RNs’ role in reducing gang violence • Free membership for new grads • CMA attacks on Medicare Registered NurseSeptember/October 2007 JOURNAL Reaching out to people living with mental illness Nurses team up with other health professionals to help rebuild lives.

PM 40006768 RENEW YOUR RNAO MEMBERSHIP TODAY & GET THE MOST OUT OF YOUR PROFESSIONAL ASSOCIATION It's time to renew again! Ensure your membership is current.* By renewing early, you will: • maintain your eligibility for CNPS professional liability protection coverage without interruption. • be in the loop and receive your subscriptions to Registered Nurse Journal and Canadian Nurse staying current on health-care issues. • receive members-only savings such as discounts on workshops, and group rates on home and auto insurance!

* RNAO membership year ends October 31, 2007. The new 2007-2008 membership year begins November 1, 2007 RENEW ONLINE www.rnao.org or CALL 1.800.268.7199 TODAY. Registered Nurse JOURNAL Volume 19, No. 5, September/October 2007

FEATURES

HOPE FOR AFRICA’S GRANDMOTHERS 11 By Jill Scarrow RNAO awareness initiative supports grandmothers caring for orphaned children in Africa.

IT TAKES A TEAM TO TREAT MENTAL ILLNESS 12 By Jill Scarrow Nurses join with other health professionals to help people with mental illness rebuild their lives.

HELPING THE HOMELESS FIND THEIR VOICE 16 By Cathy Crowe In an excerpt from her new book, Dying for a Home, street nurse Cathy Crowe introduces readers to homeless activist James Kagoshima.

RNs HAVE ROLE TO PLAY IN 18 REDUCING GANG VIOLENCE By Clinton Baretto, RN, BScN 25 Nursing graduate Clinton Baretto believes social justice issues will inspire young RNs to make a difference. THE LINEUP KEEPING POVERTY ON THE EDITOR’S NOTE 4 19 POLITICAL AGENDA By Jill Scarrow PRESIDENT’S VIEW 5 All of Ontario’s political parties play a role in ensuring MAILBAG/OBITUARY 6 poverty gets the attention it deserves.

EXECUTIVE DIRECTOR’S DISPATCH 7 PASS THE POPCORN NURSING IN THE NEWS 8 20 By Kimberley Kearsey RNAO members take politicians to see SiCKO,a OUT AND ABOUT 10 documentary by Michael Moore. RN PROFILE 23 CMA ATTACK ON MEDICARE GENERATES NEWS TO YOU/NEWS TO USE 24 22 PASSIONATE RESPONSE FROM RNs NOTICE OF RNAO’s 2008 AGM 26 Nurses weigh in on the Canadian Medical Association’s proposals to privatize health care. CALENDAR 27 FREE MEMBERSHIPS FOR NEW 25 NURSING GRADS By Jill Scarrow New sponsorship program with HUB eases the financial burden on Ontario’s new RNs.

Cover photograph: J. Michael LaFond Registered Nurse Journal 3 The journal of the REGISTERED NURSES' Editor’s Note ASSOCIATION OF ONTARIO (RNAO) 158 Pearl Street Toronto ON, M5H 1L3 Phone: 416-599-1925 Toll-Free: 1-800-268-7199 Fax: 416-599-1926 Website: www.rnao.org E-mail: [email protected] Letters to the editor: [email protected] Making a difference through EDITORIAL STAFF Marion Zych, Publisher Kimberley Kearsey, Managing Editor collaboration, partnership Jill Scarrow, Writer Stacey Hale, Editorial Assistant This fall, I read about an American woman – near EDITORIAL ADVISORY COMMITTEE Carmen James-Henry, Chair bankruptcy from cancer treatments – who is searching for a Joseph Gajasan, Anne Kelly, Connie Kuc, Holly Lake, Sylvia Rodgers, Shannon Landry, Canadian husband so she can take advantage of Medicare. The Rosanna Wilson 52-year-old Seattle resident makes no bones about looking DESIGN, ART DIRECTION, PRODUCTION S. Dale Vokey/James Ireland enviously over the border at those of us who have access to Fresh Art + Design Inc. publicly funded, not-for-profit care. ADVERTISING And she’s not alone. Registered Nurses' Association of Ontario Phone: 416-599-1925, Fax: 416-599-1926 A Michigan woman in Michael Moore’s latest documentary,SiCKO, also speaks SUBSCRIPTIONS openly about how she’s thankful to have access to health services in Windsor because a Registered Nurse Journal, ISSN 1484-0863, is a benefit to members of the RNAO. Paid subscriptions are Canadian man has agreed to pose as her common-law partner. welcome. Full subscription prices for one year (six issues), including taxes: Canada $38.52 (GST); Outside I saw SiCKO this summer and I was among the thousands to walk away from that Canada: $42. Printed with vegetable-based inks on recycled paper (50 per cent recycled and 20 per cent film with a sense of pride in our publicly funded system. Many RNs share that pride. post-consumer fibre) on acid-free paper.

Registered Nurse Journal is published six times a In this issue of Registered Nurse Journal, you will meet some of those proud members year by RNAO. The views or opinions expressed in the editorials, articles or advertisements are those of the who saw the movie and teamed up with RNAO to ensure politicians did the same authors/advertisers and do not necessarily represent the policies of RNAO or the Editorial Advisory (pg. 20). Members have also been actively involved on several other Medicare fronts Committee. RNAO assumes no responsibility or liability for damages arising from any error or omission or from this summer and fall. For instance, nurses have joined forces to speak out against attacks the use of any information or advice contained in the Registered Nurse Journal including editorials, stud- on Canada’s health-care system, including the Canadian Medical Association’s call for ies, reports, letters and advertisements. All articles and photos accepted for publication become the property of more private delivery of health services (pg. 9/22). the Registered Nurse Journal. Indexed in Cumulative Index to Nursing and Allied Health Literature. While these nurses are teaming up to protect our national treasure, others are join- CANADIAN POSTMASTER: Undeliverable copies ing forces closer to home to ensure those in need of care – particularly mental health and change of address to: RNAO, 158 Pearl Street, Toronto ON, M5H 1L3. Publications Mail Agreement care – are getting the attention they deserve. In our cover feature (pg. 12), we explore No. 40006768. how collaboration among health professionals is making a difference to mental health RNAO OFFICERS AND SENIOR MANAGEMENT Mary Ferguson-Paré, RN, PhD, CHE patients across the province. In this issue, we also take you beyond Canadian borders to President, ext. 204 Africa, where partnerships are flourishing to protect grandmothers with little choice Wendy Fucile, RN, BScN, MPA, CHE President-Elect, ext. 504 but to care for their orphaned grandchildren. Doris Grinspun, RN, MSN, PhD (c), O.Ont. Examples of teamwork and collaboration abound in this issue of the magazine. Executive Director, ext. 206 Irmajean Bajnok, RN, MScN, PhD They’re an important reminder of just how much we can accomplish when we call on Director, International Affairs and Best Practice Guidelines Programs, ext. 234 the strengths of others to complement our own.And they should provide inspiration Sheila Block, MA for others to step outside their comfort zones and form alliances with the goals of pro- Director, Health and Nursing Policy, ext. 215 Nancy Campbell, MBA tecting what we hold dear and promoting better health. Director, Finance and Administration, ext. 229 Daniel Lau, MBA Director, Membership and Services, ext. 218 Heather McConnell, RN, BScN, MA (Ed) Associate Director, International Affairs and Best Kimberley Kearsey Practice Guidelines Programs, ext. 248 Managing Editor Anitta Robertson, RN, BAAN,MPA Director, Centre for Professional Nursing Excellence, ext. 240 Marion Zych, BA, Journalism, BA, Political Science Director, Communications, ext. 209

4 September/October 2007 President’s View with Mary Ferguson-Paré

Increasing the minimum wage and introducing a child benefit for low-income families – as implemented by the Liberal The road ahead for Ontario: government during its first mandate – are positive measures, but even Liberal politi- cians concede more needs to be done.At Charting the next stage the Vote Out Poverty concert RNAO co-sponsored in Toronto, Liberal candidate Premier Dalton tional investments in health care, necessary and re-elected MPP Kathleen Wynne McGuinty and his to ensure there are enough health-care announced that the Premier plans to team are settling into providers to meet the needs of Ontarians, establish firm targets to combat poverty. a second term of especially our seniors who live at home This was music to my ears and an indica- office.The people of and those who reside in long-term care. tion that this government is serious about Ontario gave them a They deserve the highest standard of care. dealing with poverty.We will be there to strong mandate to help set those targets. continue governing Medicare A community-based housing strategy this province. Over the next four years, the The continued assault on our single-tier and more childcare spaces are also impor- Premier says he will continue to build the system, as evidenced by the new constitu- tant next steps.To ensure individuals and province’s public services. tional challenge, will require continued families don’t fall farther behind, we also vigilance from the new government.We need to see regular increases in both the Nursing will look for a vigorous legal defense, and hourly minimum wage and social assis- As a health stakeholder, RNAO worked any future health-care legislation must tance rates. Make no mistake; RNAO with the McGuinty government to re- incorporate not-for-profit delivery as a expects a clear and comprehensive plan build the nursing workforce. Many of our governing principle.We expect the within the next 12 months. recommendations were adopted and imple- McGuinty government to stop those try- mented during McGuinty’s first mandate. ing to undermine Medicare by setting up Environment Thousands of nurses were hired, we for-profit clinics. What we know today about the quality reached 61.6 per cent full-time employment of the air we breathe and the chemicals for all RNs, and we launched the Sudbury in the environment is nothing short of District Nurse Practitioner Clinics, the first alarming. Chronic conditions such as nurse-led NP clinic in Canada, which will “We are on a path asthma, cancers and birth defects have provide care to some of the 4,500 patients been linked to these trends. who have been without a family doctor for at RNAO. I call on you We owe it to our children, their chil- years.These are just some of the successes dren and to the generations yet to come to that RNAO helped shape. to help us advance hold the government accountable to But more work and other challenges these initiatives and improve air quality and reduce smog.This remain.We need more young people to join area is of special significance to me because the profession.We must enable our experi- to recruit others to I believe successful societies care for their enced nurses to continue working.We want people and look after their environment. an Ontario where nurses can build success- join us. ” We intend to hold Premier McGuinty ful careers and where internationally trained accountable for the work he believes is not nurses who choose to make Canada their yet complete and to the promises made new home can qualify for practice. during the election campaign. Phasing out The Liberal government has pledged to Poverty coal-fired electricity plants, reducing toxic improve on the gains of its first mandate in RNAO has been vocal about the need to substances, and instituting a province-wide office. I can assure you that RNAO will develop a comprehensive strategy and poli- pesticide ban that mirrors bans already in hold Premier McGuinty and his team to cies to reduce poverty.As nurses, we know place in dozens of towns and cities across the promises made, including strengthening poverty is the single most preventable Ontario will help us change course. our role and our profession.This means cause of poor health and early death. We are on a path at RNAO. I call on 9,000 additional RNs and 70 per cent full- It is reprehensible that one in seven you to help us advance these initiatives time employment.This is paramount to people in this province lives in poverty and and to recruit others to join us.The larger ensuring continuity of patient care. It also that 324,000 of them are children.These our numbers, the louder and stronger means more nurse-led clinics (Premier children and their families must be able to our collective voice.Together we will McGuinty committed to 25) with an count on politicians to do the right thing. contribute to a sustainable society. RN emphasis on primary health care and The association’s platform laid out a specif- chronic disease management. ic set of recommendations that we believe MARY FERGUSON-PARÉ, RN, PhD, CHE, IS We also welcome the promise of addi- must be adopted to turn the tide. PRESIDENT OF RNAO.

Registered Nurse Journal 5 Mailbag

RNAO diversity statement than Toronto, I have observed how nursing teams, it was somewhat surprising that the ensures accountability truly has a long way to go to confront contributions of other health professionals Re: Intolerance of Ontario’s cultural richness racism within and outside the profession. were minimized. I recognize that nurses and wealth of diversity cannot continue, I’ve met many people working hard to play a central role in the assessment and President’s View, July/August 2007 combat racism in nursing. They have suf- management of clients in clinics such as I am extremely pleased to see that RNAO fered politically, professionally and person- those described in the article, but it is has brought diversity, racism, sexual orien- ally for their cause. Frankly, so has nursing. important to recognize that optimal patient tation and gender identity to the forefront RNAO’s new policy on this issue means care is provided through the combined of its policies. It is very encouraging to see their efforts were not in vain. I thank you efforts of an interdisciplinary team. RNAO take action and leadership in these for bringing racism and diversity issues to Leslie Whittington-Carter, areas. Racism is a central player in the the forefront, and for moving even closer Registered Dietitian determinants of health, and has no place in to making individuals, management and Wallacetown, Ontario nursing. As a nursing student at the organizations responsible and accountable University of Toronto, I worked closely on for racism in their workplace and work- this issue as part of my community clinical place practices. We want to placement at the Centre for Equity in Christy Ip, RN hear from you Health and Society (CEHS). This place- Guelph, Ontario Please e-mail letters to [email protected] ment made me aware of the ‘unbearable or fax 416-599-1926. Please limit whiteness of nursing.’ As a ‘white’ nurse Interdisciplinary practice responses to 150-250 words and coming from a small, rural community, I essential to manage chronic care include your name, credentials, was especially grateful to have the oppor- Re: Managing chronic illness, July/August 2007 hometown and telephone number. tunity to confront my own prejudices and The article on chronic illness stressed the RNAO reserves the right to edit participation in ‘everyday racism.’ It was importance of chronic disease management eye-opening to say the least. Now, practic- in the health-care system. Considering letters for length and clarity. ing in a smaller, less diverse community today’s emphasis on interdisciplinary care

Obituary

Lois Fairley, RN 1931-2007

For RN Lois Fairley, nursing was more RN Jane Addison worked with do it,’and I could.” than just a job; it was a way to give back Fairley for more than 30 years. Grant Fairley, the eldest of to the community, one patient at a time. She remembers her friend and three sons, also remembers his Her work and life were remembered this colleague’s ongoing support for mother’s dedication to the summer when, at 76, she died of cancer. nurses, noting that she acted as a profession. “She was very A former RNAO board member mentor and was always vocal proud to be a nurse,” he and president of the Ontario Nurses’ about workplace issues such as recalls, adding that her com- Association (ONA), Fairley was recog- salary and benefits she knew mitment sometimes meant nized for her commitment to ensuring RNs deserved. leaving her husband waiting in the car nurses were as well taken care of as their Addison first got to know Fairley for hours outside the hospital while she patients. She served as RNAO member- when she (Fairley) was encouraging attended to every last detail before leav- at-large for socio-economic welfare Grace nurses to become part of ONA. ing a shift. Even vacations were filled from 1984-86. Eleanor Ross was presi- She asked Addison to help get nurses to with work, he recalls. Fairley spent sum- dent-elect during that time, and sign their union cards, and although mers as a camp nurse near Sarnia, where remembers Fairley as “friendly and fair.” Addison wasn’t sure she had the persua- her nickname, ‘Shots,’ reflected her life’s She recalls her colleague’s hard work on sive powers to get her colleagues to join work and passion. Project Turnabout, a support group to the union, she says Fairley always pushed Fairley is survived by her husband, help nurses struggling with drug and people to try new things. three sons and five grandchildren. She alcohol addiction. “Lois always encouraged me,” she will be dearly missed for her contribu- Fairley spent her entire 38-year nurs- recalls. “When I’d say I couldn’t do tions to nursing and RNAO. RN ing career at Grace Hospital in Windsor. something, she’d say ‘of course you can

6 September/October 2007 Executive Director’s Dispatch with Doris Grinspun Standing up for Medicare

In the lead-up to the Foundation (CCF), an Alberta-based health care is abundantly clear in his latest provincial election, we organization that is funding a lawsuit chal- documentary,SiCKO. released RNAO’s plat- lenging the Ontario government on timely I was invited to preview the movie and form and urged nurses access to health care and patients’ ability to as soon as I saw it, I knew it was a tool we across the province buy private health insurance.This organiza- must use to tackle the kinds of attacks on to ask politicians on tion is, in effect, trying to dismantle Medicare described above. Suddenly,I was the campaign trail Medicare by seeking to remove all prohibi- hit with an idea: nurses need to extend an about their plans to tions on private health care. invitation to see SiCKO to politicians, reduce poverty,clean-up the environment, At a CCF news conference on Sept. 5, the individuals who hold the future of protect and strengthen Medicare, and sup- I sat alongside a number of reporters as Medicare in their hands. RNAO sent an port nurses.We stressed how important the foundation introduced the second of action alert to assembly members and more it is to ensure our new government pro- two patients to make a constitutional chal- than 40 took us up on the offer (see pg. 20). tects Ontario’s health-care system from lenge against the laws governing health Moore was thrilled with the initiative. attacks by for-profit advocates who prey care in Ontario. I spoke to many reporters In a public statement he said:“…I want to on the vulnerabilities of people confronted that day,reminding them that health care thank RNAO for encouraging members to with illness. bring your political leaders to go see Sadly,we have seen two troubling SiCKO. It’s important to remind your examples of such attacks in recent months. elected officials how critical it is to protect The first one came weeks before can- “The minute your Medicare system established by didates officially began campaigning.The Tommy Douglas, and the values and ideals Canadian Medical Association (CMA) you introduce behind it of taking care of everyone in unveiled its plan to ‘modernize’ Medicare, society, no matter how rich or poor…” advocating that physicians be allowed to private insurance The leaders from all of Ontario’s politi- practice simultaneously in both the public cal parties, and the three national leaders, and private health-care systems, which is into our system, were personally invited to see the film.We prohibited under the Canada Health Act. were very pleased with the genuine interest Under the guise of ‘meeting the needs of you create in the issues and challenges of privatization a new generation,’ CMA also suggested shown by those who participated. that private insurance and private clinics two classes Federal Liberal Leader Stéphane Dion would improve access to services and of patients.” accepted our invitation on Aug. 16, and reduce wait times. participated in a roundtable discussion RNAO was vocal in its opposition to immediately following the movie. I was so the plan, dubbed Medicare Plus, and sent an proud of all the RNAO members who open letter to Prime Minister Stephen in Canada is a human right, not a com- attended, many sharing not only their Harper, reminding him of the dangers of a modity to be bought and sold. I explained values and visions for a healthy system, but two-tier system.We also issued an action that the minute you introduce private also the evidence behind those values. alert and more than 400 nurses sent letters of insurance into our system, you create two There’s no question in my mind that their own to the prime minister (see pg. 22). classes of patients: those who can afford to while attacks on our publicly funded, not- Our advocacy worked. jump to the front of the queue and those for-profit system by organizations like Federal Health Minister Tony Clement (the majority) who cannot.The latter wait CMA and CCF will continue, they won’t responded immediately in the media and in in a line that is longer, the cost to taxpay- hold up against nurses’ knowledge, courage a letter to RNAO, stating in no uncertain ers is higher, and overall health outcomes and perseverance to protect and strengthen terms that:“We do not support any recom- are worse. Medicare, and to advance the vision that mendations related to the establishment of RNAO has been challenging these Tommy Douglas dreamed about five a two-tiered health-care system or dual kinds of attacks for many years and decades ago. practice by physicians.” nurses have responded unwaveringly. Stand tall and proud my colleagues. RN The second attack on our publicly Now we have another powerful ally in funded system came a few weeks later; this Michael Moore, a documentary film- DORIS GRINSPUN, RN, MSN, PhD (CAND), one from the Canadian Constitution maker whose passion for publicly funded O.ONT, IS EXECUTIVE DIRECTOR OF RNAO.

Registered Nurse Journal 7 by Stacey Hale and Kimberley Kearsey Nursinginthenews RNAO & RNs weigh in on . . .

out a doctor for years. Patients began registering for the Sudbury clinic on Aug. 2 and Butcher admits it could be months before they get to the bottom of the application pile. “We’re not putting people through on an assembly line,” she told the Sudbury Star (Aug. 23). “There are so many people in this area who don’t have access to a primary health- care professional, and we know the clinic will start to remedy that and offer [residents] the care they need and deserve,” Butcher said. (Aug. 30, Northern Life.ca) (L-R) Pamela Pogue, Doris Grinspun, Jennifer Fournier, Marilyn The Sudbury District Nurse Practitioner Clinics Butcher and Roberta Heale celebrate the NP clinic opening employs four nurse practitioners, two medical with Health Minister George Smitherman. secretaries, and one administrator. Butcher and Heale plan to hire a dietitian and social worker to com- Nurse practitioner clinic plete the team, which will address the needs of some opens in Sudbury 1,500 patients within the first year. RNAO Executive Director Doris Grinspun was instru- RNAO members Marilyn Butcher and Roberta Heale have mental in helping the two nurses capture the attention of finally taken the helm as director and board president, Health Minister George Smitherman with their proposal respectively, of Ontario’s first nurse practitioner-led clinic for funding. She commended them on their commitment in Sudbury. Local residents without a family doctor to the project, and for never giving up on their dream breathed a collective sigh of relief when the clinic official- “to serve people to the full extent of their knowledge, ly opened Aug. 30. That’s because many have been with- skill and caring.” (Aug. 31, Timmins Daily Press)

Nurses taste victory with cents, significantly less than what was rec- Park on Sept. 5, announcing its intention to increase of funding for ommended and supported in a petition. finance a lawsuit challenging the Ontario seniors’ meals “The trigger was the 11 cent increase,” government on timely access to health care After months of intense lobbying – and Shaw said of the pair’s efforts.“We obvi- and patients’ ability to buy private health more than 19,500 signatures on a petition ously didn’t get what we wanted so nor- insurance. CCF,an Alberta-based group, presented to the legislative assembly – mal citizens have taken ownership of this introduced Shona Holmes, an Ontario Angela Shaw and Julie Curitti have issue.”(July 24, Mississauga News) woman who spent $95,000 for health care finally secured more funding for seniors in “Never in our wildest dreams did we in the U.S. as she sought diagnosis and treat- long-term care facilities across the province. think we’d be on this journey,” said Curitti ment for a rare eye condition. The two Mississauga RNs were behind after the government finally approved the Holmes’ constitutional challenge of the push to increase food spending for sen- increase to $7.“It’s just wonderful to think Ontario’s legislation – which prohibits indi- iors from $5.46 per day to $7 per day. we helped our seniors.This is going to make viduals from purchasing private insurance – Pleased with the health ministry’s deci- a big difference to their quality of life.”(July is seen as a direct attack on Medicare.“What sion to increase the amount to $7 at the 31, Mississauga News) to me is so distressing is when people start end of July,the two nurses have not for- to prey on the vulnerability of patients to gotten how difficult the campaign was. It Lawsuit challenges ban on further their ideological agenda,”said was particularly disappointing when the private care RNAO Executive Director Doris Liberals announced in the spring that they The Canadian Constitution Foundation Grinspun. (Sept. 6, National Post) would only approve an additional 11 (CCF) held a news conference at Queen’s In a letter to the Toronto Star, RNAO

8 September/October 2007 For complete versions of any of these stories, contact [email protected].

President Mary Ferguson-Paré shared her a community meeting in Listowel to sympathy for Shona Holmes and others in inform residents and politicians of the RN Lynn Anne Mulrooney, senior her situation.“As nurses, we have much nursing shortage across the province. Five policy analyst at RNAO, wrote a letter empathy for the plight of patients who are political candidates participated in the to the Toronto Star thanking the looking for more timely access to health event, which ended with nurses lighting newspaper for publishing a photo spread care. However, we believe that using them candles to represent the decreasing number depicting homeless people as real to further an agenda of privatization is sim- of RNs in the profession. Perth chapter humans. ply wrong.”(Sept. 6, Toronto Star) president Jane Foster told the Stratford Treat homeless people RNAO members also weighed in. Beacon-Herald:“As the population ages, with respect “Paying for private health care does not cre- the usage of hospitals is increasing.The Letter to the editor ate new doctors, but does help to drain province needs to keep aging nurses work- Toronto Star,August 20, 2007 them away from the public system,”RN ing and increase the number of nurses Thank you for showing some Judy Greenwood-Speers wrote in a letter going into training.”(Sept. 8 and 10) of the real human beings affected to the editor (Sept. 11, National Post). RN by panhandling policies in your Samantha Dalby also expressed her oppo- Parents decide whether to photo spread (Spare some change? sition to the challenge in a letter that read vaccinate daughters for HPV Aug. 18) as a contrast to your “Evidence shows that Medicare is the best In mid-September, the Regional Niagara columnist’s characterization of way to achieve efficient and effective quality Public Health Department started vaccinat- panhandlers. Her use of ‘feral’to care.”(Sept. 5, Toronto Star) ing Grade 8 girls to protect against the describe street people links them human papillomavirus (HPV).The virus is to wild animals or plants, and her use Nurses reject CMA proposal linked to the development of cervical cancer of ‘slugs’ links them to the insect The Canadian Medical Association’s or genital warts. RNAO member and nurse world. She further makes indigent (CMA) outgoing president Colin McMillan practitioner Janice Jackson, who works at people into non-human entities by unveiled his controversial Medicare Plus the St. Catharines Sexual Health Centre, casting them as ‘steadily eroding the proposal while addressing a Rotary Club addressed growing concern among parents urban wellness of the city.’Instead meeting in Charlottetown this summer. that the vaccination program might lead of blaming our most vulnerable The proposal called on Canadians to girls to develop promiscuous behaviour residents, we should be treating embrace a system in which physicians or a false sense of safety regarding sex. them with respect. Of course, violent would be allowed to practice in both the The vaccine “won’t plant the thought or acts, wherever committed, must be public and private sectors simultaneously sway a girl who is already considering sex,” addressed by our criminal justice (see pg. 22 for more details on this and Jackson said.“There are so many other system.We also need public policies additional announcements from CMA). factors that contribute to a girl’s decision.” that will enable all Ontarians to live “Creating a private, parallel system (Sept. 10, Welland Tribune) in dignity rather than in poverty. doesn’t create more access…it just allows Lynn Anne Mulrooney, people with more money to get ahead Black-market tobacco undercuts Burlington of the queue,”said RNAO President- effort to help youth butt out Elect Wendy Fucile (Aug. 7, AM 1220 RNAO member and public health nurse Cornwall). RNAO President Mary Karen Taylor is concerned that teens in Ferguson-Paré reiterated the association’s the Haliburton, Kawartha and Pine Ridge lar, black-market business that seriously disapproval of the proposal by explaining to area are lighting up because they can easily undercut our efforts to prevent minors reporters that two-tier health care “won’t obtain access to unregulated and illegal from becoming addicted to smoking,” work and the evidence is clear about that.” tobacco products.To remedy the issue, the Taylor said. (Sept. 11, Lindsay Post) (Aug. 1, Port Hope Evening Guide) local health unit is encouraging parents to attend presentations to learn how to talk RNAO’s Perth chapter hosts pre- to their teens about the hazards of smok- Nurses promised new masks, election meeting to highlight ing and the risks associated with unregu- safety needles nursing shortage lated tobacco products.“Unregulated On Aug. 23, Health Minister George On Sept. 17, RNAO’s Perth chapter hosted tobacco products are a multi-million dol- Smitherman announced that his govern-

Registered Nurse Journal 9 Nursinginthenews RNAO & RNs weigh in on . . . ment will provide frontline health-care to the announcement with support, noting Clinic cares for patients in effort workers with N95 masks and safety needles that NHS has had a needle safety policy to ease ER waiting to make the workplace safer.The masks are since 2005.“We’ve always put our staff safety RNAO member Sue Leddy is doing what designed to protect against airborne infec- as top priority and this [policy] is one way she can to ease the time crunch in hospital tions, and the needles reduce needle-stick we can make it a reality for our staff,”she ERs.A member of the Maitland Valley injuries. Nurses were pleased:“It shows they said. (Aug. 24, Welland Tribune) Health Team in Goderich, Leddy is one of respect the fact that we need to be provided RNAO member Tiz Silveri, vice- three nurses who take turns running a clinic with a safe work environment,”said Linda president of maternal, child and surgery that treats waiting ER patients with less Haslam-Stroud, RNAO member and care at North Bay and District Hospital, pressing ailments such as allergic reactions, president of the Ontario Nurses’ also weighed in:“The government has ear infections and back injuries.The clinic, Association. (Aug. 24, Toronto Star) put funding towards this good initiative Leddy says,“…keeps all those patients, Tracy MacDonald, chief nursing exec- because safety is very important.”(Aug. 24, maybe 10 or 12 a morning, out of the (hos- utive at Niagara Health System, responded North Bay Nugget) pital) emergency.”(Oct. 3, the Toronto Star)

Out & About

On Sept. 24, RNAO’s Region 7 hosted an all-party debate on health care at Ryerson University. Regional representative Carmen RNs Beverly Morgan (left) and Lisa Ottawa’s Somerset West Community James-Henry (left) moderated the dis- Richter addressed a public meeting of Health Centre is one of only 13 cussions, which focused on social det- Hamilton City Council on Sept. 13 to facilities in Canada to have successfully erminants of health, the nursing shortage, support a Pesticide Bylaw and share achieved Baby Friendly Designation. and Medicare. Seated (L to R) are Green their views about the harmful effects The official celebration took place party candidate Mike McLean, NDP of pesticides. With the passing of the Sept. 17, during which RNAO’s candidate Andrea Nemeth, Conservative bylaw, Hamilton joins a growing list of Childbirth Nurses Interest Group past candidate Pamela Taylor, and Liberal communities that have implemented chair Nancy Watters (second from candidate Tom Teahen. legislation prohibiting the cosmetic right) presented congratulations use of chemicals, including to RN and lactation consultant Diana Toronto, London, Markham, Warfield. They are joined by Kathy Oakville, Peterborough, Venter from the Breastfeeding Newmarket, Thorold and Committee of Canada (right) and Collingwood. RNAO member Lori Levere, Ontario Breastfeeding Committee.

RNAO President Mary Ferguson-Paré (left) spent a week in early September with RNAO members in Timmins, Peawanuk, Moose Factory and Kashechewan. While visiting the health clinic in Kashechewan, she met with RNs (L to R) Leah Hiscock, Nancy McTeer, Moira Morris, Wilma McQuaker, and Priscilla Friday.

10 September/October 2007 OFFERING HOPE TO AFRICA’S GRANDMOTHERS these women need to be self reliant.” Ilana Landsberg-Lewis, executive director AND THE ORPHANS IN THEIR CARE of the Stephen Lewis Foundation, says RNAO’s International Nursing Interest Group launches grandmothers are the best experts when it comes to making life better for themselves awareness initiative to support grandmothers caring and their grandchildren; they just need the for orphaned children. tools to do it. She began thinking about how the foundation might help after noticing the ylvia Scott has seen first hand the number of proposals coming across her devastation the HIV/AIDS pan- desk that sought money for widow and Sdemic has brought to the parenting projects. She also noticed that African continent. Each year, the RN each time her father, Stephen Lewis, from Kitchener-Waterloo travels with returned from Africa, he spoke about her husband to their native Kenya to grandmothers he had met at orphan work at the Matangwe Community feeding programs, or who were holding Health Centre, which the couple support meetings under a tree. opened almost a decade ago. Landsberg-Lewis realized these women Through her international work, need help not only because of the Scott has seen too many adult men tremendous poverty they face, but also and women succumb to the disease, to cope with the grief of burying their leaving behind millions of orphaned own children while simultaneously children. She has also seen how raising grandchildren who are strug- grandmothers are reaching across gling with their own loss. generational lines to care for these In the year-and-a-half since the children. Scott says the Matangwe launch of the Grandmothers to Grand- clinic, and the community projects mothers Campaign, more than 160 that operate out of the facility, help groups have been set up across Canada, support more than 300 grandmothers raising funds for more than 200 projects looking after 2,000 orphans. in Africa. McNairn hopes RNAO’s According to the Stephen Lewis group will soon be among that num- Foundation (SLF), there are 13 mil- ber. Members of INIG have already Kenyan grandmothers receive certificates lion children in Africa who have been started talking about how to move the after completing an agricultural program at orphaned by HIV/AIDS.That leaves Matangwe Community Health Centre. resolution ahead, and hope to set up a tens of thousands of grandmothers group by December. with little choice but to take on their care. she is taking a year-long sabbatical to work Landsberg-Lewis says she looks forward At RNAO’s 2007 annual general meet- and travel abroad. She will spend six weeks at to the ongoing contributions of Ontario’s ing, members passed a resolution to promote Scott’s clinic in Kenya. grandmothers, particularly those who are awareness about two SLF programs: the Give Scott believes RNAO’s support for the also nurses. She believes nurses’ work experi- a Day Campaign, which encourages individ- Grandmothers to Grandmothers Campaign rep- ences, whether in Canada or abroad, will uals to contribute whatever they can to the resents a chance for RNs in Ontario to truly help them imagine what life is like coping foundation on World AIDS Day in understand the plight of African grandmoth- with the overburdened health-care systems December; and the Grandmothers to ers, some of whom are also retired nurses. in African nations, and the sense of duty Grandmothers Campaign, a project that allows She says Canadians need to raise money to grandmothers feel not just to their grand- Canadian grandmothers to raise funds for help find solutions that will give this older children, but also to their communities. their African counterparts. generation hope and resources to make their “It takes a leap to imagine the enormity Cindy McNairn is president of RNAO’s lives better each day. Scott and her husband of [the HIV/AIDS pandemic],” Landsberg- International Nursing Interest Group have been able to help by providing grand- Lewis says. “But it doesn’t take a leap for (INIG), which sponsored the resolution. She mothers with seeds so they can grow their nurses to imagine the responsibility of caring says the group brought the issue forward in own crops. Matangwe clinic staff worked for families and communities, and to under- part because it directly relates to health care with the grandmothers and a local nutrtion- stand the skills that are needed (to help).” overseas. But the resolution is also personal. ist to develop healthy recipes using local To find out more about RNAO’s resolu- McNairn was moved to act after hearing foods.The recipes will appear in a cookbook tion, and the Grandmothers to Grandmothers Stephen Lewis, former UN Special Envoy they hope to sell to raise money. Campaign, contact RNAO Nursing Policy for HIV/AIDS in Africa, speak at Toronto’s “We have grandmas who are doing Analyst Gail Beatty at [email protected] or George Brown College, where she teaches. absolutely amazing things,”Scott says.“If we 416-599-1925/1-800-268-7199,ext.237. RN She has since become so inspired that she can identify other income generating activ- contributes to the foundation regularly, and ities to support sustainability, that’s what JILL SCARROW IS STAFF WRITER AT RNAO.

Registered Nurse Journal 11 IT TAKES A TEAM to treat mental illness

Nurses join forces with other health professionals to help people with mental illness rebuild their lives.

RN MAXINE LESAGE HAS SPENT A LIFETIME IN that in the future, you are available to them.” the community where she works. As a result, she really Lesage is not alone in her efforts to help people move understands the health needs – and the histories – of the beyond mental illness and connect with the resources they patients and neighbours she sees every day. A community need to stay well.Although the prevalence of mental illness health nurse at the Garden River First Nation, Lesage has been well documented among Canada’s Aboriginal believes being a life-long resident of the community gives her population, it is certainly not the only group to grapple valuable insight into patients, and helps her to identify those with the issue. According to the Canadian Mental Health who may be suffering from mental illness, even if they’re just Association (CMHA), six million Canadians will develop a at the health centre to make a doctor’s appointment or visit mental illness at some point in their lives. That includes the pre-natal clinic. eight per cent of the population who will battle depression, “The family may have had a tragedy or been impacted five per cent affected by anxiety disorders, and one per cent by residential schools or experienced abuse,” she says. “It who live with schizophrenia. But it’s partnerships like the really makes a difference in your planning and how you can ones Lesage creates that give a voice to this group, helping help them.” to break down troubling barriers to care such as too few Lesage says many First Nations people are reluctant to talk health professionals, inaccessible services, and the crushing about mental illness, but by asking the right questions and lis- stigma that surrounds mental illness. tening carefully, she can uncover conditions that may not be In August, the federal government recognized these bar- obvious to doctors and nurses who didn’t grow up on the riers and announced the creation of the Canadian Mental First Nation.For example,Lesage may see a woman for a pre- Health Commission. Made up of representatives from the natal exam and may discover she doesn’t have any support at Aboriginal community, government officials, mental illness home, or is feeling depressed or unhappy about the pregnancy. survivors, and community groups, the Commission will be That revelation allows Lesage to set the wheels in motion and chaired by former Senator Michael Kirby who, in a 2006 work with the family physician to ensure the best care for report entitled Out of the Shadows, called for expanded men- both mom and baby. tal health services across the country. Over the next five She says trust is the cornerstone that allows her to refer years, the group will receive $55 million to tackle the issue patients to services both in the community – such as healing of stigma, create a place where anyone touched by mental circles where they can find a safe place to talk to someone – illness can share ideas and information, and develop a

d and outside of it, which may mean helping people access national mental health strategy. n o F

a transportation in nearby Sault Ste. Marie, and working with As the Commission starts its work this fall, it may want L

l e

a urban doctors and nurses to ensure the best care possible. to look to Ontario for some successful examples of part- h c i All that hard work pays off, she says, adding there’s noth- nerships between nurses and other health-care providers, M

. J

: ing more rewarding than seeing patients who have overcome community agencies and survivors of mental illness that are y h p

a depression or addiction thanks to her help. creating better lives for millions. By playing pivotal roles in r g o

t “There’s a sense of peace when you know you did what these partnerships, nurses are easing patients’ journeys o h

P you could.There’s a bond that’s developed … (patients) know through the province’s health-care system, and even elimi-

12 September/October 2007 S A TEAM nating some detours that take them back to hospital. RN Brent Stein says he wants to make sure patients never tell the RN Fernanda Coletto is a mental health counsellor at the same story twice.As the clinical director at the Barrie-Simcoe branch Hamilton Family Health Team, where she sees mental health of the CMHA, Stein leads the Assertive Community Treatment patients referred to her by family physicians.As a result of this col- (ACT) Team,which includes nurses, social workers, psychiatrists, peer laboration with her medical colleagues, Coletto is able to help supporters, and occupational and recreational therapists who meet patients by setting up one-on-one or group counselling, recom- daily to receive updates on changes in patients’ conditions. mending links to community services, or scheduling appointments ACT teams work with about 100 patients who have schizophre- with the team’s psychiatrist. She says the FHT helps patients from all nia, bipolar disorder, or a schizoaffective disorder, and who have not walks of life and with a variety of mental health challenges.Whether responded well to other rehabilitation or outpatient services.Whether they’re battling anxiety,a mood disorder, or depression after losing a someone wants to get a job at the local gas station or to reunite with loved one, the team is able to help. their family, Stein says ACT team members provide support. Social “I work with the client and doctor to decide the best route for workers accompany clients during family visits, RNs ensure medica- depression, anxiety disorder, mood disorders,” she says. “The client tions aren’t causing complications, and recreational therapists organize hopefully has one stop shopping.” pick-up hockey games and hikes to help clients socialize. Stein says all Valerie Grdisa, president of RNAO’s Mental Health Nursing of these activities, including working in a meaningful job, help Interest Group (MHNIG), is researching collaboration in mental improve mental illness survivors’ sense of well being. health. Her focus is on partnerships between sectors and health pro- “There’s life after illness,” he says. “We really try to look at what fessionals. The research comes after a career helping terminally ill the person’s goals are.We can help them with symptom management children and youth with mental health struggles. Grdisa says when a and with the activities of daily living,but over and above that we (help young person is diagnosed with a terminal illness, it takes a terrible them) with what’s important to them.” toll on them, and on the family and the nurses responsible for their According to the Canadian Institute for Health Information, the care.While working in pediatrics, Grdisa began holding meetings so people who receive help from ACT teams spend less time in psychi- staff could talk about coping with a child’s death. She says the gath- atric facilities and ERs. In fact, the teams work so well, the Barrie- erings offered doctors, nurses and social workers the chance to talk Simcoe CMHA recently established a second team in Orillia, which about ways to improve the team’s communication, get a better will link with patients who are leaving the Mental Health Centre understanding of each other’s roles and expertise, or develop strate- Penetanguishene (MHCP) and Soldiers’ Memorial Hospital. The gies to help families cope with a child’s imminent death. newest team will meet with MHCP staff members and patients Partnerships like these and others are working well for both before discharge so they can create strong relationships while still pro- patients and their care providers, but Grdisa says there is still plenty of viding reassurance that staff in Penetanguishene is there to help when room for improvement. She believes Ontario needs structures such as a patient feels it’s needed. electronic health records to make that happen. She also believes more For the last 15 years, RN Cheryl Forchuk has been researching research is needed on the experience of patients. just how important that link between hospital and community staff is “Although everyone is talking about patient care and the collabo- for mental health patients. In the 1990s, she conducted a pilot proj- rative process, we really haven’t conceptualized what that means for ect at the Centre for Mountain Health Care in Hamilton (formerly patients and families,”she says, adding no matter how well profession- known as the Hamilton Psychiatric Hospital). Some of the patients als may be working together, if patients have to repeat their stories in the facility at that time had lived there for five years. Forchuk and each time they see a different care provider, the collaboration is not her research team surveyed patients to find out what they needed to working as well as it could. live on their own successfully. She says they described the fear –

HOSPITAL NO PLACE FOR HOMELESS STRUGGLING WITH MENTAL ILLNESS Although everyone is at risk of developing a mental illness, the odds These are people who have no access to care.” are even greater for segments of the population that struggle with Wood has been a member of the outreach team for almost 15 poverty and homelessness. In fact, recent statistics from the years. She works with nurses, social workers, psychiatrists, a psychol- Canadian Institute of Health Information show that, in 2005-2006, ogist and other health-care professionals. Part of her job takes her mental illness was the reason for 52 per cent of acute care hospital- to a local community health centre and shelters where she monitors izations among the homeless. the medications homeless individuals may be taking. She also RN Beth Wood, a nurse who works with the Royal Ottawa demystifies some of the stigma around mental illness. The brain, she Health Care Group’s Psychiatric Outreach Team, knows these statis- tells patients, is an organ just like any other in the body. And like tics all too well. She says an acute-care hospital is not the right place other organs, it can malfunction. for men and women who have been struggling with a mental illness Wood has established partnerships with community agencies for decades while living in shelters and on sidewalks. They need and shelters in an effort to reach out to those on the street. She long-term services and health-care professionals who can care for admits, however, that more can be done to help this population. their mind and body, and speak out on their behalf. She would eventually like to see mental health clinics attached to “For me, what is important is advocating for this group because primary care centres in downtown areas. She believes more accessi- nobody will talk for them,” Wood says. “Homeless people…have a ble primary health-care services would give the homeless a place to whole lot of substance abuse problems, mental health problems. go besides the emergency room. RN

14 September/October 2007 RN OFFERS MENTAL HEALTH CARE BEHIND PRISON WALLS

RN Carolyn Kirkup makes house calls every day, checking up on “We’ll be going from one cell to another and (correctional her patients’ mental health. But she doesn’t find her patients officers) watch how we relate to the inmate,” she says. She behind the doors of their homes on suburban streets, in high often helps officers understand how to deal with a mental rises, or in rural community farm houses. Kirkup’s patients are illness, and how to watch for signs that an inmate may commit behind the maximum-security bars of the Kingston Penitentiary. suicide. “Many offenders have actually been saved by officers, In the view of this corrections nurse, the prison population has just being alert to changes in behaviours.” just as great a need for a team approach to mental health care as Kirkup works for the psychiatric facility at Kingston patients being cared for in the community. In fact, in some Penitentiary that has a team of psychologists, psychiatrists, respects, the needs of this population are much greater. nurses and corrections staff. The most severely ill patients are Kirkup says research shows there are two to three times referred to that facility, but there are still as many as 300 inmates as many people with mental illness living inside Canada’s who require care from Kirkup and her colleagues, including a prison walls as there are in the general population. Although she psychiatrist who runs a weekly clinic. doesn’t have hard data to link the number of prisoners Kirkup has built relationships with a variety of health- with cuts to community mental health services, she feels there care providers over the three years she’s worked at the prison, is a connection. Kirkup says without community support, people but she says it’s her relationship with inmates that requires with a mental illness may stop taking medications and commit constant nurturing. a crime. Once these individuals arrive in the system, it’s not “You have to be very fair and honest because these people just nurses they rely on for help. Kirkup says she always have learned who they can trust and who they can’t,” she says, collaborates with other health-care professionals and the adding it’s that trust that allows her to truly make a difference correctional officers. for the people society has otherwise given up on. RN shared by many people who have been hospitalized for long periods Parker is part of the hospital’s Wellness Project, an initiative that of time – of leaving the hospital because it’s the only support system pairs Forchuk’s research into peer support with a program called the they have ever known. Wellness Recovery Action Plan, or WRAP.Developed by a psychiatric “If losing the connection with staff they trusted was what was survivor, the plan emphasizes the need to help mental illness survivors required to leave, they’d rather stay,” Forchuk says.“They didn’t have take control of their lives while identifying and coping with stresses any similar connections in the community, but they also didn’t have that can trigger crisis. any friends.Their friends were often other patients on the ward.” In 2006, with funding from The Change Foundation, Royal By providing these Hamilton patients with the support of both Ottawa partnered with Psychiatric Survivors of Ottawa and the the community and hospital health-care providers, every one of CMHA of Ottawa to link in-patients on the psychiatric unit with ill- them was discharged.With the results of the pilot in hand, Forchuk ness survivors. ROHCG trains these survivors so they can lend an ear and her team developed the Transitional Discharge Model, an over coffee when in-patients need someone to talk to. Parker is part of approach to care that allows patients to maintain relationships with a team that has been monitoring the success of the program since its hospital staff until they’re linked with community care providers. inception, and has found both groups are better able to recover from The model also matches patients with a peer supporter. Forchuk their illnesses. Setbacks are also less devastating. She says it’s not just and her team then went on to test the research in other psychiatric patients who are benefiting from the program either. Parker believes wards across Ontario. The results, she says, are as good for the one of the most remarkable successes is that staff members are recog- health-care system’s bottom line as they are for patients. nizing that people can move beyond their illnesses. Transitional discharge decreased the length of stay on the test units “The nursing staff has really shifted,”she says of the new-found by 116 days per patient, saving the health-care system more than hope that patients can recover. “They’ve noticed a change in the $12 million. people who are involved in the program. Patients are more positive, Beyond the numbers, Forchuk believes the human impact is more hopeful.” more powerful. The Wellness Project has shown that mental health patients can She says her best discovery is just how valuable these connections emerge from years of hospitalization.They can shed the stigma, find a are for patients, especially in terms of the relationships they’re able to job, live on their own, and participate in the activities of daily living form with peers who have battled their own mental illnesses. She says most people take for granted. these friendships have also given mental illness survivors the confi- But they can’t do it alone. dence they need to improve their own lives. Partnerships in Ottawa and all across Ontario, whether they’re in a Forchuk’s research – and her innovative approach to partnerships – primary care setting, a hospital, or the community, give patients the has not only had an impact in Hamilton. It’s also influenced mental blocks they can stand on to reach for better care and take the first health practice in places like London, Whitby and Ottawa. At the steps toward independence.As long as partnerships like these can con- Royal Ottawa Health Care Group, a mental health facility, RN tinue to grow, mental illness patients will have a better chance of Doreen Parker says the connections nurses can help patients make in becoming mental illness survivors. RN the community are just as important to their recovery process as the working relationship between their health-care providers. JILL SCARROW IS STAFF WRITER AT RNAO.

Registered Nurse Journal 15 Helping the Homeless FIND THEIR VOICE BY CATHY CROWE Despite encouragement from colleagues and friends, RNAO member Cathy Crowe never felt compelled to write a book about her work as a street nurse. In fact, she dismissed the idea more than once. What she was never able to dismiss, however,was her strong belief that the heroes and heroines of Toronto’s homeless population deserve the same kind of attention frequently focused on her. That’s why she was finally convinced in the summer of 2004 to put pen to paper and tell their stories. Dying for a Home, released earli- er this year, features the stories of ten homeless people. James Kagoshima is one of them. He died before Crowe began working on the book, but she says he is the reason behind it.

first laid eyes on James Kagoshima at a National Housing Day rally on November 22, 2001, outside Toronto’s City Hall. He was in the front row,fully appreciating the live music and speech- Ies coming from the stage.To say James was charismatic is an understatement. I remem- ber being on stage trying to speak to the James Kagoshima (left) attempts to explain why people squeegee to Jim Brown, former Conservative MPP and Chair of Mike Harris' Crime Control Commission in the late 1990s. crowd and he just kept heckling me about housing, but in a fun and silly way,laughing Nathan Phillips Square, where he had slept James agreed that I could discuss his med- and chanting slogans the entire time. He the night before. ical care with his physician, Dr. Tomislav demanded my attention and pretty much There are so many reasons someone like Svoboda.Tomislav told me he had decided continued to do so in the years to come. James would still sleep outside: no shelter to treat James aggressively,to do everything He never let me forget that we met on beds available; a growing intolerance of the he could to get him out of the wheelchair. National Housing Day. It was the begin- conditions inside; and simply being an This worked because James had exception- ning of a relationship based on our mutual adult and not wanting rules like curfews. al stamina and was determined to fight his interest – ending homelessness by making I’m reminded of a phrase in one of his health problems so he could, in turn, fight politicians accountable – and a seemingly favourite books, Runaway, by Evelyn Lau: homelessness. Before long, he was walking sixth-sense way of understanding and “I’d rather be living on the streets, standing again and speaking out.

.

p knowing each other. in puddles of glistening black and neon.At In early January 2004, James, still a bit r o C

James firmly held the politicians least I’d be free.” weak, and I took a taxi to a Toronto a i d e accountable. In the fall of 2000, James I was never James’s nurse.We were more Disaster Relief Committee (TDRC) press M

n spoke at the conclusion of a City Council like colleagues.This was his decision. But I conference outside of the Fort York u S

, l l committee meeting where homeless advo- still worried about his health. I knew he Armoury.James had written a speech and it i e N ' cates had come forward to press the politi- had many serious health problems includ- was clear that although TDRC had not O k r cians to respond to homelessness as an ing a tumour in his brain. Several years asked him to be a speaker, he would be a M

: emergency. He startled the councillors by later, when he was incapacitated by health speaking.The Fort York Armoury, a federal y h p

a pointing out that while they were debating problems and confined to a wheelchair in building, was being used that winter as an r g o

t the issue inside a warm building, he had the Seaton House Annex – a harm reduc- emergency shelter, but the federal govern- o h

P come inside to talk to them from outside at tion program in a men’s homeless shelter – ment was terminating the arrangement

16 September/October 2007 with the City and was planning to force Enclosed is the invitation to a memorial, as was made by family.James was 41. homeless people out. well as a vigil, for those that have passed I later learned that the day after our At the press conference, James made his away in shelters as well as on the street. scheduled walk with the mayor, James had disgust with the federal government clear in Many thanks come from the signatures that walked himself into the St. Mike’s emer- his remarks:“Can I say I am proud to have are attached.” gency department, and then rapidly deteri- been an ex-soldier of 3PPCLI (Princess Ironically, James himself would be orated. He died one week before Mayor Patricia’s Canadian Light Infantry)? The air- remembered at the same vigil only two Miller’s Summit on Housing and borne has disgraced the uniform, myself – months later. Homelessness, where, without doubt, James James Leo Jacobs (his birth name) – and James almost got his wish to spend time would have made an impression. everybody else. Peacekeepers around the with Mayor Miller. On Friday, February James knew how tenuous life was. world? It’s another international disgrace. 13, 2004, just days before he died, James In 2003, he organized a large memorial for Thanks (Paul) Martin.” was to join me on a nighttime walkabout his friend Leo Cyrenne, who had died As if the action had been scripted, James with the mayor. James homeless. On that day, impatiently threw his hat down on the would introduce the 10 names of homeless ground, stomped on it, and walked away. I mayor to homeless people people were added to the later learned from his speaking notes that sleeping outside, and out- memorial board at the this drama was indeed scripted. This event line his own solutions to Church of the Holy led to a big victory.The feds backed down homelessness. James didn’t Trinity. Immediately fol- and postponed the eviction date, buying show up. I felt a twinge of lowing that service, James time for the City to negotiate a deal with worry but suppressed it. rushed back to Seaton the owner of an empty building, once used There were many reasons House for yet another as a nursing student residence, for it to be he might not have made it. memorial for another used for emergency shelter during the Little did I know... man. James often said that remainder of the winter.As an even sweet- On Tuesday February he would be next. er victory,that same building has now been 17, I woke, and for reasons James was born James turned into affordable housing. not clear to me and which Moreau Jacobs. He was James reached out to many of his broth- I still can’t explain, I called taken from his native ers and sisters on the street – people I could my colleague Michael mother when he was very never have reached. He brought them Shapcott to cancel a morn- little and was bounced sleeping bags, food, and friendship. At the ing meeting with him. I Cathy Crowe around a number of foster same time he did what I call ‘upstream’ had a nagging feeling that I at her book homes until he was about advocacy. He was thrilled when David was supposed to go to St. launch eight. When he was Miller was elected Mayor (of Toronto) and, Michael’s Hospital, although I wasn’t sure adopted as a young boy he became Jim at a TDRC press conference, declared why. I couldn’t think of anyone I knew in Buchanan, and later when he moved in Miller good enough to be prime minister. hospital at the time. with the son of one of his foster parents, he On January 9, 2004, James sent a typed let- Then, around 11:00 a.m., Art Manuel, became Jim Mahon. ter to the mayor: “Welcome to office, from Seaton House, called me.“Cathy, I’ve A memorial celebrating his life was held Mayor Miller. It’s very nice to have a per- got bad news.” He told me James was in at the Church of the Holy Trinity,the place son of your concern for our City,economy, ICU, not doing well. It didn’t look good. where James himself had often remem- and people, in office. Congratulations.” Did I know how to reach family? Well, I bered fallen comrades. Members of his James was always a sophisticated advo- knew what those words meant. I grabbed a family, homeless people, Seaton House cate and his political follow-through was cab and headed to St. Mike’s. staff, leaders from faith communities, hous- impeccable. Several months later, he James was in ICU. He wasn’t conscious, ing activists, non-profit housing builders attached a copy of over 100 signatures to a but I spoke to him and told him how brave and university students attended. To quote letter to the mayor: “This letter is coming he was and how much we loved him. I felt Catherine Dunphy from the Toronto Star, from the many at the Seaton House Annex quite out of place in the high-tech space. “He fought homelessness from the front program that voted for you after your visit. There were lots of tubes, whose purpose I lines for another reason: He lived it.” We are asking you if you could see to the didn’t even know, going into James. Nurses James honoured homeless people: men, opening of more Out of the Cold pro- were looking at me with curiosity. My women, and children. He honoured the grams and/or beds/harm reduction spaces memories of what happens to homeless Seaton House shelter staff that cared for to help our friends and others.We are espe- people once they’re in hospital flooded into him deeply. He honoured Mother Earth. cially concerned about teens, women’s, and my mind. How could I explain to the ICU Mostly,he honoured the right for every children’s shelters.” nurses that the man lying there was an person in Canada to have a home. RN Again showing the kind of follow- activist; a great man? through many advocates could learn from, I learned that family had been contact- FROM DYING FOR A HOME: HOMELESS he ended with:“Could your office arrange ed and had visited James. Other friends and ACTIVISTS SPEAK OUT, BY CATHY CROWE a meeting with Annex clientele at a place Seaton House staff visited him too.The dif- ET AL., PUBLISHED BY BETWEEN THE and time of your convenience?...P.S. ficult decision of removing life supports LINES, TORONTO, 2007.

Registered Nurse Journal 17 by Clinton Baretto RNs have role to play in reducing gang violence Nursing graduate Clinton Baretto believes a better understanding of social justice issues will inspire young RNs to see how they can make a difference for youth.

hroughout my education, I learned many theories and philosophies T about ‘how’ to practice nursing. Social justice, however, is the only philoso- phy I have adopted to guide ‘where’ and ‘why’ I practise. I believe that teaching nurs- ing students about social justice issues will inspire a whole new generation of RNs in much the same way it has inspired me. When I graduated from McMaster University in 2006, I left the comforts of home in an urban setting to work at Grassy Narrows First Nation reserve, north of Kenora.This reserve struggles with many of Grassy Narrows RN Clinton Baretto and teacher Paul Clugston (standing, left and the social justice issues facing society today. right, respectively) talk to high school students about health and leadership. One such issue is youth violence. Although the reserve itself does not have any body in, resuscitates the victim, and sends advocates for change, social justice must gangs, it is close to Winnipeg and Thunder them on their way. Soon after, another body become an integral part of nursing educa- Bay, two cities with known chapters of vio- appears, and then another, and another and tion. In my final year of university, I had a lent gangs.Youth from the reserve can devel- so on.The health-care worker is so focused professor who encouraged students to think op gang affiliations when they visit these on resuscitating the victims that he dismisses beyond conventional nursing.When I deliv- centres.The resulting violence on the reserve the idea of going upstream to find out where ered a seminar on youth gangs, some of my can have a devastating effect on the health they are coming from, and fixing the under- classmates struggled to accept the role social and emotional well-being of the community. lying cause. justice advocacy plays in nursing. Responses Across Ontario, gang violence is receiv- In the case of gang violence, these bod- such as ‘the nurse’s job is at the bedside’ and ing a great deal of media attention and is a ies may be victims of gunshots, stabbings, or ‘advocacy is someone else’s job’ showed an growing concern no longer confined to other sources of physical, mental, or emo- ingrained narrow focus of nursing. major cities. This issue is an ideal example tional harm, that pass through various clini- Given these attitudes, I believe it’s vital to to use to teach new nurses about social jus- cal settings. Nurses are often so busy dealing specifically address the role of the nurse when tice, to help them develop an awareness of with the acute issues that we don’t go look- discussing social issues. Developing this socioeconomic and political issues that ing for the root cause. It saddens me when awareness throughout the education process impact health, and to prepare them to be politicians argue back and forth about allows students to openly critique social atti- advocates for change. greater gun control and policing solutions tudes that contribute to poor health and Gangs have a negative impact on the but miss the real issue of economic disparity. encourages advocacy for social justice, both as health of individuals in the community,both This is where nurses can come in, believing professionals and citizens of the world. acutely through physical violence, and that holistic care and health promotion We’ve all cared for patients who made us chronically through its psychological and make a difference. think: “If only they lived in a better area, social impact. Growing up in poor neigh- Nursing students who decide to pursue they had more money,or a better lot in life.” bourhoods increases the likelihood that a career in public health and other special- For these patients, we have an obligation to youth will become hostile. This contributes ties can engage in social justice advocacy by take on this great challenge, despite the to a negative outlook on the future, one of lobbying politicians, creating public sup- notion that it might be a utopian dream. No several traits associated with a higher risk of port, speaking from experience, and pro- single organization, agency, community mental and physical illness. moting involvement in advocacy of those group or discipline can successfully address a Youth who join street gangs generally directly affected. Pediatric nurses can also complex problem such as gang violence come from lower income families who live in play a role by advocating for the child they alone. But for the sake of future generations neighbourhoods known for gang activity.Poor cared for who was hit by a stray bullet. of youth in our communities, it’s a challenge mental health and minimal parental and com- Obstetrical nurses can become more vocal we must all take on. RN munity supports present additional risk factors. about the stress on mom and baby caused A fable was once written about a health- by living in a dangerous neighbourhood. CLINTON M. BARETTO, RN, BScN, IS A care worker on a fishing trip. He sees a body And the list goes on. COMMUNITY HEALTH NURSE AT GRASSY floating down the river, wades out, pulls the In order to prepare young nurses to be NARROWS FIRST NATION.

18 September/October 2007 by Jill Scarrow Keeping poverty on the political agenda Ontario voters chose the Liberal party to lead the province again for the next four years, but that doesn’t mean other parties do not have a role to play in ensuring the poverty issue gets the attention it deserves.

days before Ontario voters headed to TEN polling stations for the fall election, Premier Dalton McGuinty made a campaign stop at a food bank in Toronto, announcing that his government would commit to setting poverty reduction targets within the first year of a new man- date.The commitment was one of the few occasions poverty was addressed during the campaign.As the Liberals begin their second mandate, RNAO will be looking to ensure the Premier keeps his promise. For most of the 2007 election cam- paign, RNAO pushed for more than just sound bites about how political parties The All-Party Debate on Poverty and Health on Sept. 25 featured panelists (L to R) Marie planned to help people who are strug- Bountrogianni, Sheila White, Carol Goar gling.The association, in partnership with (moderator), Angela Kennedy and Sanjeev Goel. the Income Security Advocacy Centre and Health Providers Against Poverty, made it programs like the Ontario Child Benefit likely to die compared to those who have an the central issue at an All-Party Debate on will help to ease the effects of poverty, but adequate, healthy place to call home. Poverty and Health at the University of years of cuts to programs in the 1990s made “Our party will invest in more affordable Toronto on Sept. 25. the job difficult for the Liberals during their housing, co-op housing and work with all According to Statistics Canada, more first mandate. “We’ve done a lot to address sectors, private, public, and all levels of gov- than one in seven people in Ontario live in poverty, but we’re starting from behind,”she ernment, to make a long-term strategy,” poverty. That includes more than 230,000 told the crowd of more than 200. Kennedy said of the Conservative stance on with a disability, and 345,000 children and Green Party candidate Sanjeev Goel, PC homelessness. teens. It has long been known that meeting candidate and RNAO member Angela Goel went a step further by announcing basic needs forms the foundation for good Kennedy, and NDP candidate Sheila White that the Green Party would eliminate health. For example, according to an article also participated in the event, which was homelessness within a decade by building published in the Journal of Nutrition, a lack of moderated by Toronto Star columnist Carol rent-to-own housing. healthy food is linked to chronic illness, Goar. The panelists answered questions “We want to get people out the cycle of depression and heart disease. And there is focusing on social assistance rates, the mini- poverty,” he said.“We’re going to allow peo- plenty of evidence to suggest that as a fami- mum wage, child care, affordable housing, ple to take charge of their own destiny.And ly’s income falls, the likelihood goes up that and help for new immigrants and individuals that’s something that’s radically different.” children will suffer from poorer mental and with disabilities. Although the votes have been counted physical health for their entire lives. Raising the minimum wage was a hot and the campaigning is done,Ferguson-Paré “Nurses see so many people who have topic throughout the evening. “The mini- says RNAO and groups such as Health difficulty making ends meet,” said RNAO mum wage is probably the most meaningful Providers Against Poverty and the Income President Mary Ferguson-Paré.“That’s why thing we can do, right now, to address Security Advocacy Centre will continue to we sponsored this debate. We wanted voters poverty levels in this province,”White said. hold all politicians accountable to what they in this province to know where each of the “We need $10 an hour right now.” said during the election.“We need to stand parties stands on this issue and their plans to Beyond the need to ensure everyone up for those in our communities who sel- help the hundreds of thousands who are earns a living wage, RNAO will also watch dom have a voice,”she says.“Only then can hungry, can’t afford to pay the rent, or are to see that politicians address the desperate we end the devastating poverty that affects working several low-paying jobs.” need to improve conditions for the home- the health of so many people.” Former cabinet minister Marie less. Studies published in the Journal of the For more information, and to watch seg- Bountrogianni, who represented the American Medical Association have shown that ments of the debate, visit www.rnao.org. Liberals at the forum in September, said those who live on the street are much more

Registered Nurse Journal 19 by Kimberley Kearsey PASS THE

RNAOPOPC members take politicians to see SiCKO, ORN a film that exposes the tough realities of for-profit health care in the U.S.

Members of RNAO’s Middlesex-Elgin chapter invited London-Fanshawe NDP MP Irene Mathyssen (fourth from left, front) and Liberal MPP Khalil Ramal (third from right) to a screening of SiCKO on Aug. 9. Fourteen nurses participated in the outing, including (L to R) Karen Thompson, Anna Wilson, Aric Rankin, Barbara Watson and Josline Steele Manguen.

RNAO’s Essex chapter president Lynda Monik (right) and member Marcia Bear were thrilled to hear SiCKO distributor Alliance Atlantis was offering free tickets for all health-care professionals to see the film in July. They were among 6,000 Canadian nurses to take advantage of the offer.

Liberal MPP Peter Fonseca stripes were invited by RNAO members to see the movie, including emerged from a Mississauga movie party leaders at both the provincial and federal levels, and the health WHEN theatre after seeing Michael ministers at Queen’s Park and on Parliament Hill. Moore’s new film SiCKO, he said it was “…a real eye-opener for The goal: provide politicians with the same ‘aha’ moment me in terms of where we don’t want to go.”The documentary, Fonseca describes. which opened June 29, profiles Americans who have faced chal- RNAO’s support for SiCKO is linked to the association’s ongoing lenges accessing health care despite having private health insurance. advocacy to protect publicly funded, not-for-profit health care. For Fonseca – who was participating in RNAO’s Pass the Popcorn initia- Canadians and Americans alike, the message Moore’s trying to convey tive – saw the film with members Julie Curitti and Norma Nicholson. in the documentary isn’t new.In fact, some RNs and physicians who “It was interesting to see it with two nurses and hear their perspective,” left Canada to practice south of the border have returned, in part, he told a local reporter.“I think it has strengthened my conviction.” because they don’t feel comfortable working in a system that often That was the idea, Curitti says. “I think it’s very important to favours profits over patient care. have our government see the film and realize the tremendous The Pass the Popcorn initiative was launched in response to investment we all have in (health care).” several attacks on Canada’s publicly funded system in the early sum- The July 23 screening in Mississauga was one of several to take mer months (see pg. 7 for more on these). It has received tremendous place across the province this summer. MPs and MPPs of all political support from RNs. “Congratulations on this proactive approach,”

20 September/October 2007 RNAO President-Elect Wendy Fucile Stéphane Dion, Leader of the Liberal Party of Canada, saw SiCKO with RNs on presents Peterborough’s Liberal Aug. 16. He then participated in a roundtable discussion to hear the group’s MPP Jeff Leal with a copy of the views about two-tier health care. (L to R) Valerie Glasgow, Simcoe North association’s election document, Liberal candidate John Waite, Hilda Swirsky, Cathy Kitely, Ruth Schofield, Creating a Healthier Society, out- Liberal MP Carolyn Bennett, Sue Matthews, Mary Ferguson-Paré, Haldimand side the theatres where they saw Norfolk candidate Eric Hoskins, Dion, Liberal MP Bonnie Brown, Liberal MP SiCKO on July 23. Susan Kadis, Doris Grinspun, Keith King, Jennifer Yoon, and Kim Meighan.

On July 19, ten RNAO members joined Toronto Star reporter Ashifa Kassam for a screening of SiCKO in downtown Toronto. The group then headed to home office for a roundtable discussion. From L to R: RNAO senior policy analyst Lynn Anne Mulrooney, board Ontario’s Health Minister George Smitherman chats with member Hilda Swirsky, Karen Gayman, Tilda Shalof, nurses outside an Aug. 16 screening of SiCKO in Toronto. Executive Director Doris Grinspun, Gurgit Sangha, Allie From L to R: RNAO board member Hilda Swirsky, Jennifer Starr, Ann Chang, Munira Nanji, and Stacey Stenson. Yoon, Smitherman, and Keith King.

Hampton RN Gail Brimbecom wrote to RNAO. “I’ve seen (the opposing two-tier health care, and reiterated what he had told movie) and thank God there are people like Michael Moore who are reporters outside the theatres that same afternoon: “There are strong appropriately outraged about health care in the U.S..” lobbies that would like to take us there (two-tier health care), but they In addition to arranging screenings with politicians in Toronto, won’t have the ear of the Liberal party.” Mississauga, London and Peterborough, RNAO organized two “While the weight of evidence and research proves that our roundtable discussions, one with the leader of the Liberal Party of Medicare system offers a higher quality of care, at a much lower cost Canada, Stéphane Dion, and another with Toronto Star reporter to taxpayers than the U.S. model, SiCKO uses the stories of real Ashifa Kassam.The 10 nurses who participated in the latter agreed patients to effectively drive the point home,”Ferguson-Paré said. that the movie was well done, but were somewhat troubled by Thanks to members’ involvement in the Pass the Popcorn initia- Moore’s rosy view of health care in Canada, and his decision not to tive, these stories have reached decision makers at both the provin- expand on the troubling wait times we face.The nurses also discussed cial and federal levels. Hopefully, they will ignite a similar passion the role their U.S. counterparts can play in advocating for vulnerable for Medicare in politicians that so clearly exists among nurses populations like those featured in the film. across the province. RN According to RNAO President Mary Ferguson-Paré, Dion was attentive to nurses’ concerns during the roundtable at home office on KIMBERLEY KEARSEY IS MANAGING EDITOR / COMMUNICATION Aug. 16. He thanked members for their convincing arguments PROJECT MANAGER AT RNAO.

Registered Nurse Journal 21 CMA attack on Medicare generates passionate response from RNs Nurses weigh in on CMA’s plans to privatize Canada’s health-care system.

July 30, outgoing Canadian Medical Association (CMA) “My pre-Medicare memories go back language pathologists, and all the sup- ON President Colin McMillan to 1967…when I graduated from the portive services.We are not simply driven unveiled his vision for “an expanded and Royal Victoria Hospital in Montreal. by medicine, but a collaborative arrange- modernized” health-care system. He During my three years as a student ment. Instead of looking for more dollars released a document entitled Medicare Plus, nurse, Medicare was just developing in to contract out, look within and let us calling on Canadians to embrace a system Canada. My memories of private versus show you how we make it work with in which physicians would be allowed to public care are quite vivid. I remember, what we have.” practice in both the public and private sec- for example, a student rotation at…the Rose-Marie Dolinar,RN tors simultaneously. Less than a month private wing of the hospital where the Ottawa, Ontario later, incoming CMA President Brian Day floors were carpeted, the private rooms took that vision a step further by advocat- and the private nurses plentiful, and the “I grew up in Florida in the 1950s. My ing the introduction of private insurance private doctors very much in control grandfather lived with us, became criti- and a market model for hospital funding. and driving really nice cars. I also cally ill, and ended up in hospital. My The CMA argued these measures were remember a rotation in the public clin- family’s health insurance would not necessary in order to ensure ‘timely access’ ics that were scheduled in the basement cover the cost of the proposed treat- for Canadians, and to keep Medicare ‘sus- of the hospital, where no light entered ment and so he died.Years later, when I tainable.’ and overworked interns and student went into nursing and learned about In RNAO’s view, CMA is once again nurses managed the hundreds of Tommy Douglas’ universal health-care pushing a privatization agenda. President patients who waited for hours.Very few system…I felt great sorrow about our Mary Ferguson-Paré argued that the pro- non-student doctors graced those cor- experience. Had my grandfather been posal “would lead to larger and longer pub- ridors or cared much about what hap- in Canada, he might have survived.” lic wait lists as it has in other countries pened there. Let’s be sure to pay atten- Nancy Bikaunieks, RN where parallel, private hospital systems tion to the direction we are headed, and Newmarket, Ontario exist.” RNAO is also troubled by CMA’s be sure we know the consequences of recommendation that Canadians be our decisions before we make them.” “As a nurse who has previously worked allowed to purchase private insurance. Beverley Simpson,RN in the U.S…I was proud to tell my col- Executive Director Doris Grinspun said Toronto, Ontario leagues how, in Canada, we have an “the minute you introduce private insur- amazing health-care system that allows ance into the system, you create two lines “When profit enters the health-care people equal access. Adopting a private of patients.Those in line who can afford it system, quality goes out the door in system will only place greater strains on pull out their VISA card, while others, the order for the shareholders to make a the health-care system, further reduce majority of Canadians, wait in the second profit. I strongly urge you to not allow available practitioners, and will not line.This is two-tier pure and simple.” the further proliferation of a two-tiered enable equitable access that all citizens of RNAO issued an open letter to Prime system.We all deserve the right to have Canada should have available to them.” Minister Stephen Harper, reminding him access to the same health care, whether Carrie Heer, RN(EC) that physicians have a choice to work pri- we’re wealthy,middle class, or poor.” Kitchener, Ontario vately by opting out of the Canada Health Brenda Hallihan,RN Act, and that it’s telling a great majority have Peterborough, Ontario “I describe this as a quicksand sys- chosen not to do so. tem…the rich and mighty can anchor An action alert was also sent to members, “I invite you to come and visit our hos- themselves while the weak and urging them to write their own letters to pital, and I will show you what national unknown will just fall and be forgot- the prime minister, reiterating why nurses Medicare does. Let me introduce you to ten.” believe CMA’s position is a threat to our nurses, physicians, dietitians, physiothera- Charito Rabi,RN Medicare system. pists, recreation therapists, respiratory London, Ontario More than 400 nurses responded. Here’s therapists, occupational therapists, speech a taste of what they had to say…

22 September/October 2007 by Nicholus Nurse Camaraderie, humour helped soldiers and nurses survive horrors of Second World War As Remembrance Day nears, one RN reflects on her wartime experience caring for soldiers.

Pauline Lamont Flynn remembers the attempts at humour to keep spirits up, day she set sail for England to serve as a even at the worst of times. Some would military nurse during the Second World volunteer their help once they were stable War. A modest cargo ship known as The and out of the beds. Others would offer Araguade carried the 23-year-old and her cigarettes to those without arms. The fellow nursing sisters towards a massive camaraderie between staff and patient was luxury vessel in the distant Atlantic. Flynn born out of necessity and became a factor grew excited at the thought of journeying in their morale. to Europe in style. As they sailed up to – It’s not just her memories of the men in and then past – the fancy ocean liner, she her care that fills Flynn with pride; it is also realized she was already aboard the ship the blue uniform she donned during the that would transport her to the battle- war. For Flynn, the nursing uniform was a fields. Somewhat disappointed, she tucked powerful emblem that signified a duty to the episode away in her mind and made care and a responsibility in the war effort. the best of the situation. She now realizes The uniform was also a symbol of compas- the modest cargo ship was probably the sion and aid, which seemed to evoke a sense best preparation she could have for the of reverence in soldiers and other staff. journey that lay ahead. “You knew you were going to be Flynn was born 87 years ago in the respected,”she says. small village of Denfield in southwestern NAME: Pauline Lamont Flynn That same uniform is now one of the Ontario. As a child, she remembers listen- OCCUPATION: Retired Nursing Sister items that Flynn showcases every ing to riveting stories of care and humanity HOME TOWN: Ottawa, Ontario Remembrance Day during the Meet a from a nurse who served in the First World Veteran initiative, sponsored by Veterans War. Mrs. Fraser was her name, and she “…one day you might be in their position Affairs Canada. The event takes place in was a close friend of Flynn’s mother.“She and you’d want someone to do the same Ottawa at the war museum and provides impressed upon me the horror of all the for you.” It was this compassion and veterans with the opportunity to interact wounded young boys,” she recalls. “They Flynn’s strong work ethic that buoyed her with civilians and talk openly about their (the nursing sisters) needed more help for the two years she was abroad. experiences. Flynn plans to take part again than they had.” The number of injured soldiers who this year, and is eager to educate the public Fraser’s captivating vignettes stirred a arrived daily at the military hospital was about the vital role nursing sisters played sense of compassion within Flynn and cre- overwhelming, Flynn recalls. All of the during the war. ated a lasting impact. When it came time ward beds and the three operating rooms Those compelling stories precede an to choose a direction in life, Flynn’s deci- were perpetually full. “There were too equally rich chapter in her long life. sion to train as a nurse was obvious. She many men and not enough staff. You She returned from Europe in 1946 and graduated in 1941 from the Toronto wondered how you were going to do accepted a position as an RN at Toronto’s Western School of Nursing and immedi- what you were supposed to do.” Sunnybrook Hospital, a post she held until ately looked to contribute her new skills The frenetic pace at which the nurses 1951. Flynn left nursing when she left to the war effort overseas. worked – often with limited resources – Sunnybrook, choosing instead to marry, Flynn arrived on the shores of Scotland meant they had to be secure enough in their raise a family and volunteer in emergency in May, 1944. She was immediately taken nursing expertise to make decisions quickly rooms as much as she could. She admits to her assignment at a military hospital, and efficiently.“Doctors were often busy in that although she decided to leave the pro- just south of London.After witnessing the surgery or attending to a patient. So, if a sol- fession, there will always reside within her devastation of warfare on the city, and dier fainted and required a blood transfu- the heart and soul of a caregiver. coming face-to-face with wounded sol- sion, I had to make that call,” she recounts In a gentle tone, as if it were an eternal diers – many still ‘boys’ – who were look- with pride.“It made me feel self-confident.” truth, she confidently declares: “Once a ing to her for care, Flynn realized she Flynn paints a picture of life on the nurse, always a nurse.You never lose that needed to develop a specific mindset in frontlines not with specific individuals, but connection.” RN order to stay sane. “All the unpleasant with faceless representations of ‘soldier’ or things that you had to do were put in the ‘nurse.’ Decades have passed since the war NICHOLUS NURSE IS A FREELANCE back of your mind,” she says, adding but Flynn still remembers the soldiers’ WRITER IN OAKVILLE.

Registered Nurse Journal 23 toYou NEWStoUse

Ginette Lemire Rodger, Senior Vice-President of Professional Practice and Chief Nursing Executive at The Ottawa Hospital, has been named an Officer of the Order of Canada.“I’m delighted,”the honourary life member of RNAO said of her investiture.The Order, she explains, recognizes people who have made a difference in nation building.“This identifies nursing as an important contributor to Canadian society,”she says. Lemire Rodger is no stranger to the awards stage. She’s received a Commemorative Medal for the Queen’s Golden Jubilee from the Government of Canada (2003), a proclamation as Nurse Leader of Care, Knowledge and Innovation by the City of Ottawa (2004), and a Jeanne Mance Award, the highest honour handed out by the Canadian Nurses Association (2004). She will accept her Order of Canada from Governor General Michaëlle Jean in February. Lemire Rodger

More than 1,300 RNAO members expressed their outrage this fall with a Dentyne gum commercial in which a ‘nurse’ climbs onto a patient’s bed and participates in a level of nurse-patient contact that is insulting and inaccurate. The ad suggests nurses are sexually available to their patients, and disparages the knowledge, skills and commitment of RNs. As a result of the overwhelmingly negative feedback from RNAO members, Cadbury Adams Canada Inc., the organization behind the offensive campaign, announced it would pull the ad in early October. It’s not the first time this company has been contacted by angry RNAO members concerned about the misrepresentation of the profession. In 2005, another division of Cadbury produced a Motts Clamato ad using similar exploitive tactics.

It’s been almost two years since the tragic murder of Windsor RN Lori Dupont, who was killed by anaesthesiologist and former boyfriend Marc Daniel at Hotel-Dieu Grace Hospital in November 2005.An inquest into the circumstances surrounding both Dupont’s and Daniel’s deaths (he commit- ted suicide) began on Sept. 24 and is expected to last eight weeks.The coroner’s jury will examine issues around domestic violence and harassment in the workplace, and will hear from approximately 50 witnesses testifying on the actions of the hospital and the criminal justice system.Watch this feature Dupont for news of the inquest outcomes, and jury recommendations, in early 2008.

The Canadian Federation of Nurses’ Unions has published Conversations with Champions of Medicare, a book that examines public health care in Canada through interviews with high profile advocates, including: Monique Bégin, former Minister of National Health and Welfare; Allan Blakeney, part of Saskatchewan’s inner cabinet when the province’s Medicare act was introduced; Kathleen Connors, President of the Canadian Federation of Nurses’ Unions; Shirley Douglas, daughter of Tommy Douglas; Tom Kent, former policy secretary to Prime Minister Lester Pearson; Roy Romanow, former Saskatchewan Premier; Hugh Scully, a member of the Ontario Premier’s Council on Health; Evelyn Shapiro, champion for community-based care and prevention of illness; and Sharon Sholzberg-Gray, former co-chair of the Health Action Lobby. For more information about the book, visit www.nursesunions.ca.

On Sept. 15, Canada Health Infoway launched Clinician eHealth Support Network, an initiative that allows nurses, physicians and pharmacists from across Canada to support one another as they navigate the world of e- health. RNAO member Lynn Nagle, Senior Nursing Advisor for Canada Health Infoway,says:“The network will support the exchange of best prac- tices and lessons learned.”She adds that it is also a vital step to achieving the goal of pan-Canadian electronic health records. For more information, contact [email protected]. Nagle

High school students in Hamilton are getting a head start on training for a career in health care thanks to a pilot program called Specialized High Skills Major. The project, which is being offered through both the public and separate school boards, is being led by nurse-turned-teacher Gail Cipriani. It allows teens to bundle their courses and gain an advantage before heading to college or university to study one of three majors: health and wellness, hospitality and tourism, or manufacturing. The stu- dents focusing on a health major are the only ones participating in placements, some of which take place at a skills lab in Hamilton’s Chedoke Hospital.

24 September/October 2007 their new knowledge and idealism. Free memberships “These new nurses bring the kind of knowledge, passion and courage that RNAO must build on to continue our suc- for new nursing grads cess into the future,”she adds.“But we also recognize that it’s a time when they may be RNAO launches sponsorship program with HUB, struggling to get by as they make the tran- easing the financial burden on Ontario’s new RNs. sition from the classroom to the working world.We all must be there for them with BY JILL SCARROW open arms and sound advice.” According to Daniel Lau, RNAO’s hen Khrisette Linay fin- According to the Canadian Federation of director of membership and services, the ished her nursing exam Students, the average university grad has program is working. Since the introduction last June, she was surprised about $25,000 in debt when they graduate. of the new grad guarantee, the number of W to find RNAO members Fortunately,new nurses need not add to new RNs joining the association has almost and staff waiting at the end of a granola bar, that red ink.The free new grad membership tripled, from 583 in 2005 to 1,556 in 2007. eager to explain all the reasons why she – a $133 value – exists thanks to a $100,000 “Our work with Hub has provided a should join the professional association.The sponsorship program by Hub International great opportunity for us to reach out to recruiters were passing out the crunchy Ontario Ltd., RNAO’s home and auto new graduates,” says Lau. “By connecting goodies to let novice RNs know about an insurance provider. “It can’t get better than with this group early, we can show them exciting initiative that allows new nursing the benefits of making life-long member- graduates to join the association for free. ship a habit.” Linay, a graduate of the Humber Linay says being able to join College/University of New Brunswick RNAO for free was a big reason collaborative nursing program, joined for becoming a member so RNAO less than a month later. She’s quickly. Rather than waiting eager to take advantage of pro- until she can afford it, Linay is grams like the best practice guide- now looking forward to partici- lines (BPG), attend conferences pating in RNAO activities that at a reduced rate, and receive allow her to put the theory she insurance discounts. She says learned in school into practice. it’s nice to know she’s part of RN James Chu says he hears an organization that will stick that same sentiment echoed by her, no matter what hap- among his colleagues in Ottawa. pens during her career. Chu, past-president of RNAO’s “As a student, you have Nursing Students of Ontario your school for support,” she (NSO), and an RN at the says.“Now (I) have a larger body Children’s Hospital of Eastern to back (me) up.” Ontario, says he notices that col- RNAO believes that by support- leagues are much more interested in ing new graduates, you are not only sup- RNAO’s different programs and opportu- porting the future of the health-care system, nities than they were as students. you are building the profession.The associa- that,” says Executive Director Doris “I’m starting to hear more people say, tion does this by offering BPGs to improve Grinspun. “So please encourage every new ‘did you hear about this conference,’ nurses’ workplaces, local chapter structures grad you know to rush to the phone or web- because they’re receiving the mailings,” he that give new grads a chance to connect site and sign up as a member now.” says. “It allows them to be able to access a with experienced nurses, and legal assistance The sponsorship program was first new foundation of knowledge and programs that provide resources to members announced in 2006, offering partial funding resources to mold their professional career.” who may have challenges at work. for new grads. It has since been expanded to That’s something Linay says she’s eager Welcoming Linay and her peers into cover the entire cost for hundreds of new to do. RNAO is a priority because their knowl- nurses. “They are at a crucial period in And, while a granola bar back in June I l l u

edge and talent will add to the expertise of their lives when they’re eager to learn more may have helped ease her hunger after the s t r a more senior nurses, giving the profession about their chosen profession and are in RN exam, it’s this new connection to t i o n : greater strength. need of a welcoming hand,” Grinspun says. RNAO, and learning how to advocate and J a s But inspiring new grads to become “They have so many fresh ideas to con- influence, that she believes will give her the o n

S c

members right at the beginning of their tribute, and we are enriched by embracing sustenance to last the duration of her career. h n e i

careers can be a challenge given competing them. New grads gain from the expertise of d e financial obligations coming out of school. more seasoned nurses, and we gain from JILL SCARROW IS STAFF WRITER AT RNAO. r

Registered Nurse Journal 25 Notice of 2008 AGM submit resolutions for ratification at the 2008 Call for Nominations 2008-2010 AGMAnnual General Meeting. Please 2008 send materials Hilton Suites Toronto/Markham Con- RNAO Board of Directors (BOD) to [email protected] ference Centre on Friday,April 11, 2008 DEADLINE: Friday, December 14, 2007 Take notice that an annual general meeting of Important to note: at 1700 hours (5:00 p.m.) the Registered Nurses’Association of Ontario • a maximum one-page backgrounder As your professional association, RNAO (hereinafter referred to as ‘association’) will be must accompany each resolution (one page is committed to speaking out for health, held at the Hilton Suites Toronto/Markham INCLUDES references) speaking out for nursing. YOUR talent, Conference Centre commencing the evening • the resolution must bear the signature(s) expertise and activism are vital to our success. of April 10, for the following purposes: of RNAO member(s) in good standing This year, RNAO is seeking nominees for • To hold such elections as provided for • all resolutions will be reviewed by the Members-At-Large (nursing administration / in the bylaws of the association. Provincial Resolutions Committee nursing education / nursing practice / nursing • To appoint auditors. research / socio-political affairs), Provincial For clarity of purpose and precision in the • To present and consider the financial Bylaws, Provincial Resolutions and Provincial wording of your resolution, we recommend statements of the association (including Nominations Committees, and Interest Group that each resolution include no more than the balance sheet as of October 31, 2007, a Representative (IG rep)* three ‘whereas,’and preferably only one, but statement of income and expenditures for Being a member of RNAO provides you never more than two ‘therefore, be it resolved.’ the period ending October 31, 2007, and with opportunities to influence provincial, the report of the auditors of the association Please refer to the following successful 2007 national and international nursing and thereon) for the fiscal year of the association resolution for guidance: health-care policy,to discuss and share com- ended October 31, 2007. WHEREAS morbid obesity is becoming mon challenges related to nursing, nurses, • To consider such further and other business an increasing health care risk to treat and health care, social and environmental issues, as may properly come before annual and manage due to improperly constructed work and to network with numerous health general meetings or any adjournment or environment, lack of appropriate equipment professionals dedicated to improving the adjournments thereof. and limited emergency evacuation prepara- health and well-being of all Ontarians. By the order of the Board of Directors, tions plans resulting in unsafe workplace Becoming a member of the RNAO Board Mary Ferguson-Paré, RN, PhD, environments, and of Directors will provide you with an CHE President WHEREAS there is a great lack of public extremely rewarding and energizing experi- awareness regarding the impact and discrimi- ence.You will contribute to shaping the Call for Resolutions nation faced by the morbidly obese population present and future of RNAO.You will also DEADLINE: Friday, December 14, 2007 which ultimately leaves them feeling isolated, act as a professional resource to your con- at 1700 hours (5:00 p.m.) embarrassed and depressed thereby exacerbat- stituency. Please access the nomination Do you want to shape nursing and health care? ing further comorbidities resulting in poten- form on RNAO’s website. If you require As a member of your professional association tially negative health outcomes, and further information, please contact Penny you can put forward resolutions for ratification WHEREAS there is a lack of government Lamanna, RNAO Board Affairs Coordinator, at RNAO’s annual general meeting, which funding to support very badly needed at [email protected] takes place on Friday,April 11, 2008. By sub- resources to develop appropriate bariatric care mitting resolutions, you are giving RNAO a units and to develop expertise in healthcare * Interest Group Representative mandate to speak on behalf of all its members. professionals to work with this population Important note: We are also seeking It is important to bring forward the many both on a psychological and physical level, nominations for IG rep. to the BOD. pressing nursing, health and social issues that THEREFORE BE IT RESOLVED that Please note that in accordance with RNAO affect nurses’ daily lives and the public we RNAO lobby the Minister of Health and Bylaws this individual will also be elected at serve. RNAO members represent the many Long-Term Care, the Minister of Health the AGM by a vote of IGs Chairs only: facets of nursing within the health system.You Promotion and the Minister of Finance for Bylaw 3.18(1),“[ONLY] the Chairpersons play a vital role in ensuring nurses’ voices are major funding to support the development and of each Provincial Interest Group heard, and in advancing healthy public policy implementation of bariatric care along with shall elect an Interest Group Representative, across the province and elsewhere. RNAO appropriate equipment and diagnostic equip- who shall be a current or immediate past encourages chapters, regions without chapters, ment/tools needed to meet the holistic health Provincial Interest Group Chairperson, to the interest groups and individual members to care needs of this population across Ontario. Board of Directors in even numbered years.”

26 September/October 2007 Calendar

November February April November 15 February 21 April 7-11 Ethics for Nurses: Fight or Flight: New Designing and Delivering Regional Workshop Solutions and Strategies Effective Education Programs Video Conference to Workplace Conflict RNAO/OHA Joint Program RNAO Home Office Regional Workshop OHA Office Toronto, Ontario (Roadshow Series) Toronto, Ontario Arcadian Court Toronto, Ontario April 22 Preceptorship for Nurses January February 22 Regional Workshop Ontario Association of Rehab- Video Conference January 7-9 ilitation Nurses Conference RNAO Home Office South Florida Winter Evidence- Westin Prince Hotel Toronto, Ontario Based Nursing Institute Toronto, Ontario University of Miami Miami, Florida March May January 10-11 May 22 Nursing Excellence: Bringing Best March 26 Sharing Visions of Practice Evidence to the Point of Care Best Practice Guidelines Healthy and Possibility: Esprit, Miami Beach Resort and Spa Work Environments Workshop: Excellence and Evolution Miami, Florida Focusing on Developing and PNEIG Spring Symposium Sustaining Effective Staffing Arcadian Court January 17 and Workload Practices Toronto, Ontario Critical Incident Debriefing RNAO Home Office for Nurses Workshop Toronto, Ontario RNAO Home Office Toronto, Ontario Unless otherwise noted, please contact Becky Bays January 27 – February 1 at RNAO’s Centre for Professional Nursing Excellence Best Practices in Wound Care: Minding the Gap Institute at [email protected] or 416-599-1925 / 1-800-268-7199, Fern Resort ext. 227 for further information. Orillia, Ontario

WANTED: WORKPLACE LIAISONS Workplace Liaisons are leaders who choose to speak out for health and speak out for nursing by representing RNAO within their organization. Do you have what it takes to share the wealth of professional resources that RNAO offers? Contact Jody Smith at RNAO home office, [email protected] or by calling 1-800-268-7199 ext. 220.

Registered Nurse Journal 27 Classifieds Recognition BUSINESS OPPORTUNITY for RNs to distribute Health Care scientifically validated nutritional supplements and anti-aging skin care products. Awards Leadership and Call 905-727-8882. Ask for Karen or Dr. Taylor. Management BAD CREDIT? BANKRUPTCY? DIVORCE? now open If you’ve had some credit problems in the past Program and think you can’t qualify for a home – We Nominations for Chapter can help you. Our Lease to Own program of the Year, Interest Group allows you to choose the house and location of the Year, and the RNAO that YOU want. We also offer a loyalty pro- Leadership Award in gram called Cada Cash™ that credits your Political Action are due by GRANTING UNIVERSITY CREDIT AND account too. Your dream of home ownership Friday November 23. LEADERSHIP AND MANAGEMENT is waiting. Don’t let it pass you by. Contact us PROGRAM CERTIFICATE OF COMPLETION today at [email protected] or 416-740-5930. Endorsed by the CNA. Submit a nomination to All courses individually facilitated by an LOOKING FOR ANSWERS TO YOUR CHAL- Educational Consultant celebrate your colleagues’ Courses Offered: LENGING PATIENT SAFETY QUESTIONS? contributions to Speaking Join conference chair Dr. Irmajean Bajnok of out for Health and Leadership/Management in Health Care the Registered Nurses’ Association of Ontario Organizations Speaking out for Nursing. (6 units) and your nursing colleagues Jan. 29-30, 2008 in • 9 month course completion Toronto to discuss the patient safety issues that • both theoretical and practical content matter most. To find out more about The For more details or a important in today’s work environment Leading Effective Teams in Health Care Canadian Institute’s Patient Safety 2008 confer- nomination form, visit Organizations ence, visit www.canadianinstitute.com/ (3 units) www.rnao.org/awards or • 6 month course completion patientsafety08 for details. Register today by contact Home Office at • study of leadership, team dynamics impacting calling 1-877-927-0718 and quoting 406AX04. 1-800-268-7199. the workplace, types of and team structure in health care organizations Conflict Management in Health Care Organizations (3 units) • 6 month course completion • explores the types and processes of conflict in health care organizations and applies Are you protected? theory and research to conflict situations in the current workplace Quality Management in Health Care Organizations (3 units) Every nurse should have • 6 month course completion • theories, concepts including safety culture professional liability protection. leadership in creating a culture of accountability • critically analyzes and applies paradigms to address quality and safety issues in the workplace Advanced Leadership/Management in Health Care Organizations (6 units) • 9 month course completion • builds on the Leadership/Management course • topics include transformational and quantum leadership, emotional intelligence and organizational culture Integrated Leadership Project (3 units) • Final course integrates theories and concepts of the Program and provide opportunities to apply these to a real situation in the workplace The Canadian Nurses • Through the use of a champion leader, the student develops and understanding of Protective Society managing key organizational processes PROGRAM COURSES AVAILABLE IN TUTORIAL is here for you! CLASSROOM FORMAT (OVER 12 WEEKS) For further information please contact: Leadership and Management Program Call for a free consultation. McMaster University Phone: (905) 525-9140 Ext 22409 Fax: (905) 570-0667 Email [email protected] Website: www.leadershipandmanagement.ca www.cnps.ca 1 800 267-3390 Programs starting every January, April & September Seneca_FHS Ad_RN Journal 3/28/07 10:42 AM Page 1

The picturesque surroundings of Peterborough FORENSIC and the Kawarthas offers great outdoors with unparalleled waterways and recreational HEALTH STUDIES activities! Our city is Vibrant and Growing! The Peterborough Family Health Team mission is to improve community access to primary care with an CERTIFICATE overall mandate to keep Ontarians healthy, reduce wait times, and provide better access to doctors and nurses. Find out how science, technology and the law Nurse Practitioners can be combined to better serve your clients. You will join a large group of established nurse practitioners that are working to the full scope of practice and contribute to our primary care Learn current forensic health science principles team consisting of family physicians, dietitians, and social and mental and techniques, criminal law procedures, and health workers. You will meet the needs of unattached patients in the greater Peterborough area, conduct assessments, formulate and how to manage victims of crime in one communicate medical diagnosis, and determine the need for specialized procedures, prevention strategies, and pharmacological and counselling multidisciplinary certificate program. interventions. You have a current RN (EC) designation combined (ideally) *Offered in partnership with BCIT with several years of experience in primary health care in an advanced nursing capacity. Peterborough is leading the way for Family Health Teams and has the APPLY NOW support of our local family physicians. We welcome you to explore the dynamics of our highly dedicated team of interdisciplinary healthcare 416.491.5050 x5208 professionals and play an integral role within our vibrant community. Whether you’re looking for big city events or small town charm – [email protected] Peterborough has what you’re looking for! Please apply in writing to: Human Resources Manager, Primary Health Care Services 150 King Street, 3rd Floor, Peterborough, ON K9J 2R9 e-mail: [email protected] fax: 705.740.8030 SCHOOL OF HEALTH SCIENCES www.senecac.on.ca/healthsc www.health.gov.on.ca/transformation NURSING EDUCATION INITIATIVE CONTINUING EDUCATION Distance Education You may be eligible to receive up to for Nurses $1,500 in tuition reimbursement! GeorgeBrownCollegeispleasedto For pertinent deadline information or to now offer distance education courses obtain a copy of the application form, please in forensic nursing. visit the RNAO website at www.rnao.org Registernowforthese forensic nursing courses: For the most current • Introduction to Forensic Nursing information about the • Forensic Issues in Sexual Violence Nursing Education Initiative, • Clinical Applications in Forensic Nursing • Forensic Issues in Interpersonal Violence please contact:

RNAO’s Frequently Asked Questions line 1-866-464-4405 Viewcoursedetailsandregisteronlineat coned.georgebrown.ca OR Call 416-415-5000, ext. 3164, [email protected]. or e-mail [email protected].

I came for the job. I stayed for the team.

“Teamwork creates friendships and that’s why this job is special. I’ve gained expertise and developed lifelong friendships — while supporting the health and well- being of patients.” Janet K., Nurse Clinician

New Challenges. New Horizons.

To find out more and to apply, visit: www.vch.ca/careers Phone: 604.875.5152 Toll-Free in North America: 1.800.565.1727 5905_HUB_AD 7/13/07 11:04 AM Page 1

Now I know why thousands of nurses have chosen HUB!

I used to think insurance was insurance and The HUB representative also asked whether never gave much thought to where I bought I had upgraded or added on to my home. it – I assumed it was the same everywhere Now, my home has been undergoing and all that mattered was finding the best extensive renovations for some time, but it price. Was I ever wrong! I heard about HUB had never occurred to me that those Personal Insurance from a colleague at work. upgrades could affect my insurance policy, She mentioned that HUB offers RNAO or more specifically, any claim I may have members great rates on home and auto while these changes are taking place. HUB insurance, but it was her comment on the brought me up to speed on what to include outstanding service that made me decide on my homeowners policy immediately and to find out for myself. made further recommendations for when the renovations are completed. When I contacted HUB, I spoke to an insurance advisor immediately – no pushing I was impressed. I now realize insurance a million buttons or leaving a voicemail is not the same everywhere. There are message. The advisor assessed my insurance differences in product features, pricing, needs and gave me a no-obligation quotation and most importantly, in the people and on the spot. The savings were significant and I the advice they provide. really appreciated the great additional benefits Thank you to the RNAO and HUB for HUB offers. I switched to the HUB plan for taking care of me! Now I know what the RNAO members right away! HUB is all about! Contact HUB today. Call 1 877 466 6390 or visit www.hubinternational.com

Toni Sammut, R.N.