When Patients Are Prisoners Carolyn Kirkup Is One of Many Rns Who Has Built a Fulfilling Career in Corrections

J une 2010 May/ JOURNAL

When patients are prisoners Carolyn Kirkup is one of many RNs who has built a fulfilling career in corrections. PM 40006768

RNAO’s 85th AGM • Nursing Week 2010 • On the set of NurseRegistered nu rseJackie journal 1 Conference Keynote Presentations: Mobilizing Public Opinion: The Power of Nurses Maude Barlow, National Chair of the Council of Canadians Clinical Knowledge: The Art and Science of Nursing Caring Doris Grinspun, Exectutive Director, RNAO Florence Nightingale’s 21st Century Legacy Deva Marie Beck, NIGH International Co-Director Barbara Dossey, NIGH International Co-Director

Over 200 abstract presentations for ALL areas of nursing! acute care, paediatric, primary care, public health, home health care, education, research and informatics. J une 2010 May/ 3, N o. m e 22, Volu contents

Features the lineup

12 Behind bars 4 editoR’S NOTE 5 PRESIDENT’S VIEW RNs describe the challenges and rewards 6 eXECUTIVE DIRECTOR’S DISPATCH of working in corrections. 7 RN PROFILE By Helena Moncrieff 8 nuRSING IN THE NEWS 10 out AND ABOUT 17 AGM 2010 11 nuRSING NOTES 27 POLICY AT WORK Members celebrated RNAO’s 85th annual 28 CALENDAR meeting with debate and discussion to help set the course for the year ahead.

24 Lights, camera, action – and education A visit to the set of Nurse Jackie reveals the real-life lessons actors are getting about nursing. By Suzanne Gordon 24 12 ears y

Speaking out for health. Speaking out for nursing. ears y

Speaking out for health. Speaking out for nursing. cover Photo: Jonathan Sugarman

Registered nurse journal 3 The journal of the REGISTERED NURSES’ Editor’s Note Jill scarrow 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]

EDITORIAL STAFF Marion Zych, Publisher Jill Scarrow, Acting Managing Editor Jill-Marie Burke, Acting Writer AGM provides the chance Stacey Hale, Editorial Assistant to catch up with members EDITORIAL ADVISORY COMMITTEE Nancy Purdy (Co-Chair) Ruth Schofield (Co-Chair), Sheryl Bernard, Nathan Kelly, Fo r t h e s t a ff w r i t e r s w h o w o r k group of nurses who were Pauline Tam (journalist), Sandra Oliver on this magazine, RNAO’s part of the conversation at this

Art DIRECTION & Design annual general meeting is an year’s AGM: RNs who work Fresh Art & Design Inc. opportunity to connect with in Ontario’s jails. During the

ADVERTISING members from all over Ontario debate on a resolution that Registered Nurses’ Association of Ontario who we may never have seen focused on providing more Phone: 416-599-1925, Fax: 416-599-1926 before, but with whom we’ve support to nurses in this sector, had plenty of email or phone members heard about the SUBSCRIPTIONS Registered Nurse Journal, ISSN 1484-0863, is a conversations. Writing about the unique challenges of working benefit to members of the RNAO. Paid subscriptions work that 29,000 members are in a place where your patients are welcome. Full subscription prices for one year (six issues), including taxes: Canada $36 (GST); doing in a province larger than are locked behind bars, and Outside Canada: $42. Printed with vegetable-based France and Spain combined security is just as important as inks on recycled paper (50 per cent recycled and 20 per cent post-consumer fibre) on acid-free paper. means we talk to most of the care. Many people wonder why people we interview on the these RNs want to work in this Registered Nurse Journal is published six times a year by RNAO. The views or opinions expressed in phone. So it’s nice when we have environment. The nurses you’ll the editorials, articles or advertisements are those of the authors/advertisers and do not necessarily the chance to meet members read about in our cover feature represent the policies of RNAO or the Editorial one-on-one, even if only for a admit it can be tough, but it’s Advisory Committee. RNAO assumes no responsibility or liability for damages arising from any brief ride in a hotel elevator. also rewarding. Corrections error or omission or from the use of any information The AGM also gives us a nurses use all their knowledge or advice contained in the Registered Nurse Journal including editorials, studies, reports, letters and chance to collect ideas that and skill to care for people who advertisements. All articles and photos accepted for sometimes turn into future may never have been in contact publication become the property of the Registered Nurse Journal. Indexed in Cumulative Index to stories in this publication. with the health-care system Nursing and Allied Health Literature. Politicians’ speeches, debates before, and who may be CANADIAN POSTMASTER on resolutions, and the struggling with chronic diseases, Undeliverable copies and change of address to: Members’ Voices segment of addictions, mental illness or RNAO, 158 Pearl Street, Toronto ON, M5H 1L3. Publications Mail Agreement No. 40006768. the meeting – when chapter need stitches after a fight. and interest group representa- We also reflect on many RNAO OFFICERS AND SENIOR MANAGEMENT David McNeil, RN, BScN, MHA tives share the work they’re of your efforts outside the President, ext. 502 Wendy Fucile, RN, BScN, MPA, CHE doing in their communities workplace. Our annual Nursing Immediate Past-President, ext. 504 – are always a great time to hear Week supplement features Doris Grinspun, RN, MSN, PhD (c), O.Ont. Executive Director, ext. 206 about innovative programs and photos of the events you held Robert Milling, LL.M, LLB roles you’re spearheading. In to celebrate your profession, Director, Health and Nursing Policy, ext. 215 Daniel Lau, MBA fact, there is rarely an AGM that including the annual Take Your Director, Membership and Services, ext. 218 goes by where we don’t meet an MPP to Work visits. More than Irmajean Bajnok, RN, MScN, PhD Director, International Affairs and Best Practice RN who’s taken on a new or 40 politicians took part this year Guidelines Programs and Centre for Professional unique role. Sometimes, the to see the work RNs are doing in Nursing Excellence, ext. 234 Marion Zych, BA, Journalism, BA, Political Science work that’s most interesting communities, primary care, Director, Communications, ext. 209 goes beyond clinical practice hospitals, long-term care, Nancy Campbell, MBA Director, Finance and Administration, ext. 229 and is part of the member’s research and education to Louis-Charles Lavallée, CMC, MBA volunteer efforts on behalf of improve health care. It’s an Director, Information Management and Technology, ext. 264 this association to meet with event that allows politicians to politicians, recruit new gain some of the insight into members, or get involved on your world that we here at RNAO an RNAO committee. hear about on the phone every

ears In this issue of the Journal, day, or during conversations in

y our cover feature looks at a the elevator at the AGM. RN

4 MaYSpeaking/JUNE 2010 out for health. Speaking out for nursing. president’s view with David mcneil

Building on 85 years of advocacy to move into the future

It i s a n h o n o u r a n d p r i v i l e g e t o speaking out for nursing. Each attention. At the April assembly delivery. These changes need to begin my term as RNAO of you contributes to that meeting we discussed some of be further explored and better president and to share my first important work by being a those, including the strategic understood, and your feedback message with you, the member of an incredibly change happening at the on what’s happening is vital. members. During our annual strong and influential force. Canadian Nurses Association You can find RNAO’s position general meeting in April, I Thank you and congratulations (CNA) with the formation of the on strengthening patient talked about how I am looking for all of the work you do Canadian Council of Registered centred care in hospital forward to the opportunities beyond this most critical Nurse Regulators. RNAO will settings online. that we have to address the commitment. To continue our support CNA through this And, of course, we will challenges that face our success we need to continue transformation to ensure we continue to build momentum health-care system, and in our great work and recruit have a strong advocacy voice and awareness around Creating ensuring that nursing’s role is others to our team. I leave and strong regulation at the Vibrant Communities, the at the forefront of leading this you with this challenge. national level. At the assembly report we released in January. change. We have an impres- When I reflect on the and annual general meetings The document articulates sive 85 years of heritage to accomplishments of our we also discussed the need to actions needed to achieve draw upon. I will do my best to association, I am always drawn transform our health-care healthy communities for build on the wisdom of our everyone. The report repre- founders as your president, sents a challenge to all and I ask all of you for your “W h e n I r e f l e c t o n t h e accomplishments provincial parties to adopt the support in continuing the o f o u r association , I a m a l w a y s d r a w n comprehensive recommenda- pursuit of our mission. tions on health care and social Of course, fulfilling RNAO’s t o t h e a c t i o n s o f i n d i v i d u a l m e m b e r s . I and environmental determi- mission is not limited to the a m i n s p i r e d b y w h a t m a n y o f y o u d o f o r nants of health as they prepare President or the Executive for the next provincial election. Director. It’s a collective t h e association , t h e p r o f e s s i o n , a n d There is enough in this policy responsibility that is achieved m o s t importantly , f o r o t h e r s .” document for each of us to through the work of board find a passion, become members, regions, chapters, engaged and speak out. interest groups, and individual to the actions of individual system so it can meet the As the October 2011 provincial members. This is what gives members. I am inspired needs of our children and our election approaches, I invite RNAO its strength. by what many of you do for the grandchildren – a reality that you to become engaged and As a profession, nursing has association, the profession, was acknowledged by Premier to use this document to speak a social and service account- and most importantly, Dalton McGuinty during his out for a better, healthier and ability to the public. This for others. speech at the AGM. RNAO more prosperous Ontario. accountability requires no In the last year, we have must continue to play a lead Finally, as we begin our regulation, rather it’s inherent accomplished much together role in system reforms to work together, I will endeavour to our profession and it’s including government ensure models of care delivery to make myself accessible something that every nurse commitments to full funding recognize the high-quality care to you, the members. I might needs to exercise. This for Registered Nurse First outcomes that result when RNs even consider learning how accountability can take many Assistants, continuation of the are employed in all health-care to use social networking forms, all of which are Nursing Graduate Guarantee settings and sectors working websites like Twitter, which essential to nurses’ and and expanded scopes of with members of the inter- will be a real learning RNAO’s success. For the practice for RNs and nurse professional team. Finally, there opportunity for me! RN association, it means continu- practitioners. continues to be significant ing to do what we do best: We also face some immediate dialogue around changes d a v i d m c n e i l , r n , b s c n , m h a , i s speaking out for health and challenges that require our occurring with models of care p r e s i d e n t o f r n a o .

Registered nurse journal 5 Executive Director’s Dispatch with Doris Grinspun

Standing up for Medicare

Du r i n g a t r i p t o w a s h i n g t o n And we need to enhance calling on governments to funded, not-for-profit and D.C. in April, I was thrust into Medicare by including national examine market mechanisms, universally accessible health the American health-care programs such as home including their role in health- care works. It costs less, we get system’s troubled waters. When health care, pharmacare, care delivery. Anne Doig, CMA more, and we can trust it is my hotel’s concierge discovered and dental care. president, speaks about the there for us. Not so with I am a nurse, he told me of his Unfortunately, our federal need to decide which health- for-profit care, as Albertans are car accident. He ended up in an government isn’t rising to the care services should be realizing. Recently, the Health ER, and developed an adverse task. The government’s most necessary and universally Resource Centre, a private reaction to medications. That recent report to Parliament on accessible. But instead of calling Calgary hospital that has been meant a four-day hospitaliza- the Canada Health Act acknowl- for new public programs, she performing hip, knee, foot and tion with a $14,000 price tag. edges violations of the law, but defends her predecessors who ankle operations for four years, Now, without insurance, he takes little action to remedy wished to privatize the system. announced its bankruptcy. Now, owes three years of monthly them. The government is not Thankfully, not all physicians taxpayers have to pick up the tab. payments. If he can’t pay, a standing up to actual or potential agree. Canadian Doctors for Nurses must continue to credit agency will come calling. provincial violations, including Medicare and the Medical remind Canadian politicians of Then a taxi driver shared his in Quebec where health-care Reform Group are vocal about these facts. We must speak out story. He went to an ER with a loudly and clearly with the knee ailment. The solution: “We n e e d t o e n h a n c e Me d i c a r e strength of our values, the ibuprofen and a sleeping pill; authority of the evidence, and no diagnostic or lab test needed. b y i n c l u d i n g n a t i o n a l p r o g r a m s s u c h the courage of our convictions. He was uninsured and left with a s h o m e h e a l t h c a r e , p h a r m a c a r e , Medicare must be expanded a $1,000 bill. Both men shared through publicly funded home their hopes about President a n d d e n t a l c a r e .” health care so that everyone, old Obama’s changes that promise and young, lives long in the insurance for more Americans. user fees have been proposed. strengthening Medicare. community. Canada needs a These were important and Following the 2003/4 Health Even the strongest free-market dental care program so those timely conversations. I was in Accord and Action Plan, Prime defenders, such as Britain’s new who cannot afford costly the American capital to share Ministers Chrétien and Martin prime minister, David Cameron, procedures can shake off the RNAO’s work with the Health committed $41 billion in new can discover the benefits of stigma of poor oral health. And Resources and Services federal funding over 10 years to publicly funded and delivered our politicians must move Administration (HRSA), an advance, among other goals, health care. In 2003, Cameron’s ahead with creating national agency that improves access to home care, primary care, and a eldest son was born with severe pharmacare. We ask that you care for groups such as the national pharmaceuticals cerebral palsy and epilepsy. Both speak with your families, uninsured or isolated. It’s strategy. Sadly, Prime Minister Cameron and his wife are neighbours, co-workers, the headed by Mary Wakefield, RN, Harper’s government has wealthy, but they still couldn’t public and the media. We must PhD, appointed to this top demonstrated little political afford the care their child needed pressure politicians to get on position by the President. will to achieve these goals. before he sadly passed away at with the task of strengthening Hearing these experiences Moreover, politicians remain age six. Cameron relied on the public Medicare. Stories like brings shivers and reminds me mum about the agreement’s National Health Service (NHS), those of my concierge and of Michael Moore’s documen- renewal as it comes to a close. the British version of Medicare, taxi driver in Washington tary, Sicko. These stories alert Meanwhile, the Canadian and he saw it worked. During will continue to remind us of Canadians to stand up to those Medical Association (CMA) this year’s election campaign, he that. RN who promote “competition” continues to call for increased pledged that government and for-profit services. We need competition and privatization. At spending cutbacks won’t harm d o r i s g r i n s p u n , r n , m s n , p h d to support governments that the last CMA annual meeting, the NHS. (c a n d ), o. o n t i s e x e c u t i v e commit to public health care. members passed a resolution Many leaders know publicly d i r e c t o r o f r n a o .

6 MAY/JUNE 2010 RN Profile By Jill-Marie Burke

Promoting independence RN helps people solve incontinence without surgery.

When someone has a secret patients stay dry reduced the realized that many female some health providers promote she’s too embarrassed to tell money they spent on inconti- patients experienced inconti- surgery to young women who even her best friend, Jennifer nence products by a quarter. nence after they fractured a hip. are leaking urine after giving Skelly is the person she can Providing continence care in a She wondered what the link was, birth and want a quick fix. In confide in. For almost 30 years, clinic setting also proved to be and decided to go back to school most of these cases, non-surgi- Skelly’s been helping adults of more cost effective than home to hone her research skills. cal interventions like doing all ages overcome urgency, visits because more people can In the 1980s, Skelly earned Kegel exercises to strengthen frequency, leaking and other be seen. Last summer, Skelly two master’s degrees in health the pelvic floor muscles can get aspects of incontinence, a embarked on a continuation of science and epidemiology before things back to normal within a condition that affects an estimat- that initiative with funding from completing her PhD. Today, she few months. ed 3.3 million Canadians. Ontario’s Aging At Home continues her research while Skelly looks beyond a patient’s Skelly is a nurse continence strategy. She now oversees six practising as a nurse continence anatomy to determine how advisor and associate professor new continence clinics for advisor, a role that fills an lifestyle and other factors at McMaster University’s School seniors that have been set up important niche in the health- contribute to their condition, of Nursing. She divides her time across the Hamilton Niagara care system. She says studies and treatment. Lifestyle changes between work at her Hamilton Haldimand Brant Local Health show half of family physicians are also needed to help older continence clinic, teaching and people who experience severe conducting research. She’s also urgency which sometimes the president of the Canadian creates a burning sensation, Nurse Continence Advisor Asso- “Th e r e i s n o g r e a t e r frequency and occasional loss of ciation and led the panel that s e n s e o f accomplishment urine. Skelly says women often developed RNAO’s Promoting think they have a vaginal yeast Continence Using Prompted t h a n t o h a v e p a t i e n t s infection, but their symptoms Voiding best practice guideline. t e l l y o u t h e y a r e d r y .” are related to changes that occur Despite her many responsi- during menopause. After she bilities, Skelly still makes time – Jennifer Skelly educates them about the for patients at the clinic she importance of drinking more established 16 years ago at water and less caffeine (which St. Joseph’s Healthcare in Ham- Integration Network (LHIN). don’t ask patients about irritates the bladder), for ilton. Each year, Skelly refers She hopes that by providing incontinence because they don’t example, Skelly says many just 10 per cent of her patients, evidence of the cost savings, know how to treat it. She’s also patients can re-gain their who are mainly women, to a the clinics will become frustrated by urologists who independence. She says the urologist or gynecologist. She permanent. recommend patients learn to do most rewarding aspect of her says that demonstrates Although she’s now an their own catheterizations job is learning that a plan she education can help women to international incontinence without checking to see if they and a patient devised has been manage incontinence in a way expert, Skelly didn’t set out to have a bladder prolapse. Skelly successful. “There is no greater that can improve their lives and achieve that goal. In 1981, she shudders when she remembers sense of accomplishment than save themselves, and the health was working in intensive care at an elderly woman who was to have patients tell you they are system, money. St. Joseph’s when she learned a referred to her to learn to do dry and how much it has In 2007, Skelly led an gynecologist with expertise in intermittent self-catheterization. changed their life,” she says. initiative that examined the incontinence was hiring a nurse “That’s not a good long-term “They can suddenly go and take impact continence clinics had for his clinic. She was intrigued solution for her. If she can’t do the bus trips they like and not on clients from the Hamilton- by the new machine he’d just it in two years time, she will worry about it.” RN Wentworth and Grey-Bruce purchased to measure pressure immediately go into a nursing Community Care Access in the bladder, and embarked on home,” Skelly says. j i l l -m a r i e b u r k e i s a c t i n g s t a ff Centres. She says that helping a new career path. She soon Skelly is also concerned that w r i t e r a t r n a o .

Registered nurse journal 7 RNAO & RNs weigh in on… nursing in the news by stacey hale

Nursing Week 2010

A flurry of announcements that called for applications for 14 additional nurse practitioner-led clinics and earmarked funds for Registered Nurse First Assis- tants (RNFA) helped kick off Nursing Week celebrations in the province. On May 10, Premier Dalton McGuinty met with nursing students at York University in Toronto to promote his government’s plan to accept applications for the next wave of NP-led clinics. In a classroom set up to mirror a hospital, the premier moved from bed to Premier Dalton McGuinty, centre, meets with York University nursing students. He visited bed to watch students practise their skills. the school during Nursing Week. RNAO member Crystal Van Leeuwen took part, and explained to the premier that she knew nursing was her calling when she held a girl infected with HIV during a trip to a clinic in Thailand. “Nursing chose me,” she told the North York Mirror (May 11). The following day at a media conference in Toronto, RNAO member Grace Groetzsch, Canada’s pioneering RNFA, joined Health Minister Deb Matthews to announce full funding for 34 RNFA positions (Global TV, May 11). Along with announcements, news outlets across the province told stories highlighting nurses’ knowledge and talent. In the Toronto Star’s annual Nursing Week supplement, RNAO Immediate Past-President Wendy Fucile described why RNs are politically active on topics ranging from poverty to the environment. “An enormous number of issues have huge potential impact on nurses in their work life and on the communities they serve,” she said. The news supplement also highlighted some of the challenges facing nursing, chiefly the nursing shortage. RNAO President David McNeil talked about the importance of keeping experienced mid-career RNs in the profession. “Some challenges are related to the workload, and those challenges are very real,” he told the Star. RNAO member Suman Iqbal knows all about the challenges of being a mid-career nurse. She described her real-life story of how years of lifting patients and moving heavy equipment forced her to Grace Groetzsch speaks during the govern- make a change. She returned to school, obtained her BScN and is now the ment’s press conference to announce funding for RNFAs. assistant director of care at a long-term care home in Toronto (May 8).

Opening access to NPs easing the flow of traffic at told the Canadian Press and admit, treat and discharge Speaking to RNAO’s annual Ontario hospitals by allowing CTV Toronto the change would patients in emergency rooms general meeting on April 16, nurse practitioners (NP) to mean patients could move and primary care settings, but Premier Dalton McGuinty said admit, treat and discharge through the system more only doctors can discharge he is open to discussions and in-patients. Doris Grinspun, quickly and get better care patients who are hospitalized. will start consultations on Executive Director of RNAO (April 16). NPs can already Meanwhile, NPs also have a

8 MAY/JUNE 2010 nursing in the news by stacey hale

role to play in linking patients sense of relief. You’re taking stresses why shaking a baby is care professionals have legal to primary care. Grinspun away ... something they see harmful. Charron, a nurse and professional obligations to called the government’s Health some benefit in,” she told the educator, told the Windsor Star keep (your) information Care Connect program (which Globe and Mail (April 27). she hopes parents will confidential and secure,” matches orphaned patients to a understand it’s OK to put a she told the Sarnia Observer family doctor or nurse Helping stroke victims baby in a safe place and walk (April 20). practitioner) a success, but RNAO member Doris Noble away when they’re frustrated added patients would be better has helped more than 100 (April 19). Nurse fatigue served if the government stroke victims across Huron Irmajean Bajnok said govern- follows through on its promise and Perth counties re-gain the Health privacy ments and employers need to to open up nurse practitioner- ability to do some of the In April, RNAO member Anne pay attention to a disturbing led clinics that have already activities they enjoyed before Coghlan, president of the study that indicates a majority been announced. “Eleven their strokes. Noble leads a Federation of Health Regulatory of nurses cite workload as the clinics have been announced … team of nurses, physiothera- Colleges of Ontario, responded reason they’re tired. On May 11, and none of them has opened… pists, rehabilitation therapists to a recent survey by the EKOS RNAO and the Canadian (they) need to open …” she told and others at the Huron Perth research firm that found 17 per Nurses Association released the Toronto Star (May 3). Healthcare Alliance. She cent of Canadians worry that Nurse Fatigue and Patient coordinates the team’s travels their health information – in- Safety, a report that surveyed Smoking ban at CAMH throughout the two counties as cluding details of a visit to care more than 7,000 registered In April, RNAO member they visit patients and imple- providers and health-card nurses across all sectors of Margaret Tansey, Vice-Presi- ment an individual rehabilita- numbers – isn’t secure. And 60 health care. More than 55 per dent of Professional Practice tion program for each. “It’s a per cent aren’t aware of laws to cent of RNs reported almost and Chief Nursing Executive at challenge for rural patients to protect the privacy of personal always feeling fatigued on the the Royal Ottawa Hospital, access rehabilitation (and) it’s health information. “Health- job, while 80 per cent indicated weighed in on a decision by the easier for someone to come Centre for Addiction and into their homes,” Noble told RNAO Members Speak out! Mental Health (CAMH) in the Stratford Beacon-Herald Toronto to enforce a smoking (April 8). On May 11, RNAO member Brenda Mundy wrote a letter to the ban. Starting in July, staff and Orillia Packet and Times encouraging her community to recognize patients will no longer be Safe babies nurses’ work. permitted to smoke on hospital A new program in Windsor is Take a moment to appreciate nurses during Nursing Week property. Until now, policy making babies’ health and As we go about our busy lives this week, I would encourage everyone makers and members of the safety a top priority. RNAO to pause for a moment and reflect on the incredible contributions our mental-health community have member Debra Charron helped local nurses make to our communities. May 10 to 16 is Nursing been reluctant to adopt strict the Windsor Regional Hospi- Week. What an excellent opportunity to recognize this group of bans because their patients tal’s Family Birthing Centre amazing, skilled and dedicated individuals who represent the very have a psychological depen- launch an educational program foundation of our health-care system. There’s something reassuring dence on cigarettes that can aimed at reducing the number about knowing that nurses (registered practical nurses and registered make quitting particularly of shaken baby syndrome nurses alike) are there to provide their expert brand of caring to our difficult. Mental-health patients cases. The free program helps friends, families and loved ones in their hours of need. Let’s seize this also have much higher people understand and deal chance to recognize and thank these local heroes, who have smoking rates than the general with an infant’s crying. Parents dedicated their lives to caring for the most vulnerable among us. I population. Tansey says it’s not are given an instructional encourage everyone to join me in recognizing nurses -- and all a simple issue. “We do DVD, which teaches ways to health-care professionals -- for the incredible work they do. understand that for those with comfort their child and Brenda Mundy major mental illnesses, important steps to take when RPN and RN, Holland Landing smoking does give them a crying is frustrating. It also

Registered nurse journal 9 nursing in the news

OUT AND ABOUT they always felt tired after University of Windsor nursing finishing work. The report professor who has studied 1. This spring, Region raises questions about patient patient safety and quality 10 members hosted safety, as well as the recruit- improvement in hospitals. their seventh annual ment and retention of RNs. “Hospitals in general ... have breakfast with politi- “We know if you’re tired, it focused on the bottom line… cians. More than 60 affects your thinking processes, so this is very positive,” she told RNs and nursing your ability to process knowl- the Windsor Star (May 4). The students had the edge, make good decisions and proposed legislation would see chance to talk to local judgments,” Bajnok, RNAO’s hospitals that provide better and federal politicians Director of International care and more complex including city councillor Alex Cullen (left), shown here with RNAO Affairs and Best Practice procedures rewarded with more member Leslie Ashton. Guidelines told the Hamilton patients and more funding. Spectator (May 15). The report “What the government is saying 2. On April 27, Hamilton also calls for public reporting is: ‘Don’t just tell us wait times chapter member and of RNs’ overtime, sick time and are better and your patients are Community Health disability statistics. so happy. Prove it. And prove it Nurses’ Initiatives by these quality measures,” Group member Leanne Combining nursing Freeman said. Siracusa (right) met NDP and sport Leader Andrea Horwath RNAO member and second- Regulating retirement (left) at a rally at Queen’s year nursing student Noelle homes Park to call for an end to Montcalm was recognized as a In May, RNAO Executive clawbacks of the Ontario Woman of Influence for Director Doris Grinspun Child Benefit for families on social assistance. Siracusa spoke at the excellence in sport and explained RNAO’s view on event, organized by Hamilton-based anti-poverty groups, and took in academics during a luncheon the government’s proposed Question Period in the Legislature after the rally. in Toronto on April 30. The legislation to regulate retire- University of Windsor track ment homes. The new 3. In March, Nurses in the London area had the chance to talk about and field star was one of 19 regulations would set clear care the social determinants of health, health-care and nursing issues in women given the award, which and safety standards that RNAO’s platform, Creating Vibrant Communities, with Health Minister is presented by Ontario Ontario’s 700 homes would and local MPP Deb Matthews. The event, hosted by Middlesex-Elgin University Athletics (OUA). have to follow, including chapter and the Mental Health Nurses Interest Group, attracted more The 22-year-old athlete has publicizing inspection reports than 50 RNAO members including (L-R): Ali Rankin-Nash, Cheryl Yost, won more than a dozen OUA and measures to protect Kristie Clark, Matthews, Janet Hunt, Kamini Kalia, Jennifer Collins, medals in indoor track and residents’ rights. Although Steven Holbert, and Aric Rankin. field and was named as one of Grinspun said the legislation is the Canadian Interuniversity something the association has Sport’s Academic Top 8 for been calling for, the definition 2008-2009 (CHWI-TV of a retirement home must be Windsor, April 29). changed to include a cap on the number of services it can Quality care rewarded provide. Grinspun said without RNAO member Michelle the cap, people on a waiting list Freeman says the government’s for a bed in long-term care plan to tie hospital executives’ could opt to buy extra health salaries to the quality of patient services in a retirement home care and see hospitals compete because they could afford it. for funding is a step in the right Grinspun said this could “result direction. “We’ve not always in a slippery slope to two-tier been patient-centred in health health care for older persons,” care…” says Freeman, a (Canadian Press, May 17). RN

10 May/june 2010 nursing notes

RNs earn cancer care award Linda Johnson (centre) celebrates her This spring, Cancer Care Ontario award with (l-r), Lynn Hall, Anne Elliott honoured RNAO members Linda and Barb Filion. Johnson and Karen Simpson with its Human Touch Award. Johnson, an RN at Winchester District Memorial Hospital’s satellite chemotherapy unit, received the honour for her commitment to care and evidence-based practice. Karen Simpson (left) receives Simpson is a nurse practitioner at her award from Carol Tarbeck, a patient’s family member. Grand River Hospital in Kitchener. The award celebrates health-care providers and volunteers whose work improves the lives of cancer survivors.

British Columbia It’s one of only five municipalities in Health and Addiction Programs and removes nurses from the screening nurses set to vote on the province to receive the honour. the Ontario Hospital Association function at blood donor clinics. leaving CNA Organizations and communities can released a study that recommend- Canadian Blood Services plans to On April 10, the board of the become baby friendly by offering ed long-term strategies to strengthen train phlebotomists and clinic College of Registered Nurses of maternity care and programs that health care. Among the report’s assistants to screen potential British Columbia (CRNBC) voted to support breastfeeding. ideas: better management of donors to ensure they’re healthy withdraw its membership from CNA. chronic illnesses; shifting appropri- and eligible to give blood. CBS says The decision reflects the College’s RN to run in next ate services from hospitals to a minimum of two nurses will still concerns about a conflict of interest federal election communities; and more effectively work at clinics and none will be laid between regulatory and advocacy RNAO member Michelle Stockwell is managing physician and pharma- off. But Linda Silas, President of activities in a single organization. hoping to win the next federal ceutical costs. the Canadian Federation of Nurses Since the BC government estab- election. The Liberal Party chose the Unions, has pointed out nurses are lished the Health Professions Act in RN to represent the riding of New NP anesthesia best qualified to screen donors. 2005, CRNBC has been focused Hamilton East-Stoney Creek when diploma solely on regulation. CRNBC the vote is called. Stockwell told the The Bloomberg Faculty of Nursing Cancer screening to members will vote on the proposal Hamilton Spectator she wanted to at the University of Toronto is now save lives to leave CNA at the CRNBC annual run to promote ideas including a offering a Diploma in Anesthesia A study published in April in the general meeting on June 25. national day care program, better Care, the first of its kind in Canada. medical journal The Lancet found CNA is currently working with the mental health programs, the need The program is available to Master flexible sigmoidoscopies save lives. RN Network of BC, a new group for a suicide prevention strategy and of Nursing students in the nurse British researchers discovered the which would allow registered nurses’ improvements for seniors’ pensions. practitioner field as a concurrent procedure, in which a small scope voices to be heard on issues beyond diploma in anesthesia care, and as is used to examine the lower third regulation. RNAO is also sharing its Improving health care a post master of nursing (NP Field) of the colon, can reduce the risk of expertise in association manage- This spring, several provincial stand alone diploma in anesthesia developing colon cancer by ment, healthy public policy and health groups partnered to create care. For more information on the one-third, and reduce the risk of advocacy matters with the group. their own prescription for making course, visit http://bloomberg. death from the disease by 43 the health-care system more nursing.utoronto.ca. per cent. In Ontario, 13 RNs are Becoming baby-friendly sustainable. In April, the Ontario trained to perform the procedure as In April, Chatham-Kent earned the Association of Community Care Blood donor screening part of a pilot project run by the World Health Organization’s and Access Centres, the Ontario Health Canada has given a green provincial government and Cancer UNICEF’s Baby Friendly designation. Federation of Community Mental light to a new staffing model that Care Ontario.

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Carolyn Kirkup spent 18 years caring for people behind bars.

Registered nurse journal 13 the RNs in the sector admit they didn’t know much about it before working in the sex trade may never have been told how to protect they started working there. Many stumbled upon the career by themselves from sexually transmitted infections. Others will have chance. They may have known someone already working in a jail an opportunity to be screened for HIV, hepatitis C and tuberculo- or gone looking for a job with limited overnight shifts when their sis. According to Correctional Service of Canada, the prevalence of families were young. Daytime hours are among the pluses in HIV is 1.67 per cent inside prisons, compared to just 0.2 per cent corrections. So is the autonomy. Mrakovic says nurses are often in the general population. The prevalence of hepatitis C is 29.3 per the only health-care staff on site, so their assessments drive the cent, compared with 0.8 per cent outside. care. “It’s independent work so you have to be comfortable But there are some similarities when it comes to health care inside, following medical directives,” she says. “When the doctors come and outside, the prison walls. Like the general public, the prison in, you tell them what’s going on. You don’t work for them, you population is aging and diseases like heart disease and diabetes also work with them.” need treatment behind bars. Evelyn Wilson, Nurse Manager at the Mrakovic and other RNs say they also enjoy the bond they Hamilton Wentworth Detention Centre, says nurses try to get have with co-workers, the many challenges inmates to choose the low sodium and and, perhaps most surprising to those diabetic options at mealtimes, but it outside the system, caring for inmates. doesn’t always pan out. When they buy With sentences of two years plus a day, “You don’t snacks from the canteen, they may opt for federal inmates could be serial murderers, agree with potato chips or chocolate. bank robbers, sex offenders or drug dealers. Wilson says it’s harder to get provincial Many have gained notoriety in the news. what they’ve inmates to make lifestyle changes because Before they get to a federal jail, most have done, but shorter sentences mean nurses have less been through the provincial system. exposure to patients. “You help them try to Provincial inmates may still be awaiting trial. that can’t be compliant with diabetes,” she explains. Their stays could be as short as a day and affect your “You discuss diet and exercise and you their crimes, or the offences they’re accused hope they are on the right track.” Then of, run the gamut from skipping child care…to they are released, some not for long. support payments to terrorism. The nurses have a “They come back in and their sugars are who care for them don’t want to know. “It’s haywire again.” Wilson says old lifestyles not why I’m there,” says Mrakovic. “The positive get in the way and, with limited incomes, courts and the lawyers deal with that.” effect, you purchasing healthy options outside may Joanne Barton is an RN and Project Officer not be easy. for Correctional Service of Canada, where she have to She sees the same with efforts to help oversees policies and provides advice to senior believe in the addicted withdraw. “That’s a bit managers on health issues and nursing across disheartening. But I keep my expectations the country. She says RNs working in prisons your heart realistic,” she says. “You have to know epitomize the nursing principle of being that people that you did the best you could and made non-judgemental. “You don’t agree with what patients aware of programs available in they’ve done, but that can’t affect your care,” are capable the detention centre and community. Barton says. “You provide services congruent of becoming Some wouldn’t be living otherwise.” with professional standards of practice and put Despite any setbacks, Wilson has your feelings aside.” law abiding enjoyed the 23 years she’s been working in Barton first tried out corrections as a citizens.” the system because she’s had the opportu- student during a clinical placement at the nity to use so many nursing skills. She Kingston Prison for Women in 1987. She says because few new graduates come into believes nurses who choose corrections have faith in people. “To the field, nurses working in corrections bring a wealth of experience work there and have a positive effect, you have to believe in your that often goes unnoticed. “I don’t think correctional nurses are heart that people are capable of becoming law abiding citizens.” recognized for the skills that they bring to the table,” she says. They She says statistics show most people do not reoffend. Anecdot- are also not financially compensated at the same rate as other nurses. ally, she’s seen transformations. She remembers a prisoner who Correctional nurses work under collective agreements negotiated had been very belligerent through her five-year sentence, swearing with public service unions. In many places, they don’t match the pay constantly at everyone around her. Some time after her release, scales negotiated through the Ontario Nurses’ Association (ONA). It Barton ran into her at a store and braced herself. “I thought, ‘Is makes recruitment difficult. But once they are hired, Wilson says, she going to start yelling obscenities?’ Instead, she simply said they are never bored and will use every skill they have, then learn ‘Hi.’ She was so appropriate. She had a child. The difference was some more. night and day.” As a new RN 10 years ago, Sheleza Latif was drawn to the sector Correctional nurses also need to have faith in their own ability to because her mother worked there. She saw how challenging it could improve the health of people who may never have had someone to be to work in a field where things are not always as they seem. look after them. For some offenders, incarceration has led to their “You can’t just assume that a patient is telling the truth,” Latif first contact with health care in a very long time, if ever. Women says. For example, she explains that most inmates know that

14 MAY/JUNE 2010 complaining of chest pains could get them moved to the hospital came into the clinic wearing slippers. It was against the rules and because the detention centre doesn’t have the equipment or staff to the corrections officer wanted him back in his cell, but his feet were do cardiac monitoring. So, in addition to a physical examination, too sore to put shoes on. She spent half an hour working with him, there is a long checklist of factors to consider before sending an then talked to the guard. inmate offsite. “Maybe he is in danger in his cell, maybe he’s been Latif believes any division between RNs and their other correc- threatened or is being muscled for medication,” she says. “Or tions colleagues can be overcome if everyone remembers the maybe he’s moving drugs so needs to be somewhere else.” When ultimate goal is to help people re-integrate into society. “If we aren’t in doubt, Latif says, you call 911, but you can’t panic. able to rehabilitate, we all lose,” she says. Latif is a staff nurse at the Toronto East Detention Centre and has For many people in the prison system, the need for care goes just completed a master’s thesis on the corrections experience. She beyond chronic illnesses and addiction. The overwhelming health shared her expertise as part of a panel that developed RNAO’s issue is mental illness. Mental health problems are two to three methadone maintenance best practice guideline, which includes a times more common in Canadian prisons than among the general specific correctional section. She population. Correctional Service of says when medications are being Canada reports that 13 per cent of dispensed, wariness must apply. male offenders in federal custody About 80 per cent of federal presented mental health problems inmates have some form of when they were admitted in 2008. substance abuse problems, That’s up 86 per cent from 1997. For according to Correctional Service women, the figure reaches 24 per of Canada. Some inmates may try cent, an 85 per cent increase over the to use another incarcerate’s name same time. And in the general prison to gain access to drugs. population, those with a mental Several years ago, an inmate illness are at risk for abuse by other claimed to be someone else and inmates and suicide. overdosed on methadone not Carolyn Kirkup has just retired prescribed to him. Today, Latif from an 18-year career caring for the says nurses use photo and mentally ill prison population. Before number identification and that, she spent 10 years at the Centre repeatedly confirm names, for Addiction and Mental Health birthdates and doses with patients (CAMH) working with patients in methadone programs. suffering from schizophrenia and in The medication should be child and family psychiatry. When she paired with addiction counselling moved to Kingston in 1990, the and community support, but Latif federal penitentiary, which houses says that piece of the treatment about 400 offenders and a 143-bed hasn’t been implemented in the psychiatric facility, was hiring. “Some detention setting. The high people were quite upset at the turnover rate of inmates would thought,” she recalls of the reaction to make it complicated. Still, she her career shift. Even her mother was says, using the medication skeptical about the job. But Kirkup alone can help. has a passion for the work. “I’m very Barton remembers a difficult interested in helping offenders. I try man at Millhaven Institution in to understand where they are coming Bath, just west of Kingston, who from. How do you handle being was always in trouble, his name routinely mentioned in the morning mentally ill and being locked up?” briefings. “We got him on a methadone program. In a four-month Kirkup often imagines how anguishing it would be to have a period he had gotten out of segregation, started attending school and lucid moment and realize what crime you had committed. “There’s was burning through the course work. He put his relationship with nothing you can do to change that,” she sighs. “How do you live his mother back together. He was finally able to reconnect because with that regret and sorrow?” he could have a decent conversation with someone,” she says. Sadly, some people find they can’t live with the burden. The Despite the success stories, Barton says it can be challenging to suicide rate in prison is very high. In 2004, the rate for federal provide health care in an environment where the primary purpose incarcerates reached 86 per 100,000 people. In the general is security. The nurses are quick to say how much they appreciate population it’s 11.3. the support of the correctional officers constantly at their side. They Kirkup found dealing with suicides the most difficult. She are protectors and supporters and often are the first to identify a remembers the first. “I had just seen the man 10 minutes before. health problem. But their job descriptions sometimes conflict, and He had talked to his brother on the phone. He seemed well.” nurses need to explain why their work is important. Barton Minutes later he was found hanging. “You question yourself, ‘Why remembers working in Kingston when an elderly diabetic man did I miss that?’ ”

Registered nurse journal 15 And yet there is hope, even for inmates taking a break when required.” who’ve been abandoned by their family “Nurses Innocent says if nurses take verbal abuse members who can’t cope with what’s personally, they might respond in a like happened to their loved one. Kirkup bemoan manner. She saw how that evolved when remembers a “crabby” fellow who was dying seeing she worked in supervisory positions at of cancer. He had never been pleasant in Toronto East Detention Centre and prison but after he died, she learned he had patients Central East Correctional Centre in purchased a little evergreen tree to honour who are so Lindsay from 2001 to 2006. Some nurses another inmate who had committed suicide. adopted the foul language of inmates and “The outside doesn’t realize how these people profoundly withheld care in an effort to change behav- use all their energy to become family for each mentally iour. Innocent imagines some thought it other,” she says. was the only way they would be heard. Nurses bemoan seeing patients who seem ill that it’s “I would hire nurses with all the right so profoundly mentally ill that it’s difficult to difficult to skills. They’d do the orientation and know how they made it through the court training in being non-biased, non-judge- system. “Sometimes it’s not obvious to the know how mental,” she says, adding with despair, judge who has spoken to the person for only a they made “Despite that we ended up losing some of brief time,” says Judeline Innocent, who spent those nurses who became correctional five years working in correctional centres it through officers in lab coats.” before studying the sector as part of her work the court But such incidents are the exception, on her master’s degree. She’s now working on not the rule to nursing practice in a PhD on mental illness stigma. “(Some system.” prisons. Innocent thinks of a very senior inmates) are being punished for having a nurse she worked with who was so mental illness and they are not receiving the right care. It’s not until gentle and concerned for her patients. When an inmate who’d the nurses in jail are doing an assessment that they’ll see something been released was arrested again, Innocent recalls how the nurse isn’t right.” Sometimes it’s the correctional officers who notice an engaged the man and encouraged him. “He said, ‘you are like the inmate responding to voices or not hearing instructions. mother I never had.’ Maybe no one had ever spoken to him that Innocent believes there needs to be more evidence-based practice way.” Although she’s currently the Program Director for Mental for nursing in the correctional system. She says nurses working with Health, Complex Continuing Care and Rehabilitation at Quinte this vulnerable group should recognize that patients are knowledge- Health Care in Belleville, she says she’d like to go back to able about their own care, and acknowledge their suffering. She says correctional nursing one day, equipped with the research and nurses also need to learn not to take a patient’s behaviour person- knowledge she’s gleaned from her graduate studies. ally, even when belligerence is directed at them. Innocent says that “My love for correctional nursing will never die because of the involves “knowing themselves as nurses, knowing the patient in potential good that comes out of an environment that is predomi- terms of relationship, consulting with other nurses, the health- nantly bad,” she says. RN care team, the patient and the literature, viewing each situation as a learning experience, imagining the patient’s situation and h e l e n a m o n c r i e ff i s a f r e e l a n c e w r i t e r i n t o r o n t o .

Reaching out to students placement opportunities. across the province considering nursing school. Recruiting nurses can be a competitive CSC Project Officer Joanne Barton says it’s “Some will leave saying that’s not a setting business, particularly when your workplace a change in philosophy. The prison system for me,” Stalkie explains. Others, however, are isn’t a traditional health-care setting. Many used to require at least two years experience drawn to the sector because they treat students entering nursing school have little, if from its nurses. Today, the thinking is that if everything from earaches to traumas. any, awareness of the opportunities available new graduates are capable of working They are all surprised by how much education in Canada’s jails. Correctional Service of elsewhere, why not in corrections? The is done by nursing staff, something they may not Canada (CSC) is working to change that and response has been terrific. experience in a hospital setting. Stalkie says has launched new initiatives to form alliances In a partnership with CSC, St. Lawrence they are also surprised by the patients. She says with more nursing schools to expose College/Laurentian University nursing students some expect inmates to be mean, but actually students to the varied health-care opportuni- have access to experiences in the seven find they are polite. ties in its facilities. prisons in the Kingston area. Professor Laralea Barton has seen how a clinical placement Ian Irving is a registered nurse and Manager, Stalkie says when the school first offered can turn into a life-long career. She had a rare Clinical Services, with CSC’s Ontario Regional opportunities four years ago for community opportunity to work at the Prison for Women Headquarters. He says as part of an overall placements, students were a bit apprehensive. when she was in her fourth year at Queen’s recruitment and retention strategy, the This year she has 35 applications for 18 spots. University in 1987. She gave it a shot, department is participating in more job fairs, It’s become one of the top three most popular returned a few years later and has made her advertising and providing more clinical options and is a draw for potential students career in corrections ever since.

16 MAY/JUNE 2010 AGM2010 At the 85th Annual General Meeting, members celebrated the association’s past, and looked towards the future.

In mid-April, more than 750 and everything she learned practice for RNs and NPs. She announced the government will RNAO members celebrated the from them. also spoke about work at home support the Registered Nurse association’s 85th Annual “I am humbled by the quiet office to achieve 2,500 attend- First Assistant role, which General Meeting, and wel- work of nurses across our ees at conferences, 1,733 media allows specially trained RNs to comed the next President, province, by your dedication, your hits, more than two million assist during surgery. She also David McNeil, to his role at the commitment and your wisdom,” page views to the website, work confirmed that funding will be helm of the Board of Directors. she said. on four new BPGs and three made available for 14 additional In his inaugural speech to Fucile also looked back on awards for the program, and nurse practitioner-led clinics. members, McNeil built on the RNAO’s accomplishments the release of a comprehensive Meanwhile, McGuinty told AGM’s theme, Nurses: Vision, during her tenure, including nurses’ political platform 18 the audience that the govern- courage and strength from our work to achieve a provincial months ahead of the 2011 ment will be moving ahead roots. He pledged to remain true ban on the use and sale of provincial election. with a consultation process on to the vision RNAO’s founders cosmetic pesticides. Members also heard from allowing NPs to admit, treat, had of a strong profession and RNAO Executive Director politicians who spoke at the and discharge hospital health-care system, and called Doris Grinspun also updated meeting, including Premier in-patients. He also praised on members to join him in that members on the association’s Dalton McGuinty, Health Minister RNAO’s Best Practice Guide- work. “Nursing has the work during the past year. She Deb Matthews, Progressive lines Program as a model that knowledge to help the province highlighted RNAO’s member- Conservative Party Deputy can be used to improve patient find ways to create a sustainable ship now at 29,082, a net gain Leader Christine Elliott and outcomes, and ultimately save health system,” he said. of 1,206 RNs and 252 NPs NDP Leader Andrea Horwath. the system money. During her outgoing-presi- working in the system, full-time At the AGM’s opening cerem “Together, let’s build a health- dent’s address, Immediate employment at 65.6 per cent, 11 onies, Matthews re-affirmed the care system that not only meets Past-President Wendy Fucile additional NP clinics, and government’s commitment to our needs today, but is also talked about the privilege of RNAO’s impact on numerous several programs. She said strong enough to meet the needs meeting so many RNs during pieces of legislation including funding for the New Graduate of our children and grandchil- her two-year presidency, HPRAC to expand scope of Guarantee will continue, and dren tomorrow,” he said.

RNAO’s Board of Directors

Front row (L to R): Ruth Schofield, Interest Group Representative; Wendy Fucile, Immediate Past- President; David McNeil, President; Doris Grinspun, Executive Director; Nancy Watters, Region 10 Representative; Rhonda Seidman-Carlson, Region 8 Representative. Back row (L to R): Sheryl Bernard, MAL Nursing Practice; Kathleen White-Williams, MAL Nursing Education; Amarpreet Kaur Ahluwalia, Region 6 Representative; Claudine Bennett, Region 4 Representative; Raquel Meyer, MAL Nursing Research; Jacquie Stephens, Region 1 Representative; Kaiyan Fu, Region 7 Representative; Marlene Slepkov, Region 3 Representative; Paul-André Gauthier, Region 11 Representative; Maureen Cava, MAL Socio-Political Affairs; Cheryl Yost, Region 2 Representative; Kathleen Fitzgerald, Region 12 Representative. Absent: Sara Lankshear, Region 5 Representative; Linda MacLeod, MAL Nursing Administration

Registered nurse journal 17 AGM Peer recognition for 2010 outstanding RNs

Leadership Award in chronic diseases. Her passion to Nursing Education advance quality, client-focused (Academic) home care has led to many The RNAO Leadership Award in changes in the sector. The Nursing Education (Academic) is South West presented to the RN who excels Community as a nursing educator in a Care Access university or college. The Centre has winner enhances the image of adopted her nursing by encouraging critical work on evidence-informed thinking, innovation and debate practice, leading to flexible, on nursing issues and acts as a client-driven service delivery. President David McNeil, right, role model and mentor. Her research has also influ- presents Wendy Fucile with the Carroll Iwasiw is the winner enced policies and practices at immediate past-president’s pin of this year’s award. A professor other agencies including the and thanks her for leading the at the Arthur Ontario Association of association with vision and wisdom. Labatt Family Community Care Access School of Centres and VON Canada. Nursing at the McWilliam is a professor at the University of Arthur Labatt Family School of Western Ontario, Iwasiw has Nursing at the University of been teaching for three decades. Western Ontario. She has She has also held many published extensively in leadership roles. She has served peer-reviewed journals and as director of nursing at been a speaker at many forums Western, chaired the Council of in Canada and around Ontario University Programs in the world. Nursing and currently heads the accreditation bureau of the Leadership Award in Honourary life member Margaret Canadian Association of Schools Nursing Administration Risk left, and Judith Skelton-Green of Nursing. She mentors many The Leadership Award in take a moment to mingle before emerging researchers and Nursing Administration honours the AGM opening ceremonies on graduate students, and has also a member who shows exem- April 15. been active internationally. She plary management skills in an led the nursing education arm acute, long-term, community, of a six-year program to help education, research or other rebuild health care in Rwanda, setting. This individual actively including creating the country’s implements ground-breaking first BScN program. ideas to enhance patient care, and demonstrates a commit- Leadership Award in ment to improve the quality of Nursing Research health care. RNAO’s Leadership Award in This year’s recipient is Liz Nursing Research is presented to Janzen, former Senior Nurse a member whose work supports for Toronto Public Health and the implementation of innova- the former head of the Healthy Progressive Conservative Deputy tive and progressive nursing Living/Healthy Communities Leader and health critic Christine practice that leads to positive directorate. Although now Elliott reinforces her party’s support patient and nurse outcomes. officially retired, Janzen’s for maintaining a publicly funded Carol McWilliam’s extensive enthusiasm for health health-care system that focuses on body of research during her promotion is described by quality, front-line care, during her 20-year career has improved colleagues as “infectious.” address on April 15. care for seniors living with Her expertise in public health

18 May/june 2010 spanned 30 years, during area of research, the CHC has which time she worked with aligned its work on a study groups ranging from infants to evaluating the methods and AGM2010 seniors. She moved several effectiveness of providing health promotion initiatives Nicotine Replacement Therapy forward such as the Diversity, with implementation of the Access and Equity Strategy. Integrating Smoking Cessation She also coordinated programs into Daily Nursing Practice Best that responded to the city’s Practice Guideline. More than homeless three-quarters of the nurses who population, work at the CHC belong to and she led the RNAO. Staff members are also development encouraged to take advantage of and implemen- various professional develop- tation of a comprehensive drug ment opportunities offered by strategy, including harm the association. reduction. She also supported her staff to become involved in Honourary Life Socializing at the AGM are (L-R) leadership opportunities. Membership Tim Lenartowych, Shirley Kennedy, The Honourary Life Membership and Carmen James-Henry. RNAO in the Workplace is conferred on long-standing Award RNAO members who have The RNAO in the Workplace made outstanding contributions Award recognizes an Ontario to nursing practice, education, health-care organization for its administration or research at work to foster involvement of the provincial, national or RNs in their professional international levels. This association, its creation of a includes activities that promote climate of professional partner- the association among nursing ship and quality work life, and colleagues, the government and its commitment to promoting other health-care partners. professional development and Suzanne Finnie has been an research-based practice. RNAO member for 36 years, The Sandwich Community and has led the association Health Centre in Windsor has through historic changes. In Olga Muir, left, and Elsabeth been selected as this year’s 1996, she spearheaded the Jensen celebrate the start of winner. The CHC demonstrates amalgamation of three chapters RNAO’s 85th AGM during a the importance of a quality work in east Toronto to create Region reception before the opening environment by ensuring that 7. She was a member of ceremonies. more than 90 per cent of its RNAO’s Board of Directors RNs are from 1995 to employed 1999 and full-time. The helped shape CHC uses nursing policy several through her Sandwich CHC approaches to work on RNAO’s various Chief Executive create a committees for resolutions, Officer,L ynda supportive by-laws and research. Finnie Monik. learning was also President of the Nurse environment Practitioners’ Association of for its staff, including a Ontario from 1977 to 1979 and preceptorship program, online helped to draft the Standards of (L-R) University of Ottawa nursing learning resources, and regular Practice for Nurse Practitioners. students Christel Palumbo, Nancy “lunch and learn” sessions. In Finnie spent her career – nearly Akor and Jessica Chu stop for a April of 2009, it was chosen as four decades long – caring, photo with Premier Dalton a Best Practice Spotlight teaching and mentoring in McGuinty during a break from Organization Candidate, the family practice and primary official business on April 16. first CHC to be selected. In the care nursing.

Registered nurse journal 19 Beverley Simpson has been continued funding for the Blood an RNAO member for 20 years Conservation Program, which AGM2010 and has made significant she is part of as an Ontario contributions to nursing Transfusion Coordinator at education and practice; many Peterborough Regional Health colleagues describe her as one Centre. The role provided her of nursing’s best cheerleaders. with the opportunity to learn She helped develop, and is a key about joint replacement surgery, program director for, the which she embraced as a new Dorothy Wylie Nursing challenge after spending much Leadership Institute, which of her career working with helps shape nursing leaders. newborns at PRHC. RNs who Simpson was have worked with Staples say her also instrumen- mentorship inspired them to tal in the earn their own achievements re-organization such as the international of the Regis- lactation consultant certification. tered Nurses’ Foundation of Ontario. Her efforts in RNAO HUB Fellowship organizing a fundraising The RNAO HUB Fellowship, system have ensured that sponsored by RNAO’s home registered nurses and nursing and auto insurance provider, Outgoing President Wendy Fucile students seeking financial offers recipients the chance to speaks about the privilege she felt support get the chance to participate in a week-long, serving members over the past further their education. one-on-one placement with two years. Simpson’s quiet persistence RNAO Executive Director also helped in her work with Doris Grinspun. the University of Toronto As the President of RNAO’s and the College of Nurses of Peel Chapter, Jannine Bolton is Ontario to create the first a role model and mentor to RNs acute care nurse practitioner in the region. program in Canada. She has formed partnerships RNAO Award of Merit with nurses, The RNAO Award of Merit community recognizes registered nurses leaders and other stakeholders, who have made outstanding increased RNAO membership, contributions to RNAO and to and worked tirelessly to the profession of nursing in strengthen the nursing voice in Ontario. Winners demonstrate the community. She was the responsibility for professional lead for the Bridging Health Care development, and are exem- Delivery from Hospital to plary role models and mentors Community initiative for the to peers. Mississauga-Halton LHIN and Jill Staples is this year’s recently helped to organize a winner. As president of RNAO’s screening of Home Safe Toronto, Kawartha/Victoria Chapter, a documentary that tells the Incoming President David McNeil Staples has promoted RNAO to stories of families who are promises to build on RNAO’s nurses living with homelessness. strong history of collaboration to throughout the leverage the voice of nurses during community. President’s Award for his remarks on April 16. She also Leadership in Clinical ensures local Nursing Practice MPPs are aware of RNAO’s posi- RNAO’s President’s Award for tions on issues and regularly Leadership in Clinical Nursing attends the annual Day at Practice is presented to an RN in Queen’s Park. She also a staff nurse position who frequently speaks out for consistently demonstrates

20 May/june 2010 expertise and evidence-based provider. Hooper is a strong practice in one or more areas of advocate for her patients, clinical practice. particularly street-involved youth AGM2010 Maria Tandoc works in the and young women. intensive care unit at the Trillium Health Centre where Student of Distinction she mentors other critical care The Student of Distinction Award nurses and is a preceptor for is given to a nursing student new staff members. Last year, who is a role model for she and the ICU team decreased professionalism and contributes ventilatory-associated pneumo- to the advancement of RNAO/ nia (VAP) rates when she NSO within her/his nursing developed and program. This student also implemented acts as a resource for other an oral care nursing students. program in the Colleen Wright-Loree ICU based on graduated from the McMaster- recommendations in RNAO’s Mohawk-Conestoga nursing best practice guideline on oral program in December. Despite health. Tandoc is also very a heavy course load, she found involved in RNAO. She is the time to mentor students membership and workplace through her part-time work as liaison for Peel Chapter and the a facilitator of two peer-sup- Health Minister Deb Matthews membership officer for the ported learning groups at re-affirms the government’s Nursing Research Interest Conestoga. She also worked commitment to several programs Group. She works with Peel with 25 students through an during her remarks at the opening Chapter executive members to initiative known as the Nursing ceremonies on April 15. plan workplace liaison meet- Undergraduate Buddy System ings, develops postcards to and offered informal tutoring invite lapsed members to sessions to those in her re-join, and can be found at Conestoga RNAO events encouraging all nursing RNs to join the association. community Sandra Hooper is a nurse who required practitioner with the City of help. Wright- Ottawa’s Healthy Sexuality Loree (left, with nominator Clinic whose commitment to Jane Hamilton Wilson) public health encourages demonstrated enthusiasm and leadership, critical thinking and energy for her professional clinical excellence. As an active association by communicating member of RNAO and NPAO, the benefits of RNAO to fellow she has provided valuable nursing students. Her interest insight to policy development, in nursing research led to her both locally and nationally. At involvement in a practicum the clinic, she supports an where she undertook a expanded nursing role by systematic literature review of teaching the theory and cannabis use. Her work led to overseeing the practical aspects the development of a position Premier Dalton McGuinty speaks of completing statement that has been about the progress of nursing over the certification submitted to the Canadian the years, including an increased required to Nursing Student Association scope of practice for RNs and NPs. perform pelvic for approval. Wright-Loree is Members gave him a standing examinations. currently working in the ovation during his remarks on April Her work allows registered emergency department at 16, when he announced his nurses to provide contraception, Groves Memorial Community government was open to the idea of Pap smear tests and sexually Hospital in Fergus and allowing NPs to admit, treat and transmitted infection screening plans to become an acute discharge patients from hospitals. to people without a primary care care nurse practitioner.

Registered nurse journal 21 AGM2010 85 years of agms Registered Nurse Journal looks back at some highlights from annual meetings of the past.

1926 RNAO held its first 1975 RNAO marked its annual general meeting from 50th AGM with the theme Out April 8 to 10 in Belleville, of the past, an exciting future. (L-R) Crystal Edwards, Michael Ontario. The association celebrated its Scarcello, Tia Cooney and Nicole anniversary with the publication Landgraff were among the 750 1956 For the first time in of Nurse, a collection of short attendees who participated RNAO history, a group of male stories profiling nurses’ work. in the AGM on April 16. nurses held a lunch and meeting during the AGM. 1985 During the board Twenty-three of the 100 men meeting before the AGM, board then registered to practice in of directors members joined Ontario attended, and some psychiatric nurses protesting at formed a special RNAO Queen’s Park. The nurses were committee on male nurses demanding wage parity with chaired by Albert Wedgery. their colleagues in hospitals. In 1967, Wedgery became the association’s first male 2003 RNAO rescheduled president. its 78th AGM after Severe Acute Respiratory Syndrome (SARS) 1963 The largest AGM in emerges in Ontario. NDP Leader Andrea Horwath RNAO’s 38-year history is held congratulates RNAO on its 85 in Toronto. More than 2,300 2008 Dr. Sheela Basrur, years of advocacy and service RNs, including 300 students, Ontario’s former Chief Medical in Ontario during her address on were on hand for the three-day Officer of Health and leader in April 15. meeting, where members voted managing the 2003 SARS to continue to support the outbreaks, was invested in the newly formed College of Nurses Order of Ontario after RNAO of Ontario. Nurses also heard nominated her for the award. about a new study that would Basrur was congratulated by examine arbitration legislation members of the association at for the profession. the AGM, which came just seven weeks before her 1965 RNAO members untimely death. adjourned the association’s annual general meeting early 2010 RNAO marks its on April 29 to take their call for 85th AGM with speeches and collective bargaining for all announcements from politi- RNAO members Andrea Richards, nurses to MPPs at the provin- cians and the swearing in of Elizabeth Datars-Shkolnik and Dina cial legislature. More than David McNeil as the associa- McGovern take some time to 1,000 nurses marched on tion’s second male president. network during the Opening Queen’s Park to call for the Ceremonies. government to pass the Nurses’ Bargaining Act.

22 May/june 2010 Members help chart course for RNAO’s work AGM2010 RNAO encourages chapters, regions without chapters, interest groups and individual members to submit resolutions for ratification at each annual general meeting (AGM). Resolutions are part of RNAO’s democratic process, giving all members the opportunity to propose a course of action for the association. In the interest of democracy, the Provincial Resolutions Committee does not endorse or censor resolutions. All resolutions that have met the required format are distributed to RNAO members for consideration in advance of the AGM. In this issue of Registered Nurse Journal, we reveal voting delegates’ decisions on each resolution proposed at the 2010 AGM.

Resolution # 1 and unprofessional. introductory and advanced levels encourage the Ministry of Health & Submitted by Kimberley English, Status: DEFEATED of nursing programs. Long-Term Care to develop a RN, Durham-Northumberland Status: CARRIED not-for-profit laboratory services Chapter, on behalf of fourth-year Resolution # 4 program in rural and Northern com- Trent University Nursing Students: Submitted by Susan McIntyre, RN, Resolution # 7 munities made available to the Yasmin Snippe, Allison Parker, on behalf of Halton Chapter and Submitted by Carmen Rodrigue, public, which ensures equality of Cheryl Prinze and Nicola Doherty with support from the Pediatric RN, President, Clinical Nurse access for all Ontarians, cost- THEREFORE BE IT RESOLVED Nurses Interest Group (PedNIG) Specialist Interest Group (CNSIG) effectiveness and transparency. that the RNAO and its members and Community Health Nurses’ THEREFORE BE IT RESOLVED Status: CARRIED collaborate with the College of Initiative Group (CHNIG) that RNAO include the CNS in Pharmacists and other health-care THEREFORE BE IT RESOLVED the staff mix being presented to New business item # 3 providers to actively promote and that RNAO collaborate with all health-care organizations and the Submitted by The Nurses Shortage raise awareness regarding socially relevant sectors of the health-care government of Ontario and and You Committee and environmentally conscious and family support systems to promote the CNS as part of the THEREFORE BE IT RESOLVED disposal of pharmaceuticals. promote and implement “The solution in the management of the that the RNAO shall continue to Status: CARRIED Period of Purple Crying” program care of complex and/or vulnerable vigorously mobilize against or other evidence-based resources populations in the health-care attempts by the government, Resolution # 2 for professionals and parents system; and hospitals, community employers Submitted by Daniel Ball, RN, regarding the prevention of THEREFORE BE IT FURTHER and LHINs to balance budgets by Co-President, Men in Nursing Shaken Baby Syndrome, in all RESOLVED that RNAO promote the cutting registered nurse (RN) Interest Group areas of Ontario. significant contributions of the nursing positions; and THEREFORE BE IT RESOLVED Status: Referred to RNAO’s CNS as an Advanced Practice THEREFORE BE IT FURTHER that the RNAO, in collaboration with Board of Directors Nurse (APN) in the health-care RESOLVED that the RNAO shall its nursing partners and the Men in system of Ontario and beyond. continue to vigorously lobby for Nursing Interest Group, actively Resolution # 5 Status: DEFEATED Ontario’s RN workforce to be advance efforts in the public media, Submitted by Nurse Practitioners’ increased by an additional 9,000 forums and educational institu- Association of Ontario (NPAO) The following resolutions were full-time equivalents by the end tions, which would promote nursing THEREFORE BE IT RESOLVED proposed during the New Business of the next government’s mandate, as a viable and attractive career that RNAO lobby the provincial section of the AGM. in 2015. choice for men. government to include all smoking Status: CARRIED Status: CARRIED cessation aids on the provincial New business item # 1 drug formulary under Ontario’s Submitted by the Nursing Students New business item # 4 Resolution # 3 drug benefit programs. of Ontario Submitted by Kathleen MacMillan Submitted by Carolyn Davies, RN, Status: CARRIED THEREFORE BE IT RESOLVED and Rani Srivastava, Region 7 and Elizabeth Battle Haugh, RN, that the President or Vice-Presi- members Essex Chapter Resolution # 6 dent of the NSO Interest Group be Therefore be it resolved THEREFORE BE IT RESOLVED Submitted by Kristine Clark, RN, a non-voting ex-officio member of that the RNAO lobby all levels of that RNAO petition CNO to ensure Middlesex-Elgin Chapter the RNAO Board of Directors. government and the Canadian that reports to CNO of nurses THEREFORE BE IT RESOLVED Status: DEFEATED Nurses Association to advocate for displaying workplace violence in that the RNAO advocate to the greater structural support for any form be investigated fully and, Canadian Association of Schools New business item # 2 corrections nurses (governance, where warranted, referred to the of Nursing (CASN) to include Submitted by Region 2 members accountability, professional Discipline Committee as behaviour specific competencies related to THEREFORE BE IT RESOLVED development). that is disgraceful, dishonorable care for older adults at both the that the RNAO and its members Status: CARRIED

Registered nurse journal 23 Behind the scenes Nurse Jackie may be fiction, but the actors who put the television show on air are getting some real-life lessons on the profession. by Suzanne Gordon

Everyday between mid-September and December, the cast and viewers learned more about the real-life challenges nurses face as crew of Nurse Jackie gather at the Kaufman Astoria Studio in New they try to do their critical work. York City. On the day I arrive in November, they’re working on Unfortunately, not enough nurses understand how revolutionary the dark comedy’s second season, which aired this spring on the this program is. In the U.S., the New York State Nurses and Movie Network. The group includes former Soprano’s star, Edie Oncology Nurses Associations have lodged protests with the Falco, who stars as Jackie Peyton, Anna Deavere Smith who plays producers, demanding that Nurse Jackie air a disclaimer because Nurse Administrator Gloria Akalitus, Eve Best who has the role of its main character violates nursing’s code of ethics. They just can’t Jackie’s best buddy, the steely Dr. Eleanor O’Hara, Peter Facinelli, get past the fact that Jackie is flawed and breaks the rules. That’s who plays junior ER attending MD Fitch Cooper, and Meritt why I’ve come to the Astoria studio to talk to members of the cast Wever as student nurse Zoey Barkow. Each day, additional actors and crew. I want to know what they’ve discovered about nursing and extras, producers, directors and screenwriters fill out the through their work on Nurse Jackie. What I learned confirmed my permanent cast. And finally there is real-life ER nurse Lisa Wing, expectations: Nurse Jackie not only teaches its viewers about who’s on the set to make sure technical details are correct. nursing, it also educates the cast and crew. After studying the image of nursing for more than two decades, Some of those associated with Nurse Jackie have had serious as soon as I learned that three new TV shows about nurses were off-screen encounters with the health-care system. Steven airing last year, I immediately tuned in. Between HawthoRNe, Wallem, for example, who plays the RN Thor, was diagnosed with Mercy, and Nurse Jackie, it was no contest. Nurse Jackie won hands Type 1 diabetes when he was 10 years old. His family has thus down. Not just because of its great production values and acting, been in steady contact with both RNs and MDs. He tells me he but because it’s also the best contemporary television has to offer knows how important nurses are and he would like to encourage about nursing. Jackie Peyton is a smart, tough, no-nonsense, and more men to go into nursing. Executive producer Richie Jackson matter-of-factly caring RN. also recognized the power of nursing pre-Nurse Jackie. From the show’s opening scene in the very first episode of the In 2000, he and his wife were expecting identical twins, who premier season, it was clear to me that Nurse Jackie was breaking arrived three months early. One of his sons died two hours after new ground. When a young bike messenger was brought into the he was born, the other spent three months in neonatal intensive ER, Jackie – not the physician who missed it entirely – knew he care units. “The nurses who took care of my son had three had a brain bleed and was in trouble. In a voice over, Jackie patients, not just one,” Jackson recounts. “There were the two explains the physiology of the injury. In both the entertainment parents as well as the baby. What was extraordinary to me was and journalistic media, the golden rule is that RNs never, ever get their skill and expertise and how agile they were. They had so to explain the scientific facts. That’s the doctor’s job. But here, it’s much more experience than some of the doctors. They would

ation: J e r m y br uneel I llust r ation: the nurse’s as well. On each subsequent episode in season one, know what was going on medically. Because of all their experience,

24 MAY/JUNE 2010 they were able to tell us when there was something to worry that Jackie is addicted to medication. Falco, who is a recovering about, and when not to worry. They were able to manage this alcoholic, had complicated feelings about Jackie’s addiction. She roller coaster we were on.” has, however, learned Jackie isn’t the only nurse – or doctor One of Jackson’s experiences became part of an episode of – who has trouble with drugs. She also believes that Jackie’s Nurse Jackie. “A day or two after our son was born a doctor came inability to take care of herself – while, that is, she spends her in and gave me a very grave assessment of his condition,” he time taking care of others – rings very true for many people, not recalls. “It was awful and a nurse was standing behind him just nurses. As a single mother of two young children, she knows shaking her head no. When he left, she said, ‘it’s not that bad.’ that caregivers tend to put themselves last, even though they too She was right, and she literally kept me from collapsing.” have needs that need to be addressed. Not all members of the cast and crew have had such difficult Falco and others on the show know that it has struck a nerve educational encounters. They have learned about nursing from their among nurses. Although a lot of nurses believe Nurse Jackie nails work on the show. Wever believes that she is not only a student of modern health care, some are understandably skittish about nursing on the set but off, getting valuable lessons about the Jackie’s flaws. As an actor, Falco does not believe it is her job to profession from real-life nurses. When I first meet Best, who plays remind people that this is a dark comedy, not a documentary. “I Jackie’s physician friend, the very first words out of her mouth are, am not willing to get in there and fight the good fight for my TV “Nurses and teachers should make more money than anyone else.” show. I love that people are talking about it even though some of And Deavere Smith offers an interesting insight into the relationship the things they’re saying are not positive. Who knows if people, between the nurse administrator she plays on the show and Jackie. nurses, are uncomfortable then maybe the show is portraying Deavere Smith’s character, Gloria Akalitus, has things as they really are and they don’t so much trouble with Jackie, Deavere Smith want to be seeing things about the issue surmises, because she “knows that it’s Jackie of drug use or other things that I am who is in control.” Nurses who enact this discovering are real. If it weren’t complex choreography of control every day capturing something real, perhaps they’d will certainly find much to reflect on in this just say ‘it’s a silly TV show’. I’m just analysis of the dynamic. happy that it’s causing conversation.” Falco has particularly interesting insights “From the opening She’s also pleased that people are on the subject of nursing and nurses. She enjoying the show. “I have kids now and says what drew her to the show was Jackie’s scene, Nurse Jackie I don’t want to be putting any more character, not her profession. “The character viruses into the subconscious of the of Jackie Peyton would have been interesting broke new ground. population. I want people to see to me no matter what she did,” Falco something positive.” explains. “She’s unwilling to let things get in On each episode, In my view, Nurse Jackie is definitely the way of doing what she needs to get done. positive. It highlights the problems with She doesn’t have a lot of room for bureau- viewers learned dysfunctional nurse-physician relation- cracy and rules when they stand in the way ships, what happens when units are of her taking care of someone.” about the challenges short staffed, don’t have appropriate lift Falco now realizes what she describes as equipment, and when RNs don’t have “the magnitude of the obstacles that nurses nurses face.” enough authority over their work. Yes, of have to deal with in order to perform the course, Jackie bends – sometimes even simple but noble task of helping people.” shatters – the rules. But she’s a character From talking to real nurses and watching Wing, the on-set nurse in a 21st century medical drama. To create the kind of drama that expert, she has also recognized the magnitude of knowledge makes good television, writers and producers have to create nurses have. Before she started to play Jackie, for example, she credible, interesting, and compelling characters who don’t have visited Bellevue Hospital, which has one of the busiest ERs in picture perfect lives, and constantly break the rules. Today’s New York City. heroes – consider the doctors on House or Denis Leary and his Falco says that she learns about nursing everyday by studying fellow firefighters in Rescue Me – are a mess, but also masters of Wing. “She’s very understated. She’ll say, ‘well the reason for this their craft. is…’ and she’ll rattle off the names of things, and you’re in awe of As real life RNs watch Nurse Jackie they might consider what the amount of information she’s gotten on top of the amount of the Pulitzer Prize-winning American historian, Laurel Thatcher training she’s had. It’s huge. She also has the ability to put her Ulrich, said about women: well-behaved women seldom make hands on patients, and soothe them just with the tone of her voice. history. They don’t make good television either. RN You see her dealing with extras or day players who have to play the patient. I watch her, and she’ll say, ‘I’m going to put this on you s u z a n n e g o r d o n i s a j o u r n a l i s t w h o h a s o b s e r v e d a n d w r i t t e n and it’s going to hurt a little. ’ And I think, ‘how beautiful.’ You a b o u t n u r s i n g f o r t h e p a s t 25 y e a r s . s h e i s t h e a u t h o r o f n u r s i n g really can imagine feeling secure with these people around you.” a g a i n s t t h e o d d s : h o w h e a l t h c a r e c o s t -c u t t i n g , m e d i a stereotypes Falco has also learned a lot, she says, from people’s reactions to a n d m e d i c a l h u b r i s u n d e r m i n e n u r s e s a n d p a t i e n t c a r e . h e r l a t e s t the show. Some doctors have made it clear they do not appreciate b o o k i s w h e n c h i c k e n s o u p i s n ’t e n o u g h : s t o r i e s o f n u r s e s s t a n d i n g the way MDs are portrayed. Nurses have worried about the fact u p f o r t h e m s e l v e s , t h e i r p a t i e n t s a n d t h e i r p r o f e s s i o n .

26 MAY/JUNE 2010 policy at work

listened as RNAO’s executive argued it’s time to act on the director, Doris Grinspun, recommendations it and other applauded the government’s organizations such as the Health moves to introduce measures to Council of Canada, the Canadian rein in the cost of generic drugs Health Coalition and the and expand the clinical services Romanow Commission have provided by pharmacists. made on numerous occasions to During her April 29 address one of the largest costs appearance, Grinspun said in the health-care system. RNAO was pleased with the legislation because Ontario The 1st Ever Public pays higher generic drug prices Health Nursing than most industrialized Summit countries including the U.S., RNAO collaborated with an UK and Spain. She argued important public health Wendy Fucile appears with Jack Gibbons of the Ontario Clean Air Alliance at a cutting the professional partner recently when it held press conference to call for the closure of coal-fired power plants. allowances (widely known as its first ever Public Health kick-backs) pharmacists receive Nursing Summit. The Ontario from generic manufacturers Agency for Health Protection Why shutting Ontario’s capacity already exists to meet would increase accountability and Promotion (OAHPP) and coal plants could save expected demand. and allow resources to be better RNAO co-hosted the day-long 1,000 lives Recalling her own experience allocated towards other meeting aimed at sharing On April 20, immediate growing up in a town where health-care needs. information about the role past-president Wendy Fucile bad air days meant walking to Grinspun also pointed to the public health nurses play in represented RNAO during a school with a kerchief over her need for government to show improving population health media conference at Queen’s mouth, Fucile explained that the same bold leadership when outcomes and lowering health Park to highlight the dangers getting rid of toxins associated it comes to brand name inequities among vulnerable of producing electricity from with coal production such as pharmaceuticals. She cited a groups. Michael Creek of coal. Appearing with Dr. Hilary mercury would also reduce the report that shows big pharma Voices From The Street shared de Veber of the Canadian estimated 100,000 asthma accounts for 73 per cent of the his personal story about what Association of Physicians for the attacks and other illnesses that four billion dollars spent it’s like to live in poverty. Environment and Jack Gibbons people suffer in the province annually on the province’s Summit attendees also heard of the Ontario Clean Air Alliance, annually. drug program. presentations from public Fucile called on the government Fucile told reporters that health nurses about the clients to immediately close the ending the use of coal in they see every day and the remaining coal-fired electricity Ontario would be the equiva- social conditions that enable generators in the province. lent of taking seven million people to be healthy. A panel of Citing a study prepared for cars off the road. nursing researchers spoke of the government, she told She said the government the need to give public health reporters that almost 250 Ontar- could easily offset the power gap nursing a higher profile and to ians die each year as a result of by placing more emphasis on increase the number of nurses coal-fired power generation. conservation and cleaner, energy Doris Grinspun presents RNAO’s who work in this sector. On views on generic drug prices. Although the province has efficient alternatives such as behalf of their associations, pledged to end its reliance on natural gas and wind power. Grinspun added that RNAO OAHPP President Vivek Goel coal by 2014, Fucile said waiting wants Ontario to quickly engage and RNAO Executive Director that long would increase the Making the case for other provinces and the federal Doris Grinspun committed to death toll to 1,000. Gibbons pharmacare government to develop a working together to explore explained that putting the coal MPPs who sit on a legislative national pharmacare program. how community nurses can be power plants on standby now is committee examining the In its written submission to the better supported to advance possible because sufficient government’s budget bill finance committee, RNAO public health in the province. RN

Registered nurse journal 27 calendar

August October classifieds August 8-13 October 18-20 Cozy, private, two-bedroom waterfront cottage for rent at the tip of Healthy Work Environments Knowledge, the Power of the Bruce Peninsula. Swimming and sunbathing afforded by the Summer Institute Nursing Conference: cottage’s rocky shoreline. Relax on the deck overlooking Lake Hockley Valley Resort, Orangeville, Celebrating Best Practice Huron and Georgian Bay. Minutes away from two sandy public Ontario Guidelines and Clinical beaches, the Bruce Trail, The Bruce National Park’s new Leadership interpretive centre, tour boats and the charming village of InterContinental Hotel, Metro Tobermory. Cottage comfortably sleeps four and is outfitted with a september Toronto Convention Centre full bath, dishwasher, microwave, cable TV, DVD player and a large Toronto, Ontario stone fireplace. For info, rates, and pictures visit http://web.mac. September 15 com/jstewartguelph/Site/Welcome.html or call 519-242-8999. Preceptorship for Nurses Workshop November Sudbury, Ontario, Live. Available by Did you know? OTN across Ontario November 4-6 You can access the ‘members only’ section of the RNAO Nurse Practitioners’ website to update your e-mail and mailing address. Never September 23-24 Association of Ontario miss an issue of Registered Nurse Journal and stay connected RNAO Board of Directors Conference with your nursing colleagues across the province. Update your Meeting Doubletree by Hilton, Toronto profile today by visiting www.rnao.org/members. RNAO Home Office Toronto, Ontario December September 25 RNAO Assembly Meeting December 6 Hyatt on King, Toronto, Ontario Preventing and managing violence in the workplace September 26- WORKSHOP October 1 Windsor, Ontario 2010 Chronic Disease Management Fall Institute Toronto Star congratulates Westin Prince Hotel, Toronto, 2010 Award Recipient Ontario Carole Veenema, RN

Unless otherwise noted, please contact [email protected] or call Honourable Nominees 1-800-268-7199 for more information. Pandaungchai Kitchindaophat, RN Manuel Martinez, RN Norma Nicholson, RN RNAO at work Speak out for nursing by All Nominees whose names representing RNAO at work. came forward this year. Become a Workplace Liaison today! You have touched the lives of others in a Visit www.rnao.org/wl or call 1-800-268-7199 special and meaningful way. to receive regular updates and materials.

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Get Involved with RNAO: COMMITTEE WORK OPPORTUNITIES Leadership and Management There will be vacancies on the following board committees Program (not the Board of Directors), effective June 30, 2010: • Legal Assistance Program Committee • Bylaws Committee • Provincial Nominations Committee • Provincial Resolutions Committee • Editorial Advisory Committee • Membership Recruitment & Retention • Nursing Education GRANTING UNIVERSITY CREDIT AND LEADERSHIP AND MANAGEMENT • Nursing Practice PROGRAM CERTIFICATE OF COMPLETION • Nursing Research Endorsed by the CNA. • Policy Analysis & Development All courses individually facilitated by an Educational Consultant RNAO Board Committees 2010-2012. Term of office is July 1-June 30 Courses Offered: (2-yearAre term). you For informationa healthcare regarding a specific vacancy or committee Leadership and Management Terms of Reference, contact Penny Lamanna at [email protected], (6 units) notingprofessional which committee you working are interested inwith joining. • 9 month course completion • both theoretical and practical content important in today’s work environment

Interested candidates must submit s

seniors & their families? r their CV with a letter attached, Leading Effective Teams outlining any relevant experience, a (3 units) Do you have questions about care services e • 6 month course completion

and describing their interest in the position. y and accommodations for seniors? • study of leadership, team dynamics impacting Speaking out for health. Speaking out for nursing. the workplace, types of and team structure in By simply calling our 24 hour toll-free line, you can health care organizations DEADLINEspeak with a qualiﬁFOR edSUBMISSIONS professional who– can Monday, assist you May 3, 2010 Conflict Management in arranging immediate services for your clients. (3 units) • 6 month course completion • explores the types and processes of conflict in • immediate accommodations health care organizations and applies theory and • short term stays research to conflict situations in the current • caregiver relief 24-hour personalized workplace • secured living for dementia care information Quality Management • interim care while awaiting long term care (3 units) • in-home care services 1-877-929-9222 • 6 month course completion • theories, concepts including safety culture • permanent retirement residency [email protected] leadership in creating a culture of accountability • critically analyzes and applies paradigms to address quality and safety issues in the workplace Advanced Leadership and Management (6 units) • 9 month course completion reveraliving.com • builds on the Leadership/Management course • topics include transformational and quantum Revera: Canadian owned since 1961 with over 200 locations. leadership, emotional intelligence and

2443 organizational culture Integrative 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 WORKPLACE HEALTH & SAFETY • Through the use of a champion leader, the A Practical guide student develops and understanding of managing key organizational processes for the nursing PROGRAM COURSES AVAILABLE IN TUTORIAL profession CLASSROOM FORMAT (OVER 12 WEEKS) For further information please contact: The Legal Assistance Program’s Work- Leadership and Management Program McMaster University place Health and Safety – A Practical Phone: (905) 525-9140 Ext 22409 Fax: (905) 529-3673 Guide for the Nursing Profession booklet Email [email protected] is now available. To receive a free copy, Website: www.leadershipandmanagement.ca contact Lee Minty at [email protected] or call 1-800-567-4527. Programs starting every January, April & September 3770_RNJ Jan-Feb Feb1.qxd 2/1/10 3:01 PM Page 30

NURSING EDUCATION ForFor Working Working Professionals Professionals INITIATIVE EARNEARN A A B.A.B.A. in in Health Health Care Care Services Services ININ 15 15 MONTHS! MONTHS! You may be eligible to receive up to $1,500 in tuition reimbursement! &RQYHQLHQWZHHNFRXUVHV• Convenient 5 week courses For pertinent deadline information or to /HDUQPDQDJHULDODQG• Learn managerial and obtain a copy of the application form, please OHDGHUVKLSVNLOOV leadership skills visit the RNAO website at (DUQFROOHJHFUHGLWIRUOLIHDQG• Earn college credit for life and www.rnao.org ZRUNH[SHULHQFH work experience 3ULRUFROOHJHFUHGLWVDFFHSWHG• Prior college credits accepted For the most current )LQDQFLDO$LGDYDLODEOH• Financial Aid available information about the CallCall Now Now Nursing Education Initiative, Ph: 305 474 6823 please contact: 3K ,QVWLWXWHIRU3URIHVVLRQDO6WXGLHVInstitute for Professional Studies RNAO’s Frequently Asked Questions line $OHNVDQGUD=XSDQAleksandra Zupan 1-866-464-4405 D]XSDQ#VWX[email protected] ZZZVWXHGXKFVwww.stu.edu/hcs OR [email protected]

DO YOU KNOW A SPECIAL NURSE? Toronto Star readers are being asked to nominate someone in the Nursing Profession for the TORONTO STAR NIGHTINGALE AWARD 2010. Information on Award Criteria and where to send your nomination will be published in the Star and online at www.thestar.com/nightingale Deadline for nominations is March 22, 2010. Winner will be announced during Nursing Week 2010.

2010

Nightingale RNAO 2010 Call for Entry 1 1/14/10 4:16:30 PM 5th Annual Insurance Tips Creating Healthy

What to Do When You Are Involved in an Auto Accident Work Environments

Summer Institute • Stay calm, do not argue and call the police immediately.

• Do not voluntarily assume liability or responsibility, sign statements August 8-13 2010, regarding fault, or promise to pay damage at the scene of the accident. Hockley Valley Resort, • Record all details of the accident (take pictures).

• Record details concerning the other party and vehicle such as name, Orangeville, ON address, phone #, vehicle year, make and model.

• It is important to obtain the insurance information of the other driver: insurance company, policy number and name of broker or agent. Looking to

These tips are general rules of thumb only, and may not fit all situations. For the definitive word, contact your insurance broker.

1.877.466.6390 Recharge

Your

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