Category Archives: Nursing

My Journey with ARNBC, by Linda Axen, RN

Congratulations on finding your way to the ARNBC webpage! By cruising through the website and reading blogs you have already taken your curiosity from thought to action. I also took that step exploring ARNBC online a few years ago and now I find myself privileged to sit on the Board of Directors representing the diverse voices of nurses working in northern B.C. This blog is my story of taking action which I hope will inspire some of you who have been thinking about becoming more active in your profession to find ways to take the next steps.

A professional high-point for me was having the opportunity to attend and present at the Canadian Nurses Association 2012 Biennial Conference. Attending that conference, soaking in the words of Canadian nursing leaders was an awe-inspiring event. I encourage all nurses to endeavour to attend at least one CNA conference for the simple yet profound sense of professional pride you will enjoy. Of particular interest was the sharing of the report A Nursing Call to Action: The health of our nation, the future of our health system. It filled me with hope and a sense of purpose that nurses throughout the country were capable of contributing to solutions to better the health of Canadians.

In early spring of 2014 I received an email notification that nominations for the ARNBC Board were open. I wanted to have my name put forward but at the same time I was very nervous and reluctant to compete for a Regional Director position. I overcame my fears only because I knew my regrets would haunt me if I didn’t try for the position. I am so happy that I took that risk. As a Board Director, I have attended meetings which occur approximately five times a year face-to-face and a few times per year by teleconference. The time commitments for connecting with nurses in the regions vary for each Board member. At every meeting and teleconference I am continually inspired by the passion that fellow Board members exhibit in representing nurses throughout the province. I am proud to think   that time spent on Board activities Board allows me to contribute my voice to influencing positive change on social and health issues in British Columbia.

So if you are like I was a few months ago, thinking about being more active in representing the voice of nurses, take the time to familiarize yourself with the webpage, explore becoming a network lead or consider contributing your voice on the Board of Directors. Nominations for Directors are open, so visit our website for more information  and consider letting your name stand for nomination. It’s a decision you won’t regret.


Linda1Linda started with Northern Health in October 2011 as the Nursing Research Facilitator and is currently the Northern Health Cardiac Triage Coordinator. Prior to the Nursing Research Facilitator role, Linda worked for many years in clinical research in Vancouver including five years in Cardiology Research at Vancouver General Hospital. In completing her Master of Nursing in 2011 from the University of Victoria, Linda gained a greater understanding of the contributions nursing makes to health policy development and the complexities of the social and environmental forces within which nursing has developed as a profession.

Concurrent to working in Northern Health as the Nursing Research Facilitator, Linda co-taught the Introduction to Nursing Research course at the University of Northern BC. Working with the students afforded Linda insight into the amazing strength, energy and professionalism that newly graduated nurses bring to our ever-evolving work environments. Linda is passionate about encouraging practicing nurses to develop expertise in research and research-related activities and evidence-informed practice. Linda has been actively involved in the BC Ethics Harmonization Initiative and is a certified member of the Society of Clinical Research Professionals. She is well aware of the powerful economic contribution the north makes to the overall fiscal strength of our province and recognizes that this economic contribution requires a healthy and robust workforce.

Budget Lockup: Insights from ARNBC, by Zak Matieschyn, NP

Recently, I had the privilege of joining Joy Peacock, Executive Director of ARNBC, in the B.C. Budget Lockup. For those who are not aware, this is a secured room wherein around 200 stakeholders have an advanced preview of the details of the budget and service plans. This is also where the media interviews these stakeholders in order to get their stories aired in a timely manner following the budget speech.

This was the first time ARNBC was invited to participate in the Budget Lockup – an event that can only be attended by invitation of the Finance Minister. Beginning January 1 of this year, ARNBC entered a new phase, and is now a member-driven organization representing all B.C. registered nurses and nurse practitioners. Being invited to participate in Budget Lockup was a strong signal of how government views the importance of the Association and the work we’ve been mandated to do.

The budget itself was a relatively benign affair for healthcare. Increases to healthcare spending will be a very modest 2.9% per year. My review of the Ministry of Health service plan noted much of the same language as last year: commitments to primary disease prevention and health promotion, improving primary/community care through inter-professional teams, and improving rural healthcare to name a few. From a theoretical perspective – this is music to the ears of the nursing profession. As we know and have been educated, these points are among the mainstays of what are needed to reform healthcare. What is concerning is a lack of a blueprint of how we get there. We are talking about a fundamental shift in how healthcare is delivered to become more up-stream, integrated, and team-based. Uttering the correct words is a fine start, but such an objective will require dedicated monies to operationalize this plan, as well as an understanding that this will be a front heavy, longer term process. That is, the benefits will be slower to materialize than can fit in a single budget year or government election cycle. The other point lacking is collaboration with nursing. Registered nurses and nurse practitioners possess exactly the knowledge and expertise of a healthcare system described in the service plan. It is simply a waste of available talent, capacity and leadership to exclude nursing from the spheres of policy planning and implementation.

Also disappointing was the lack of mention of nurse practitioners when commenting on plans for improving access to full service primary care. Over the past 10 years, NPs have slowly been implemented to improve access for British Columbians to primary health care – both in urban and rural settings. Once again, new NPs find themselves without an existing hiring initiative, let alone a robust funding model, to permit them the opportunity to improve primary healthcare access to regions of the province in desperate need of help.

On the brighter side, I was pleased to observe the significant step of eliminating the clawback of child-support payments for single parents on income or disability assistance. This is a relatively low cost intervention (costing only $19 million annually but helping to lift nearly 6000 children out of poverty) which directly impacts the health of these individuals and the health of our society. Nursing has long known the impacts of social determinants on health and government would do very well to continue to explore these evidenced based health and social policy reforms.

The media scrum that occurred towards the end of lockup was a chaotic scene – throngs of stakeholders and reporters mobbing each other. I noticed a friend of mine in the crowd representing another group. “How does this thing work?” I asked. “You just grab the next available reporter and talk to them” she expertly answered. Seemed simple enough yet daunting to the novice that I am, but as I observed the goings on, there did seem to be an order amongst the madness. I did manage to speak with a few reporters about our associations’ reactions to the budget and with luck they may use the story.

I will sharpen my elbows for the next opportunity.


Zak’s interest in health and healing began at the early age of nine years-old when he would carry a small first aid kit while playing with friends. Since then, his passion for healthcare and health policy has been unwavering. He was particularly inspired by concepts of family, community, and societal health, as well as the social determinants of health during his nursing undergraduate (BSN UVic, 2000), graduate work (MN UVic, 2008), and clinical experience in urban, rural and remote B.C. communities.

Zak has served on numerous boards and committees, including the BC Nurse Practitioners Association Executive and is the only Nurse Practitioner in B.C. who has been invited to sit on a Division of Family Practice Board (Interior). Through this work he has gained valuable experience in member engagement, optimizing board governance, and relationship building among diverse stakeholders. In his clinical practice, Zak has worked med/surg, emergency, intensive care, vascular access and outpost nursing. After obtaining his NP education six years ago, he began a practice in a West Kootenay family clinic, providing primary healthcare to the general public with a focus on marginalized populations. Zak is president-elect of ARNBC.

Reflecting on our Success, by Julie Fraser, RN, MN, ARNBC President

As we move forward into 2015, and my final months as president of ARNBC, I value this opportunity to reflect on ARNBC’s achievements over the past year and look ahead to the future that is unfolding for the Association and nursing in BC. I am so proud that through the hard work and dedication of many nurses in BC, ARNBC has grown into its role as the professional voice for nursing leadership, policy and practice in British Columbia.

In January 2015, registered nurses and nurse practitioners began the registration process with the College of Registered Nurses of BC (CRNBC). This was an historic occasion as, for the first time CRNBC began collecting professional association fees on behalf of ARNBC. Through the Health Professions Act, the province has set a visionary and revolutionary precedent by providing professions with the ability to self-regulate in the interest of the public, while continuing to advance their profession and influence change for health and social policy issues.

Upon registration, CRNBC is now collecting a total of $450.18 from each registered nurse and $651.48 from each nurse practitioner. When you register, you will notice that a total of $98.82 is allocated as Association fees. Of this, CNA receives $57.69 and ARNBC receives $41.13. It is important to note that registration fees for individual nurses have not increased at all.

At this point in the registration process, nearly half of you have already registered for 2015, and just over 85% of you have clearly indicated that you want to hear from ARNBC and CNA. This is a fabulous show of support and validates what so many of you have been saying for the past decade – B.C. nursing needs the contributions of all three nursing organizations – the College, the Union and the Association. We value the trust you have placed in us and regard it as our responsibility to move forward with you in the months and years to come. That said, we are pleased to offer all registered nurses and nurse practitioners access to all ARNBC and CNA programs and services – even if you have chosen to not receive our information updates.

ARNBC continues to build a strong relationship with our national organization, CNA. As president of your Association, I sit on the CNA board of directors where I have the honour of raising health and nursing issues from a B.C. perspective at the national level. CNA continues to be one of our greatest partners and ARNBC is one of many associations and nursing groups that make up the CNA Board. We value their support and leadership in recognizing ARNBC as the best option for B.C. nurses to connect on a national and international level. ARNBC’s status as the CNA jurisdictional representative provides B.C. registered nurses and nurse practitioners with more than a subscription to Canadian Nurse: opportunities to be a voting delegate, chances to inform on CNA resolutions and bylaw forums, engagement in federal lobbying initiatives and connecting with specialty nursing groups.


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My greatest hope is that over the next weeks and months, nursing in British Columbia will begin to unify to claim the strong, compassionate, and informed voice that our patients have come to expect and trust from us. The College, the Association and the Union all bring unique but important perspectives to patient care and health system improvements – and at a time when there are so many important issues to manage, we need to work together for the health of our patients and the advancement of our profession.

As you can see, our list of achievements is long and growing steadily longer, in large part because you have told us what you would like to see in an Association. We are excited to be heading out to many parts of the province over the next few months, and hope that we will meet as many of you as possible and you will share your vision for what an Association can do for you. Every single conversation with a registered nurse or nurse practitioner is important to the Association. After all, your voice is our strength!

Click to view ARNBC programs and services for registered nurses and nurse practitioners.


JulieJulie Fraser is a Clinical Nurse Specialist in the area of Home Care. She has been a registered nurse for more than 15 years and has practiced in a number of different settings from residential care to acute medical and surgical care units, before focusing on community nursing, working in both clinical and educator roles.

Self-Care in Nursing: A Call to Action, by Maren Austen, BSN Student

There is evidence that nurses know that we should take care of ourselves and how we should be doing it, yet there is still a gap between what is known and what is practiced (Malloy, et al.). As a profession centered on caring, nurses spend much of our time providing care for others; unfortunately, we often do not give the same consideration to self-care – those activities we do to rejuvenate and refresh ourselves, our spirit, and our energy (Lombardo, et al). Kravits, McAllister-Black, Grant, & Kirk summarized the impact of poor self-care succinctly, “Nurses whose own emotional reservoirs are low are less equipped to meet the care needs of their patients, and this may negatively impact patient safety”.

The World Health Organization defines self-care as “activities individuals, families, and communities undertake with the intention of enhancing health, preventing disease, limiting illness, and restoring health”. According to the Buffalo University Master’s in Social Work Self-Care program, a successful self-care plan factors in six key areas: Physical, Mental and Emotional Wellness, Spiritual Needs, Positive Relationships, and School/Work/LifeBalance (Butler, et al). Exercising, journaling, eating well, meditating, maintaining outside interests, and praying, are examples of self-care strategies.

For many RNs, self-care is a concept that seems like a luxury that we do not have time for (Lombardo, et al). However, it doesn’t matter if you are a nursing student, new graduate, acute care nurse, or community health nurse, we all need to take care of our own wellbeing so that we can meet the challenges each of us will face at school, work, and home (Jackson, et al).

So how do you find the time for self-care? First of all it is important to acknowledge that there is no one-size-fits-all self-care plan. We each have different workloads, lifestyles, circumstances, interests, and needs. Therefore, it is important that each of us take a couple of minutes to identify our individual needs and priorities.

Self-Care Assessment – How are you doing?

As nurses, we are all familiar with the importance of eating healthy meals throughout the day, getting enough sleep, and exercising regularly but when was the last time you praised yourself? Belted out a song? How about made time to be sexual with yourself or your partner? These are all simple ways that we can recharge and refill our own personal energy stores. Butler et al. have created a comprehensive Self-Care Assessment Tool to help individuals evaluate their current self-care strategies. While I understand that this tool was developed by a Masters in Social Work program and not specifically for nurses, I believe it is a wonderfully comprehensive assessment tool from a fellow health care profession with similar caring and burnout concerns. Take a few minutes and follow this link to explore this assessment tool – you can’t fix what you don’t know!

Make a Self-Care Plan

Butler et al (2014) recommend making a self-care plan to help you maintaina positive self-care regime. Examine your Self-Care Assessment responses and look for trends and annomolies. Are there any areaslacking in support? For each of the six areas (physical, mental, emotional, spiritual, relationships, school/work/life-balance), write out your current practice and then below it, write out your new practice. Some areas might need only slight alteration and others might never have been consciously addressed before. Keep your goals interesting to you and simple enough to fit into your current schedule. Follow this link to a sample self-care plan by Butler et al, (2014):

Make a Commitment

Once you have developed an initial plan, it is time to make a commitment to yourself and share your commitment with those around you. If you are able to articulate to your loved ones, classmates, coworkers, and friends why you are taking time for you and how you are also making space and time for quality relations with each of them, they are better able to support you and your wellness plan. Also recognize that this plan is a work in progress and will need to be reviewed and adapted as you incorporate self-care into your lives and especially as your lives change and evolve.

Wishing you all balance and wellness!


I am a 4th year student in the Bachelor of Science in Nursing program at North Island College in Courtenay BC with a 4.0 GPA. Being a full-time student, working part-time as an employed student nurse in addition to raising my young daughter, I have come to understand the need for self-care first hand. This topic has become so important to my own overall wellbeing that I have felt compelled to share my learnings with those around me. With this in mind, myself and several classmates have spent many hours outside of the classroom creating opportunities for our fellow nursing students to engage in self-care and to help them develop the self-care strategies they will need to be compassionate, engaged nurses in their future practice.



Butler, Rinfrette, & Reiser, (2014). Self-care starter kit. Buffalo University Master of Social Work Program.

Jackson, J. & Gaudet, S. (2009). Self-care practices among nursing students. Canadian Nursing Student Association Positions and Resolutions.

Kravits, K., McAllister-Black, R., Grant, M., & Kirk, C. (2010). Self-care strategies for nurses: A psycho-educational intervention for stress reduction and the prevention of burnout. Applied Nursing Research, 23, 130–138. doi:10.1016/j.apnr.2008.08.002

Lombardo, B. & Eyre, C. (2011).Compassion fatigue: A nurse’s primer. The Online Journal of Issues in Nursing, 16(1). Retrieved from:

Malloy, P., Thrane, S., Winston, T., Virani, R., & Kelly, K. (2013). Do nurses who care for patients in palliative and end-of-life settings perform good self-care? Journal of Hospice & Palliative Nursing, 15(2), 99-106. doi:10.1097/NJH.0b013e31826bef72

WHO. (1984). Health education in self-care: Possibilities and limitations. World Health Organization, Geneva, Switzerland: WHO; 1984 Retrieved from:


B.C.’s Flu Shot Policy for Healthcare Providers: it just makes sense, by Hannah Varto, NP

This year again the BC Ministry of Health has mandated that all healthcare providers must receive the influenza vaccine and if they choose not to, they must wear a mask for the duration of flu season whilst providing patient care. I applaud this decision and am frustrated by some of my colleagues who argue against science and common sense. Let’s examine some of the arguments.

Point 1: Flu kills.  It doesn’t tend to kill healthy people. I could care less if I personally get the flu but I care a lot if some nurse or doctor gives my elderly grandmother the flu and she becomes very sick (or worse).  I care a lot if some family doctor, NP or public health nurse gives my two week old baby the flu during a home visit. Flu kills our young, our elderly and our sick. It really is that simple. And these are the people we have agreed to take care of.

Point 2:  “I’ll stay home from work if I get the flu”. Great thinking….but you’ve already spread the virus before you even knew you had the flu.  Most flus and colds work that way. You’re spreading it before you have any symptoms.  Why should I have to cover for your sickness at work?  I took personal responsibility for my health and the health of my patients and co-workers to prevent getting sick but I’m supposed to cover for you because you didn’t? Thanks. Why should your employer and taxpayers have to pay more because you didn’t take responsibility for your own health? Something seems pretty unfair about that.

Point 3: Mandated vaccines. We are already mandated to get a vaccine, it’s called Hepatitis B. When healthcare providers are accepted into their schools and training programs and when we’re hired we are asked to prove we’ve had hepatitis B vaccine and also that our level of protection is adequate. So, we’re already mandated to get a vaccination because of our chosen profession. This isn’t new. Why is flu vaccine different? Why aren’t we crying “human rights” about Hepatitis B, Tetanus and MMR vaccines too?

Point 4: TB Skin testing.  Read point 3…same thing for TB Skin testing.  The fact is that healthcare providers have agreed to care for our most vulnerable populations and this includes a personal responsibility to do our best not to bring additional disease and infection to our patients.

Point 5: Shoddy science and “Big Pharma”.  Healthcare providers who are citing out of date, scare tactic “research” just to support their points need to check their professional commitment to evidence based practices. I look to the science, the evidence and the experts.  Conspiracy theorists abound and it’s difficult to sort through the rhetoric on both sides. Who should be making these vaccines instead of pharmaceutical companies? I would love nothing more than to have self-sacrificing scientists who are barely paid a living wage come up with amazing scientific breakthroughs. This isn’t happening in Canada. It’s a problem. But it doesn’t mean that the scientists who are working for pharmaceutical companies are all corrupt and out to kill and maim people. Our government has a vested interest in keeping the population healthy and out of emergency rooms.

Point 6: Only a few strains are covered. Sure, flu vaccine might only be 40% effective and only protect against two strains – but it’s better than 0%.  It’s the best we have for now.  We have a vaccine for hepatitis A and B but not for C so does that mean I won’t take Hep A and B vaccines?  If I took this logic into any other harm reduction strategy, my credibility could be called into question. This argument is like not wearing a bicycle helmet because it only protects my head – but I still might fall and break my arm.

Point 7: Safety.  I’ve been involved in flu vaccine campaigns for more than 12 years now.  I have yet to see a reaction more serious than redness at the injection site or a sore arm.  But, because I also don’t support anecdotal evidence as actual scientific evidence I look to the research.  It supports my observation.  Rare reactions (which can happen with any food or drug) do occur but at such super low rates you’d be more likely to win the lottery first.

Point 8: Getting the flu from the flu vaccine. Read up on first year immunology. Flu vaccine is an inactivated vaccine. It cannot infect you with the flu.  It simply stimulates an immune response.  Now, this being said, there are a lot of anecdotes about people getting the flu right after getting the vaccine. The fact is, you have a different strain or you were already infected before you got the shot.  Just as you don’t get hepatitis B from the hepatitis B vaccine, you don’t get flu from flu vaccine…but wait, even if you did, I thought you said you didn’t mind getting the flu?

Point 9: Human Rights and Bullying.  Ok, so yes, you as a Canadian, have a right to your decision-making about your own healthcare.  No problem with me.  Your employer and patients also have a right to ask you to protect those around you and stay healthy in order to work. I wear gloves during procedures because it protects me and the patient. I change the gloves to protect the patients, not me. I don’t ever need to change gloves to protect myself…but I do, because I know it’s important to protect my patients. Don’t like these policies?  Feel free to go work somewhere else or chose a different career.  Feel free to go work where the elderly, young and sick are happy to have the flu.  Just let me know where you’re going….because I’ll be going the other way and taking my family with me.

Unfortunately, the logic and evidence is unlikely to change the minds of those people who are staunchly against flu vaccine. It makes me sad that they are closed to logical arguments and so entrenched in poor science, conspiracy theory and anecdotal evidence that they are willing to put the lives of their patients at risk. This winter, I’ll be wearing my “Flu Sticker” on my employee badge with pride.  It shows that I care about the people around me.  It shows that I care about my health.  It shows that I support evidence based practice. I will stand united in herd immunity to decrease the spread of the flu this year.  It’s part of my job, my career, my profession and my humanity.


Hannah Varto is a family nurse practitioner and an ARNBC Network Lead. She enjoys working as a part of interdisciplinary teams of health care providers. Her career focus has been primarily in the field of sexual and reproductive health, specific to women and adolescent populations. She has worked in a variety of settings including public health, youth clinics, walk-in clinics, telehealth, education, travel medicine, communicable disease and as a sexual assault nurse examiner. Hannah is on the board of directors for the McCreary Centre Society, a leading non-profit organization focusing on adolescent health research. Currently Hannah is leading the implementation of ARNBC’s first community of practice – the BC Contraceptive Management Community of Practice.

Canadian Nurses Association Lobby Day on Parliament Hill: Insights on Nursing as a Political Act

Have you ever had one of those days where you said to yourself “If I had the opportunity to go to Ottawa, I’d tell those politicians how to fix our health care system”? Well, that is just what happened for five nurses from B.C. who were part of the Canadian Nurses Association annual “day on the hill” lobby opportunity on November 25th, 2014. These nurses included two current CNA board members; Julie Fraser, B.C. jurisdictional representative and Jocelyne Reimer–Kent, Specialty Network representative; as well as three nurses selected as CNA board observers for the November meeting, Zak Matieschyn, Joy Peacock and 4th year nursing student Jessy Dame. The following insights are from the nurses who participated in this extraordinary event.

From left: Barb Shellian, CNA President Elect; Zak Matieschyn, ARNBC President Elect; Julie Fraser, ARNBC President; Karima Velji, CNA President; Joy Peacock, ARNBC Executive Director; Jocelyn Reimer-Kent, CNA Board Member; Jessy Dame, BSN Student; Anne Sutherland Boal, CNA CEO

From left: Barb Shellian, CNA President Elect; Zak Matieschyn, ARNBC President Elect; Julie Fraser, ARNBC President; Karima Velji, CNA President; Joy Peacock, ARNBC Executive Director; Jocelyn Reimer-Kent, CNA Board Member; Jessy Dame, BSN Student; Anne Sutherland Boal, CNA CEO

Julie Fraser, President ARNBC

“The energy the morning of the day was palpable – the nurses going to lobby spent the afternoon and evening prior brushing up on our key “asks”. We arrived on parliament hill focused on creating change through arranged 30 min meetings with selected members of parliament. CNA President Karima Velji started the day with powerful comments in a pre-event with the Health Minister, many members of Parliament and the CNA board members and observers. Karima expressed the opportunities to create access and quality in our health care system by establishing national standards for home care. She shared powerful statistics – 75% of Canadians think it’s important to be able to age at home with access to health care in the home setting and that same amount agree there is an enhanced role of nurses in delivering health care to seniors in the home setting. Federal Health Minister, Rona Ambrose, expressed how she appreciated the specific “asks” from CNA and the partnership with the new Health Innovations working group and HEAL (Health Action Lobby). The results of the day may be hard to technically quantify, but there were impacts. 25 nurses gained valuable experience on the “how to-s” of lobbying that can be used within our provinces and territories. Many members of parliament heard the message that #homeishealth, but with needed design and resources. Most importantly, nursing was seen at the national level as an informed politically astute profession, caring about the health of Canadians and the way we spend our health care dollars.”

Jocelyne Reimer–Kent, CNA Specialty Network Board Member

“The “Hill Day” was a great opportunity to meet with members of parliament and discuss issues pertinent to CNA. The focus this year was on home health and seniors. I met with The Honourable Joyce Murray Member of Parliament (MP) for the electoral district of Vancouver Quadra, which she has represented in the House of Commons as a member of the Liberal Party of Canada since 2008.

MP Murray was keenly interested in CNA’s issues and also gave an open invitation to nurses to attend a monthly breakfast speaker series that she hosts “MP Breakfast Connections” on Friday mornings at Enigma Restaurant (4397 W 10th Ave, Vancouver, BC). These meetings are non-partisan and designed to provide an accessible networking forum and opportunity to learn and engage in current policy issues ( Most issues have health implications so please feel free to join in this gathering and bring the voice of nursing to the fore.

With a federal election on the horizon I would encourage each and every nurse to speak with their MP. As nurses we are the most trusted healthcare provider but we also have untapped power that is ours to release.”

Jessy Dame, 4th year Thompson Rivers University Nursing Student

“Starting the day off with a bang is an understatement for how Karima Velji, the 46th President of CNA, welcomed attendees during breakfast on Parliament Hill. The welcoming speech spoke to the major topic of the day #HomeisHealth and how patients’ outcomes could be much higher if individuals stayed at home. Through this experience, I was able to obtain communication skills with government officials, learn insights on the lobbying process, increase my understanding of the Member of Parliaments (MP) role, as well as, acquire a taste for how the different political parties valued topics that nurses brought forward. Though I felt prepared to enter the rooms of the MPs, my insecurities of being a student were still present. These insecurities often lead me to introduce myself as a “just a student nurse”. This introduction quickly got the attention of my passionate mentor who then lead me to the realization of the importance of my role as a student nurse and that I am not just a student nurse, I am a future nurse and my role is just as important. The group I worked with was amazing and provided me with the inspiration to come home and continue expressing the importance of CNA’s three main asks and #HomeisHealth. My motivational gas tank has been refueled and I cannot wait to start driving my own car (My Own practice).”

Joy Peacock, Executive Director ARNBC

“Nursing is a political act. The privilege of being a registered nurse and representing our profession on Parliament Hill is something I will always hold close to my heart. Nursing is about making a difference. Attending “Hill Day” in Ottawa with CNA is one way to demonstrate advocacy in action, through collaborative leadership. I know we made a difference. I know together we will continue to make a positive difference.”

Zak Matieschyn, President Elect ARNBC 

“My first experience with the work of Canadian Nurses Association (CNA) was illuminating. For so much of my nursing career it existed as something vague, abstract and far-removed from my own nursing practice – both geographically and functionally. This all changed in the last week of November 2014 when I had my first introduction as an observer with our B.C. jurisdiction.

It was an opportune time to dip my toe into CNA activities – not only was there the annual day on Parliament Hill, but as well there was significant strategic planning undertaken to chart the course of the association over the next five years. I cannot overstate the level of sophistication present within this organization. Even the physical space of the ‘CNA House’ building emanates a solidness of history and wisdom – no doubt as a result of being filled with many of the great Canadian nursing leaders over the decades. That tradition continues to this day as I found myself struck by the depth of knowledge and experience I witnessed when observing the board explore issues, consider opposing points of view, and develop innovative solutions to very challenging problems.

Equally exciting was our day on Parliament Hill. Our large group was divided into 10 groups of four people and we were assigned to three unique MPs to speak with. The brilliant strategists at the CNA had developed three well thought out and specific ‘asks’ in the realm of home care and seniors’ health for us to pitch. We engaged with members from government as well as opposition parties. I can say my personal experience was one of excitement to offer evidence-informed policy solutions (an area in which nursing is well versed) to some of the complex health care problems of our times.


Joy Peacock, ARNBC Executive Director; The Honourable Rona Ambrose, Minister of Health; Julie Fraser, ARNBC President; Jessy Dame, BSN Student

All in all, I felt my passion for nursing further renewed. I look forward to my future involvement with the CNA in the coming years as British Columbia’s jurisdictional representative. Nursing is, and will continue to be, a leader in health care in Canada.”

13 million Canadians will be providing some type of care to family members or friends with age related needs (CNA, 2014). Therefore, the advocacy work around home care continues for the nurses of B.C. at both the provincial and municipal levels. Although Health Care falls within the federal jurisdiction, we understand that the key implementation decisions occur at the provincial level. Nurses have the solutions to transform health care and will continue to do this to improve the health of the individuals we serve, our families and communities. We welcome stories of your own advocacy and lobby efforts as responses to this blog.

Canadian Nurses Association (2014). Health Begins at Home.

How nurses can contribute to transforming cancer care systems, by Tracy Truant, RN and Sally Thorne, RN

Recent commentaries by oncology health professionals, patients, journalists and the Minister of Health about the state of cancer care in British Columbia (BC) have revealed significant challenges to delivering timely, high quality cancer care in that province. It is likely that these challenges are actually felt across the country, and are not unique to B.C. Oncology health professionals, including nurses are working to their maximum with the vision to deliver care that is person centred, compassionate, effective and timely, yet many would agree that the system in which they try to operationalize this care is in fact one of the barriers they must overcome.

While exceptional leadership and collaborative relationships across both the BC Cancer Agency and the Provincial Health Services Authority are essential to delivering timely high quality cancer care, other significant shifts must also occur. Much of the dialogue in the media has focused on timely access to care and containing costs, which are important, but other elements of high quality care must also be considered when looking for solutions. In fact, some have suggested this focus on timely access to cost contained care is a distraction from the real goal, that being maximizing value for patients. Instead, Porter and Lee (Leading Health Care Innovation, Harvard Business Review) suggest that organizing care around patient needs is more likely to achieve system transformation.

Nursing has long advocated for a transformed system of care that aligns resources with patient and family needs. Perhaps this time of reflection on how well the cancer care system in BC is performing is an opportunity for nurses to add their voice to solution-focused approaches to addressing the challenges.

As more cancer treatments are delivered in ambulatory settings where patients manage much of their cancer treatment effects at home, there may be opportunities to explore positioning of oncology health professionals, including specialized oncology nurses, outside of specialized cancer centres, into primary care and home care settings. Innovative models of care, such as the Infermiere Pivot enOncologie (known as “IPO” or “Pivot Nurses”) in Quebec have demonstrated improved quality of life and patient outcomes when Pivot Nurses care for patients from the point of diagnosis throughout their cancer treatment and care, and into the survivorship period. In this way, instead of tying oncology nursing resources to treatment systems, nurses are positioned where patients and families may benefit from their expertise most, as their needs change across the cancer trajectory.

In addition, nurses caring for cancer patients within the specialized treatment setting may be optimally positioned to practice to their full scope in a way that best meet patients’ needs in the context of the interprofessional team. Rather than working in silos, which further fragments care and can create workflow issues, a renewed focus on interprofessional care needs to be initiated.

As more patients survive cancer and experience long term effects as a result of cancer treatment, positioning specialized oncology nurses and/or Nurse Practitioners in primary care settings to care for the holistic needs of survivors after primary treatment ends may be beneficial to reduce the volumes of survivors still being seen in cancer treatment settings. With survivors’ renewed focus on health promotion, cancer prevention and the need for long term symptom management, oncology nurses’ skills and knowledge align well with survivors’ needs at this point in the cancer trajectory.

Sometimes missing from the design of cancer care systems is the voice of patients and families, including those who experience marginalizing conditions within society. While many organizations have begun to include patient engagement strategies, truly effective cancer care systems will not add patient/family voices in as an afterthought to an efficiency driven and access-focused system – rather, systems of care must be built around the beliefs, values, goals and needs of patients and families to achieve high quality care.

So instead of using our voice to add to the dialogue about enhancing access and infusing more resources, let’s pause and reflect on what we are championing better access to – It’s time for nurses to advocate for high quality care and to be very clear on how we may position our unique knowledge and skills to align with patient and family in a way that infuses value for them.


Links to Media

October 17, Gary Mason, Globe & Mail –

October 20, Don Carlow, Vancouver Sun –

October 21, Carl Roy, Vancouver Sun.

Nov 5, Gary Mason, Globe & Mail –



Tracy Truant is currently a doctoral candidate at the UBC School of Nursing and the President-Elect of the Canadian Association of Nurses in Oncology. She is a former professional practice leader at the BCCA Vancouver Centre and is currently conducting research on systems of care for cancer survivorship.




Sally Thorne is a professor at the UBC School of Nursing with a longstanding program of research in communication in cancer care. Former Board Chair of the BC Cancer Agency and Board member of the Canadian Partnership Against Cancer, she has been actively involved in cancer policy and strategy over many years.


Do You Know if YOU are the Bully?

ARNBC does not generally print blogposts from anonymous sources. Ideally nurses could state their opinion on virtually any topic, without repercussions. However, the following blog was submitted by a nurse who feels so threatened in her workplace that she does not feel it would be safe to identify herself publicly. Bullying is a topic that we know impacts many nurses and we feel strongly that it is important to publish this piece in its entirety.

Nurses are frequently named by the public as one of the most trusted professions, second only to firefighters. Our inherent compassion, professionalism, and dedication to our patients is the root of this. While we seem to have mastered our interactions with our patients, why is nurse on nurse bullying so common? Why can’t we show compassion and respect for each other in addition to our patients? Why does the body of literature on horizontal bullying have to be so vast as part of the accepted language of nursing? Why do instances of nurse on nurse bullying continue to grow? And maybe most importantly, why do we allow bullying to continue in our workplaces?

Seattle nurse and consultant Kathleen Bartholomew has explored the challenge of nurse bullying and notes that “because nursing has its fundamental roots in caring, it’s often hard for nurses to admit that they could be hurting one another. But studies show that 60 percent of new nurses leave their first position within six months because of some form of verbal abuse or harsh treatment from a colleague.”1

You know what I’m talking about. The snide comment about you behind your back that you hear when you’re walking by the nurses’ station. The whispered tones, the smiles to your face and the lies that live underneath fake smiles. We’ve all seen senior nurses do this to younger nurses. They chalk it up to learning the ropes, or growing pains that are necessary to experience. They have to ‘toughen up’. Or, ‘my nurse manager did this to me when I was a new grad’. I’ve also seen younger nurses act like their seasoned colleagues are out of touch dinosaurs for not adopting new looks, methods or body art. Many of our younger colleagues simply don’t respect that experience is a great teacher.

bullyingWhat if it’s your manager or supervisor who is doing this to you? Every time that person calls into question your practice, he or she destroys a little piece of your confidence and makes you question your ability. Constructive criticism provided in a supportive and open environment articulated with respect for the individual is absolutely necessary. The problem comes when there is a lack of regard for opposing opinions and perspectives, and the blatant lack of respect that rears its ugly head when an idea is dismissed, when a person is belittled, or when someone acts like you don’t get to count. Literally and figuratively they may turn their back on you.

I know. Sticks and stones may break my bones but names will never hurt me. Sorry, Mom but that’s just wrong. Names do hurt and they do inflict damage. Damage can be inflicted quickly and painfully by bullying managers and colleagues. As professionals we cover up the damage done as not to let it show in our professional lives, but in private the toll is very real. Anyone who has ever felt sick about having to go to work, afraid of what the day might bring about, knows how this feels. A job you love can quickly become a frightening and difficult place to be.

Stand up to the person. The bully is afraid. The bully is threatened by you. Don’t let anyone push you around. That all sounds great, but what if I lose my job because I was the lone person who made the choice to stand up to the bully? What will I do when a power-wielding bully takes me away from a job that I can’t afford to lose?

The literature tell us that that the roots of horizontal violence often come from workload stress, shiftwork and the emotional toll nursing care takes on people. I get it. We have stressful jobs, we work in high pressure situations and we literally have lives in our hands. Violence begets violence – if you learn it, you do it. And if someone does it to you, you will likely do it to someone else. But is that really our best excuse? If these issues are the roots of violence, then it seems to me that the better response would be to show some empathy to our fellow nurses. The better response would be to recognize that for the most part, we all do the best we can. Don’t we all want healthy and supportive work environments where our patients get the best care possible?

This seemingly too usual response of bullying and putting each other down isn’t working. Perhaps it’s time we all take a long look at our own behaviour and ask ourselves the hard questions. Are you the bully? Did you leave your work today having been a positive force for your colleagues? Or, did you let your bad day, bad mood, or just the fact that you don’t like someone allow you to be a negative force for someone today? Is it such a stressful time for you that it really justifies bad behaviour against a fellow nurse? Should your bad mood and insecurities get to dictate the well-being of those around you?

I write this blog to ARNBC’s members anonymously because I feel so fundamentally unsafe in my working environment that I don’t want any of you to know who I am. Some of you will shake your heads and say what a shame, not realizing that perhaps YOU are the bully in my workplace. Others will understand the feeling, and share my despair – because you also can’t afford to be the one to stand up and say you won’t take it anymore.

In her article Addressing Nurse-to-Nurse Bullying to Promote Nurse Retention, Carol F. Rocker identifies a number of strategies that can prevent workplace bullying:

1)      Education – teaching nurses how to decrease bullying by helping them understand what to do and not do when confronted by a bully.

2)      Policy – involving nurses in policy development to give them ownership and responsibility for their own workplace environment.

3)      Celebration – celebrating positive, bully-free work environments

This is a start, but do we not have some responsibility for our own actions? We’re the second most trusted profession – but only if you ask non-nurses. Within our ranks, we know there’s good reason for the expression “nurses eat their own”.

It’s time to figure out how to end bullying, for the good of our colleagues, our patients and ourselves!





Canadian Centre for Occupational Health and Safety:

CBC News:


Other Resources:

BC Research – Houshmand, M; O’Reilly, J; Robinson, S, Wolff, A, “Escaping bullying: The simultaneous impact of individual and unit-level bullying on turnover intentions”. Human RelationsJuly 2012 vol. 65 no. 7 901-918. (ABSTRACT –  

Stokowski L., “A Matter of Respect and Dignity: Bullying in the Nursing Profession”. Medscape Nurses, September 2010.

Johnson S., Rea R., “Workplace Bullying: Concerns for Nurse Leaders”. Journal of Nursing Administration, 2009; 39(2):84-90. (ABSTRACT –

Griffen M., “Teaching Cognitive Rehearsal as a Shield for Lateral Violence: An Intervention for Newly Licensed Nurses.” Journal of Continuing Education in Nursing, 2004;35 (6):257-63.



  1. Ending Nurse-to-Nurse Hostility: Why Nurses Eat Their Young, HCPro, 2006

Advocacy is the Core of Nursing, by Suki Grewal, RN

Each year the College of Registered Nurses of BC (CRNBC) presents Awards of Excellence to highlight the achievements of noteworthy Registered Nurses in British Columbia. One of these awards is for excellence in advocacy. According to CRNBC, the advocacy award is given to “registered nurses who have made outstanding efforts in advocating for health benefits to a specific group” (CRNBC, 2013). I was humbled and honoured to receive this award in 2013, although I believe what I have done in my nursing career should be done every day, by every nurse, to support the well-being of those under their care.

What is advocacy? According to the Merriam-Webster Collegiate Dictionary (2009a) it is the act or process of supporting a cause or proposal. Advocating on behalf of our patients or colleagues is an important role for all nurses, as our health care system becomes more and more complex and challenging. With the increase in immigrants to Canada, nurses are faced with unique challenges to learn the beliefs and practices of the diverse communities they provide care to. Having our regulatory body acknowledge nurses with this award is a great way to honour these nurses while encouraging others to also engage in this core competency of advocacy.

Receiving this special award made me sit back and reflect. My family emigrated from India to England in the early 1960s. Soon after my mother was hospitalized, and I became her voice because she was unable to speak English. I began to accompany my mother and other ladies in the neighborhood who needed assistance with medical visits. This influenced me to choose nursing as a career even though it was not considered a favourable career for girls in my community and my mother was not very pleased with my decision!

Once I started nursing, I become more and more aware of the difficulties the immigrant population experiences, not only with language barriers but also in trying to make health care professionals understand their beliefs and practices about health care and health seeking. Immigrants, many of whom come from rural areas, have an extremely difficult time accessing and navigating the health care system and struggle with language issues, lack of familiarity with the health care system, accessibility to transportation and nutritious food, child care and personal barriers around having a male as their primary care provider. When I look at my South Asian community, I see women facing all of these factors, as well as their fear of discussing private issues with their health care professional.

When I first started to advocate in the UK, I began with little steps, such as asking the local hospital where I trained if I could translate the menu into Punjabi for patients who did not read English. When I moved to Vancouver and started to work as a community health nurse I began seeing women suffering unnecessarily because they were not aware of or utilizing preventive health care services. This caused great stress in my life and working with a colleague we spearheaded a project to have a South Asian Pap Test clinic where women could come and meet health care professional who were able to speak their language and understand their particular ways of seeking health.

Collaborating with local physicians, community, women and health care agencies was vital to the success of our idea. In addition, we needed evidence to support us, and were pleased that nurse researchers from the University of British Columbia (UBC) School of Nursing became an integral part of this initiative. Ultimately, we the nurses were meeting many of the standards of nursing practice as well as the code of ethics of CRNBC and CNA. There were times when my family had to look after themselves, which is looked at negatively in my community, as South Asian women are meant to put their families before themselves. But I felt strongly that this work needed to continue, and wanted to be a role model for my children and others.

As the health care system continues to change and become more challenging for us as nurses, it is essential that each one of us engage in an advocacy process for safety of our patients, ourselves and our colleagues. Let us work daily on building on our already positive public image of being the most trusted health care professional.

Click here for more information on the CRNBC Award of Advocacy



Suki Grewal is a nurse educator at Langara School of Nursing. Originally from the UK, where she received her SRN (State Registered Nurse), and SCM (State Certified Midwife), Suki worked as a labour & delivery nurse for many years before turning her focus to community health. Eventually, she became interested in research and decided to return to school to obtain her BScN and MSN from UBC. She is an advocate for the South Asian community, and is passionate about improving the health and well-being of immigrant South Asian women.

Advocacy and Unity in Action, by Pam Burton, RN

May 12, 2014 was a memorable day for nursing in British Columbia. For the first time in history, a group of 20 nurses travelled to the Legislature to launch nursing week. This was a celebratory event, bringing the family of nursing together to share our stories, and demonstrating our desire to work together with government and each other in a collaborative manner.

Our group represented the whole nursing family – four licensed practical nurses (LPNs), five nurse practitioners (NPs), seven registered nurses (RNs) and four registered psychiatric nurses (RPNs).

The day began with all 20 nurses meeting at the Empress and sharing our hopes for the day. We quickly realized we had many similarities, in addition to a desire to continue to build positive relationships with one another and with government representatives over the course of the day.

Next, two roundtables discussions occurred simultaneously. A group of eight met with B.C. Minister of Health Terry Lake, Associate Deputy Ministers Lynn Stevenson and Elaine McKnight, and Acting Assistant Deputy Minister Ted Patterson. The remaining fourteen interacted with senior Ministry staff including Kevin Brown, Acting Executive Director of Health Workforce Planning, Debbie McLachlan, a Registered Nurse and Director in Health Workforce Planning and Evan Howatson, Director of Labour Relations and Negotiations. Both roundtables provided opportunities for all of the participants to raise issues that are important to nurses, the nursing community and clients. Discussion was engaging and lively, and we appreciated the opportunity to hear each other’s perspectives, and that of the government, on a wide range of important topics.

Two general themes emerged. Firstly, there is a need for greater client-centred, multidisciplinary and interprofessional approaches to healthcare. Secondly, the government and nurses are both in agreement that collaboration and ongoing dialogue between the nursing family and government is welcomed and needed.

Following a meet-and-greet and photo opportunity with Minister Lake in the Legislature Rotunda, all 20 nurses spent an engaging and interactive hour with Opposition Health Critic, Judy Darcy. We discussed important issues such as Aboriginal nursing challenges, the impact of the closure of primary health care clinics on clients, struggles nurse practitioners are facing as they integrate into the healthcare system, cuts in mental health which impact registered psychiatric nurses, and the pressure staff mix models are having on both licensed practical nurses and registered nurses.

Following our meeting with Ms. Darcy, we were honoured to be invited to meet with Independent MLA Andrew Weaver. We had rich dialogue about the role of nursing in healthcare, staff mix, and the need for consultation with B.C. nurses.

Our final event of the day was to attend the afternoon session where we sat in the public gallery to hear greetings from Minister Terry Lake and Judy Darcy. This was followed by two private member statements celebrating nurses, nursing and the launch of nursing week. I felt great pride in our profession during the member statements, and felt so privileged to be present and hear the acknowledgement given to our profession.

This day was packed from start to finish. Not only did we advocate to the highest levels of government on behalf of the four nursing groups in British Columbia, we appreciated the unique opportunity to spend time with our nursing colleagues. The unity and relationships that were created were an important and meaningful part of the day and we have vowed to continue the dialogue as we work together to achieve a common goal – demonstrating that we can come together, be collaborative and speak with one voice about many important issues.

We would like to thank Minister Lake, Judy Darcy and Andrew Weaver for sharing their valuable time with us and committing to ongoing discussion and dialogue between the nursing profession and government. Thanks also to the Ministry staff – Lynn, Elaine, Ted, Kevin, Debbie and Evan, who shared their thoughts and plans, listened to our ideas, and demonstrated a willingness to work more closely together in the future. Our thanks as well to the terrific staff who work with the Minister, Judy Darcy and Andrew Weaver for your willingness to help us plan our day. We look forward to working with all of you in the future as we continue to share the expertise, knowledge and recommendations of all of nursing with government and decision-makers.

Click here to view comments made in the Legislature

Click here to view the Summary Notes

Click here to view the picture gallery

Click here to view the proclamation


PAM Passionate and committed to the profession of nursing, Pam has a keen interest in how the professional voice of nursing shapes the nursing profession, health policy and health care. Pam was involved in the former Comox Valley RNABC Chapter, attending several AGMs as a voting delegate. Pam has over a decade of experience as a RNABC Workplace Representative/CRNBC Professional Support Program Rep and has 28 years of RN practice including bedside nursing in acute and residential care. She currently works as a Nurse Educator and sits on the ARNBC Board as a Director at Large.