Filling prestigious nursing research chairs • The China Project • Telehealth RN takes your calls Registered NurseMarch/April 2007 JOURNAL

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

Toni Sammut, R.N. You spend your time taking care of others. Now let us take care of you. Call for a no-obligation-quotation and you could WIN pampering for 2 at a spa of your choice! Registered Nurse JOURNAL Volume 19, No. 2, March/April 2007

FEATURES FAMILY HEALTH TEAMS IMPROVE 12 PRIMARY HEALTH CARE By Jill Scarrow A look at the role NPs and other nurses are playing on Ontario’s newest interprofessional teams.

RNAO’s EIGHTH ANNUAL 16 DAY AT QUEEN’S PARK By Kimberley Kearsey and Jill Scarrow Nurses meet one-on-one with decision-makers to address everything from poverty to nursing employment to Medicare.

POSITIVE RESPONSE PROMPTS 19 RN TO PUBLISH AGAIN By Kimberley Kearsey Tilda Shalof talks about the release of her second THE LINEUP book, and how the feedback of readers fueled her ambition to write. EDITOR’S NOTE 4 PRESIDENT’S VIEW 5 RESEARCH AND DISCOVERY 20 By Jill Scarrow MAILBAG 6 Why we need more qualified RNs to fill prestigious EXECUTIVE DIRECTOR’S DISPATCH 7 nursing research chairs in Ontario.

NURSING IN THE NEWS 8 NURSES: MAKING A DIFFERENCE OUT & ABOUT 10 23 By Susan Rutherford One reluctant caregiver thanks nurses for RN PROFILE 11 the important work they do. NEWS TO YOU/NEWS TO USE 25 CHINA PROJECT CALENDAR 26 24 By Jill Scarrow RNAO partners with Chinese nurses to build leadership qualities and enhance nursing skills.

Registered Nurse Journal 3 The journal of the REGISTERED NURSES' Editor’s Note ASSOCIATION OF ONTARIO (RNAO) 158 Pearl Street Toronto ON, M5H 1L3 Phone: 416-599-1925 Toll-Free: 1-800-268-7199 Fax: 416-599-1926 Website: www.rnao.org E-mail: [email protected] Letters to the editor: [email protected] The simple things make all the EDITORIAL STAFF Marion Zych, Publisher Kimberley Kearsey, Managing Editor difference Jill Scarrow, Writer Tiffanie Ing, Editorial Assistant When Martha Dyer, the subject of this issue’s RN Profile EDITORIAL ADVISORY COMMITTEE Patricia Stiles, Chair (pg. 11), talks about her work as a Telehealth nurse, it’s obvious Joseph Gajasan, Anne Kelly, Connie Kuc, Holly Lake, Sylvia Rodgers, Shannon Landry, she loves what she does. It’s also obvious her voice on the other Rosanna Wilson end of the line is welcome relief for people who call in search DESIGN, ART DIRECTION, PRODUCTION of health advice, sometimes in the middle of the night. I was Dean Mitchell/James Ireland Design Inc. one of those late-night callers just a few weeks ago, and I can ADVERTISING Registered Nurses' Association of Ontario attest to that sense of relief. I walked away from that phone call feeling better than Phone: 416-599-1925, ext. 211 I did when I dialed. I also walked away pleasantly surprised by the nurse’s closing Fax: 416-599-1926 comment. She recognized my name and said:‘You write lots of really good articles.’ SUBSCRIPTIONS Registered Nurse Journal, ISSN 1484-0863, is a I was grateful to receive such kind words. I was also surprised because it’s often benefit to members of the RNAO. Paid subscriptions are welcome. Full subscription prices for one year (six hard to know if your words are reaching the people you hope to reach. issues), including taxes: Canada $38.52 (GST); Outside Canada: $42. Printed with vegetable-based inks on RN Tilda Shalof describes those same feelings of gratitude and surprise in our recycled paper (50 per cent recycled and 20 per cent post-consumer fibre) on acid-free paper. feature about her newest book, The Making of a Nurse (pg. 19). She told me the one

Registered Nurse Journal is published six times a thing that’s truly surprised her about publishing is the fact that she has readers. year by RNAO. The views or opinions expressed in the editorials, articles or advertisements are those of the Sometimes the Journal’s editorial team feels the same way.It’s a simple thing, but it’s authors/advertisers and do not necessarily represent the policies of RNAO or the Editorial Advisory so important. Once you know your words are resonating with readers, it helps to Committee. RNAO assumes no responsibility or liability for damages arising from any error or omission or from make you feel your hard work was worth it. the use of any information or advice contained in the Registered Nurse Journal including editorials, stud- This issue’s cover feature about Ontario’s family health teams (FHTs) also touches ies, reports, letters and advertisements. All articles and photos accepted for publication become the property of on the need to feel appreciated and understood at work (pg. 12). In the case of the Registered Nurse Journal. Indexed in Cumulative Index to Nursing and Allied Health Literature. FHTs, it’s nurse practitioners who are seeking that appreciation, and are taking significant strides in the push to educate not only the public but other health-care CANADIAN POSTMASTER: Undeliverable copies and change of address to: RNAO, 158 Pearl Street, professionals about the important work they do. Toronto ON, M5H 1L3. Publications Mail Agreement No. 40006768. Kim Stockinger told us she’s thankful patients are starting to recognize how vital

RNAO OFFICERS AND SENIOR MANAGEMENT nurses are to FHTs.And she’s particularly gratified that her own patients have started Mary Ferguson-Paré, RN, PhD, CHE asking if the rest of their families can come and see her too. President, ext. 204 Joan Lesmond, RN, BScN, MSN, Ed. D (c) As good as it feels to receive praise; everyone knows it sometimes feels just as Immediate Past President, ext. 202 good to be on the giving end of gratitude.Telling someone they’ve made a difference Doris Grinspun, RN, MSN, PhD (c), O.Ont. Executive Director, ext. 206 in your life makes you feel good because you’re making them feel good.That’s Irmajean Bajnok, RN, MScN, PhD exactly what Susan Rutherford wanted to do in her article, Nurses: Making a difference Director, Centre for Professional Nursing Excellence, ext. 234 (pg. 23). She acknowledges that it’s often easier to point out what people do wrong Sheila Block, MA and not what they do right. She thinks it’s important to say ‘thank you’ to nurses. Director, Health and Nursing Policy, ext. 215 Nancy Campbell, MBA And she has. Just two little words, but they mean so much. Director, Finance and Administration, ext. 229 Daniel Lau, MBA Director, Membership and Services, ext. 218 Kimberley Kearsey Anitta Robertson, RN, BAAN, MPA Managing Editor Director, Special Projects, ext. 240 Tazim Virani, RN, MScN, PhD (cand) Director, Best Practice Guidelines and Advanced Clinical/Practice Fellowships Marion Zych, BA, Journalism, BA, Political Science Director, Communications, ext. 209

4 March/April 2007 President’s View with Mary Ferguson-Paré

New graduate full-time guarantee and 80/20 go hand-in-hand

When 4,000 new to implement these programs because and sick time stayed low.Most notably,the nursing graduates there is sound evidence that they not study revealed the cost of staffing did not finish school this only work, but they are also cost effective increase significantly more than in the two spring, they will be and better for nurses, patients and the comparator units. welcomed into the health-care system. On Feb. 9, I shared these results workforce with a In my role as vice-president, profes- with MPs at a meeting on Parliament guaranteed full-time sional affairs and chief nurse executive at Hill, hosted by the Canadian Federation job. In February,the University Health Network (UHN), of Nurses Unions.The politicians were provincial government announced $89 I have had the opportunity to conduct interested in the results of UHN’s research million for the New Graduate Guarantee, research on just how effective the 80/20 and asked me if policy support would which will fund full-time work for over model of employment can be. In 2004, be needed to implement the model in seven months.The details of this program other organizations.The amount of are good news for many of our new col- interest in this work clearly demonstrates leagues, and for RNAO. that the issues with which nurses wrestle Since 2003, the association has lobbied “RNAO members at work need to be addressed using the government to make this kind of promise evidence at hand. a reality.RNAO members should take should take pride Further evidence from groups such pride in knowing that the announcement as the Quality of Worklife Quality of demonstrates how our voices are being in knowing Healthcare Collaborative, of which I am heard at the highest levels of government. a member, and the 2005 National Survey We are helping to create policies that that February’s of the Work and Health of Nurses by build the steps for a profession that is Statistics Canada and the Canadian providing knowledgeable, well-prepared announcement Institute for Health Information (CIHI), RNs, both now and in the future. also supports the need for continued The New Graduate Guarantee is a good demonstrates lobbying to ensure more opportunities starting point toward that goal, and now – for workplaces in all sectors to implement more than ever – we need the expertise how our voices are programs like 80/20 for their nurses. of seasoned nurses to mentor the new The Statistics Canada report, which generation. For this we will continue to being heard at the was released just two months prior to lobby for the 70 per cent solution, which my presentation on Parliament Hill, aims to see 70 per cent of all RNs highest levels of detailed the amount of overtime nurses working full-time.We will also forcefully are working, and the level of support pursue the 80/20 model of employment, government.” they receive on the job. Policy makers whereby nurses 55 and over, in all sectors, and system administrators cannot ignore spend 20 per cent of their time on profes- those facts.These realities will continue sional development or other activities, 33 nurses on UHN’s acute orthopaedic to drive RNAO’s work to create programs especially mentoring new colleagues. and rheumatology unit took part in a that will improve workplaces for RNs. As you know,RNAO has been lobby- two-year study that enabled them to As the fall election nears, we will ing for the 70 per cent solution since spend 20 per cent of their time on contin- continue to press political parties for their 2000, and Premier Dalton McGuinty uous learning and professional develop- positions on all of these programs.They’re incorporated it into his 2003 election ment. Each nurse also participated in just some of the many solutions that will platform. Since the Liberal government an education program that focused on not only support nurses at every step of took office, the number of RNs working advancing patient-centred practice. their career, but will have positive full time has risen to 61.4 per cent.This The results of the study were promis- results for our patients and our health- is great progress, but more work must be ing: patient and staff satisfaction increased; care system. done to ensure every nurse who wants there was no turnover among participants full-time work can find it. at the end of the two-year period; and the As we head into a provincial election length of stay decreased on the unit by 0.9 MARY FERGUSON-PARÉ, RN, PhD, CHE, IS this fall, we continue to urge government days.There was also a decrease in overtime PRESIDENT OF RNAO.

Registered Nurse Journal 5 Calling all RNs Tell us about your Nursing Week activities Nursing Week is less than one month away, and Registered Nurse Journal wants to feature your event in a special four-page Nursing Week pull-out Mailbag section in the May/June issue. Inescapable gossip makes for breached this, at evaluation time you unhealthy workplace weren’t a ‘team player.’ When I worked for We know that members Re: Building healthy work environments, this coordinator, my time was strained due Jan/Feb 2007 to family problems but I didn’t feel safe are involved in many I’m not surprised to hear that “half of... sharing that or anything else. I feared it celebrations around the nurses... said they had little support from would just bring more hostility – from the province, and we want to their co-workers.” My workplace atmos- coordinator and other staff – than I had share news of those events phere and the collegiality of my current already encountered in what was an insular with our readers. nursing colleagues is a major reason why I community hospital and an even more have opted out of closer employment and insular nursing ‘clique.’ In the 14 years I What unique event is your have driven 140 kilometres to work for spent as a paramedic, I rarely encountered chapter, region, interest almost three years. I have nursed at inter- from my mostly male colleagues the catty group, organization or vals since 1981 and worked concurrently as pettiness I have observed in mostly female workplace planning? a paramedic and aeromedical attendant. As nurses. Equally, but not surprisingly, these a nurse, I dreaded the inescapable all-night were the same group who had spit in their gossip at one community hospital. My ears tone when talking of “ambulance drivers” Send your photos by mail to: burned on my days off since the victims whom they thought too ambitious. 158 Pearl Street, Toronto, were never present.Another hospital didn’t Janet Breen, RN Ontario, M5H 1L3. have staff to cover for night breaks. Only Peterborough Attention: once I insisted on my 45 minutes and took Kimberley Kearsey a nap. I heard a snarled “we HAD to call CORRECTION Or you can e-mail to staff from the other end to cover YOU!” The president and founder of RNAO’s [email protected] However, the smokers took frequent new Men in Nursing Interest Group was breaks without comment. The ultimate identified in the January / February Call us at 1-800-268-7199 treat was working with one unit coordina- issue of Registered Nurse Journal as a tor who stood in the station at shift change ext. 233 or 416-408-5602 registered nurse. He is, in fact, a nursing to tell us how you will be and tutted sourly if you weren’t there to student. We regret the error. report in at least 15 minutes early. If you celebrating Nursing Week 2007.

We want to And remember, to ensure hear from you high quality photos for the Please e-mail letters to [email protected] or fax 416- magazine; set your digital 599-1926. Please limit responses to 150-250 words and camera to the highest include your name, credentials, hometown and tele- resolution, or send us the phone number. RNAO reserves the right to edit letters prints directly. for length and clarity.

6 March/April 2007 Executive Director’s Dispatch with Doris Grinspun

Trip to India reveals lessons Canadian RNs can learn from their counterparts abroad

In January,I was a Graduate Institution of Medical Education these opportunities to learn, and not just delegate of Premier and Research in Mumbai. Both were overseas, but right here at home.As we Dalton McGuinty’s absolutely eager to partner with us. I also strive to strengthen our own communities trade mission to India. had the privilege of a visit with executives and address our own diverse needs, there is It was a tremendous from the Krishna Institute of Medical much we can learn from one another. honour and privilege Sciences, including their Vice Chancellor, Buy a train ticket or a plane ticket, and to represent our profes- Dean of Nursing and Chief Financial visit different communities in Ontario. I sion on such a mission, Officer.These individuals traveled for sev- will be visiting Manitoulin Island in May. my first to this fascinating country. eral hours to meet with me and discuss Members should also consider visiting One thing I realized while I was meet- partnership opportunities. other places that have adopted our guide- ing health-care professionals in New The discussions at many of these meet- lines, including Saskatchewan, Miami, Delhi, Bangalore, Mumbai and Chandigarh ings centred around health, health care and Iowa, China, India, Kenya, Italy or Chile. was that their anticipation for shared nursing priorities.We also discussed India’s We can help you make the connections knowledge was similar to the anticipation tremendous challenges with poverty,and I and you can reap the benefits and rewards I felt when I first visited China in 2005. of sharing and learning in a seamless way. That trip marked the beginning of our Just take the lead of RNAO’s inspiring exciting partnership in leadership training “Opportunities BPG Champions who are collectively with the Chinese Nursing Association transforming the world of nursing and are (CNA) and the Beijing Nightingale to engage more nurses inspiring others to become knowledge Consultation of Culture (BNCC). On ambassadors, bringing knowledge to col- page 24 of this issue, you will find details of in international visits leagues and learning how to strengthen the China Project to date, and can read our own nursing worlds and practices. about a recent visit of Chinese delegates to can only lead to more Across Ontario and the rest of the RNAO in February. It was clear to me stimulation, and a country, the stage has been set and momen- during this visit that their respect for tum for widespread BPG implementation RNAO’s work, and our shared goals, is greater understanding has been building since 1999. Internat- helping us to move from a position of ionally, there’s no doubt we’ve also started strength to even greater strength. that knowledge shared building positive momentum, especially I was honoured to see that same when you consider the ongoing work that’s respect for RNAO when I met with many is power gained.” being done on the China Project. Indian nurses and health professionals dur- As we watch this partnership with ing the trade mission in January.They China grow,and marvel at the fruits of our showed a tremendous eagerness to partner shared information about RNAO’s focus labour, we will not forget there are so with RNAO, to advance nursing in their on the social determinants of health. Our many new partnerships that we can build. own country,and to learn as well as share colleagues know all too well that without RNAO has already signed an agreement their own expertise. food in the belly and a roof over our with India that will see us partnering The trip to India didn’t just highlight heads, good health is not possible. nurses from each of our respective profes- for me the things other countries can All my hosts made it clear to me that sional associations.We will soon begin learn from us. It also reminded me how they are anxious to host Canadian nurses. working on strategies for the exchange of much knowledge we can bring from They want to learn more about Canada’s knowledge between nursing colleagues in abroad and apply to our everyday practice health-care system, and they want to teach both countries, and I know that many of here at home.And there are so many peo- Canadian nurses about their own systems. I you will join in the journey. ple ready and willing to share that knowl- can attest to the fact that their knowledge Building nursing as a collective at edge with Canadian nurses. is exquisite and their warmth is delightful. home and across continents and cultures During our one-week stay,we visited Opportunities to engage more nurses enables us to stand tall as a profession and several health-care facilities, including two in international visits can only lead to to remain inspired as individual nurses. of the most impressive institutions in more stimulation, and a greater under- India: the All India Institute of Medical standing that knowledge shared is power DORIS GRINSPUN, RN, MSN, PhD (CAND), Sciences in New Delhi and the Post gained. I encourage all nurses to embrace O.ONT, IS EXECUTIVE DIRECTOR OF RNAO.

Registered Nurse Journal 7 by Tiffanie Ing Nursinginthenews RNAO & RNs weigh in on . . .

Oakville bans pesticides RNAO member Renee Lehnen, Co- ONTARIO President of an environmental organization called Gardens Off Drugs, led a group of RNs BUDGET: to Oakville’s city hall in early February to urge councillors to pass a bylaw to ban pesti- A first cides. It’s the fourth time in just over three years that an anti-pesticide bylaw has come to step city council. The group’s efforts were success- ful, leading Lehnen to say: “It’s a great day for towards Oakville, especially the children of Oakville… It will give them an extra measure of protec- tackling tion against chemical pesticides that can harm their health.” (Feb. 5 and 13, Toronto Star)

poverty RNs call for anytime, anywhere policy for On Feb. 19, the Toronto Star published breastfeeding moms this photo of RNAO In January,several RNAO members member Maureen banded together to call on Toronto Public Gmitrowicz and colleagues. Health (TPH) to consider a report urging The story focused on a that the city develop a policy that affirms group of seniors, the right of breastfeeding mothers to nurse including Gmitrowicz, who belong to the in all public places controlled by the Durham chapter of municipality.RNAO member and TPH Make Poverty History. manager Joanne Gilmore said:“We don't want mothers who decide to breastfeed On March 22, the provincial government are poor." (Feb 19, Toronto Star) their babies to feel they have to stay in tabled its 2007 budget and announced its • RNAO member and Toronto Street their homes all the time…We're not saying anti-poverty strategy, including the introduc- Health nurse Drew Kostyniuk is fighting to every mother that you have to bare tion of the Ontario Child Benefit, and poverty by encouraging good nutrition: yourself in public. Some women choose increases in social assistance rates and the "Every day I see clients on social assistance to do it more discreetly,in a private place, minimum wage. RNAO issued a press release with diabetes and other chronic illnesses… and that's their right. But it's also their saying the McGuinty government is taking Many manage to pay the rent, but then they right if they choose to sit on a bench and an important first step to reduce poverty in are forced to make poor food choices which do it.”(Jan. 23, National Post,Toronto Star, Ontario. RNAO President Mary Ferguson- have a significant impact on their health." CanWest News Service) Paré said: “We are keenly aware of the con- (March 15, Canadian Press, CBC.CA News, • Tazim Virani, Director of RNAO’s Best nection between poverty and illness. We see Canada.com, Toronto Star, Canoe.ca, Practice Guidelines Program, wrote a letter the effect poverty has on many Ontarians Healthcare Industry Today) to the National Post in support of this posi- who are struggling to make ends • RNAO Executive Director Doris Grinspun tion, saying: “Nurses know that breast milk meet…these investments will help people penned a letter to the Toronto Star calling is the healthiest nourishment for babies…By

g stay healthier and will begin to address the on the McGuinty government to step up its recognizing this as a natural, nutritious and r e B income gaps between families in Ontario.” efforts to increase the minimum wage: socially acceptable activity that should be e n n • RNAO member Maureen Gmitrowicz is “Common decency, basic humanity and this o encouraged, the Toronto Board of Health is v Y

: one of a growing number of social activists government's promise to rebuild social cohe- making an important contribution to the y h p

a who argue: “Children are not poor in isola- sion and healthy public policy dictate that health of our children.”(Jan. 31) r g o

t tion. They are poor because their parents this is an urgent moral imperative.” (Feb 13) • RNAO member and Peel Region o h

P Family Health Director Anne Fenwick

8 March/April 2007 For complete versions of any of these stories, contact Tiffanie Ing at [email protected].

Nurses applaud Ontario’s new grad initiative

On Feb. 27, Ontario’s Ministry of Health and Long-Term Surgery and Maternal/Child-Care Centres at North Bay and Care pledged $89 million in targeted funding for a Nursing District Hospital, told the North Bay Nugget: “[This Graduate Guarantee that will ensure up to 4,000 new announcement] is particularly timely and could ease the nurses in Ontario secure full-time work for just over seven [human resources] situation…About 15,000 of Ontario's months. RNAO issued a press release and many members 85,000 registered nurses are eligible to retire…The average responded positively to the news: nurse at the [North Bay] hospital is 47, and each year • Tracy MacDonald, RNAO member and Niagara Health more nurses are retiring.” (March 3) System Vice President of Patient Services, said: "This is a • RNAO member and Southlake Regional Health Centre wonderful new initiative and it really does give us an Vice President and Chief of Nursing Annette Jones said opportunity to bring nurses into the health-care sys- she’s delighted by the announcement: “Patient volumes tem…(and) provide that mentorship early on in their at the hospital are increasing by nine per cent each career." (Feb 28, Welland Tribune) year, forcing Southlake to increase its staff by three per • RNAO member Ruth Pollock, Interim Coordinator of cent…Recruiting staff is always a challenge and this Laurentian University’s Nursing Degree Program, says the will allow us to recruit some new graduates." (March 3, promise of a full-time job upon graduation should entice York Region Newspaper Group) more students in the coming years to enter the nursing • RNAO member Dauna Crooks, Director of the Trent- profession, which is facing a shortfall of workers as the Fleming School of Nursing, says the announcement is population ages: "That's one of the first questions [stu- “great news for the Peterborough area…This is a truly dents] ask when they start," said Pollock. "And I don't wonderful opportunity for our students, especially since blame them." (March 3, Cornwall Standard-Freeholder) it's been hard for graduates to find full-time work in • RNAO member Tiziana Silveri, Vice President of this area.” (March 6, Lindsay Daily Post) launched an initiative in December to anxious to hear from families who have the media about the BPG, and the decision encourage restaurants to become breast- had this experience…" (March 1, London by her employer, Cornwall Community feeding friendly places by posting stickers Free Press, CBCK-FM Kingston) Hospital, to implement the guideline: “The in their front windows. Fenwick says too screening is very effective.We had a woman often nursing mothers feel they have to RNAO recognizes come in with a broken arm and when she stay cooped up at home.“It is just such a International Women’s Day was asked about abuse, she denied it…But natural way of feeding a baby and some- March 8 was International Women’s Day and the story just didn't match. So, the nurse got thing that we promote in public health.” RNAO marked the occasion by recom- her alone in a room and just gently said,‘I’m (Dec. 21, CP Wire,Toronto Star) mending health-care organizations adopt its concerned about how you got these injuries... • RNAO member Sandra Letton, Best Practice Guideline on woman abuse. Did someone hurt you?’And then she said, Vice President of Professional Practice The guideline recommends that nurses rou- ‘Yes,my husband did this to me.’”(March 8, and Chief Nursing Executive for London tinely screen all females over the age of 12. CFOS-AM Owen Sound; March 9, CBC-R Health Sciences Centre (LHSC) and Asking women and girls if they have experi- National;March 12, Sun Media) St. Joseph's Health Care (SJHC), revealed enced violence gives them an opportunity to that over 30 families came to LHSC and discuss their situation in a safe and supportive Staffing problems at SJHC with complaints that new mothers environment. Social worker Sarah Kaplan, Scarborough General Hospital were not encouraged to breastfeed.“I'm who helped develop the guideline, spoke to In mid-January,Scarborough General Hosp-

Registered Nurse Journal 9 ital’s emergency department faced severe harmful effects of tobacco and nicotine. Nurse praises Kingston diabetes staffing problems: several nurses quit and • Jacquie Logan-Stephens, RNAO mem- education program for promoting three dozen doctors penned a letter to the ber and Chief Nursing Officer at Chatham community prevention and knowledge hospital's president warning of an “impend- Kent Health Alliance, talked to Chatham Letter to the editor ing crisi”" should conditions not improve. Daily News about the hospital’s total smoking Kingston Whig-Standard, Feb. 23, 2007 • RNAO member and Patient Care ban, launched on Jan. 24: “Nurses will dis- Re: New education team to help diabetics Director of Emergency Services Louise cuss the patient's current smoking habits and, Diabetes is at epidemic proportions in Canada, LeBlanc said:“Is there an impending doom if necessary,request a physician order for pre- and indeed around the world. People who and crisis situation? I would say no…We are scription of a nicotine replacement aid for have diabetes are at higher risk of heart attacks, challenged at the moment but no more than use during the hospital stay.” (Jan. 24) strokes, kidney disease, blindness, lower limb any other hospital in Toronto… We've got • RNAO member and Group Health amputations, and many other health problems. great staff and they work hard and they're Centre nurse practitioner Wendy Payne The cost of diabetes is great, both to the committed to the patients.”(Jan. 17, Globe helped three-pack-a-day smoker Nancy person with diabetes and to the health-care and Mail, CFRB-AM Toronto; Jan. 18, Gabriel quit by registering her in the system.Through research, we know that Metroland – Toronto Division) Centre’s Smoking and Tobacco Cessation people who know more about their disease • RNAO member and Ontario Nurses’ Program. (Jan. 24, Sault Star) have better outcomes and will do better at Association President Linda Haslam- managing the disease. Funding education Stroud agreed:“This is not the only hos- Clinical BPGs help to helps make this happen. It also provides pital that is having difficulties recruiting prevent falls prevention information to the population and retaining nurses…the reason is two- Cambridge Memorial Hospital recently that is at risk of developing diabetes. pronged. First, nurses’ working conditions became an RNAO Best Practice Spotlight The addition of another education have suffered due to problems within the Organization because of its implementation program will help meet the needs of some health-care system, and there's also an of the best practice guideline (BPG) focusing of the 70 per cent of people with diabetes overall shortage of nurses across the on falls prevention and improving patient who are currently not receiving education. province.”(Jan. 17, Globe and Mail) care. RNAO member Lorna Zubrickas, Margaret Little, RN a clinical educator at the hospital, says one Options for Diabetes, Kingston Weedless Wednesday – goal is to excite nurses.“You can take that smokers encouraged to quit to the bedside and help the patient.” Jan. 24 was Weedless Wednesday in Ontario. (Feb. 26, The Record (Kitchener,Cambridge and Nurses voiced their concerns about the Waterloo))

Out & About

Above: Executive Director Doris Grinspun President Mary Ferguson-Paré (centre) visited India in January as a member of visited Timmins to debunk some of the Premier Dalton McGuinty’s trade mission. myths put forth by proponents of for- Canada’s High Commissioner in New Delhi, profit health care. Porcupine Chapter David Malone, hosted a reception at his President Karen Hill (left) and Treasurer home. In attendance (L to R) were Sheila Susan Yuskow presented Ferguson-Paré Seda, Secretary General of the Trained with a print of the Northern Lights by Nurses’ Association of India (TNAI), local artist and nurse Gail Hayes. McGuinty, Grinspun, and Evelyn Kannan, Assistant Secretary General, TNAI. Centre bottom: Brant Haldimand Norfolk chapter hosted its annual Centre top: On Feb. 9, Health Ministers general meeting on Feb. 1. Debbie Van- from across Canada met at Toronto's Every, Ruth O'Donnell and Lisa Bishop Westin Harbour Castle Hotel to discuss (L to R) each received recognition for wait times. Outside the hotel, dozens their long-time commitment to the gathered to press for public solutions to association. Bishop, a chapter president, the wait times issue. RNAO Board and Van-Every have been members for Member-at-Large, Socio-Political Affairs, 25 years, and O’Donnell for 40. Hilda Swirsky, was among the speakers.

10 March/April 2007 by Jill-Marie Burke Fielding calls, finding answers RN Martha Dyer thought her career was over when she became paralyzed in 2001. Then, she discovered Telehealth and unlocked a passion for providing care over the phone. The man’s chest pain had radiated to Dyer, who works at the London call Supporting callers in distress can be his jaw and left arm, but he insisted it was centre, says there are 20 nurses answering stressful, explains Dyer. Nurses are encour- indigestion and refused to go to the hospi- the phones at any given time. There are aged to take personal breaks whenever tal. In desperation, his wife called always French-speaking RNs on duty and they feel the need. During breaks, they can Telehealth Ontario and described the an interpretation service is available to debrief with co-workers or supervisors. symptoms to Martha Dyer, who asked the callers who speak other languages. Each Dyer says she needed a break the day she woman to put her husband on the phone. call is charted and nurses must reference all handled two back-to-back calls regarding Convincing him to go to the ER was a the advice and information they provide abuse. One of the calls was from a 12-year- challenge, but Dyer finally succeeded by using evidence-based clinical guidelines, old girl who was at a pay phone. She said saying:“I can hear kids in the background. approved websites, and other resources in her father was abusing her and her little Do you want to take the risk of not being the Telehealth library. sister.The girl was worried because her sis- around for them in the future?” When Dyer first started, she worked ter was still at home with the father. Dyer A few weeks later, Dyer learned she full-time. She is now part-time, working 24 reported the abuse to the Children’s Aid saved the man’s life. His wife called hours each week and every other weekend. Society (CAS) and advised the girl to wait Telehealth to say thank you and to let Dyer says the most common calls come at a friend’s house until she saw CAS staff them know he had flatlined in the ambu- from parents who are worried about a and the police arrive at her home. lance and again when he arrived in the child’s stomach aches, cold and flu symp- Telehealth nurses need to have patience, ER. Hours after his phone empathy, computer savvy and conversation with Dyer, the excellent listening skills, she says: man had triple bypass surgery. “Patients need to describe their It’s rare for Telehealth nurs- symptoms, so you really have to es to find out what happens use open-ended questions. For after their callers put down the instance, if they have rash, you phone, so Dyer was thrilled to don’t say:‘Do you have vesicles?’ get this news and to hear that You say: ‘Describe the rash to he was alive. “I was ecstatic,” me.’ You may be pretty sure it’s she remembers. “You hear hives…but you’re not there these kids in the background looking at it.You’d be surprised and…you’re glad that you at people’s ability to describe were involved.” things,and you get pretty good at For Dyer, the rewards of drawing things out of people.” being a Telehealth nurse are She explains, however, that she profound, especially considering she thought NAME: Martha Dyer and her colleagues are not expected to know her nursing career was over in 2001.That’s OCCUPATION: RN, Telehealth Ontario the answer to every question.They often put the year a complication occurred during an HOME TOWN: London, Ontario callers on hold to consult with other RNs or epidural and she was left paralyzed from the to refer to other resources. Dyer works with chest down. Prior to the epidural, Dyer toms, childhood diseases like chicken pox, nurses from a variety of specialties and they’re worked in ICU after graduating from or whether they’ve given a child too much always willing to share their expertise. Mohawk College in 1989.While wonder- medicine. Questions about breastfeeding, While Dyer admits that the first few ing if she could continue nursing in a diaper rash, and how often babies should weeks of Telehealth nursing is a ‘culture wheelchair, she heard about Telehealth be fed are also typical. shock’ for nurses used to caring for Ontario, a free, confidential service funded Parents with crying babies are among patients face-to-face, she says it is a by the Ministry of Health and Long-Term the most distraught callers, she says: “You rewarding job that she would highly rec- Care.A few months later, Dyer was fielding get parents who have a baby that’s been ommend. “Your practice becomes so calls from all over the province. screaming for six hours…and they’re usual- multi-faceted because you do pedi- Through Telehealth, registered nurses ly getting hysterical on the phone.The first atrics…ortho…trauma…cardiac. You provide health advice and general health thing we tell them is to go put the baby learn about everything and you’re con- information 24-hours-a-day, seven days a down in their room and shut the door stantly learning.” RN week. Five call centres – in Toronto, Barrie, because it only takes a second to shake that London, North Bay and Sudbury – handle baby too hard.They don’t understand that JILL-MARIE BURKE IS MEDIA RELATIONS more than one million calls a year. the baby is going to be okay.” COORDINATOR FOR RNAO.

Registered Nurse Journal 11 Ontario’s FHTs hold promise, BUTNOT WITHOUT

NURSESEight Ontario NPs talk about the challenges of staffing the province’s new family health teams, and the important role they play in ensuring these interprofessional groups provide the best primary health care to the public. BY JILL SCARROW

amantha Dalby had just become a Dalby says she was never given a reason practitioners, including PHCNPs like primary health care nurse practi- for her termination, but its effects have rip- Dalby and acute-care nurse practitioners tioner (PHCNP) when she land- pled across the community and the rest of (ACNPs), to play leadership roles on the ed her first job last August at the the province. In February Ontario’s teams. At present, ACNPs are not included Brighton Family Health Team Minister of Health and Long-Term Care in the College of Nurses of Ontario’s RN S(FHT), one of 150 provincially funded inter- George Smitherman established a three- Extended Class (RN(EC)) designation like professional teams created to improve pri- member panel to evaluate the way the their primary care colleagues, but they pro- mary health care for 2.5 million Ontarians. Brighton FHT is run. vide advanced, collaborative nursing care to She spent five months caring for 500 RNAO Executive Director Doris patients who are acutely or critically ill. patients in the small community 90 minutes Grinspun says each of the 150 FHTs In many places in Ontario, from the time east of Toronto, where she developed and planned for the province must operate in a funds for an FHT are announced to the managed several programs, including cervi- way that involves NPs fully in every aspect moment the first patient walks through the cal screening and a flu vaccination program of the team’s work. front door, nurses are an integral part of that immunized 1,000 people. “NPs need to have fair, full integration making sure these new interprofessional One Sunday afternoon early this year, into the teams,” she says.“That means full- teams reach out to as many Ontarians as pos- her dream job came to an end when the time work if they want it, working to their sible.Athough challenges such as those faced executive director of the Brighton FHT full scope of practice, and being full part- in Brighton are very real for NPs, there are a called Dalby and told her not to report to ners in governance and clinical decisions.” number of FHTs across the province that are

g work the following day. Pamela Pogue, President of the Nurse working well for both nurses and patients. N

n “I was absolutely shocked,”she says of her Practitioners’ Association of Ontario Constructing these teams, however, has o m i

S dismissal from the FHT.“My work up until (NPAO), says her association is educating its not happened overnight. : n o

i that time had received nothing but positive members about contracts that ensure NPs More than four years have passed since t a r t responses at the board level…to say I was on FHTs negotiate acceptable arrange- Roy Romanow called for changes to pri- s u l l I surprised is absolutely an understatement.” ments. NPAO is also lobbying for all nurse mary health care, a patient’s first and most

12 March/April 2007 T S frequent contact with the health-care sys- are operational, but the exact status of each teams truly successful requires support. He tem. He said reform is the number-one remains unclear. The Health Council says the government is investing in inter- action that will improve and sustain the reports that most Ontarians still receive professional mentorship and coaching health-care system. Subsequent First their care from solo practices, and 33 per opportunities, as well as plans to educate Ministers’ meetings on health care have cent of physicians still work alone. future health providers about interprofes- allocated millions of dollars to the cause. Joshua Tepper,Assistant Deputy Minister sional care before they graduate. In Ontario, primary health-care reform in the Health Human Resources, Strategy Dalby says the support is needed. She was has come in the shape of FHTs, first Division at the Ministry of Health and never provided with a job description, and announced in 2005. Over the last two years, Long-Term Care, believes that more and although the minutes of board meetings the provincial government has announced more health-care providers are beginning to show she held a seat on the board of direc- 150 teams, each with the ambitious goal to see the benefits of working together. tors, it was never written into bylaws. improve access to care by 2008. The teams “When you have people working in true, Despite these difficulties, Dalby says her will not only provide access to care outside functional teams, patient care is improved. work was rewarding, and she still believes normal business hours, they will also provide You get better patient safety,better commu- FHTs can improve access to the health-care health management for chronic disease. nication, better outcomes and patient satis- system for so-called ‘orphan’ patients who But progress on each FHT varies. faction,”he says.“From the health provider’s don’t have a primary health care provider. According to the Health Council of viewpoint, when you have functioning “I think the experiences I had in Canada, in November 2006, there were 125 teams, those are areas where providers pre- Brighton are not representative of what’s FHTs in various stages of development fer to work.” out there. There are a lot of places where around the province. Seventy-four of those But Tepper acknowledges making these family health teams are working. And they’re working because there are doctors, Canada’s first NP-led clinic to open in Sudbury nurses, nurse practitioners, social workers and dieticians who really care and are Marilyn Butcher and Roberta Heale have my suitcase and leave this community on a working together.” long known it will take more than a band- regular basis, when I know there are peo- According to the 2005 Report on the age to heal the gaping wound in Sudbury’s ple who need access here,” she says. Integration of Primary Health Care Nurse health-care system. Thirty per cent of the Last year, Heale and Butcher saw a per- Practitioners into the Province of Ontario, Dalby area’s population does not have access to a fect opportunity to submit a proposal for an is not alone in her appreciation for the value primary care provider. As local NPs, they NP clinic with government money ear- know they have the cure at their fingertips. marked for family health teams (FHT). Heale of collaboration. More than 30 per cent of And, after many years of tireless lob- says they knew their model didn’t exactly fit the 365 PHCNPs who completed the sur- bying, they can now offer that cure. the criteria the government was looking for vey said collaborative practice was one of the Last November, Butcher and Heale in an FHT, but it was worth a shot. most positive aspects of their role.The report secured $1 million in provincial funding to They submitted their proposal with also described how nurse practitioners can create Canada’s first nurse-practitioner led the support of all 15 NPs in the area, as be better integrated into practice, including primary health-care clinic. In a press well as local community organizations providing them with clearly defined job release to announce the clinic, Health and RNAO, which set up the pair with descriptions. Minister George Smitherman said: government decision-makers to ensure Mary Woodman, a PHCNP at the “Making more use of nurse practitioners the NPs’ voices were heard. Prince Edward Family Health Team in will increase access to health care for peo- “This clinic will give the people of Picton, and NPAO’s representative on the ple across the province. The addition of Sudbury access to the care they deserve,” this clinic will have a positive impact on says RNAO Executive Director Doris provincial government’s FHT Action the health of thousands of residents in Grinspun. “This is an excellent demonstra- Group, says job descriptions are not the northeastern Ontario.” tion of what can happen when RNAO only challenge that can prevent full integra- Heale says the announcement couldn’t and its members work together.” tion of NPs.Another area of concern is the have come soon enough. Heale says when officials from the way patients are registered with FHTs. “The emergency department is really Ministry of Health called to tell her the She explains that all FHTs currently reg- overloaded, and there are at least a clinic was approved, she was shocked, ister or ‘roster’ patients to a physician on the dozen walk-in clinics. We really want to and “wanted to pinch myself, because it team, not to the team itself. In some cases, be able to provide comprehensive pri- couldn’t be true.” patients may be listed on a physician’s roster, mary health care to patients, and we feel Now that the shock has worn off, but they’re only ever seen by a nurse practi- that this clinic is the best way to do that.” there is plenty of work to do. Butcher says tioner. Woodman says all her colleagues in Butcher says that without funding she hopes the clinic will open its doors this for NP positions, Sudbury has been spring, with sites in Sudbury, Chapleau Picton – including the physicians – support exporting many under and unemployed and Dowling. the idea of rostering their 800 patients to the NPs to other parts of the province. Heale says she can’t wait to open the team, but that can’t happen without changes Butcher herself has worked as far away doors and finally use the leadership and at the government policy level. as Peterborough and London while clinical skills of NPs to heal the wounds that “If you’re really working as a team, the still living in Sudbury. have left many in the Sudbury area wanting patient should be rostered to the team. Let’s “It has been extremely difficult to pack for the care they deserve. RN get the doctor and the nurse working together,”she says.

14 March/April 2007 At the Tilbury Family Health Team, care, it also educates family medicine resi- PHCNPs Kim Stockinger and Bonnie dents and other health professionals who Teamwork and Showers-Malanoski agree that doctors and join the FHT for clinical placements. collaboration key nurses must work together in order for Nursing students learn about interprofes- to success at CHC FHTs to succeed. Both joined the Tilbury sional practice before they graduate. According to Colleen Kennelly, family team in October 2006 and have since been “One of our goals is to train primary care health teams (FHT) are not the only educating physicians and patients about providers in a team environment so new grads environments where you’ll find NPs col- what NPs can do. Stockinger says it has understand the benefit of a collaborative envi- laborating in the community. In fact, paid off, and now everyone appreciates the ronment,” she says, adding the reaction of nurse practitioners work in community nurse practitioner’s skills. many medical students has been positive. health centres (CHC) around the “Usually, by the second appointment, In Guelph, ACNP Jo-Anne Costello says province and have developed plenty patients will ask if I have any openings her physician team members are also learning of experience with interprofessional because the rest of the family would like to how valuable nurse practitioners can be. In teams in these environments. come and see me too,” she says. “It’s almost February, Costello left her position at St. CHCs offer primary health care and like families send someone out to interview Mary’s Hospital to become the lead for the health promotion specifically designed to meet the needs of particular popula- you, and then when they find out they’re lifestyles program and lead NP at the Guelph tions. In most cases, the centres care for comfortable with you and realize you’re com- FHT.She says she wants to make a difference people who have difficulty accessing the petent, they sign up the whole family. That’s a in patients’ lives before they end up in the health-care system, such as the homeless very nice compliment.” hospital. In her role, she will create programs or new immigrants and refugees. Nearly 200 kilometres away,nurse practi- to prevent cardiac disease by focusing on Since 1995, Kennelly has worked at tioner Sue Leddy says the citizens of hypertension, obesity, diabetes and smoking the North Lambton Community Health Goderich are also becoming cessation. She will also provide Centre, one of 54 CHCs across the more aware of nurse practi- education and will help patients province. She says when she first tioners, and what interprofes- “Usually,“Usually, by by thethe manage disease. began working there, no one knew sional teams can do for them. Costello says the physicians much about the NP role. second appointment, “Even the physicians I worked The Goderich FHT was second appointment, have been excited about what with were new to the concept. We all one of the first announced by she brings to the team, and are patientspatients willwill askask ifif had to find our way together…to the province in April 2005. committed to setting up struc- figure out how to introduce the role The first government cheque, II havehave anyany openingsopenings tures that ensure all team to the community.” however, didn’t land in the members are supported by According to Kennelly, the initial bank until February of this becausebecause thethe rrestest one another instead of ham- confusion has cleared and there are year. During their two-year pered by a hierarchal reporting now thriving relationships. Her CHC wait, Leddy says the team ofof thethe familyfamily wouldwould structure with physicians at team cares for the First Nations com- raised funds to build a brand the top. Costello says she munity on the Kettle and Stoney Point new building. Although she likelike to come and believes more ACNPs should First Nation, as well as the elderly living and the physicians moved in get involved in FHTs. in isolated rural areas. see me too.” Just like the new FHTs budding together in June 2006, they see me too.” “It’s a very exciting time; across the province, CHCs also face chal- were still functioning as inde- it’s an opportunity to make a lenges. Kennelly says they’re most often pendent practitioners until the funding difference early on in the trajectory of illness related to the restrictions imposed by arrived in February. rather than at the end,”she says. the health-care system. For example, Leddy and two other NPs have now start- Pogue agrees:“There are a lot of success although she can refer patients to spe- ed to form teams with their physician part- stories,” she says. “And those are built on cialists, those specialists won’t be paid a ners, and the team has hired a pharmacist, nurse practitioners collaborating effectively consultation fee for seeing an NP refer- social worker, RN, and executive director. with their physician partners and registered ral. Kennelly often sends patients to her A life-long Goderich resident, Leddy nurses.” physician partner to do the referral says the FHT’s services are critical for 5,000 As NPs begin to take on more leader- instead. That can mean delays for a of her neighbours who have been without ship roles in Ontario’s FHTs, Pogue says patient. Kennelly says the team works primary health care for too long. Up until there will undoubtedly be challenges. It’s a through those glitches because they have formed strong, open relationships now, many have driven more than an hour matter of working through the kinks along with each other, and that collegiality is to London for an annual physical. the way. She’s confident NPs will continue what makes Kennelly’s job rewarding. “It’s horrendous. I desperately want that to offer solutions, and are eager to work And it’s what she believes will be need- to change so people feel like they can get through the challenges. ed to make FHTs work. the care they need.” If nurse practitioners are truly equal “It takes time,” she says of the Improving patients’ access to care is also partners within the FHTs, she says, we will developing relationship between phy- a top priority for Brenda Taylor, an NP at certainly see many more successful teams sicians and NPs. “When doctors are the Queen’s Family Health Team in across Ontario. RN new in the family health team group, Kingston. Taylor says the Queen’s FHT is they need to see what we can do.” RN unique because it not only offers clinical JILL SCARROW IS STAFF WRITER FOR RNAO.

Registered Nurse Journal 15 RNAO’S EIGHTH ANNUAL DAY AT QUEEN’S PARK With an election just months away, and politicians preparing to hit the campaign trail, nurses at RNAO’s Eighth Annual Day at Queen’s Park take advantage of their one-on-one encounters with decision-makers to address everything from poverty to nursing employment to Medicare. BY KIMBERLEY KEARSEY AND JILL SCARROW

Frank Klees, Conservative MPP for Oak Ridges, and Critic, Citizenship, Immigration and Education (left), meets one-on-one with members to talk about the need for full-time work for new grads. Esther Green, Board Member at Large, Administration (right), Valerie Grdisa, Chair of the Mental Health Nurses Interest Group (centre), and Paula Manuel, Board Representative for Region 6, step to the microphone with questions for Conservative Leader John Tory. Pamela Pogue, President of the Nurse Practitioners' Association of Ontario (NPAO), poses a question to Conservative Leader John Tory about his plans to help NPs work to their full scope of practice.

Oct. 10, Ontarians will head members each year, saw nurses sharing their Laura Carson, a Laurentian University to the polls to determine expertise on many pressing health-care issues nursing student, took to the microphone ON which political party will that RNAO will continue to advocate dur- during a Q&A session at the event to chal- govern the province for the next four years. ing the election campaign,including address- lenge Ontario’s Minister of Health George Although the parties are only now ing poverty and other social determinants of Smitherman on an important issue for beginning to seriously prepare their plat- health,supporting nurses so they can work to Ontario’s nursing students: the new gradu- forms and position themselves for the cam- their full scope of practice, continuing ate initiative to provide new nurses with paign trail, in late January RNAO mem- toward 70 per cent full-time employment for full-time jobs. bers started setting the tone for the upcom- all nurses, full-time job guarantees for new “Details must come soon, because now ing election at RNAO’s Eighth Annual grads and 80/20 for nurses 55 and older, and is the time we’re thinking of going to the Day at Queen’s Park. strengthening Canada’s publicly funded, not- U.S,”she said in late January. The event, which attracts more than 100 for-profit health-care system. One month later, Smitherman ann-

16 March/April 2007 L DAY AT QUEEN’S PARK

More than 20 nursing students from Queen’s University, Laurentian University, Trent University, York University, and the University of New Brunswick got a taste of the associa- tion’s political activity by visiting home office for the board meeting, and attending Day at Queen's Park activities.

President Mary Ferguson-Paré presents Mona Peter Tabuns, NDP MPP for Sawhney, a clinical nurse specialist and acute care Toronto-Danforth, and Critic, Public nurse practitioner in pain management at North Infrastructure and Transportation York General Hospital (right), with the Best Practice (right, foreground), met one-on-one Guidelines (BPG) PhD Fellowship Award. Sawhney with members to discuss transportation receives $25,000 from Ontario’s Ministry of Health needs for the disabled, and energy to focus her research on RNAO's Assessment and conservation. Management of Pain BPG.

ounced details of the government’s plan, meetings with MPPs and their staff, includ- to the U.S. Martel stressed the need to offer including $89 million in funding for 4,000 ing former Minister of Health Elizabeth nurses full-time jobs in all sectors. While new grads to secure full-time jobs this year Witmer, Liberal MPP Kevin Flynn and recruitment and retention of nursing stu- (and multi-year funding thereafter). NDP Leader Howard Hampton. Prior to dents was a hot topic, Martel also addressed “Ontario can no longer afford to be a those closed-door meetings, nurses had the other important health-care issues. During place that exports new grads to other juris- opportunity to hear presentations from her speech,she lashed out at the current gov- dictions, especially when so much money Smitherman, Conservative Leader John Tory, ernment for leaving the door open to further has been invested in their training,” he said and NDP Health-Critic Shelley Martel. privatization of health care by continuing to during Queen’s Park Day. During a Q&A session following those use private funds to build hospitals. This year’s annual meeting with govern- presentations, Martel faced questions on full- “(Hospitals) should be publicly financed ment decision makers provided nurses with time work from Carson, who asked how the so that money that should be going to an opportunity to participate in one of 17 NDP would keep new grads from heading patient care is not diverted to profit,” she

Registered Nurse Journal 17 told the audience. Martel also raised con- cerns that legislation governing the Local Health Integration Networks (LHINs) and On the government’s pledge the long-term care sector doesn’t go far to hire 8,000 new nurses: enough to ensure services are provided in the not-for-profit sector. Q&A “We are far short of the elec- Members also pressed leaders about their tion promise. And I don’t have plans to improve social determinants of to tell you of the great need to health.Tory outlined his thoughts on tack- On poverty: meet that election promise both ling poverty in response to a question from from the perspective of how RNAO member Claudine Bennett, who “The government still continues many nurses could, in the next asked whether or not he supported increas- to steal back about $250 million three years retire, and may ing the minimum wage to $10.Tory said he from the lowest [income] fami- without some incentive to stay, would like to see consultations about how lies in the province.” and secondly the problem that and when to raise the minimum wage, and — NDP Health Critic Shelley Martel is occurring now when we don’t pointed out a more comprehensive effort, on the clawback of the national child have RNs at the front line pro- including funding for social programs, is care benefit. viding care.” needed to ease poverty’s strain. — NDP Health Critic Shelley Martel RNAO board member-at-large, socio- political affairs, Hilda Swirsky directed the same question to Smitherman, who defended his government’s increase of the minimum wage to $8-an-hour, and pointed out the Liberals have taken steps to ease poverty’s strain by increasing access to health-care serv- ices through Community Health Centres. Both Smitherman and Tory were also probed about enabling nurse practitioners to provide care to more Ontarians. NPAO SHELLEY MARTEL President Pamela Pogue asked what Tory would do to get all nurse practitioners work- “Good access to care is what peo- GEORGE SMITHERMAN ing to their full scope of practice. She also ple need. Our government has wanted to know how a Conservative gov- increased the number of commu- “The commitment that we’ve ernment would bring acute-care nurse prac- nity health centres to help that.” made with respect to 8,000 new titioners into the extended class.Tory said he — George Smitherman, nurses in the province of is interested in addressing the issue, especially Minister of Health and Long-Term Care Ontario is in sight, and by work- when so many people don’t have access to ing together, I know that we primary health care and RNs and nurse can achieve it to the benefit not practitioners are prepared and available to just of nurses, but to the benefit provide that care. most especially of the patients “In the nursing profession, more people that we’re privileged to serve are highly trained than ever before,”he said. together.” RNAO President Mary Ferguson-Paré — George Smitherman, facilitated the morning discussions along- Minister of Health and Long-Term Care side Executive Director Doris Grinspun. They concluded that the day provided an “The current government excellent opportunity for RNs and politi- pledged to hire 8,000 nurses… cians to exchange views on important We now read from the College health, health care, and nursing issues. The JOHN TORY of Nurses that pace of job event also provided politicians with valu- creation has slowed to a able tips on what they can expect from “We must start working trickle in McGuinty’s second nurses, and information they can take to together to address social year of office, dropping to their caucus tables and incorporate into determinants of health. less than one-fifth of what their election platforms this fall. Poverty is an enemy of it was before.” “Nurses know how government poli- anyone’s health.” — Conservative Leader John Tory cies affect all aspects of health, and they are — Conservative Leader John Tory ready to speak out for our vulnerable citi- zens,”Ferguson-Pare said. RN

18 March/April 2007 nurse or with patients has changed me in some way. That’s what the book is about.” Since publishing her first book, Shalof says Positive response nurses from across the country and around the world have contacted her to say ‘this is my story too.’ Another common theme to her prompts RN to publish again conversations with readers pertains to the pri- vacy issues of patients.Many nurses have asked her ‘how did you write about your patients?’ It’s been three years since “I think that’s what holds nurses back,”she says of the scarcity of nursing literature on the Tilda Shalof’s bestselling book, bookshelves.“We are bound to confidentiality with our patients, but I knew there were ways A Nurse’s Story, hit bookshelves. to write these stories without breaching trust. “You go to sections of the bookstore or She’s just released her second, library and you see memoir after memoir… The Making of a Nurse, and doctors write about all their fascinating case histories, lawyers write about their court- has high hopes that it will room dramas and trials. I thought if these professions can do it,why are we prohibited? inspire other nurses to I didn’t want to tell the specific stories of Mr. X or Mrs.Y.It was the universal theme follow in her steps. that was (important)…” Shalof believes more nurses need to share BY KIMBERLEY KEARSEY their own stories in print.“I think the time is right…the public is really interested in what we do…look at all these medical shows on TV. there’s one thing that’s truly sur- and struggles of being a caregiver…it’s quite If someone wants to write about their experi- prised Tilda Shalof since publishing demanding work,” she explains. “I think ences, now’s the time…I’ve opened the door.” IF her first book, it’s the fact that she most people choose nursing because they Shalof assures colleagues that the pub- has so many thankful readers.“You sit alone. want to help people…without really know- lishing process is not as daunting as they You’re writing, writing, writing. You don’t ing what that means and all that it implies.” might think. She admits she kind of fell into even know if you’re going to get published,” The Making of a Nurse explores Shalof’s it herself. One day at work several years ago she says humbly.“The book comes out and own journey through 25 years in the profes- she heard that McClelland and Stewart, a all of a sudden you’re hearing from peo- sion, most of which she spent in critical care large Toronto-based publishing house, was ple…that your stories of your specific life nursing. It’s been a struggle at times, but one interested in publishing medical memoirs. had an impact on them.” that she says has made her a stronger person She thought ‘why not nursing?’ She brought Before publishing A Nurse’s Story in and a better nurse.“I’ve come to a resolution her stories in and a week later she had a 2004, Shalof says her only readers were about some of the issues that troubled me in publishing deal. Shortly thereafter, she was “friends and family I managed to coerce nursing…” she explains, citing the hardships of on the bestsellers list. “What did I do that into reading my stuff.” being a caregiver, learning boundaries and was really so groundbreaking? I just wrote In March, she released The Making of a how much caring is enough,and learning how about my work,”she says. Nurse, and says she hopes her latest collec- to handle emotions in difficult situations.“My “This is a very honest view of nursing. It’s tion of anecdotes and tales of real-life nurs- first book was focused on the issues that arise not a glamourized or glorified view. The ing resonate with a new crop of readers. in critical care nursing. This new book is hardships are definitely highlighted. If you feel “There’s a lot of personal experience in broader and deals with nursing in general… you can surmount them, or want to confront this second book and I think anyone who and how the personal affects the professional.” them and reap the rewards…you’ll know has any personal struggles that have an Shalof believes that even though nurses what they are if you read this book.” RN impact on their life as a nurse…as mine practice in different roles, there are common did…will find some comfort, some consola- experiences.“I was very surprised and grati- KIMBERLEY KEARSEY IS MANAGING tion, knowing they’re not alone.” fied that nurses who are working in areas EDITOR/ COMMUNICATIONS PROJECT Shalof says the role of nursing was one other than my own…still found my stories MANAGER FOR RNAO. that was familiar to her growing up because resonated with their experiences,” she says. she took care of her ailing mother through- The book explores these common experi- RNAO will host a book launch for The Making of a Nurse at 158 Pearl Street out most of her adolescence. Choosing to ences and how they bring the profession (Toronto) from 4:30-6:00 p.m. on become an RN “was not a eureka moment” together.“Each anecdote in the book – and Wednesday,April 25, 2007. Copies of both she admits. In fact, it’s something she’s strug- there are hundreds of them – gives another books will be available for sale at the event. gled with. “I describe in the book the joys insight into how encounters with another

Registered Nurse Journal 19 RESEARCH AND DISCOVERY Nursing researchers say more must be done to ensure qualified RNs build the backgrounds they need to fill prestigious nursing research chairs in Ontario. BY JILL SCARROW

or almost 15 years, McMaster for nursing research, are worried about the research careers. Chairs allow holders to University nursing researcher low number of RNs with doctorates. focus on advancing research in a particular Heather Arthur has dedicated They’re also worried that funding for nurs- field, both through their own work and by her work to finding out how ing research chairs is disappearing because supervising graduate students and working social factors – such as mood and there aren’t enough qualified nurses to fill with other researchers. Chairs span every Fpersonality – affect heart disease. As the the chairs. Some Ontario-based RNs who discipline and topic area, and are funded by Heart and Stroke Foundation of Ontario already hold research chairs say their work government agencies, foundations like the Chair in Cardiovascular Nursing, Arthur makes an important difference to patient Canadian Health Services Research says the autonomy and rewards of her work care, and to training the researchers of Foundation (CHSRF) and the Canadian far outweigh the challenges. tomorrow. Institutes of Health Research (CIHR), It’s “the excitement of discovery, the fun In 2004, Jensen says $2 million in fund- individual donors, universities, and hospitals of working in multidisciplinary teams…and ing for a stroke nursing chair, or organizations that focus on the creativity of bringing a team together offered by the University of Researchers worry certain conditions, such as the and thinking about a question” that keep Western Ontario (UWO), the that funding for Heart and Stroke Foundation. her intrigued. London-based Lawson Health The type and amount for each Arthur admits, however, there’s a short- Research Institute, the Ministry nursing chairs position depends on the chair. age of RNs to dedicate that same intrigue of Health and Long-Term Care, Some give chair holders a cer- is disappearing and enthusiasm to research because many the Heart and Stroke tain dollar amount over a peri- PhD-prepared nurses find their teaching Foundation of Ontario, and St. because there od of years. Others, called obligations eat up most of their time. She Joseph’s Health Care (London), endowed chairs, exist in perpe- says that means nurses’ unique perspective was withdrawn after a year-long aren’t enough tuity, and funding comes from on holistic, patient-focused care is missing search across North America qualified nurses the interest generated on a from the proliferation of medical and scien- failed to find a suitable candi- lump sum of money. tific data that shape peoples’ health and lives. date with the needed skills. to fill the chairs. Arthur, whose chair in car- In 2003,Arthur co-authored a report for Once money for a chair is diovascular nursing will always Health Canada’s Office of Nursing Policy withdrawn, she says, it will often be re-allo- reside at the McMaster University School that found just 671 RNs working in Canada cated, but not necessarily to nursing again. of Nursing, regardless of who holds it, says held a PhD in 2002. In that same year, only She believes nurses must capitalize on all it can be hard to generate a pool of well- 234 had a doctorate in nursing. Arthur opportunities to obtain funding so they can established nursing researchers eligible for w a admits the numbers may now be a few years continue to demonstrate how RNs’ chairs because nurses face challenges that i L

n old, but they illustrate an emerging and research and practice enriches the lives of individuals in other fields of study may not. o s n

A important issue in the profession: there sim- patients, and improves the health-care sys- For example, she says many RN-doctorate : n o i ply aren’t enough PhD-trained RNs. tem overall. students are in their mid-40s, and after t a r t

s Some researchers, including Elsabeth Research chairs are positions granted to completing the rigorous PhD program, u l l I Jensen, RNAO’s board member-at-large individuals with long, intensive, successful may not be interested in going on to invest

20 March/April 2007 the past few years means there will be more nurses who can do research. The trick, however, will be for current researchers to mentor them and help them earn the awards that will advance their careers. DiCenso believes her CHSRF/CIHR chair in advanced practice nursing (APN) allows her to do just that. She offers finan- cial and academic support to graduate and post-doctoral students, as well as to emerg- ing nurse researchers. Her chair also allows her to connect younger researchers with decision-makers so they can have a direct impact on the way APNs practice, and how their positions are evaluated. “It became clear to me that by taking on this chair, I would be training the nurse researchers of the future,”DiCenso says.“By training a cadre of these nurse researchers, my research moves forward much faster than if I was doing it by myself.” Denise Bryant-Lukosius and Faith Donald are two researchers who are helping DiCenso push that work forward. Three years ago, Bryant-Lukosius, a nursing pro- fessor at McMaster University and clinical nurse specialist in oncology at Hamilton’s Juravinski Cancer Centre, began working with Cancer Care Ontario (CCO) to con- duct a study that evaluated five new APN roles in regional cancer centres. That study has since expanded to examine all APN roles in both adult and pediatric oncology in Ontario. Esther Green, Chief Nursing Officer and Director of Health Human Resource Planning at CCO, says Bryant- Lukosius and DiCenso have created a way of identifying what oncology patients need, and how to meet those needs.This, she says, is invaluable to oncology in Ontario. more time in a post-doctorate to further Preparing tomorrow’s nurse researchers Research chairs also provide nurses with refine their research skills and develop a is also important to RNAO members Alba the opportunity to lend their perspective to focused research career. She also believes DiCenso, Nancy Edwards and Linda different fields. At UWO, RN Beverly teaching demands prevent PhD-educated O’Brien-Pallas, three Ontario-based Leipert is the Ontario Women’s Health nurses from dedicating enough time to CHSRF/CIHR nursing chairs conducting Council Chair in Rural Women’s Health research. research in advanced practice nursing, com- research, the only chair of its kind in North Arthur believes nursing students should munity health, and nursing human America. A former public health nurse in begin to get excited about research at the resources, respectively. In 2000, the three rural Saskatchewan, Leipert says the posi- undergraduate level and should be encour- researchers received 10-year funding from tion affords her the resources to dedicate aged to begin graduate work at a younger CHSRF, CIHR and the province. research to her passion for rural health. age. While many nurses return to school DiCenso, who works out of McMaster Unlike the CHSRF/CIHR chairs, after several years in the workforce, Arthur University, is also Director of the Ontario Leipert’s chair exists in perpetuity. She says getting an early start on graduate work Training Centre in Health Services and works with graduate students from a num- gives students time to establish the exten- Policy Research. She believes that, ber of fields including nursing, social work sive, successful research career required to although there is pressure on PhD-pre- and anthropology.Leipert believes any chair compete for funding or research chairs later pared RNs to devote themselves to teach- – whether it’s specific to nursing or another on in their careers. ing, the growth of more PhD programs in health field – raises the profile of the kind

Registered Nurse Journal 21 of advanced research nurses do. University of Ottawa, nurse researchers “Nurses bring an enriched, comprehen- now have an avenue to build relationships sive, holistic understanding of health to with other researchers, create opportunities their research,”she says. for collaboration, and partner with others to Like Arthur, Leipert believes cultivating submit joint research proposals and receive future researchers must begin at the under- joint funding for their projects. graduate level. That means funding to hire RNAO has partnered with the Ministry enough professors so students are no longer of Health and Long-Term care to finance taught in cavernous lecture halls that hold 12 research projects through the Best more than 200 people. Instead, students Practice Guideline (BPG) Program (see should have the chance to work closely sidebar for more details), and each year with professors who can excite them about offers 36 Advanced Clinical Practice Fell- research and graduate work. She says inspir- owships to nurses who want to develop ing that passion in students is important if their research, leadership and BPG imple- research is to compete against other nursing mentation skills. specialties during a nursing shortage. RNAO President Mary Ferguson-Paré For many years, RNAO has been doing says BPGs offer nurses opportunities to its part to excite nurses about research and become friendly with research, but suggests discovery. With the recent creation of the health-care organizations are also responsi- Nursing Best Practice Research Unit ble for making research a priority in the (NBPRU), led by RNAO and the workplace. “For practising nurses,having an environ- ment where you’re asking questions about Twelve new BPG projects bring what you do and exploring ways of address- research to the frontlines ing those questions; that is a very satisfying Kathryn Higuchi, an Assistant Professor work does not come without its chal- kind of environment to work in,”she says. at the University of Ottawa, is one lenges. She says making site visits are cru- Ferguson-Paré says fostering that kind of of a handful of researchers involved in cial because they offer a window into the research-friendly atmosphere at Toronto’s an RNAO best practice guideline (BPG) workplace world that can’t be revealed by University Health Network (UHN), where initiative bringing research and practice interviewing staff or holding teleconfer- she is the vice-president of professional affairs together to make a difference to ences. Researchers have to be willing to and chief nurse executive, has been done by patient care. commit to this aspect of the project, and creating a new role: the Director of Nursing Higuchi is the principal investigator must understand the importance of main- and New Knowledge and Innovation. UHN for a project looking to see if using the taining constant, open communication has also developed a nursing chair in oncolo- guidelines changes how nurses make with practitioners. decisions in public health and a hospital. Virani says frontline RNs have to make gy, is recruiting another chair in cardiovascu- She is also the co-principal investigator a commitment to the project as well, but lar nursing, and has recently appointed a on a study looking at vascular access it pays off by providing an up-close view PhD-prepared nurse clinician scientist in devices. Higuchi says she is excited to see of how the research world works. Nurses neuro-sciences. how the guidelines are affecting practice begin to understand the challenges that Ferguson-Paré says UHN hopes to on the frontlines. arise as research and practice cultures eventually have a nurse clinician scientist in “It’s seldom that researchers have merge, she explains. For instance, research every program, and a nursing research chair these kinds of funding opportunities. I’m is described as a ‘hurry up and wait in each of its three sites. To achieve these really pleased to be a part of all this,” process.’ After the rush of activity to pre- goals, she says each hospital must cultivate she says. pare proposals, weeks may pass before the nurses already working within its own Tazim Virani, Director for RNAO’s Best funding bodies or ethics boards reply. This walls, including helping advanced practice Practice Guidelines (BPG) Program, says wait may leave RNs on the frontlines won- the 12 projects, which began in 2006, dering about the status of their project. nurses obtain their PhDs. examine a variety of topics and focus on a According to Virani, all 12 research These kinds of initiatives are key to specific selection of RNAO’s 30 BPGs. She projects are expected to be completed by ensuring the nursing profession continues says RNAO has helped to link hospitals, 2009. The results will be presented in the to cultivate the minds of future RN- public health units and Community Care workplaces where they took place, ensur- researchers.“The speed of change in health Access Centres (CCACs) that share a com- ing the lessons learned can spread across care is really requiring us to utilize best mon interest in the BPGs. the frontlines in a way that will lead to practices and recent research,” says “RNAO is bringing researchers and better patient care. Virani also hopes the Ferguson-Paré. practitioners together in a way that will projects spread enthusiasm for research And it’s that relevancy that will help excite both groups about research,” into every corner of health care. nurses keep patients – and the health-care she says. For more information, visit system – healthy. RN Higuchi admits, however, that the www.rnao.org RN

JILL SCARROW IS STAFF WRITER FOR RNAO

22 March/April 2007 NURSES: Making a DIFFERENCE Susan Rutherford has met many nurses while dealing with illness and death in her family. She says she now truly understands and appreciates the important role nurses play in people’s lives.

age 43, I am very fortunate to and health-care fields. Perhaps I shouldn’t enjoy good health, and I’m have been surprised by the fact that nurses AT happy to say that I have not do not receive the acknowledgement and required any significant hospital visits or praise they deserve. nursing care. I have, however, experienced It’s not easy for anyone to be stuck in nursing firsthand; in some respects far more the ER when there is a bed shortage. than I would have liked. My experience Often there are delays in getting tests done comes mainly from my role as primary due to demands exceeding resources, and caregiver to loved ones who have been sick. difficulties connecting with doctors. In 1988, I saw my infant daughter go Patients and their families will often vent through three open heart surgeries over a on the closest person at hand – the nurse. period of six months. Sara’s nurse would During episodes of trauma and illness, we monitor her vitals, administer medication, do not usually take the time to thank the and feed her in my absence. Over and above nurses who are truly the cornerstones for that, she knew Sara’s preferred position for helping us cope with difficult situations. sleeping, how she liked to be cuddled best, That’s why I want to say thank you to and basically mothered my child when I all nurses for your patience and under- was away from the hospital. Sara’s nurses standing. For taking our phone calls even made me feel safe and ‘at home.’ old at the time; such a simple gesture and though you don’t really have the time to When my daughter passed away, the act of kindness that meant so much.These do so. For talking to us and making us nursing care did not end. It was a nurse wonderful hospital and visiting nurses realize that we are not alone. For being who sat with me in the quiet room while made a difference. humorous when you see we need a I held my child, not wanting to let her Two years ago, my mother, in her terminal lift…and for comforting us when we are go. And it was a nurse who kept in touch stages of cancer, came to live with me and frightened or grieving. with me for several years after that, simply my family.We could not have coped with- Thank you for bonding with us despite to let me know that she still ‘remembered.’ out the support and services of visiting the emotional toll it takes on you when we The amazing nurses on ward 4A in the nurses. I will be forever grateful to the part ways – whether that is caused by death ICU at the Hospital for Sick Children RNs who enabled my mother to die in the or a return to better health. made a difference. same manner she lived her life – with dignity No matter what your nursing role – Four years later, my six-month-old son and grace.You made a difference. bringing new life into the world, helping was diagnosed with neuroblastoma. I spoke to nurses about my respect for the to achieve a gentle end through palliative Michael is now a healthy 15-year-old, but profession at RNAO’s annual general meet- care, or anything in between – thank you at the time, nurses played a key role in ing in April 2006. I never expected the for caring for us. ensuring that road to health.They were also responses I received after that presentation. You make a difference. RN

i instrumental in educating me about his Nurses sent me e-mails, phoned me, and s i n o i illness. Nurses were a wonderful source of approached me at subsequent events to thank SUSAN RUTHERFORD IS MARKETING D a r support – in the hospital for chemotherapy me for sharing these personal experiences. MANAGER FOR HUB PERSONAL INSURANCE d n a treatments, during clinic visits, and when It became clear to me that nurses usual- (A DIVISION OF HUB INTERNATIONAL S : n

o they visited us at home. It was a nurse who ly hear what they do ‘wrong’ and not what ONTARIO LIMITED). HUB HAS BEEN THE i t a r t brought stickers and played games with they do ‘right.’The same can probably be GROUP HOME/AUTO INSURANCE PROVIDER s u l l I Michael’s sister Julia who was three years said for front-line workers in other social FOR RNAO MEMBERS SINCE 1995.

Registered Nurse Journal 23 2005, when Grinspun was invited to speak at an International Nursing Conference in China Project Beijing. Last summer, she returned to China with Irmajean Bajnok, Director of Ontario RNs provide inspiration, the Centre for Professional Nursing knowledge to 1.3 million Chinese nurses Excellence, to sign a contract to develop a training program for China’s nurses. BY JILL SCARROW Through that program, Bajnok and Nancy Fletcher, an RNAO Senior Professional Development Manager, will travel to Beijing this spring to provide leadership and management education to charge nurses, nurse managers and directors.They will then train up to 60,000 management colleagues across China, giving them the knowledge and skills to lead effective workplaces. The program is being developed by RNAO staff, and will consist of 18 modules addressing topics such as leadership attrib- utes, hiring practices, interviewing skills, motivating and supervising staff, perform- ance appraisals, budgeting principles, and University Health Network (UHN) RNs shared details of their best practice guideline work with scheduling practices. RNAO’s Client RNAO's Chinese partners in late February. From left, Pat Hung, Romeo Cruz and Baiba Zarins met Centred Care BPG and the recently released for a tour of UHN's facilities with Irmajean Bajnok, Director of RNAO's Centre for Professional Nursing Excellence, Mary Ferguson-Paré, RNAO President, and BNCC President Jiang JingHui. Healthy Work Environment BPGs are cen- trepieces in the curriculum development. or one week in February, RNAO work with our international colleagues,” “This partnership provides a real members and staff welcomed two Grinspun said.“It’s an honour to be able to opportunity to extend the work of all our FChinese leaders who were in Ontario show the growth of RNAO’s membership guidelines around the world,” Bajnok says. to learn more about RNAO’s work, and our collective political and clinical “Nurses in every nation face work chal- including the clinical and healthy work influence.” lenges, and it’s a privilege for us to be able environment best practice guidelines Daniel Lau, Director of Membership to help them overcome some of those (BPG). Jiang JingHui, President of the and Services, translated during the visit.“As obstacles to make a real difference for the Beijing Nightingale Consultation of a Chinese Canadian, I’m thrilled to see profession, patient care and their own Culture (BNCC), and Sun XiuJu, a BNCC RNAO’s expertise making a difference in careers.” consultant, were also visiting to assess the health care and nursing for the 1.3 billion Ten nurses from China will also visit progress of a leadership training program people in China.” RNAO in June to attend the International RNAO is developing for Chinese nurses. The February visit marks the next stage Conference on Evidence-Based “We’ve only seen best practice guide- in an innovative relationship between Guidelines.They will discuss plans for lines on paper,” JingHui said in advance of RNAO, the Chinese Nursing Association week-long leadership internships in the visiting three of the 22 health-care facilities and BNCC. That relationship began in fall, including observations and job shad- that have been designated RNAO owing of clinical and administrative lead- Spotlight Organizations for their work in ers in practice settings. implementing BPGs.“We want to see what Grinspun says she is looking forward to these best practice spotlight (organizations) tapping into the expertise of many have done,”she said, adding,“I’m very con- RNAO members as she plans for the fident and proud to be working with internship program. RNAO.” “I know RNAO members will share Executive Director Doris Grinspun said their pride in the profession, their associa- JingHui and XiuJu were provided with a tion and their expertise,”she says, adding comprehensive overview of the associa- “…nurses’ enthusiasm for leadership will tion’s policy, communications and mem- From left: Sun XiuJu, BNCC consultant, then inspire our Chinese colleagues to bership work, which has fostered the same Anitta Robertson, RNAO's Director of return home and apply what they’ve kind of strong leadership skills in Ontario Special Projects, Jamison Steeve, Special learned.” RN Assistant, Health Policy, in the Office of the nurses that they are looking to develop in Premier, JingHui, RNAO Executive Director For more information, contact Angela their nursing workforce in China. Doris Grinspun, and Daniel Lau, Director Joyce at [email protected] or 1-800-268- “I was inspired as I heard us sharing our of Membership and Services at RNAO. 7199 ext. 228/416-408-5629.

24 March/April 2007 toYou NEWStoUse

Dorothy Pringle, a member of RNAO for 26 years, has been appointed as an Officer of the Order of Canada. Pringle has spent much of her career in academic nursing, including two terms as Dean of e t t Nursing at the University of Toronto. Her clinical and research interests focus primarily on the care of e u q older people with dementia. She says she’s “thrilled” about the award, which she will receive later this a P l a year at a ceremony hosted by Her Excellency the Right Honourable Michaëlle Jean, Governor c s a

P General of Canada.The designation formally recognizes outstanding achievement and service in : o t

o various fields of human endeavour. Pringle’s appointment was announced on Feb. 20. h DOROTHY PRINGLE P

RNAO member Linda Kelloway is one of two nurses representing Ontario on Canada’s new National Stroke Nursing Council. The Council’s goal is to build a network for nurses who specialize in stroke care, offering a venue through which they can identify critical issues and gaps related to stroke. The group’s focus is on clinical practice, education and research.

In mid-February,the Canadian Nurses Association (CNA) released a discussion paper that it hopes will help to inform nurses on Canada’s foreign policy position on the global trade agenda.The document provides insight into trade agreements and their impact on the nursing profession. Entitled The GATS and Health Services in the Doha Round Negotiations, the paper identifies themes emerging from recent rounds of trade negotiations that may have an impact on health-care systems. For more information, or to request a copy of the document, contact [email protected].

Street nurse Cathy Crowe released her first book, Dying for a Home: Homeless Activists Speak Out, at Toronto’s Sherbourne Health Centre on April 18. The book brings to life the voices of ten homeless activists who, in some cases, have lived on the street for over a decade. They tell their stories, and reveal their sugges- tions for working towards an equitable future. “The word home- less conjures up many stereotypes, but rarely does it suggest brav- ery, courage, charisma, or intelligence,” Crowe says in describing the individuals in her book. Crowe has worked with the homeless for more than 18 years, and is a current recipient of the Atkinson Charitable Foundation’s Economic Justice Award. She also co-founded the Toronto Disaster Relief Committee (TDRC), which in 1998 declared homelessness a national disaster. CATHY CROWE

Three RNAO members were among 15 Ontario health science profes- sionals nominated for the 2006 Ontario Premier’s Awards for College Graduates.Although they did not receive the top honour, they were recognized for their outstanding achievements at a gala awards dinner on Feb. 19.Anne-Marie Dean, Executive Director of Hill House Hospice in Richmond Hill, and the focus of the RN Profile in the Jan/Feb 2007 issue of Registered Nurse Journal, was acknowledged for her excellence in palliative care. Heather Elliott, a Clinical Nurse Specialist in Gerontology at Trillium Health Centre in Mississauga, was sin- gled out for her strong advocacy for the elderly. And Lee Mantini, an International Health and Development Consultant, was recognized for her passion and commitment to quality health care at home and around the world. ANNE-MARIE DEAN LEE MANTINI

Registered Nurse Journal 25 Calendar

April May April 13-14, 2007 May 3, 2007 May 9, 2007 EIGHTH ANNUAL OPTIONS FOR LEADING AND SHAPING RNAO HEALTHCARE DIABETES CONFERENCE SUCCESSFUL CHANGE: EXPOSITION: Holiday Inn, Kingston, ON REGIONAL WORKSHOP NURSING CAREER FAIR Contact Margaret Little at 613- Capone’s Catering 89 Chestnut Residence 547-3438 or Ottawa, ON Toronto, ON [email protected]

April 19-21 RNAO ANNUAL GENERAL MEETING June Hilton Suites Toronto/Markham June 7-8, 2007 June 10-15, 2007 Conference Centre and Spa INTERNATIONAL CONFERENCE NURSING BEST PRACTICE Markham, ON IN EVIDENCE-BASED BEST GUIDELINES: SUMMER PRACTICE GUIDELINES: SETTING INSTITUTE April 27 - 28, 2007 THE CONTEXT FOR EXCELLENCE Nottawasaga Inn & Convention SOLE PASSION: NURSES’ IN CLINICAL PRACTICE AND Centre ENTREPRENEURIAL FOOT CARE HEALTHY WORK Alliston, ON ASSOCIATION OF CANADA ENVIRONMENTS (NEFCA) ANNUAL FOOT CARE Hilton Suites Toronto/Markham CONFERENCE Conference Centre and Spa Holiday Inn, Kitchener, ON. Markham, ON 30 Fairview Rd. S For more information please visit: www.nefca.ca

Unless otherwise noted, please contact Vanessa Mooney at RNAO’s Centre for Professional Nursing Excellence at [email protected] or 416-599-1925 / 1-800-268-7199, ext. 227 for further information.

26 March/April 2007 Classifieds Nursing and Health Care Leadership/ Sheridan College School of Nursing Ontario Association of Non-Profit Homes and 25th Reunion Services for Seniors (OANHSS): Leading educa- Management To be held in Oakville, as part of the Sheridan tion in not-for-profit long-term care. 2007 Distance Homecoming at the Oakville Trafalgar Campus Annual Meeting & Convention. October 2007. Updates will be provided closer April 30 – May 2, 2007, Westin Harbour Castle, Education to the time when we receive your contact Toronto. Workshops specifically tailored to Program information. gerontological nurses. Contact: Karen Elliott, Please contact Geri at [email protected] Conference Planner, 905-727-1537, karenel- [email protected]. Visit www.oanhss.org.

GET PUBLISHED about the focus of your piece and its suit- Registered Nurse Journal wants to hear from ability for publication. GRANTING UNIVERSITY CREDIT members interested in contributing to the • Draw up a brief framework to tell us how AND CERTIFICATE OF COMPLETION publication. you’re thinking about framing the story, and Endorsed by the CNA. All courses individually facilitated A few things to consider before submitting: what approach you’d like to take. by an Educational Consultant • Look through back issues of the magazine to • Call if you have questions while preparing Courses Offered: get a sense of the flavour of stories and the your framework. We’re here to help you. range of issues covered. Leadership/Management (6 units) • 9 month course completion • Put yourself in the reader’s shoes. What do For more information about submissions, visit • both theoretical and practical content you want to read about? Is your idea new, www.rnao.org and follow the links to the important in today’s work environment unusual, or the first of its kind? Media Room and Registered Nurse Journal. Advanced Leadership/ • Talk to the communications department Or call 1-800-268-7199 ext. 233 / 416-408-5602. Management (6 units) • 8 month course completion • builds on the Leadership/Management course • topics include transformational and quantam leadership; emotional intelligence and May 3 – 5, 2007 organizational culture; applies theories and concepts to current work environment W e stin Prince Hotel • Tor onto Conflict Management (3 units) • 6 month course completion • explores the types and processes of conflict in health care organizations and applies theory and research to conflict situations 1st National Conference for in the current workplace Leading Effective Teams (3 units) • 6 month course completion Community Health Nurses: • theory and methods of teams by intergrating professional and leadership disciplines Mapping the Future Decentralized Budgeting (1 unit credit) • 4 month course completion • concepts of financial management and budget preparation for Better Health • important to nurses involved with decentralized management Quality Management (3 units) • 6 month course completion • theories, concepts, including safety culture, leadership in creating a culture of accountability • critically analyzes and applies paradigms addressing quality & safety issues in the workplace For further information please contact: Leadership/Management Distance Education Program McMaster University, School of Nursing 1200 Main Street West, 2J1A Hamilton, Ontario, L8N 3Z5 Phone (905) 525-9140, Ext 22409 Community Health Community Health Nurses Fax (905) 570-0667 Nurses Initiative Group Association of Canada Email [email protected] Internet http://www.fhs.mcmaster.ca/nursing/ educ_leader.shtml Programs starting every January, April & September Visit www.chnac.ca or www.chnig.org NURSING EDUCATION INITIATIVE The picturesque surroundings of Peterborough and the Kawarthas offers great outdoors with unparalleled waterways and recreational You may be eligible to receive up to activities! Our city is Vibrant and Growing! The Peterborough Family Health Team mission is to $1,500 in tuition reimbursement! improve community access to primary care with an overall mandate to keep Ontarians healthy, reduce wait For pertinent deadline information or to times, and provide better access to doctors and nurses. obtain a copy of the application form, please Nurse Practitioners visit the RNAO website at You will join a large group of established nurse practitioners that are www.rnao.org working to the full scope of practice and contribute to our primary care team consisting of family physicians, dietitians, and social and mental health workers. You will meet the needs of unattached patients in the greater Peterborough area, conduct assessments, formulate and For the most current communicate medical diagnosis, and determine the need for specialized procedures, prevention strategies, and pharmacological and counselling information about the interventions. You have a current RN (EC) designation combined (ideally) with several years of experience in primary health care in an advanced Nursing Education Initiative, nursing capacity. please contact: Peterborough is leading the way for Family Health Teams and has the support of our local family physicians. We welcome you to explore the dynamics of our highly dedicated team of interdisciplinary healthcare RNAO’s Frequently Asked Questions line professionals and play an integral role within our vibrant community. Whether you’re looking for big city events or small town charm – 1-866-464-4405 Peterborough has what you’re looking for! Please apply in writing to: OR Human Resources Manager, Primary Health Care Services 150 King Street, 3rd Floor, Peterborough, ON K9J 2R9 e-mail Meagan Wright e-mail: [email protected] fax: 705.740.8030 [email protected].

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