National Nursing Week | 2018

A SUPPLEMENT TO THE WINNIPEG FREE PRESS | THURSDAY, MAY 3, 2018 | VIEW ONLINE AT winnipegfreepress.com/publications

NATIONAL NURSING WEEK 2018 MAY 7-13, 2018 cna-aiic.ca

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MANY PLACES. REAL IMPACT. #YESThisIsNursing

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INNOVATORS, CAREGIVERS, EDUCATORS AND MORE CELEBRATING THE MULTITUDE OF PROFESSIONAL ROLES NURSES PLAY IN HEALTH CARE

N ational Nursing Week is held each year during the week of May 12, coinciding with the birthday of Florence Nightingale, who is seen as the founder of the profession. For the second year, the national theme is #YESThisIsNursing, a hashtag that acknowledges the growing role of technology in nursing, as well as the wide range of roles nurses play in every area of health care, as registered nurses and nurse practitioners, licensed practical nurses and registered psychiatric nurses.

transmitted diseases and diabetes. “It will take two years for that to be fully implemented. It’s already underway, and there’s some education that registered nurses need to take. In those three areas, they will be able to prescribe medications that are required by the individuals they care for,” Stansfield says. “They will be working within a collaborative environment, but they will be able to prescribe for those patient populations on their own. It increases the accountability of registered nurses and gives them credit for their knowledge and skills.” As a result, patients will benefit from improved access to care, especially if the nurse is the first person they encounter in the health-care system. “That nurse can then move forward with a plan of care so the rest of the team can benefit from the information when they come together,” she says. “Registered nurses are always ultimately focused on what is best for the patient and what is the right and safe care for the patient. Within the RHPA, the focus is to create balance between access and safe, quality care.” Registered nurses pursue four years of baccalaureate education, and nurse practitioners also take a master’s degree program. Currently, 13,004 registered nurses and 203 nurse practitioners are registered in our province. Both groups fall under the oversight of the College.

“As a regulator, we’re the ones that hold nurses accountable on behalf of the public. We work together with registered nurses to achieve that mandate,” Stansfield says. “They work to protect the public by providing quality nursing care and through the support and practices that we encourage at the college, the public can be very secure that the registered nurses are providing quality care.”

of three post-secondary institutions: Assiniboine Community College, University College of the North and Université de Saint-Boniface. Internationally educated nurses have the option to take a different route. “They can be assessed by us to compare their educational competencies to the Manitoba LPN,” Breton says. “We have a clinical competency assessment and we also have a bridging program called the Practical Nursing Qualification Recognition Program.” For both components, the College works in partnership with Manitoba Health, Seniors and Active Living as well as Assiniboine Community College. “An internationally educated nurse can go through this bridging program and come out with the same competencies as a Manitoba- educated LPN. Both of those groups have to write and pass the national exam to get into the profession,” Breton says. “When our internationally educated nurses write the Canadian Practical Nurse Registration Exam, they consistently get the same scores as the Manitoba-educated, which are usually the highest success rates in the country.” Manitoba has approximately 3,400 active practising LPNs. The College also regulates graduate practical nurses and student practical nurses, which adds about 200 more registrants.

COLLEGE OF LICENSED PRACTICAL NURSES OF MANITOBA

COLLEGE OF REGISTERED NURSES OF MANITOBA

Licensed practical nurses (LPNs) provide safe, competent, ethical care across the spectrum, from birth to end of life. They work in a multitude of settings, including home care, long-term care and clinical areas. LPNs can be facility managers, case co-ordinators, research assistants and much more. “The public puts trust in nurses. They impact people and their families when they are at their most vulnerable,” says Jennifer Breton, executive director of the College of Licensed Practical Nurses. “All nursing groups co-ordinate the care being provided to the public, and that trust is given wholeheartedly.” The path to becoming an LPN in Manitoba begins with a two-year diploma program at one

Times are changing for registered nurses, who will soon have an expanded scope of practice under the Regulated Health Professions Act (RHPA). “We are now working towards the deadline of May 31 for implementation, so it’s a very exciting time for registered nurses in Manitoba,” says Katherine Stansfield, executive director of the College of Registered Nurses of Manitoba. “It acknowledges the scope of knowledge and skill that registered nurses bring to their practice every day.” Soon, registered nurses will become authorized prescribers in the areas of travel health, sexually

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IN CELEBRATION OF NATIONAL NURSING WEEK, the CLPNM would like to recognize the dedication and contribution

LPNs make to the health and wellness of all Manitobans.

The CLPNM is the regulatory body that governs the practice of student practical nurses, graduate practical nurses, and licensed practical nurses in Manitoba.

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#YESThisIsNursing MAY 7-13, 2018 NATIONAL NURSING WEEK 2018

“AS RAPID RESPONSE NURSES,WE CONDUCT

ASSESSMENTS AND CARE PLANSTHAT HELP CLIENTS UNDERSTANDTHEIR DISEASE PROCESS, HOW TO MANAGE THEIR SYMPTOMS,WHY THEIR MEDICATIONS ARE IMPORTANT, AND WHEN TO ASK FOR HELP...”

Dawn Siegers, one of nine registered nurses in the Rapid Response Nursing Program.

PHOTO BY NATASHA WOLOSCHUK / WINNIPEG REGIONAL HEALTH AUTHORITY

RAPID RESPONSE NURSING HELPING PATIENTS SELF-MANAGE CHRONIC CONDITIONS AT HOME By Mike Daly / Winnipeg Regional Health Authority

It’s a safe bet that no health-care facility ever topped anyone’s list of favourite places to visit. That’s especially true for people living with lung disease, congestive heart failure, diabetes, asthma, hypertension or other chronic conditions that can frequently land them in an emergency room, hospital bed or urgent care centre. “The clients I see want to remain in their homes and they want assistance in identifying the resources they need to do so,” says Dawn Siegers, a 26-year nursing veteran and one of nine registered nurses from the Rapid Response Nursing program, which was launched in 2017 by the Winnipeg Regional Health Authority. Targeted to clients being discharged from in-patient units, emergency departments, urgent care or clinical assessment units, Rapid Response Nursing is a short- term home care service that supports a successful discharge home, with prompt interventions that can help avoid any unnecessary returns to hospital. These interventions may include ensuring prescriptions are filled and taken as instructed, follow- up doctors’ visits are made and kept, and ongoing medical assessments continue during the crucial first few weeks after a client leaves hospital. The goal is to improve the client’s ability to self-manage symptoms and remain safely at home.

Achieving that goal benefits both the client and the health-care system. “It’s an advantage for people to remain in their homes for as long as possible. Evidence shows that it leads to improved patient outcomes and improved quality of life,” Siegers says. It’s also less costly to the health-care system when clients are using emergency departments or acute care facilities only when it’s appropriate. “As Rapid Response nurses, we conduct assessments and care plans that help clients understand their disease process, how to manage their symptoms, why their medications are important, and when to ask for help. We can help connect them with appropriate resources and supports, and provide them and their caregivers with the information they need to manage common symptoms, such as shortness of breath and dizziness, without the need for them to access an emergency room or acute care facility.” Clients are referred to the program by hospital or community-based case co-ordinators. “I have one client who has used the emergency room 11 times this year and another who visited the emergency room five times in the last four months,” Siegers says. “In addition to the inconvenience and disruption, it can be very costly for them, since they don’t always have coverage for emergency services such as ambulances and are paying out of pocket.” Frequent trips to an emergency room can often be

avoided when the client is provided with the information and resources they need to manage their condition at home. “Clients thrive when they have appropriate information and resources,” Siegers says. “Various ‘what if’ scenarios are meticulously described in the care plan to help ensure their safety, so they understand that to remain in their home they will need to monitor their symptoms and know when they have to seek additional medical support.” The program is a great example of the results that can be achieved when a good plan comes together. “I absolutely love this new position and find it very rewarding,” Siegers says. “I’ve always enjoyed community-based health care and enjoy helping people maintain their independence in the communities in which they live for as long as safely possible.” Her clients are big fans of the program too. “When we’ve placed the proper supports in place, they feel very empowered,” Siegers says. “We’ll notice that they are laughing more and there’s an ease where, previously, they may have been having difficulties coping. People are most happy when they are at home and they are so appreciative of the services we provide.” ✚

REGISTERED PSYCHIATRIC NURSES

From Our Team To Yours

Professionally educated to help Manitobans achieve the highest possible level of mental health. Their contributions to our community are vital, and often surprising and unique.

As we recognize National Nursing Week, the Flight Nurse team at STARS’ Manitoba Base salutes our fellow nurses throughout the province. We are proud to be part of the critical care chain in Manitoba and proud to fight for life alongside the talented professionals in our province. From our team to yours, thank you!

The CRPNM is the regulatory body for the psychiatric nursing profession in Manitoba crpnm.mb.ca

STARS.CA

WINNIPEG FREE PRESS - THURSDAY, MAY 3, 2018

#YESThisIsNursing MAY 7-13, 2018 NATIONAL NURSING WEEK 2018

PHOTO BY NATASHA WOLOSCHUK / WINNIPEG REGIONAL HEALTH AUTHORITY DELIVERING THE RIGHT CARE

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Reflecting on the national theme #YESThisIsNursing, Breton foresees an exciting future for nurses. “LPNs have always been nimble to make sure they work within the system as the population’s needs change,” she says. “The profession changes to keep moving forward, and technology is just another changing aspect in the field of practical nursing. Nurses play a role in the evolving technology.” As both an RN and an LPN herself, Breton offers a unique perspective on the profession. “I’ve been nursing for almost 30 years,” she says. “It’s like a candy store — once you step in, you won’t know what to choose because there are so many options.” COLLEGE OF REGISTERED PSYCHIATRIC NURSES OF MANITOBA Registered psychiatric nurses take a uniquely holistic approach to patient care. “We try to look at the entire person because we need all of those pieces to be healthy. It’s about their physical and mental well-being but also their social, emotional, cultural and spiritual well-being,” says Isabelle Jarrin, president of the board of directors of the College of Registered Psychiatric Nurses of Manitoba. “RPNs have the education and knowledge to provide that approach. We want to collaborate with our clients and families and communities. We see ourselves as partners in their care.” The College of Registered Psychiatric Nurses of Manitoba is preparing to come under the Regulated Health Professions Act in the future, she adds. “We are one of the three regulated nursing professions in Manitoba, along with LPNs and RNs. We have a lot of similar core base competencies and nursing background, but the education is different. Our education is more focused on mental health,” Jarrin explains. “The undergraduate program leads to a bachelor of science in psychiatric nursing. It is offered through Brandon University, and they have a Winnipeg site as well.” With more than 1,000 RPNs in Manitoba, the majority work in mental health with individuals, families, groups and communities. Others work in long-term care, such as personal care homes and geriatric rehabilitation. Although nurses often tend to shy away from attention, National Nursing Week provides an opportunity to pause and appreciate all they do. “We’re very collaborative, so it’s an opportunity to celebrate one of the professions that’s part of the health-care team. Because we have RPNs and RNs and LPNs at the table, it’s well-rounded care — and that’s a strength for our clients and our families.” RPNs can also take pride in the fact that they make up the largest single group of regulated mental health professionals in the province. “In terms of the impact that RPNs bring, we see ourselves as collaborative and we bring a holistic approach. It goes along the whole spectrum,” Jarrin says. “There’s mental health promotion and well-being, and on the other end of the spectrum, there is illness. It’s about navigating and meeting the person wherever they’re at.” ASSOCIATION OF REGISTERED NURSES OF MANITOBA Created by nurses for nurses, the Association of Registered Nurses of Manitoba (ARNM) was incorporated in January 2016. “We are the professional voice of registered nurses in Manitoba. The professional association is required with our Regulated Health Professions Act that was brought forward through the government,” says executive director Mary Smith. “Three years ago, a very dedicated, passionate group of nurses said we need to have that collective voice, and we need to be able to advocate for the profession and continually promote professional development. That is basically the mandate of the association.” Today, ARNM represents more than 87 per cent of registered nurses in Manitoba. “It’s voluntary, so we are very happy that they see the value in being a member. As a profession, it’s part of our professional responsibility to support and be part of that collective voice,” Smith says. “We are also the jurisdictional member for the Canadian Nurses Association, which is our national body, and for our professional liability protection that all nurses practising in Manitoba are required to have,” she adds. “Nurses turn to us for advocacy. If there are questions or concerns they might have about the health-care system or their professional development, we are here for them. We are a small staff, but we have the ability to connect with all our members who have tremendous expertise.” Members can access online resources through the association’s website. It also offers professional development opportunities that members can access in person or remotely from across the province. “That whole idea of lifelong learning is so important because health- care issues change so frequently. We want to keep nurses well informed on trending topics so that we are effectively involved,” Smith says. “Our association feels that the work we do is ultimately to improve the health outcomes of Manitobans.” During National Nursing Week, the association will launch a nomination process for nursing awards.

NURSES MAINTAIN MOTIVATION IN CHANGING HEALTH-CARE SYSTEM By Mike Daly / Winnipeg Regional Health Authority

Grace Hospital nurse Julie Miller has been on the front lines of health-care system changes aimed at providing the right care, in the right place, at the right time. But her overall goal, and that of her colleagues, has remained the same.

“Even with all of the systemic changes taking place in the health-care system, patient safety remains our number one priority,” Miller says. “It’s very important that we all work together to ensure everyone is getting the care they need, and that it’s being done safely and efficiently. Our role is to help get people back home where they want to be.” Now entering her eighth year at the Grace Hospital, Miller is one of three professionals on her floor filling a newly created role as clinical resource nurse (CRN). “The role is fairly new to the medicine program,” Miller says. “Part of my role is to provide leadership to staff and to ensure we are following clinical practices and guidelines. I also act as the liaison between staff, physicians, and the unit manager to make sure clinical orders are being completed and patients are receiving optimal care. “In the long term, I see the role turning into something where nurses come up to me whenever they have difficulties with a new procedure or they want someone to coach them through something. I see it as a pivotal role in managing the flow and getting patients the care they deserve.” Teamwork remains critical to success, she says. “We are a clinical teaching unit, so we have nurses, medical students and residents, attending physicians, and specialists such as home-care co-ordinators, physiotherapists, occupational therapists — all the specialties needed to help a patient return to their health baseline. Because we’re all busy with respect to the activities involved in our own disciplines, we need to take the time to meet together and make sure that everyone is doing what’s required. Communication is the biggest key to success. Without it, things may be missed and not get done.” Grace Hospital is one of the three fully acute hospitals (the others being Health Sciences Centre Winnipeg and St. Boniface Hospital) where emergency and acute services are being consolidated to enhance 24-7 access to specialist care and diagnostic services. “The advantage to patients is that by concentrating on acute care, we’re more quickly getting them back home, where they want to be, supported with resources,” Miller says. “Those who are waiting in emergency for a room don’t have to wait as long, and that’s an advantage for them.” The challenge, she says, comes from staff and patients getting accustomed to Grace Hospital’s new focus on acute care. “The biggest change from when I started eight years ago is that people stayed in hospital longer and stayed in the same hospital, no matter what their acuity level was. Now, there are new services and places they can go to receive the optimal level of care they need at different stages of their healing journey. We tell our patients that we will handle the acute portion of their care, but when that’s complete, they may move to a sub-acute bed at, say, Victoria Hospital because they may need a

little bit of time to improve their mobility, or because more time is required to wean them off of oxygen. Or they may become a Priority Home patient, where they’ll receive care that can help ensure they are managing well at home. They’re still going to receive all the care they need, but it may not all happen at the Grace. Once we’ve explained it that way, patients better understand why these changes are taking place.” Overall, Miller says it’s a more efficient system that benefits the patient. “Efficiency has been added to the system. It’s a little challenging to nurses and other staff now, because these changes are still new to us. We need time to learn what our resources are and how they can be accessed, but at the end of the day, once it’s all flowing and working optimally, it’s going to be great.” And, throughout all the changes, the rewards

of being a nurse remain intact. “It’s a lot of work, but in the

end you are seeing patients at a very vulnerable time in their lives, and you’re there to help them through it. That is something not everybody gets to do, and it’s very rewarding.” ✚

“For Nursing Week, we also plan to get out as much as we can to engage and consult with our members,” Smith says. “It’s a wonderful opportunity to celebrate nursing excellence.” ✚

Julie Miller fills a newly created role as a clinical resource nurse at the Grace Hospital. PHOTO BY NATASHA WOLOSCHUK / WINNIPEG REGIONAL HEALTH AUTHORITY

Happy National Nursing Week! Celebrating the profession of nursing and the dedication of our members. arnm.ca

The Professional Voice of Registered Nurses

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#YESThisIsNursing MAY 7-13, 2018 NATIONAL NURSING WEEK 2018

LIKE A BREATH OF FRESH AIR INNOVATIVE TEAM HELPS CHILDREN AND FAMILIES BATTLE ASTHMA AND ALLERGIES By Mike Daly / Winnipeg Regional Health Authority

“ASTHMA CONTROL IS AN ACHIEVABLE GOAL, SO CHILDREN WITH ASTHMA TODAY SHOULD NOT BE IMPACTED THE WAY THEY WOULD HAVE BEEN 20 YEARS AGO.”

Registered nurse and certified asthma educator Nancy Ross. PHOTO BY NATASHA WOLOSCHUK / WINNIPEG REGIONAL HEALTH AUTHORITY

Registered nurse and certified asthma educator Nancy Ross is proud to be part of a team helping children and families dealing with asthma and food allergies breathe a little easier and lead healthier, more active lives. Working alongside allergists, nurse clinicians and certified asthma educators at the Children’s Allergy & Asthma Education Centre (CAAEC), located across the street from the Children’s Emergency department, Ross and the CAAEC team help ensure that a diagnosis of asthma or food allergy doesn’t result in living life on the sidelines. “With the right information, medications and proper compliance with treatment plans, children with allergic diseases can live healthy, active lives,” Ross says. “They can even play high- level sports without having asthma interrupt their lives.” Asthma, she explains, is a common, chronic respiratory condition where the airways in the lungs get inflamed and swollen muscles around the airways tighten, causing difficulty in breathing. It usually begins in childhood and is typically associated with allergy, eczema and

food allergy. There has been a dramatic increase in allergic diseases over the past 20 years. “Six to eight per cent of Canadian children have food allergies,” she says. “Asthma currently affects about 12 per cent of children in Canada.” The good news is that as the prevalence of allergic conditions has increased, so too has knowledge about how best to treat them. “Through research, we’ve learned so much more about asthma and have improved medications to treat it,” Ross says. “Asthma control is an achievable goal, so children with asthma today should not be impacted the way they would have been 20 years ago.” Another major change over the past number of years is the availability of information that can help families keep asthma and allergies under control. That’s a particular point of pride for the CAAEC, which has been working hard to maximize the power of the Internet and social media to keep families informed. “These days, people have access to a lot of information through the Internet, but not all of that information is correct or evidence-based,” Ross says. “One of our challenges is making sure that we’re a reliable presence on the Internet and social media. We are able to offer people the kind of accurate, safe and up-to-date information they need to manage their child’s asthma or food allergy. We have developed a website (www. caaec.ca), Facebook page, and a Twitter account. We’ve also developed, with the assistance of the

Children’s Hospital Foundation, short videos on our YouTube channel that can help families get quick, easy-to-digest information about managing a child’s asthma, medication, asthma triggers, eczema and food allergies.” A new gaming app, called KungFood and developed in collaboration with Food Allergy Canada, is also nearing completion. Developed with funding from AllerGEN (a national research network established in 2004 by Innovation, Science and Economic Development Canada) and the Children’s Hospital Foundation of Manitoba, KungFood was created by Winnipeg- based Tactica Interactive to help children and young teens with food allergies. The app allows users to earn belts as they work through trivia and allergy scenarios. The goal is to increase knowledge and their confidence with food allergy. The app also provides food-allergic teens with an allergy alert tool that allows them to share information about their allergy with friends. “I think that what we offer families is unique,”

Ross says. “We have a great team that’s really working on education and prevention to keep kids healthy and that’s something that, as a nurse, I find very fulfilling.” That information and education is a vital resource for families. “We want to improve quality of life by giving families who attend our education sessions the confidence and support they need to effectively manage their child’s asthma or allergic condition,” Ross says. “Success for us is seeing active and healthy children with good asthma control, and knowing that we’re helping families who live with food allergy to find that balance between risk and safety live a healthy life. “It’s very satisfying to see somebody who, maybe the year before, couldn’t play sports or who was struggling with sleep issues related to poor asthma control, come back and say that they’re doing great and are healthy and active. That’s very rewarding.” ✚

Learn more at www.caaec.ca

WINNIPEG FREE PRESS - THURSDAY, MAY 3, 2018

#YESThisIsNursing MAY 7-13, 2018 NATIONAL NURSING WEEK 2018

PSYCHIATRIC NURSING USING TECHNOLOGY, THERAPIES TO TREAT MENTAL HEALTH ISSUES By Mike Daly / Winnipeg Regional Health Authority As she was training in university to become a registered psychiatric nurse, Sara Wikstrom looked forward to the day when she’d be able to guide patients along the road to improved mental health.

What she didn’t know was that she’d soon be working on the forefront of a new technology —repetitive transcranial magnetic stimulation (rTMS) — that’s yielding promising results in patients with mild to moderate depression. “I’ve always been interested in psychiatric nursing and my goal was to work in an outpatient department, helping people in the community who were dealing with mental health issues,” Wikstrom says. “rTMS was something I was unaware of as I was training, but a position became available that allowed me to get a foot in the door, and it ended up being something I’m really excited to be a part of.” rTMS uses a concentrated magnetic field to produce pulses that activate neurons firing in a small area of the brain’s frontal lobe that is believed to be related to symptoms of depression. It is non-invasive and the patients are awake the entire time. They can talk, drive after treatment, and unlike electroconvulsive therapy (ECT or shock therapy), there are no memory loss concerns, issues with dizziness or loss of consciousness. A headache is the most common side effect. Through research conducted by Dr. Mandana Modirrousta, director of the Neuromodulation and Neuropsychiatry Unit at St. Boniface Hospital, Wikstrom is able to explore the use of rTMS treatment with her patients. “Our positive response rates are somewhere in the 60-65 per cent range,” Wikstrom says. “As a treatment option, it’s really the new kid on the block and a relatively new technology in the field of psychiatry. It’s not a perfect fit for everybody, but it’s nice to see this option available.” Wikstrom has been part of the rTMS program since its inception at St. Boniface Hospital in 2012, splitting her time between that team and managing a caseload of about 40 patients for a variety of services that include medication management, resource connections, psychotherapy and cognitive behavioural therapy. No matter the treatment methodology she employs, Wikstrom says her ultimate goal remains the same. “The rewards of being a psychiatric nurse flow from helping patients meet their mental health goals, whatever they may be,” she says, adding that the range of patients she sees defies categorization. “I see patients from all walks of life,” she says. “Mental health issues don’t discriminate and it’s something that everyone is going to experience at some point in their lives, either with themselves, a loved one or close friend. It’s going to touch all of us at some point.” Nevertheless, she adds, the stigma around mental health issues is only slowly dissipating. “There’s still a lot of stigma surrounding mental health and many people are still

hesitant to seek out treatment,” Wikstrom says. “I’ve seen that changing slowly over the course of my career and there are a lot more awareness drives in the community,” she adds, including initiatives such as Bell’s Let’s Talk and advocacy efforts like the Winnipeg Jets’ Hockey Talks initiative, a national awareness campaign for Canadian

Registered psychiatric nurse Sara Wikstrom says no one should suffer in silence.

PHOTO BY NATASHA WOLOSCHUK, WINNIPEG REGIONAL HEALTH AUTHORITY

COLLEGE OF NURSING

NHL teams designed to encourage conversations about mental health.

“When you get celebrities involved, you can see that there are people who are very successful in life that are struggling and overcoming mental health concerns every day. So it’s slowly changing, but there’s still a lot of stigma and a lot of resistance at times “THE FASTERYOU CAN DIAGNOSE A MENTAL ILLNESS,THE FASTER YOU CAN FIND A SOLUTION, WHETHER IT’S A MEDICATION REGIME, A NEW TECHNOLOGY SUCH AS RTMS, OR SOME SORT OFTHERAPEUTIC ALLIANCE WHERE YOU CAN SPEAKTO SOMEONE ABOUT WHAT’S GOING ON. SO, IF YOU ARE HAVING ISSUES WITH YOUR MENTAL HEALTH, DON’T SUFFER IN SILENCE. REACH OUT to seeking out mental health services.” Overcoming that resistance is an important factor in early intervention and better outcomes, she says. “The faster you can diagnose a mental illness, the faster you can find a solution, whether it’s a medication regime, a new technology such as rTMS, or some sort of therapeutic alliance where you can speak to someone about what’s going on. So, if you are having issues with your mental health, don’t suffer in silence. Reach out to anyone who might listen. “Family physicians are great resources. Seek help soon. Just as if you find a cancer tumour in an early stage, or recognize the warning signs for chronic illnesses like diabetes or high blood pressure, your chances for a positive outcome for a mental health issue is likely going to be a lot higher when you access diagnosis and treatment earlier.” ✚ TO ANYONE WHO MIGHT LISTEN.”

YES, THIS IS NURSING

THE COLLEGE OF NURSING AT THE UNIVERSITY OF MANITOBA IS PROUD TO CELEBRATE NATIONAL NURSING WEEK, MAY 7-13, 2018. We congratulate all nurses in Manitoba for your dedication and commitment to the advancement of the profession of nursing and excellence in health care. Thank you for your support and mentorship of our nursing students. As education leaders, we are committed to promoting excellence and preparing our nursing students through hands-on clinical practice and state-of-the-art technology, to bring their best to their patients. It is our honour to grow the profession by educating our province’s future nurses.

umanitoba.ca/nursing

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#YESThisIsNursing MAY 7-13, 2018 NATIONAL NURSING WEEK 2018

PRIORITY HOME CARE PROGRAM HELPS NURSES IMPROVE PATIENTS’ QUALITY OF LIFE By Mike Daly / Winnipeg Regional Health Authority

Case co-ordinator Melinda Homola helps patients recover at home.

It’s only been a few months since the Winnipeg Regional Health Authority’s Priority Home program debuted, but it’s already making a difference in its clients’ lives and in the lives of the nurses it employs. “Personally, it’s been quite rewarding,” says Priority Home case co-ordinator Melinda Homola, one of five nurses currently working in the program. “I’m learning new things every day, and I’ve had the opportunity to work with a really great team that shares the same goal — to improve our patients’ quality of life while maintaining them at home.” Priority Home, which got its start in November, is a person-centred, collaborative philosophy focused on keeping patients — specifically high-needs seniors — safe in their homes for as long as possible using community supports. It’s officially described as a short-term (up to 90 days), transitional, intensive, and restorative service available to eligible individuals who may need: • intensive case co-ordination • health-care aide or home-support worker assistance • rehabilitation services (occupational therapy, physiotherapy, speech language pathology and rehabilitation assistants) • other home care supports

“What often happens is that, while in hospital, a patient may become what we call deconditioned; less mobile, weaker, or not up to the functional ability they had prior to their hospital admission,” Homola says. “Our goal is to try to help them regain some of that strength, mobility and function so that they can recover at home rather than having to stay in the hospital or enter a long-term care facility. “As case co-ordinators, we collaborate with the occupational therapists, physiotherapists and speech pathologist on our team, and with the patients and their families, to identify goals that may allow the patient to become more independent and have a more successful transition back into the community. When we accomplish that, it’s very rewarding.” Many patients not only prefer their home environment, but often maintain better health in it. “There is evidence from other programs within Canada to support that clients tend to do better at home, especially when supported by additional resources such as occupational therapists and physiotherapists,” Homola says. “They have the benefit of familiar surroundings and the comforts of home, some of which, such as food, may be particular to their culture.” Helping her clients stay in their home environment speaks to the reason Homola entered the nursing profession nine years ago. “I went into nursing to help people and in this role I get to work quite closely with my patients to build a good rapport. I’m helping to see them through a difficult time in their lives and, at the same time, I get to use my nursing knowledge to help identify any medical problems that

may develop. It’s a very challenging role. I develop complex care plans for my patients that help them with their often challenging medical conditions.” Even in those cases where safety concerns make staying at home impractical for patients, Priority Home’s case co-ordinators are able to provide valuable assistance. “Ultimately, the goal is to help sustain the individual at home,” Homola says. “If we are able to do that and prevent unnecessary hospital admissions or trips to the emergency room, that’s a success in itself. But the goal can change if we, the patient or their family recognizes that being at home may not be the most appropriate approach,” she adds. “Then we can talk

about placement into assisted living, supportive housing, or help them through the process for long-term care. Helping clients and family members navigate through

those various options relieves their stress, and they are very appreciative of that.” ✚

PHOTO BY NATASHA WOLOSCHUK / WINNIPEG REGIONAL HEALTH AUTHORITY

CRITICAL CARE IN THE AIR STARS FLIGHT NURSES RESPOND TO EMERGENCIES ACROSS THE PROVINCE By Dean Pritchard

Melvin Yumang knew early on in his nursing career that he wanted to work with patients in crisis. What he didn’t know was that his workspace would be the inside of a helicopter, thousands of feet in the air. Yumang, 34, is a flight nurse with STARS (Shock Trauma Air Rescue Society), the non-profit helicopter emergency service that provides medical care and transportation for critically ill and injured patients. “We are taking care of people likely on the worst day of their lives,” Yumang says. “The fact that we are able to provide that care for that individual, for families to know that everything possible is being done for their family members, is something that is immeasurable. I have to pinch myself sometimes because I really do consider myself quite lucky to be part of this organization, to be part of this team.” From the STARS hangar at the Richardson International Airport, Yumang and the rest of his flight crew — two pilots, an advanced- care paramedic and sometimes a doctor — can be called at a moment’s notice to respond to medical emergencies at locations across the province. On one memorable occasion last February, Yumang and his crew received a report early in the evening of a snowmobiler who had been seriously injured at Falcon Lake. Complicating the rescue was the fact the injured girl and her friends were in a heavily wooded area with no cell phone service. “Landing close to the scene of the accident just wasn’t possible … so it was hard to be located by us, and even by the ground

crews,” he says. “It almost became a search and rescue situation. We were approaching sunset, basically, and at that point there was additional pressure to get to this individual who needed our care.” The helicopter eventually landed in a clearing two kilometres away from the accident scene, where Yumang and a paramedic were met by members of the snowmobile party and driven to the injured girl. “We treated her injuries as best we could and essentially had to walk her on a backboard for 45 minutes back to the helicopter,” he says. The patient was then transported to Winnipeg for further medical care. And that was Yumang’s second mission of the day. All in a day’s work for a STARS flight crew. STARS was founded in Calgary in 1985 and since then has added bases in Grande Prairie, Edmonton, Saskatoon, Regina, and Winnipeg, flying 30,000 missions along the way. STARS missions are made up of scene calls and inter-hospital transfers. “A scene call would typically be a response to an accident, such as a motor vehicle accident on a rural highway or a critical fall that … requires us to land in the vicinity of (the patient’s) home,” Yumang says. “The other half of the time we conduct inter- hospital transfers, meaning we will present to a rural facility with the intention of bringing critical-care resources to that rural site to allow for safe transport into Winnipeg.” Yumang works part-time at St. Boniface General Hospital. It was there that he met several nursing colleagues who also worked for STARS, piquing his interest in the air service. He joined STARS as a part-time flight nurse two years ago.

“WE ARE TAKING CARE OF PEOPLE LIKELY ONTHE WORST DAY OF THEIR LIVES.” STARS flight nurse MelvinYumang takes part in a simulation exercise. PHOTOS COURTESY OF STARS

oui! Where success begins Prepare for your nursing career … And expand your employment opportunity Baccalauréat en sciences infirmières • Prepare for your nursing career … And expand your employment opportunity Baccalauréat en sciences infirmières •

“At St. Boniface, I got to meet many of the nurses I now consider my mentors,” he says. “Of the eight nurses we have on crew at STARS, five of them, including myself, have some sort of tie to St. Boniface.” STARS’ ongoing commitment to training and innovation has made it an integral part of Manitoba’s health-care system, he adds. Recent innovations include the ability to provide inflight blood transfusions, a development Yumang describes as “game changing.” “I think we’ve demonstrated how important we are in the chain of survival, and ensuring care is provided for those that otherwise would not be able to access it in a timely fashion.” ✚

ustboniface.ca • Au coeur d’une communauté ustboniface.ca École des sciences infirmières et des études de la santé (Bachelor of Nursing Sciences) Soins infirmiers auxiliaires (Practical Nursing) (Bachelor of Nursing Sciences) Soins infirmiers auxiliaires (Practical Nursing) • Au coeur d’une communauté

WINNIPEG FREE PRESS - THURSDAY, MAY 3, 2018

RNs ARE INVOLVED IN ALL ASPECTS OF HEALTH CARE.

We are proud to regulate the

profession to ensure Manitobans receive safe, competent and ethical registered nursing care.

PHOTO BY DARCY FINLEY RN and PhD Lynda Balneaves is a researcher and associate professor at the University Of Manitoba’s College of Nursing.

crnm.mb.ca

MOMENTS & MILESTONES:

MARIJUANA AND MEDICINE LEGALIZATION MESSAGES COMPLICATE CANNABIS RESEARCH By Holli Moncrieff

AUG. 31, 2017: RN regulations passed under the RHPA “These regulations will optimize RN scope of practice and allow RNs to continue to work in collaborative practice to support sustainable health-care delivery for Manitobans. The RHPA supports our regulatory mandate to protect the public through quality

registered nursing regulation.” – Marie Edwards RN, President L-R: Colleen Mayer, MLA St. Vital; Marie Edwards, College of Registered Nurses of Manitoba President; Kelvin Goertzen, Minister of Health, Seniors, Active Living

SEPT. 12, 2017: co-host education day on collective competence We were proud to partner with the other nursing colleges in Manitoba (the College of Licensed Practical Nurses and the College of Registered Psychiatric Nurses) to host our annual education day. The theme was collective competence, a topic that is more relevant now than it has ever been. Lorelei Lingard was our keynote speaker and she brought a wealth of information and provoked thoughtful discussion about collaboration in health care. NOV. 24, 2017: hosted our first Stakeholder Summit We spent a whole day with our stakeholders to continue the conversation on how we can best work together. We heard from health-care regulators, providers, organizations, associations, the public and more. We look forward to putting our shared ideas into action. DEC. 14, 2017: first community reference group meeting The goal of this group is to provide us with meaningful linkage with the public. Of course, six people can’t represent the entire population of Manitoba, but our hope is that they will serve as a type of ongoing focus group for issues or projects we are working on. They will provide us with their thoughts and recommendations on a variety of issues related to regulation, for example, the clarity of information on our website.

Public education campaigns surrounding the impending legalization of recreational marijuana could have a detrimental effect on studies of medical cannabis. Lynda Balneaves, researcher and associate professor at the University of Manitoba’s College of Nursing, says educational programs being unveiled in anticipation of legalization are only increasing the stigma around the drug. “Cannabis is already quite stigmatized and it’s going to take a long time for that to change. We’ve basically had over 100 years of prohibition,” she explains. “The educational programs being developed across Canada are very much focused on the harmful aspects. It’s been very difficult to do research on plant cannabis because of its illicit status in Canada.” The stigmatization of the drug has also made patients hesitant to talk about it and doctors reluctant to authorize access to it, Balneaves adds. “Physicians have been very cautious in recommending or authorizing the use of cannabis, as we haven’t had the studies done yet and physicians are accustomed to working with drugs that are evidence based.” Even though Canada has had an official, federal medical-cannabis program since 2001, many patients have encountered barriers when trying to access the drug. Others have not been able to get the strains they felt were most helpful to their condition, or discovered the cannabis was of poor quality once they received it. “Some patients wanted the capacity to grow their own, and now, through court challenges, some are able to grow a small amount of plants to meet their medical needs,” Balneaves says. Medical studies on the benefits of cannabis are still in the early stages, but already there have been some positive indicators. “A growing number of studies have started to suggest there is a role for cannabis with some individuals, especially those who haven’t responded to traditional pharmaceuticals,” Balneaves says. “It can mean an improved quality of life and less pain for those with multiple sclerosis, wounds, and certain

types of cancer, and cannabis’s high strains of cross-reactive carbohydrate determinants (CCD) may have a key role in easing pain and insomnia.” While the jury is still out on the benefits of medical cannabis, almost everyone agrees it is safer than opioids. Balneaves says places where cannabis has been legalized are seeing a reduction in opioid prescriptions and opioid dependence. “We’ve focused a lot on looking at the access and affect on patients who are using medical cannabis. I’m hoping to get back to my roots of working at CancerCare Manitoba and hopefully moving forward with some clinical trials,” she says. “Beginning trials suggest cannabis could extend life and possibly shrink tumours in patients with glioblastoma (a type of brain cancer).” Cannabis’s affect on mental illness will be more difficult to quantify. Balneaves explains that those with illnesses like schizophrenia and bi-polar disorder may find their conditions worsen with cannabis use, while those with depression and anxiety could find it beneficial.

“BEGINNING TRIALS SUGGEST CANNABIS COULD EXTEND LIFE AND POSSIBLY SHRINK TUMOURS IN PATIENTS WITH GLIOBLASTOMA (ATYPE OF BRAIN CANCER).”

“It’s a double-edged sword. There’s concern that cannabis can make some mental illnesses worse, especially if used daily and in high concentrations, but others report that it’s helping.” Balneaves hopes nurse practitioners will soon be able to authorize the use of medical cannabis for patients. However, she warns that people should avoid using cannabis, whether recreational or medicinal, until the brain has stopped developing. “Cannabis impacts the developing brain. The earlier it’s used, the more impact it has on brain development. We recommend abstaining for as long as possible, until the age of 25.” ✚

AT THE END OF 2017 WE HAD:

13,682 RNs

204 Nurse Practitioners

158 Non-Practicing Registrants

26 Graduate Nurses

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TR UBLE SLEEPING CAN’ LIFT KIDS

Find more information on prevention tips for musculoskeletal injuries and sign up for the SAFE Work Matters e-newsletter at safemanitoba.com Sprains , Strains & Tears

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