BY TAYLOR PERRY

Teamwork is a fact of life in nursing. And it stands to reason that as healthcare becomes increasingly complex, so will the complexity and diversity of the teams that constitute it. If healthcare teams are to be mirrors of the societies and communities they serve, then it is imperative in a community nursing context to feature teams that possess many different languages, cultures, and – yes – ages. It is therefore incumbent upon leaders in community nursing to address issues of diversity in order to ensure a positive team culture and quality provision of services.

Claire Heath, the nurse educator at Evergreen Community Health Centre, asked me to conduct a literature review on the subject of age diversity in teams. It was a topic of particular interest to her, as the team at Evergreen was undergoing changes making it a more multi-generational unit. She wanted to know how these changes would affect team morale and unit culture. And she happened to have a UBC nursing preceptor student available to find out.

I conducted the review throughout the course of my preceptorship. What I found was that there was actually a fairly robust literature on the subject of multi-generational teams and the traits that make them successful. Little of this research, however, came from the field of nursing. Most of it, in fact, came somewhat unsurprisingly from the private sector. European (primarily German) researchers have been investigating the effects of age diversity on firm efficiency and productivity for some time. While these ends may be of slightly more importance in the private sphere, the literature also focused on the concept of group cohesion. Group cohesion, of course, is positively correlated with increased efficiency and productivity.

So how could we translate these findings into a community nursing context?

Well, the answer is a simple one. Although there are a variety of ways to foster group cohesion, as gleaned from the private sector, the most important goal is to create spaces that encourage innovation and creative freedom. But how nursing units can accomplish this – by promoting safety, learning together, and implementing diversity training – is ultimately unrelated to the notion of multi-generational teams. Successful age-diverse teams share traits of all successful teams, more generally. For nursing teams in the community, we should all learn to accept differences, communicate effectively, and value each other’s contributions. Sometimes, research simply affirms what we already intuitively know. With age-diverse nursing teams, it is much the same.

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UBC School of Nursing director @SHCampbell27 supports our students & Faculty at today’s D&I Day. LSC atrium a beehive of activity! pic.twitter.com/l1llsZBocI

— UBC Nursing (@UBCNursing) April 7, 2017

Kudos @ubcappscience for successful Design & Innovation Day! Proud of @UBCNursing students' capstone projects! #UBC @ugm @P4HAnimalFdn pic.twitter.com/fHjnY7GIQh

— Khristine Carino (@KhristineCarino) April 8, 2017

UBC Nursing Synthesis Project Feature: Kelsi Jessamine and the Vet Pop Up Clinic from Khristine Carino on Vimeo.

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The I-CAN project started as collaboration between two UBC School of Nursing faculty members, Maura and Ranjit, and the Director of the Union Gospel Mission (UGM), Melissa.

Maura and Ranjit posted a notice about the I-CAN project, and 10 students signed up for the project. The 10 students are those circles closest to the center of the snowflake.
In an initial project meeting between Maura, Ranjit and Melissa, Melissa identified the need for a sustainable foot care clinic. The School of Nursing currently does foot soak clinics every 6 weeks. This activity is very popular at UGM, but the staff and clients would like to expand available services, based on client requests for professional foot care.

Melissa suggested that we begin our project by talking with UGM staff and getting them on board. Four student volunteers interviewed these UGM staff. UGM staff members provided additional names of inner city clinics that might partner with us on this project. The students are setting up interviews with these clinics to determine whether or not they are supporters or competitors. These inner city services are in the next layer of the snowflake with ?s (competitor, supporter). We hope to win them over to our project!

Our asks are: 1) Are there professionals who can do foot assessments? 2) If so, would they be willing to volunteer their services every 6 weeks during the School of Nursing foot soak clinic? 3) Would they be willing to review the accuracy, utility of deliverables we create through this project? (We are creating a “Foot Care Tips” card and a referral form for UGM clients).
The bold lines between students indicate students who are working together on interviews or other aspects of the project. Melissa and UGM staff members have asked for a “Foot Care Tips” card to give to clients during foot soaks—a teachable moment for students doing client foot soaks. Two students are designing this card.

The UGM staff members have also asked us to create a standardized referral form to connect clients with foot disorders to inner city services. We need to identify inner city service providers who will receive UGM referrals, and we need to set up a standardized process for referrals to happen smoothly, efficiently. Two students are working on the referral form.

A third deliverable for this project will be a video of foot assessment: for all foot care clinic volunteers to watch. The UGM staff members (and UBC faculty) want to ensure that anyone volunteering for the clinic has basic information about foot assessments and specific issues for the UGM client population. Our intention is to ask service provider supporters to review and approve our three deliverables (i.e., foot care tips card for clients, referral form for inner city foot care services, and a video for foot care clinic volunteers).
The UBC faculty leads have been having conversations with the UBC chapter president of IHI Open School. They are discussing the possibility of making the foot care clinic an initiative of the UBC chapter. One student, a member of the UBC Social Medicine Network, is also talking with members of this student association to determine inter-professional student interest in our foot care clinic.
We realize that our snowflake will continue to grow as we establish more contacts and relationships with services (non-profits and for-profits) in our inner city area.
We have a question: We have not included the UGM clients as part of our team. We are, however, having regular discussions with them about the services they want, and we will ask for their input and feedback on our project deliverables. Should they be included in the snowflake?

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BY KELSI JESSAMINE

                  Photo Credit: Sandy Sharkey

On December 4^th, 2016   a team of UBC Nursing students collaboratively put on Vancouver’s first primary care clinic for clients and their pets. The idea for the clinic was proposed by Kelsi Jessamine, a 4^th year UBC School of Nursing (SoN) student, who integrated development of the clinic into The SoN Synthesis Project course (N334). Kelsi worked on organizing, developing, and directing the clinic with devoted team of UBC Nursing students. The student team included: Jessica Ardley, Laura Gallagher, Livianna Cristea, Jennifer Hoffman, and Anna Dupas. The team of students partnered with the non-for profit agency, Community Veterinary Outreach (CVO), to provide free veterinary care to pets of under housed individuals, while offering health and social services to the owner(s).  CVO and the UBC Nursing students collaborated with groups including: Paws for Hope, Vancouver Coastal Health, Vancouver Family Services, to launch the highly success pilot at Directions Youth Services.

The Nursing Team from left to right: Elena Bernardi, Liviana Cristea, Laura Gallagher, Jess Ardley, Kelsi Jessamine and Jennifer Hoffman. Anna Dupas missing from photo.

The pilot was targeted to street youth with pets in the downtown region. Internal referrals for the clinic were made by Michlle Simms (NP, VCH); however, walk-in appointments were also accepted the day of the clinic. Paws for Hope provided veterinary care to 25 animals which included: immunizations, deworming, spay and neuter referral, nail trimming, and preventative education to owners. The UBC nursing students provided primary health care services to the pet owners. The services provided included the administration of 11 influenza vaccine youth and suppling 33 clients with naloxone kits and training. Additional care and education was provided on topics such as: dental care, STIs, and wound care.  The CBC story of the pilot can be found at the following link:  http://www.cbc.ca/news/canada/british-columbia/free-vet-care-for-homeless-youth-in-vancouver-aims-to-help-pets-and-people-1.3881226

“We realize the potential of veterinarians and veterinary care to influence the health and welfare of marginalized people who are pet owners”, says Dr Michelle Lem (CVO founder). 

“The opening is the animal.”

UBC Animal Biology Student, Chloe Roberts assisting with the veterinary examination.

 CVO clinics are extremely influential in improving the public health of vulnerable populations, through harnessing the strength of the human-animal bond, especially in those who are marginalized. The same group of students and UBC Master of Public Health Candidate, Dr. Doris Lueng, are planning another clinic with CVO on May 1^st at the Veteran’s Manor and Evelyn Sallor Center. This May 1^st event will be promoted under the title, “Pet Fair and People care”. At this event primary care services will be offered to clients and grooming services to the pets. The event will be held from 12-4pm. This event will be offered as an UBC IPE event for both Nursing and Pharmacy students, with additional contribution from UBC Masters of Public Health Candidates. The will be opportunity for invaluable leadership and clinical experience for students. If you would like to find out more information about the upcoming event or future clinic, please contact Kelsi at: kelsi.jessamine@vetoutreach.com. More information about CVO and how to get involved, please visit http://vetoutreach.

Special Thanks to:

Paws for Hope

Michelle Simmsm, NP (VCH)

Matt Smith (Assistant Manager, Directions Youth Services)

Dr Maura Mcphee, RN, PhD (UBC School of Nursing)

Joanne Ricci, MSN (UBC School of Nursing)

Warner Brothers (The Flash)

Whole Foods (4^th Avenue)

Cobbs (4^th Avenue)

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By KARLIE SCHRIBER & AMANDA SY DE JESUS

Every Friday morning, Covenant House holds a Women’s Drop-In Center that offers numerous supports such as breakfast, clothing, and access to Youth Workers and Case Managers.

Youth (16-24 years) experiencing homelessness and facing barriers related to the social determinants of health are provided with a safe space. Numerous youth expressed their satisfaction over having a place where they could feel completely at ease and be surrounded by other women facing similar life experiences.

We attended these drop-in sessions for four weeks building relationships, getting used to the space, and engaging with the attendees. During our last week, we held an information session about safe pregnancy because it was a health topic that had not been done previously. The three main components of the information board were early signs of pregnancy, health centers and resources in the area, and a game with fact or fiction myths regarding pregnancy.

We used tea tree oil balm giveaways as a “hook” to incentivize them to partake in the game. Tackling pregnancy myths was a good way to gauge the different levels of knowledge and engage in health teaching. One interesting thing that was prominent was the lack of knowledge about safe influenza vaccinations for individuals who are pregnant.

We took this as an opportunity to emphasize the importance of flu shots for this demographic and the different resources available. It was great to engage the young women with knowledge that they were interested in! Not everyone has regular opportunities to seek out medical and health-related information. The information board and interactive game seemed to be very well received amongst the women!

Overall, we had a very positive experience at Covenant House, as it was a great learning opportunity to experience public health nursing in a community setting.

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