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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Celebrating the unveiling of Gitxsan art at Wrinch Memorial Hospital

Curtain being pulled off of art piece.

Mary Vanstone and Chief George Gray unveiling the art.

This past fall, Mary Vanstone, local administrator for Wrinch Memorial Hospital in Hazelton, hosted an event celebrating the unveiling of Gitxsan art. Local Indigenous artwork in health care settings helps to create a more welcoming and culturally safe space. For many people at the event, the commissioning and unveiling of this artwork was more impactful than expected.

The artwork symbolizes robes of authority with a crest that depicts the Indian Residential School experience from the Gitxsan perspective. The Northwest East Aboriginal Health Improvement Committee commissioned the art for the hospital entrance as part of an initiative funded by Aboriginal Health to develop local cultural resources.

The art was made by residential school survivors participating in the Gitxsan Health Society Indian Residential School Resolution Health Support Program. At the unveiling event, several people who participated in its creation spoke about its meaning and their experiences working on it. Indian Residential School Resolution Health Support Worker Pamela Torres described the sessions where Indian Residential School survivors and family members from Kispiox, Sikedakh, and Gitanmaax came together, shared their stories, experiences, tears, and laughter as they worked to complete the beautiful artwork.

Also at the event, fellow support worker Gary Patsey described his experiences as an Indian Residential School survivor. He spoke about specific statistics of residential school impacts on the Gitxsan Huwilp and shared sensitive insights into his journey of healing. He challenged service providers to educate themselves on the 94 Calls to Action flowing from the final report of the Truth and Reconciliation Commission of Canada.

Ardythe Wilson, manager of the support program, concluded the event with a reminder that all health care workers and service providers in the area are in positions where they can become partners of true reconciliation by working with, and supporting, the Gitxsan in developing a reconciliation model. The unveiling was a significant event and those in attendance were visibly moved.

The art was designed by Michelle Stoney, whose grandparents survived residential school and now actively promote Gitxsan history and culture. The crest represents the four clans of the Gitxsan Huwilp inside a mother and child, portraying the matrilineal foundation of the Gitxsan Nation. It recognizes those who suffered the abduction of their children and the intergenerational healing that continues to take place as a result of the long-reaching impacts of residential schools.

Vanstone shared:

It was an honour to help organize and be part of this event. The unveiling event provided an open forum for discussion and a step toward healing from the atrocities of the residential school system and the trauma sustained by First Nations in this community. As a health facility supporting the people of this community, we acknowledge that we have a lot of work left to do, however, we are confident in the collaborative relationships we are building with our community partners. The artwork hangs in our foyer as a symbolic reminder of the unbreakable bond between mother and child and the strength provided by the Wolf, Fireweed, Frog and Eagle clans of the Gitxsan people.

Verna Howard, Community Engagement Coordinator with the First Nations Health Authority, helped organize this event and said:

This event has made a big difference. It’s the first time we have seen our First Nations people and dancers involved in the hospital system. I could see on the elders’ faces the impact the cultural dance group and cultural recognition had, especially for those who reside there. The community members and residential school survivors, who have heard talk about reconciliation but have seen little action, saw this as a great step forward.

The event followed local Gitxsan protocols with Chief George Gray providing a formal welcome to the traditional Gitxsan territory and Elder Frances Sampson, opening the event with a prayer. Following the unveiling, there was a reception in the cafeteria where the Gitxsan Cultural dancers performed. Verna Howard and I spoke about the role of Aboriginal Health Improvement Committees and how Northern Health, First Nations Health Authority, and Indigenous communities and organizations are partnering to improve the health of Indigenous peoples in the north. Hereditary Chief Ray Jones, a residential school survivor, shared about the three constant companions in residential school: hunger, loneliness, and fear.

Cormac Hikisch, Health Services Administrator for the northwest area said,

I was grateful to be a part of this event – witnessing local residential school survivors share their stories and express appreciation for the button blanket as recognition of their suffering. It helped provide me with a better understanding of the real impacts to this tragic part of Canadian history, and more deeply realise the still current trauma that First Nations are working to move forward from.

This event was one step in Northern Health’s journey to honour and acknowledge local First Nations and making health care environments more culturally safe.

The women who created this blanket are Amanda Wesley, Theresa Stevens, Virginia Fowler, Rebecca Jagoda, Cindy Martin and Mae Martin with guidance from Marjorie Mowatt and Sadie Mowatt. Final touch-ups were provided by Lavender Macdonald.

Three women with button blankets.

Victoria Carter

About Victoria Carter

Victoria works in Northern Health's Aboriginal health program as the lead for engagement and integration. She is an adopted member of the Nisga’a nation and was given the name “Nox Aama Goot” which means “mother of good heart.” In her work she sees herself as an ally working together with Aboriginal people across the north to improve access to quality health care. She keeps herself well by honouring the mental, emotional, physical and spiritual aspects of her life through spending time with her friends and family, being in nature and working on her own personal growth.

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