Healthy Living in the North

Thermometers help keep kids out of Dease Lake emergency room

Two staff holding thermometers.
L-R: Amy Bolton, Dease Lake Pregnancy Outreach Coordinator and Anna Fritch, Northern Health Nurse.

When someone goes to the emergency room with a cold or a mild fever, they often end up using some of the time and care needed for people with more urgent health concerns.

Anna Fritch, a nurse in Dease Lake, noticed this trend and decided to do something about it. Her goal was to cut down on the number of unnecessary emergency room visits.

She realized that many people who come to the emergency room don’t have basic health information on how to treat minor illnesses at home.

“I thought, ‘What do I know about taking care of a cold?’ I learned what to do from my mother as a child and how she self-treated us at home,” Anna says.

She realized one problem is that people don’t know where to get health information. Another problem is that people call emergency saying that their child has a fever, but when asked what their temperature is, parents respond that they don’t own a thermometer.

Anna works closely with the pregnancy outreach coordinator in Dease Lake, Amy Bolton. They meet a few times a month to collaborate and share information. When Anna mentioned the issues to Amy, Amy was immediately on board, offering to use some of her budget to buy thermometers.

Anna and Amy now wanted to work out how to give out the thermometers, but also educate people at the same time. They tried to do monthly pre-natal education sessions, but even though Dease Lake is a small town, the turnout wasn’t great.

The next step was to share the information with Dease Lake residents. At a community health fair, Anna provided thermometers, HealthLink BC info on how to take temperatures (children and adults), Northern Health info on treating a child’s fever at home, and a pamphlet from BC Children’s Hospital.

Now, Anna has the same information in her office, along with the thermometers. When a family or an elder comes to the emergency room, she takes the opportunity to educate them about fevers and gives them a thermometer. She teaches them what a fever represents, when to be worried about it, and what to do.

This education “makes a fever less frightening and puts a bit more agency into the hands of families,” says Anna. “People tend to think the moment they’re unwell, there’s nothing they can do.”

“It’s a willingness to partner and support people, but it’s also ‘here’s the tool you need and how to use it.’ These are the situations in which you can help yourself,” says Anna.

Anna says that now, when people call the emergency room to say they’re coming in with a feverish child, they can attach a number to their concern because they’re using a thermometer.

“There’s a difference between hot to the touch and clinically having a fever,” Anna says. “When I did the teachings, I tried to emphasize that ‘I’m giving you the thermometer because when you call me, I want us to be talking about the same thing.’”

Anna and her nursing colleagues are still working on increasing people’s confidence to care for family members themselves. But now, they can objectively measure temperature, which gives Anna and the other nursing staff a talking point to use when they call or come into emergency.

This is a great example of how a simple tool and a little education can help reduce emergency room visits.

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Our People: Spotlight on Cheryl Dussault

Cheryl Dussault sitting at her desk.

Congratulations to Cheryl Dussault for 30 years of service at Northern Health! Cheryl is a nurse practitioner in Prince George. She works at the CNC Health and Wellness Centre and for UNBC Health Services, two clinics that provide primary health care to students.

Why did you choose your career?

As far as I can remember, I wanted to be a nurse. I come from a family of nurses and that’s what I had my mind set on. I came to Prince George from a small community to do the nursing diploma at the College of New Caledonia. I thrive on providing patient care and working in that kind of environment. Eventually, I wanted to further my education and becoming a nurse practitioner allowed me to do that and stay closely connected to patient care. I graduated as a nurse practitioner in 2015 from the program at UNBC.

How did you end up at NH?

There are different opportunities at Northern Health as a nurse. My plan was to return to my hometown when I graduated from the nursing program, but I realized I liked working in the hospital in Prince George. I wanted to get more experience, and 30 years later, here I am. The community definitely grew on me.

What would you say to anyone wanting to get into your kind of career?

If you enjoy being challenged, becoming a nurse practitioner is for you! It was quite a shift for me after being a nurse in the hospital for the majority of my career. Being a nurse practitioner, I have more autonomy and it’s very rewarding. I feel part of a larger community and still get to be part of patient care improvements. I like that I see people now to try to prevent them from going to the hospital. At the clinics at CNC and UNBC, we see a lot of students from other communities that don’t have a family doctor or nurse practitioner in town, and we deal with a lot of international students. They bring a different set of challenges because of language barriers and being from different cultures.

What do you like about living in Prince George?

I like that there’s a variety of services available and that it’s a very welcoming community. When I moved here for my schooling, I was overwhelmed by how nice people are here. There are also lots of resources for people raising a family. It’s large enough so you have what you need, but also close to bigger cities.

What’s your favourite thing to do outside work?

I’m very family oriented, I have two young grandsons. And I like to help at the local soup kitchen.

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Our People: Spotlight on Kara Hunter

Kara Hunter in a snowy outdoors.

Kara Hunter is a nurse practitioner (NP) in Prince George and has been working for Northern Health (NH) for 20 years – congratulations to Kara on two decades of service! She works at the CNC Health and Wellness Centre and for UNBC Health Services. These clinics provide primary health care to students.

Why did you choose your career?

I fell into nursing as it was convenient and offered at the College of New Caledonia, in Prince George. I never intended to be a nurse, but loved caring for people once I started. Nursing has allowed me to travel the world, balancing family and professional life. Through my years of nursing I have worked surgical, internal medicine, emergency and intensive care.

In my years of critical care nursing, I was discouraged by the sheer amount of preventable chronic disease that crossed my path. In 2010, I started graduate studies at Athabasca University to become a Nurse Practitioner. My goal is to reduce the burden of chronic disease by engaging people to become owners and advocates of their personal health. I currently work full time for NH as an NP.

What’s your favourite thing to do outside work?

Travelling and spending time with my family engaged in some form of outdoor activity – hiking, skiing, camping. Our most recent adventure took us to Australia to live abroad for a year.

How did you end up at NH?

I applied to NH as my husband had work in Prince George. In 1998, I was hired as a casual RN on the surgical wards.

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Team health care shines in Dawson Creek – because a patient spoke up

The outside of Dawson Creek and District Hospital.

When interprofessional health care teams, emergency rooms, and patients all work together, the result can be great health care. A case in point: a recent story from Dawson Creek.

While he was at the Dawson Creek emergency room for another concern, a patient — let’s call him “Fred”* — asked for a hepatitis B vaccine. Fred also made sure the nurse knew that the interprofessional health care team was involved in his care. This was a key step in ensuring he got the best care.

The emergency department then called the health care team to see if they could get the vaccine for Fred right away, so he wouldn’t have to book a separate appointment.

The answer from the interprofessional health care team was “Yes!” A public health resource nurse working with the team took the vaccine across the street to the emergency department, then helped the ER nurse give it to Fred.

Note: Given that Fred has unique health concerns, this approach made sense for his specific case – but normally, people who need immunizations should book them through their local health unit.

“This spoke to the client engaging in his own health care,” said Deanna Thomas, Manager of Community Services in Dawson Creek. “It shows the value of building relationships with clients so they feel empowered to speak up.”

Patients are a huge part of the solution in health care – high-fives to Fred for making sure the emergency department had all the facts, and to the emergency department and the health care team for their collaboration and quick response!

*Not his real name – identifying details have been changed.

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Proactive health care helps keep Chetwynd mill workers healthy

Primary Care Nurses and the community paramedic from Chetwynd.
L – R: Charla Balisky, Chelsea Newman, and Jennifer Peterat (Primary Care Nurses) and Jaidan Ward (BCEHS – community paramedic and station chief for ambulance).

The Canadian Men’s Health Foundation estimates that a staggering 72% of Canadian men live unhealthy lifestyles. As well, most forest industry workers are male; for example, Canfor’s BC operations employ about 3,620 men, but only 500 women.

Taken together, these two facts suggest that taking health care directly to pulp mills and sawmills could be a great way to help men improve their health.

With that in mind, the interprofessional health care team from the Chetwynd Primary Care Clinic reached out to Canfor’s Chetwynd mill and West Fraser’s Chetwynd Forest Industries mill to offer on-site screening and health education.

Good health care can, of course, dramatically reduce sick time. As well, there are lots of resources in Chetwynd to help make it easier for people to stay healthy, including a pool, rec centre, parks, and trails.

The two mills were on board, and everyone involved was excited to start this initiative.

Accordingly, nurses and the community paramedic visited the two mills, where they checked workers’ blood pressure and blood sugar, and offered tips for healthy lifestyles.

As well, they handed out information packages containing condoms plus HealthLink BC handouts on a number of topics, including:

  • Prostate exams
  • Breast exams
  • Sleep
  • Flu shots
  • Addictions
  • Mental health

“This was a great way to educate people,” said Chelsea Newman, Primary Care Nurse. “Surprisingly, plenty of people didn’t know Chetwynd even had a clinic. As well, as it gave people the opportunity to look through the [HealthLink BC] information privately.”

The healthcare team was even able to catch a couple of potentially serious health concerns: they sent two mill workers to hospital, where early treatment should help them stay as healthy as possible.

The screening and education were well received: the two mills have asked the healthcare team to come back for more education sessions, and to continue helping them promote healthy lifestyles.

“Overall, I think we now have a better and stronger relationship with the Chetwynd forest industry. This has opened more opportunities for the community as a whole, like more education, less wait times at the clinic, more screening to help avoid hospitalizations, and so on,” said Chelsea. “I’m looking forward to the New Year and working closely with industry to continue the path of health and wellness based on the primary care model that Northern Health is striving for.”

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Garry’s story: Coordinated team care + courage add up to a remarkable recipe for change

Headshot of Garry McPhee.

Garry McPhee, 50, is a member of the Tahltan First Nation in Northern British Columbia, which includes the communities of Telegraph Creek and Dease Lake. The Fort St. John resident had struggled with alcohol addiction, and also suffers from seizures. For much of the past 20 years, Garry has been homeless.

In June 2016, Northern Health’s Intensive Case Management Team (ICMT) became involved in Garry’s care. This story describes how the team was able to help Garry tap into his own inner strength and courage, and support him to abstinence, dignity, and independence.

The Intensive Case Management Team gets involved

The ICMT is a multidisciplinary team whose goal is to improve its clients’ health and social functioning. The team works with people who struggle with both substance use and mental illness. They provide case management and support navigating health and social services. The team also plays an important role in advocating with community services to ensure quality care for their clients. The team is made up of substance use specialists, life skills workers, and nurses.

The ICMT became part of Garry’s life in June 2016.

“Before:” A dangerous situation

At this point, Garry’s life was chaotic and his health was poor. He was drinking, his seizures became unmanageable, and he was in danger of becoming homeless again. During a 6-month period, Garry spent over 60 days in hospital due to his deteriorating health.

During the 113 days he wasn’t in hospital, Garry visited Emergency 190 times — an average of 1.6 times per day – often arriving by ambulance or RCMP. Fort St. John paramedics, emergency room staff, and RCMP officers all knew him on a first-name basis.

When ICMT became involved, Garry was living at the Northern Centre of Hope in Fort St. John, using his income assistance cheque to pay for room and board. Garry was soon housed in the Supportive Recovery Bed program, a housing program for homeless people who are struggling with substance use.

In the past Garry had tried residential treatment, but due to a negative experience, he was wary of attending again. He rarely saw his family doctor.

Building trust and setting the stage for change

When the ICMT started working with Garry, their first priority was to build a trusting relationship: they met him regularly, whether at the Northern Centre of Hope, the hospital, or on the street. With his participation, Garry and the team created a patient-centred plan to enhance his quality of care.

Sometimes their interactions with Garry would just be to say “Hi!” and ask about his day. At other times, the ICMT had a more varied role:

  • Helping Garry learn about being safe and healthy, despite his alcohol use.
  • Helping him manage his medications.
  • Attending medical appointments with him.
  • Arranging ongoing physical and mental health assessments.
  • Coordinating his care, including social services.
  • Ensuring he attended for regular lab work.

Together with emergency department staff, the ICMT team developed an emergency department care plan for Garry. This was to make sure that when Garry was in hospital, he’d get the best care possible.

The team also met often with Northern Centre of Hope staff to give them support around working with Garry, and to make sure he could keep his housing with them.

As well, ICMT encouraged Garry to:

  • See his family doctor regularly, and follow up with lab work when needed.
  • Visit community psychiatric services.

ICMT also collaborated with Garry’s family doctor and psychiatrist to ensure he was receiving the best care.

During ICMT’s involvement, there were significant changes. Garry had only 135 visits to the emergency department and spent only 20 days in hospital — a 29% reduction in emergency department visits, and a 67% reduction in hospital days.  

ICMT also helped Garry apply for BC’s Persons with Disabilities program (PWD). He successfully joined the program, giving him a more secure source of income.

Throughout, ICMT always respected Garry’s dignity and his right to make his own decisions. Garry was always the one in charge of any changes that were made.

Tragedy brings a fresh challenge

Garry is the oldest of five children, and he and his younger brother were very close. They lived together at the Northern Centre of Hope and spent most of their time together. The brothers were always looking out for each other.

But in July 2017, Garry’s brother passed away. This was a very difficult time for Garry and he thought about moving back to the Yukon, even though he knew that he would likely return to drinking. ICMT checked in with Garry regularly to offer any support they could.

Garry had been undecided about residential treatment for his alcohol use. His experience at the previous treatment centre wasn’t positive, and he had been worried about leaving his brother and mother behind in Fort St. John.

But after his brother died, Garry’s feelings changed. When he was offered a spot in a residential program in Prince George, he took the brave step of deciding to go. ICMT worked with the treatment centre in advance to make sure that Garry would have the best possible chance for success.

Before attending treatment, Garry stayed in the Prince George Detox Centre. There he attended recovery groups, met the staff, and heard other clients’ stories about recovery. After hearing many positive reviews, he was excited about going to the treatment centre. After he completed detox, Garry attended residential treatment for 42 days.

“After:” A new life of abstinence and dignity

Since finishing treatment and returning home to Fort St. John, Garry’s life has been a catalogue of independence, self-care, and confidence. It’s a stunning contrast to his old life. His experience is a testament to the support from the ICMT staff, and proof of this man’s courage and strength in making real change:

  • Garry has abstained from alcohol, and he’s been attending AA meetings. Instead of drinking, he spends time with friends at the Northern Centre of Hope or cooks meals with them, which they eat together while watching sports.
  • He attended the treatment centre’s refresher program in June 2018, and may attend again in June 2019.
  • He regularly visits the hospital to see his mother in Peace Villa or to say a quick “Hi and thank you” to emergency room staff.
  • He has been arranging his own medical appointments without ICMT’s help.
  • He’s currently renting a room in the high barrier housing program at the Northern Centre of Hope.
  • Garry is a caring and responsible pet owner, ensuring his 15+ goldfish are always fed and happy.
  • And, finally, Garry volunteers weekly at the Salvation Army clothing store in Fort St. John.

This inspiring story shows the massive difference that coordinated team care can make to a person’s life and health. It’s also a deeply humbling story that reminds all of us that it’s never too late for change.

Northern Health thanks the Intensive Case Management Team for their outstanding work with Garry, and most importantly, we thank Garry for sharing this uplifting story – we know it will inspire many others.

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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“Catching people in the net of the team:” patient-centred care in practice

Headshot of Carey Mastre, Mental Health & Addictions Clinician in Mackenzie BC.For Carey Mastre, working in a patient-centred model makes total sense. She’s a Mental Health and Addictions Clinician in Mackenzie who trained in Calgary, AB, at a large not-for-profit agency.

“In practice, the expectation was that we would make contact with the patients’ doctors,” Carey says. “We were allowed to share information with each other, but the doctors and the mental health clinicians didn’t really have time for it. It was rarely fruitful…”

Carey started working with Northern Health in October 2016.

She was initially working offsite from the rest of the health care team, which wasn’t totally functional for her. In January 2018, she moved into the same building as the team and the primary care providers. Because they’re now located together, she can walk the patient to the doctor and vice versa. This has been particularly helpful for patients who are new to the community and for crises.

“At Northern Health, it’s so wonderful to have a scheduled time with the doctors and a working relationship to support client care,” Carey says. “We need to know and trust each other and trust each other’s judgment. Being co-located creates that sense of immediacy and we’re often able to better anticipate and meet the patient’s needs. Everything flows better.”

Another great thing about the team is the flow of information. There are clear ways to follow up with referrals and find out if appointments happened and to learn the outcome.

“It’s super helpful when you’re joining a team to have that regularity. Relationships are created far more quickly. There’s also so much culture to learn at Northern Health; belonging to a health care team allows you to become functional in your role much more quickly – so much is learned through osmosis,” Carey says.

There are two mental health and addictions care providers in Mackenzie and patients come to them either directly or through the doctor’s office.

On a health care team, the team members can also support the hospital, and help the patients when they transition out of hospital.

The team model ensures that “fewer clients fall through the cracks – people are typically caught in the net of the team,” Carey says. “We’re mentally prepared for care transitions and we can better anticipate needs.”

From her perspective, good things did happen in the old model – but she finds it far easier to work as part of a health care team in the new integrated model.

The team in Mackenzie in particular is “just so warm and inviting,” Carey says. “The leaders in Mackenzie really role-model ‘team’ — it’s just been the best thing.”

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Primary and Community Care transformation is hard: How one nurse changed her perspective

An NH Connections bus parked out front of the Mackenzie & District Hospital & Health Centre.

An NH Connections bus parked out front of the Mackenzie & District Hospital & Health Centre.

At first, changing the way she worked seemed like a terrible idea.

“I don’t like change and I knew I was retiring soon,” Kathy Sloan says.

She was not interested in going through a major career shift.

Kathy, 64, had been a Home and Community Care (HCC) nurse in Mackenzie for 17 years. She mainly worked alone, consulting with the Health Services Administrator on complex issues.

The new way of working, in an integrated primary and community care model, would mean she had to start working on an interprofessional team and in a different way with the primary care physicians.

Kathy didn’t see the benefit.

“I’ve always worked as a team,” Kathy says. “I had easy access to everyone and the doctors and other nurses were always close by.”

“I was in a groove in my role,” she adds. “I resisted the change so much that I wore a groove right in the pavement!”

But when Kathy realized that this new way of working was here to stay, she decided to shift her perspective.

“I started to think about the clients and the people I’m serving,” Kathy says. “If the change is better for them, then I need to get on board.”

Fast-forward a year or so, and now Kathy is on an interprofessional team that she describes as “great,” with “awesome support” for each other.

Kathy has seen many benefits from the new team approach.

“Everyone gets on board [to help the patient] quicker,” she says. “As we work together, it’s so fruitful.”

Other benefits Kathy has seen from working in an interprofessional team:

  • The team is very client-focused.
  • It’s amazing what comes out of team huddles in only a half-hour period.
  • Everyone is contributing – community paramedics, primary care nursing, life skills worker, doctor, mental health counsellors, etc.
  • There is more awareness of serving the client and helping out other team members.

“I really felt defensive to the change at first,” Kathy says. “It made me question, was I doing my job properly?”

But in the end she came to realize that the changes were not about her, they were about the people we are here to serve. Kathy has a great team lead in Mackenzie who has been supportive throughout the process and collaboration is so much easier now.

To anyone who is new to the work, or maybe even struggling with the change, Kathy suggests to just “keep going, you are always developing and changing at work, as a person and in life. There are good leaders out there that will help you in your transitions, connect with them, share your frustrations, ask for help and push past your comfort zone and take a chance on moving forward!”

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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Reflecting on the Wildfires of Summer 2017

One year after the wildfires that changed the summer for many people across BC, Northern Health is taking the time to reflect on some lessons learned from the experience.

Last year, Northern Health committed to helping the people who were evacuated from Williams Lake and the surrounding communities. We worked to set up a temporary doctor’s office and nurse practitioner office in the College of New Caledonia in Prince George.

Staff posing in doorway.

Situations like the 2017 wildfires are an opportunity to form important connections between health care workers who normally work in different facilities or different departments in Northern Health, and with family doctors and nurse practitioners and specialists

Looking back on the response to the 2017 BC wildfires, we are proud to share the following lessons learned:

  1. There is so much importance in providing the right care to the right patient at the right time.
  2. Communication is essential, from the use of an electronic medical record and internal communications with staff, to external communications with the evacuees and to the community of Prince George.
  3. Situations like this are an opportunity to form important connections between health care workers who normally work in different facilities or different departments in Northern Health, and with family doctors and nurse practitioners and specialists.
  4. Forming partnerships between local organizations are essential (for example, we worked very closely with many, including Prince George Division of Family Practice, First Nations Health Authority, Red Cross, Health Emergency Management BC, Interior Health, the City of Prince George, etc.)
  5. Team-based care (doctors and nurse practitioners working with a team of health care professionals such as nurses, occupational therapists, and counsellors, etc.) will provide the best care that the patient needs.

Do you have any more important lessons to add? Share your story in the comments!

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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