Four things I learned at the CNSA National Conference in Winnipeg 2017


Skye Maitland, Erica Benson, Whitney Radforth

Representing University of British Columbia as a Canadian Nursing Students Association (CNSA) Associate Delegate, I flew to Winnipeg with two colleagues, Skye Maitland and Whitney Radforth,  in January 2017.

The CNSA is “the national voice of Canadian nursing students, whose aim is to increase the legal, ethical, professional and educational aspects which are integral to nursing”. The conference certainly reflected this mandate as I surrounded myself with dedicated, outspoken and insightful peers from across the nation and attended inspiring workshops. Here are four things, among many,  I learned over four days steeped in the CNSA National Conference.

1) NCLEX? 

At the beginning of my semester, I remembered hearing my professors say the NCLEX was imperfect, at best. What did that even mean?? The CNSA filled me in. Since 2015, the Canadian Registered Nurse Regulators adopted the NCLEX entry to practice exam for Canadian Nurses, abolishing the previous Canadian Registered Nurses Exam. The result? National first-time pass rates dropped from 87% to 69.7%. Canadian students are taking an American exam, based on American content and suffering for it. Schools are taking precious class time to prep for an exam that isn’t ready for Canadian students. What is being lost? In a campaign letter writing session, delegates from across the nation sealed envelopes in order to send a loud message to provincial and federal regulators. The exam must be remediated to accommodate Canadian nursing students and it must happen soon! Join the movement.

2) Hers, his, theirs: transgender patient introductions

Transgender issues are not about preference, it’s about identity. It’s about waking up in a body you do not love, do not feel comfortable in and then constantly be referred to as someone you don’t feel like. When working with transgender individuals there are simple extensions you can make to ensure the interaction comes from a trauma and violence informed perspective. Instead of asking, “What is your preferred pronoun?”  instead ask, “What is your pronoun?” Using the word preferred implies the individual has choice. Secondly, using terms such as “tranny” or “transvestite” are outdated and are not taken kindly. Lastly, remember it’s about client-centered care. How can we create a safe space and make caring for this client the best experience for them?

3) Policy: The Interim Federal Health Program

Policy matters. Sure, it may seem dry and far off…something that bureaucrats do in an office somewhere, battling over two words in a motion. But what is a motion? What if those two words meant the difference between someone in Canada accessing medication after a heart attack? Policy matters. The legacy of the Interim Health Program and subsequent protest demonstrates the importance of voicing political disagreement and flexing solidarity to advocate for change.  Depending on who is in power will determine the equity of access to health care for different levels of immigrant status, which brings in the powerful question: Is access to health care a human right? If a refugee claimant from Ghana walks across the Emerson-United States border through a blustery night in December in knee-deep snow wearing jeans, losing his fingers to frostbite, should we then send him a bill for the hospital costs? These important ethical questions influence policy and policy affects every nurse and patient in Canada. 

4) Comfort Zone

Imagine you have just arrived at a conference and you’re drinking a morning coffee, flipping through the program plotting out your day. What workshops are you drawn to? The titles where you know a little about? The ones that seem interesting because they resonate? What about the ones you know absolutely nothing about. I challenge you to leave that area of familiarity and comfort. Instead, I suggest you dive into the workshop that makes you feel uncomfortable. There, you may be pushed emotionally, spiritually or physically, however I guarantee you will learn something. You may even be inspired by something you did not know existed. It was at one of these workshops that I learned about female genital cutting, a topic that pushed my comfort levels, touched me deeply and increased my understanding of the practice. As a health care provider in 2017 and beyond, we must be prepared for anything and anyone, and that includes individuals from all cultures and backgrounds.

A student’s insights on the 2017 BC Quality Forum- Rebecca Anthony


Photo by Franco Folini, Labelled for Reuse.

The Institute of Healthcare Improvement (IHI) is an international organization dedicated to quality improvement in healthcare. IHI offers online coursework that is free of cost for health care students that focuses on quality improvement and safety for the delivery of healthcare. The IHI Open School Change Agent Network (I-CAN) is an international community of learners from countless disciplines and geographies, who are committed to applying leadership and community organizing skills to improve health and health care in their local settings. IHI Open School provided us with a framework and the necessary guidance and knowledge to plan and improve our community engagement initiative. Specifically, it provided us with the Plan, Do, Study, Act framework to implement our project and improve upon it through each iteration.

As a final project of the Bachelor of Science in Nursing at UBC-Vancouver, students engaged in a multitude of community engagement projects that are aimed at improving healthcare quality and safety and health promotion. For our initiative, we collaborated with the Union Gospel Mission (UGM) to host free foot soak clinics during their lunch service. The UGM is a charitable organization in Vancouver’s Downtown Eastside (DTES). Every day, they provide free meals, emergency shelter, and recovery programs to people living with poverty, mental illness and addictions in this neighbourhood.

Our foot soak service offered clients accessing the lunch service to soak, clean and have their feet massaged and dried thoroughly, and to get a new pair of socks; a small action that goes a really long way in Vancouver’s damp weather. During this time, the UBC student nurses were able to engage with clients, assess their foot health, talk about their general health and their concerns and make a referral to primary health care services in the community if desired and indicated. Simultaneously, students were able to get to know some of the real people living in this community and were able to gain some understanding of how social positions intersect as the social determinants of health can impact an individual, a community and populations health and well-being. Every six weeks students working through their community health rotations would cycle through and participate in hosting the foot soak clinics.

Photo by Khristine Carino

On March 3, 2017, with the support of UBC Faculty members Ranjit Dhari and Dr. Maura McPhee, I co-presented with fellow student Maryam Koochek, at the Quality Forum 2017 in Vancouver, B.C. We participated in the rapid-fire presentation series: Engaging Students in High Quality Care. We shared the story of our IHI I-CAN quality improvement project. We shared that through this work we were most proud of the positive rapport and long term relationship we have built with our partners and the pope accessing UGM; people look forward to the UBC nursing foot soak clinics, and even though we are not the same people each time, we are known in the community as a group of people who are there to listen and care. The greatest lesson we learned throughout this experience has been that creating sustainable change is not easy; It is complicated and nuanced and it takes a lot of hard work and creativity. It cannot happen overnight or even in 8 weeks. What you think is important for the client is not always accessible for them. You need to change from a minset of “fixing” to a stance of listening and supporting. Our presentation was met with overwhelming positivity and interest from the audience, including an offer to collaborate with other health professions, to come roll up their sleeves next to us.

The I-CAN project also received the 2017 Quality Culture Trailblazer Award-  Runner Up. Read more about the award here.



A student’s insights on the 2017 BC Quality Forum- Maryam Koochek


Left to right: Dr. Maura MacPhee, Ranjit Dhari, Maryam Koochek and Rebecca Anthony. (Photo by Khristine Carino.)

The BC Patient Safety and Quality Council holds a Quality Forum once a year to showcase quality projects that are benefiting our patients and to raise awareness of initiatives that are being implemented to meet the demand for quality improvement. At this year’s event, the objectives were to:

Ignite action to improve quality of care for patients and providers;

Create and strengthen connections and collaborations across all areas of care; and

Share effective strategies and leading practices to stimulate and sustain improvement

These objectives were met through inspirational plenary presentations, from important figures in the healthcare community including the current provincial minister of health, Mr. Terry Lake; various interactive workshops, rapid fire presentations and field trips to organizations that are known for having complex operations such as the Port of Vancouver.  The diversity in the mode of delivery and the topics discussed ensured that every attendee had plenty of opportunity to attend and learn about their area of interest.

Given my interest in community nursing and working with marginalized populations, I attended workshops on team-based care in the community, trauma informed practice, cultural safety and responding to a public health emergency: the opioid crisis in BC just to name a few. This last session struck me as especially inclusive of all the players in this crisis. There were three speakers, each with their own unique place within the crisis response management. The session began with Laura Shaver, the president of Vancouver Area Network of Drug Users (VANDU). Laura is a recovering heroin user who is currently on the methadone program and has been witness to the devastating loss of life that has resulted from illicit fentanyl on the streets. She is a powerful advocate for her community and having her at the session gave us a glimpse of the lived experience of those who are closest to the crisis. Dr. Christy Sutherland is the medical director of PHS community services society and she gave the audience an account of the daily challenges and the on the ground response from her team including setting up Naloxone tents in alleyways and working around the clock to meet the demands of this crisis. The third speaker was Dr. Bonnie Henry, the Deputy Provincial Health Officer for BC. She gave the audience an overview of what is being done at the provincial and federal levels to manage the crisis including working with Health Canada to open more safe injection sites; working with the the Border Agency to curb the entry of these substances from abroad and working with local agencies to put more resources in place.

I concluded the Quality Forum by presenting the student IHI I-CAN Quality Improvement Project with my colleague Rebecca Anthony. The presentation was very well received and showcased the amazing work of UBC students and our ever supportive faculty.

Attending the forum was inspiring and motivational and I would recommend every nurse to attend it. One of the lessons I took away from attending the forum is how well our program has prepared us for practice. I sat with nurse managers who had never heard of trauma informed practice or cultural competence. I feel that as soon to be graduating nurses, those fundamentally important concepts are forever embedded in our cells and that is partially due to the education and awareness we have received over the course of our training.