Healthy Living in the North

Success in Smithers: How cross-training and staff education has led to a fully staffed, skilled primary health care team

Members of the Smithers primary health care team are lined up, smiling, in their office.

Members of the Smithers primary health care team. L-R: Mike Oaks, Primary Care Nurse; Heather Olsen, Primary Care Assistant; Sandra Stanley, Team Lead; Stacey Pederson, Primary Care Assistant; Sam Bosscher, Primary Care Nurse.

Over the last couple of years, the primary health care team in Smithers has been struggling to get to a point where they have a complete number of staff. Today, we’re happy to say that all primary care nurse (PCN) positions are full!

What is a primary health care team and what’s the latest on the Smithers team?

A primary health care team is composed of nurses, social workers, physiotherapists and occupational therapists, dietitians, a diabetes educator, and other professionals who work together to support patients in the community.

Out of the 11 full-time and part-time staff who make up the PCNs on the Smithers primary health care team, only three team members have worked on the team for more than 18 months. That means that 72% of the team are new staff. Right now, there are two casual employees that are in permanent positions, and only one of them has been in Smithers longer than 18 months. The team has hired nine casual PCNs over the last 18 months and nearly all of them have become permanent employees or are in temporary positions.

PCNs and primary health care are pretty new… what’s happening with training?

I spoke with Sandra Stanley, Team Lead for the Smithers primary health care team, to find out how she’s cross training the new staff.

“The ‘how we did it’ is partially the people that are here. They’re amazing people – intelligent, kind, compassionate, and motivated to give great care,” says Sandra.

When Sandra started as the Team Lead, many skilled staff had left and new staff members were struggling. They needed support to provide the full range of expected services. Smithers faced many challenges getting to this point, but they now have a stable team and good morale.

“I believe now, from talking with nurses, that the morale has improved, and they have become a tight and supportive team that work really well together, and genuinely like each other,” says Sandra. “They’ve picked up the education with enthusiasm and [they’ve] been keen learners. They’re intelligent, compassionate, and good critical thinkers. I count myself as fortunate to be leading such a team and the credit for what I see as success is due in very large part to them and their excellent qualities.”

Sandra believes that, wherever possible, a key to training is modeling the skill for others. Along with “walking the talk,” here’s how the Smithers team is tackling training for different aspects of their roles:

Palliative care
Palliative care is a “way of being” with people. It requires nurses to have the ability to assess the state people are in emotionally and spiritually, as well as physically. It can’t all be taught in a classroom. The skills are learned through experience, and being with other nurses who can mentor those skills. It was important to Sandra to pair less experienced nurses with others who have strong palliative care skills. The team was fortunate to have a primary care nurse with strong palliative care skills come back and join the team after moving away to work elsewhere. This was a game changer in many respects and helped provide that knowledgeable, consistent presence the nurses needed.

Long-term care needs assessment
Sandra’s team is focused on training related to completing the resident assessment instrument (RAI), which a requirement for a patient to go on a wait list for long-term care. With more primary care nurses using the RAI, people are assessed as needing long-term care and put on a wait list earlier. The team’s health care aides supports community members until they are ready to transition to a long-term care home. Health care aides are an essential part of a community program and are critical to supporting patients who are at home, waiting to enter a long-term care home.

Diabetes education services
After the diabetes educator in Smithers had to decrease workload, waitlists for service were longer than usual. In response, two nurses are training to help educate new diabetics to give insulin, manage blood sugars, and decide what to do when the sugars are high or low. There’s been an incredible amount of training and cross-training done in general, as well as new diabetes work taken on by the nurses due to the back log of diabetes referrals.

Mental health services
To support mental health patients in Smithers, there are cognitive behavioural therapy groups that include members of the primary health care team. These teams teach people with mental health issues how to cook, shop, bank, take care of themselves, and more. The other team lead in Smithers, Cynthia Rondeau, works very hard to ensure there is quality mental health support for clients.

Cross-community support

When the team has struggled, they’ve received help from Hazelton and Houston, and they helped those communities in return. These three communities are working well together and being generous when it comes to helping wherever they can.

“The better connected we are with the people in the community, the better we can prevent admissions to the hospital and visits to the ER that are unnecessary,” says Sandra.

Sandra’s work, helping her team learn and grow as primary care nurses, has been instrumental to providing Smithers with skilled health care professionals.

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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Clinical simulation helps nursing school instructors provide better training

Simulation Debriefing Training Workshop Facilitators and Attendees.
Simulation Debriefing Training Workshop Facilitators and Attendees. L – R: Michael Lundin, Coordinator, Northern Clinical Simulation, Northern Health and Workshop Facilitator; Joey Zeller, CNC Instructor, Quesnel Campus; Suzanne Betts, CNC Instructor, Prince George Campus; Shelby Montgomery, CNC Instructor, Prince George Campus; Danielle Brandon, CNC Instructor, Prince George Campus; Stacey Conway, CNC Instructor, Prince George Campus; Lyndsy McFadden, Yvonne Mott, CNC Instructor, Prince George Campus; Tara Green, CNC Instructor, Prince George Campus; Lizann Schultz, CNC Instructor, Quesnel Campus; Liza Voliente, CNC Instructor, Prince George Campus; Nancy Esopenko, CNC Instructor, Prince George Campus; Anita Muchalla Yeulet, CNC Instructor, Prince George Campus; Tanya Barrett, Clinical Nurse Educator, Northern Health and Workshop Facilitator; Crystal Patenaude, CNC Instructor, Prince George Campus; Renee Peterson, CNC Instructor, Quesnel Campus.

For health sciences students, clinical simulation is an important part of learning. It lets them practice on realistic mannequins known as simulators without risk to patients. And of course, their instructors’ knowledge of simulation techniques is key.

On January 11, Northern Health’s Clinical Simulation Program hosted 16 nursing instructors from the College of New Caledonia (CNC) for a simulation training session.

The all-day session took place at the University Hospital of Northern British Columbia (UHNBC) in Prince George, and instructors from CNC’s Prince George and Quesnel campuses participated.

The training focused on the debriefing part of simulation education. This is when the instructor and students discuss the simulation session after it’s over, discussing what went well and areas for improvement. This is the first time a debriefing workshop has been offered by Northern Clinical Simulation.

“This session is part of the evolution of simulation use in year 2 at the CNC campuses,” says Nancy Esopenko, a CNC instructor in the Northern Collaborative Baccalaureate Nursing Program. “In 2018 we began a pilot project for students around simulation. We wanted everyone to take part in simulation during their medical or surgical rotations at UHNBC and GR Baker Hospital in Quesnel. Before this, the students’ exposure to simulation varied. We wanted all our students to learn using simulation.”

By taking this training, instructors are increasing their knowledge around simulation. This makes the sessions with students even more valuable.

“Debriefing is a very important part of simulation training and overall learning. It enhances the experience for both instructors and students. This training has given our instructors the tools to have difficult conversations,” says Nancy, who’s also Year 1 & 2 Coordinator in the nursing program. “It was very valuable to watch experienced instructors word their questions. We appreciated the chance to practice before teaching students.”

The experience has been beneficial for both new and experienced instructors: “They’re more confident in their approach and communication style,” says Nancy. “All the instructors learned new ways to engage in conversations and provide feedback. They liked playing the student role during the simulation scenarios, too – it let them see things from the student perspective.”

The commitment shown by the CNC instructors in taking part in these workshops will a go a long way in training future nurses for years to come.

Tamara Reichert

About Tamara Reichert

Tamara is the communications advisor for the innovation and development commons at Northern Health where she works on a number of projects with the research, quality improvement, clinical simulation, and education teams. Born and raised in Prince George, Tamara grew up on a ranch where she rode horses, played with farm animals, built forts, and raided the family garden. She enjoys spending time travelling, hiking, cooking, reading, and cheering for her favourite sports teams.

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Northern Doctor’s Day brings together 150 doctors from across the North

NH staff standing at the registration table for Northern Doctor's Day.

Northern Health staff welcome physicians at the registration table on Northern Doctor’s Day. Left to right: Kelsey Guldbransen, Continuing Medical Education Program Assistant, Jayleen Emery, Physician Quality Improvement Coordinator, Heather Gummow, Continuing Medical Education Program Coordinator.

The 42nd Annual Northern Doctor’s Day was held on November 2 and 3 at the University Hospital of Northern BC (UHNBC) and the Courtyard Marriott in Prince George. This year, 150 doctors attended from throughout Northern BC.

The event is an annual conference that offers learning opportunities for physicians. It’s a chance for physicians throughout the North to network and build relationships, as well as to attend educational seminars. The educational program hosted a variety of topics this year including: Trauma Informed Approach to Addressing Inequity in Indigenous Health, Pharmacologic Treatments for Child/Youth Depression & Anxiety Disorders in Primary Care, and A Morning of Orthopedics for the Primary Care Physician.

Annually, Northern Doctor’s Day also features recognition of retiring physicians from the Prince George community.

Janna Olynick, Research Associate, and Erika Belanger, Research Associate, from Rural Coordination Centre of BC (RCCBC) offering rural physicians resources and information on practice.

 Erika Belanger and Janna Olynick, Research Associates, from Rural Coordination Centre of BC (RCCBC), offering rural physicians resources and information on practice.

Candice Manahan, Executive Lead, Physician Quality Improvement offers information and resources to support doctors in their practice.

Candice Manahan, Executive Lead, Physician Quality Improvement offers information and resources to support doctors in their practice.

Sanja Knezevic

About Sanja Knezevic

Sanja is a communications advisor with Northern Health’s medical affairs department and is based in Prince George. She moved to Canada in 1995 from former Yugoslavia to Fort Nelson where she lived for a few years before moving to Prince George in 2000. Sanja enjoys photography, curling up with a good book, cooking and spending time with her friends and family.

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Share your story!

We want to highlight the lasting impact of teachers and coaches on the health and wellness of northerners by sharing stories about the positive influence of school experiences, and WE NEED YOUR HELP! Will you share your story?

These stories will be highlighted in a new resource from the Every Child and Coach a Winner (ECCAW) program, which aims to support the health and wellness of children in schools across the north. ECCAW equips ‘coaches’ with key health messages to engage children in their own health, preparing them to become healthy, responsible adults while supporting teachers to create a healthy school.

Your story, however brief, serves as an important reminder about the role of school staff, educators and coaches in the health and wellness of young people.

As an example, here’s what George Wiens in Dawson Creek says:

“As a grade nine student, I had a very dynamic English teacher. It was the first time I had experienced interactive study sessions, where I leaned philosophy and history intertwined and tied to the literature from the curriculum. After school our English teacher would take a group of us interested students to the tennis courts where he taught us how to play while continuing to learn and discuss English topics. He set different expectations for learning. We were challenged to think and act independently, to pull together why we thought and did things and to defend the actions we took. It was an incredible mentoring process that went beyond the normal hours and expectations of a classroom. I don’t think he would have called himself a coach, but he was coaching in a different way, challenging us as students and young adults. This is an experience that remains vivid and impactful for me.”

Having your voice and the stories of our colleagues and friends will strengthen this initiative and ensure that northern voices are represented in this resource.

Email your story to julia.stephenson@northernhealth.ca or post it as a comment on this post.

More info: I previously shared a blog post that describes more about ECCAW here: https://blog.northernhealth.ca/happy-lifestyles/was-your-health-or-lifestyle-positively-influenced-by-a-school-experience/

Julia Stephenson

About Julia Stephenson

Julia is a master’s of public health graduate working with the 2015 Canada Winter Games. She is passionate about upstream health and creating environments that support well-being. Julia grew up in Ontario, but feels at home in B.C., and is embracing the move north with all the opportunities for outdoor activity. She enjoys hiking, camping, canoeing, swimming, and being outside exploring new places.

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Combating the fear, shock and stigma around HIV/AIDS

Be a warrior against HIV

Playing cards developed by the STOP HIV/AIDS program for the hiv101.ca campaign.

I first learned about AIDS when I worked as a newspaper reporter in Vancouver in the mid-1980s. AIDS Vancouver, one of the first AIDS support organizations in Canada, was in its infancy, and little was known about this mystery disease other than it only seemed to affect gay men who were dying of a strange form of pneumonia in various North American cities.

When it became known that AIDS was actually a global epidemic that also affected heterosexual men and women, people everywhere reacted with fear, shock and stigma.

Fast forward to October 2011, when I was hired by Northern Health to work as a communications officer on the provincially-funded STOP HIV/AIDS pilot project. Things haven’t changed much since the 1980s. Mention HIV/AIDS now and many people still react with fear, shock and stigma — mainly because they’re woefully uneducated on all things related to HIV/AIDS.

What has changed is that HIV is now considered a manageable chronic disease — it’s no longer an automatic death sentence. That’s where Northern Health’s STOP HIV/AIDS pilot project comes in. The project has been operating since 2010 and on May 29, 2012, we launched the education/awareness component of the project. As communications lead, I’ve had the opportunity to work with talented consultants, dedicated community partners and Northern Health staff on this education/awareness campaign. We’re giving northerners the facts about HIV. We’re telling them that HIV affects everyone: all genders, all ages, all races. We’re encouraging people to take an HIV test and, if necessary, seek treatment to control the disease which will allow them to lead longer, healthier lives.

Our aggressive campaign, running in communities across northern B.C., features newspaper, radio, TV and billboard ads; a new website, hiv101.ca; and catchy drink coasters, posters and other promo items all encouraging people to take an HIV test. We also created the very powerful video posted below.

It’s been a real team effort — and a very emotional one. It’s been heartbreaking to hear people living with HIV describe how they were diagnosed with the virus and, in some cases, shunned by their families and friends.

On the flip side, it’s been truly inspiring to work with people who’ve bravely allowed their photos and words to be used in our very public campaign. Their courage has enabled us to begin breaking down barriers about HIV in the north, and getting people talking about how to combat its spread. As the Canadian HIV/AIDS Legal Network points out, “Reducing the stigma and discrimination surrounding HIV/AIDS is key to both stopping the spread of the epidemic and improving the quality of life of people living with the disease.”

I’m not sure how many people we’ll actually reach with our STOP HIV/AIDS campaign. Some people say that our year-long education/awareness campaign will reach a saturation point, with our HIV/AIDS messages eventually ignored. I respond that behaviour change can take years to occur. The fact that we’re still fighting stigma about HIV more than 25 years after AIDS first appeared tells me that we still have much work to do. But I’m optimistic that if we and others persist with our education efforts that, perhaps one day, the stigma around HIV can be eliminated — along with the disease itself. For more information, visit hiv101.ca.

Joanne MacDonald

About Joanne MacDonald

Joanne MacDonald is a communications consultant for Northern Health. Prior to joining Northern Health, Joanne worked in the journalism and communications fields in the lower mainland, Whitehorse and Ottawa. She keeps active by taking Zumba and spinning classes.

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