Healthy Living in the North

“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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Volunteer translator saves the day in Dawson Creek

A headshot of George Holland, Operating Room Manager at Dawson Creek & District Hospital.

George Holland, Operating Room Manager at Dawson Creek & District Hospital, recently lived out the Northern Health value of innovation using his German translation skills to help assist a patient.

George Holland, the operating room manager at Dawson Creek & District Hospital, was recently recognized by his peers for living out the NH value of innovation: “Innovation: We will succeed in our work through seeking creative and practical solutions.”

An elderly traveller from Germany needed medical attention in Dawson Creek. She spoke no English and needed someone to translate so she could better understand her situation. George was on the volunteer translation list as an Austrian translator, and he can also speak German.

As soon as he joined the group and started translating, staff noticed the tension leaving the patient and her family.

“They knew where they had to go and what tests were going to happen,” said Donna Anderson, Registration Clerk. “A great experience for our visitors!”

Thank you, George, for demonstrating our values and providing exceptional care for patients and visitors!

Brandan Spyker

About Brandan Spyker

Brandan works in internal communications at NH. Born and raised in Prince George, Brandan started out in TV broadcasting as a technical director before making the jump into healthcare. Outside of work he enjoys spending quality time and travelling with his wife and daughter. He’s a techie and loves to learn about new smartphones and computers. He also enjoys watching and playing sports.

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Fire infographic

A dramatic infographic presents Northern Health’s response to the 2017 wildfires. Greg Marr, NH’s Regional Director, Medical Affairs, and Jason Jaswal, Prince George Director of Long Term Care and Support Services, presented it at the BC Health Care Leaders Conference in Vancouver.

infographic showing statistics during 2017 wildfires

Sincere thanks to everyone involved in supporting the northern wildfire response both this year and last year, including NH Emergency Management and all NH staff members and physicians, and thank you to Jason and Greg for highlighting these details!

Greg and Jason side by side in suits.

Greg Marr (L), NH’s Regional Director, Medical Affairs, and Jason Jaswal, Prince George Director of Long Term Care and Support Services, at the BC Health Care Leaders Conference in Vancouver.

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Diagnosis: Retiring. Here’s what retirement looks and feels like to two long term Prince George doctors.

As my co-worker, Bailee, and I walked down the street to meet up with and interview Drs. Garry and Susan Knoll, we jokingly bantered back and forth what we would do if we were retiring. The Knolls have been family doctors in Prince George for over 25 years, and they’ve finally made the decision to retire. Susan officially left her practice at the end of September and Garry is hoping to be done at his practice by January 2019.

“I bet they’re popping a big ol’ bottle of champagne and sailing to Tahiti!” I exaggerated.

Bailee, a tad more realistic than myself, mentioned something about being leaders in the medical community… something something? My mind was on a sailboat in Tahiti.

But, moments into the interview, I soon discovered, and probably should have predicted, Bailee was right. Even though the Knolls are parting from their full-time practices, the two doctors still have their stethoscopes on the heartbeat of the medical community. Here’s what each of them had to say on the topic of “retiring.”

susan knoll sitting on a bench with a statue, eating ice cream.What will you miss about practicing full time?

Susan:

I’ll miss my patients. I’ve been looking after them for 20+ years. We have a relationship with each other and we’ve been through a lot together.

I’ll also miss the camaraderie at the office. I have been sharing an office with Ed Turski for most of the years in Prince George and Lindsay Kwantes joined us about six years ago. Both were fantastic partners – we never even came close to an argument! And our MOA, Colleen Price looked after us and our patients very well. I think we all respected and liked each other. Lindsay moved to be near family this summer, so we recruited two new grads from our Residency Program, who I was privileged to oversee through their training. It made it somewhat easier to leave, knowing that our office remains in good hands. But it will still be hard, in some respects, to part ways with that “family”.

Garry:

I’ll miss feeling that sense of accomplishment at the end of the day, and all the fun I had in the office. I really enjoyed the intergenerational relationships we built, and working with everyone at the hospital. I just came from a meeting with my interprofessional team and it was really good – we’re really getting to know the team and what people bring to the table, which makes it tough to leave.

I’ll also miss being part of the forward progress our system is making. It’s nice to be a part of a plan from the beginning, and since switching to integrated primary and community care, it’s been like going to Mars! There’s no turning back. We’ve decided to commit to a plan that I’m confident it will be better for everyone in the long run. It feels like we’ve recently made such positive strides in the right direction.

What are you looking forward to most about being retired?

Susan:

Well I can tell you what I won’t miss! I won’t miss getting up to an alarm and rushing through rounds, then rushing to the office, and that feeling of always being late!

Now that I have a bit (a lot) more time, I’ve joined the Cantata Singers, which is great. I’m also able to hang out with my grandkids more and attend to all the “pieces of my wellness pie”! I’m looking forward to doing more travelling also.

Garry:

You know, as a doctor, you’re always in a rush and with a lot of time pressure. I won’t miss that. I also won’t miss all the documentation!

Are you planning to stay involved with the medical community in some way?

Garry:

I’m still going to work some shifts at the Nechako walk-in clinic and cover for other doctors’ vacations at my clinic. And I’m still going to help with the Prince George Divisions of Family Practice for a bit. We have a lot of friends in the medical community still, which makes it easy to stay connected. In Prince George, doctors have really good foresight and can grasp the ‘big picture’ of medicine. It keeps us very interested in what’s happening locally.

Susan:

I’ll still be doing a few shifts at the Nechako walk-in clinic as well. Prince George has a really unique medical community that makes us want to stay involved. About 40% of our Family Physicians were graduates of our Residency program here in Prince George – I don’t know anywhere else that’s like that.

garry knoll cycling on a road in the summer.When you’re both retired, will you be doing anything immediately to celebrate?

Susan:

Truthfully, the last day of work at my clinic just slipped by. When you’re in charge of making sure everything will run smoothly when you’re gone, it sort of sneaks up on you. I didn’t even have time to tell my patients or the medical office assistant that it was my last day! The clinic had a lovely celebration later.

Garry:

When I finish, we’re planning to go cross-country skiing for three weeks in the New Year! Honestly, when you’re in charge of a practice, you don’t really get a “clean cut.” In one way or another, you’re involved. I think the hardest thing will be when we both decide to hand in our licenses. That will be a tough day.

In your career, did you ever experience physician burnout or woes? Would you have any advice for medical students who might be experiencing something similar?

Susan:

I experienced a bit of burnout about 10 years ago. Luckily, I was able to recognize it, so I decided to get a coach and I discussed my values and what I hoped to get out of life. It was then that I decided to scale back the number of patients I was seeing in clinic, and added the part-time position of site director for the Family Practice Residency Program, Prince George site.

It’s so easy to get sucked into the vortex and just go, go, go. Some advice for new graduates and medical students: read my article on wellness. It’s important to keep a balance in life and not be afraid to make changes. Realize that good work is part of the balance, you’re contributing, and it makes you feel good.

Garry:

I’ve never had the burnout experience, although lately I have been thinking a lot about retirement! There have been times when I’ve felt frustrated, but I think any job has those.

The last 12 years I’ve been really focusing on finding a way forward for my practice, and the patients in the practice. I want patients to have a doctor that’s going to be there for the long term. Now that the practice has that, it makes it a LOT easier to step back.

Longitudinal care is so much better for patients and doctors – to have that long term relationship with their doctor. My hat’s off to the patients that have been there to educate residents over the last long years!

My advice for burnout: Self-reflection is important to be committed to. It’s important to receive feedback, and you need that group of people willing to give it in your professional and social life. You have to ask yourself, “Am I doing the things in life that align with my values?”

What was the biggest challenge for each of you both being general practitioners (family doctors)?

Garry:

I think the biggest challenge was getting time off together. It was always a big scheduling event. We cared for the same patients in La Ronge, Saskatchewan, and so we always talked about them when we weren’t at work. When we moved to Prince George we didn’t have the same patients, so we didn’t have that connection. There are definitely upsides to always understanding each other’s work demands.

Susan:

For me, balancing the call of work and family was challenging. It actually became easier to overwork when the kids grew up, because they weren’t at home demanding our time. Overworking is easy when you both have busy schedules!

So, as it turns out, “retiring” to this pair of doctors is more about slowing down than anything else. Although there are no immediate plans of sailing towards Tahiti, it was genuinely satisfying to hear the praise and confidence they have for the direction northern BC healthcare is headed, and the people who are involved in moving it forward.

Thank you Garry and Susan for your interview time, and for leaving a lasting positive impact on your community!

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Dunrovin celebrates Care Aide Assistants day

thank you post its Care Aides at Dunrovin are at the heart of the services we provide to our residents every day. Whether they’re helping with meals or aids to daily living, or providing social interaction and emotional support, Care Aides build close relationships with those they serve. To celebrate this, Dunrovin asked for words of encouragement to be displayed on a poster board and shared with co-workers, residents, families and visitors.care aides standing and smiling with thank you board We also showed our appreciation with food! chart of thank yous.Each unit got sandwiches and goodies delivered and the BCGEU supplied a wonderful cake in the staff room.

The leadership team at Dunrovin would like to publicly thank all the Care Aides for the work they do every day, and for the person- and family-centred commitment they show to our residents and families.

Adele Bachand

About Adele Bachand

Adele is currently the manager at Dunrovin Park Lodge in Quesnel, where she has been for the past three years. Before that, she worked for a variety of service providers in social housing, as well as independent and assisted living organizations. Her background is in human resources and organizational development, and she's an advocate for helping people enjoy what they do every day and reach their full potential. She lives in Quesnel with her two dogs, a Great Pyrenees and a Papillon.

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Rural Nursing: A Love Story

chetwynd nursing team outside in fall weather

Teammates and friends! LPN Darlene, RN Bradt, RN Stephanie, MRT Megan.

“Why Chetwynd?”

“What’s in Chetwynd?”

“Can’t you find work in Prince George?”

These are all frequent questions that I’m faced with after I tell my friends and family where I work.

I know, it’s odd for a 24-year-old new graduate nurse to leave her home town of Prince George, a place of roughly 80,000 people, and move to a community of 2,500. So yeah… I can understand why these questions come up.

Let me tell you: “Why Chetwynd.”

Picture this: I’m commuting to work, and I barely get through two songs on the radio because the whole drive is a staggering five minutes – including my Timmies run. Upon my triumphant arrival, I’m greeted by every staff member, and I mean everyone, in the hospital (*cue Cheers theme song*).

You might think I’m being sarcastic, but the part I truly cherish most about my job is the friendships that I’ve made in the past year and a half. Working in a rural facility means that the x-ray department isn’t just the x-ray department; it’s made up of friends that you go out for wings with, and people whose strengths and weaknesses you know. You begin to appreciate not only the teamwork of your department, but of the healthcare team as a whole.

steph goulet with her team in chetwynd.

Steph and her team of physicians: Dr. Sadeer Hanoosh, Dr. Rafal Banas, and Dr. Osamah Hanoosh.

Another rural nursing benefit that I really enjoy is the amount of time I get to spend with patients. I always hear from friends who work in larger facilities that the patient turn-over rate is so high, you don’t really get time to see a full picture of your patients. In Chetwynd, not only do I often get to triage, treat, and admit clients, but I also get to follow through with their care.

I’ve enjoyed getting to see the whole picture, and I can confidently say that this continuity of care has given me a solid foundation in my overall client care-planning skills.

Though I’m leaving Chetwynd to return home while I specialize in emergency nursing, I won’t forget the experiences and knowledge that I’ve gained from being the “everything nurse.” I can’t imagine what my nursing practice would look like without the mentorship and guidance of the physicians and nursing staff in this awesome little community.

I plan to bring the positivity of rural nursing wherever I go, and I’d like to thank everyone at the Chetwynd Hospital, Primary Care Clinic, and BC Ambulance for their welcoming environment, and genuine good times. I’d proudly recommend Chetwynd to anyone looking for a great rural healthcare experience, and will look back on my time spent here fondly, with a permanent smile!

About Stephanie Goulet

Stephanie is a Registered Nurse with Northern Health.

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UHNBC Trauma Team delivering great results

The Trauma team at the University Hospital of Northern BC.

Photo caption: Trauma Team at the University Hospital of Northern BC in Prince George. L – R: Brittany Coulthard, Family Practice Resident; Dr. Matthew Wahab, Emergency Medicine Physician; Andrea Davidson, Psychiatric Nurse; Deandra Cormier, Emergency Room RN; Chad Ridsdale, Emergency Room RN; Ann Marie Henderson – Social Worker; Dr. Dick Raymond.

How long do people with major injuries stay in hospital? If the hospital is UHNBC in Prince George, the average is 8.5 days (as compared to the BC average of 12). The UHNBC Trauma Team aims to get people back home as soon as possible, and they’re succeeding — readmission rates for major injuries are also very low. Thank you, Trauma Team, for helping Northerners recover quickly!

 

The Trauma team at the University Hospital of Northern BC.

The Trauma team at the University Hospital of Northern BC (UHNBC) in Prince George BC.

Anne Scott

About Anne Scott

Anne is a communications officer at Northern Health; she lives in Prince George with her husband Andrew Watkinson. Her current health goals are to do a pull-up and more than one consecutive “real” push-up. She also dreams of becoming a master’s level competitive sprinter and finding a publisher for her children’s book on colourblindness. Anne enjoys cycling, cross-country skiing, reading, writing, sugar-free chocolate, and napping -- sometimes all on the same day!

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Tumbler Ridge physician makes 33rd appearance in long-running journal feature

Canadian Journal of Rural Medicine cover, in which Dr. Helm has an article.Dr. Charles Helm, who practices in Tumbler Ridge in Northern BC, is the author of “Country Cardiograms case 64” in the Canadian Journal of Rural Medicine’s Fall 2018 issue. The recurring feature presents an electrocardiogram and invites readers to make a diagnosis, letting readers pit their skills against those of the physician author. This is Dr. Helm’s 33rd publication under “Country Cardiograms” — congratulations to Dr. Helm!

Anne Scott

About Anne Scott

Anne is a communications officer at Northern Health; she lives in Prince George with her husband Andrew Watkinson. Her current health goals are to do a pull-up and more than one consecutive “real” push-up. She also dreams of becoming a master’s level competitive sprinter and finding a publisher for her children’s book on colourblindness. Anne enjoys cycling, cross-country skiing, reading, writing, sugar-free chocolate, and napping -- sometimes all on the same day!

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It’s Canadian Intensive Care Week!

Celebrate Canadian Intensive Care Week Oct 21 – 27. Each year, over 100,000 Canadians receive life-saving care in ICUs. Thank you to Northern Health’s critical care nurses, ICU physicians, and other ICU care providers for all the hard work you do every day!

Anne Scott

About Anne Scott

Anne is a communications officer at Northern Health; she lives in Prince George with her husband Andrew Watkinson. Her current health goals are to do a pull-up and more than one consecutive “real” push-up. She also dreams of becoming a master’s level competitive sprinter and finding a publisher for her children’s book on colourblindness. Anne enjoys cycling, cross-country skiing, reading, writing, sugar-free chocolate, and napping -- sometimes all on the same day!

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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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