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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The Northern Table: Farm to School BC blossoms in the Northwest

People creating a garden.

Students working the school garden at Smithers Secondary School.

How do you get students excited about healthy, local food? According to Farm to School BC, the winning formula is simple: get students involved by providing opportunities to grow, prepare, taste, and explore healthy, local food!

Established in 2007, Farm to School BC (F2SBC) is a diverse and expanding provincial program that works to support healthy eating and sustainable regional food systems. This is done by working to have local food in schools, providing hands-on learning activities, and building school-community connections. Farm to School BC programs are tailored to the interests and needs of each school and community.

To date, F2SBC has supported 33 Farm to School initiatives across Northern BC, and is committed to supporting and inspiring even more programs across the region. Recognizing the need to provide on-the-ground support, the Northwest Regional Hub was launched, with Margo Peill as the Hub’s Community Animator.

A tray of sprouting plants.

A classroom project at Ecole Mountainview in Terrace, BC.

The Northwest Hub includes the geographic areas of the Coast Mountains School District (#82) and the Bulkley Valley School District (#54). Margo will be working with schools, farmers, and community partners to strengthen local partnerships and networks that will support sustainable F2SBC programs in the years to come.

I caught up with Margo to learn more about Farm to School BC in the Northwest, and some of the exciting opportunities she is supporting! Here’s what Margo had to say!

What are some examples of current Farm to School initiatives in the region?

We have some fantastic projects happening in the Northwest region! Each school develops their own unique projects that work within their school and community. Some projects include:

  • Cultivating bountiful school gardens
  • Experimenting with tower gardening and microgreens in the classroom
  • Incubating and hatching chicks
  • Dehydrating fruit gathered from their community for school snacks
  • Salad bar programs
  • Field trips to forage traditional and wild foods

The projects really do look different in each school, and so far, that is something we’ve seen the Northwest Hub really excelling at — coming up with creative solutions to incorporate Farm to School BC projects into the curriculum and classroom!

Can you tell me more about your role and the role of the F2SBC Northwest Regional Hub?

We’re really excited to take a community development approach to growing Farm to School BC programs in the Northwest region. Through the Northwest Regional Hub, we’ll be building networks, growing strong relationships with community partners, supporting their initiatives, and working to secure additional funding and support for the Northwest Hub.

One of our core values is to support school and community connectedness, so we really want to ensure that teachers and school champions have a strong network around them to help support the sustainability and growth of their projects. We’ll be hosting learning circles, professional development days, networking events, and an annual spring celebration to highlight and share the inspiring work that is happening here in the Northwest region.

How can local community members and groups get involved in Farm to School activities?

We are always looking for collaborations, even unlikely ones! On May 22, we’ll be hosting an official Northwest Hub launch and networking event at Cassie Hall Elementary (2620 Eby St., Terrace). Everyone is welcome to attend, share, and learn more about Farm to School BC programs while making community connections. The event will take place from 4:30 pm to 6 pm and some light refreshments will be provided. We look forward to seeing you there!

 

Note: Farm to School BC is administered by the Public Health Association of BC and supported by the Province of British Columbia and the Provincial Health Services Authority.

Emilia Moulechkova

About Emilia Moulechkova

Originally from the Lower Mainland, Emilia started her career with Northern Health as a dietetic intern in 2013. Since then, she has worked in a variety of roles as a Registered Dietitian with the population health team. In her current role, she supports schools across the north in their efforts to promote healthy eating. Emilia is passionate about food’s role in bringing people and communities together, and all the ways it can support physical, mental, and social health. Her overall philosophy on healthy eating can be summarized by this Ellyn Satter quote: “When the joy goes out of eating, nutrition suffers.” In her spare time, she loves exploring the beautiful northern outdoors by foot, skis, bike, or canoe!

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Big moves with big health rewards

Leah Smith with her dog, Sage, holding a fishing rod near a river.I, like many other healthcare professionals, find taking care of patients to be second nature – it’s just built into who I am. However, when it comes time to taking care of myself, it’s easy for me to neglect my own personal health and well-being.

As healthcare professionals, we’re very good at talking the talk. So, why are so many of us unable to walk the walk? This was a question I found myself pondering after 10+ years working as a pharmacist. As a result, I’ve realized we can’t fully look after our patients if we aren’t talking care of ourselves. This revelation has led me to make some big lifestyle changes this past year.

It wasn’t overnight that I decided I needed to make changes; in fact, my story spans a decade now. I started out my career in 2007 working as a community pharmacist in the Okanagan, and within a year and a half I found myself in a management position. After five years, I decided I needed a change – life had become too busy and hectic, my stress level was off the charts, and ultimately, I just wasn’t happy. So in 2013, I made the move to Smithers to work for Northern Health (NH).

It was a huge move, but I did it for the lifestyle and the opportunities that northern living brings. Since working for NH, I’ve been fortunate to gain experience working in several different roles. I currently have a unique position; my job title is Regional Remote Pharmacist. This means I help cover sites across the region, all the way from Prince Rupert to Dawson Creek! It certainly has its challenges, but I feel lucky that I get to work with so many different individuals across the north.

With this vast repertoire of experience, one of the common themes I continue to realize is that looking after one’s health doesn’t just happen; it takes work and practice to make good lifestyle choices.

Healthy Eating

Our diet is often one of the first things to overlook. With a busy, unpredictable workload, I would often grab things to eat that were easy and quick. These were never whole foods; most often, they were processed and certainly not well balanced. I now try to always have healthy snacks available, and make an effort to think about the food I have around my house, and the choices I make related to eating.

I don’t deprive myself, and I still enjoy special treats and more extravagant meals here and there; it’s just all in moderation. If I’m going to allow myself to overindulge, I plan some sort of extra activity in my day to make up for this special occasion, which brings me to the next big change I made!

Physical Activity

I always thought of myself as an active person because I enjoy the outdoors. I love hiking, biking, fishing, skiing, snowshoeing – really anything that gets me outside. But the reality is, doing these activities once a week doesn’t fulfill our physical activity requirements. Being a weekend warrior doesn’t mean you can take the week off in between and expect to be in peak shape.

So, I recently adopted a 12-week workout challenge, which I now do four times a week! I have a very busy schedule, so in order for me to be successful and stick with it, the workouts were designed to be targeted and short enough that I can complete them during my lunch hour. At seven weeks into the program, I can confidently say that I see and feel big changes in both my health and appearance. This experience has certainly laid the groundwork for incorporating a regular exercise routine into my life!

Mental Wellness

Although the change in diet and exercise have been wonderful, I couldn’t do either if I wasn’t mentally healthy. If I’m not in a healthy frame of mind, the last thing I want to do is exercise and I definitely don’t reach for an apple. For me, the best source of mental strength and balance is in spending time with friends and getting outside to enjoy the fresh air with my four-and-a-half year old German Shorthaired Pointer, Sage.

True friends always have a way of allowing us to show up and be who we truly are, without fear of judgment or recourse. Social engagements with them, whether it’s an activity or meal, is an essential part of keeping me connected and grounded.

My dog keeps me motivated to get out – whether I feel like it or not! We love to go out cross-country skiing in the winter and camping has become our favourite summer pastime, ideally next to a river where we love to fish! I love watching Sage’s enthusiasm when we are out, and more importantly, I love the peace and serenity I feel when I’m standing next to a river, skiing through the snow-capped evergreens, or gazing into a campfire. These places are where I feel the best, and where I go after a busy, hard day at work. These experiences and activities keep my body, and mind, healthy.

 

You can also view this article in Northern Health Spring 2018 edition of the Healthier You Magazine, Wellness by Professionals.

About Leah Smith

Leah Smith is a Regional Support Pharmacist with Northern Health.

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“The village helped to raise our child”: A Smithers family reflects

Young man sitting in a restaurant wearing a Sport Chek uniform

With the support of a microboard and various community members, Jesse recently joined the workforce in Smithers.

When you walk into Sport Chek in Smithers and see Jesse Clegg unpacking garments and hanging gear, you may not realize the significance of that moment.

You may not realize the number of people, programs, time, and advocacy that created that moment. You may not realize that moment wouldn’t have been possible just ten years ago, or that it shines a light on some ongoing challenges facing families. You may not realize that what you’re seeing is a powerful example of a healthy family supported by a healthy community.

And this is exactly why Jesse’s story is so important to share.

“When you have a child with a disability,” said Anita Clegg, Jesse’s mother, “there are no days off.” Jesse, now 21 years old, was born and raised in Smithers. Jesse has Down syndrome and, throughout his life, the Clegg family was committed to breaking ground in the community. “We put ourselves and Jesse out there,” shared Anita, “because it was important for us to show that everyone has abilities. As people learn more and connect with Jesse, we’ve seen shifts in thinking.”

When Anita says that “the village helped to raise our child,” this is not a cliché. While Jesse’s parents continue to assume a strong advocacy role, the impact of community members, organizations, and businesses on Jesse’s life is profound.

Consider the local bowling alley …

“Anything round that moved, Jesse was on it!” said Anita. “So bowling was a good fit. Jesse couldn’t start with Special Olympics until he was a teenager so, when he was 10, we asked about joining the town league. The bowling alley was very supportive and Jesse joined a team with typical kids. One year, he was the high scorer for the teen youth league! Jesse still loves to bowl and the bowling alley is a safe, welcoming, and familiar place for him.”

… and the pediatrician …

“Our pediatrician truly went to bat for Jesse. He understood Jesse’s needs, made connections that others wouldn’t have made, and helped to advocate for Jesse from birth right until he turned 18.”

Young man holding a wrench

In addition to being an artist and photographer, Jesse has taken up industrial iron furniture making.

… and the family friend …

“Safe and reliable respite is so important for families,” shared Anita. “We were very fortunate to have a family friend offer to take Jesse one day each week, starting in his last year of high school. They started out by just playing cards with me around but now they spend the afternoon together. Jesse has dinner with her family.”

… and the local business owner …

“Jesse is now in the workforce,” said Anita, “and that involved a lot of people coming together. It was a lengthy process but well worth it! When we told Jesse that the employment plan was going to be possible, his exact words were: ‘Everything is perfect!’ This process started with Jesse’s microboard (nine family members and community members) working with Jesse to create a picture of his skills, interests, and strengths. Jesse shared that he’d love to work at Sport Chek – which came out of the blue to us since he’d never been there! Our local WorkBC office asked the manager if they’d be interested in a supportive employment opportunity. The manager instantly said yes and went even further, integrating Jesse as a full team member, without a support person. His colleagues trained him and have been fantastic – many of them knew Jesse from school.”

Young man sanding stool top.

Jesse puts the finishing touches on a bar stool he built.

These supportive community experiences, however, also point to some of the challenges that Jesse’s story illuminates:

  • Access to health and social services is an important determinant of health. Unfortunately, Jesse’s pediatrician – whose role cannot be understated – recently retired. Anita identified this, along with some other changes to local social service delivery, as a challenge.
  • Respite for families is crucial. The Cleggs benefited from the generosity and support of their friend. Unfortunately, Anita shares that funding for organized respite and semi-independent housing for young adults with disabilities is being spread thinner and thinner.
  • Jesse’s new work life is a fine example of how integration has made a huge difference for him. This hasn’t always been the case. As Jesse made his way through the school system, the Cleggs experienced both integration and segregation, often changing based on policy and funding. They chose to home-school Jesse for a period of time when the school system was unable to meet his needs.

What does this boil down to for Anita Clegg?

“Smithers is a wonderful place and an amazingly generous community. My son knows way more people than I do,” she laughed, “and people watch out for him. There are just a few missing pieces, especially for some of the day-to-day, nitty-gritty challenges of raising a child with a disability.”

Concepts like healthy and inclusive communities can be hard to define, but in Jesse’s case, they are clear and their impact is profound. It’s the friend offering respite, the welcoming bowling team, and the local business eager to offer him work.


This article first appeared in Healthier You magazine. Find the original story and lots of other information about accessibility in the Fall 2016 issue:

 

Vince Terstappen

About Vince Terstappen

Vince Terstappen is a Project Assistant with the health promotions team at Northern Health. He has an undergraduate and graduate degree in the area of community health and is passionate about upstream population health issues. Born and raised in Calgary, Vince lived, studied, and worked in Saskatoon, Victoria, and Vancouver before moving to Vanderhoof in 2012. When not cooking or baking, he enjoys speedskating, gardening, playing soccer, attending local community events, and Skyping with his old community health classmates who are scattered across the world. Vince works with Northern Health program areas to share healthy living stories and tips through the blog and moderates all comments for the Northern Health Matters blog. (Vince no longer works with Northern Health, we wish him all the best.)

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Overcoming challenges for physical activity

Crystal, outside physical activity.

Crystal, showing dedication and braving the Dawson Creek winter elements to fit some physical activity into her work day.

Fourteen years ago I was diagnosed with an autoimmune disorder that drastically turned my world upside down. Being active was something that was always important to me and now, at the age of only 20 years old, I was faced with learning how to live with a disease that affected my ability to perform even the simplest of everyday activities.

Working at Northern Health has been a good fit for me, but especially in managing my health. I have enough flexibility in the job that on good days I could be out in the field working and on bad days I could stay in the office. As time went on, I noticed that I started to spend more time in the office. As a result, I walked less and sat much more. Something needed to change.

In 2009 I made a life change. I stepped outside of my personal comfort zone and signed up for a 12 week boot camp at the local gym. I still remember that first day. I was so self-conscious about being weak and poorly conditioned. But, instead of giving up, I kept with it. I also hired a personal trainer. It was a learning experience for both of us as we figured out how I could modify the movements.

At Northern Health we are beginning to walk the walk and be the face of health within our communities and, as we have learned the last few weeks, workplaces are great locations to promote healthy living and integrate physical activity into daily life. I decided that I wanted to use what I had learned over the years and share it with my co-workers, so I created a contest.

In the winter of 2013, the Dawson Creek and Fort St. John health units challenged the Smithers and Terrace health units in the first ever internal Workplace Wellness “Healthier You Challenge.” This challenge was a fun, in-house 12-week pilot project designed around the Northern Health position papers. The focus of the challenge was to educate and engage staff on incorporating healthy lifestyle behaviours into their everyday routines.

Between the four health units, over 100 staff committed to the challenge. Each week I sent out a new worksheet that explained the week’s challenge. The “weekly” challenges were designed to get you moving and start thinking about healthy food choices.

The physical activity component was based on the key message that every move counts. This theme was carried over from week to week. Anytime an employee participated in any form of physical activity for 10 minutes or more, they logged that into their worksheet and gained points for their team. Participants also gained points for every kilometre travelled and/or steps that they took for the day. I got lots of motivation from B.C.’s Physical Activity Line.

The food challenges were based on Canada’s Food Guide and provincial initiatives. These changed week to week. Examples included eating vegetables and fruit, and reducing the amount of trans fat and high sodium foods that were consumed.

One of the big successes of the challenge was the creation of the “Break Challenge.” During the challenge, employees were encouraged to participate in some sort of physical activity for 15 minutes while at work. Each day a group of staff from the Dawson Creek Health Unit could be found outside walking around on their coffee breaks. It was common on the really cold days to find staff lunging, frog jumping, or walking in the hallways. At the end of Week 1, employees had participated in 342 physical activity breaks, 306 hours of physical activity, and had walked 2097 kms.

At the end of the challenge I surveyed participants, asking them what they liked best about the challenge and what changes they had made in their workplace as a result of the challenge. Some of the comments were:

  • Breaking down the challenge week by week made it feel more manageable and seem less daunting. I also liked the fact there was a different challenge each week.
  • For me the best part of the challenge was the joining of the individuals in our health unit to challenge each other in a supportive environment.
  • Able to critically look at the everyday and identify small opportunities for positive change vs. drastic and likely short lived changes.

This is the challenge that I developed for my fellow co-workers. It was fun and really got people engaged. For more information on some of the weekly challenges, or to find out which health unit won bragging rights, make sure to keep an eye for my future updates on the Northern Health blog. Alternatively, if you are looking for a workplace wellness program that your workplace can join, we encourage you to look at the Canadian Cancer Society’s Wellness Fits program.

Crystal Brown

About Crystal Brown

Accepting a position as an Environmental Health Officer with Northern Health, Crystal Brown moved from Nova Scotia to Dawson Creek in 2004. Since then, Crystal has developed an interest in health promotion and how our built environments impact our health. As the B.C. Branch President-Elect since 2011, Crystal works provincially and nationally with the Canadian Institute of Public Health Inspectors to promote the mission statement and maintain the integrity of public health. In this, she also participates in initiatives that will help to strengthen and advance the profession. To stay active, Crystal attends a morning outdoor boot camp, runs and walks her dogs. In August, Crystal participated and completed her first ever Emperor's Challenge in Tumbler Ridge, B.C.

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