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FAMILY LAW • DIVORCE • SEPARATION • CHILD CUSTODY/ACCESS • SEPARATION AGREEMENTS • CHILD/SPOUSAL SUPPORT • DIVISION OF PROPERTY • MEDIATION / COLLABORATIVE LAW • WILLS & POWERS OF ATTORNEY • To all members of the Registered Nurses’ Association of Ontario, we offer you a free, one hour initial consultation and 10% off* all our services. *Excluding Wills and Powers of Attorney Regional Offices Aurora 16 Industrial Parkway South Barrie 500 Mapleton Avenue, Suite A Downtown Toronto 100 King Street West • Suite #5600 Mississauga 2 Robert Speck Parkway, Suite 750 Scarborough 10 Milner Business Court • 3rd Floor Recommended by: TORONTO POLI CE www.lisagelman.com First to respond since 1952 416.736.0200 4211 Yonge Street, Suite #210 Toronto (just south of 401) VOL. 30, NO. 3, MAY/JUNE 2018 MAY/JUNE 3, NO. 30, VOL. CONTENTS FAMILY LAW • DIVORCE FEATURES 22 10 Nursing Week • SEPARATION Members celebrate the profession with events and gatherings in their communi- ties and workplaces. • CHILD CUSTODY/ACCESS Compiled by Kimberley Kearsey • SEPARATION AGREEMENTS SPECIAL *PULL-OUT* SECTION 13 AGM 2018: Powering nursing to advance health • CHILD/SPOUSAL SUPPORT Coverage of this spring’s annual general meeting (AGM), including a celebratory • DIVISION OF PROPERTY spread of the newest BPSO designates. By Kimberley Kearsey 13 Photography by Victoria Alarcon, • MEDIATION / COLLABORATIVE LAW Alicia Saunders, Marion Zych

21 The look of change • WILLS & POWERS OF ATTORNEY We reflect back on the early 1990s in this • To all members of the Registered Nurses’ Association of Ontario, we third installment of our series to mark offer you a free, one hour initial consultation and 10% off* all 30 years of RNJ. By Kimberley Kearsey our services. *Excluding Wills and Powers of Attorney 22 COVER STORY Ticking Lyme bomb Regional Offices Talk of Lyme disease is ramping up Aurora with the arrival of warmer weather. What do nurses need to understand 30 16 Industrial Parkway South about the disease to help ease the Barrie suffering of those infected? THE LINEUP 500 Mapleton Avenue, Suite A By Daniel Punch 5 PRESIDENT’S VIEW Downtown Toronto 26 Ontario’s new chief nurse 6 CEO DISPATCH Since January 2018 Michelle Acorn has 7 NURSING NOTES 100 King Street West • Suite #5600 8 NURSING IN THE NEWS been providing the ministry of health with 12 RN PROFILE Mississauga advice on the nursing profession. 28 POLICY AT WORK 2 Robert Speck Parkway, Suite 750 By Daniel Punch 30 IN THE END Crystal McLeod writes about her connection Scarborough with rural nursing in this issue. 10 Milner Business Court • 3rd Floor Recommended by: TORONTO POLI CE www.lisagelman.com REGISTERED NURSE JOURNAL 3 First to respond since 1952 The journal of the REGISTERED NURSES’ EDITOR’S NOTE KIMBERLEY KEARSEY 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: RNAO.ca Email: [email protected] Letters to the editor: [email protected] EDITORIAL STAFF Marion Zych, Publisher Kimberley Kearsey, Managing Editor Bravery behind every story Victoria Alarcon, Editorial Assistant Alicia Saunders, Communications Assistant

EDITORIAL ADVISORY COMMITTEE Laryssa Vares, Desmond Devoy, Una Ferguson, Larissa Gadsby, Chad Johnson, Elizabeth Kerr, Joanne Laucius, Maria Rugg While greeting members at our Sue Faber is another member ART DIRECTION & DESIGN Fresh Art & Design Inc. communications booth at the who has let down her walls and ADVERTISING annual general meeting (AGM) offered up the very personal story Registered Nurses’ Association of Ontario in April, I met several people of her family’s struggle with Phone: 416-599-1925 Fax: 416-599-1926 who wanted to share their Lyme disease (page 22). She was SUBSCRIPTIONS personal stories. Their raw at the AGM to present a Registered Nurse Journal, ISSN 1484-0863, is a emotions ranged from excite- resolution that she hopes will benefit to members of the RNAO. Paid subscriptions are welcome. Full subscription prices for one year ment at upcoming travel plans not only raise awareness but (six issues), including taxes: Canada $38 (HST); to help vulnerable people on also lead to earlier diagnosis Outside Canada: $45. Printed with vegetable-based inks on recycled paper (50 per cent recycled and another continent, to sadness and better treatment of the 20 per cent post-consumer fibre) on acid-free paper. and frustration around issues of disease. She told me that when Registered Nurse Journal is published six times a suicide and workplace injury. she started to talk to colleagues year by RNAO. The views or opinions expressed in the editorials, articles or advertisements are those It’s not easy to open up your at the AGM about how her of the authors/advertisers and do not necessarily personal life to people you experience led to the resolu- represent the policies of RNAO or the Editorial Advisory Committee. RNAO assumes no responsibility don’t know, and I’m truly tion, she got hugs and thanks or liability for damages arising from any error or moved and appreciative of from people who didn’t realize omission or from the use of any information or advice contained in the Registered Nurse Journal those who do it. In most cases, the extent of the problem. Her including editorials, studies, reports, letters and it’s to raise awareness of an interactions, she said, made advertisements. All articles and photos accepted for publication become the property of RNAO. issue that needs attention. And her realize her vulnerability Indexed in Cumulative Index to Nursing and Allied Health Literature. real-life stories are the best way was worth offering up. to get that attention. These personal anecdotes are CANADIAN POSTMASTER Undeliverable copies and change of address to: During the keynote presenta- vital to the stories we tell in this RNAO, 158 Pearl Street, Toronto ON, M5H 1L3. Publications Mail Agreement No. 40006768. tion on the last day of our magazine. We need real people AGM, Louise White stepped up with real experiences to help us RNAO OFFICERS AND SENIOR MANAGEMENT Angela Cooper Brathwaite, RN, MN, PhD to the mic and told a room of personalize bigger issues. Each President 300+ people about her family’s first-hand account helps others Carol Timmings, RN, BScN, MEd (Admin) Immediate Past-President experience with addiction. It’s realize that some of the most Doris Grinspun, RN, MSN, PhD, LLD(hon), Dr(hc), hard to imagine the courage complex health and health-care O.ONT, Chief Executive Officer, ext. 206 that takes. And she continues issues come down to real people Nancy Campbell, MBA to share her story in this issue and real lives. There’s no better Director, Finance and Administration, ext. 229 Daniel Lau, MBA (page 12) and through speaking way to impact policy and Director, Membership and Services, ext. 218 engagements and online decision-making than by Louis-Charles Lavallée, CMC, MBA forums in hopes it will help bringing these stories forward. Director, Information Management and Technology, ext. 264 other families dealing with the Thank you to all who are Marion Zych, BA, Journalism, BA, Political Science same harsh reality that willing to open up to help others. Director, Communications, ext. 209 addiction does not Your generosity has not gone discriminate. unnoticed. RN

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4 MAY/JUNE 2018 PRESIDENT’S VIEW ANGELA COOPER BRATHWAITE

My pledge: to support, serve and advocate

It is a privilege and honour to An important part of advo- have already elected a new to mention RNAO’s robust serve as RNAO’s 55th president. cating for patients is recognizing government. However, that does professional liability protection, When Carol Timmings passed Ontario’s diversity. Based on my not change our resolve or our which is included as a benefit of the ceremonial gavel to me clinical observations, we can do a approach to our policy and membership, and the Legal during RNAO’s annual general better job delivering culturally political action. We will continue Assistance Program (LAP), which meeting (AGM), I pledged to competent care. When the care to engage all parties to ensure we can each choose to join. support, serve and advocate. That we provide matches a patient’s or all our recommendations We are 41,130 members is my motto for my presidency. resident’s perception of their become policy. strong and growing. It’s my For those of you who don’t know me, I am sharing a bit of “w e are 41,130 members strong and growing. my journey from the bedside to the boardroom. I began my it’s my goal to have 45,000 members by the end of my career in clinical practice, presidency in 2020.” working in different sectors and different roles, including public health problems, incorporates Together with our board of goal to have 45,000 members health and primary care. their individual beliefs and directors and CEO, I will support by the end of my presidency in Following two decades on the practices into care planning, and you in advancing nurses as 2020. We can do it. And I want front-lines, I became an educator meets their expectations for members of a vital, knowledge- you to join me in achieving this and researcher. I was a member treatment, nurses are providing driven, caring profession and important target. of RNAO’s board of directors culturally competent care. significant contributors to health. Together we will build a from 1996 to 1998 and returned If you are not familiar with We will do this by continuing to stronger-than-ever RNAO and a in 2014 as member-at-large for RNAO’s best practice guideline advocate for adequate numbers stronger-than-ever Ontario. nursing research. In 2017, I was Embracing Diversity in Health of RNs and NPs, and ensuring all Together we will resolve voted in as your president-elect. Care: Developing Cultural practise to their full scope. problems and issues. These experiences – past and Competence, I encourage you to During my presidency, I will Together we will make a present – have allowed me to read it. And if you are conducting also continue to do what I have difference in the health-care witness first-hand RNAO’s clinical research on patients or always done: promote the value system and society. monumental and inspiring families, I encourage you to of belonging to RNAO, the We know we can do it because transformation from a relatively include culture as a variable in strongest professional associa- we know our collective voice has quiet organization to a your studies. Adding culture to tion. We all have a role to play in already made a difference. powerhouse. research studies provides a stimulating membership, and we Let’s move forward with the Throughout my career, I have comprehensive approach and can achieve this together by same determination that has been aware that leadership is key improves the credibility of encouraging colleagues, peers, brought us unimaginable to improving patient outcomes. findings. If your organization nursing faculty, nursing success. Let’s show everyone During my earlier role as a lacks cultural competence students, staff nurses, adminis- what a committed and diverse director of nursing, I proposed policies, you may also want to trators, executives, and former group of RNs, NPs and nursing that we use the Association of facilitate the development and members to join RNAO. Nursing students can achieve. Women’s Health, Obstetrics and implementation of them in your professors and instructors should Let us continue to be coura- Neonatal Nurses’ standards to work settings. also encourage their graduate geous, strong and a force to be increase the budget, ensuring Another way we can advocate nursing students to keep their reckoned with. RN adequate staffing in the hospital’s for patients is to continue RNAO membership and stay maternity unit and positive health speaking out about the policy engaged in the association. Just angela cooper brathwaite, rn, mn, outcomes for new mothers. Every recommendations outlined in think about the camaraderie, phd (admin), is president of rnao. nurse has the power to be a our election platform, Improving life-long friendships, professional leader simply by advocating for health for all. By the time you read growth, and opportunities to Follow me on Twitter @angelacooperbra their patients. this, the people of Ontario will influence policy and practice, not

REGISTERED NURSE JOURNAL 5 CONVERSATIONS WITH MEMBERS DORIS GRINSPUN

Members propel RNAO forward as a social movement

You may notice the name of my This increased involvement bigger than any of us. It needs more power as an association, column has changed from CEO represents a tipping point for to be about members and the we need to keep in mind the Dispatch to Conversations with RNAO. We have more and people they serve. end goal. This is not about members. As you read on, you more members joining, and RNAO already attracts so building power at RNAO for will begin to understand the more and more members who much attention from nurses, the sake of RNAO. This is thinking behind this change, are actively engaging in politicians, the public and the about building power for the and hopefully you will become activities. Comments like media. This is because we take sake of the people we serve. as fond of this new title as I am. “…it’s difficult to move this on difficult issues that others And, with that power comes Recent developments at chapter” or “I don’t have an may shy away from: minimum the opportunity for change that RNAO are behind this title executive,” are behind us, and wage and social assistance; care makes a difference for the change. When I met with staff health of people, the health and our board of directors to care Ontarians receive, and the discuss specifics for this year’s “i am inspired by powered members who health of nurses. annual general meeting We are building a social (AGM), I began to take note of are in-turn powering rnao as a whole, movement that can be over- some developments in 2018 propelling our association forward whelming at times because it can that I have not seen in previous feel like it takes on a life of its years. One example: we had like never before.” own. And that’s okay. RNAO 187 consultation representa- members are driven when it tives register for this year’s comes to tough and sometimes event. In the end, despite life’s this is thanks to an activist co-ordinators in primary care; controversial issues. The theme hurdles and less-than-desirable board, an energetic assembly, independent RN prescribing; for this year’s AGM was weather, a total of 149 consul- and 41,130 members who own medical assistance in dying Powering nursing to advance tation representatives RNAO and propel it forward. (MAID); cannabis; nurse health. And I am inspired by participated on April 20, which I witness this vibrancy every practitioner-led clinics; NP powered members who are marks a 15 per cent increase time I have the privilege of admit, treat and discharge in in-turn powering RNAO as a from last year and an unprece- visiting members. In partic- in-patient hospital units; whole, propelling our association dented number for RNAO. We ular, the enthusiasm was attending NPs in nursing forward like never before. also had 13 resolutions palpable during this spring’s homes; calling for public This brings me back to the approved for discussion at the Nursing Week visits to inquiries, as we did when we name change for my column. AGM, which is the same Humber River Hospital, learned of the devastation caused To fully power members, we number of resolutions as the Trillium Health Care, and by former RN Elizabeth must continue to engage in last two years combined (see SickKids. The positive buzz Wettlaufer’s crimes; and courageous conversations about page 13 for our AGM coverage). from clinicians and managers securing standing at the policy change and gutsy advocacy Our director of membership, has reinforced for me that we Wettlaufer inquiry, as well as the that matters. These “conversa- Daniel Lau, also shared with me need to write a second book Supreme Court hearing to save tions” are fuel for our work going that for the past few months, together (our first was released Insite, the first legal supervised forward. Let me know what you Carrie Edwards, senior in May, see page 11) that focuses injection site in North America. think. Email me at dgrinspun@ membership and services on RNAO as a social movement These are issues we bring to RNAO.ca RN co-ordinator, and Patricia Hogg, that powers nurses to improve the forefront because they are project co-ordinator, have health for all. important to nurses and to the doris grinspun, rn, msn, phd, lld received more requests than As we continue to move this patients we serve. We repre- (hon), dr(hc), o.ont, is chief ever before to notify members forward, we must remember sent nurses’ collective voice executive officer of rnao. that their interest group and/or there is one caveat with this and we must be loud. chapter is hosting a local or type of social movement. It As we continue to take on Follow me on Twitter @DorisGrinspun specialty event. needs to be about something these tough issues and amass

6 MAY/JUNE 2018 NURSINGCONTINUED NOTES

Susan Gapka receives a key PPE council member gets to the city from Toronto Mayor John Tory on May 17. key to city of Toronto

Susan Gapka, a trans rights activist and member of RNAO’s Patient and Public Engagement (PPE) council, received one of seven keys to the city from Toronto Mayor John Tory on May 17. She is the first transgender person to receive this honour. Gapka came to Toronto as a teenager and spent 10 years living on the street. She volunteered for Parkdale Com- munity Health Centre’s street outreach program 30 years ago while homeless, and became a member of its board of directors 10 years later, after finding housing. In this role, she helped create the first community based methadone clinic in Ontario. She founded the Trans Lobby Group, which lobbied for public funding for transition-related surgeries, as well as amending the Ontario Human Rights Code to include ‘gender identity’ and ‘gender expression.’ “This, hopefully, is a metaphor that we can use this key to provide opportunities to those who lack access to a decent home, good health care, transportation, or food,” Gapka says. “I’m hopeful that this may help achieve some of that.” RNAO was on-hand May 17 to celebrate Gapka’s recognition from the city. As a member of the association’s PPE council, RNAO looks to Gapka and others for insight on patient, family caregiver, and public engagement. This insight informs the organization’s overall goals, including its healthy public policy work. The council is comprised of members of the public as well as health-care providers. Its goal is to focus on the patient lens of health care to help shape RNAO’s values. To find out more about the council, visit RNAO.ca/resources/RNJ and read our feature article about the initiative in the Jan/Feb 2018 issue (page 22).

RNAO leaders the letter reads. It mentions Saskatchewan nurses helps to reduce the stigma send letter Miranda Lamb, a team leader produce documentary associated with HIV/AIDS. of thanks in the emergency department about AIDS According to the Public Health In the aftermath of a deadly who told the media: “Every- A documentary about HIV/ Agency of Canada, in 2015 van attack that took place in the body just went into the roles AIDS in Saskatchewan was Saskatchewan had an HIV north end of Toronto on April they needed to go into… recently released with support diagnosis rate of 14 per 100,000 23, Sunnybrook Health Everybody was on task. We from the Saskatchewan Union people compared to a national Sciences Centre received were in our bubble.” of Nurses (SUN). Saskatchewan average of 5.8 per 100,000 trauma patients injured in the “Their capacity to respond has the highest rate of HIV and people. Saskatchewan’s ministry attack. RNAO President Angela quickly and calmly with stellar AIDS in the country. The film, of health report, HIV Prevention Cooper Brathwaite and CEO expertise and competency in which showcases the work of and Control 2016, shows the rate Doris Grinspun sent a letter of the midst of a most difficult Saskatchewan RNs to combat of infection is higher in thanks to Sunnybrook staff situation – for all staff, the disease, is important, Indigenous populations, where for their quick response to especially direct caregivers, according to SUN, because 79 per cent of those diagnosed the tragedy. including our nursing many of its members are on the with the disease in 2016 self RNAO “…takes great colleagues – is simply frontlines of the epidemic. The identified as Indigenous. Visit inspiration, energy and pride inspiring,” the letter continues. union is supporting the work YouTube.com and search in your work and wants to Read the full response at because it sheds light on the “Saskatchewan nurses on the acknowledge it publicly…” RNAO.ca/Sunnybrookletter reality of living with HIV. It also front lines” to watch the film. RN

REGISTERED NURSE JOURNAL 7 RNs, NPs, AND NURSING STUDENTS WEIGH IN ON… NURSING IN THE NEWS BY VICTORIA ALARCON

Nurse to the rescue

When RN Rachel Barlow began watching her son’s hockey game at Burlington’s Central Arena on Friday, April 13, she did not expect to be called to the bench to look at a laceration on one of the player’s noses, then to hear shouts from the ice that someone was down. “I turned around to see the ref (Jean-Paul St. Jules) face down on the ice and not moving,” Barlow recalls. She bolted onto the ice, and when she reached him and turned him over, he was unresponsive with his eyes wide open. “I felt…for a pulse and it was very weak,” Barlow recalls. The team trainer, who is also a firefighter, started to RN Rachel Barlow (second from left) comes to the rescue of her son’s ref Jean-Paul help by cutting St. Jules’ shirt off, while Barlow began chest St. Jules (middle) with the help of Nick Finelli (left), Ryan Stewart (second from right) compressions. After two rounds of CPR, someone brought over and Mark Commisso. a defibrillator. Placing the pads on his chest, the trainer shocked the man before beginning chest compressions again. EMS arrived soon after. By the end of the night, St. Jules, who had suffered a heart attack, was in stable condition in hospital. Although hailed as a hero by others, Barlow says she doesn’t feel like one. “It’s what we do as nurses.

PHOTO: CHRIS CHARD I consider myself extremely fortunate to be able to help people in their most vulnerable state.” (Burlington Post, April 17)

Connecting families, compiled from a survey of the Despite the pressure of creating supportive Oxford County LGBTQ Commu- overseeing a team of nurses that communities nity, found 85 per cent of those sometimes exceeded 250, Fedec To help parents and families of who disclose their sexual was determined to help the LGBTQ+ youth and adults, the orientation reported their parents thousands who relied on the Oxford County Rainbow were somewhat or very support- hospital, and whose situations Coalition has formed a support ive of them. “I felt that was were often quite tenuous. “I group that meets once a month. something to work with,” Milne really encourage people who are “I feel there is a need for a group says. “We do need to include interested (in travel nursing) to such as this in our community, parents in the conversation and have a look and see how they can where people can feel very provide tools to be more contribute, whether it’s donating isolated in their experiences and supportive.” The group meets (to a cause) or applying have limited access to resources once every month. Find out themselves (to travel),” says due to the size of our communi- more at Oxford County’s Fedec. (Sudbury Star, April 15) ties,” says Gayle Milne, public Rainbow Coalition Facebook Fedec oversaw nurses as well health nurse and chair of the page. (Woodstock Sentinel-Review, as some of the paramedical Good mental health, coalition. The group connects March 29) activities such as the lab, pre- and post-partum parents and families of LGBTQ+ pharmacy and supply. At a camp In honour of World Maternal youth and adults with other Sudbury nurse in Bentiu, South Sudan, she Mental Health Day on May 2, families that have similar helps refugees helped care for a population of dozens of expectant and current experiences. They also provide On a mission to help the world’s refugees that had surpassed mothers, along with their kids, opportunities for building peer most vulnerable people, Sudbury 130,000, and continues to grow headed to Orillia Soldiers’ support systems as well as RN Julia Fedec spent one year in today. “What we focused on in Memorial Hospital to support educational opportunities. “I am the Democratic Republic of the hospital was emergency care, one another. Jaime Charlebois, very excited to see this group Congo and then six months in so everything from pediatrics the perinatal mood disorder evolve and grow,” Milne says. South Sudan. In collaboration and malnutrition to maternity co-ordinator at the hospital, and A report, released in 2017 and with Doctors Without Borders, and obstetrics,” Fedic recalls. one of the event organizers, says

8 MAY/JUNE 2018 NURSING IN THE NEWS BY VICTORIA ALARCON

one in five women is affected commented on Ontario PC attendance for the opening Nurses fail on physical during pregnancy (or in the year Leader Doug Ford’s absence at ceremonies on April 19, activity guidelines that follows) by perinatal mood the 93rd Annual General sharing her party’s election Whether it’s in the morning, disorders that vary in severity Meeting (AGM) in April. platform, including a promise afternoon or evening, Lesli and manifest in different ways. “Nurses were expecting him to to double the annual funding Richmond, an RN of 30 years, Diagnoses range from anxiety to come. We knew that he may for First Nations housing, and says she is on the road driving depression, and in rare not be able to (and) we to build 30,000 supportive to see clients or busy with instances, psychosis. “Our rates understood Jeff Yurek was housing units. (April 20) paperwork, leaving little time in north Simcoe/Muskoka are going to come (in his place), for exercise. “I’m usually in my seven per cent higher than the but he was a no-show,” says Beating cancer car (at) about 7:30 in the provincial average,” Charlebois Grinspun, adding that every Known to her pediatric morning, and I’m usually on notes. She suggests the high single year the leader of the oncology patients as Patty the road until six at night,” says rates may be related to poverty, opposition has come to Cakes, Patty Jansen has worked Richmond. “Then at night, I and also isolation as a result of RNAO’s AGM. Then premier as a nurse for more than three usually do anywhere from two limited transportation in some Kathleen Wynne attended the decades at Kingston’s Cancer to four hours of paperwork. So areas. “Our moms and new event on April 20, making Centre of Southeastern Ontario, I don’t get a lot of chances for families are determining the several health-care announce- a place she calls her second exercise.” Richmond’s health of our new generations, ments, including news of home. “I always say: Here, we experience is not unique and we need to provide…more funding for a wound care spend about this much time on among nurses. According to a support,” Charlebois adds. centre of excellence, which cancer,” she says as she holds study published in the (BarrieToday.com, May 2) RNAO will lead, and funding her fingers a couple of centime- International Journal of Nursing for an RNAO program that will tres apart. “The rest of the time Studies, 77 per cent of hospital PC representative offer pre- and post-natal care is making sure the family has… nurses do not meet current missing from for Indigenous women in all of the supports they need so physical activity guidelines, AGM line-up communities affected by they can look after their child which recommend 150 In an interview with CP24, tobacco use. NDP Leader and they can be here for them.” minutes of moderate to RNAO CEO Doris Grinspun Andrea Horwath was also in Jansen, along with her col- vigorous activity a week. leagues, helps families navigate “We’re tired, and we’re the winding and often long road stressed, and we’re burning of treatment, including taking out,” says Richmond, who, as a time off work, finding financial former acute care nurse, is not resources, making sure their surprised by the results. loved one’s life stays as normal According to the co-author of as possible, informing and the study, Jennifer Reed, the caring for other family lack of activity puts nurses at members, and much more. greater risk for cardiovascular Although children often disease. With that are risks for respond to cancer treatment obesity and high blood better than adults, with fewer pressure. To combat this, side-effects, 15 per cent do not Richmond says workplaces, make it. The centre is hoping senior management, and that, with effective screening policy-makers need to be aware processes and new research of the issue, and need to advancements, cancer will one develop strategies where

PHOTO: FRANK MATYS/METROLAND day be viewed as curable. physical activity is part of the

Jaime Charlebois, a perinatal mood disorder co-ordinator in Orillia, helps to (Kingston Whig-Standard, daily routine. (CBC News, organize an event to raise awareness of World Maternal Mental Health Day. April 27) May 8) RN

REGISTERED NURSE JOURNAL 9 Nursing Week 1 2018 Nurses across the province celebrate the profession with activities in and around 2 their own communities and workplaces...

Shining a spotlight on BPSOs Five RNAO Best Practice Spotlight Organizations (BPSO) hosted events for Nursing Week to celebrate the work of champions across the province implementing best practice guidelines (BPG). (PHOTO 1) IABPG Associate Director Heather McConnell (left) was at St. Michael’s Hospital in Toronto on May 8 to participate in its poster walk and to con- gratulate the hospital for being one of the BPSOs to implement the most BPGs. (PHOTO 2) Stephanie Kim, RNAO long-term care co-ordinator for LHIN 11-Champlain (centre), was at Perley and Rideau Veteran’s Health Centre in Ottawa on May 7 to chat with residents about their knowledge of best practice, and how it impacts their care.

Nurses take their politicians to work

To celebrate Nursing Week, and for a MPP candidates from three of the major parties visited Mississauga’s Credit Valley Hospital on May glimpse of life on the frontlines, 50 10. PC candidate Nina Tangri (second from left), Liberal candidate Bob Delaney (second from right) and Green Party candidate Abhijeet Manay (right) joined RNAO CEO Doris Grinspun (centre) for a politicians participated in 35 site visit with nurses on a surgical unit, including Nicole James (left) and Dian Williams (third from left). visits with nurses across Ontario.

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Celebrating the 2018 Nightingale Awards (PHOTO 5) Once each year, the Toronto Star honours an Ontario nurse with its Nightingale Award, handed out at RNAO’s career expo during Graduates mark milestone with visit from RNAO president Nursing Week. Taking home the honour this year was Sue Coffey (sec- ond from right), associate professor at the University of Ontario Institute (PHOTO 4) RNAO President Angela Cooper Brathwaite (second from right) offered a of Technology (UOIT). In addition to the top prize, several nurses are rec- keynote presentation to graduates of the CARE Centre for Internationally Educated ognized as honourable mentions. This year, those honourees were (from Nurses on May 11. Pictured (at left and right, respectively) are graduates Marie left) Holland Bloorview Kids Rehabilitation Hospital RNs Caron Gan and Antonette Maceda and Ian Lacamento, as well as CARE Executive Director Ruth Catharine Petta, and Karen Smith, a patient care manager at the Ross Lee, one of this year’s RNAO Lifetime Achievement Award winners. Tilley Burn Centre, Sunnybrook Hospital.

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Declaring Nursing Week Celebrating RNAO’s in Sudbury first book launch (PHOTO 6) Members of RNAO’s (PHOTO 3) Irmajean Bajnok (seated), for- Sudbury chapter hold the formal mer director of RNAO’s IABPG program, declaration of Nursing Week visited Humber River Hospital on May 7 2018 with (from left) Brian Big- for a book signing following the release ger, Sudbury’s mayor, Paul-André of Transforming Nursing Through Knowl- Gauthier, local executive member edge, which she co-authored with RNAO and chair of the chapter’s plan- CEO Doris Grinspun. Although the book ning committee for Nursing was available in April, there were several Week, Suzèle Jambakhsh, Local book signings during Nursing Week, and 2 Ontario Nurses’ Association an official launch party at RNAO home (ONA) representative, and David office on May 10. Groulx, chapter president.

Premier Kathleen Wynne (right) and RNAO CEO Doris Grinspun (cen- NDP candidate Jennifer French (right) attended a Durham-Northumberland tre) speak with a mother during a visit to the Hospital for Sick Children breakfast meeting on May 11. She met with local members Rhonda (SickKids). Wynne made an announcement during that visit that her Seidman-Carlson (lower left), Marianne Cochrane (upper left), and Mary government is committed to hiring 3,500 more nurses, including Lynch (upper right) to discuss RNAO’s platform, Improving health for all and 2,500 in hospitals, and one additional RN in each long-term care home. hear their experiences working in Ontario’s health-care system. RN

REGISTERED NURSE JOURNAL 11 RN PROFILE BY VICTORIA ALARCON

FAR from home PERSONAL EXPERIENCE LEADS RN ON PATH TO HELP FAMILIES COPE WITH ADDICTION.

At toronto’s mount sinai along the way. After six months, her husband, who took a job in bed,” she says, adding she felt Hospital, RN and lactation White left Ottawa for a position London, England. isolated, judged and stigma- consultant Louise Lemieux at the Hospital for Sick During her break from tized because addiction is seen White reviews the chart for a Children (SickKids) in Toronto nursing, White focused on her by many as a moral failing. new mom who has just had to expand her knowledge in growing family and reassessed Desperate, White found a her first baby and is struggling neonatal surgery. what she wanted to do residential treatment centre in with breastfeeding. It says she “It was a higher level of illness professionally. She knew she the U.S, and sent her daughter uses cannabis. and intensity of care,” she says, wanted to continue working away to begin her recovery. She “Five years ago, I would have noting one aspect of the role was with babies and parents, but has been drug and alcohol free ignored that. I was naive and to develop relationships with the also believed she had a gift for ever since. feared what I did not know,” Something needed to be White admits. But today, done about the lack of support knowing what she knows about for parents in the same addiction, she decides to address Three things you situation, she says. That’s why, her patient’s drug use and listen didn’t know about in 2016, White and Angie to her story. In 2014, White’s Louise White: Hamilton, a parent whose son then 14-year-old daughter was 1. She’s an avid had a similar experience, struggling with an addiction to tennis player. teamed up to form the drugs and alcohol, and needed 15 2. She loves to travel grassroots Canadian registered months of treatment to get to a to the UK. charity, Families for Addiction place where she would not need Recovery (FAR). Their goal is 3. She has a five-month-old to self-medicate to relieve her Portuguese Water Dog to support families and protect emotional pain. named Indie. individuals, particularly youth “Having that knowledge and and young adults. They want to empathy allowed me to have that change the face of addiction by conversation (with my patient),” ending stigma and advocating says White, who approached the parents of the infants she cared teaching. In 2003, now back in for evidence-based treatment. woman with a sense of under- for. Despite learning a lot in her Canada, she became a certified “(We would like) to bring standing, not judgment. position, she knew additional childbirth educator and began awareness and be a movement White credits the experiences education would help her to teaching at Mount Sinai for social change,” says White. in her own personal life that have provide better support to parents. Hospital before earning her At 53, White now balances allowed her to become the nurse In 1989, White left SickKids to certification as a lactation her work as a lactation consul- and person she is today. And pursue her BScN at McMaster consultant in 2006. tant with her busy schedule she’s not afraid to talk about University, working part-time at It would be less than 10 years advocating for an open-minded those experiences. Toronto General Hospital on an later when White would approach to individuals with White’s nursing career adult intensive care unit. Two discover her young daughter’s addiction. Supporting parents started in 1986 after gradu- years later, she graduated and drug and alcohol addiction. “In and families is a big part of ating from the French Nursing accepted a position as case a few months, we were facing a what she does as the co-founder Diploma Program at Algon- manager for a Toronto home- daughter who did nothing but of FAR. quin College in Ottawa. She care organization. In that role, look for her next fix,” White “I’ll keep on that slow road to began working in the surgical she oversaw nurses and services explains. “When we were progress and see what happens… infant unit at the Children’s for clients who required in-home seeking some help in our because I know I can make a Hospital of Eastern Ontario. care. But the position was province and in our city, we difference,” White says. RN She treated everything from short-lived. She put her career on found that there wasn’t any. wounds and burns to tumours, hold in 1992 to begin her family. There were long wait lists... victoria alarcon is editorial learning a lot about infant care Shortly after this, White followed over a year for a residential assistant for rnao.

12 MAY/JUNE 2018 AGM2018 Powering nursing to advance health

BY KIMBERLEY KEARSEY PHOTOGRAPHY BY VICTORIA ALARCON, ALICIA SAUNDERS, MARION ZYCH

Premier Kathleen Wynne (centre) takes a moment to chat with members following her address and subsequent Q&A on April 20. Powering nursing to advance health

tephanie Bowa and Charlie Baraluk, first- and third- year nursing students at UOIT and Sault College, respectively, may be studying in different parts Sof the province, but they, like more than 700 other RNAO members from diverse settings, found common ground when Stephanie Bowa (right) and Charlie Baraluk were the two student finalists who received they came together in April for RNAO’s an all-expense-paid trip to attend the AGM from HUB International. 93rd Annual General Meeting (AGM). Hinting at the theme for this year’s event – Powering nursing to advance Tigges, added to the celebrations. Both Ontario NDP Leader Andrea health – Bowa and Baraluk, who were congratulated RNAO for its contributions Horwath shows off her copy of Transforming Nursing finalists in a contest to attend the AGM for to nursing, health and heath care at home Through Knowledge, the free (sponsored by affinity partner HUB and abroad. Kennedy also urged Ontario to just-released book about the evolution of RNAO’s best International), say they left the experience stop replacing RNs with lesser prepared practice guidelines program. feeling motivated to learn more about the health providers. She and other guests at the opening ceremonies received impact they can have on the profession by Visitors from Nova Scotia, Belgium, China, a copy. getting involved in their professional Colombia, Jamaica and Spain were an association. In fact, Baraluk says his important part of the opening procession. involvement this year has inspired him to Each raised their flags as they were recog- consider applying for the student position nized among the newest 14 Best Practice on RNAO’s board of directors next year. Spotlight Organization (BPSO) designate The enthusiasm of these young nursing organizations. They were joined students was unmistakable, and so too was by established designates from the spirit of the large crowd of RNs, NPs Australia, Chile and Italy.

and nursing students who signed up to Things wrapped up on April 21 with ARCHIVES PHOTO: RNAO attend the AGM. The association hit a few a compelling panel discussion about record numbers with attendance overall, cannabis, and the future of nursing with more consultation representatives practice with the legalization of the than ever before, and with more than a drug. The panelists (see photo on dozen resolutions up for discussion. page 20) provided unique perspec- The energy of invited guests was also tives, followed by a Q&A that palpable. Then Premier Kathleen Wynne, touched on the need for education, NDP Leader Andrea Horwath, and Liberal and some of the ethical questions MPPs John Fraser and David Zimmer around the new legislation. participated with the same enthusiasm we Moderated by RNAO CEO Doris see from politicians each year at the AGM. Grinspun, the panel made for a A powerful video from Annette Kennedy, perfect ending to the event. president of the International Council of For these and other highlights Nurses (ICN), and a moving letter from from AGM 2018, visit RNAO.ca/ Sigma Theta Tau International Honor AGM-live for a collection of videos Society of Nursing president Beth Baldwin and photos not featured here. RN

14 MAY/JUNE 2018 Powering nursing to advance health AGM2018

David Zimmer, then minister of Indigenous relations and reconciliation (left) and Bob Bell, deputy minister of health (right), join the opening ceremonies with RNAO’s then-president Carol Timmings and CEO Doris Grinspun (left and right, respectively).

Undergraduate nursing student associates (from left) Vigne Sridharan, Saepom Cho, Alysha Mattos, and Megan Pople settle in for the start of AGM 2018.

(L to R) Former provincial chief nursing officer Kaiyan Fu, former RNAO IABPG director Irmajean Bajnok, and RNAO past-president Gail Paech socialize and network at the President’s Banquet on April 20.

Attendees at the President’s Banquet grab fun mementos from the photo booth for a quick picture before dinner.

REGISTERED NURSE JOURNAL 15 Designates celebrate milestone

ourteen of RNAO’s newest Best Practice Spotlight Organization (BPSO) designate organizations joined the F procession at the AGM opening ceremonies to receive formal recognition for their commitment to evidence-based practice and implementation of best practice guidelines (BPG). Designation as a direct or host BPSO comes with RNAO support, mentorship and consultation on BPG dissemination, implementation, uptake, sustainability and evaluation. To find out more about the association’s 125 direct BPSOs and seven host BPSOs, together representing 700 health-care and academic organizations, visit RNAO.ca/BPG/BPSO… Résidence Saint-Louis Renfrew Victoria Leeds, Grenville & Lanark Residence (Bruyère), Ontario Hospital, Ontario District Health Unit, Ontario

The UWI School of Nursing, Mona, Jamaica

Pioneer Ridge, Ontario

Scarborough and Rouge Hospital, Ontario

16 MAY/JUNE 2018 Designates celebrate milestone AGM2018

La Universidad Autónoma de Renfrew Victoria Bucaramanga (UNAB) - Hospital, Ontario El Programa de Enfermería, Colombia Investén-isciii, Spain (Host)

Southlake Regional Health Centre, Ontario St. Francis Xavier University, Nova Scotia

University of Antwerp, Department of Nursing and Midwifery, Belgium

Beijing University of Chinese Medicine, School of Nursing & Dongzhimen St. Joseph’s Care Hospital, affiliated with the Beijing Group, Ontario University of Chinese Medicine, China

REGISTERED NURSE JOURNAL 17 And the award goes to…

RNAO’s annual Recognition Awards were handed out to members who are passionate about their professional association and are regarded as strong and inspired leaders. Read their full biographies at RNAO.ca/recognitionawards…

Sarah Ellis, chief nursing officer and BPSO This year’s Leadership Award in Nursing lead at Grey Bruce Health Unit, and winner Research was presented to Doris of the 2018 Leadership Award in Nursing Howell (below, left) for her extensive work Administration, says everyone has the capacity to help cancer patients improve their health to be a leader with the right support and while living with and beyond their disease. encouragement.

Sheila O’Keefe-McCarthy, recognized in April with the Leadership Award in Nursing Education (Academic), says being an educator means learning as much from her students as they learn from her.

For Gillian Strudwick, who has mentored a variety of nurses, from RPNs to RNs, advanced practice clinicians, managers, specialists, and nursing students, the Leadership Award in Nursing Education (Staff Development) was a welcome surprise.

Interest Group of the year Marilou Gagnon helped open and operate a pop-up overdose prevention site in Ottawa In less than three years, RNAO’s Ontario Correctional Nurses’ Interest (the first in Ontario). Her continued efforts to Group (OCNIG) has grown from 113 members to 579. “We’ve done an speak out about supervised injection services, incredible job…sharing our concerns, our knowledge, and our expertise harm reduction and HIV have led to this year’s with correctional decision-makers,” says its president Shirley Kennedy. Leadership Award in Political Action. Those efforts were acknowledged with the 2018 Interest Group of the Year award. On hand to celebrate were OCNIG members (L to R): Angela DiMarco (president-elect), Natania Abebe, Vanessa Mesaglio, Nancy Zuliani, Amber Mahoney, Kennedy, Rosemary Galbraith, Maggie Northrup, Nicole Baker and Wence Asonganyi.

Claudette Holloway’s Leadership Award in Student Mentorship is the culmination of 25 years of nursing experience through which the former RNAO board member says she realized mentoring students of all ages strengthens her own nursing career.

RNAO’s 2018 Student of Distinction award went to Gwendolyn French, a Brock University student who does not shy away from speaking out at RNAO events about social determinants of health and health equity.

18 MAY/JUNE 2018 And the award goes to… AGM2018

Chapter of the Year

According to Irene Molenaar, president of RNAO’s Hamilton chapter, the local executive is a powerful team. “We are a force to be reckoned with,” she says. The chapter took home the award for Chapter of the Year. Representing the group at the AGM were (L to R): Lisebeth Gatkowski, Kimberly Jones, Lisa De Panfilis, Chelsey Henderson, Molenaar, Elizabeth Stec, Bahar Ighani and Trish Haycock. President’s Banquet

Five RNAO Recognition Awards were handed out at the President’s Banquet on April 20. (From left) Ruth Lee received one of two Lifetime Achievement Awards, Andrea Zides took home the President’s Award in Clinical Practice, Isabelle Wallace became the newest inductee into the HUB Fellowship program, Paula Manuel received the Award of Merit, and Cathy Crowe was the second of two Lifetime Achievement Award winners. AGM2018

Therefore be it resolved that…

Members discussed and debated 13 resolutions at this year’s AGM. All 13 were carried, and focused on (in order): Lyme disease; spiritual dimensions of care; child and youth mental health; clinical nurse specialists; the cost of caring; psychotherapy and OHIP coverage; health-care professionals and the tort system; support for a northern, rural and remote nursing orientation program; proactive education for dealing with workplace violence for nurses; palliative care as an issue of the public’s health; wound care resources; nursing infrastructure and public-private partnerships; and initiatives to support BScN education at Seven Generation Education Institute, serving learners in north-western Ontario. To read the full text of the resolutions, sign in to myRNAO.ca and click on “volunteer resources.” Links to the resolutions, Carol Timmings (right) stepped down from her role as president and including backgrounders and references, can be found under “volunteer leaders, received an orchid as a gesture of thanks from incoming President consultation representatives.” Angela Cooper Brathwaite at the close of the AGM on April 20.

The closing keynote panel discussion on April 21 brought together knowledgeable and respected voices to discuss The legalization of cannabis: What does it mean for nursing practice? They are (from left): The Honourable Ratna Omidvar, Senator for Ontario; Amy Archer, palliative pain and symptom management consultant for the Victorian Order of Nurses; Colin MacRae, mental health nursing professor in the University of New Brunswick-Humber College collaborative nursing program; and Jann Houston, director of strategic support for Toronto Public Health.

20 MAY/JUNE 2018 Since the beginning of the year, we have been THE LOOK OF exploring how Registered Nurse Journal has changed over the decades. Not only has its look changed, its frequency has as well. In this third part in our series, change we look at how the priorities of the association helped shape the Journal’s content. BY KIMBERLEY KEARSEY

There was a legal issues section published on a regular basis, as well as the new Portrait of Leadership feature, which profiled legends in nursing. These included the likes of Florence Nightingale, Jean Gunn, Florence Emory, Sister Mary Jones, Isabel A. Hampton Robb, and Elisabeth McMaster. Rounding out each issue were feature articles that touched on broader topics such as violence against nurses, liability protection, public health and safety priorities like helmet safety, and even the odd How-To article, in one case about planning an all-candidates meeting or debate. It’s hard not to notice that much of this content is still relevant today. hen The Registered Nurse was re-envisioned in 1989, Watch our next issue for more highlights from the 1990s. RN the member communications cluster – a group specifically created to shape and direct RNAO kimberley kearsey is managing editor for rnao. communication with its members – decided to shift Wfrom a members-only publication – focused on RNAO issues – to a In pictures… publication that addressed a broad range of nursing roles and Magazine photography has advanced by leaps and bounds over the workplace issues. The circulation jumped to 80,000 working nurses in last 20 years. Images in print may have been limited in the 1990s, an effort to attract new RNAO members. By 1991, the cost to produce but here are a few that stood out… and distribute the magazine became too expensive, and the association 1 went back to its focus on member issues, and its circulation of 16,000 members, plus 10,000 non-members. The external publishing company enlisted to produce the magazine worked in close partner- ship with a core group of editorial advisors at RNAO (above). Today, this group is known as the editorial advisory committee, and although the committee members have changed, the mandate has not. The group still plays an important role in critiquing each issue and 2 providing valuable input for future issues. The editorial advisors of the early 1990s stayed true to the vision that the magazine would include more content from members. The RNAO News section was created as a standing feature that could be pulled out of each issue and hung on workplace bulletin boards. This section included chapter and interest group news, details on professional development opportunities, local events, volunteer opportunities, surveys, meeting updates, 1 In February 1992, then board member and chair of the editorial advisors group, event listings, news on meetings with politicians, obituaries, and Donna Rothwell (centre), introduced assembly members to the new magazine editor Bruce McDougall (left) and publisher Jim Davidson. much more. Outside of the bite-sized bits of information in this pull-out 2 At the 1993 AGM, Rothwell (centre), alongside past-president Shauna Fenwick (right) and Deborah Kyle, dressed in Star Trek gear and hosted a presentation that had them section, the magazine’s content focused primarily on research, arriving on earth to help members “boldly go” where none had gone before in their education, administration, and practice issues. There were more strategic vision for the future of RNAO. reference lists, notes and suggested readings than there were photos, although we started to see the inclusion of more colour Find more unique content and photos online at RNAO.ca/RNJhistory images when they did appear.

REGISTERED NURSE JOURNAL 21 Ticking

Lymebomb

Increased awareness of Lyme disease among health professionals will help alleviate some of the suffering associated with the illness. BY DANIEL PUNCH

n tears, Sue Faber pleaded with her family into a heated controversy about the Faber doesn’t recall ever having a tick bite doctor to give her one more chance. nature and transmission of Lyme disease, and or bullseye rash, so it was surprising when “Please,” she implored during a July inspire her to rally together other nurses to her blood test came back positive for Lyme 2015 appointment. “Is there anything advocate for Lyme sufferers. disease. Her doctor was also surprised, telling Ielse you can think of that might be wrong The arrival of warmer weather in Canada her it was almost surely a false positive. But with me?” didn’t always trigger media hype about Lyme when Faber began researching the disease, it For 14 years, Faber, a Burlington RN with disease, an infection reported to be caused by all finally added up. The crushing fatigue that expertise in both emergency and community the Borrelia burgdorferi bacteria, typically made her collapse after coming home from case management, had struggled with transmitted to humans via tick bites. Until the work, the pain that migrated all over her body, mysterious and debilitating symptoms. She 1990s, Lake Erie’s Long Point Provincial Park and the “brain fog” that sometimes made it had seen half-a-dozen specialists who put her was the only area in the country with ticks tough to remember her kids’ birthdays – through every test imaginable. Each one came carrying the bacteria. But rates of Lyme these were all common symptoms. back negative. infection have risen dramatically in recent Faber says she spent the next few months In 2015, she was juggling a part-time years – from 143 in 2010 to nearly 1,000 in dealing with skepticism and outright job, a master’s degree program, and three 2016, according to the Government of dismissal from the Canadian health-care frequently sick young children. She was Canada – and infected ticks have spread system. On the advice of other Lyme desperate for answers. across the country. sufferers, she paid to see an American doctor Reluctantly, her doctor agreed to order Public health authorities are now warning who sent her blood to Germany for testing one more round of blood work. She Canadians to be on the lookout for signs of a that came back positive. Unfortunately, the handed Faber the requisition form, then tick bite, including a round, red “bullseye” Canadian medical community disagreed. She immediately took it back. We may as well rash. A resulting Lyme infection could come was referred to an infectious disease add Lyme disease, she said, since there with symptoms like extreme fatigue, fever, specialist who confidently told her she did was so much hype in the media. headache, heart problems, and issues with not have Lyme disease and recommended Faber admits she didn’t know much about short-term memory. As Lyme becomes more she try yoga and meditation to help Lyme disease at the time, and doesn’t prevalent in Canada, patients and health alleviate her symptoms. remember learning about it in nursing professionals are questioning whether Faber continued advocating and eventually school. She didn’t realize it then, but her education and awareness about the disease a diagnosis of late-stage chronic Lyme disease doctor’s last-second decision was a break- have kept pace. Many Canadian health-care was confirmed by her Canadian infectious through in her long journey toward a providers have little or no experience with disease doctor. She began antibiotic treatment diagnosis. It would eventually lead to patients who have Lyme disease, and the in January 2016, and her symptoms eased treatment that relieved her symptoms, but not two-stage blood test commonly used to almost immediately. She felt hope for the first before she spent thousands of dollars and felt diagnose it has been criticized as inade- time in years that she would get better. she was failed by the Canadian health-care quate by sufferers of the illness, as well as Unfortunately, that hope was short-lived.

system. It would also thrust her and her some specialists. Within six weeks of her treatment ending, the PHOTO: STEF + ETHAN

22 MAY/JUNE 2018 bomb

Sue Faber (left) and Catherine Kinsella pour over research materials to support their ongoing work on Lyme disease. We listen“ to our patients, we advocate for our patients, and we care for our patients. I believe we, collectively, can be a BEACON OF HOPE for Lyme sufferers, and we can also be a VOICE FOR CHANGE.

– SUE FABER ”

Sue Faber (left) has been back and forth to Ottawa to push for change with LymeHope co-founder Jennifer Kravis. symptoms returned. She went back to her groups like the International Lyme and the symptoms could linger for up to a year, Canadian infectious disease specialist hoping Associated Diseases Society (ILADS) that but she was no longer infected with Lyme for another course of antibiotics. Instead, she recognize chronic Lyme disease. According to disease and the treatment was adequate. was told she was cured, the treatment was ILADS, 40 per cent of Lyme patients end up “And that was the end of that. Here I was over, and her symptoms were no longer with long-term symptoms. Its guidelines going downhill without a doctor,” she recalls. caused by Lyme. recommend that health professionals use Fortunately, she wasn’t alone. She found Frustrated, Faber chose to pay for additional their clinical judgment and provide longer- strength at Lyme disease support meetings in antibiotic treatment in the U.S. She has been term antibiotics if needed. the Hamilton area, where she lives and works taking antibiotics on and off since April 2016, Caught up in the “Lyme wars” are people as a research assistant. The meetings were full and says her symptoms have improved to the like Faber and fellow RN Catherine Kinsella. of people with similar chronic symptoms, point where she can function and work In the summer of 2013, after her own rocky many of whom were never officially diag- part-time as an RN care co-ordinator. Though road finally led to a diagnosis, Kinsella was nosed. She was struck by the trouble everyone she feels better, she is dismayed by how prescribed antibiotics to treat the Lyme seemed to have accessing health services in Canadian doctors refused to accept she could disease that – on top of the typical flu-like Canada. “I think we’re decades behind in our have Lyme disease, then refused to believe her symptoms – caused neurological symptoms knowledge about this disease,” Kinsella says. symptoms could be ongoing. associated with bell’s palsy, a condition in Determined to get better, she found a new Faber had stumbled upon one of the which the muscles on one side of your face doctor who continued her treatment, and she most hotly debated questions in health become weak or paralyzed. eventually felt like herself again. She was also care: whether Lyme disease can be a Kinsella suspects she contracted Lyme determined to raise awareness about Lyme chronic illness. while hiking at a provincial park near disease and promote new research so others On one side are organizations like the Kingston in the spring of 2013, ten days wouldn’t have to struggle as she did. Infectious Disease Society of America before she got sick. Warning signs were That passion led her to meet Faber on (IDSA), which publishes popular guide- posted on the trail, so she checked for a tick Facebook in 2016. The pair bonded over their lines for treating Lyme. IDSA bite after the hike. She didn’t find anything. shared desire to research Lyme disease and recommends a single course of antibiotics, Even as a nurse, she says Lyme disease wasn’t advocate for better care. “I knew I had to use saying it will cure more than 95 per cent of on her radar back then. She wonders if her my experiences and my expertise as a nurse... patients. While IDSA acknowledges that disease trajectory may have been different if to help others,” Faber recalls. some patients will have lingering symp- she had more education about it. By that time, Faber had three more reasons toms after treatment, it says there is no Her symptoms improved with treatment, to take up this fight: her kids. While biological evidence to prove the existence and she was able to return to work part-time researching her own illness in November of chronic Lyme disease and advises after months on sick leave. But they returned 2015, she read about studies indicating that against ongoing antibiotic treatment. shortly after finishing her course of untreated pregnant women could pass the On the other side are a growing number of antibiotics. In a follow-up appointment, Borrelia burgdorferi bacteria to their children,

health professionals, patient advocates, and Kinsella’s infectious disease doctor told her causing them various physical and cognitive PHOTO: JESSICA DEEKS

24 MAY/JUNE 2018 symptoms. Could this be why her daughters framework for a new Lyme disease strategy. RNAO,” says chapter president Louela were often so sick? Though it included a significant investment Manankil-Rankin. Like chronic Lyme disease, congenital in research, Faber and Kravis were disheart- In the weeks that followed, Faber, Kinsella transmission is not widely accepted in the ened that none of the issues and concerns and Manankil-Rankin co-authored a medical community. Faber was unable to find they had heard from Canadian Lyme sufferers resolution that urges RNAO to “…advocate, at a doctor in Canada who would test her kids were addressed, including inadequate testing, all levels of government, for Lyme disease because they’d never had a tick bite. Again, alternate modes of transmission, and prevention programs and the rights of all she paid out-of pocket in the U.S., and all persistence of infection. In response, patients with symptoms consistent with Lyme three of her daughters, aged 7, 13 and 15, LymeHope launched a petition that same and/or co-infections to receive evidence- tested positive for Lyme disease antibodies. month on which they’ve since received nearly based, patient-centred care for both acute and Out of options in Canada, Faber paid for 60,000 signatures to get these issues on the multi-systemic chronic presentations of the treatment for her two (symptomatic) government’s agenda. Many people also disease in Canada; emphasizing health-care daughters from a pediatrician in Connecticut. shared their personal experiences in the provider education that acknowledges She says they both improved significantly comments section of the online petition, alternate modes of transmission, persistence within a month of starting treatment, but it allowing Faber to amass more than 14,000 of infection, and integration of a collaborative didn’t come cheap. Between her treatment Canadian Lyme stories. clinical model inclusive of ILADS guidelines and her daughters’, the family has spent more In the spring of 2017, Faber and Kravis in the treatment of this illness.” than $40,000. Faber recognizes she is lucky went back and forth to Ottawa three times The resolution was carried on April 20. to have had the option to pay out-of-pocket. with binders full of these personal stories. “I’m so proud to be part of a profession that Not every family can afford that kind of care. They shared them in meetings with MPs supported me and lifted me up,” Faber says, Knowing this strengthened her resolve to do and were invited to speak as witnesses at noting that several colleagues at the AGM whatever she can to improve Lyme care for all the Parliamentary Standing Committee on approached her with hugs and thanks for Canadians. Health. Around that time, Faber and bringing the resolution forward. In January 2017, Faber met with then Kinsella also met two RNAO colleagues Both Faber and Kinsella will continue to federal health minister Jane Philpott to share who suggested the association could help work on Lyme disease research. Faber also her family’s story. Inspired by that meeting, get the message out: CEO Doris Grinspun meets regularly with government and public she started the “Lyme letters” campaign, and Halton chapter executive member health officials, and attended a roundtable reaching out on social media to encourage Opal Robinson. Grinspun encouraged discussion on Lyme disease with federal MPs people from across the country to send her them to write a resolution about Lyme in May. Both nurses say they are hopeful a their stories about Lyme disease and their disease for the next annual general shift in policy is on the horizon. struggles with diagnosis and care. Letter after meeting (AGM) and Robinson invited If things are going to get better for letter came to her doorstep, and her inbox Faber to share her story at the chapter’s Canadians with Lyme disease, Faber says flooded with emails. Within a few months, November meeting. nurses will be a critical part of the solution. she amassed 2,700 personal stories. It was Nurses at that meeting were alarmed by the “We listen to our patients, we advocate for around this time she teamed up with challenges Faber faced accessing health our patients, and we care for our patients. retired lawyer Jennifer Kravis to create services for her family, and decided to take I believe we, collectively, can be a beacon of LymeHope, a not-for-profit organization action. They voted to support a resolution on hope for Lyme sufferers, and we can also be dedicated to education and outreach on Lyme disease, seeking to raise awareness and a voice for change.” RN Lyme and related diseases. amplify the voice of patients. “We wanted to In February, as the letters continued to pour bear witness to the suffering of these daniel punch, former staff writer for rnao, in, the federal government released a draft patients...and bring their story to the rest of does freelance writing in the u.k.

Consultation representatives at RNAO’s 2018 AGM vote in (L to R): Opal Robinson, Sue Faber, Louela Manankil-Rankin, favour of the resolution about and Catherine Kinsella Lyme disease.

REGISTERED NURSE JOURNAL 25 Ontario’s new chief nurse

Michelle Acorn talks about the “amazing opportunity” she’s been given to have an impact on nursing across the province.

BY DANIEL PUNCH

n January 2018, veteran NP and long-time RNAO member (Getting the job was) surreal. It’s exciting to think about what an Michelle Acorn became Ontario’s provincial chief nursing officer amazing opportunity this will be. At the same time, you can’t (PCNO). She arrived at Queen’s Park with three decades of imagine what it was like to leave Lakeridge Health after 29 years nursing experience in various roles at Lakeridge Health in Whitby and four months. (Working in a hospital), I can make a difference and Oshawa, and a commitment to life-long learning that includes at a clinical level. But I wanted to make a difference from a Ia doctor of nursing practice (DNP) degree from D’Youville College and leadership role in terms of strategic planning and decision four years as a lecturer at the University of Toronto. making. As PCNO, Acorn is tasked with providing leadership and strategic advice to the government and Ontario Public Service RNJ: As an NP, you’re certified in both primary care and adult (OPS) on a wide range of nursing issues. Registered Nurse Journal care. You have also held many leadership roles, and have taught caught up with her to discuss her career, the transition into this nursing at the university level. How will this diverse experience role, and her vision for the future of nursing in Ontario. influence your work? MA: I have experience across all health sectors, including acute Registered Nurse Journal (RNJ): Tell us about why you got and post-acute care in hospitals, primary care clinics, corrections, into nursing. and long-term care. That unique blend of advanced nursing Michelle Acorn (MA): My nursing path was influenced from practice as a clinician, educator, scholar, innovative leader and birth. I was named Michelle after a nurse who made a difference systems influencer will help shape my role as PCNO. for my mother when I entered this world. I was also fortunate Thanks to my experience, I also understand (Ontario’s nurses) enough in my early teens to work in long-term care. It was a and can relate to them. I remain practising clinically...in the privilege to learn from, support and care for seniors. community…and I do some correctional work with young offenders. I think that’s important. I need to be able to connect RNJ: Why did you want to become Ontario’s chief nurse, and with patients, connect with families, and connect with all classes what does this appointment mean for your career? of nurses to be on the leading edge of information and change. MA: Three or four colleagues sent me the job posting and That’s going to impact my advice (to the ministry). encouraged me to apply. I thought: This role is everything I want to do right now, and what a difference I can make in terms of RNJ: Tell us about your first few months in the role, and your impact on the nursing community. goals going forward.

26 MAY/JUNE 2018 MA: My early focus was building our team and establishing the RNJ: How will your history of involvement with RNAO help you office of PNCO (as well as) engaging and connecting with nurses. in this new role? Navigating the OPS is a little daunting as a newcomer, but I am MA: I have been an active member of RNAO since my graduation in learning and figuring my way through. 1987. As past-president of the Nurse Practitioners’ Association of A priority focus (going forward) will be to strengthen and forge key Ontario (NPAO) (while it was an interest group of RNAO), I acquired relationships with both internal and external nursing partners as well leadership and governance experience. Opportunities to co-chair as others in the broader health-care community. (I am also) liaising RNAO best practice guidelines, and as a member of the expert working with other jurisdictional PCNOs and nursing leaders across the group created by RNAO to develop the NP utilization toolkit, shaped province and Canada, because I need to make sure I know my further expertise to inform my PCNO role. I have a respectful partners. We are currently mapping the nursing landscape and relationship and have received support from RNAO and other nursing horizon to pin down specific goals. I’m associations in the past, present and into only a few months into it, (but) we know the future. exactly where we want to go. (Working in a hospital), RNJ: What advice do you have for other RNJ: What are some major challenges I can make a difference at nurses looking to enter leadership facing nursing and health care in “ positions? a clinical level. But I wanted Ontario that you want to tackle as the to make a difference from MA: Go outside of your clinical comfort province’s chief nursing officer? zone. Start slowly by getting involved in MA: A key challenge (is) preventing a leadership role in terms committee or council work. Grab violence in the workplace. Nurses are of strategic planning and opportunities to participate in working being hurt and harmed, and we have to groups or in advisory capacities. think about their safety. We need to make decision making. Embrace the opportunity to be a appropriate policy to prevent violence preceptor, charge nurse, team leader, against nurses and have safety checks in place. In my first month program champion or educator. Secure a mentor for coaching and as PCNO, I was named the divisional leader of a joint task force leadership development.” Get involved in professional organizations between the ministry of health and ministry of labour (seeking to and external LHIN activities. Have those courageous conversations, address violence against health workers). challenge the status quo, and be a disruptive innovator. RN Additionally, our nursing workforce is aging. Health workforce planning, (including) recruitment and retention will be pivotal, daniel punch, former staff writer for rnao, does freelance writing especially in rural, remote and underserviced areas. in the u.k.

Michelle Acorn (second from right) was a special guest at the opening ceremonies of AGM 2018, where she chatted with other attendees (from left) Gurjit Toor, RNAO evaluation manager, Arlene Burla de la Rocha, RNAO’s 2016 HUB fellow, and community care RN Carolyn Davies.

REGISTERED NURSE JOURNAL 27 POLICY AT WORK

linking the care provided by RNs with improved patient satisfac- tion, better health outcomes, and lower health system costs. Find out more, and sign RNAO’s action alert, at RNAO.ca/news/ ontario-patients-need-more-rns

Action and advocacy in the lead-up to the provincial election RNAO members took their responsibility as advocates for nursing, health and health care to new heights during the provincial election campaign. A total of eight all-candidates debates were organized throughout the month of May by members of Peel, Chatham Kent, RNAO President Angela Cooper Brathwaite (left) responds to questions at a Queen’s Park media conference to mark the start Lambton, Windsor Essex, and of Nursing Week 2018. She is joined by ONA President Vicki McKenna (centre) and RNAO CEO Doris Grinspun. Middlesex Elgin, as well as regions six and seven. Home Ontario needs vacancies are leaving patients in acute and cancer care office staff helped to co-ordinate more RNs without access to the expert care hospitals should be RNs. the events and prepared media Representatives of RNAO joined of RNs and vulnerable to Ontario lags behind other advisories to promote the forces with the Ontario Nurses’ increased risks of morbidity and provinces when it comes to the debates. The resulting media Association (ONA) at the start of mortality. number of RNs. Figures show coverage served to advance Nursing Week to issue an The two associations urged all there are just 703 RNs per RNAO’s election platform important call in the name of political parties to commit to 100,000 people compared to 839 Improving health for all. The patient safety. At a media making RN staffing a health- RNs per 100,000 in the rest of platform contains recommenda- conference at Queen’s Park, the care priority by including a the country. Action will begin to tions in five key areas: access to two nursing organizations promise to immediately post fix this deficit. nursing care, Ontario’s health revealed that 10,000 RN and fill the RN vacancies as part The vast majority of hospital system, living standards, the positions are currently vacant in of their election platforms. They patients have complex care needs environment, and fiscal provincial hospitals. They said the also stipulated that all new hires and there is clear evidence capacity. RN

Liberal, Green, NDP and PC candidates (L to R) participate in a panel discussion hosted by RNAO’s Chatham Kent chapter.

28 MAY/JUNE 2018 CLASSIFIEDS the NURSING STATION LEGAL NURSE CONSULTING (LNC) a blog for nurses TRAINING – ONLINE Rediscover your love of nursing. Open up new opportunities. Apply your knowledge in a whole new way. Learn to objectively and Where can RNs, NPs and nursing students go to share thoroughly analyze adverse events. LNC their thoughts and experiences, and even a few laughs training benefits all nurses in all areas of about their practice? practice. Available online – take anytime, from RNAO is proud to welcome you to anywhere! Visit www.connectmlx.com for more information. the Nursing Station.

Here’s what people have to say about This brand new blog will showcase the voice of Ontario’s nurses via personal the course… anecdotes, thought-provoking editorials, and fun content all nurses can relate to. Whether you want to discuss the joys of the job, the future of the health system, or “The course was great!” the best shoes to wear on a 12-hour clinical shift, the Nursing Station will have “I waited a long time to take this course, something for you. and I’m so glad I did.” Be sure to check it out at RNAO.ca/blog “I loved it!!” As a nurse-driven initiative, your stories will bring the Nursing Station to life. RNAO is inviting nurses at all stages of their career to submit content. If you have an idea for CLASSIFIED ADVERTISING IS AVAILABLE a blog post, please contact [email protected] to discuss. TO MEMBERS With a valid membership number, you receive a 15 per cent discount. All adsa are subject to aproval and must be supplied electronically in Microsoft Word. For more information, email [email protected]

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RNAO_Halfpage_MagAd_19Mar2018_3.indd 1 2018-03-28 2:53 PM IN THE END BY CRYSTAL MCLEOD

What nursing means to me…

From small villages to backwater hamlets, gathering places for the thoughts on rural health issues, such as the high rate of occupational agricultural community have always been my home. So when I injury among famers, or the challenges retaining health-care profes- graduated with my nursing degree, I saw no better way to start my sionals in rural areas. career than to take care of the people I know best: farmers. Eventually, I came to realize how inseparable my nursing career was I began nursing in two separate cities in southwestern Ontario. I from my role as Queen, and decided to make the most of this unique worked in a community hospital in one, and in a long-term care centre opportunity. I embraced every conversation with the public at in another. My knowledge of rural nursing grew because of the agricultural events as a chance to learn more about rural health from farmers I got to know through my practice. In fact, my patients helped the patient perspective. I wanted to know what farmers thought was me realize that nursing, to me, is a practice informed and guided by lacking in their health care, how they felt about reduced access to the community I serve. specialized health services, and what they wanted to see in terms of By attending fall fairs, helping neighbours muck horse stalls, and management of chronic lung disease after long-term exposure to immersing myself in an agricultural society, I began to understand agricultural pollutants. When my year-long reign was over, I handed health from the perspective of farming communities. I also learned the crown to the next Queen, realizing I had formed a strong idea of when soybeans are ready for harvest, and how to spot the difference what nursing means to me. between Jersey and Holstein dairy cattle. My experience as Queen of the Furrow may seem strange to anyone Reflecting on this, I can’t overlook one particularly special experi- outside of an agricultural community. It was strange for me too at ence: my reign as the 2014-2015 Bruce County Queen of the Furrow, a times. Yet, several years later, I view the experience as being quintes- leadership position for young women who are interested in agricul- sential to who I am as a nurse. ture, and show promise in public speaking. Across Ontario, there are Hearing directly from the community gave me knowledge of what nearly 25 Queens crowned each year to champion agricultural causes. patients expected from my care, how they valued their health, and what Raised in a farming family, I thought I could champion a love for obstacles they encountered when pursuing rural health services. rural living. However, not long after being crowned, the nurse in me Today, rural care is the focus of my research as a master’s student at (who was still practising) realized my focus would be to champion the Western University. This knowledge continues to inspire my passion cause of rural health. Farmers, who don’t usually fuss over health, for rural nursing long after my crown was passed down. RN inadvertently supported my cause by openly discussing health-related issues when I mentioned I was an RN. The politicians and members crystal mcleod currently works in the icu at windsor regional hospital.

ILLUSTRATION: PETE RYAN ILLUSTRATION: of the media that I met would also discover I was a nurse, and ask my she hopes to go back to rural nursing one day.

30 MAY/JUNE 2018 JOIN OUR TEAM

RNAO represents RNs, NPs and nursing students across Ontario. Since 1925, the association has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health system, and influenced decisions that affect nurses and the public they serve. To contribute to this important work, why not consider joining our team?

Director of Nursing and Health Policy

RNAO is seeking an outstanding professional to join its An understanding of the political landscape and process senior management team as director of nursing and as it relates to policy development and realization is health policy. Reporting to the CEO, you will proactively essential to the position. You are experienced working with identify critical issues in nursing, social policy, and a range of stakeholders in the health and health-care health care that impact the role of nurses and the health sectors, including nurses, other health providers, of the public. You and your team will develop policy, write governments, and the public. You have superior writing and position papers, develop advocacy plans, and present communication skills that will enable you to persuasively findings and recommendations to the CEO, board of communicate and advance RNAO’s strategic objectives. directors, and other stakeholders. Your ability to identify The successful candidate will be a registered nurse or emerging issues, clearly articulate ideas, and present nurse practitioner who holds a master’s degree in a evidence-based arguments will contribute to the relevant field, with five years of progressive experience in formulation of association strategies that are congruent the field of nursing and health policy at a senior level. with RNAO’s mission. A PhD is an asset. Salary commensurate with experience.

Project Lead Commercial Tobacco Intervention in Indigenous Communities

RNAO is seeking a committed, knowledgeable and resources. You will also assist with execution of key passionate registered nurse to join the International Affairs deliverables, including guideline development, report and Best Practice Guidelines (IABPG) Centre team. preparation, knowledge exchange events, and preparation of This is an excellent opportunity to contribute to RNAO’s program materials for dissemination. You will represent RNAO mission to advance healthy public policy and promote the full in a variety of settings with other stakeholders and the participation of RNs, NPs and nursing students in improving government. health and in shaping and delivering health services now and This is an initiative funded by the ministry of health and in the future. long-term care. In this role, you will lead the development of ongoing The successful candidate will be a member of RNAO and professional partnerships with Indigenous communities to the College of Nurses of Ontario (CNO). A master’s degree is support the development and implementation of a guideline an asset. You will bring lived experience and in-depth on commercial tobacco use by Indigenous people (on and off knowledge of Indigenous cultures and communities to this reserve). You will focus on equitable access to services and role. Ability to speak an Indigenous language is an asset. supports for pre- and post-natal women and their families. This is a full-time position commencing immediately and You will lead collaboration initiatives, and build and running through to March 31, 2019, with the possibility of maintain relationships with community stakeholders and extension. Salary commensurate with experience. RNAO is external partners to provide support, education and a member of HOOPP.

Please submit your cover letter and resume by email to [email protected] or by fax to 416-599-1926 DEADLINE FOR BOTH POSITIONS: July 13, 2018 S•R•T Med-Staff is a trusted leader in the healthcare community with

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On The Pulse of HEALTH CARE

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