CNSA National Conference, Calgary AB Delegate Report
Official Delegate Report by Natasha Lennam & Nicky Nicholas
CNSA National Conference, Calgary AB
Aspire to Inspire: Celebrating Student Leadership and Advocacy
January 21-26, 2019
Natasha Lennam, CNSA Offical Delegate
Nicky Nicholas, CNSA Associate Delegate
Tuesday, 21 January 2019
OD/AD Breakout Sessions
Aspiring to be an Indigenous Ally
Chloe started her presentation acknowledging the traditional lands this conference was held on, thanking the Blackfoot Confederacy, Stoney Nakoda, and the Metis Nation Region III. Chloe had the opportunity to pursue her desire to advocate for Indigenous Health initiatives by doing her final preceptorship in Kugluktuk, Nunavut.
Chloe started the presentation with a video that spoke out the suicide rate of this small community and the factors that residents believed contributed to it. Of note, Kugluktuk was a dry community and as such, had a bootlegging problem that drew a lot of the youth in to. This is a factor that many believed added to the suicidality of the youth. As a result of the increasing rate of suicide, the community voted to establish liquor control and licensing to eliminate bootlegging.
Another factor spoke about was the effect of colonization. A physician that had lived in the community for many years consulted with the local community regarding the suicide rate and from this consultation realized the effects of colonization and the loss of connection with the land is where much of the suicide was also stemming from. This knowledge inspired him to create an initiative called Young Hunters that took young boys into the tundra and learn to hunt with experienced huntsmen. This provided a much needed connection to the land, one that hadn’t been present in that community since colonization.
From her experience in Nunavut, Chloe presented some tips and advice for people seeking to be an Indigenous ally:
· Seek to identify barriers to culturally-safe care
· The best way to start is in your own practice
· Be alert to practices that promote stereotypes, both individually and systemically
· Be familiar with the barriers that some Indigenous people face when accessing health care
· Ask good questions and be curious
· Wear your enthusiasm
· Know your emotional intelligence because becoming an Indigenous ally will have situations that are emotionally challenging; you can’t do everything right when you are learning
Peer Mentorship: Nurses Empowering their Young
Megan D’Souza, RN and Alston Seto, RN
Megan and Alston talked about their experience with peer mentorship at their school. Both graduated in 2018 and are working in non-traditional areas of nursing. Megan is working in forensics and Alston is working in occupational health and safety at a slaughter house; both Megan and Alston were exposed to these areas of nursing due to being a part of their school’s peer mentorship program.
The purpose of the student-led peer mentorship program is to have senior students mentor newer students in the areas of academic excellence, professional identity, promoting leadership. Their peer mentorship program helped students build community; develop positive relationships and social capital; guides them through transitions and how to face expectations; and helps develop early academic experience leading to stronger growth in the program.
A key aspect of their peer mentorship program was the opportunity to share experiences. One area that Megan and Alston suggested had the biggest impact on students was the ability to share clinical experience, because not every student will have the opportunity to practice in all the clinical areas. They also found that at their school, there was a lot of interest and engagement in their academic events. These events include semester review sessions, where the student leading the session could bring back concerns and praises to the faculty. They also let their mentor/mentee relationships develop organically out of the numerous social events the peer mentorship program would put on each semester. This created a more even relationship between the students and prevented the problem of the mentor/mentee not working out.
Megan and Alston also suggested several tips on how to start a peer mentorship program. A point they drove home was the need to evaluate the programming put on. If the students aren’t attending, perhaps the focus needs to change. They talked about how important it is to elicit feedback from the student body. They also underscored the importance of having a strong understanding with faculty about what the program does and does not offer to students. This is important so that instructors do not feel threatened by the work that the peer mentorship program is doing. The most important four recommendations that came from this session are
· Experiential learning with junior and senior students
· Adding a social media portal for accessibility for different schedules
· Involve first years because when first year students are involved with peer mentorship, they are more likely to finish the program successfully
· Faculty involvement as teaching and learning method, specifically with the use of the SIM lab and to communicate the goal of each workshop
Western-Prairie Regional Meeting,
Wednesday, January 22, 2019
Fundraising and student event ideas from other schools:
· Sift and thrift
· Kahoot NCLEX Trivia Night
· Welcome back/orientation pizza party
· Comedy night
· Lunch and learns
· Pizza and patho nights
· Mental Health First Aid
· Scavenger Hunt
· Facebook Auction
· Giving Tree
· Board Game Nights
· Teddy Bear Clinic
· Mock Skills Test
· Indigenous Movie Night
· Indigenous Medicine Speaker
CNSA Global Health Podcast on Spotify
CNF Awards – check their website for awards, there are 10 specific to the CNSA
Global Health curriculum survey sent out to CNSA chapter school emails
Environment Day tentative date February 25 2019, zero waste informatic to be sent out
Possible AVI PreP info session lunch and learn?
Western Prairie Regional Conference Oct 31-Nov 3 in Abbotsford, BC. Theme is ‘Nursing the Spectrum: Diversity and Inclusion Within the Realms of Health’
Thursday, January 24, 2019
Nurse Speed Dating
Bev Lent, Canadian Federation of Mental Health Nurses
Canadian Federation of MH Nurses
· Part of the CNA, influence federal policy on MHSU and they have representatives fro every province and territory
· $20 student memberships, can have input in national standards of practice (camimh.ca)
· Their national conference is held every two years, this year it will be during October in Winnipeg, students get discounted ticket rate
Bev is a Psych Nurse with 45 years experience, currently working in psych youth emergency
o Neuropsych lens à PET scans and labs… finding behavioural changes often related to autoimmune encephalitis and inflammatory brain disorders
Shawna Reid, Gerontology
· Join association, often get specialty covered by nurse managers are gerontology is growing within acute care
· Interesting d/t patho, polypharmacy à hard to figure out presentation
o Older adults present in unique and unusual ways, both from younger adults and from each other
· Lots of work with families
· Dementia and vulnerability; feels good to figure out reasons for discomfort
· Really relies on assessment skills because sometimes the older adult isn’t able to verbalize what they are feeling
· The nurse takes on many different roles: clinician, secretary (recording dictation when the older adult is no longer able to write), chaplain, interior decorator (helping them arrange their house so that their IV pole, oxygen tank, mobility aids, etc. will be useable)
· National conference in Calgary during May 2019
Julia Imanoff, Perinatal Nursing
· Women’s health across the lifespan
o Labour and delivery, antenatal, prenatal, OR, etc.
· Beneficial to join CAPWHN as student or email Julia if interests lie in LDR/women’s reproductive health
Giselle Incze, Canadian Nurses Protective Society
· Offers liability protection and legal support to nurses
o Fees of registration in BC go directly to CNPS so all registered nurses can use this service
· Check out website for webinars, articles, case studies
· Importance of documentation as lawsuits can arise 18-20 years after the fact
· Social media confidentiality risk
· Protective society associated with BCCNP, covers legal fees and provides legal consult
Trent Moser, National Emergency Nurses Association (NENA)
· 5 levels of emergency (level 1 trauma = most severe)
· Level 1 trauma centers have to be attached to a University
· Sponsor emergency nursing courses
· National Conference May 24-26 2019 in St John; US chapter joins and students have access
· Fast-paced environment where the nurse gets opportunity to try all specialties because almost everyone goes through the ER
· Prior to working in emergency require critical care courses and suggested med-surg, internal medicine experience
Jody Dumanski, Canadian Vascular Access Association
· PICC team: care, maintenance, insertion
· Difficult peripheral IVs
· Most PICCs inserted for bone infections, home IV Abx treatment
· Ultrasound training for insertion = higher success rates (95%)
· Association advocates for IV teams, but department funding always a barrier
Kathy Bouwmeester, Canadian Association of Critical Care Nurses
· Associations shape role and scope of nursing
· Benefits of being part of an association include leadership and governance, support, connection, mentorship, community, and access to best practices and new research
· Chosingwiselycanada.com for best practice and evidence-based practice
· Conference in Halifax during September 2019
· Goal to improve patient care
Barbara Mushayandevu, OR Nurses Association
· Students can join as associates www.ornac.ca
· Patient advocacy in the OR is major role of OR nurse
· Scrub nurse must also know anatomy of area being worked on as nurses in OR are equally liable for mistakes as surgeon, need to be able to identify when something about surgery isn’t right
Cheri Purpur, Canadian Hospice Palliative Care Group
· Affiliated with CNA
· 11% of Canadians have good access to EOL care and many palliative care units are wings in LTC or acute care hospitals
· Advanced Care Planning important for ensuring your EOL needs are met
· Often midwives and LDR nurses move into palliative care
· With working palliative patients in acute care, pull in all resources to decrease trauma to family (social work, music therapy, chaplain)
· A nurse must work a certain number of hours to be eligible to write the exam to be specialized, then they can be a member
Diana Snell, Community Health
· Community health nurses of Canada
· Self-study certification through CNA
o Happens twice per year and it’s recommended that a nurse recertify every five years
· Overlaps with many other areas (palliative, family practice, rural, public health, etc.)
· Disagree that you need hospital experience to work in community
Learning, Teaching Leading: Developing Sense of Self
Carla Ferreira MN, RN, CCHN (CC), CHSE
Carla is a nursing instructor at the University of Calgary and she teaches SIM and nursing education courses. The theme of this session was to begin to explore and understand the ways we learn and the ways we teach. She defined learning, teaching, and leading with statements and phrases that were meaningful for her. Learning was defined as a process that leads to change and that occurs as a result of experience. Teaching is a process, half science and half art; it is leadership, partnership, and sharing, and not dictatorship. Leading, Carla stated, was showing the way by going in advance and to guide or direct a course of action.
After a brief discussion with our peers, we were asked to complete Kolb’s learning profiles. After figuring out which quadrant we belonged to, we were grouped into 4 based on our results and had to figure out what kind of learning style we thought we were. We also had to name our groups. After that discussion, we met as a group and shared our group name and what kind of learners we thought we were. Carla revealed what each quadrant was and discussed the 4 different types of learner. She asked what drives us as a learner and what makes us uncomfortable. She said exploring these questions helps us to understand our own learning needs. Carla suggested that before we can start teaching something to someone, we need to understand our learning style because that will influence how we teach. Being aware of one’s learning style doesn’t mean that this area is static. Carla asserted that learning styles do change, and kind of have to change during nursing and nursing school.
The second portion of the session related to teaching styles. She emphasized that a lot of nursing is teaching and we took the teaching perspectives inventory (TPI) test online to understand what types of teachers we are, and what our behaviours, values and attitudes are. This session was a great immersive experience in learning more about how we learn and teach and what that means for our practice. Carla stressed leadership isn’t about holding a position, but about how one reacts in certain situations.
Keynote Speaker: Barb Shellian
Barb Shellian is Director Rural Health – Calgary Zone Alberta Health Services and is located in Canmore, Alberta. She has extensive experience as a staff nurse, educator, manager and clinical nurse specialist. From 2016 to 2018, she was the president of the CNA.
Barb centred her speech on the theme of leadership. She focused on how leadership is based on relationships and we need to encourage others to participate with us. She stressed that leadership is not management, though leaders can be managers. Barb re-evaluated how we define leaders and provided two examples of nursing leadership that are outside of the realm in which we generally envision nurse leaders:
1. Leadership can be dangerous: The WHO sent Barb and another nurse to Chile to work with local nurses on writing a scope of practice document for nurse legislation. While there, she noticed plaques surrounding the fireplace. When asked who the plaques were for, the nurses replied that they are for the missing nurses. Chile was under military dictatorship from 1973-1990 and in that time people were not allowed to “associate” with each other, so if two or more nurses got together to discuss healthcare, they would be seen as banding together against the regime. Nurses would meet in secret to discuss healthcare, but when discovered the nurses would disappear.
2. Leadership can be quiet: A nurse working in the remote community of Grisfjord has worked with this small community for decades. She takes the children out cross-country skiing, she purchased an inflatable pool to keep the children out of a cold, potentially dangerous pond and she is incredibly connected with the community. She is engaged in improving the health of the community by influencing and bringing people with her.
Barb used these two examples of nursing leadership to engage students to think outside of positions of power and rather to reflect on leadership as working with others to improve the whole. She stated that influence is based on a foundation of relationships and values, a sense of interdependence, a sense of community and belonging, as well as responsiveness and peacefulness. Barb encouraged us as nursing students to be leaders in healthcare by advocating for change we see as necessary for our communities, and to do this by engaging with the foundations for leadership: availability, commitment, and trust.
Policy and Politics: A Nurse’s Role
Why are nurses in the perfect position to advocate for policy change? Because our practice is grounded in evidence, we have close interactions with the community, and we can translate experiences to stories of impact.
Bryce Boynton is an RN and a MN candidate working in health policy. His session was concerned with nursing’s role in advocating for health policy changes and political change.
“Nursing’s combination of numbers, reputation and reach should translate into power and influence… yet, politically, the profession punches below its weight” (Lewis, 2010). Bryce stated that nurses make up 70% of the healthcare workforce, but are under-represented in healthcare reform. WHY? We have access to direct patient care, nursing knowledge and a responsibility within the Code of Ethics.
Little ‘p’ policy, Bryce suggested, is more informal and can easily be participated in. Areas that fall under little ‘p’ policy are unit policy, both utilizing and informing; social media; and engaging with evidenced-based practice. Big ‘P’ policy is more formal and can be harder to participate in. Areas of focus in this realm are research and sitting on a policy table. Bryce argues that policy development is not so different from the nursing process and that nurses should be consulted more during health reform.
Bryce argues that sexism, media images, a history of low healthcare status and nursing stereotypes are impacting the strength of our voice. However, he believes nurses are capable of making both informal and formal policy change easily, and that the community’s established trust in us should add clout to our messages.
Bryce suggested making abstracts of articles and sending them to politicians so they have the “quick facts” of nursing research. Furthermore, he suggested voting, encouraging others to vote and involvement in nursing associations as easy ways to inform policy change.
Addictions and Recovery: All In
Stacey Peterson, RSW and Lisa Simone, CACC
Stacey Peterson is the Executive Director of a men’s addictions recovery program in Calgary called Fresh Start and Lisa Simone is their National Communications Director. They are both recovering addicts and shared their personal stories to add depth and meaning to the concept of addiction recovery. They started their presentation by showing a short-film called “nuggets.” https://www.youtube.com/watch?v=HUngLgGRJpo
Stacey defined addiction as habitual behaviour sometimes associated with drugs and alcohol, or vicarious trauma. He also stated that addiction is a chronic disease that affects the brain’s reward system and motivation and memory functions. He spoke to Adverse Child Experience (ACEs) as a model for understanding the complexity of addiction, as well as THIQ (tetrahydroisoquinoline) to understand the genetic component of addiction. Addiction is now understood to be epigenetic in nature, involving both genetics and experiences.
Recovery, they state, is a process of healing the underlying conditions that lead to the addiction and there is not just one road to recovery; it looks different for each person. In order to recover, one must have courage in vulnerability.
Fresh Start is a non-profit charity that fundraises to decrease or cover the costs of their program participants to complete their recovery journey. They also act as consultants to other recovery centers that are looking to expand or increase their funding. Stacey never underestimates the ability to bring about positive change in someone else’s life.
The message both speakers wanted to enforce is that recovery has many pathways and it takes courage and vulnerability to build the resiliency required to recover from addiction. They left us with the quote “everything you earn in life will rot and fall apart… the only thing left is what is in your heart.”
Concurrent Capability: Advocating for Concurrent Disorder Population
Danielle Kim, RN, BN, Clinical Consultant for Alberta Health Services
Concurrent capable care, also known as concurrent capability, is a concept of recognizing both addiction and mental health needs simultaneously. In Alberta, these two services were integrated in 2009, with a harm reduction policy set to be launched in February 2019.
Concurrent Disorder is defined as a mental health disorder combined with substance use or a gambling problem. 1/5 people experience mental health issues and 10% of people over the age of 15 years with battle with drug or alcohol dependency. Danielle’s presentation focused on navigating through the Algorithm for Concurrent Capable Practice developed by Alberta Health Services.
In 2015 Alberta Health Services adopted the Patient First Strategy, which is essentially a patient and family centred care approach to nursing. This approach to care is interwoven within the Algorithm as it’s essential to work with clients to develop their own goals for care. This was emphasized throughout the presentation.
Danielle went over some risk factors for developing concurrent disorders, which included ACEs, genetic markers, vulnerable populations, and gender theory. Danielle also emphasized the importance of maintaining “empathetic detachment” when working with patients with concurrent disorders in order to maintain boundaries, as nurses will often see the same patients repeatedly and tend to form bonds.
Danielle’s presentation focused mostly on Alberta Health Services, but the biggest take-aways would be identifying your patient’s strengths to rebuild self-confidence, learning about different cultures, including gender identity, in order to better serve your patients, and referring to Prochaska and DiClemente’s Stages of Change to identify where your patient places and what supports you can provide for that stage. This presentation was not only helpful for those interested in mental health nursing, but for all nursing students as mental health and addictions cannot be avoided in care.
Dianne is part of the harm reduction policy team that has been established in Alberta in response to the opioid crisis. The team has been working hard to effect change in policy and culture to better care for people who use substances. As nurses, we must speak up when we hear stigmatizing language from colleagues. She began her presentation with a quote, “people who use drugs are not expendable – they are human beings who come from families who love them.”
Harm reduction is defined as policies and programs that aim to reduce adverse health, social, or economic consequences. Dianne found that the policy about harm reduction required more direction in order to be useful. This is what her team has been working on. She stressed the importance of having stakeholders, those with lived experience using substances, be consulted in this process. During the entire overhaul of their harm reduction policy, she ensured that there was a person with lived experience on each committee formed. She wanted to inform health care practitioners that abstinence or reduction in use is not a requirement to receive adequate health care.
Dianne’s new policy will come into effect on 3 February 2019 in Alberta. She has been developing scripts on how to talk with people who use substances to avoid stigmatizing language and guide appropriate conversations. She ensured that at the heart of this harm reduction policy is the belief that each person is the expert on their life.
She also spoke briefly about injectable therapy with hydromorphone that is happening in Vancouver now. Dianne spoke about the program’s successes, and she hopes to bring the same model used at Crosstown in Vancouver into Alberta.
Feminisms and Sexualism in Indigenous Society
Victoria Marchand, Director of Indigenous Health Advocacy, CNSA
Victoria Marchand is an Algonquin First Nation from Kitigan Zibi Anishinabeg. She is an advocate for Indigenous rights and health equity in Canada, new President of the CNSA and a member of the Executive Board of the CNSA. Victoria’s presentation was broken up into two parts. In the first part, she discussed the history of colonialism in Canada and how certain legislations have changed the “natural and normative ways of the Anishinabeg people.” Victoria highlighted the differences between the First Nations, Inuit and Metis people and provided a breakdown of the Indian Act, a history of Indian Hospitals and the 60s scoop and the impact of these experiences on Indigenous people today.
Victoria defined the term Two-Spirited (2S) as a First Nations person who identifies with multiple gender roles beyond men and women. She discussed how the gender binary is used as a violent tool of colonialism to assimilate First Nations, Inuit and Metis people. The loss of 2S identities resulted in the internalization of homophobia, transphobia, and discrimination within Indigenous communities. Victoria talked about the vicious cycle of racism starting with stereotypes that lead to prejudices which forms into discrimination and these band together to oppress a society of people. Oppression of a culture perpetuates stereotypes and the cycle continues.
The second part of Victoria’s presentation focused on intersectionality and Indigenous feminisms. She encouraged allies to listen and ask questions, educate themselves about how they can support First Nations, Inuit and Metis people. Though Victoria advocates for Indigenous allies, she states that it is not the Indigenous person’s responsibility to labour a non-Indigenous person’s emotions during this sometimes difficult journey.
Victoria used an image of a tree to describe the social determinants of health. The leaves are considered the proximal determinants such as gender and education. The trunk are the intermediate determinants, relating one’s involvement in the education or legal systems. And finally, the roots are akin to the structural factors that affects one’s SDOH, such as the colonial structures that continue to oppress Indigenous peoples. She stressed that it is not the leaves that make the tree sick. She went on to speak about contemporary issues that relate to the structural factors that are continuing to affect First Nations, Metis, and Inuit people in Canada.
Two websites recommended for those interested in learning more about Indigenous Feminism:
Feminist Decolonial Politics https://decolonialthoughtworkshop.wordpress.com/
National Collaborating Centre of Aboriginal Health https://www.nccah-ccnsa.ca/en/
Keynote Speaker: Grandmother Doreen Spence
Doreen gave a presentation on love, acceptance, and tolerance. She used personal and cultural stories to guide her presentation, which was personal and profound, and for this reason, we cannot provide a summary. We have provided her bio from the conference manual as she is a very accomplished woman.
Doreen was born of Cree ancestry in Northern Alberta. She has represented her people and
the values by which they live in an effective and exemplary manner for the past forty-five
years. Drawing on her own experiences as an indigenous woman as well as those, peoples from across the world, Doreen is capable of addressing any issue that impacts on the Aboriginal community.
She travels extensively to present at numerous conferences around the world sharing her
message of healing, tolerance, human rights, and the wisdom of First Nations traditional
Doreen is the founder and executive director of Canadian Indigenous Women’s Resource
Institute. Prior to CIWRI, she was the founder and President of the Plains Cultural Survival School Society and was a senator at the University of Calgary.
Internationally, Doreen is the Canadian representative to the United Nations Working Group of Indigenous Populations, and as part of that, she advocates on behalf of indigenous peoples worldwide.
Doreen has been honored numerous times for her work, including:
· A Nobel Peace Prize Nominee for the 1000 Women of Peace project in 2005
· International Award at the New Zealand Spiritual Elders Conference in 1992
· International conference along with His Holiness the Dalai Lama.
· Indspire Award recipients 2017
· Bachelors of Nursing 2017
Human Trafficking in Health Care
Asmaa Mabrouk, Nursing Student uOttawa
Asma works at H.E.A.L.T.H. (Healthcare-Education-Advocacy-Linkage-Trauma-informed-Healing), a Nurse Practitioner run clinic that uses a trauma-informed lens to provide health care to victims and survivors of human trafficking. The clinic offers services to anyone over the age of 13 (some exceptions) who has experienced trauma. The clinic was founded on the premise that the ER and a GP’s office can be prohibitive and/or frightening to survivors. It is a primary care facility trying to meet the day to day wellness needs of its patients. There is no commitment requires and patients do not need to provide ID to obtain services. The clinic is connected with victim services and is affiliated with the organization Voice Found.
To clear up any misconceptions between some similar terms, Asma defined human trafficking, human smuggling, and sex work. Human trafficking has a lack of consent and the goal is exploitation of the individual. Human smuggling is a voluntary service, meaning the person often volunteers to smuggle. The goal is transportation of the good(s). This can easily blend into human trafficking if the person’s ID is taken and not returned, forcing the person to do another smuggle. Sex work is a consensual transaction and the worker chooses to provide sexual services. Again, this can blend into human trafficking if the person is forced to provide sexual services or if they are forced to provide the money earned to another.
Asma focused her presentation on the invisibility of human trafficking in health care and ways we can support victims or patients who have experiences trauma. Many people may not identify with the label of human trafficking, so Asma stressed the importance of asking questions about safety and/or coercion. As for treatment, Asma emphasized establishing a trusting relationship as foundational for ensuring patient’s return. She said to pay attention to subtle and non-verbal cues, and to take care of the immediate needs of the patient (what they came in for).