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.
ABOUT SUKI GREWAL, RN
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.