Jennifer Taylor and Marcia Johnson, two Toronto general nurses who spent a month working in the Attawapiskat First Nation community on James Bay.
Northern exposure
May 10, 2008
Special to the Star
For nurses in a big-city hospital, the pace is fast, their role is specialized and they often don't see each patient for more than a few minutes.
But for four weeks in March, Toronto General Hospital nurses Jennifer Taylor and Marcia Johnson got an eye-opening taste of what life is like for nurses working in small Northern Ontario communities.
"The nurses perform quite an expanded role there – they wear so many hats," says Taylor, a Toronto General Hospital nurse who spent a month working at a clinic in Attawapiskat, an isolated First Nation town of 1,300 near the shores of James Bay. "They function quite often as doctors, nurses and social workers; they prescribe and dispense medication – they are all things to all patients up there.
"In the south, we take for granted the accessibility we enjoy. For instance, up there, the hospital doesn't have a CT scanner or a pharmacy – it relies on a pharmacy in Moosonee," she says. "If I was working in Toronto General emergency and someone came in with chest pain, I would have blood work and results back in three hours. Up there, it would be several days, which is unheard of down here. The people in the North are falling through the cracks so badly."
Taylor and Johnson were the first to participate in the James Bay Project, a new program developed by the University Health Network (UHN) to provide outreach to Moose Factory, Moosonee, Port Albany and Attawapiskat. In turn, nurses from the northern hospitals will get a chance to work at Toronto hospitals.
The experience was a huge departure from their normal routines. Taylor has been at Toronto General since she graduated from nursing school 19 years ago, working mostly in emergency medicine and psychiatry. Johnson, a nurse for 10 years, works in general surgery.
Johnson says she found the 16-bed hospital in Attawapiskat to be well-equipped, but was surprised by the standard of living. The community is inaccessible by road, except for an ice highway a few weeks each winter. So, patients must be flown out for CT scans, ultrasounds, chemotherapy and appointments with specialists – all at a huge cost to the system.
"Diabetes is rampant and there is a lot of non-compliance for the care of diabetes," Taylor says. "That was very disheartening. There is also a lot of teen pregnancy – it was normal to meet women in their mid-20s with five and six children. They have the most beautiful babies and children I've ever seen but they age quite rapidly after the age of 30. There is also a lack of dental care."
The program was spearheaded by Mary Ferguson-Paré, vice-president of professional affairs and chief nurse executive at UHN. She had travelled to the North and realized the potential benefits an exchange program could offer both the communities and her staff.
"It's a great opportunity for them to go up North and rejuvenate themselves and look at health care from a totally different perspective," says project manager Baiba Zarins. "Not only does it attract nurses to UHN ... but is also retains staff who want an opportunity to practise outside and learn."
Johnson found the experience both challenging and rewarding.
"We weren't limited in any way," she says. "Here, there is a specialist for everything. But up there, we were doing everything – you didn't feel restricted and I felt I was really helping.
"I also felt like they really trusted me after a while. I would like to see more nurses get this exposure to the North. We tend to go overseas but it makes more sense to go north."
Taylor agrees.
"We need to become aware of what is going on in the rest of our province, especially in terms of accessibility in health care. It's an eye-opener."