Healthy Living in the North

Community paramedics partner with Northern Health communities to increase access to care

Community paramedics are changing patient care in some communities in Northern Health. They’re helping increase access to basic health care services in non-urgent settings, in patients’ homes, or in the community. Throughout Northern Health, 26 communities have community paramedics helping patients.

Patients can see a community paramedic if they’re referred to them by their doctor or health care team, or when they’re discharged from the hospital.

Community paramedics are employed by BC Emergency Health Services, but they work very closely with the teams of health care professionals in the community.

In Fort St. James, the “biggest positive is she [the community paramedic] works really well and has a positive relationship with the First Nations bands. She’s a great liaison for information and understanding their culture,” says Cathy York, team lead for Fort St. James.

The health care team and the community paramedic in Fort St. James are encouraged to share information and they all have a great working relationship. The community paramedic does a lot with the First Nations bands on naloxone training for overdose prevention, and also educates people on diabetes, chronic obstructive pulmonary disease (COPD), and heart disease. She’s also starting to work with local schools to do naloxone training.

Fraser Lake saw benefits when the first community paramedic started. At the time, they were short on nurses, so it was difficult for them to have eyes on some of the people they were concerned about in the community.

“We’re so thrilled to have the program start here, and the paramedics are such an asset to the team,” says Lora Lee Pacheco, team lead for Fraser Lake.

The community paramedic attends team meetings (called “huddles”) in Fraser Lake, which has helped close loops and encourage open communication. If there’s a concern with a patient, the community paramedic will bring it up to the team and sometimes suggest that the physician pay a home visit. They’re proactive in their care and address people’s health concerns early on.

“For example, a man used to come in every second week to the doctor’s office and was going to the hospital once a month. Now, because of the home visits of the community paramedic, he hasn’t been in the hospital since July,” says Lora Lee. “It just goes to show how important it is to check in on people and how far this program goes to prevent hospital admissions.”

Fraser Lake’s community paramedic has also taken over naloxone and CPR training in the community itself, as well as in surrounding First Nations communities. To save time, she’s also spending 1-2 hours a week at the Autumn Services Centre to follow up with people she would normally do a home visit with.

In Burns Lake, the community paramedic started only a few months ago. Since then, the team has found that he’s able to catch concerns with patients earlier on than if they waited to see their doctor. To help prevent crises, he’ll bring patients with any concerns directly to the health care team – another great example of how community paramedics are partnering with Northern Health and the local community health care teams to provide better patient care.

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 Barb Haagenson

Barb Haagenson outside against a wintery background.Barb Haagenson is a social worker on the primary care interprofessional team in Tumbler Ridge. She joined the team in September 2018, moving from Powell River, BC.

Can you tell me about your role as a social worker?

Currently, I’m working as a social worker and focusing on people struggling with mental health and substance use issues. I work with adults, and I also do traditional social worker jobs, such as helping with applications for disability and assisting with finding housing for people. I’m working on expanding my knowledge and helping people that are receiving home and community care or palliative services.

When I was doing my undergraduate degree at the University of Victoria, we learned about the perspective of generalism, described at school as a basic grounding of integration of practice, policy, and research at each system level of practice. It’s about a broader view of work among and across systems. I’ve done a lot of work with people and this perspective just fits. Whatever comes up in a person’s life, that’s what we work on with them.

I bring a generalist lens to every patient that comes to see me. For example, if they’re coming to talk to me because they struggle with depression, I also look to see if there are housing or economic struggles. I feel fortunate because I’m biased towards having a generalist perspective. There is such a huge benefit of working this way for the patient – they come to me to discuss what’s important to them and I work with them where they’re at.

I did my graduate degree at the University of BC – Okanagan. It was more specialized with a clinical focus. I learned with nurses and other health care professionals and worked in an interprofessional way – it felt like a good fit.

What brought you to Tumbler Ridge?

I really enjoy living and working in remote and rural places. When I was exploring options for work, the North was one of my first choices. I feel really grateful to be working and living where I am. The interprofessional team approach fits with how I want to work and so the team in Tumbler Ridge, combined with the community, was a great fit for my life.

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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Four-person show in Hudson’s Hope

The four staff members in Hudson's Hope looking at a document.
L-R: Cara Hudson, lab/x-ray technologist; Susan Soderstrom, primary care nurse; physician; Faye Fladmark, primary care assistant.

Think it can’t be done? Think again. One doctor, one nurse, one combination lab/X-ray technician and one assistant are managing 1,200 patients in the community of Hudson’s Hope.

They do it all. This team works together to manage any emergencies in the community before they are transferred to Chetwynd or Fort St. John, as well as provide regular family doctor visits and checkups to their patients. The team is small so they communicate well with one another.

Because the community is only about 1,200 people, the staff know their panel well and have good relationships with their patients.

On a typical day, Susan Soderstrom, the primary care nurse, could be out in the community assisting a patient and then come back to the clinic and need to help the doctor with a major emergency.

Cara Hudson, the lab/x-ray technologist, took combined training aimed towards working in rural communities so that she can provide both services. Normally, two different people would provide these services.

There is one solo doctor in the community, and he treats a wide variety of issues – everything from prescriptions to chainsaw injuries.

Faye Fladmark, the primary care assistant, deals with everything else that comes through the doors. Managing patient records, ordering supplies, etc.

Through collaboration, innovation, and great communication, this incredible team confidently handles anything that comes their way!

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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Connecting a community one meal at a time

Two program volunteers at the Terrace health unit.
From left to right: Kristen Gogag and Linda Preston are Primary Care Assistants at the Terrace Health Unit and both help run the Terrace Meals on Wheels program.

Sometimes the smallest act can have the biggest impact. For Meals on Wheels volunteers in Terrace, that small act is delivering meals to seniors in the community. However, the benefits of the program go far beyond just filling someone’s belly.

The Terrace Meals on Wheels program

Meals on Wheels is a program that delivers hot and cold or frozen meals on Monday, Wednesday, and Thursday mornings each week (except stat holidays).

Linda Preston, a Northern Health Primary Care Assistant at the Terrace health unit, helps coordinate the program’s meal deliveries.

“It’s a program to deliver meals to people who are elderly, shut in, recovering from surgery, or have mobility or other issues. They can’t always get out and they feel safe in their home,” says Linda, who’s been part of the program since June 2018. “Having someone come to their home with a meal helps them.”

Kristen Gogag, also a Primary Care Assistant at the health unit, handles the administrative side of things. “I’ve helped out with the program for the last two and a half years. I help with questions as needed when people come into the health unit. Linda is more on the run,” says Kristen.

“Kristen is great to have at the health unit,” says Linda. “She can provide information to people and can give them the form to fill out or brochures.”

25 years of meals and smiles

According to the pair, their involvement is relatively brief compared to some program volunteers.

“The program has been running in Terrace for the last 25 years. We have some volunteers who have been a part of it since it started,” shares Kristen. “One of our volunteers, Arlene, has been doing it for 24 years. Another one of our volunteers, James, has been with us for 15-20 years.”

The program was started to help people stay at home rather than at the hospital, as well as help with nutrition and mental wellness – especially social connectedness. These have positive health impacts for both the client and program volunteers.

Who benefits from Meals on Wheels?

When posed this question, Linda was resolute: “Everyone benefits. The person getting the meal gets some contact and interactions. The family of the person receiving the meal benefits as they know their family member is getting a meal and having someone check in. This person can stay in their home rather than going into a facility.”

Some might wonder what the boundaries are for this service: “There are no boundaries,” laughs Kristen. “If we have volunteers, we deliver. If there’s not as many volunteers, it just might take a bit longer,” she adds. “We’re actually looking for more volunteers right now.”

Meals on Wheels graphic

It’s more than just a meal

For Linda, the most rewarding thing about being part of the program is the connection with those receiving the meals.

“I have a little conversation [with the meal recipient]. They get some contact and an interaction,” says Linda. “Sometimes they need me to read something for them like a calendar because they can’t see. They know we’re coming and it brightens up their day. The meal helps them too. The interaction for me, is the most rewarding.”

For Kristen, it’s getting to know the clients: “You see the same people and you get to know them. They like to show off their family and stuff. I’ve had a couple of clients pass away since I started and that’s hard but that’s life. I miss it now that I’m in more of an administrative role. Delivering, you get to be out in the community and visit. Now I do more of the paperwork side of it. Linda and I sit beside each other at the health unit so it’s nice to get updates from her on clients and know how a particular person is doing.”

Delivery volunteers needed!

Right now Meals on Wheels is looking for anyone who can help with meal delivery. Kristen advises that volunteers should have the following to qualify:

  • Personal vehicle
  • Valid driver’s license
  • Clean criminal record check
  • Clean driver’s abstract
  • Available at least one day per week

Linda stresses the importance of the program: “It isn’t just delivering meals – it’s touching the community.”

Pride tinges Kristen’s voice when she talks about it: “It’s a really good program. It gets people more involved in the community. Delivery volunteers might be lonely too. It helps them get out and help. They could be a widow – it gives them someone to visit. Or they could be retired and need something to do. Or they could be new to the community and want to get connected. We had two ladies recently who were new to Terrace – they just wanted to do something.”

The program doesn’t deliver on statuary holidays but Kristen emphasizes, “We never leave our clients hanging. We offer our clients the option of having extra meals delivered the day prior to the holiday.”

For more information or to volunteer

Please call Linda at the Terrace Health Unit at 250 631-4260.

Haylee Seiter

About Haylee Seiter

Haylee is a communications advisor for Public and Population Health. She grew up in Prince George and is proud to call Northern BC home. During university she found her passion for health promotions by volunteering with the Canadian Cancer Society and became interested in marketing through the UNBC JDC West team. When she's not dreaming up communications strategies, she can be found cycling with the Wheelin Warriors or spending time with family and friends. (NH Blog Admin)

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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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Canadian Patient Safety Week: Not all meds get along

Rob Pammett, Research and Development Pharmacist, holding a large bag of meds.

Rob Pammett, Research and Development Pharmacist – Primary Care, removing expired and unneeded medications from a patient’s home.

Canadian Patient Safety Week is October 29 – November 2, and this year’s theme is Not All Meds Get Along. It’s a reminder that modern medicine is very complex and requires careful monitoring to make sure people don’t experience medication-related harm.

Two thirds of Canadians over age 65 take at least five medications regularly, and more than 25% take over 10. We enjoy longer, healthier lives partly thanks to effective modern medications, but we should always be aware of the possibility of medication-related harm.

Medication interactions

Sometimes medications can interact with each other, making them work too well or not well enough, with serious consequences.

For example, imagine taking a natural health product that made your blood pressure medication work too well – you might start feeling woozy, low-energy, or even faint. This is a real example of what might happen if you took  peppermint extract and felodipine, a common blood pressure medication.

The importance of reviewing medications

Medication reviews help develop a clear list of your medications and how you’re taking them. A medication review can also help optimize your medications, making them easier to manage, safer and more effective. A review also gives both you and your healthcare team an up-to-date list of your medications, which can be vital if your health status changes, or if you need emergency care.

A wide variety of medications on the counter.Before starting any new medications (including over-the-counter products from a pharmacy, natural health products and vitamins, or even cannabis products), it’s important to talk to your pharmacist, doctor, or nurse practitioner. They can review your medications and give advice on whether they’ll be safe and effective for you.

Who should have a medication review?

I use the following 5 questions to help identify people who might benefit from a medication review:

  1. Do you regularly take 5 or more medications? (including prescription and non-prescription products, vitamins and minerals)
  2. Do you take 12 or more doses of medication each day?
  3. Are you currently taking medications for 3 or more medical conditions?
  4. Have your medications or the instructions on how to take them changed 4 or more times in the past year?
  5. Do you take any of the following medications?
    • Anti-epileptics
    • Anti-coagulants
    • Drugs for chronic pain
    • Insulin
    • Drugs to lower blood sugar
    • Lithium
    • Digoxin
    • Methotrexate

Answering “Yes” to 3 or more of these questions means there’s a good chance that your medications can be optimized: you should ask for a medication review. Stay healthy and have a great Canadian Patient Safety Week!

Rob Pammett

About Rob Pammett

Rob Pammett is the Research and Development Pharmacist – Primary Care, a partnership between Northern Health and the Faculty of Pharmaceutical Sciences at the University of British Columbia, where he holds the rank of Assistant Professor (Partner). He has an active clinical role in multiple primary care homes in Prince George and works with interprofessional teams to provide comprehensive care to patients.

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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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