Nursing Chat-May 27,2020
Nursing Chat-Transcript
May 27, 2020
donnerwheeeler
Mary Wheeler: A month ago we started these, nursing chats. We had in the first
cohort, what I would call, nurses in leadership roles. And then we had the
second week students and the third week we had a nurses from a variety. So we had
nurse practitioners. We had nurse educators. we had Kim English who was up in
Attawapiskat.
So we had quite an eclectic group. and we
taped all these, nursing chats and posted them. It was very interesting. what
people talked about in the nursing chats when they told their amazing nursing
stories of what they were doing throughout the, pandemic, they were feeling
they were on an emotional roller coaster.
There were lots of changes going on and
lots of unknown and on the opposite side, what they said is it was, they felt
there was a lot of courage. Like I was using a lot of courage to sort of leap
into something. I didn't know. I was surprising myself. I was excited. lots of
new learning. I had to step up to the plate because I didn't, you know, I just
said, yes, I'll do it.
And, I never realized I had the capacity
that I had. So that was just some nuggets when I listened to the three
conversations.
Coming back tonight, there were two
questions and we said that. To make your experience over the pandemic,
meaningful going forward. What's the one thing you'll do, whether in your
practice or in your personal life. And then the second question, what insights
do you have from this experience? That could help guide, inform or redesign the
nursing profession in the future.
So I'm wondering if both Georgina and
Cathy could introduce themselves where they're working and what their role is.
Cathy Szabo: I'm Cathy Szabo, the president and CEO of Providence care. We're a
subacute hospital with 270 beds usually, but during COVID, we've gone up to
473 beds. We've doubled our capacity in the hospital, to accept COVID patients
or non COVID patients as part of our regional role.
We also have a longterm care home that has
243 beds in it. And we also are in the process of redeveloping that and 22
community programs. During COVID we've had four outbreaks with no spread -- one
was a nursing home resident and the rest were staff. The staff in the
organization more than half of our staff had been here longer than 10 years,
and they're very committed to the organization.
Mary Wheeler: Thanks Cathy.
Georgina.
Georgina
MacDougall: Hi, I'm Georgina MacDougall. I'm the
HIV clinic nurse coordinator at Sick Kids. my, leadership lies really with my
relationship with my patients. And, we've continued to see our, our patients,
Regularly. And, it's taken a lot of, my capacity and my trust relationship to
convince families that it's safe to come to the hospital and to continue, to
see us.
Mary Wheeler: Great. Thanks Georgina. So in week two, then we focused on students
and, there were two, co-leads for that.
And I see Jean-Claude from that week is the
only one here tonight. So, welcome back, Jean-Claude. And I'm wondering if you
could just introduce yourself
Jean-Claude
Fillion: Yes. my name is Jean-Claude. I am located
in Toronto. now I'm actually a nursing student with Collège Boréal, just
finishing up my practical nursing program.
Well, trying to, I'm in that weird, section
of the program where. COVID-19 started right when we finished our class exams
and we just need to do our clinical placement and then graduate and then be
able to do our licensing exam. I'm actually enrolled, with George Brown for
September the bridging program in order to go up to RN and hopefully, maybe a little
bit higher up than I've maybe a master's or doctorate.
I have gone through some challenges, with
the coordination of transferring into the bridging program and the licensing
exam dates and things like that.
Mary Wheeler: Great. Thanks Jean-Claude. So there were two co-leads Amy and
Janice, if you'd just like to introduce yourselves,
Amy Vokarek: Hi, I'm Amy Vodereck and I am an executive coach and I teach at Mac
in the school of nursing as well, leadership and management. And I'm happy to
be here.
Mary Wheeler: Great.
Janice Waddell: And I'm Janice Wadell and I teach at Ryerson. I'm a associate Dean
with the grad studies at Ryerson. So for the nursing students, it's, the
graduate students that I work with, just in, in the chat we had that there were,
there were two of them. And what was impressive to us, I think collectively was
the resilience of those nurses, as they're trying to juggle not only their
academics and all that stood in their way in terms of their thesis, the
courses. but also their ability to navigate that, but also to feel privileged
in the role and being able to help
Mary Wheeler: Thanks Janice, so there's no one on the screen here that I see from
a week three, but Michelle and Chris were the co-leads. And I'm wondering if
you could just introduce yourself.
Michelle Cooper: Michelle Cooper. . I'm a, an independent consultant coaching,
organizational development and leadership development.
I've been associate of donnerwheeler for,
well, I think it's about 15 years The chat last week was nurses on the
frontline. And I think that what I heard was the passion for nursing, the
courage to step up and I, I know I left feeling inspired by all that people
were doing.
Chris
Kebbel: I'm Chris Kebbel, I'm associate with donnerwheeler. that's
sort of my part time gig my full time gig, more than full time gig as at
University Health Network, my background's in critical care nursing, but now I
work in a nursing informatics role.
At the start of this, I really thought
that I would be heading back to the bedside. Given everything that was said,
but, to my surprise and a little bit to my disappointment, to be honest, I
didn't get called back to the bedside instead. They've got me working lots and
lots and lots of overtime, helping coordinate some of the it and the
electronic, assessment side of things.
Mary Wheeler: Thanks Chris. . I'm wondering Sue, if you could just introduce
yourself,
Sue
Bookey-Bassett: Hi everybody. So I'm Sue
Bookey-Bassett. I'm currently an assistant professor at Ryerson . I didn't
participate in any of the other chats, but I work with Mary and Gail and Janice
on, the NIA, award committee with RNFOO.
And I've also known Michelle, Janice, Mary
Gail for a long time, but I'm also working on two, studies related to COVID.
One is at UHN looking at, the impact of the PPE on nurse fatigue and nurse
workload. And I'm also working on another study. That's looking at the impact
of COVID on students related, particularly because of the, the cessation of in
person classes and the impact that that's had not only on their clinical
experiences and potential ongoing learning, but sort of the next steps and
career decisions.
So, I just wanted to chime in to see. What
the conversations were given given, I'd seen a little bit on Twitter about some
of the themes. So I think it's interesting to participate.
Mary Wheeler: Thanks Sue. Susan.
Susan Greenfield: . Hi. Well, nice to be on. This is lovely. I kind of fell into this
accidentally. I was a classmate with Janice, many moons ago in our Halcyon days
at U of A doing our BSC nursing.
I left nursing to become an actor and then
sort of fell back into, connecting both worlds.
I work a lot in simulation with, the
universities and colleges, standardized patients, simulation, simulated
patients, and simulated persons. And I'm involved right now in creating this
course up at York for clinical leadership. And I just was really interested to
hear everybody's stories and what challenges people are facing these days
because we're in the middle of creating scenarios that we'll do as, simulations
with the people in the course. And I, I thought it would be really interesting
to hear the realistic world that people are living in so that we can come up
with some ideas of things that are actual challenges for people and hear, what
it's like and the things that work things haven't worked.
And so, anyway, it's just been so wonderful
to hear everybody's real life stories about the challenges these days. Cause
they're so huge. So thank you for letting me be a part of this, it's great!
Mary Wheeler: Our pleasure, Susan. So down in the next corner, Sam, Samantha.
Samantha Salatino:
My name is Samantha Salatino. I'm an a junior
professional practice associate at WeRPN formerly known as the registered
practical nurses association of Ontario. I am here today as an observer.
A little bit about me. I've been an RPN
for about three years now or so. Similar to Jean I, went back to school and I
was trying to complete my education while this pandemic is going on. So I've
recently completed a bachelor of health studies from York University. and now
I'm going on to Queens University and pursuing a master of science in health
care quality degree
Mary Wheeler: Demi
Demi Te: I am a registered practical nurse for six years now, up until March,
I was working at Bernstein diet clinic while I was trying to finish my OR
certification, however, my placement was postponed, due to the pandemic and,
just today I had an interview at a nursing home for Chartwell in Scarborough,
Ontario. So hopefully I get to help out along with the community, with this
fight against COVID and also develop to develop my skills as a nurse. .
Mary Wheeler: Thanks for joining us Demi. What an amazing group of, nurses here ,
in this chat! So, the first question , we posed: "To make your experience
over the pandemic, meaningful going forward, what is the one thing you will do?
In your practice in your personal life."
Jean-Claude
Fillion: I would say that the, the thing that I
would take from this pandemic and bring it into my practice, once I start my
practice, would be to practice self care. Because often times I hear that some
nurses they're working and working and working, and then there's burnout.
So I want to prevent that. so I, even
during my practical program, I practice a lot of self care.
I listen to some soft music while studying,
just to bring my mind at ease and lower anxiety and all these things and really
center myself and focus on a self reflection as well. More like a weekly
self-reflection to see what can I do as a person to improve.
So just being aware of what is to be worked
on and, what strategies I can be doing or, Also just thinking about what I can
do for the patients next time, that could be better, in planning in terms of,
how I'm doing a certain care towards them. just to try to prioritize better and
plan better.
Mary Wheeler: Great. Thanks Jean-Claude.
Cathy Szabo: One of the things that I've learned is not to take anything for
granted or not take any time off for granted. And, the self care piece
resonates because the last couple of weekends, I, when I come back to Toronto,
I've actually done nothing like really nothing.
I mean, other than, you know, Make a meal
or a cup of tea, or do a bit of laundry, but not have anything planned and,
spent more time then just, with like, if my mother comes over just to have a
conversation with her. So, I think it's, it's the doing nothing on the weekends
or follows the self care piece to not over plan or be, overzealous about making
sure that I'm, working flat out all the time
Chris Kebbel: I was just going to say, I think this is sort of an extension of
what was said already, but it's also making sure your priorities are correct.
Obviously part of that , is, self care. but also even within your workplace to,
realize what your own personal professional priorities are, because very rarely
are those around you's priorities the same as yours. And to always be
reevaluating that, and, you could easily, you could work 70, 80 hour work weeks
and still do not enough work would be done it just to take a step back and say,
wait, what, what really needs to get done? Part of that may be self care.
Part of that may be what you're doing at
work, but not everything needs to be done.
Mary Wheeler: Georgina then Janice.
Georgina
MacDougall: Staying connected. it's so easy when
you're bombarded at work with the rapidity of change. and you get home , and
you just sometimes just want to cocoon and isolate yourself and just like shut
everything out. But. I think staying connected to family and friends that , you
would have normally, maybe gone for coffee with, or, just, just staying
connected .
Mary Wheeler: I was speaking to someone today who lives alone.
And, she said, I miss touch and I'm just
really missing hugging someone. , Janice,
Janice Waddell: I think probably a combination of what's been talked about, but
when Jean-Claude talked to about it, you know, taking that time for self care,
building your resilience, from other students' comments last week...I think as
an educator remembering that, not everyone who is teaching students sees the
importance of building in that kind of self care , and, highlighting resilience
as a part of your practice as important. So it slips out of curriculum, quite
frequently. And it's just another reminder that this is a part of what we do in
education is to reinforce the importance of building your resilience. And
during this time, reaching out to students who have been research assistants
with me over the years and you know how good it makes us all feel when they
respond right away and we can act and connect to one another. It is so
energizing. Not only I think for them, but for me.
Mary Wheeler: Thanks, Janice, Michelle.
Michelle Cooper: This whole notion of urgency, like what is real urgency and what is
false urgency and when you think about how many things no longer became urgent,
when all of this struck connect both in my work, but also what I've seen
happening around me and how much of that urgency do we create for ourselves,
which stresses us and puts us into that stress loop and, to step back and say,
who's urgency. Is it, is it mine or somebody else's. And, and can I be more
discerning , or mindful about what I really put a high self in terms of
pressure and others,
Mary Wheeler: Amy.
Amy Vokarek: When I'm teaching the students in particular, just giving some space
for emotions to recognize that there's a lot of emotions happening right now.
Many of them are working and allow them to , have that be part of the
conversation and give extra padding, like extra space into the way that I'm
providing, the course material and the other piece, even from a personal
perspective, I have four kids and they're all university age now and they're
back home, three of them and , the emotional roller coaster they're going
through too. As all these big major life events are being missed.
Mary Wheeler: Yeah
Amy Vokarek: It was grads, all that thing. So also holding space here, which
connects to me needing self care as much as providing space for them. And then
looking for the silver linings. I think that's something I hear with the
students and hear it at home too, is the silver is that people are finding and
that sort of helps to balance out some of the more difficult emotions.
Mary Wheeler: Thanks Amy.
Michelle Cooper: I just found a personal level. We've been experiencing the isolation
of the COVID as, family members. Both. I have my mother passed away and now my
mother-in-law is in hospital. And the sense of helplessness that there is, and
reaching out to them to say, we need you to help us reach into our family
member because you feel very disconnected.
We were fortunate with my mother that we
actually had Skype set up in the room in her longterm care and we could dial in
and it would open up and see her and with my mother in law, she's confused. She
can't hear, she's doesn't know where she is and where her children are.
Why am I not here? And when you hear that
and it's, it's very distressing. So we actually did manage to get somebody to
break the rules and let us in and do a Skype call like a FaceTime with her. But
it's, I think what my observation was is that is if I was advocating and it
kind of goes into the next one, that it's, the, there needs to be more
attention to helping people reach out to their families because their families
are important part of the caregiving team. And when we can be there, it's very
hard on the patient. We know social isolation by itself is hard on an elderly
person. And then also I was thinking now in longterm care, they've been doing a
lot better job of really dedicating people to use iPads and connect and Skype
and do all those things. And in the hospital, it's not sort of the orientation
and , I've actually talked to the social worker to say, you know, maybe, you
know, 75% of people had their own cell phones, but some of these folks need
help reaching out.
Mary Wheeler: Yeah. Yeah.
Michelle Cooper: That's been my personal experience.
Sue
Bookey-Bassett: So just to tag onto what Michelle
was saying. So my inlaws Michelle have also had, challenges in terms of they
live in Montreal. My. Mother-in-law has dementia and is deteriorating and she's
tested positive for COVID.
She's had several tests and remains
positive. And my father in law, who's 92 years old lives in the same building,
but he's downstairs and they haven't been allowed to see each other, but
there's also been no facilitation by the staff to allow any kind of
communication. So. The communication is only because my husband who lives in
Oakville, Ontario, calls the center to say, can we get an update on my mom?
And unfortunately , neither of them have
any kind of iPad or a cell phone to allow, , that communication face to face.
so it's quite, quite distressing cause no one's really seen her for, almost
two months now, I guess, in terms of her physical state. And I find it
interesting because I'm almost going to say the opposite, what Michelle said,
because I know in ICU, a lot of staff have made an effort to connect families
using cell phones, but then I've almost heard the opposite in longterm care
where that hasn't happened.
And then again, you know what came out the
last two days in the reports in terms of how do we value our elderly and the
relationships with, with families? .
Cathy Szabo: I'm going to pick up on a conversation that Gail and I had, a while
ago. And that's that I, I think we. We as a healthcare system made a mistake in
not realizing that the family is part of the care team and that segues into
your next question, because we have to reengineer this system because even if
we had all the money in the world, which we'll have to pay for all of this that
we're doing now, because the purse is open and we can make some great gains
right now.
We will not have the health human resources
in the next 10 years to be able to care for everybody that needs care. So we
need to get serious about family members being part of the care team because in
longterm care had one designated family member have been by the side of the
person that was in longterm care.
I don't think we would have had to have
waited this long to see the carnage that was in some of those homes. one of the
homes in particular, I know, had been under supervision for almost a year and
they weren't changing. So it wasn't anything new, COVID amplified what was
going on there. One of the ones that the military was sent to.
So we, we haven't, been serious about
family as caregivers or as our partners in care. We also have been slow to jump
on the virtual bandwagon. I was talking to a colleague out west, and their goal
was to have a virtual hospital in three years. And what they told me was they
were doing 6% of all their care and virtual visits and they run acute care,
longterm care housing.
They have, they have a wide variety of care
that they deliver. Within days, they were 60% virtual, within days, but it took
money and the need to be able to do that. And that, that was the next best
solution. And they said all of a sudden this software that the government had
been, toying around with, do we use it? Do we not use it? Is it encrypted
enough is et cetera. All of a sudden in two days it was fine and they
implemented it. So I think we as care providers have to, push government a
little harder and, not let perfect be the enemy of good enough and start going
in the direction. Intuitively I think sometimes where we need to go.
Gail Donner: Yeah, I think that's helpful, Cathy. I wonder if that's a good
segue, you're quite right into what, what can we do? What do we need to change
in nursing, in the system and et cetera?
Georgina
MacDougall: So just, I think the, the technology
aspect is, is the, is the key change. you know, lots of people talked about
moving to virtual clinics and lots of practitioners are very resistant, or had
been resistant to the idea of doing that, that we can't manage patients that
way. And COVID has certainly forced our hand to recognize that we can do it and
what technology do we need to have.
So , it really has pushed that agenda
forward , which is good. I do worry about the, two aspects of the technology
and that is that, technology somehow allows families sort of this carte
blanche, open access to healthcare providers.
So I've heard lots of, of my peers say that
they they're getting emails and text messages from families at all hours of the
night.
Oh, I've got one more question for you ,
where the regular office visit would be done and we'll see you next month. ,
and not that that's the better solution, but , this being on call 24 seven and
you know, nursing in particular, having to learn how to set, the professional
boundaries that, I'm not available 24 seven.
If you have urgent issues, this is what you
need to do. And I think that that's going to be a big learning for all of us.
Jean-Claude
Fillion: Yes. just to add that to Georgina's, comment,
the fact of the technology. Allowing us to be accessible all days, all time of
the day. I see it as a potential downfall or an actual downfall of the
healthcare system. If, People were to not set enough boundaries or limits.
before I took the nursing program, I worked as a financial advisor and I was a
consultant with, investors group, and I found that I would actually try to go
through all my emails because, I want to try to, answer everybody as quickly
as possible. So I would actually wake up in the middle of the night and start
emailing people and all these things, or like delay response for like 9:00 AM.
So that I'm typing the email now sending,
but then it won't send until 9:00 AM and things like that. So it just ended up
becoming an issue, like down the road of just trying to like set boundaries and
like practice more self care. but also I really do hope that. we see technology
as an option to use, but not the main option to be used.
I know that with online learning, with me
doing the, the program or the class of the psychology of wellbeing with the
Yale university right now, in the meantime, during the pandemic. It's very
different than face to face teaching. And I would rather have the face to face
teaching. I find there's more of a connection and I know that a lot of the,
school boards and government are pushing for online learning, everywhere and in
the country and provincial wide as well.
Also I just wanted to continue the
conversation on self care. something that . I actually just had a recent
conversation with one of my older friends.
Her husband is in a home, out in Sudbury
with Alzheimer's and was, taking care of her husband for a few years at her own
home. And then, ended up transferring him to, a specialized home for that
care. but I was, discussing with her how the importance of, not having that
guilt of having the self care and not time for yourself to rejuvenate your
energy, because when you are caring for a loved one at home .
It is your partner, but has now become your
patient. And it's 24 seven. You're not having any break from it. So I told her
that , I'd rather have the mentality of knowing somebody is able to care for
the loved one, at a hundred percent energy and then the tap out, basically
after eight hours, 12 hours, and there's another person that's recharged at a
hundred percent able to take care of that loved one compared to having to do it
yourself at home and is 24 seven.
And. You might not be at a hundred percent
to be able to give all the care and everything that you would love to give to
the loved one, it is also important to have at home, care as much as possible,
but it comes to a limit where you want to prevent a burnout of yourself and
know that there's other people as specialized people that are able to help your
loved one. to give you that much needed. Space or time to collect all your
energy back again.
Gail Donner: Thanks Jean-Claude. This is all part of, I guess, the compassionate
piece that needs to go along with the technological piece,
Chris, I think you're next.
Chris Kebbel: I guess two things, I guess one is that with all the rush towards
technology and don't get me wrong, I'm all for technology. but sometimes we
forget about the simpler things. A friend of mine, works in a longterm care home
and she helped facilitate a lift, like a forklift type thing so that relatives
could come in and see , their loved ones from the other side of the glass, so
to speak, even if it's three stories up.
Those sorts of things just cause in an
iPad doesn't necessarily mean it's the same sort of connection. And I thought
that was an incredible story that she shared.
The other thing is, is that I worry that ,
with the zoom and all the other things is that the effect on the frontline
nurse. and don't get me wrong. It's not an excuse not to have that
communication, but I see that in terms of communication with family, which is
obviously a key nursing role, but also with COVID.
And I see, of course I saw before COVID is
that, Oh, well, a frontline nurse can , do this and collect that piece of
information for my research study and do this other thing and do this other
thing and do this other thing. And it all seems to trickle down and it ends up
stacking up over time.