Foreword
Seldom in the fast-paced workplace do nurses have the opportunity to share their nursing memories that vividly colour their personal histories. The climate of the Canadian North has been the backdrop for experiences that have been etched in the memories of those nurses who have chosen to practise in this vast, sparsely populated land.
Jan Stirling, Yellowknife, NWT
The North is a very special place to live and work, and between the covers of this book, you will read stories, anecdotes and fragments written by some exceptional people - mostly nurses - who have spent part, or all, of their lives there. They will tell you about their experiences, sometimes in very remote locations, and you will be amazed at the level of proficiency in the everyday practice of their profession. It should come as no surprise that two of our contributors, Sr. Cécile Montpetit and Barbara Bromley, have been awarded the Order of Canada for their work in the North.
You will also meet two Community Health Representatives from the aboriginal community. The work of the CHRs in the nursing stations and health centres is invaluable. Winnie Greenland of Fort McPherson is one who worked with the nurses for many years. Another CHR, Regina Pastion, started initially as a volunteer at the Hay Lakes Nursing Station and later at the health centre in Assumption, Alberta. She still helped out there when in her seventies.
Bill Murray provides another perspective. As an environmental health officer who travelled the Inuvik Zone for a few years, Bill was always welcome in the stations. He knew how to help out in the kitchen - a hard lesson for many visitors (including doctors) was finding that they were judged more by their kitchen skills than by their professional expertise.
Some of the stories in this volume are fragments of the writers' overall time in the North, yet they stand out because of their humour, excitement or drama. Other pieces tell us about the authors' lives over many years in the North and how that experience has changed them forever. Also included are stories of the daily (but rarely dull) work which goes on in a nursing station that operates as a 24-hour walk-in clinic.
Each day in the station or health centre is different. As there are usually no appointments made, nurses don't know what problems they have to contend with until they walk into the treatment room, or answer the phone in the middle of the night. They could treat standard coughs and colds, or conduct follow-up visits from people on the "chronic list" which every station keeps for such diseases as TB and diabetes. Then there are the preand postnatals, and if there is a birthing centre, all the low-risk deliveries. Even when the station is not mandated to do deliveries, Nature may override the policy manual, at which point improvisation is needed, such as an incubator made out of spare parts. The nurse and the CHR regularly go out to the homes of mothers with newborns and at the same time, they review the immunization status of the other young children in the family. They also visit the elderly to check on their medications and overall well-being.
Nurses in the North often work on their own. If they are lucky, there will be another nurse or if they are really lucky, there will be a doctor in residence. They may have to deal with snowmobile accidents, gunshot wounds and comas - situations that would normally require an emergency or intensive care unit. In the event of having to wait for the medical evacuation of a patient, due to weather conditions or the distance the medevac team has to travel, nurses must rely on their own skill and expertise with the assistance of a telephone link to the nearest hospital.
And as every nurse knows, there is that famous line in the job description: "... and other related duties." The nurse may be a mentor for young nurses, the trainer for new visiting doctors, or the undertaker. She or he may have to be the dentist, orthopaedic specialist, paediatrician, psychologist, radiologist, social worker, youth counsellor or sex educator. Whatever is required when a specialist is not at the station, the nurse is it. That could even include substituting when necessary for the veterinarian, the plumber, or the furnace repairperson. To handle night calls without an interpreter, nurses may need to master basic local language skills as well.
Because everyone lives and dies by the weather in the North, nurses too must have a constant awareness of it. They often develop an uncanny instinct for reading the skies. But sometimes, all they have to do is check the thermometer to know that nothing is flying, even though they need a medevac. They quickly learn to understand the implications of the pilot's announcement that ice fog has everything grounded. They realize how vital it is to know if the ice road· is open, whether the ice bridge is in or out, and what the condition of the runway is.
During my years in the North, I noticed that the nurses who lasted the longest were those who got enough sleep. For them, medical problems were usually brought to the station during clinic hours and not in the middle of the night. In a real emergency - and there were many - nurses were always up and dressed in a flash, and into the clinic. It was sleep deprivation, especially during flu epidemics, which wore nurses down more than anything else. Those who were well-rested were the ones who were able to socialize in the community and enjoy the culture of their working environment. They had the time and energy to learn from the Native people. One wise zone nursing officer used to encourage nurses to start planning their next vacation as soon as they returned from holidays. Knowing there was a scheduled break ahead helped relieve stress.
The RCMP played an important role in the North, especially if a nurse was on her own when things started to get out of hand. For her safety, a nurse was instructed never to go to a home alone if she suspected that alcohol was involved. If an interpreter or another nurse was not available, standard procedure was to ask an officer to accompany her. The RCMP, "The Bay Boys" and the pilots were only a phone call away, and they were always right there. Their help was much appreciated by the nurses.
I often told young nurses who came to my occupational health office as part of their orientation to the Zones, "You will never be a normal nurse again after this experience. You will do procedures, and acquire nursing and medical knowledge that you were never taught in college or university, and you will discover that you are far more capable and competent than you ever dreamed. When you return home, you will find it almost impossible to cope within the limited range of duties allowed in southern hospitals." Perhaps that is why northern nurses keep going back for more - but more likely it is for the sense of independence they acquire, the adventures they experience, and the satisfaction of conquering seemingly impossible situations and meeting such wonderful people.
J. Karen Scott RN, BScN
Introduction
My first excursion into the North came in 1970 while doing fieldwork for Dr. Brian Lowry of the Division of Medical Genetics at the University of British Columbia. During that year, I visited almost every reserve in B.C. My most memorable trip was with a Health and Welfare nurse who took me along to Telegraph Creek. I had flown into Hazelton from Vancouver where she met me at the airport. Taking one look at my jeans and cowboy boots, she said, "I am not taking you dressed like that!" There was a scramble to find some thermal underwear and get me outfitted so I wouldn't freeze. As it was, I almost did. But that is another story.
Some years later, after I had finished a summer working at the Cystic Fibrosis Camp on Lake Couchiching in Ontario, I was sitting in a Tim Hortons in Orillia, wondering what to do with myself for the next year. Noticing a Health and Welfare sign across the street, I remembered being impressed with their nurses whom I had met in my travels. I pondered briefly, and always ready for a challenge, took a deep breath, walked over and inquired about a job. A few days later, I had a call from Miss Maria Skov in Ottawa, asking me to meet her at the Royal York Hotel in Toronto for tea. Thus began my twenty-five years with the Government of Canada.
Shortly after the Royal York interview, I was off to Sioux Lookout Zone where I wandered about the hospital for a few days, waiting for a zone nursing officer or director of nursing to appear. (I discovered later that I had been nicknamed Texas Lil because of my cowboy boots and my six-foot stature.) For the next two years, I worked in the Sioux Zone in New Osnabourg and Big Trout Lake and then as the Federal Public Health Nurse in Sioux Lookout. It was while on this last assignment that I was seconded to Povungnituk, PQ for a month. That story comes later in this book.
From Sioux, I transferred to a public health position at Six Nations near Brantford, Ontario, where I enjoyed working with Rebecca Jamieson, an educational consultant. After I had been there for two years, a poster crossed my desk advertising for ships' nurses. I applied, and two weeks later, joined the Canadian Scientific Ship Hudson as Chief Medical Officer. Every summer, we sailed into the high Arctic and in 1981, we circumnavigated North America. In 1982, ours was the first ship to reach the site of the Ocean Ranger disaster, where the crew recovered bodies under alarmingly dangerous conditions.
After four years aboard the Hudson, I moved back to Toronto to get reacquainted with the real world. My apartment just didn't have the amenities of the Officers' Mess, and not being used to cooking for myself, I was hungry for the first while. I was assigned to what was then called Revenue Canada where I did "boot camp" training in union, management and staff relations. During my time there, I was grateful to Betty Bannon, the taxation employee representative for PSAC (Public Service Alliance of Canada) and Marion Porrier of staff relations. This administrative background gave me an advantage when I later went to Yellowknife in the Northwest Territories as the Regional Occupational Health Nurse.
Over the next five years in the NWT, I worked with Dr. David Kinloch, the Regional Medical Health Officer, to establish the Federal Occupational Health Unit for the NWT. It quickly became apparent that a large part of my job would involve administering the employee assistance program, especially for federal employees in the remote communities. (The program we set up was effective, in spite of our not following the prescribed Ottawa format - we simply didn't have the personnel.) This work lasted until the federal government transferred health services to the Government of the Northwest Territories. Occupational Health, being a Treasury Board mandated program, was not transferable and the office was closed about a year later.
By that time, I was taking graduate level nursing courses at the University of Alaska in Anchorage. While there, I had the opportunity to travel with Circumpolar Health to the Russian Far East for two weeks. We visited hospitals, a reindeer camp with its own portable clinic and a mining camp with a large medical facility. On my return to Canada, I transferred to Charlottetown, Prince Edward Island, to work for Veterans Affairs Canada. I worked there for five years until I had to come back home to Ontario.
This book has been a labour of love. As a northern nurse, I knew that hundreds of northern nurses' stories were untold. Northern Nurses collects some of these true and exciting adventures from Canada's North. Enjoy!
J. Karen Scott RN, BScN