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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Drop and give me twenty!

Army patch

The shoulder patch of the 1 Canadian Mechanized Brigade Group. Reg was a part of Lord Strathcona’s Horse (Royal Canadians), which is an armoured regiment in the brigade. There, he learned a lot about motivation and physical activity!

The New Year is upon us and no doubt many of us are setting goals to become more physically active. If you’re one of those people, I have a question for you: How motivated are you?

If you don’t feel motivated, have you thought about joining the army? I can tell you from experience that it works! But why does it work so well?

One is that the army ensured that I got regular physical exercise. No matter what the weather, there was always the physical training that I took part in, no exceptions, no complaints allowed.

Second, the army has a set of specific goals and objectives that I was expected to meet. It has very specific, measurable goals, like being able to run a kilometer within a certain amount of time. Not to mention pushups!

Soldiers marching

Footage from Reg’s graduation parade.

And then there was the built-in motivator, otherwise known as the Master Corporal (the Canadian version of the Drill Sargent in basic training). He was the guy barking at me as I moaned and groaned my way through the obstacle course. Master Corporals weren’t always nice in their “motivational methods,” but you know what, for me, it worked. I ran that kilometer and did those pushups. I made it through the obstacle course.

Then again, it’s not necessary to join the army if you’re looking to get more physically active. But in reflecting on my own time, I think that some of the principles are the same and definitely taught me a lot. You need to make time for physical activity and do it. You need to set SMART goals and strive to reach them. You need to find your motivation.

I often see the scale or body measurements used as motivators. While it’s important to measure your progress towards your goals in other ways (like how many minutes of activity you did today), don’t get hung up on those numbers. Health is measured in more ways than pounds or inches. For some, buying something special upon reaching a milestone can be a motivator. However, that might not work in the end and it’s possible that your motivation may falter between milestones.

So, what are you to do?

Motivation needs to come from within if it’s going to last. Here are some suggestions for building up your motivation:

  • Make sure that you find ways to be active that you enjoy. Find activities that keep you coming back.
  • Focus on the experience. Enjoy the surroundings if you’re outside. Enjoy the camaraderie of team sports. Enjoy the solitude if you’re on your own.
  • Learn to recognize and appreciate the health benefits of being active. Enjoy your improved mood and increased energy.
  • Engage in physical activity as a way to reward yourself. A nice walk down a forest trail is a great way to relax after a long day at the office.
  • Keep challenging yourself. Walk an extra ten minutes or lift that extra ten pounds.
  • Acknowledge and celebrate your successes.
Medal

A medal from Reg’s time peacekeeping in Cyprus. What did his time in the army teach him about physical activity and setting SMART goals?

It can also help to let people know about your goals and ask them to help you stay on track. If your motivation slips a little, they’ll let you know (sort of like the Master Corporal did for me!).

I have to admit, writing this blog rekindled some great memories from the old army days.

Q: Is having a Master Corporal shouting in my ear one of them?

A: No.

Q: Would I push harder if he was standing there “motivating me?”

A: You bet I would.

As much as I enjoy the memories and the lessons, I’m not re-enlisting in the army for the motivation – not even for the food or the cool uniforms! But I’ll definitely use the things I learned about motivation to stay physically active in 2016!

The only person responsible for motivating you to be physically active is you.

Unless you join the army, and they take that responsibility very seriously, even when you don’t.

Reg Wulff

About Reg Wulff

Reg is a licensing officer with Northern Health and has his BA in Health Science. Previously, he worked as a Recreation Therapist with Mental Health and Addictions Services in Terrace as well as a Regional Tobacco Reduction Coordinator. Originally from Revelstoke, Reg enjoys the outdoor activities that Terrace offers, like mountain biking and fishing. Reg also likes playing hockey, working out, and creative writing. He is married and has two sons and believes strongly in a work/life balance as family time is important to him.

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20 minutes a day: for my dog, or me?

Dog laying in grass

Abby laying in the shaded, cool grass after a good exercise and training session.

How many times have you heard the phrase, “consistency is key”? I’ve heard it lots in the context of physical activity for myself and my own healthy eating. However, since I’ve become the proud owner of my pup, I’ve also heard it in the context of dog training.

I want to be consistent with my pup’s training and, because there are only 24 hours in a day, I have to find ways to make it healthy for me, too. I want to work smarter and not harder, so I find ways that I can incorporate the two activities – my health and my pup’s training. More motivation for me to get off the couch and more motivation for me to be consistent with my dog training. Win-win, right?

I’d be lying if I said it is easy or convenient. It is certainly something that I have to work on. Every. Single. Day.

It’s so much easier to take her for a leisurely walk than to work on the training, but if I want to keep training as a focus, it has to happen.

Three dogs laying in grass outside of home.

Abby laying in the backyard with her friends from the neighbourhood, “Ronin” the St. Bernard and “Oscar” the Boxer. Their play time counts towards her active time (some down time for me!).

My dog trainer recommends 15-20 minutes per day to focus on training and to make it fun. There are lots of benefits to me for this investment:

  • Get outside
  • More obedient dog
  • More quality time spent with my dog can lead to a better overall relationship
  • Sunshine (Vitamin D) (depending on where you live!)
  • Fresh air

As a bonus, I’m rarely back in the house after those 15-20 minutes. The training usually just pulls me away from zoning out on the couch after work. And, as much as I want to do this some days, my commitment to working with her forces me to go outside and look at the trees, hear the birds, and explore the nooks and crannies of my yard and my neighbourhood. We poke around in the yard together, I can pull a few weeds (better gardens!), explore the neighbourhood trails for signs of new wildlife (I live in a rural area and will commonly see signs of moose, deer, coyotes and more), meet and chat with my neighbours (social interactions and building community), and – last but not least – I get a lot more physical activity than I would otherwise (more steps on my tracker!).

Sneaker next to moose track in dirt.

Fresh moose track on the trails behind our house.

I’m not saying that a dog will give you all these benefits. My dog is a lot of hard work and she is a serious commitment (one that doesn’t go away in the dead of winter in -20 C!). Daily, I have to find ways to keep her and I motivated to keep active and socialized. But, getting her is truly one of the best decisions I’ve ever made.

Do you have a dog? How does s/he help you and your health?

If you don’t have a dog, what kinds of things do you do to prompt you to get health benefits or do healthy things?

Chelan Zirul

About Chelan Zirul

Chelan Zirul is the Regional Manager for Health Promotions and Community Engagement for Northern Health. As a graduate from UNBC, she did her Master's of Arts in Natural Resources and Environmental Studies. She explored regional development decision-making and is an advocate for policy that is appropriate for the needs of northerners. This, combined with her personal interest in health and wellness, drew her to work in health communications. Born in northern B.C., she takes advantage of the access to outdoor living. She enjoys hunting and exploring the backcountry with her dog and husband and enjoys finding ways to use local foods.

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