National Nursing Week

C M Y K NURSING WEEK NATIONAL 4 WINNIPEG FREE PRESS - SATuRDAY, MAY 10, 2014 Chronic-care units are not typically associated with hope and healing. But the nursing team at Deer Lodge Centre has worked hard to change that perspective — and they've changed lives in the process. Clinical resource nurse John Prefontaine has seen remarkable improvements since he began working in the 44-bed chronic-care unit called Lodge 6 two years ago. "Chronic care used to be a destination for pa- tients with chronic needs, but there wasn't a lot of expectations that they were going to improve in their conditions," he says. "It was really more of a place to decline. That was anticipated." Many Lodge 6 patients have end-stage diseases that may require dialysis, feeding tubes or breathing tubes. Some patients may need help with every- thing from washing and feeding to sitting up and turning over in bed. No matter what type of complex care a patient requires, the overall goal is the same for everyone. "Our mission has been to try to figure that pa- tient out and to bring them up to the optimum health level," Prefontaine says. Both Prefontaine and his manager come from an intensive-care background, and they bring a new perspective to chronic care. "It's just a different way of thinking. I like to call it continual care. In an acute-care setting, you evalu- ate a patient and you try to make changes to the patient's care plan. That's the kind of nursing model that we're using. Coming from acute care, we looked at what we could do to make our patients' health better," he says. "One of our missions at Deer Lodge Centre is to make lives better. And my vision is patient-centered care, so that's the vision we use. We look at the patient and we try to make some changes that would better their health. We really have to involve the family to provide optimum care." Prefontaine supervises a team of 52 health-care providers. They've seen steady improvements in quality of life for Lodge 6 patients, whose average age is between 55 and 65. "We had a total of four patients in 2013 that were able to remove their feeding tubes. They were actually eating. That is rare in chronic care. At one time, you would just take for granted that they would be with their feeding tube for the rest of their days," he says. "We've also had people that we've assessed for swallowing. They still have their feeding tubes, but they're able to take nourishment by mouth also. They don't eat enough to maintain their health, but they're able to get some from their feeding tube and some orally. There's another five people in that cat- egory." As well, staff were able to remove breathing tubes for another five patients last year. "Some of those tubes have been in a very long time. Some of those people now are actually eating and talking," Prefontaine says. "It's quite remarkable that somebody would take their first bite of food after years of not being able to do that." Every nurse on the floor is sent to wound-care seminars, and they use a new system to evaluate skin. Since 2012, nurses and health-care aides have worked together to reduce the number of pa- tients with wounds from 36% to 6.8 % — a dra- matic improvement. "They're not just surviving anymore, but they're actually thriving. We have to invest the time. My duty is to invest my efforts to make optimum care. I'm here to do that. We work on it on a daily basis in Lodge 6," Prefontaine says. "The staff here is absolutely wonderful. We've made an investment in our patients. It takes the nurses. It takes the health-care aides working with us, but it also takes the entire health-care team." Some patients have even made the transition out of chronic care and back into the community. "They might go home with home care. We have some gentlemen that are going to an assisted living arrangement. We've also had some patients that may go to a personal care home. That's something that wasn't happening in chronic care, so it's quite exciting to us." Along with two colleagues, Prefontaine is writing a feature article on their nursing model for a Can- adian Nurses Association (CNA) publication. They've been asked to present their work at a CNA annual meeting and biennial convention, which will be held in Winnipeg in June. As part of their research, they reviewed charts from 2013 and found that 24 of 73 patients experi- enced a reduction of their chronic-care indicators or had them removed entirely. "That's the new beginning for some of these people. They thought they were coming to chronic care to stay here for the rest of their days. In fact, their quality of life has improved. They're going to have different living arrangements, so that's very exciting," Prefontaine says. "It really comes back to making lives better. You always need to strive for that. These are people that we're dealing with, and we have an obligation to provide the optimum health that we can." New Lease on Life Chronic-care patients aren't just surviving, they're thriving By Jennifer McFee – For the Free Press Photo by Darcy Finley Clinical resource nurse John Prefontaine and his team bring hope to patients at Deer Lodge Centre.

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