training at the hospital to study, collaborate with classmates, and practice their skills. It is an important investment in future medical professionals, both current students and youth, who will eventually join medical training programs as physicians, nurses, and physiotherapists in northern B.C.
“The Northern Medical Program’s focus is to train physicians who can work in rural and remote communities, including northern B.C.,” said Dr. Paul Winwood, vice provost medicine, UNBC and regional associate dean, Northern B.C., UBC Faculty of Medicine. “The new Learning and Development Centre will be a benefit for our students as it creates a dedicated space with state-of-the-art lecture and teaching rooms with flexible configurations, a library and a place for them to meet, study and attend other learning activities right on the hospital campus.”
“It is known that when future students make choices of where they want to study, the facilities available to them make a difference,” said Michael McMillan, Northern Health chief operating officer. “The Learning and Development Centre will enhance the already amazing facilities in Prince George for post-secondary medical education.”
The Northern Medical Program also has space on the fifth floor of UHNBC that includes seminar rooms, small group teaching spaces, clinical skills training rooms and clinic offices, where students can meet with patients as part of their training.
The centre is an important component for students and residents in the Northern Medical Program, a UBC Faculty of Medicine Program hosted at the University of Northern BC. There are currently 128 students studying in the Northern Medical Program, and these students are required to spend time at UHNBC as part of their academic and clinical education. The Learning and Development Centre will include space for these students to study, participate in lectures, and video conference with instructors and other students across the province. It is an important contribution to the development of well-trained medical and other health professionals in the north, many of whom will hopefully practice in the region in the future.
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Another key component for the facility is the move of the simulation centre. The Northern Clinical Simulation Program uses state-of-the-art robotic patient simulators to allow health care students, staff and physicians to learn and practice skills for responding to a patient’s real-life care needs. Patient simulators exhibit patient signs such as pulses, breathing, heart sounds and speech, based on customizable scenarios. Those scenarios, and the learning outcomes from them, can then be shared with students and staff throughout the network. The project is expected to be complete and ready for current and future medical professionals in April 2015.
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A Community Health Star: Myles’s Mindcheck By Mike Erickson, health promotions project assistant, Northern Health
Biking, playing hockey, and hanging out with friends: standard fare for a 15-year-old male in northern B.C. Myles Mattila shares these interests, but it’s his other extracurricular hobby that makes him anything but your average teenager; in his spare time, Myles works to promote mental health in youth throughout the Prince George area. Myles’s mental health work is directly connected to his love for hockey, exemplifying the impact that professional athletes can have as positive role models. A ninth-round draft pick of the Vancouver Giants in the 2014 WHL draft and a midget player in Prince George, Myles was inspired to begin working with mindcheck.ca after reading a newspaper article in the Vancouver Province. The article was about the twoyear anniversary of Rick Rypien’s suicide, and the impact that the tragic loss had on his friend and Vancouver Canucks teammate, Kevin Bieksa. In the article, Bieksa talked about the Raise-it-4-Ryp Golf Tournament, a charity event that he hosts in honour of Rypien, which raised $23,000 dollars for mindcheck.ca. “I related to the story,” said Myles of the Vancouver Province article, “because I had a teammate with mental health issues, and was unsure how to help. I came to the conclusion that my peers should have the resources they need to get help, regardless of the mental distress that they’re experiencing.” Having been exposed to mindcheck.ca, Myles would, like Bieksa, strap on a skate of a different kind – one that would help him cut through the stigma surrounding mental health issues in youth. A Healthier You | 16 | November 2014
Myles would, like Bieksa, strap on a skate of a different kind – one that would help him cut through the stigma surrounding mental health issues in youth. Mindcheck.ca provided an excellent starting point for Myles. The website – a partnership between Fraser Health, BC Mental Health & Substance Services, and the Provincial Health Services Authority – addresses mental health in a manner that is accessible for youth. It features a broad range of topics, including depression, mood and anxiety issues; coping with stress, alcohol and substance misuse; body image, eating disorders, and more. Offering a range of resources like quizzes, stories, tips, and helpful contact information, mindcheck.ca also has links for friends and family members of youth who are suffering from mental illness and would like to learn more. Mental health is an often-overlooked health subject, affecting more people than you might think and, unlike many other health issues, there is a stigma surrounding the topic. In fact, according to the Canadian Medical Association, only 49% of Canadians said they would socialize with a friend who has a serious mental illness. A shocking number when considering that one in five Canadians will experience a form of mental illness at some point in their life. Due to the stigma, two in three Canadians will suffer in silence and only one out of five children who require services will obtain them.
According to the Canadian Medical Association, only 49% of Canadians said they would socialize with a friend who has a serious mental illness. The importance of educating youth on mental health and wellness cannot be overstated. Mental health and substance use disorders are the primary health issues experienced by young people in their teens and early 20s. Additionally, 75% of mental health and substance use issues begin by the age of 24, often going unrecognized and untreated, which makes early identification vital to providing help. Given the above statistics, you can imagine the tremendous challenges faced by youth looking for help. “There is stigma attached to youth,” said Myles, “and even worse is the stigma for a youth who also has mental illness. The belief can be that they are incapable of having insight into what they need so then others speak for them without necessarily being their voice. While promoting mindcheck.ca, I have realized that talking is important for everyone to raise awareness about mental health. It makes it easier for everyone to open up and share their experiences when they are in need … breaking down the stigma of mental health, trying to make it an issue that everyone can talk about. ” So, what is the message that Myles wants youth to take away from his presentations and the mindcheck.ca website? “… that they are not alone,” he said. “Many people struggle with mental illness. If they are struggling, they need to be aware that they have resources and contacts who can help them get through these difficult times.” He also recommends that anyone, youth or otherwise, who wants to champion the cause of mental health in youth find promotional materials at mindcheck.ca.
Anyone, youth or otherwise, who wants to champion the cause of mental health in youth can find promotional materials at mindcheck.ca.
Northern Health’s Community Health Stars Northern Health couldn’t be happier to have someone like Myles as a voice for youth and mental health in our region. As a result, Myles will be featured as Northern Health’s first Community Health Star. Community Health Stars is a new and ongoing program that shines the light on members of northern communities who are doing exceptional work, on their own time, to spread the message of personal health and wellness.
You can nominate a person who you feel would make a great candidate for Community Health Star at northernhealth.ca.
Nominate a Community Health Star today at northernhealth.ca!
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Northern Health Staff Profile
Staff Profile: Karen Wonders A long-time nurse of Northern Health, Karen Wonders currently lives and works in Prince George as a public health manager. Sandwiched between helping her kids to stretch their wings and supporting aging parents, Karen finds ways to be active with her friends, family, and her dog, Theodore.
Tell us a little about yourself and your role at Northern Health. I was born and raised in Ottawa, Ontario. As I was always determined to be a nurse, I completed my registered nursing diploma from Algonquin College in Ottawa in 1985, and later completed a bachelor of science in nursing through the University of Victoria in 1994. I moved to Edmonton, Alberta in 1985 to take a full-time permanent nursing position at the Royal Alexandra Hospital. After all, it was hard to resist when they hired over the phone and said to be out in a week for permanent work! It was here where I met my husband and our northern journey began. We eventually moved from Edmonton to Peace River, AB, and then to Fort Nelson, BC. We then moved to Dawson Creek and then Prince George. I started working for Northern Health in 1989. I have been fortunate in my nursing career to have had a variety of experiences in the cities and communities I have lived, including acute care, rural nursing, home and community care, sessional college instructor, and public health. I am a strong advocate for the health of children and youth. In my current role as a public health manager in Prince George, I am able to focus on healthy schools. In this, I work with health, education and other community members to support children, youth, and families to lead healthier lives where they live, work, learn and play.
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What do you do to live a healthy life?
What do you enjoy about living in northern B.C. that supports your personal health and wellness?
As a family, we enjoy our lifestyle in northern B.C. Prince George has been a great place to raise our children, who are now 18, 22 and 24 years old. Access to parks, trails, green space, and a variety of year-round activities helps us to keep active and to enjoy what we are doing. Some of our favourite activities include skiing, snowboarding, fishing, and golfing. I think that living in the north is calming, which we value and enjoy.
I am finding this current stage of my life to be the busiest so far! Working full-time, helping our children successfully â€˜fly the coop,â€™ and supporting aging parents living in Ottawa and Victoria keeps our lives exciting and keeps me very busy. To maintain a healthy lifestyle, I walk my chocolate lab, Theodore. I enjoy spending time with my husband, family, and friends. I also very much enjoy travelling to new places, meeting new people, and resuming or trying new activities, such as scuba diving!
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Active Living: Every Day, Your Way! By Mandy Levesque, physical activity lead, Northern Health
From the moment you wake up in the morning until the time you go to sleep, you make many choices that affect your health each day. You may not think that today’s choices will have long-term impacts, but choosing healthier options especially when it comes to having an active lifestyle in your youth – can set the stage for a longer, healthier life.
You’ll have a better chance of sticking to the plan if you enjoy what you’re doing!
Active living is a way of life that encourages people to include physical activity into their daily routines. An active lifestyle includes everyday activities, like walking or biking to get to school or work. You don’t have to be in organized or competitive sports, or join a gym, or run a marathon to be active - any moderate-paced activity counts! So how much activity do youth need? The Canadian Physical Activity Guidelines for youth ages 12-17 years recommend at least 60 minutes of moderate to vigorous-intensity physical activity daily. This should include: • Vigorous-intensity activities at least 3 days per week (cause you to sweat and be ‘out of breath’) • Activities that strengthen muscle and bone at least 3 days per week You don’t have to get all 60 minutes at once. Incorporating activity into your daily routines can be broken down into shorter periods throughout the day. Getting together with friends for a walk or any other type of activity not only adds a fun and social aspect but can also make time fly by. Going solo is always a choice too - putting on those headphones and heading outside for some fresh air can really get your body moving! Why is this important again? The Active Healthy Kids Canada 2014 Report Card revealed that only 7% of kids aged 5-11 and 4% of kids aged 12-17 met the recommended guidelines for physical activity. Being active for at least 60 minutes daily can help children and youth: • • • • • • • •
Improve their health Do better in school Improve their fitness (endurance, flexibility, strength) Have fun Maintain a healthy body weight Improve self-confidence Feel happy Learn new skills
So how do you get started? One way to get going is to make a conscious effort to minimize the time you spend during the day being sedentary, which means doing very little physical movement. Some examples of “being sedentary” include: sitting for long periods of time, watching TV, playing video games or being on the computer, and using motorized transportation. Trying something new can be exciting but also challenging, even intimidating for some people. Set SMART goals for yourself and ensure that you choose activities you like. A Healthier You | 20 | November 2014
Example of an active living goal
Specific: Know what it is that you want to achieve!
“I want to walk or ride my bike to school more this year.”
Measurable: How will you know that you have reached your goal?
“I will start off trying to walk or bike for 3 out of 5 school days per week.”
Attainable: Make sure that your goal is possible over time!
“I live close enough to the school for this to be possible most days.”
Realistic: Set goals you will be able to accomplish and consider any obstacles you may need to overcome!
“On days when I am running really late I may need to get a ride, but I will try to wake up earlier to have more time.”
Time-bound: Set a date that you want to achieve your goal by!
“I will try this for one month and see how I did.”
Where to get more information The Physical Activity Line is a great, free resource for British Columbia residents wanting information on active living and provides helpful tips on goal setting www. physicalactivityline.com/pdf_files/pal-doc-goalsetting.pdf
Grab a friend, set a goal, and donâ€™t give up - you can do this!
What are you waiting for? Get out there and find an activity you want to try and have fun! Set your stage to be active for life!
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Keeping Young Men Healthy By Holly Christian, regional lead for men’s health, Northern Health
“The sooner the better.” Whether it’s when to start saving for retirement, or when to put on your winter tires (hey! we are in the north), these are words of advice that we hear regularly. The earlier you take action, the better it truly is for you – especially when it comes to your health! Establishing healthy habits and checking in with your body on how things are running can not only improve your health in the short term, but help prevent illness later in life. This is especially important in northern B.C. where men are more likely than their southern counterparts to develop chronic diseases like diabetes, coronary artery disease, high blood pressure, and many types of cancers. A great resource that Northern Health developed to support men’s health is the MANual (find it online at men. northernhealth.ca). This guide covers many topics related to men’s health, from nutrition and physical activity, to mental wellness and specific disease information, such as prostate cancer and cardiovascular disease. The information is developed for – and specific to – men, including young men! Do you know your maintenance schedule? The guide (developed by Northern Health’s own health professionals) suggests that “dudes” (guys aged 18-39) should have some regular maintenance, including: Yearly: • Blood pressure check • Dental checkup • Testicular self-exam (optional) Every 3-5 years: • Lipid (cholesterol) blood test • Diabetes check If you have specific risk factors or symptoms, you may also want to look into: • Prostate checkup • Colon & rectal cancer screen • Depression screening • Influenza vaccine* • HIV test (if you are sexually active)
Have you talked to your doctor about any of these? A Healthier You | 22 | November 2014
GOLFing for testicular cancer? Did you know that testicular cancer more commonly affects younger men? This is one body part you definitely don’t want to ignore! You can grab your life by the … err … “horns” by performing regular self-exams! Just remember GOLF: • Groin • Only takes a moment • Look for changes • Feel for anything out of the ordinary If you do find anything unusual or alarming, talk to your doctor today! Talk to the experts Regular maintenance, along with healthy eating and regular physical activity, will give you the chance to get ahead of a major break down. Frequent checkups with your doctor can help to keep your engine running like it just came off the lot! *Keeping all immunizations up-to-date is an important part of routine maintenance for all men. Generally, this means getting a tetanus/ diphtheria/pertussis booster every 10 years and making sure you have the shots you need when you travel.
Healthy Living Youth Program
Healthy Living Program for Youth in Prince George By Arkell Wiley, program coordinator, Northern Health
In northern B.C., many youth and their families can find it challenging to achieve a healthy lifestyle. Winter conditions, for example, can impact activity levels and demanding work schedules can make preparing healthy family meals difficult.
emotional wellness. Prince George Healthy Children and Families aims to offer a non-judgmental environment where families can work towards overcoming barriers and gaining the skills to be the healthiest they can be.
This winter, Prince George Healthy Children and Families is offering a unique opportunity for families in Prince George who have youth (6-17 years) and who are looking to improve their health through meaningful lifestyle changes. Northern Health and the YMCA of Northern BC are partnering to deliver the program, an evidenced-based intervention program that focuses on simple and realistic changes. The program is offered in select communities across B.C (known in other communities as “Shapedown B.C.”).
“The program is really about empowering families with the knowledge for healthy eating and active living. Everybody benefits,” said provincial team member, Dr. Laura Brough.
We know that kids can thrive and must be accepted in all shapes and sizes. The program is, therefore, not focused on dropping inches and pounds but rather finding ways for the whole family to improve and maintain physical health and
Participation in the program requires a physician’s referral. Contact your family doctor or visit northernhealth.ca/ YourHealth/HealthyLivingCommunities/ShapedownBC. aspx for more information.
The program consists of ten weekly sessions held at the YMCA in Prince George (on Highland Drive). The interactive group sessions focus on self-esteem, building strong relationships, healthy eating, and active living. Part of each session is also spent with an exercise specialist having fun in the gym.
November 2014 | 23
| A Healthier You
How Can We Help?
How Can We Help? By Chelan Zirul, health promotions and communications officer, Northern Health
Stay tuned for more!
In our February 2015 issue, we will feature similar listings of services available in the northern interior health service delivery areas. For the northeast service delivery area, check back to the August 2014 edition (available online: www.northernhealth.ca/ NewsEvents/AHealthierYou.aspx)
Northern Health has a variety of services available all across the north to support your health and wellness. Our services are more than acute care. We support healthy community development, public health and mental wellness. One of the most important things you can do for your health is be aware of who to call when you need help. We encourage you to rip this page out and post it on your fridge so it’s always close at hand!
My family physician’s phone number is:
Haida Gwaii emergency numbers:
• • • • •
In case of emergency, call 9-1-1. Here is a listing of services available in the northwest area. More information on all services listed below is available at www.northernhealth.ca/ourservices.aspx or you can visit www.northernhealth.ca/OurServices/ContactUs/ CommunityContactsFacilities/NorthWest.aspx for a listing of all contacts in your region. Northwest health service delivery area Aboriginal patient liaisons can help you to navigate the health system. • • • •
Hazelton: Angie Combs, 250-842-4666 Prince Rupert: Mary Wesley, 250-624-2171 Smithers: Lillian Lewis, 250-847-5211 Terrace: Lloyd McDames, 250-638-4085
Community care licensing supports the health, safety and well-being of adults and children in licensed care facilities, such as day care and residential care facilities. • Terrace: 250-631-4222 • Smithers: 250-565-2150 (Prince George office) • Or, call Enquiry B.C. to contact the office nearest you: 1-800-663-7867 Environmental health officers can help you with issues that affect the health of the general public, such as foodborne illness outbreaks and sewage entering neighbouring properties. • Prince Rupert: 250-622-6380 • Terrace: 250-631-4222 • Smithers: 250-847-6400 Home and community care promotes independence, choice and dignity for northerners through in-home supports, respite, assisted living, residential care, and hospice palliative and end-of-life care. Please contact the office nearest you for more information: • Atlin, Kitimat, Stewart, and Terrace: 250-631-4234 • Dease Lake, Hazelton, Houston, and Smithers: 250-847-6430 • Masset: 250-626-4727 or 250-626-4729 • Prince Rupert: 250-622-6313 • Queen Charlotte City: 250-559-2321 • Tumbler Ridge: 250-242-4262
A Healthier You | 24 | November 2014
Police (RCMP): 250-626-3991 Fire department: 250-626-5511 Hospital: 250-626-4711 B.C. Ambulance: 1-800-461-9911 B.C. Wildfires: 1-800-663-5555
Lab testing services are available near you. For hours, please call: • • • • • • • • • •
Dease Lake: 250-771-4444 x.239 Hazelton: 250-842-4607 Houston: 250-845-2294 Kitimat: 250-632-8659 Masset: 250-626-4705 Prince Rupert: 250-622-6173 Queen Charlotte City: 250-559-4321 Smithers: 250-847-2611 Stewart: 250-636-2221 Terrace: 250-638-4041
Medical imaging, such as X-ray, is available near you. Please call: • • • • • • • • • •
Dease Lake (Stikine Health Centre): 250-771-4444 x.258 Hazelton: 250-842-4613 Houston: 250-845-2294 Kitimat: 250-632-8333 Masset: 250-626-4704 Prince Rupert: 250-622-6172 Queen Charlotte City: 250-559-4307 Smithers: 250-847-6214 Stewart: 250-636-2221 Terrace: 250-638-4046 (X-Ray, ultrasound and CT); 250-638-4093 (nuclear medicine)
Mental health and addictions community programs offer services such as crisis response, intake, support and education. To learn what is available near you, please call: • Dease Lake: 250-771-5024 • Hazelton: 250-842-5144; 250-842-5211 (after hours or emergency) • Houston: 250-845-5964; 250-845-2294 (after hours or emergency) • Kitimat: 250-632-3181; 250-632-2121 (after hours or emergency) • Masset: 250-626-4718; 250-626-4700 (after hours or emergency) • Prince Rupert: 250-622-6310 • Queen Charlotte City: 250-559-8765; 250-559-4300 (after hours or emergency) • Smithers: 250-847-6405; 250-847-2611 (after hours or emergency) • Stewart: 250-636-2525 • Terrace: 250-631-4202; 250-638-4082 (after hours or emergency)
24 Hour Crisis Line: 1-888-562-1214 1-800-suicide: 1-800-784-2433
Public health nurses can help you with adult, women’s, infant, children and family health, including communicable disease prevention and control, dental, hearing, school and youth, and speech and language services. Call your local health unit or health centre: • • • • • • • • • • •
Atlin: 250-651-7677 Dease Lake: 250-771-4444 Hazelton: 250-842-4640 Houston: 250-845-2294 Kitimat: 250-632-3181 Masset: 250-626-4727 Prince Rupert: 250-622-6380 Queen Charlotte City: 250-559-2350 Smithers: 250-847-6400 Stewart: 250-636-2221 Terrace: 250-631-4200
HEALTH TIPS FOR YOUTH Limit recreational screen time to no more than two hours per day.
In addition to what is available locally, there are also a variety of regional services available: • Check out the Community Health Information Portal to learn about key issues that affect our health: chip.northernhealth.ca • The patient care quality office is here to help you obtain quality health care. If you have a complaint and cannot resolve it with the person who provided the service, please call toll-free: 1-877-677-7715, or visit: www.northernhealth.ca/OurServices/ PatientCareQualityOffice.aspx • Population health provides lots of information on healthy living, including healthy eating, physical activity, tobacco reduction, injury prevention, men’s health, and more: www.northernhealth.ca/AboutUs/ PositionStatementsAddressingRiskFactors.aspx • IMAGINE grants support local health initiatives. Learn more at www.northernhealth.ca/YourHealth/ HealthyLivingCommunities/ImagineGrants.aspx • Call HealthLinkBC to talk to a registered nurse, a dietitian, or a pharmacist. They can be reached at 8-1-1, or visit www.healthlinkbc.ca • Northern Health is always looking for professionals to join our team in your community. Visit careers.northernhealth.ca/ today to learn more! • NH Connections provides low-cost bus transportation if you have to leave your home community to access health services. Learn more at www.northernhealth. ca/YourHealth/NHConnections(medicaltravelservice). aspx
November 2014 | 25
| A Healthier You
Dr. REM Lee Hospital Foundation (Terrace, B.C.) By Ron Bartlett, Chair, Dr. REM Lee Hospital Foundation
Formed in 1988, the Dr. REM Lee Hospital Foundation works to update and provide new equipment for Mills Memorial Hospital and Terraceview Lodge in Terrace. Since 1988, the Foundation has raised over $2.5 million. Upgrading and introducing new equipment improves the ease and efficiency of patient care and can help to attract new health care professionals to the area. An added benefit to having current technology is that patients may have to travel less for treatment and procedures, meaning reduced financial burden and stress on families. Mills Memorial Hospital is considered a “hub hospital” and serves up to 80,000 patients, including some from as far away as the Yukon Border, to Haida Gwaii, the Nass Valley, the Hazeltons, Kitimat and Prince Rupert. The Dr. REM Lee Hospital Foundation is comprised of a Board of working Directors including: Chair: Ron Bartlett; Treasurer: Dominic Ignas; Co-Chair: Dianne Rooker; Directors: Gayle Appleton, Jo Colley, Richard Kriegl, Janine Kraft, Tammy Hockett; and Honorary Members: Bill McRae, Helene McRae, and Eileen Kennedy. Very recently, the Foundation hired their first employee, Stacey Kennedy. Stacey works part-time as an administrative assistant and is available to support the Board in its fundraising activities and office administration. The Foundation recently purchased a $34,529 bed warmer for newborn babies. It arrived at Mills Memorial Hospital on September 26th and is already much appreciated! The Foundation is currently raising funds for the 2014/15 project: a high definition endoscopy suite. The Dr. REM Lee Hospital Foundation has committed to raising $300,000 towards the total $414,000 needed to purchase this equipment. The suite will be replacing Mills Memorial Hospital’s current, aging analog scope inventory. In addition to the new technology, the Foundation has chosen to purchase a paediatric scope to serve infants and young children, eliminating the need to travel out of town. This new technology will provide enhanced visibility and ability to detect pre-cancerous cells and conditions; provide diagnosis of colon, stomach and upper GI symptoms; and provide high quality emergency bleed treatment. The Dr. REM Lee Hospital Foundation relies upon support from its Directors and volunteers, corporations, businesses, groups and individuals.
A Healthier You | 26 | November 2014
The Dr. REM Lee Hospital has been blessed with a very generous donation of $100,000 from the Christ Evangelical Lutheran Church. This money represents 1/3 of the Foundation’s commitment towards a new HD endoscopy suite (including a paediatric scope). Pictured from left to right are: Dianne Rooker (Foundation); Kathy Kuzyk & Bertha Watmough (Christ Evangelical Lutheran Church); Eileen Kennedy & Dominic Ignas (Foundation).
Heads Up! Preventing and Managing of Concussions By Shellie O’Brien, injury prevention coordinator, Northern Health
Participating in sports is an excellent way for children and youth to be active, meet new friends, and learn life lessons. But, with any activity or sport, there are associated risks, such as the risk for concussion. Concussions are caused by a direct blow to the head or other body part resulting in a rotational movement of the brain within the skull.
Evidence suggests that children and youth are at the greatest risk of having a concussion and take longer to recover, and that concussion can permanently change the way a child or youth talks, walks, learns, works and interacts with others. So how do we let our children grow, develop and play while minimizing these risks? It’s important for parents, coaches, educators and players to understand how to prevent, recognize and manage concussions. Having the resources and tools to do so is the first step in minimizing the risk to our children and youth.
Make your home safe. Falls around the home are the leading cause of head injury for infants, toddlers, and older adults. Keep your home well-lit and your floors free of clutter. To reduce the risk of injury to children, use edge and corner guards on furniture, block off stairways, and install window guards. Wear sensible shoes. Shoes with good traction can protect you from injury. If you’re older, wear shoes that are easy to walk and manoeuvre in. Ensure a safe playground. Choose a wellmaintained playground for your child with a ground surface made of shock-absorbing material such as mulch, sand, or hardwood.
The Canadian Paediatric Society recommends that anyone working with children be educated about the signs and symptoms of concussion and the appropriate management of a child with a concussion.
The BC Injury Research and Prevention Unit has developed a free online training tool including a 30-minute online course on the recognition, management, and prevention of concussions. The Concussion Awareness Training Tool (CATT) supports coaches, parents, and players to take the necessary steps to prevent long-term consequences of a concussion and to understand the effects and treatment should such an injury occur. It includes up-to-date concussion education training, video lessons and resources to effectively prevent, recognize and manage a player’s recovery. Learn more at www.cattonline.com. Some tips on how you can prevent concussion: Wear protective gear for sports and recreation. Always use the appropriate protective gear for any sport or recreational activity such as helmets and/or neck protectors. Make sure the equipment fits properly, is well maintained, and is worn correctly. Buckle your seat belt. A high number of concussions result from automobile collisions. Wearing a seat belt may prevent serious injury, including an injury to your head during a traffic collision.
November 2014 | 27
| A Healthier You
Health: There’s an App for That By Nick Rempel, mental health & addictions services manager, Northern Health
As I finish waiting in line to buy tickets for the show, I have already checked Rotten Tomatoes, read the synopsis, watched the trailer and read user reviews. I’ve also updated my Facebook status and ‘checked in’ at the movie theatre. Only two likes?! Maybe I should post a selfie? (#catchingaflick) All of this information and interconnectivity is available to me at the touch of a button, or a slide of a finger. These amazing devices make our lives easier and help us to communicate instantly with one another in ways that were not possible even 10 years ago. In my opinion, one of the most exciting prospects about all of this functionality in the palms of our hands is the advancement and increased access to health and wellness support, information, and tools. A number of app designers have invested in mobile technology for wellness. You can get apps that track your mood, coach you in deep breathing, or can track your immunizations. Separately, YouTube and other social media channels are used by scholarly institutions, health authorities, and health professionals as a way of sharing wellness information that can be accessed in the privacy of your own home, from the bus, or wherever you have the desire (and the data plan) to access it. Research is demonstrating some of the benefits of the emerging field of ‘mobile health.’ For example, research is following individuals who are quitting smoking and receiving text message encouragements (for example, see quitnow.ca), or setting people with specific medical conditions up with education and reminders through their mobile device. In the north, where winter roads and lengthy distances can make travel difficult, technology is emerging with some exciting options for people to promote wellness and ownership of their health. Informally, communities of likeminded individuals are gathering on sites like Reddit and Pinterest to share wellness tips and information, as well as links to pertinent research or videos. However, users need to take caution. Not all health information, sites, or sources are created equally. With the increasing ease of information sharing, it’s important for individuals to exercise caution until an app or information found on the internet can be verified. For information to be trusted, it should come from a credible source, like a health authority. Check with your family doctor if you are unsure. The future is bright with touch screens and I’m optimistic we’ll continue to see the benefits and development of this area of health services in the years to come.
With the increasing ease of sharing information, individuals need to exercise caution.
A Healthier You | 28 | November 2014
Youth Urged to Use Common Sense and Practice Safe Sex By Joanne MacDonald, communications officer, Northern Health
Anyone can become infected with HIV or other sexually transmitted infections (STIs), including young people. That’s why it’s so important to take precautions before having sex, advises Shannon Froehlich, manager of support services at Positive Living North (PLN) in Prince George. Froehlich said there are many tips young people can follow if they’re considering having sexual relations, which includes both oral sex and intercourse (vaginal and anal). “Abstinence is the safest approach. But if that’s not an option, young people should use a condom and lubrication every time they have sex,” said Froehlich. “And young people seem to consider oral sex to be safe sex — but they should be advised that it’s not.” Just as important, she said, is having a conversation with your partner before having sex. “And don’t drink or do drugs beforehand to prevent careless actions,” said Froehlich. Young people in northern BC are encouraged to visit their local health unit if they have questions about sex or are considering having sexual intercourse. Youth who want to be tested for STIs can visit their family doctor, or they can visit the local Opt clinic, which offers sexual health services including STI testing, birth control counselling, and low cost contraceptives and supplies. Froehlich said PLN staff can supply youths with condoms and have conversations with them about sex — which will be kept anonymous. “We can also share information about different STIs, and give them brochures that they can take to their partner to have a discussion about sex,” she said. PLN, a not-for-profit HIV/AIDS/HCV organization, is a Northern Health community partner, and was a key participant in Northern Health’s award-winning STOP HIV/ AIDS education and awareness project. PLN can be reached at three locations in northern BC: Prince George at 250-562-1172; Smithers at 250-877-0042; and Dawson Creek at 250-782-5202. Visit hiv101.ca for more information and to learn about online youth educational options. More information: • Find your local health unit: northernhealth.ca/ OurServices/Facilities/HealthUnits.aspx • Options for Sexual Health: optionsforsexualhealth.org/ providers • Positive Living North: positivelivingnorth.org/ourservices
November 2014 | 29
| A Healthier You
Hand Washing: Flu Season and Beyond! By Kyrsten Thomson, communications liaison nurse, Northern Health
You can’t avoid germs. They are always collecting on your hands – when you open doors, handle money, use your cell phone, or play with the dog. While you can’t avoid germs, you can reduce their presence on your hands, and the chance of passing them on to others, by cleaning your hands often.
• Playing with pets or animals • Taking care of a child or sick family member • Playing (outdoors, in group settings, with toys)
Good hand hygiene is important to reduce the spread of germs that can cause influenza and other illnesses such as colds, diarrhea, or vomiting. Getting into the habit of cleaning often is important during flu season and beyond!
• Wet your hands under running water. Remove any jewelry on the hands and wrists first. • Scrub your hands well with soap (including between your fingers, fingernails, front and back of your hands) for at least 40-60 seconds. Teach children to sing the “ABC” song while they wash. • Rinse your hands under running water. • Dry your hands with a clean towel.
While you can’t avoid germs, you can reduce their presence on your hands, and the chance of passing them on to others, by cleaning your hands often. Clean your hands before: • Preparing or eating food • Feeding your baby or child • Giving a child medication Clean your hands after: • • • •
Preparing or eating food Changing a diaper Using the toilet Sneezing, wiping or blowing your nose (or your child’s nose)
A Healthier You | 30 | November 2014
Steps to hand cleaning with soap and water:
Alcohol-based hand sanitizers can also be used if no soap and water is available. Wash your hands with soap and water if they are visibly dirty. Steps to hand cleaning with alcohol rubs: • Remove any jewelry on the hands and wrists first. • Apply a palm full of product in a cupped hand and rub your palms together. Rub all areas of your hands well (including between your fingers, fingernails, front and back of your hands) for at least 20-30 seconds. • Let your hands dry.
November 2014 | 31
| A Healthier You