Nursing New Dreams

A transformational $1-million RBC Foundation donation builds on the long tradition of nursing excellence at St. Paul’s Hospital.

As the largest group of care providers, nurses are, for many canadians, the face of health care. Skilled professionals tempered by a spirit of compassion and caring, nurses are a crucial resource when we are in pain, comfort and educate us when we have fears, and are a lifeline when circumstances take a turn for the worse.

However, nurses are getting much harder to come by. First, many nurses are preparing to leave the profession as more than 20 per cent of Canada’s nurses are now eligible for retirement. In addition, according to a report by the Canadian Nurses Association, there’s currently a shortage of more than 11,000 registered nurses (RNs) nationwide. By 2022,
this number will reach 22,000 if nothing is done to address the problem.

Advancing the Profession

St. Paul’s Hospital is doing its part to inspire practising nurses as well as entice new nurses to join its ranks, thanks in large part to a $1-million donation to St. Paul’s Hospital Foundation from the RBC Foundation. The milestone sum has created the new RBC Leadership Program for Nursing Innovation. Launched during national Nursing Week in May 2009, the program has two main components based on findings from an extensive consultation process in February 2009 involving Providence Health Care nurses and leaders.

With a philanthropic tradition dating back to 1891, RBC is one of Canada’s largest corporate donors, which sponsors key initiatives in the communities it serves.

“RBC truly admires the success and impact St. Paul’s has had in nursing practice over the years,” says RBC regional president Graham MacLachlan. “We share St. Paul’s long-term vision of growing the number of qualifi ed nurses in B.C. and we believe the new RBC Leadership Program will help attract and retain nurses, creating a lasting legacy of
excellence and innovation in nursing care.”

The first component of the program is a mentorship initiative, the RBC Nursing Mentorship Program, enabling a dedicated, highly experienced nurse mentor to provide on-the-spot coaching and general support to nursing staff – particularly early-career nurses.

“We have nurses here with tremendous skills and expertise. Some may not want to work the same shifts anymore and others are looking for a new career opportunity. They now have that opportunity, in collaboration with our educators, to contribute through point-of-care support,” says David Byres, vice-president of Clinical Programs, Chief of Professional Practice and Nursing at Providence Health Care, which operates St. Paul’s Hospital.

The second component of the program, called the RBC Nursing Education Awards, grants financial support to nurses pursuing a range of educational opportunities (e.g., bachelor’s degree, a master’s degree or, for the first time at St. Paul’s, a PhD in nursing) or support to present a paper or research with other nurses around the globe.

Encouraging Retention

One of the major findings from the nursing consultation process was that such educational and mentorship opportunities are critical for attracting new nurses and retaining experienced ones.

“Increasingly, nurses want to advance their careers by pursuing graduate degrees or specialized training,” says Byres. “Now we’re able to support them in that.”

Stephen Shapiro, St. Paul’s Hospital Foundation’s president and CEO, believes the RBC Foundation gift is transformational, providing an innovative solution to the challenges presented by B.C.’s nursing shortage: “The RBC investment is a powerful recognition of the integral role that nurses play in our health-care system. It will ensure that St. Paul’s remains at the forefront of nursing advances by providing progressive training and mentoring opportunities for our nurses.”

However, nobody is leaving the advancement of the profession to chance.

“While we know from the literature that improved nursing knowledge has many benefi ts, we want to demonstrate outcomes,” says Byres. “Through formal evaluations each fiscal, we expect to show that improved clinical support for direct-care nurses leads to more nurses
remaining in the workforce. We also expect to show the relationship between the clinical support enhancing knowledge and improved patient care.”

One RBC nurse-mentor position was filled in June 2009 by a 34-year veteran of the profession, and 26 nurses have already benefi tted from the RBC Nursing Education Awards.

Someone to Watch Over Me
RBC nurse mentor Cheryl McDonald gives fellow nurses someone to lean on

Back in the 1970s, Cheryl McDonald, then a newly minted RN working in Nelson’s community hospital, found herself working wherever the need was greatest at the moment – orthopedic surgery, vascular surgery, general surgery, labour and delivery, gynecology – you name it.

“I was brand new with no experience and I was the only RN on at night, so often I was it,”
says McDonald.

McDonald’s first two years on the job were very stressful, but she is proud that she stuck it
out as a new nurse. Now, after 34 years working in hospitals throughout Western Canada,
she knows first-hand that the profession loses too many novice but potentially excellent
nurses due to lack of support.

“It’s that first year that can make or break a nurse’s career,” says McDonald.

Today, as St. Paul’s Hospital’s first RBC nurse mentor, McDonald devotes her time to helping
nurses navigate their way through those pivotal first years.

During her more than two decades at St. Paul’s McDonald has worked as a staff nurse, acting head nurse and clinical nurse leader in various areas, including gynecology,
surgery, intensive care, coronary care, and the gastrointestinal clinic.

Now, as a seasoned nurse veteran, she wants to give back by sharing her wealth of
knowledge. In her new position, she will support nurses to help them integrate all their
learning and skills for the best possible patient care on four units at St. Paul’s: two cardiac and two surgical.

“I’ve definitely learned from more experienced nurses and now it’s my pleasure to coach
and advise new nurses who are coming out of four-year programs with less clinical experience than when I graduated,” says McDonald.

New nurses will clearly benefit from a fulltime mentor on staff, but so will more established
nurses: “I’m there as a sounding board if they want to discuss something specific about a
patient’s care or need help with some procedure they’re not familiar with. My schedule is posted in each unit; I have a pager and I’m there for all of the nurses, new and experienced.”

In addition to being an in-the-moment, individual support for nurses, McDonald will
work with nurse educators to identify the overall training needs of the unit, develop nurses’
learning plans and determine systems and procedures that need refinement.

In a role with many exciting challenges, McDonald will always be sure to keep a goal in
mind: sparing other nurses the same terrifying sink-or-swim experiences she endured as a
young RN in order to keep nurses in nursing.

Expanding Horizons
An award from RBC Foundation is helping a patient educator do what she was meant to do

Brynn Laurillard loves a challenge. A good thing, too, because she got more than her fair
share when she went back to school a year ago to pursue her master’s in nursing while working full time as patient nurse educator in St. Paul’s John Ruedy Immunodeficiency Clinic, which cares for 1,200 people living with HIV/AIDS.

Fortunately for Laurillard and her patients, an RBC Nursing Education Award has helped her meet some of the financial challenges of her first year back at school, which wrapped up in June 2009.

“The award gave me a term’s worth of tuition and peace of mind,” says Laurillard. “It provided me with some scheduling flexibility, allowing me to take the time to focus on school.”

There was never any question that Laurillard would go back to school. She decided to go back sooner than later, just four years after graduating from the University of Ottawa as
an RN and returning to Vancouver to work in St. Paul’s HIV/AIDS unit. It’s work that
Laurillard fell in love with instantly.

“I knew right away this is what I wanted to do with my life,” says Laurillard. “I loved that I was working with patients that tend to be marginalized; patients who other people might
not be willing to care for. And I really liked that St. Paul’s is on the leading edge in Canada in
the area of HIV/AIDS, with the only in-patient unit in Canada for HIV-positive patients.”

The fact that Laurillard has been able to tailor her degree (she’s focusing on HIV and addictions) and pick subjects that she cares about and that she will eventually be able to
apply to her work has helped her stick with the intense schedule in spite of the sacrifices.

“I don’t have much of a social life,” she says, adding that the payoff is worth it. “This past year, my mind has been opened up to so much. My undergraduate degree was clinically oriented, which is great, but the master’s is giving me a lot more knowledge about HIV/AIDS.”

Of course, Laurillard has something no degree can teach; namely a deep regard for her patients.

“This is a unique patient group already dealing with terrible stigma,” says Laurillard.“You won’t keep them coming back for treatment if you’re judgmental or disrespectful.”

In the end, all the effort of the past year hasn’t been about the degree at all. For Laurillard,
the master’s is just a means to a more important end – better care for people living
with HIV and AIDS.

Position of Influence
An award from RBC Foundation will help an up-and-coming researcher broaden her reach in nursing

It wasn’t until Martha Mackay was a patient that she first started thinking about becoming a nurse. She was a teenager at the time and briefly quite ill: “I was awestruck by how much
the nurses contributed to making me feel better – by just how good the good nurses were.”

That experience was enough to inspire Mackay to set her sights on becoming an RN herself. Today she’s a clinical nurse specialist in the provincial Heart Centre, part of the Providence
Heart + Lung Institute at St. Paul’s. Looking back, nursing was a perfect (if not obvious) choice for someone who also happens to love research, is naturally analytical and is always asking questions.

In fact, thanks to an RBC Nursing Education Award, Mackay is poised to enter a pretty special
club: the roughly 0.1 per cent of nurses in the country who are PhDs. The degree, which Mackay expects to finish by the end of 2009, is much more than a piece of paper. It means she has the knowledge required for independent research and potential access to hotly contested research funds.

But Mackay doesn’t want to leave clinical care behind. Ideally, she’d like to stay within
the Heart Centre as a clinician-scientist, combining her clinical work with her cardiac-care
research.

“There’s a perspective nursing takes that no other discipline gets at,” says Mackay. “My clinical practice will inform the questions I ask in research studies and should improve the flow of research findings back into the clinical setting. That’s one reason it’s good for patients
to have a nursing voice in influential places.”

The research Mackay has done while working toward her PhD is a case in point. Her study, which asks the question “Do heart attack symptoms differ between men and women?” has the potential to help improve cardiac care, particularly for women, which is a group that has been understudied when it comes to heart health.

“When people have heart attacks the most important factor for survival is prompt treatment,
and literally every minute makes a difference,” says Mackay. “But studies show that women delay seeking treatment more than men. Why is that? We wondered if it is because
they don’t recognize their symptoms. The research so far on heart attack symptoms and
gender differences hasn’t been conclusive and I thought it was worth a more careful look.”

So, Mackay looked at the experiences of 325 men and women undergoing angioplasty, which is a routine procedure to improve blood flow to the heart. During the procedure blood
flow to the heart muscle is temporarily stopped, mimicking a heart attack. So it was an ideal time to ask about symptoms. Participants’ answers to a series of open-ended questions led to some interesting preliminary findings.

The most common symptoms, regardless of gender, were chest, arm or throat pain, as well as indigestion, shortness of breath and an overall feeling of fatigue. There was no difference
in the proportion of women reporting chest pain compared to men and there was no
difference between the genders in the prevalence of typical symptoms appearing as a cluster. The findings are a good beginning, says Mackay, who plans to pursue further research related to heart health and the differences between men and women.

For aspiring and established nurses alike, the opportunities afforded by the RBC Nursing
Education Awards are an inspiration.

“When I started nursing, nurses could advance only to head nurse or some other administrative role, but there were very few ways to advance while staying in clinical
practice,” says Mackay. “If nursing is seen as a career in which there are lots of different
opportunities for advancement, in which you can have a real influence, that’s going to be a
big boost for recruitment and retention.”