Announcer: [00:00:00] This is Nurses Voices.
Mary Wheeler: [00:00:05] On Today’s episode of Nurses Voices we’ll be speaking with two late career public health nurses. One, a director and one, a manager at Prairie Mountain Health in Brandon Manitoba.
Announcer: [00:00:16] Nurses Voices is supported by the Canadian Nurses Foundation and by the Canadian Nurses Association.
Mary Wheeler: [00:00:26] Welcome to Nurses Voices. I’m Mary Wheeler
Gail Donner: [00:00:29] And I’d Gail Donner.
Mary Wheeler: [00:00:31] In our episode today, we’re going to meet Jane and Janice, public health nurses who are working in the frontline of vaccination distribution in Brandon, Manitoba. Manitoba was hit hard by COVID. As of this week, 73% of the population have had their first dose and 38% of 12 year olds and older are now fully vaccinated, due in large part to the hard work of public health nurses.
So I’d like to introduce Janice Loe. Janice is a registered nurse with a passion for population and public health who is currently working as a public health director in Prairie Mountain Health. Manitoba’s most westerly health region .
And Jane Skinner. Jane is also a registered nurse. She has 42 years of experience in public health. She’s just come out of retirement to take on the role of regional manager. Prairie mountain health COVID vaccine sites in Brandon, Manitoba. So welcome to both of you.
So I’m wondering Jane, if we could start with you, why after retirement, but you came into a new role. You were a public health nurse in the frontline before retirement, and now you’ve come back into a management role. So I think our listeners would really like to know. What that shift has been like for you from staff nurse to manager in the middle of a pandemic?
Jane Skinner: [00:02:02] Well, I, as Jan will attest to, um, over the many years, I said I was never going to be a manager.
Um, I was a public health nurse. I wanted to be with the people. Um, that was really important to me. And I loved doing what I did until the day that I walked out the door. When Jan contacted myself about being a manager for the COVID vaccine sites, I sat and thought about it, and for 42 years, I’ve been doing vaccine.
I’ve been doing immunization clinics. I knew that I had that skill set. The advantage is for me right now, as well, is that coming out of retirement I had nothing else on my plate, so I could give a hundred percent and do it, and I’m not being torn in other ways. I can’t get to my family right now. And so that was also a main thing that drove me because I want to get people vaccinated so that, um, we are, I can get to see my families.
And I’m very happy to say that as of today, Manitoba is number one in Canada for our vaccines immunization rate. So I’m, very, very happy. I’m very, very proud and Prairie Mountain Health is, is right up with the provincial standard. So we’re very, we’re doing very well.
Mary Wheeler: [00:03:18] I’m listening and there’s so much joy, just even when you’re talking, not only the success, the success of the vaccination, but just wanting to come back to public health.
Can you talk a little bit more about what public health means to you? To be a public health nurse?
Jane Skinner: [00:03:38] I tell everybody I, I started and it’s never been the same job. If you asked me, did I do the same thing on May 28th, 1979 is the same thing I did May 29th, 2020, not nowhere near the same thing. The roles have changed.
And that’s the exciting thing about public health is we, we change, we adapt. We go with what’s happening. We’re always there. I mean, people maybe don’t know that we’re there. I loved getting to know my community. Um, that was a great, great part of it. And I think you have to want to get to know your communities and get to know everybody that’s in that community. It’s knowing the people that, that are so special.
And, um, I got to actually do an immunization clinic this week, um, for, um, our sexuality education resource. They wanted a safe and comfortable place where the clients that usually go there. And I had started up our trans health clinic in public health here in Brandon. And hadn’t really got the chance to say goodbye to any of our clients because of COVID.
Well, I was immunizing and there was a whole pile of them that came in and I got to say goodbye. It was such a wonderful, like it was, it’s just nice to see those people and find out about them and public health nurses. I mean, we’re not very threatening. We really have not got a whole lot that, that really, whatever I just ask you, please don’t smoke.
I’d really rather you not smoke. And if you’re going to smoke then makes, let’s see how we can work around that. And, um, you know, I’d like you to, you know, to be safe and how can we keep you safe and, and, and do that. But, but really, and truly, um, I can honestly say I’ve never had the door slammed in my face because when public health comes, um, we’re just there to be able to offer some support and some help.
And, and people love that. We have tons of knowledge, tons of knowledge about everything. Maybe not an expert in some of the areas, but we do have the knowledge about all of it, and, um, for that, I think public health is, is amazing.
Mary Wheeler: [00:05:41] So then Janice, you make it happen for Jane to really love what she’s doing in a director’s role.
So what have been some of your challenges as the director?
Janice Loe: [00:05:53] There have been lots of challenges. I will be honest. We try to focus on what’s going well because there’s so many things going well, but I mean our main role is to not make things happen for Jane or other nurses, but just to support them to do, do their jobs, do the good work that they’re doing.
So we might, uh, we want to make sure we have the financial resources, the logistical resources, the tools they need, and the human resource has been the biggest issue through the COVID pandemic because in public health, We don’t have surge capacity. We are creative, we’re innovative. We figure things out.
But when we have a crisis of any kind of, an outbreak, a pandemic evacuees, we really just prioritize and set something aside and some work just doesn’t get done. And we focus on the most immediate task. So it’s really just supporting nurses to do, to do their job.
Jane Skinner: [00:06:49] That’s one thing that Prairie mountain health is very lucky for.
I wouldn’t be able to do this job if we didn’t have support of management and management is extremely supportive. If you’re looking at good public health, it’s come from the top.
Janice Loe: [00:07:03] I agree, Jane we’ve had phenomenal support across the region from nurses non-nurses and in our province as well. We’ve got, you know, we’ve got great public health leadership in the province of Manitoba, and that’s really helped us to work through this challenging time. Public health nurses are really at the forefront. We work with multiple partners and stakeholders and other public health providers. And they’re the leaders at the forefront of a pandemic.
Trying to keep people safe and prevent the spread of infection. For sure.
Gail Donner: [00:07:32] I have about 10 questions I could ask, but, uh, I’m going to go back to something you hinted at. And I know from a previous conversation, you you’ve talked more about it. Um, uh, Jane, but it has to do with the fact that people don’t often know.
That there are any public health nurses. And I think in one conversation you used the phrase flying under the radar. So can you talk a little bit about public health nursing “under the radar” what that, what that looks like?
Jane Skinner: [00:08:01] Well, I guess because public health is looking out for your community and looking out for the individuals in that community, we aren’t needing that, uh, CT scan.
We aren’t needing that special equipment in ICU, we don’t have special equipment that we need that somebody can donate money to. Saying, well, look at our newborn birth rates are great because of… there’s no way to say is because we happen to have a great families first program. We have great prenatal education and, and we’ve, you know, we’ve done all of this other stuff. That, that all factors in, but it’s really hard to prove that that actually has, has benefited.
And, and made a change in any of the stats. So we just kind of go along and we do our stuff. We kind of like sometimes to be under the radar because we get a lot done. And, um, and so, um, you know, that, that we can do that and, and. Uh, so I think that in some ways, public health nurses, we’d like to stay under the radar.
Gail Donner: [00:09:02] I understand what you’re saying. Cause if you liken it to some of the or compare it to some of the high-profile razzle dazzle parts, those folks are always in the eye. So everybody’s watching every little thing and I would imagine there’s less, uh, let’s say, control over what you do on a day-to-day basis.
Jane Skinner: [00:09:24] Right. Which is the exciting thing about public health. It’s never the same two days in a row. Um, and so, and if you get a really great idea and think, you know, I’d like to try this with my, with my community, with my area, then a way you go and you can do that.
Gail Donner: [00:09:37] Can you think of something in 42 years, a long time, can you think of something like that, that you could share?
Jane Skinner: [00:09:45] I don’t know. I think, I think there’s been many when I first started nursing, I was up north and when I got there, we used to have to send anybody, uh, that was, needed to get out of the community. We sent them by taxi and I’m going, this doesn’t seem right. So went to the municipality and we recruited and worked with them and provided them information and there’s an ambulance in that community now.
Janice Loe: [00:10:05] I think what’s really key about public health nurses. And as you mentioned, Jane, as we, our role is to know our communities know who the movers and the shakers are, who are the partners and the stakeholders that we might want to work with. If we assess a need in a community or a group or a population brings a need forward. We aren’t necessarily the doers, but we support the community to do what they need to do to be healthy. And another example I think of Jane is we were concerned about some teen pregnancy rates and high school graduation rates or for parents in that situation. And we didn’t have a daycare available in our high schools, so to improve our high school graduation rates for young parents.
Jane was instrumental in working with a group of partners in the community to get that daycare up and running in our largest high school in the community. And it’s available, not just for students at that high school. So young moms could return to school and graduate. And Jane was on that board as our Prairie Mountain Health representative and was chair of that board for, for many, many years.
So that’s another example I think of, when I think of a lot of that great community development work that Jane herself has done and many public health nurses across the region.
Gail Donner: [00:11:17] If you had to give an elevator pitch on why you should become a public health nurse when you graduate, what would you tell, uh, aspiring nurses?
Janice Loe: [00:11:28] I would tell an aspiring nurse that this is the best job you could ever have. It’s, it varies day is different. You can, I mean, in nursing in general, you could be a registered nurse and do multitude of things. Very similar. You can be a public health nurse and be specialized or generalist. You work with your communities, you work with individuals and it’s a privilege and an honor to be in people’s homes and part of their lives and case management is a large part of what we do. We get to know our families and communities from preconception through to death oftentimes, and that’s a really unique relationship that we, that we built and it could be intergenerational. So, and Jane will attest to that. You know, you have family and then they’re having children and then they’re having grandchildren.
They’re a large part of that family’s life. And that’s different from episodic care, and it’s very rewarding. Um, uh, you can make a difference at a population level and at a community level and at an individual and family level. So it’s very rewarding. It’s not for everybody. It’s not glitz and glamour, like Jane said, we don’t have a lot of high tech equipment.
We might have a baby scale and a vaccine fridge. Um, but it’s very rewarding and the relationships and the partnerships are, are really key. So if you kind of like to work alone and you don’t really like that partnership piece, probably not the career for you, but it’s, it’s so rewarding and there’s so many career opportunities.
I think if we work with students and give them great broad experiences for their rotations through public health or their senior practicums, any students we have for senior practicums we are, they often come back to public health sometimes not right away, but often in the future, because I think people can see how rewarding it can be to work at a population health level.
And what a difference it makes.
Mary Wheeler: [00:13:15] You’ve talked about those experiences. And I, one time I was a public health nurse, so I can relate to it also where you’re meeting with someone for one purpose, but it is in the conversation and the story with that individual or the family that you’re able to touch other lives, other people within that home.
Um, is there anything that stands out for you?
Jane Skinner: [00:13:37] Um, I, I think so often we go into people’s homes because they’ve had a baby, then you’re looking at the housing and okay. Now what are we doing about the housing? And so then we get ahold of the housing people, and you’re going to do that. And you’re going to be working with the housing people to, to upgrade their, their housing, to work with that.
Janice Loe: [00:13:55] You know, we built that trust sometimes over time, like Jane said. Um, sometimes even you would see that at teen clinic, I know Jane teens would present with one issue because it sort of seems like a safe issue too, to come and ask for assistance with. But as you build that relationship, more of that story comes out.
People start to trust you with their very personal and intimate details of their life. And, you know, we might get people connected to housing or primary care or help with a job search or. Helping fill out some paperwork so that they can actually file some income tax or might be with domestic violence or a history of child abuse that they’ve never ever shared with anybody.
So it’s that trust and relationship that’s so, so critical in public health nursing, and then knowledge of all of the community resources to help people.
Jane Skinner: [00:14:47] People tell you things that. I’m going –“I probably don’t need to know all that”, but they will tell me their stories. I didn’t going into an old shack and Northern Manitoba where the beaver balls hanging and a woman handing me a cup of tea and I’m looking at it and thinking, well, we’ll just attempt this a little bit.
Her granddaughter actually is down and attending Brandon University right now. And she said, “you know, we remember”, that really melts my heart. That’s why I went into public. That’s those are the things that you want to see.
Gail Donner: [00:15:18] I hear some things in what both of you are saying that should apply across the board.
Regardless of where you’re practicing or what your specialty is. And one of them is this connection to community. I mean, we do a big job. You know, my career has been in mostly in academia. We do a big job of talking, talking social determinants, whatever, but I’m not sure other than in public health, there’s much attention paid to who is this person in front of me. And where do they come from and what is as Mary says, their story or their issues. And it may look like one thing, but it may not be that at all, it may have to do with housing or poverty or food insecurity or, or whatever. So that part strikes me, the other part were your comments about the leadership.
And I think that also is something it’s not just in public health. We’ve heard that in other Nurses Voices, people talking about what you really need is support from leadership. Maybe you could say a word or two about this notion of connection to community. How would you talk to nurses about that? Even if they don’t want to be public health nurses?
Jane Skinner: [00:16:37] Um, I look at emerg. Like we want the emerg nurses to know, uh, you know, where are the social workers? Where are the people that help somebody that’s come in, uh, you know, with the third attempt of suicide? Where, where are we doing with. Like who are, who are the resources? What, I mean, emerg nurses, they’re not going to be able to, they’re too busy, they’re doing whatever, but the ones who do have some ideas about, about what the what’s out there in their community.
And, and I do agree with you. I think part of being a nurse is that I do know my community and if I’m going to work in the community and be a nurse, then I, I think I need to know all about it. I don’t think we should ever as nurses ever look at an individual and just sorta take that shell and say, oh, that’s that type of person.
Um, it always drives me crazy when I hear about, oh, that’s my tonsillectomy. And that’s my, I mean, I have no idea. I’ve never stepped foot in a hospital. I shouldn’t talk about hospitals. Um, it’s the people have a name and, and they they’re part of your community. So
Janice Loe: [00:17:35] I agree Jane. I think that one of the, the benefits of public health nursing and being in the community when we work in clients’ homes, If you really get to know that family, and it’s very different than interacting with someone in a controlled environment or within the four walls of a facility, it’s an uncontrolled environment, you’re on your own, an autonomous practice and you really get to know people in the environment that they live work by. For some people, the public health nurse is the first person that’s really met them, where they’re at, been the first person that they’ve actually interacted with, who really they felt was nonjudgmental. And that they could trust to share their story.
And I wouldn’t be labeled. And I think that public health nurses learn a lot through their academia, but I think to a large degree, it’s really the values and beliefs that people hold as individuals.
Mary Wheeler: [00:18:28] I want to build on what Gail asked, is there a way that you can look at what do we need for public health, but what do we need for nursing in general?
What needs to happen? Do you have any insights?
Jane Skinner: [00:18:39] We live in a world right now where everybody is… worrying about myself and me and my number one. And that’s not public health nursing. We need to be caring for the whole group of people from the pandemic has been a great example of that. We’ve used the line all the way through the pandemic that “getting your vaccine is helping somebody else out”.
Um, it’s helping your community out. It’s helping your family out. I would hope to think that maybe we’ve learned a little bit from pandemic, but I also have lost faith in some that, um, That we see just how entitled some people do feel. I think the pandemic may have shown people how much more important that we need to be doing some of this.
And thinking about, about all of this.
Janice Loe: [00:19:28] We’re really about the collective action for the greater good, I think in public health, it’s about the population and what’s the benefit and the greater good for the masses versus the individual many times
Gail Donner: [00:19:41] Because some good, as you say, some awareness has come out of this awful situation across the world, really and there always good lessons to be learned. And that’s maybe one of them.
Mary Wheeler: [00:19:54] There’s nurses across Canada and others listening. Is there something in closing that you would want to share?
Jane Skinner: [00:20:01] For me, I would like people just to know that it’s wonderful to be called a public health. There is no great in my mind, there is nothing greater than being called the public health nurse.
I actually hadn’t realized how many times I said “Hi,Jane Skinner, public health”, till the day I retired. And my children taped me answering the telephone. And I, it was a taped consistently. Hi, James Skinner, public health, Hi Jane Skinner, public health. It is exciting. Um, and I think in the future, we are going to see public health, having even more things. And you’re going to be hearing about us more. Everybody now knows who the chief public health officer is in the provinces. They have done amazing things. People are now looking at what are they saying? What are they meaning? I think public health nursing is a great way. Even in an urban setting to get to know your community.
It is so much fun when you’re rural, because you get to, you get to know everybody. My parents moved to Toronto 40 years ago just after I went into public health. And the first thing I said to him is make sure you find out where’s your public health unit.
Janice Loe: [00:21:10] I’ll jump off what Jane said, certainly the pandemic has highlighted the unique skillset of public health nurses, and COVID work is clinical nursing work that requires highly skilled public health nurses who understand the clinical piece, but also the art piece, sort of the art and science of nursing.
How we, how we empower people and we advocate and get individuals and communities on board is a real unique skillset that the pandemic has definitely highlighted and public health nurses are great detectives, whether they’re investigating a communicable disease, but also, sleuthing out, what are the resources in a community?
And you might get a call from somebody in another province, a friend, or a family member. We’re kind of the go-to people for anything. It’s kind of like, I don’t know where to go with this question. Well, I’ll go to my public health nurse and inevitably he, or she will find the answer for you because we just keep digging until we find those resources, whether it’s in our own community or somewhere else.
So we know people, we know the stakeholders, we know, we know who to call, where to get information.
Mary Wheeler: [00:22:18] Well, I want to thank the both of you. I have just found it, just a lovely conversation with the two of you. So, um, again, as I’ve said to other places, if I’ve, if I’m ever in Manitoba, maybe one time, Gail’s from Manitoba.
If she ever goes back to Manitoba, I need to come and an opportunity to meet you face to face. You’re two amazing women. So thank you.
….
Gail, I just felt so appreciative of those two women and the story they had to tell. I think it’s an example of later career nurses who have the experience and the accomplishments… when Janice said Jane’s accomplishment of running a committee to get the daycare into the school, so they would get their numbers up for graduation. Those are the stories that most nurses don’t tell or aren’t heard how they make a difference. So that to me is there was so much in their, history and we were just trying to tease it out. Um, so that was one thing for me, just there was so much going on. I heard again, this emphasis on community and knowing your community. But also as the pub… for the public health nurse, knowing your community, but as a unit, and also having to make connections with other organizations to make things successful.
So there’s really a lot of collaboration going on. So that to me was something else. I mean, there were so many things, but those two things stood out.
Gail Donner: [00:24:00] Well, a couple of things, one of them was incredible humility. Which I really appreciated. And these two women are really leaders. Uh, I don’t care what their job title is.
They are really leaders in public and community health I’ll say. And yet they were, when we ask for examples, they have to help each other. Find the examples. Clearly they have a ton of them. So that, that was one thing that impressed me. The other thing impressed me with this notion of. Community big, like the community. Even at the end, when Jane said, when my parents moved to Toronto, I said, find out where your public health unit is and make sure, you know, you have access to the public health nurse that’s about community at large.
I think we do talk to students and new nurses about “the patient” or “the client” and understanding the whole of who they are and a little bit about their families and whatever, but I’m not sure the bigger community is much around every individual nurse’s practice and maybe that’s what the Pandemic has been about, and I just appreciated that in, in, in both of them and the other thing of course, I appreciated was I could put myself in the feet or whatever in the room, being the client, whether with the new baby or with a problem with housing or whatever. And just, I could feel myself being willing to talk to them about things that I might never talk to anybody about. They were, they were very, uh, human. In the best of the word. Yeah.
Mary Wheeler: [00:25:53] But it builds on our last episode of nurses’ voices with Alysha and Teagan, where they were working with the homeless. And then, uh, Teagan, if you recall, she also worked in acute care. And this sense I got is that sometimes, maybe as nurses, we are working in silos, we are developing an expertise in a certain area. But how do you again, have eyes be on your practice? I don’t,
Gail Donner: [00:26:23] Well, I mean, it’s, how do you expand your practice. But I think the one thing we should keep in mind maybe is what I saw was the benefit of experience.
Mary Wheeler: [00:26:36] Yes.
Gail Donner: [00:26:36] So if I would want to do anything, it would be to make sure that younger, newer nurses students had the benefit of exposure to experienced practitioners.
Mary Wheeler: [00:26:55] Yes. Yes.
Gail Donner: [00:26:56] Uh, I, I just think there is something they can teach that it’s very difficult to teach without that, that expertise
Mary Wheeler: [00:27:07] I think that, I love that because if you think of what we talk about in career development and the career continuum at that entry level, we’ve always encouraged, um, try an area, but try other areas and then sort out where you belong.
And sometimes for many situations or circumstances, people end up in one spot and might not step out into another area. So I think it will be really interesting when we close these episodes of nurses’ voices, talking with educators and students and aspiring nurses to where, where is this going for education?
Gail Donner: [00:27:48] It’s may have, given me a lot of food for thought about words we, we, uh, use that maybe we need to embellish a bit, words like mentor whatever. Yeah. We need to think about who do you need to to meet in order to keep you going, uh, you know, to give you a future. Direction, whatever. Anyway, they were great!
Mary Wheeler: [00:28:12] I hope you’ve enjoyed this episode of Nurses Voices.
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