Educated Nurses Made Their Way to Horizon — and What They Learned Along the Way Page 19

Meet the Disability Special Pandemic history Management team bond through poetry Supporting employees with Sisters, sisters-in-law and How the past Issue No. 25, Vol. 6 injury or illness sisters in transplant shapes the present March 2021 Page 7 Page 9 Page 13 HorizonSTAR A publication for the staff of Horizon Health Network

On the map: How a group of internationally- educated nurses made their way to Horizon — and what they learned along the way Page 19

Friendship, Care and Dedication: Five nurses share experiences of working together for over 30 years Page 6 Stitched with love: Wife of Palliative Care patient quilts for future patients and families Page 10 Contents 5 6 7 8 9 10 11 12 A shot of hope at Horizon’s Friendship, Care and Meet Horizon’s Disability Research findings from Special bond: Sisters, Stitched with love: Wife of Horizon, NBMS partner on The Moncton Hospital staff health care worker Dedication: Five nurses Management team and Horizon’s Saint John sisters-in-law and sisters palliative care patient quillts physician wellness project give back to the vulnerable COVID-19 vaccination share experiences of learn how they support Therapeutics project in transplant for future patients at the DECRH clinics working together for over employees with injury or published in national journal Join Horizon’s SANE team 30 years illness Annual Sussex Health to help care for domestic Centre PJ Drive a success abuse victims

SOCIAL SHOUT- OUT 13 14 15 16 17 18 19 20 How the past shapes the #ResearchAtHorizon: Social Shout-Out Helpful practices to Resilience among health New career, new On the map: How a group Welcome to the Horizon present: A look at New Collaboration wins top promote self-compassion care workers during work-life balance in of internationally-educated Storefront! Brunswick’s pandemic NBHRF honours COVID-19 New Brunswick nurses made their way to history through poetry Horizon — and what they learned along the way

On our cover: This magazine is published by Horizon Health Network’s Communications In Every Issue From left: Colleagues Christina (Tina) Christopher, Department, and is distributed free of charge to Horizon staff, physicians Message from CEO Janabelle (Jana) Pama, June Panadero and and volunteers. A French version can be found online at fr.horizonnb.ca. Editor’s Note Kriselle (Ellie) Laude pictured at Horizon’s Colleagues’ Corner Editor: GinaBeth Roberts Saint John Regional Hospital in March. Design and layout: Hudson Creative Agency Look Who’s Shining Printed by: Advocate Printing Please send comments and/or story ideas to [email protected]. A welcome note from the editor

Dear Staff, Physicians and Volunteers, It’s hard to believe it’s been over a year since COVID-19 became part of our daily lives — personally and professionally. It was on March 11, 2020 that the World Health Organization declared a COVID-19 pandemic, and it was on that same day Dr. Jennifer Russell, our Chief Medical Officer of Health, announced our first presumptive (and later, confirmed) case. Welcome to the 25th edition of the Horizon Star! A shot of hope From there, much of the world went into quarantine — while you all stepped up to the unknown challenges in front of you in an The 25th — or silver — birthday or anniversary of at Horizon’s health care worker COVID-19 vaccination clinics ever-changing health care world. anything is quite a milestone, and I cannot thank you all The Government of New Brunswick (GNB) announced in Hospital, Saint John Regional Hospital and The Moncton And since then, we’ve all had a role to play in enough for the support and encouragement I’ve received December its New Brunswick Immunization Plan for COVID-19. Hospital. getting where we are today: vaccinating New in creating 25 issues of this publication over the past five Brunswickers, ourselves included. years. Since then, Horizon has been busy establishing COVID-19 As of March 23, 2021, over 8,000 Horizon staff and physicians Our vaccination rollout has really ramped up vaccination clinics and vaccinating employees and physicians have received their first dose of a COVID vaccine. A huge thank you to everyone who has contributed to its over the past few weeks and we’ll see this (health care workers), when eligible, who are actively working in Thank you to all Horizon teams who are working together to continue in the months to come, as set out in success – everyone who has submitted, written, edited, our facilities. the Government of New Brunswick’s updated translated, designed and read stories, and especially make all of our vaccination clinics a major success, as well as vaccine rollout plan. those who’ve agreed to be photographed. Clinics for health care workers have been set-up at Horizon’s our partners at Vitalité Health Network, New Brunswick Public As of mid-March, we’ve sent 14,000 prioritized Miramichi Regional Hospital, Dr. Everett Chalmers Regional Health and many more! Together, we’ve created 453 pages of stories (double that, 4 vaccination appointment invitations to 5 Horizon employees and physicians (health when you consider the French version), and without all care workers) who are actively working in our of you, the Horizon Star would simply not exist. It is truly GETTING VACCINATED AT … facilities. Thousands have already received one a Horizon-wide publication. or two doses of the COVID-19 vaccine, and this number will continue to increase as many With competing COVID-19 priorities across the more clinics are planned. This is no small feat. Karen McGrath organization over the last year, it wasn’t easy getting President and CEO We’ve also helped with clinics for staff and here: we’ve adjusted publishing dates, scaled back residents of long-term care and First Nations, first responders, allied health on pages, and removed some of the more interactive professionals and adults with complex medical conditions. features. While being vaccinated doesn’t change our Public Health and Infection Prevention and Control directives, I do hope it provides you a much-needed shot of hope. But, it was definitely worth it! Both analytics and anecdotal feedback tell me more of you are reading Despite this positive news, it’s normal to feel many different emotions – good and bad. more of the Star than ever before, so I am so happy we can continue to share your stories with your colleagues In a video, the North American Center for Threat Assessment and Trauma Response explains how “trauma is stored in the body and that the body across the organization, no matter the format. remembers anniversaries even if the conscious mind does not” and provides As we continue to respond to COVID-19 throughout brain-based strategies for supporting your mental health and those around you. An interesting perspective, for sure. 2021, we’ll keep adjusting as necessary. At next month’s Board meeting (April 15), Horizon will release its new strategic I hope you’ll continue to reach me at HorizonStar@ plan with three strategic priorities, each with several objectives. HorizonNB.ca with new ideas. We will share more information with staff and physicians ahead of the Board meeting, as we recognize how important it is for staff and physicians at all levels Happy reading, of the organization to see where they fit within the plan. As such, you will hear much more about our strategic plan, priorities and objectives in the coming weeks and months. As you may have heard, I recently announced my plans to retire, which will be effective as of January 16, 2022. I announced my retirement intentions at this time to provide the necessary notice GinaBeth Roberts to government, so the recruitment process can begin. The goal is to have a new Editor, Horizon Star Horizon’s Saint John Regional Hospital Horizon’s Miramichi Regional Hospital leader hired to provide a seamless transition for all of you and our patients and clients. I remain dedicated to you and Horizon and I still have many goals to achieve in the coming months before this transition occurs. Sincerely,

Karen McGrath President and CEO Horizon’s Dr. Everett Chalmers Regional Hospital Horizon’s The Moncton Hospital Horizon Health Network Colleagues Corner Friendship, Care and Dedication: Five nurses share Meet Horizon’s Disability Management team and learn experiences of working together for over 30 years how they support employees with injury or illness In the field of nursing it’s common for patient and their family.” well-being first and strive to make them feel Registered Nurses (RNs) to work in several comfortable, regardless of the injury or illness. Disability management is an intentional and Rita said she chose to be a nurse because different settings throughout their careers coordinated effort to mitigate the direct and three of her friends were going into nursing. Carol Mason noted that there are two things indirect impacts of disability on employees, — there are often changes in positions, she loves most about her job: “The people I their families and their employers. Horizon’s department and facilities. “It turned out to be the best decision of my work with (and the way we work together and Disability Management (DM) team provides life,” she said. “I love my job as a nurse and So, it is very special and rare to have five RNs support each other) and knowing that I made support and resources for staff who are ill or teacher and I love taking care of people. that have been nursing together at one Horizon a difference for someone when I go home at injured at work or outside of work, and who Kindness, caring, empathy and compassion require accommodation support. facility, in one department, for over 30 years! the end of my shift.” are part of who we are.” “When injury or illness occurs, our team Carol Mason, Jackie Belyea, Carole Calnan, “We are very fortunate to have worked They share their wisdom and depend on each provides absence and disability management Rita Brown, and Michele Perkins-Stephen have together for so long,” said Michele, “and we other’s knowledge every day and through it programming to assist with the overall health been RNs at Horizon’s St. Joseph’s Hospital are proud to be St. Joseph’s Hospital Urgent all continue to put their patients’ health and of employees,” said Michèle Rankin, Horizon’s From left: Robin Savoie, Disability Clerk; Michèle (St. Joe’s) Urgent Care Centre (formerly an Care nurses!” Regional Disability Manager. “We are here to Rankin, Regional Disability Manager; and Brigitte Carter, Senior Disability Coordinator, Saint John Area, Emergency Department) since the 1980s. educate, empower and support all employees Graphic from: to successfully navigate their journey from Government of Canada at Horizon’s Saint John Regional Hospital. This team of frontline heroes has worked illness or injury, to wellness.” together through many changes over the past to offer accommodations if it causes them three decades – most notably, the transition Occupational and non-occupational “undue hardship,” taking into account factors injury / illness of their facility from a 24-hour fully-active such as financial costs, service disruption, Occupational injury / illness is a physical or health and safety concerns, and collective Emergency Department (ED) to an Urgent psychological illness or injury that arises over agreements. Care Centre in the early 2000s. the course of employment. A non-occupational Although the employer has the primary 6 injury / illness is a physical or psychological 7 When they first began nursing at St. Joe’s, responsibility to accommodate since the employer illness, injury or personal medical condition medical emergencies would arrive by has control of the workplace, everyone has a unrelated to work. ambulance to their ED. role to play including the union and the employee: Disability Management focuses on absences “Patients would come 24 hours a day to get from work as a result of both occupational and Employer: From left: April Leet, Junior Disability Coordinator, • Ensure employees are aware of their right to the emergency care they needed and could be non-occupational illness or injury, and on the Fredericton/URV & Moncton reas and Jaime Maynard, accommodation Senior Disability Coordinator, Moncton Area, at admitted to other units within the hospital,” said prevention of risks that cause these absences • Be informed on the employer’s legislated Horizon’s The Moncton Hospital. Michele. “That changed when the Emergency through accommodation, prevention, and duty to accommodate and be able to review Department became the Urgent Care Centre (to support for recovery. this with employees avoid duplication of services with the newly built Research shows early intervention helps • Explore accommodation to the point of Saint John Regional Hospital).” prevent long-term disability. That is why undue hardship and be willing to revisit and It was a big adjustment for the team, Michele Carol Mason, Jackie Belyea, Carole, Calnan, Rita Brown and Michele Perkins-Stephen have worked together as Horizon is committed to assisting its ill and modify these as needs change Registered Nurses and friends at St. Joseph’s Hospital Urgent Care Centre for over 30 years. injured employees to recover by providing • Demonstrate equal treatment of employees said, “but we adapted! Although our role options to support on-the-job rehabilitation and and respect employee confidentiality changed, our commitment to our patients provide safe, gradual return-to-work programs, • Manage simple and straightforward over the past 30+ years, and our desire to like the Direct Referrals to Physiotherapy accommodation requests independently make a difference, has remained the same.” Program available through a partnership • Consult with Human Resources or Disability between Horizon, WorkSafeNB and local Gabrielle Smith, Nurse Manager, explained Management on any questions that arise or to physiotherapy clinics. request assistance with more complex cases that like an ED, there are no “typical days” From left: Lacey Melanson, Disability Clerk and Kim at the Urgent Care Centre — every day is When an occupational injury or illness occurs, Employee: Currie, Senior Disability Coordinator, Fredericton & unpredictable. Horizon’s Disability Management staff manage • Take preventative measures to ensure URV Area, at Horizon’s Dr. Everett Chalmers all reported work-related incidents. Information personal safety and wellness Regional Hospital. Upon arrival, patients are assessed by an is reviewed, and documentation is submitted • Request accommodations when needed and RN and given a triage number. Diagnostic to WorkSafeNB for injury or illness claims in suggest appropriate measures when possible procedures and medical treatments vary accordance with the Occupational Health and • Provide medical documentation to support depending on the patient. Every patient’s Safety Act and WorkSafeNB policies. limitations and restrictions needs are unique, and so are these five nurses. Short term absences due to non-occupational Union: injury or illness are most often managed What makes them unique is not just their ability • Provide employees with accommodation at the departmental level. When these advice and guidance to adapt to this ever-changing environment, but absences grow in duration or complexity, • Support accommodation measures their teamwork and friendship. DM is often contacted to provide support regardless of the collective agreement, unless “We have shared good times and bad, busy for both the employee and manager with to do so would impose undue hardship absence management options, recover-at-work days and quiet days,” said Jackie. “My co- The DM team offers guidance, tools and programs, and safe gradual return-to-work workers always have my back and coming to expertise to support employees and managers programs and accommodations. through successful recover-at-work, return-to- work is like coming to my second home. St. Lisa Connors, Junior Joe’s is the best!” Duty to Accommodate work and workplace accommodation plans by Kimberly Williston, Senior Disability Coordinator, Employers have a duty to accommodate. exploring a number of different options, such Disability Coordinator, Miramichi & Saint John When asked what her favourite thing about They are required by law to make every as modified duties, alternate work, and more. Miramichi Area at Areas at Horizon’s working at St. Joe’s Urgent Care Centre is, reasonable effort to accommodate an injured The DM team has resources available to provide Horizon’s Miramichi Miramichi Regional Carole Calnan said: “the collaboration of care or ill employee. However, they are not required assistance in each major facility across Horizon. Regional Hospital. Hospital. as a team, focusing on the well-being of the Front to back: Rita Brown, Michel Perkins-Stephen, Jackie Belyea, Carole Calnan and Carol Mason. Want to tell your colleagues about the services you provide for patients and staff throughout Horizon? Email [email protected]. Research findings from Horizon’s Saint John Special bond: Therapeutics project published in national journal Sisters, sisters-in-law and sisters in transplant

Occupational Therapy (OT) data collected call themselves to book an appointment at a The results of the study in OT found there Linda Duncan, a nursing unit clerk at from Horizon’s Saint John Therapeutics’ time convenient for them, with high priority was an increase in referrals from clients. Wait Horizon’s Saint John Regional Hospital (SJRH), Open Access Booking Model Project has been patients receiving priority appointments,” said times did not necessarily decrease, however jumped on the opportunity to go from being a published in a national journal. Becky. “The small change made a big impact more clients were seen. It was found that Horizon employee to a Horizon patient. in administrative efficiency.” patients were discharged faster, as they would Open-access booking (OAB) refers to the In 2020, Linda’s sister Sandy became ill with progress more rapidly through the OT system administrative system by which patient A few months into the implementation of a recurring Clostridium Difficile Colitis (C. Diff) with the same quality of treatments. This appointments are scheduled. OAB, a University of New Brunswick professor infection. allowed therapists to take new clients sooner. and applied psychologist, Dr. David Speed, In 2017, a need was identified to make There was no change recorded in missed When asked, Linda, who has been part of the who was looking to conduct advanced studies scheduling patients in Therapeutic Services, appointments for OT, although this was seen Horizon team for 32 years, did not hesitate to in the area of OAB, began working with Becky including OT, Physiotherapy, Audiology and in the data for the other disciplines involved. help her sister. and Shelly Fyffe, former Horizon Process Speech Language Pathology in the Saint John Improvement Facilitator, to analyze the findings This work was published in Volume 87, Issue “When Dr. Jacquelyn LeBlanc, an infectious area more efficient. of the OAB project, beginning with OT data. 5, of the Canadian Journal of Occupational disease specialist asked me (to do a fecal Becky McCollum, Director of Therapeutic Therapy 2020 in an article titled “Investigating transplant), I replied with, “Do you mean a The goal of the study was to see if OAB Services Saint John Area and her team wanted Open-access Booking in New Brunswick poop transplant?’” Linda laughed as she said improved administrative outcomes in OT. The to reduce outpatient waitlists and increasingly Occupational Therapy” by Dr. David Speed how unique it sounds. study looked at the number of referrals, wait long wait times experienced by patients for and Shelley Fyffe. times for first appointments, whether there Linda and Sandy have a special sisterhood. these services. would be more rapid discharges, and whether With the overall success in improving They are sisters by blood, but they are also Through a LEAN Six Sigma approach, the there was a change in missed appointments. administrative outcomes, OAB will become sister-in-laws, having married the Duncan Saint John Therapeutics team transitioned to Becky and her team monitored raw data for a regional solution, set to roll out to brothers 47 and 49 years ago. an open access booking model. number of calls, no shows and wait times to Therapeutics in the Moncton, Fredericton and Throughout the years the Duncan family has track the progress when using OAB. Miramichi areas in the spring of 2021. 8 “Patients were able to self-refer and could experienced a lot, but in March of 2020, they 9 embarked on one of their most challenging experiences. Sisters Linda Duncan (right) and Sandy Duncan (left) have many incomparable experiences in life, including For many, March 2020 brings back thoughts marrying a set of brothers. In 2020 they added a fecal transplant to their list, which helped Sandy recover from of the beginning of the COVID-19 pandemic Clostridium Difficile Colitis (C. Diff). in New Brunswick, but for the Duncan sisters the month also marks Sandy’s breast cancer hospital stay, however Sandy’s condition standard therapy for Clostridium Difficile,” Dr. diagnosis. continued to worsen with many problems LeBlanc said. In April, Sandy underwent lumpectomy arising, including kidney failure. The procedure, performed by surgery. “While being in the hospital, Sandy missed gastroenterologist Dr. Cory Gillis, was a “Since it was day surgery, she didn’t need to her window of opportunity for radiation,” success, and Sandy was discharged in stay in the hospital, which we were thankful Linda said. “She has been through a lot, but October. Today, she is back to running errands for, due to COVID-19 restrictions,” said Linda. was able to get better, and I am so happy that and going about her routine. “But in the months following surgery, Sandy I was able to help.” “We are so thankful to all the staff. Sandy wasn’t feeling well, and she needed to be When Linda started sharing the news that she spent time on many different units and admitted to the hospital in July for C. Diff.” would be doing a fecal transplant for her sister, everyone was great,” Linda said. C. diff can cause symptoms ranging from many colleagues and friends expressed how “We wanted to share our story, so people can diarrhea to life-threatening inflammation of they have never heard of the procedure. hear about fecal transplants and how for us it the colon. “Fecal transplant is recognized as a very was a great option to help Sandy.” The Duncan sisters anticipated a short effective modality for cure in patients who fail

Becky McCollum, Director of Therapeutic Services, Saint John area (right) sits with Tracy Underwood, OT Manager Saint John Area, who played a key role in the success of Sisters Linda Duncan (left) and Sandy Duncan (right) have many incomparable experiences in life, including marrying a set of brothers. In 2020 they added a fecal transplant to the OAB project. The Saint John Therapeutics Open Access Booking Model Project won Horizon’s Quality Quest Award in 2019. their list, which helped Sandy recover from Clostridium Difficile Colitis (C. Diff). Stitched with love: Wife of former Palliative Care patient Horizon, NBMS partner on physician wellness project quilts for future patients and families at the DECRH “A bit of comfort in memory of Eldon Gilmore “There are seven beds in palliative care, so I she said. “Family members are sitting there for When physicians at Horizon’s Dr. Everett 2020” is stitched on the back of seven handmade wanted to do (quilt) one for each bed,” said months on end. Just sitting there, day after day, Chalmers Regional Hospital (DECRH) in quilts in the Palliative Care unit at Horizon’s The Rosemonde. and they get cold.” Fredericton approached the New Brunswick Moncton Hospital (TMH). Medical Society (NBMS) and its Wellness In two months, she completed six quilts, each Lana and her team were surprised by the caring program about supporting the installation of a Those simple words and the kind gesture with unique fabric and pattern. A quilter friend gesture. bicycle rack at the hospital, it was a natural fit. behind them have provided much needed offered one of her creations so Rosemonde “This act of kindness and concern for other warmth and comfort to palliative care patients could have seven quilts to donate. “NBMS Wellness is here to support physician people going through a very difficult time is and their loved ones. wellness initiatives, and this was a project “The quilts have a positive impact on inspirational,” said Lana. “The donation helped that had been on the minds of physicians for When Rosemonde Gilmore’s husband Eldon our patients, as they provide a home-like staff realize how much the care they provide some time,” says Lisa LePage, chief operating passed away in the summer of 2020, after a environment, warmth and comfort at a very impacts not only the patient, but their family.” officer of the NBMS. “We saw great value in month-long stay in the Palliative Care unit, she difficult time,” said Lana Hebert, the unit’s Rosemonde is overcome with emotion when partnering with Horizon on this project.” knew she wanted to do something to honour nurse manager. “Patients and families use she reminisces about her experience delivering his memory. them to cuddle up with. They are wonderful for Though it was delayed by the pandemic, a the quilts to the palliative care team. keeping patients warm at night.” new bicycle rack that accommodates both So, she began quilting. “When I brought the quilts in, two of the staff modern bicycles and fat bikes was installed Days and nights in palliative care can be long, Quilting became an addictive hobby she came out and gushed over them,” she recalls. in November 2020 at the hospital’s physician and having extra comfort goes a long way. picked up after retiring from her long career “These were the people I saw a lot when he entrance. The rack, installed on a new Rosemonde knows first-hand the difficult as a pharmacist. She learned most of her (Eldon) was in the hospital, so it meant a lot to concrete pad, enables physicians to better experience of sitting with a loved one in techniques through Victoria’s Quilts Canada, an see how happy they were.” secure their bicycles if they cycle to work. It palliative care. organization that makes and donates quilts to has spots for 14 bicycles. Eldon, of course, had his own quilt while he was people living with cancer in Canada. “The quilts are for the patients and the family,” a patient, but that one is stored safely at home. “Physicians are extremely busy, so it can be hard to find time for exercise,” says Dr. Erica 10 Frecker, head of the Department of Obstetrics 11 and Gynecology at the DECRH who initially approached NBMS Wellness about this project. “Biking is a great way to clear my head between home and work.” Dr. Erica Frecker, Head of the Department of Obstetrics and Gynecology at Horizon’s DECRH, and Daniel Lynch, Manager of Facilities Dr. Liam Hickey, Urologist, in front of the hospital’s new bike rack. Management at the hospital, said the previous bike rack was older, less secure and did not contractor, it just wasn’t possible.” said. “I know I feel better when I am more accommodate some modern styles of bicycles. physically active. With our busy schedules, Despite the delays, he was glad to see it installed. “This was on our wish list for a couple of years finding time for exercise is difficult. Now that but when the NBMS reached out in support, Dr. Liam Hickey, a urologist at the hospital, there is a reliable place to secure bicycles at we were able to expedite the project,” he believes health facilities play an important role the hospital, there is one less barrier for us to said. “We had a lot of communication back in promoting healthy choices. work physical activity into our commute.” and forth in terms of timelines. We tried to “Encouraging and facilitating active transportation This article was published in collaboration with push it through quicker but given the year that is a simple way to send a positive message to the New Brunswick Medical Society (NBMS) we’ve had with COVID and delays securing a the public about making healthy choices,” he Communications team. Fourth annual Sussex Health Centre PJ Drive a success Staff at Horizon’s Sussex Health Centre once again collected pajamas for the Sussex Salvation Army in mid-December as part PJ Drive Project Lead Estelle Arbing, RN, of their fourth annual PJ Drive. preparing to donate the 308 pairs of pajamas to the Despite the pandemic, this year’s drive proved to be very Sussex Salvation Army. successful, with 308 pairs of pajamas donated to the community. Estelle Arbing, an Emergency Department nurse, spearheaded the drive, which garnered support from staff, friends, family and community members. “With the current situation we’re in because of the pandemic we didn’t set a goal for this year’s drive,” said Monica Tays, Nurse Manager. “We felt that any amount would be a blessing.” The Sussex Health Centre PJ drive has donated 827 pairs of pajamas since 2016 to help keep the community warm and cozy and the team is already looking forward to their fifth annual drive

Two of the seven handmade quilts Rosemonde Gilmore donated to the palliative care unit at Horizon’s The Moncton Hospital. in 2021! The Moncton Hospital staff give back to How the past shapes the present: vulnerable community members A look at New Brunswick’s pandemic history Sometimes, it’s the little things that mean the most. through poetry But access to some of life’s little essentials can be hard to come by for the most vulnerable in Glen Sheppard, Manager of Budgets and Reporting, Financial Services our communities. at Horizon’s Woodbridge Centre writes about how the Ministry of Health To help ease the burden during the holiday began in New Brunswick, and how its response to the Spanish flu laid the season, staff from the Emergency Department foundation for the province’s COVID-19 response, over 100 years later. and the Sexual Assault Nurse Examiner (SANE) program at Horizon’s The Moncton Hospital (TMH) worked together to help provide everyday New Brunswick Pride essentials to those who need them most. In 1917 Dr. William Roberts was elected to a Saint John liberal seat “We decided to donate little gifts to help put a smile on someone’s face,” said Emmanuelle Twice he brought forth a Health bill, that resulted in defeat Landry, SANE Coordinator for the Moncton He tried again, with enough community support it could no longer be debated and Miramichi areas. “Throughout the COVID-19 pandemic, a lot of people have This is how the first Department of Health in the British Empire was created been struggling.” Emmanuelle and Trena Brown, nurse manager of TMH’s Emergency Department, reached When the Department of Health first started it had a staff of two out to staff asking for their help and collected It was just created when New Brunswick was hit by the Spanish Flu generous donations. 12 Dr. Melvin as the Chief Medical officer acting on behalf of the Crown 13 They were overwhelmed with the positive response from staff who wanted to contribute First official act was a proclamation shutting New Brunswick down and received more donations than expected. “It always feels good to help others and to give Emmanuelle Landry, SANE Coordinator for the Emmanuelle, with representatives of back,” added Emmanuelle. Moncton and Miramichi areas, presents donations to The Sanctuary In order to slow the spread schools, churches and theatres were closed representatives from Youth Quest Central. With a goal in mind to help people who an People were not to gather in large crowds to reduce others getting exposed Bags contained several essentials, such as cashier at TMH added her special touch to the underserved population, they decided to feminine products, shampoo, soap, nail files, donations by providing handmade toques, Masks were worn and travel by ferry and train was restricted donate bags of essentials to people at Youth mouth wash, toothbrush, toothpaste, nail scarves and mittens — much needed items to Quest Central and The Sanctuary. polish and perfume. help people through Moncton’s cold winters. Over 100 years later, the same advice, who could have predicted Youth Quest Central is a multi-resource Access to essential items like feminine Emmanuelle had the opportunity to deliver centre for youth aged 16 to 24 who are either products or soap are a guarantee for a lot of the bags and said, even through the masks, homeless or at risk of becoming homeless. The Spanish Flu you could feel fine in the morning and the next day be pronounced dead people, but can be devastating for those who you could see the huge smiles of recipients. The Sanctuary provides a positive and safe don’t have access to the items they need. Still a small few defied the proclamation gathered and held dances instead space for those who work in sex-trade by Both organizations were thankful to be on the chose or survival reasons. Florence (Flo) Bastarache, Finance Department receiving end of kindness from Horizon staff. Sounds familiar, human nature, temptation, it won’t happen to me I wish some people paid more attention when they studied history Join Horizon’s SANE team to help care for victims Dr. Roberts and Dr. Melvin contacted all the doctors and nurses of domestic violence and sexual assault Redeployed provincial staff to help stop the need for more hearses Horizon’s Sexual Assault Nurse Examiner (SANE) program is looking for registered nurses (RNs) to join their team. FHS home ec department was used by the Red Cross to make meals for the sick The SANE program plays an essential role in the care of victims of domestic violence and With resources all coordinated they could react to situations really quick sexual assault. Typically, they are the first person to treat a victim and hear their story. Training sessions take place throughout the year to prepare RNs for the role. RNs begin their Due to their actions, New Brunswick had one of the lowest mortality rates SANE clinical work with a mentor who provides support and guidance. Nothing like a real pandemic to help them to demonstrate The SANE program requires staff to be on-call on a rotational basis, outside of their primary HORIZON’S SANE COORDINATORS RN role. During these shifts, RNs will work one-on-one with victims, often during one of the It’s hard to believe how similar these pandemics really are worst times of their lives. Moncton and Miramichi areas: With all our technological advances, we really haven’t gotten very far Emmanuelle Landry, 506-857-5686 or RNs in the SANE program provide compassionate care, without judgement. They provide a [email protected] head-to-toe, forensic examination. Fredericton and Upper River Valley area: One New Brunswicker full of devotion They provide consistent, uninterrupted and supportive care and treatment to the victim and Robyn Kenney, 506-459-6540 or Set the Department of Health concept in motion collaborate with RCMP and municipal police forces, the legal system, victim services and other [email protected] community-based support services. Saint John area: With some help from the Spanish Flu If this sounds like a role for you, contact the SANE coordinator in your area or email the SANE Maureen Hanlon, 506-653-2926 or Made Canada and the world realize how important this concept is too [email protected] inbox: [email protected]. #ResearchAtHorizon: Collaboration to improve outcomes for spinal fusion surgery patients wins top NBHRF honours SOCIAL SHOUT-OUT Throughout 2020 the New Brunswick Health surgeons Dr. Edward Abraham and Dr. Neil It is important when looking to improve Research Foundation (NBHRF) accepted Manson, and the Canada East Spine Centre’s On Horizon’s social media platforms, we’ve heard from many of your patients, clients and families patient quality of life to look at the patient nominations for the top health research research team: Erin Bigney, Eden Richardson, about the professional, safe and quality care you provide. collaboration in the province. Each month, Dana El-Mughayyar, Mariah Darling and holistically. Traditionally, in medicine, surgical a project showcasing work being done as a Amanda Vandewint. specialties tend to only view patient care In this recurring feature, we’ll highlight some of these “social shout-outs.” If you see a social shout-out, tell us about it by emailing [email protected]. team was featured, highlighting that we are Taking an integrated approach to treatment, through the lens of their specialization, better together. the team examined how a prehabilitation but this approach can result in failure to identify risk factors, or miss opportunities In February, the Canada East Spine Centre program could improve patients’ outcomes Troy Lifford Gale Allen (CESC) http://www.canadaeastspine.com/ following their spinal fusion surgery. It is for preventative care. This project aims to @TroyLifford A true compassionate leader. Thanks Rhonda, you help received the first of what would become four thought that the pre-conditioning offered improve patients’ chances of minimal adverse awards for the 2020 competition (again in through cardiac rehab may improve patients’ events while maximizing chances to decrease Up at the DECH for some x-rays. #COVID19screeners doing improve patients’ and staff’s lives daily. March, April and July). physical functioning capacity and mental post-operative pain and disability, leading to an excellent job. Keeping the line moving but asking the 2:26 PM · Oct 28, 2020 health at baseline, leading to improved post- Research conducted by the CESC aims to overall improvement in patient quality of life. questions to keep everyone safe. @HorizonHealthNB 4 Likes translate into improvements in the care and operative disability and pain outcomes. outcomes for those who suffer from various Using the NBHC’s cardiac rehabilitation 1:53 PM · Dec 9, 2020 2020 Research Teams of the Month 6 Likes Laura Mazerolle spinal conditions. The dedicated team programming, patients in the study were Featuring Horizon Researchers: investigates ways to most effectively treat randomly assigned to cardiac rehab and I am so happy for these dedicated nurses, doctors, caretakers, patients holistically. This involves exploring treatment, or treatment as usual without Pan Canada Collaboration Investigates Kate medical workers, and everyone helping, to take care of people! such topics as: the impact of psychological cardiac rehab. Traumatic Cauda Equina Injury (March 2020) https://huddle.today/pan-canada-collaboration- @cummingsgoing and social factors on patient outcomes Kudo for being so dedicated and to help people’s lives, on a This study is currently in the enrolment investigates-traumatic-cauda-equina-injury/ Good morning @HorizonHealthNB, I need to shout out the following spine surgery; patients’ patterns stage. If the data supports the hypothesis that daily basis! of narcotic use to manage their pain; and The Reality Of Life Satisfaction Following A people at the DECH blood lab. In and out in 20 min even with participation in the cardiac rehab program Traumatic Spinal Cord Injury (April 2020) You are ALL, so very precious and, we love YOU all!! 14 strategies that can be employed in the prior to spine surgery improves patients’ https://huddle.today/the-reality-of-life-satisfaction- COVID protocols. Super friendly, efficient, and painless. 15 peri-operative period to optimize patients’ outcomes, then it will be offered provincially following-a-traumatic-spinal-cord-injury/ Oct 28, 2020 response to treatments. 9:09 AM · Feb 3, 2021 to at-risk spine surgery patients. Looking Beyond Patient Averages: Steps 1 reply 8 Likes Ultimately, it was the February submission There are so many impactful research projects Towards Personalized Care (July 2020) (see article published by Huddle here) that https://huddle.today/looking-beyond-patient- @Carol_Reimer being done in the area of medicine here in averages-steps-towards-personalized-care/ You are all doing a great job. Thanks to all of Horizon. All garnered them the top honours as 2020 New Brunswick and with that in mind, CESC Health Research Team of the Year. is incredibly honoured to have received the Giving Patients And Caregivers A Voice In departments. All working together in a time of shifting data Setting Research Priorities (August 2020) and plans for the health of all of us. So thankful to have you at The February 2020 team feature showcased recognition of the Research Team of the Year https://huddle.today/giving-patients-and- a new collaboration between Dr. Robert from the NBHRF. caregivers-a-voice-in-setting-research-priorities/ the pivot point of care. Stevenson and physiotherapist Stephen This project would not have been possible Research Team Looking To Improve Quality Of Editor’s Note: Carol Reimer is Horizon Board member. Mundle from Horizon’s New Brunswick Heart without the financial support from the Saint Care For Heart Surgery Patients (September 2020) Centre’s (NBHC) Cardiovascular Health and John Regional Hospital Foundation and the https://huddle.today/research-team-looking-to- Wellness Program; together with, orthopedic McCain Family Foundation. improve-quality-of-care-for-heart-surgery-patients/ Join the conversation! Follow us on

From top left corner, clockwise: Dr. Edward Abraham; Dana El-Mughayyar, Eden Richardson, Erin Bigney, Amanda Vandewint; Dr. Neil Manson; Dr. Rob Stevenson; Mariah Darling; Stephen Mundle. Megan Pollard, Brandi Person, Helpful practices to Resilience among health care workers Clinical Psychology Clinical Psychology promote self-compassion Intern during the COVID-19 Pandemic Intern

This past year has been incredibly stressful for others, prevents against compassion fatigue, as humans during a time of social distancing As a clinical psychologist in training, I am within the health care team. Group learning about the process of grief and life transitions for many people. Managing the challenges of promotes resilience, increases happiness, and isolation. Luckily, we can provide this eager to share how we can borrow various and discussion of shared experiences can be normalizing and validating as we relate daily life while navigating a global pandemic is boosts self-esteem, and protects against mental comfort for ourselves! Don’t be afraid to psychotherapeutic principles to help build can promote collegiality, understanding, to others, especially when colleagues are an enormous task and it’s easy to be critical of health concerns. The good news is anyone give yourself a hug or place a hand over your resilience in you — our health care workers (HCWs). connection and belonging. Sharing success grieving (e.g., working with dying patients and ourselves for not knowing how to do this. Today, can learn self-compassion and there are many heart to feel the warmth when you need it The impact of COVID-19 stories can help you find joy amidst chaos and their families, losing loved ones to COVID-19, can reinforce a sense of purpose. Challenges and experiencing the loss of typical social I wanted to share some tips to help cultivate practices that have been developed to help us most. Stress associated with multiple recommendations brought on by the pandemic can be openly connection). A common role transition that from authorities, fear of illness for oneself and self-compassion. comfort and care for ourselves in this way! discussed and problem-solving can become a has emerged during the pandemic is from • Compassionate Letter: Write a letter to loved ones, social discrimination or stigma, team effort that offers valuable support. clinician to “hero.” As society applauds the So, what is self compassion? Self-compassion is yourself from the perspective of someone financial instability, extended periods of isolation, heroes working on the front lines, you may being open to your own suffering, experiencing who loves you unconditionally. and ongoing loss and grief is jeopardizing the • Cognitive Behavioural Therapy (CBT) can struggle with this new identity and how to feelings of caring and kindness for yourself, mental health and resilience in the general illustrate the relationship between thoughts, • Focus on a perceived “flaw” or “failure” navigate it, managing feelings of being an taking a non-judgemental attitude toward population, but HCWs are arguably the most feelings, and behaviors. It emphasizes that you have been judging yourself for and impostor, not doing enough, and not receiving affected group of people in the fight against the even when so much is uncertain and out of our personal flaws, and recognizing that your adequate compensation to take on the new ask yourself, “What would my friend say virus. control, we can remain in charge of our own experience is part of the common human title. about this?” “How would they convey thoughts. Identifying cognitive distortions experience (Neff, 2003). It means viewing your Unfortunately, you as HCWs face additional their compassion for me, especially when can be a place to start. An example of such • Dialectical Behaviour Therapy (DBT) can personal struggles in the same way you would a challenges that increase your vulnerability to I am judging myself so harshly?” a distortion is “catastrophizing.” HCWs are identify gray areas where opposing ideas friend or loved one when they are struggling. distress and burnout. You must cope with rapidly • Fill the letter with the sense of kindness trained to anticipate worst-case scenarios in co-exist. Sentiments such as, “I am tired • Take a Self-Compassion Break: Think of a changing policies, adapt to work outside your the clinical setting, but this pattern of thought and scared and I do not want to go to work” Self-compassion has 3 key elements: situation in your life that causes stress and and caring you feel from this person. usual scope, manage fear and uncertainty about • After writing the letter, leave it for a while can lead to anxiety and fear when applied and “This is my calling and I love my job” are 1. Mindfulness – which helps be present and try to feel the emotions associated with it. personal protective equipment (PPE), navigate 16 then come back and read it later. Allow to other contexts. In terms of behavioural common themes. DBT encourages us to hold 17 separate us from our worry/fear; Say to yourself: moral distress and witness trauma. yourself to believe the words and feel the activation strategies, recommendations for these thoughts in mind and allow them to 2. Common humanity – which reminds us As a result, you are at risk for diminished mental behaviours that may have a positive impact on both be true, reducing the tension of having to a) “This is a moment of suffering.” compassion and other emotions sink in. that we are not alone in our suffering and b) “Suffering is part of life.” (Put your hand health amidst the pandemic. In a recent study, emotion (e.g., exercise, socializing virtually) can choose. DBT can also focus on the ways you protects against the loneliness of social over your heart to feel the warmth of • Taking Care of the Caregiver: Health care just over half of HCWs surveyed reported provide you with practical guidance. regulate your emotions (e.g. identifying how depression symptoms (50.7%), while 44.7% emotions escalate into distress and how you distancing/isolation; and touch.) workers need time to recharge and take • Mindfulness-Based Stress Reduction can experienced anxiety and 36.1% reported a sleep might de-escalate yourself). 3. Self-kindness – which regulates fear care of themselves in order to take care be used to facilitate stress management. c) “May I be kind to myself.” (Ask yourself disorder. through connection and warmth with what you need to hear in that moment of others. This involves giving yourself Breathing exercises, body scans, and short, • Motivational Interviewing focuses on ourselves. and say it to yourself.) permission to meet your own needs. Promoting Resilience in guided meditations are grounding. These rolling with resistance and prompting change. Health Care Workers techniques can be empowering when practiced It can be helpful in supporting HCWs who Self-compassion has many benefits. • Soothing Touch: It is more difficult to • Off the job self-care: Spend time outside Resilience can be defined as adapting to changes individually or with patients. This practice may are struggling with maladaptive habits and Researchers have found it fosters compassion receive the physical touch/comfort we need of work doing things you enjoy — listen to caused by stressful events in a flexible way and simply entail taking two minutes during each behaviors imposed by the pandemic. music, do yoga, spend time with family or recovering from negative emotional experiences. shift to focus on your breathing and give your To all HCWs: thank you for being resilient during those in your bubble, take a bath, play a It’s about our ability to withstand adversity. body a break. An alarm can be set to remind these difficult times! I encourage you to seek board game, etc. you to take a moment to relax and refocus. In health care, resilience encompasses being able support if you are feeling overwhelmed by the • On the job self-care: It can be hard to to care for patients and oneself while enduring • Interpersonal Therapy: Speaking openly impacts of COVID-19. find the time during work to take care uncertainty and unpredictability. Now, there is of ourselves. When you are stressed or the added stress of a global pandemic that has overwhelmed at work try: infiltrated our work life (and personal life). COVID-19 is a major threat to our resilience, i. Using self-soothing words (e.g. “I know and research shows we need to protect the this is hard and it is OK that you are mental health of HCWs during the pandemic. stressed. Take a minute to breathe.”). After all, maintaining the success of the health ii. Soothing Touch – place one hand on care system and provision of health care services your heart and abdomen, take 2 to3 deep depends on the well-being of you, our HCWs. breaths, notice the gentle pressure and According to the American Psychological warmth of your hands, feel your chest rise Association, it is crucial to promote psychological and fall naturally. resilience of during the pandemic so you may continue to work with the intensity and focus I hope you find these practices helpful your jobs require. Because of your training and thought-provoking. Remember: self- in understanding wellness, distress, and compassion is a skill and may require time and psychotherapeutic treatment, psychologists are practice to reap the benefits. Imperfection well positioned to respond to this need. is part of being human and self-compassion Applying Psychotherapeutic Principles allows us to provide ourselves with the love, to Bolster Resilience connection, and support we need to handle Here are a few examples of psychotherapeutic whatever challenges come our way. techniques that can offer you the opportunity for reflection and validation, and for learning about the nature of stress, coping, and resilience:

Megan Pollard is a Clinical Psychology Intern working with Horizon this year. She currently works at Horizon’s Dr. For more self-compassion exercises see: • Group Therapy: A group setting offers an Everett Chalmers Regional Hospital and Horizon’s Stan Cassidy Centre for Rehabilitation. self-compassion.org opportunity to amplify existing connections Brandi Person, Clinical Psychology Intern New Career, New Work-Life Balance On the map: How a group of internationally-educated in New Brunswick nurses made their way to Horizon — and what they Dr. Marissa Attis and Dr. Rohail Kumar, Pediatricians at Horizon’s The Moncton Hospital learned along the way What happens when two system that was foreign to us, amidst the skill sets to a hospital to help support children complexities of COVID-19. and expand on the current services. We physicians’ careers collide looked forward to knowing that we were only Two new pediatricians, in a new health care a flight or two away. to become one? setting can be daunting, but we had the Let’s roll back to 2014, in New Orleans, support of our pediatrics team here at TMH. What does a typical day look like, you might when we met during our pediatric residency While we are still learning the system, things ask? Well, to be honest there is no such thing training. Life was hectic. We were learning are slowly starting to come together. as “typical.” We do work together in the about how to provide health care for children Pediatrics Clinic to care for kids aged 0 to 16. and about a new culture in a new city, with Some days we have patients that need care new colleagues. So why did we decide on Moncton? in hospital, while other days we are solely providing outpatient care. When we are While the southern hospitality, warm weather, We anticipated Moncton would on-call, we provide care for children in the and Mardi Gras were all great experiences, we afford us a decent work-life emergency department, as well as babies in knew that this wouldn’t be our forever home. the neonatal intensive care unit (NICU). We knew we wanted to be closer to friends balance, in an environment where and family. we could be close to our family, While we faced many obstacles on our arrival, We had both chosen to further pursue our and, as a bonus, we would be close and continue to confront new obstacles, we training (Marissa in pediatric critical care and are glad that we are on this journey together. Rohail in pediatric palliative care), but as our to the ocean. We both enjoy being We are happy with our decision to be a part subspecialty training came to a close, we had outdoors and knew the Maritimes of the pediatric team at TMH and we hope we 18 to make an important decision on where we can continue to grow and make changes, each 19 would settle. We wanted to be near family and would provide us with a great step of the way. start to lay roots. platform to be able to do this. We are grateful that in these difficult “COVID The next thing we knew, we had accepted jobs times,” we can be with our family and spend at Horizon’s The Moncton Hospital (TMH), While we had to give up our subspeciality time exploring our province and helping the From left: Friends, colleagues and internationally-educated nurses Christina (Tina) Christopher, Janabelle (Jana) Pama, June Panadero and Kriselle (Ellie) Laude work together as pediatricians in 2019. It was a health care training, we looked forward to bringing our children of this community. on 3CN at Horizon’s Saint John Regional Hospital. Four internationally-educated nurses have all residency (PR), she applied for a job at SJRH. They heard about New Brunswick and found a career and work they love — together Horizon through active recruiting at their Colleague Christina (Tina) Christopher had — on 3CN at Horizon’s Saint John Regional bridge school. 15 years’ experience in her home country of Hospital (SJRH). Malaysia and the Middle East before coming to At this school, like other bridge schools, there They’re examples, they say, that show New Canada. She’s also always worked in acute care, is a competitive atmosphere, as all students Brunswick is on the map when it comes to except for a short time in LTC when she first are on a student visa and looking for sponsors international recruitment of nurses. arrived in Canada. for a work permit, which helps them get their permanent residency. All four said the province, The unit, which treats and cares for patients “You wouldn’t be in this career this long if you Horizon and their hospital supported them in hospital for general, thoracic, vascular and don’t have compassion,” she said. “It’s not just through this process. colorectal surgery, welcomed the three registered a career, it’s something within you.” nurses (RNs) and one licensed practical nurse But, at the end of the day, for this group of Janabelle (Jana) Pama started on the unit in the (LPN) — who is working towards her RN license nurses, it was all worth it. first week of August 2020, after working in her — between January and August 2020. home country of the Philippines and then Saudi They love working together — even though, They all completed their equivalency training Arabia, for several years. with rotations (a mix of 12- and eight-hour at what they call a “refresher” school in British shifts) and full patient loads — they don’t get a “It’s a tedious process, regardless of how many Columbia where they took a bridging program lot of time together during a work day. Friendly years’ experience you have,” she said. for internationally-educated nurses to transition colleagues helped make the transition easier, too. and qualify to work in Canada. June Panadero, who started with Horizon as an They all say they enjoy working bedside and LPN, is from the Philippines and has worked in The path to living and working in Canada the human interaction, especially with their Dr. Rohail Kumar is from her home country and Kuwait on surgery (OR), wasn’t always smooth, but worth it. older patients. Karachi, Pakistan. He medical-surgery and obstetric units. She moved completed his medical Kriselle (Ellie) Laude has been a nurse for 11 to Canada in early 2017 to move her career Jennifer (Jen) Ervin was the nurse manager who Dr. Marissa Attis is from Moncton, school training at Aga Khan years, starting in her home city of Manila in forward, and has done just that, having recently helped welcome the nurses to the floor. Not New Brunswick. She completed University in Pakistan. He then the Phillippines. She grew up wanting to be a finished her preceptorship and been offered a only do they bring with them much-needed her medical school training at completed his pediatric and Saba University in Saba. She then child psychiatry training at journalist, but was encouraged by her mom to full-time RN position with Horizon! experience, to a unit of young nurses, Jen become a nurse. said, but also much-needed energy, especially completed her pediatric residency Tulane University, New Orleans They all agree no matter where they work, due to nursing shortages and challenges and at Tulane University, in New He further sub-specialized “I cannot imagine myself doing another job,” nursing is the same in every continent: You’re Orleans. She completed further in pediatric palliative care at uncertainty of COVID-19. she said. often working short-staffed, but, at the end training in pediatric critical care the University of Birmingham of the day, your passion for helping someone “Having someone come onto the unit with such medicine in Nashville, Tennessee at Alabama. He joined the She started her New Brunswick nursing career achieve their recovery goals is what helps get as great outlook and positivity, it’s infectious,” before moving back to Moncton as Moncton Hospital as a in long-term care in Woodstock, but always had you through. she said. “It’s really been uplifting having them pediatrician in September 2020. pediatrician in September 2020. her mind set on returning to the environment come on to the unit and bringing their different she knew and loved best: acute care. Getting to SJRH was not an easy journey, with perspectives and experiences from different bumps, challenges and a lot of time, effort and “I feel like I’m made to be in a hospital,” she countries.” money. said, adding after she got her permanent Psssst. Hey, you! Yes, you. Did you know?

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