Monday, May 11, 2015

Happy Nurses Week

My initial four month contract is now up and I am home for a few weeks.  It's been five days and I'm still a little disoriented.  I was warned that coming home is often hard and they weren't kidding...  And why wouldn't it be? I've gone from temperatures of -5°C (and dry) to 30°C (and very humid) overnight.  The occasional call of a raven, a dog barking or the alien sound of Skidoos tearing around town late at night have been replaced by sirens, children, songbirds, televisions and (what seems like incessantly ringing) telephones.  It doesn't help either that my house faces a major intersection in a city of over half a million people. I forgot about the constant rumble and occasional honking/screeching/shouting and crashing that takes place.  Everything smells weird too.  As I type this, I've decided that I'm finally comfortable; wearing my tank top and capris I have parked myself next to the vent in the kitchen.  The quiet hum of the air conditioning and the fan on the range hood are managing to drown out most of the noise... save one robin who is very adamantly calling for rain.  He can stay for now.  If it gets too much, I may have to resort to my ear phones, like I have many times before.

My journey home was an adventure into itself, one that has carved a big chunk of time away from my family and friends.  However, that is a story for another day.  Today is the start of Nurses Week, and now that I am in a totally new position in a totally new area, I find myself drawn to talking about that instead.

Unlike here, "in the south" (as we say), RN's and RPN's (Registered Psychiatric Nurses) have a very much expanded scope of practice.  We have to: there are no regular doctors where we are and even in the most dire of emergencies, a patient has to be medivaced to Iqaluit which is over an hour away (and weather permitting).  The Community Health Nurses (CHN, or "chins") are primary practitioners;  they do everything from full assessments, to paps to giving antibiotics to dispense medication to casting to stitches and beyond.  In my world, the world of Mental Health, my job description of CPN (Community Psychiatric Nurse) does the job of many departments and agencies down here.  Myself, I am in charge of:
  • the distribution of medication for <30 chronic patients (both "injection clinic" and blister packs)
  • dispensing of PRNs and hold over medications from pharmacy.
  • the case management of >10 patients in "out of territory" placement (which currently includes 4 other provinces)
  • the case management of >5 "in community placement" clients
  • crisis intervention
  • liaising with police, social work, income support, housing and other government bodies
  • individual and group counseling for clients in a chronically suicidal community
  • psychosocial and psychiatric assessments
 ...and then some.  It's hard being the only skull jockey in town... you get called at all hours to do the damndest things.

The putting of this here is not so much "hey, dig me!" as it is with the intention of illustrating the impact that one nurse can make.  I'm especially eager to share my new findings as up until recently, I was pretty disillusioned and hopeless with my profession, especially in Ontario.  I will admit too, there were times in the never ending night of Nunavut when I asked myself what the hell I was doing here (and where exactly was that again)?  What possible difference could I make to a community that has experienced more pain, more trauma, more violence than I can ever try and explain, never mind try and change?  I'd have better luck holding back a glacier.

Well, here are some answers.  I've removed exact numbers for the sake of privacy, but know they are not an exaggeration.  One Community Psychiatric Nurse, in four months:
  • saw almost as many clients as my last unit saw in a year (documented)
  • prevented many suicides (documented)
  • reunited several families and offered/gave healing
  • helped people in need
  • revamped the metabolic monitoring program for the community (and other programs)
  • oversaw the medication for chronically ill clients
  • taught medication, illness, coping strategies, sleep hygiene, thought changing and mindfulness countless times
  • advocated constantly for the mentally ill with the public, governing bodies, police, social work, medical staff and families.
  • attended review board hearings, Community planning meetings and been a stakeholder in direct community funding from the federal government
  • fed the hungry
  • tended to the biopsychosocial needs of the community, the agencies working within the community and the employees of the health centre (nurses included).
  • got three very treatment resistive clients back on medication
  • fought for, and got, increased funding for the Tuesday lunch program for chronic psychiatric clients (and increased caloric and nutritional intake therein)
  • helped ensure there were no new cases of syphilis for 2 months (documented)
  • assisted with cases all over Baffin Island in territorial rounds

And there are 13 of us, one in each community in Qikiqtaaluk.

To be fair, I, and my colleagues, do get paid well for our work.  However, I did get more out of it than simple monetary reimbursement.  In my last four months, as a nurse in Nunavut, I also got to:

  • meet some awesome people
  • find purpose
  • learned to draw
  • did some very important healing
  • learned much about the Inuit, their culture, their past and vision for the future
  • learned to cook and eat healthy in a climate that is definitely not supportive of this
  • renewed my faith in myself
  • renewed my faith in my calling
  • renewed my love of art including photography
  • seen beauty so breathtaking, I cried 

I don't know many other professions where that would happen.  I don't know many nurses that could say that either.

I have spent my entire career believing nursing to be one thing.  It was only after leaving my home province and going north that I found it to be much more;  to be more holistic and rewarding and generally much more like what I had envisioned as I was starting out.

I was told by a seasoned traveling nurse (about a month after I arrived) that "...only in this profession can you do what we do, go where we go, help who we can. We can make this job our own.  As a nurse in Canada, you can travel the world... and globally you can give people care and healing.  Be proud that you are a nurse.  For you already have and will continue to see and do things that no one else ever will..."

I can't argue with that.

I've been asked countless times in the last month "Are you coming/going back?"

Of course I am.

I'd be silly not to, wouldn't I?

Happy Nurses Week, wherever and however you practice.  Know that you do make a difference... and that no other calling can compare.

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