BY ERICA BENSON

This summer I tracked down Kelsi Jessamine to pick her brain on her unique synthesis project. For current students attending UBC who have a project they are dreaming of, here is an inside look at how Kelsi made hers happen!

What did you do before entering the UBC accelerated BSN program?

Before entering the UBC accelerated BSN program I completed my Bachelor of Science, with a Major in Animal Biology at the University of Guelph. After graduation I worked at the university’s Animal Health Laboratory  while continuing to work and volunteer at a couple local veterinary clinics. My work with animals in the agricultural field and clinical setting soon brought me to Ottawa, ON where I was introduced to Community Veterinary Outreach (CVO) and began volunteering at their clinics.

How did that experience inform your project?

Volunteering with Community Veterinary Outreach (CVO) was an extremely inspiring experience. Despite already having extensive experience working with animals, CVO clinics introduced me to how effective leveraging the human-animal is in clinical practice and just how effective the “One Health” care-model is in engaging with marginalized and vulnerable populations.

At CVO clinics, clients receive free veterinary care, food and supplies for their pet, and are then offered parallel human health services from a nursing care team. It quickly became evident how powerful the role of the veterinarian is in not only providing pet health education but in gathering a social history from the client. Pet health education from the veterinarian covers topics from nutrition, immune, respiratory, and cardiovascular health, which share common themes with the health of their owners. The client’s willingness to engage in the offered human health services is only enhanced after consulting and building trust with the veterinary team. Even before beginning my nursing degree it was clear to me how unique the inter-professional collaboration within the “One Health” care model is and how it dramatically improves the public health status of both pets and people in a community.

Who did you approach in the SON to collaborate on the project? In the community?

For my final nursing synthesis project, I approached nursing instructors Maura McPhee and Ranjit Dhari. They were extremely supportive of my proposal right from our initial meeting and have continued to support the project along with a number of other UBC School of Nursing staff and instructors. After receiving approval from CVO to expand the initiative to Vancouver, we then partnered with Paws for Hope Animal Foundation (PFH) and launched Vancouver’s first primary care clinic for marginalized clients and their pets. The event was held at Directions Youth Services on December 4th, 2016 and was a huge success. Additionally, we held a second UBC SoN. CVO, and PFH partnered event at Evelyne Saller Community Centre on May 4th, 2017 that engaged even more clients and their pets.

Were there any roadblocks and how did you overcome them?

This was my first time leading a group of students and coordinating with various community partners to organize a healthcare clinic. It is both challenging and time consuming preparing for each clinic but it’s something that I enjoy and believe in, to not become discouraged by obstacles that inevitably arise in the organization of events like these.

What advice can you impart on current students wanting to do something alternative?

Go for it! Find an avenue to harness whatever interests you and create a space for it in the traditional healthcare field.  This integration will not only complement your nursing practice but will offer unique platforms to therapeutically engage with clients.

What are you most proud of that resulted from this project?

That it’s still ongoing!  🙂
I am thrilled to say that we have begun to establish a sustainable project. We will be holding our fourth community primary care clinic for people and their pets on November 26, 2017. At this clinic we will continue to collaborate with CVO, PFH, Directions Youth Centre, and the UBC School’s of Pharmacy and Nursing. I will also be attending the Community Engagement and Healthcare Improvement Conference this September in San Antonio,Texas. The conference will give me the opportunity to present my final nursing project and share the ongoing work being done with CVO and PFH in growing the “One Health” initiative.

Anything else you would like to add?
There are many opportunities for SoN and healthcare students to get involved with our Vancouver “Pet and People Primary care clinics”. These opportunities will be offered and advertised through the Community Nursing Course and Interprofessional Education. If you are interested in getting involved, please contact Kelsi Jessamine (RN, P) at kelsi.jessamine@vetoutreach.org.

These One Health clinics wouldn’t be possible without our community partners. Big thanks to:

Paws for Hope Animal Foundation (PFH), who provides the veterinary services and animal care products
Royal Canin — pet food donations
Warner Brothers- The Flash — printing and media
Three Bridges Clinic (VCH)
UBC School of Nursing
UBC School of Pharmacy

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BY TAYLOR PERRY

Understand that most of the work done by nursing students is completed and reviewed once, never to see the light of day again. But this past week, I had the opportunity to participate in a more lasting presentation of work undertaken during my time at the UBC school of nursing. The biennial C2U Expo – held at SFU Harbour Centre – allowed me the chance to both disseminate a personal project to a larger audience, and reconnect with friends I had made during my synthesis project.

Right – the synthesis project. I call it my synthesis project when it would be more accurate to call it a team effort. When I saw a listing for a therapeutic writing project at Turning Point recovery, I jumped at the opportunity. It was my first choice, as it was the first choice of two other nursing students. The three of us joined forces with the team at Turning Point who had been running – informally, mind you – the writing program for some time.  They had high hopes for the program, but unfortunately lacked the resources to achieve them.

Enter the nursing students. Turning Point wished to build a standardized Therapeutic Writing program that it could distribute to each of its sites, complete with lesson plans, learning objectives, and thematic elements. While this was the overarching project, as students we were able to experience the program and participate alongside the house residents during the weekly sessions. For me, this was the most memorable part of the project. We had the opportunity to form relationships with people on the recovery journey and catch a glimpse of the house’s operations. And through it all, we developed the program in consultation with the Turning Point team. Once we had completed it, I assumed our relationship with Turning Point had reached its natural conclusion.

But then came C2U. Held every two years, the C2U Expo “showcases the best practices in community-campus partnerships worldwide.” It explores spaces for collaboration and helps to foster connections between academic institutions and the communities they serve. When I was asked if I could contribute a student perspective to the Turning Point presentation, I eagerly confirmed my interest. Ross Laird from Turning Point led the discussion, Ranjit Dhari described UBC’s efforts, and I provided a student voice. Together, we introduced the Therapeutic Writing program (and two other Turning Point projects) to a room full of conference attendees. We explained its rationale, development, and the partnership forged by UBC and Turning Point. Yet it also brought some closure to the project for me, and a last chance to connect with people with whom I had worked so closely. Because in addition to building a robust writing curriculum, we had built strong friendships, too. The program is now alive and well across multiple Turning Point sites. Our hope is that we also inspired others at the C2U Expo to do something similar.

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BY NARISSA MAWJI

Are you interested in healthcare, innovation, technology, sustainability, interprofessional collaboration, or quality improvement? Do you want to make positive change to our healthcare system? The Canadian Chapter Leaders of the Institute of Healthcare Improvement are pleased to invite you to our first national conference: Health Innovation for All. The event is open to all students and professionals in various health disciplines, and seeks to encourage future healthcare leaders to learn more about how to improve our system to benefit everyone. The day will include professional and patient keynote speeches, a panel discussion with Quality Improvement experts, interactive workshops that highlight innovations in technology, sustainability, and interprofessional collaboration, and will conclude with a storyboard reception.

When? Saturday June 10, 2017

Where? UBC Nest

Our keynote speakers include Dr. Granger Avery (President of the Canadian Medical Association), Dr. Kedar Mate (Chief Innovation and Education Officer for the Institute for Healthcare Improvement) and Dr. John Pawlovich (Telehealth Medicine Provider for rural First Nations communities in BC). For more information: http://iccnconference.ca/ Please register at: https://www.eventbrite.ca/e/ihi-open-school-canadian-chapter-network-conference-vancouver-site-tickets-32018796081

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BY KRISTIN STOVALL AND MIKE FOK

A fellow student and I had the opportunity to teach parents about sexual development for their adolescent children living with disabilities. We used an interactive setting where parents were able to communicate their questions and concerns through both verbal and non-verbal means. We tried to create a safe space where parents could voice their concerns without the fear of judgement. This style of information sharing allowed parents to contribute their experiences and knowledge, so they could learn from one another. Synthesizing their ideas helped highlight important reoccurring topics, which we could use as a guide for further meetings.

Although we were meant to do the teaching, I believe the most important development from this presentation was helping create a community, where parents could learn from one another and support each other through a process that many of them mentioned could feel quite confusing and isolating. As students, this was one of the most challenging and rewarding opportunities of nursing school. We used the knowledge we had gained in courses, such as Ethics and Relational Practice as a guide when answering questions and also integrated the theory and skills of capacity building and health promotion learned and developed in the N336 Nursing Practice with Communities and Populations course. Overall, I will never forget this experience as it has taught me that in the end the most important thing is to start the conversation.

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BY ERICA BENSON

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.

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BY REBECCA ANTHONY

Photo by Franco Folini, Labelled for Reuse.
https://www.flickr.com/photos/livenature/7298902136

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.

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