BY NORM TOLLINSKY

A demonstration project funded under HealthForceOntario’s health human resources strategy is allowing nurses from opposite ends of the province to walk in each other’s shoes.

Operating since March, the one-year partnership between Toronto’s University Health Network, the Weeneebayko Health Authority and James Bay General Hospital has introduced approximately 20 nurses from one of the busiest and best equipped hospitals in the province to some of the challenges and hardships of health-care delivery in First Nation communities 2,000 kilometres away.

The project has also allowed nursing staff and administrators from James Bay communities to visit UHN sites in downtown Toronto, share knowledge resources and participate in learning experiences.

Jennifer Taylor, a UHN nurse who spent four weeks at the James Bay General Hospital site in Attawapiskat in March, was “humbled” by the demands placed on nurses working in the province’s Far North.

On her first day in Attawapiskat, she was surprised to hear one nurse ask a colleague if there was a doctor that week. Physicians, she soon learned, generally flew in from Moosonee from Monday to Thursday “if there wasn’t a snowstorm and if the plane could fly.”

Nurses in Attawapiskat are forced by circumstances to work with much more autonomy and with a much broader scope of practice, observed Taylor, an RN with years of emergency department experience.

“They have a phenomenally broad knowledge base and function pretty much as physicians,” delivering babies, suturing and casting.

“One evening I was sitting with a plastic arm learning how to suture when the ambulance came in with a man with 50 self-inflicted knife wounds,” recalled Taylor. “There was no time. We just had to get in there and, with another nurse, we sutured him up.”

Taylor found the Cree people to be “very polite, warm and kind.” When the time came to head back south, “They didn’t say a lot, but the hugs said it all.”

Hardships

Not surprisingly, she also experienced some of the hardships of living on the James Bay coast. Unable or unwilling to drink the community’s tap water, she went to the general store and handed over a $20 bill for a case of water that would normally cost $2.99 in Toronto, only to discover that the price in Attawapiskat was $47. A bag of apples the size of golf balls was $10. By the end of the four weeks, she had shed 10 pounds.

Although Attawapiskat is officially dry, alcohol still finds its way into the community through a thriving black market. Gas sniffing continues to be a problem and girls as young as 14 are having babies. By the time they’re 25, it’s not unusual for them to have six or seven children, said Taylor.

“Here are these beautiful young minds with nothing to do.”

Substandard housing conditions are also a problem with up to 15 people living in windowless construction trailers in some cases.

Because the hospital has limited diagnostic equipment and no lab, staff depend on air transportation to Moosonee and larger urban hospitals.

“I work in the Cadillac of hospitals and we have everything we want,” said Taylor. “Up there, if you need a CT scan, you have to be sent out.” Taking blood is not a problem, but in Attawapiskat, nurses have to spin it before sending it off to Moosonee for analysis.

“If someone comes into Emergency with chest pain in Toronto, we’d automatically take blood and send it off to the lab to look at the electrolytes and cardiac enzymes. I’d have the results in an hour, but, up there, if someone comes into the hospital on a Friday after the last plane has gone out, it’s not going to go anywhere until Monday.”

Baiba Zarins, who oversees the program for UHN, said “staff who have returned are truly impressed and inspired by their colleagues in the North and how they’re able to practice to their full scope. They feel quite restricted when they come back to UHN.”

The partnership, she said, benefits both parties, providing UHN nurses with valuable experience, while also augmenting resources in James Bay communities.

Zarins hopes that it will lead to the development of a core group of nurses who would be willing to serve in these communities on repeat placements.

“It would be less expensive than booking staff through agencies,” she claimed.

The exchange program was conceived by Dr. Mary Ferguson-Paré, the UHN’s vice-president and chief nursing executive, who travelled extensively throughout the James Bay region during her term as president of the Registered Nurses Association of Ontario.

www.wha.on.ca
www.jbgh.org
www.uhn.ca