Abstract

Cheryl Neely-Price, an Emergency Room Nurse at Royal Victoria Hospital in Barrie, Ontario, has travelled extensively - including trekking in Nepal and trips to Egypt, Guam, Northern Africa, Greece, Turkey and many islands in the West Indies. While on vacation, she often visits the local medical clinics and through this experience became intrigued with the idea of nursing in culturally diverse locations.

What drew you to the North?
Nursing in the North is a first-hand opportunity to experience cultural diversity. The moment I reviewed the the job posting for an RN in a First Nations Community, I knew it was something I had to do. I had read about opportunities to nurse in the north but the contracts were generally for long periods which would have been difficult for me. Along with the short-term nature of assignments, I was drawn to the opportunity because I was looking for a chance to utilize my nursing skills to their maximum and I looked forward to working in new and interesting communities. So, I responded to an ad from a Montreal-based Medical Personnel Agency and was hired a month later.

How often do you go up North?
I generally go North every three months in seven to ten day stretches. I would like to go more often, but am committed to my full-time job in the ER here in Barrie. But, I've found that the two jobs complement each other nicely.

How did you get ready for that first assignment? Did you know what to expect when you arrived at the posting?
I am extremely fortunate to have had the support and guidance of a physician who worked with me in Barrie. He had spent time in a Northern Ontario community and basically told me what I could expect - generally fewer resources than I was used to. But, I was pleased to find that the nursing station is very modern and well equipped.

He also took the time to teach me some of the medical skills that he thought I might require - specifically suturing. His support was instrumental to my decision. Nurses in the North work without a physician on site, and are often presented with some challenging scenarios. Confidence and the ability to work autonomously are essential. Working in the North encourages you to take a personal inventory of your nursing skills.

How have you been received?
My first work assignment was King Fisher Lake, a small "fly-in" community with approximately 400 residents. It is located an hour by air north of Sioux Lookout. The residents belong to two culturally and linguistically related groups: Cree and Ojibwa. Oji-Cree is the term used for the mixture of language spoken in this community. It is an interesting dialect, which I am slowly mastering. For example "good-bye" is not a native word. The common expression is "mee-way" which translates roughly as "That's all I have to say for now."

It can be challenging to attempt to assimilate into a community when you are only there for a short time. The communities I have visited have been extremely gracious and welcoming. Like most small communities, news travels quickly. When I first arrived I mentioned to one of the nursing station workers that I had never tasted moose meat. The next morning, I had several phone calls and visits from people wanting to share their hunting victories. That generosity has continued through each visit.

What is your biggest concern?
The environment is beautiful, yet isolated. During my first plane ride into the community, I recall flying over absolutely nothing but lake and bush. While I enjoy the solitude, I also realize the limitations. Serious emergencies are flown or "Medi-Vac'd" out to larger health centers - the closest being Sioux Lookout Zone hospital, an hour's flight away. Inclement weather conditions can present a challenge for nurses if planes are unable to fly into the community. This is my biggest worry and fortunately, to date, I haven't had to contend with any emergencies that could not be flown out to a sophisticated medical center in a timely matter. But these things do happen, and I've heard some real "horror stories" from seasoned northern nurses.

On your most recent assignment, you took your daughters with you. How did they respond to the experience?
It was a privilege to have the opportunity to bring my daughters with me. It was a very valuable experience for them. My children enjoyed the interaction with other children and were often asked questions about the community in which they reside. They also enjoyed the canoe, lake, community feasts and local music. And, they liked spending time with me at the nursing station.

They have studied Canadian history, so this was an opportunity to spend time with other Canadians and First Nations People whom they had read about. They have also travelled quite a bit ... but were a little apprehensive about the small aircraft.

What have you brought back with you?
As a past member of the board of health for the Simcoe County District Health Unit, my experiences in the North have given me newfound insight into the meaning of "public health." For instance, there had been a resurgence of tuberculosis in the North. The government and local health authorities have developed and established protocols for controlling and eliminating TB in the regions.

Effective health teaching by nurses is essential. Teaching can be accomplished in several ways. I made a radio appearance with an Oji-Cree translator at the local radio station. I arrived at this tiny hut, which was the local station, and began speaking on air, educating and promoting to the community the benefits of the flu vaccine. It was the goal of the health authority to have the community 100% immunized. The nurses were very successful in accomplishing this.

While swimming with the local children, I used the time to review basic water safety skills. Nurses were also able to promote healthy dietary choices at community cookouts. The key to success - and I'm sure others who have worked in the North will agree - is to respect cultural food preferences while introducing subtle changes. This can be challenging,but can be accomplished. I was also very impressed by the sense of community we experienced during our visits. You have the sense of one large very extended family.

What would you share with other healthcare professionals?
Learn how to extract a fishing hook, bring lots of bug spray, have a reasonable idea of your own inventory of skills and bring your own supply of Starbucks coffee. You'll need it. The sun doesn't set until midnight and the dazzling northern lights can be quite captivating keeping you up until the early a.m. Need I say more?