[00:00:00] Mary Wheeler: On this episode of Nurses’ Voices, we’ll be speaking with two nurses who work in the north one, a public health nurse from Baker Lake Nunavut and the other, a community health nurse and Fort McPherson Northwest territories.
[00:00:15] Announcer: This is Nurses’ Voices. Nurses’ Voices is supported by the Canadian Nurses Foundation.
[00:00:21] And by the Canadian Nurses Association,
[00:00:25] Mary Wheeler: In this episode, we’re going to meet Dianne and Betty. Nurses who are working in the far reaches of the north. Dianne is a public health nurse who was born in Baker Lake, Nunavut went away to school and returned to Baker Lake to work in her community. Betty is a community health nurse in Fort McPhearson the Northwest territories who immigrated to Canada 25 years ago from Croatia and settled in the North.
[00:00:52] Nursing in the north is faced with many challenges and many rewards. Northern nurses need to be creative and resilient when working in environments with, with chronic staffs shortages and limited resources.
[00:01:06] Betty Strbac is a registered nurse with a bachelor of science and nursing from Aurora college in Yellowknife.
[00:01:13] She has 11 years experience. And for the last three years has been working as a community health nurse in Fort McPhearson, Northwest Territories. Dianne Iyago’s a registered nurse. She has seven years experience working in the north. She completed her bachelor of science, of nursing in Iqaluit with, at the Nunavut Arctic college.
[00:01:35] She’s currently working in her home community of Baker Lake Nunavut as a public health nurse. Um, I’m wondering Betty, if we could start with you, uh, to tell us a little bit about what your role is, uh, in as a Northern Nurse.
[00:01:51] Betty Strbac: Oh, I am acommunity health nurse at Fort McPherson, a community of about six, seven hundred people.
[00:01:59] Often we have three to four of us that work in the health center. So our day looks like we start at 8:30 ’til five, that’s our day, but we do calls afterwards. So if it’s three of us or four of us in the health centre then I will do call every third or fourth day. Um, we do everything that primary care does, we do sick clinic in the morning and the afternoons are composed of well child, well women, well men, um, prenatals chronic disease program.
[00:02:35] So health promotion, health prevention, teaching, sexual health, immunization, and emergencies.
[00:02:44] Mary Wheeler: When we were trying to organize this call, the Northwest territories was really the epicenter of COVID in Canada. So what’s the situation now, and has COVID impacted your practice.
[00:02:59] Betty Strbac: Northwest Territories has always done so well since it started March last year, I think our public health officer learned so much right away from the other provinces
[00:03:10] and so she locked us down and put some major restrictions like entering in the NWT. We all had to, I isolate for two weeks. That was a must for many, many, many months. Um, and we had minimum number of cases. Minimum. Um, and the point of all that was that we just could not allow any cases because we have, I believe like four ICU beds and entire NWT.
[00:03:40] So all of these small isolated communities had to be protected as much as possible. And then we had many people vaccinated and we had one vent that, uh, caused to have many people positives and, uh, and it, and we ended up at a community spread. So be we’re still dealing with all this, uh, luckily Fort McPherson hasn’t had any cases, I believe.
[00:04:12] I just hear now that we’re going to have to go into lockdown again, because there’s more and more, yes. More and more cases, positive cases on daily basis. COVID has changed our practice in many ways. A lot of education has been done, within a community and, uh, people have been really, really good about the vaccines, our vaccination rate, double vaccinated it’s over 85%, which is amazing.
[00:04:43] Masking has been really good. Uh, people have done very well that they’ve been very receptive and willing to do really anything to protect the community.
[00:04:54] Mary Wheeler: So Dianne, first of all, could you tell us a little bit about Baker Lake and what is your day like?
[00:05:00] Dianne Iyago: Baker Lake is the only inland community in Nunavut.
[00:05:04] Um, so most of the communities in Nunavut are along the coast. The population’s a little bit bigger than McPherson. Uh, I’d say in Nunavut, we’re about the fourth or fifth largest community in new Nunavut so our population right now is around 2000. So it’s been pretty busy. My days since COVID I started public health, um, kind of in the middle.
[00:05:28] So COVID started like, in March, 2020, and I started as public health in, um, July of 2020. I tried to. Make sure all the public health programs are well-planned out, but I also know that I have to leave room for any COVID related stuff. It has taken away a lot of our program from a lot of our programming.
[00:05:54] Um, like like Betty mentioned, we do, I do the well-child visits. I do prenatal visits. I do, um, the home testing. If I need to go and test somebody at home for COVID. Um, I do a lot of the, um, isolation calls, um, following up with test results. Um, everything that’s kind of surrounded COVID in our program, but it’s also orientating the new nurses that come in and making sure that they’re following the process and making sure that Baker Lake is still remaining COVID free!
[00:06:34] Just like any other community we were, we were scared for it to come here. Um, you know, we’ve had a couple of neighboring communities who were in lockdown for quite a few months back in November. And so we just, you know, as a whole territory, I think we felt that, and we were just making sure we were providing a lot of support to that community
[00:06:54] Mary Wheeler: You did a video uh, on, uh, as a strategy on vaccines.
[00:06:59] Dianne Iyago: Yeah. So in Nunavut we have Nunavut Tunngavik incorporated, which is the organization that looks after all of the Inuit organizations and promoting a lot of Inuit communications. So I was able to help them out with making a vaccine promotion video.
[00:07:15] “I would like to encourage all eligible Inuit in Nunavut to get vaccinated against COVID-19.”
[00:07:21] The community has been really well.
[00:07:24] Uh, communicating their needs and their wants. Um, and also listening to all the public health messaging that we’ve been putting out. Um, I work really closely with the community health representative that we have in the community. And so she does a lot of our. Radio shows. Um, a lot of our, you know, communicating with the community, they’re taking it seriously and the community is taking it seriously.
[00:07:48] And what I’m working on now is just trying to make sure we get to a good vaccine percentage right now. It’s pretty good. It’s we’re at about 70%. Uh, so I’m just trying to create a public health miracle and, you know, get the people that are a little bit hesitant or you need a little bit more education about the vaccine.
[00:08:07] Um, and just make sure we get a good percentage of our community vaccinated.
[00:08:10] Gail Donner: I’m gonna jump in. I really like our viewers and listeners to get to know who you are not just what you do. I’m just going to start with you, Betty. You chose nursing after you had another career and you immigrated to Canada. You became a nurse.
[00:08:30] So why nursing and why NWT.
[00:08:34] Betty Strbac: So I ended up in Yellowknife. I heard many good things about Yellowknife and, and good place for young people to start. So that’s why we as a family and ended up there, um, nursing, um, I was looking for something different in the life, but I wasn’t really sure what would suit me.
[00:08:58] And now I figured at a time that nursing would open different doors of opportunity for me. So I was like 29, I believe, 29, and I had to do courses that would, they were part of the high school because none of them, um, diplomas were accredited in Canada. So I had to take an extra year of school, um,
[00:09:26] and opportunity.
[00:09:28] But that was in my practicum. I
[00:09:30] realized that I loved surgery. And I love of wounds and I ended up on the surgical floor and I loved it. I loved it. And then after 10 years of that, I was looking for something else and I felt that, um, community health nursing would be a good fit for me. And I don’t think I was wrong.
[00:09:50] I absolutely love. I, I one of my colleagues told me that she loves my body and I was like, Hmm, what does that mean? But I, I absolutely love every single person in that community I adore. And I, I love working with them and elders are my favorite people in the world. And there’s so much that you can learn from them.
[00:10:14] Um, And I, I know there’s many communities out there that are just as beautiful as the McPherson, but I absolutely love being in McPherson.
[00:10:27] Gail Donner: Dianne, you’re in your own community.
[00:10:29] Dianne Iyago: Yeah. I graduated from high school in Baker Lake. It took me a few years to actually get to the nursing school part. Uh, in Iqaluit. I was very determined to make sure I passed what was back then.
[00:10:41] The CRNE one of my instructors was like, you need experience before you go into the community. And I said, Nope, I’m going to go home. I’m going to go home and do nursing. And, uh, and it worked out. I had a really good mentor and she mentored me for a good six months or so. And so there, from there, I just dove into, um, my community health role.
[00:11:06] At that time I left home for a little bit. Um, I actually went to Yellowknife, and I worked at the specialty clinic there. Um, It was very different from what I was doing in Baker Lake at that time, it was an entry-level. I didn’t feel valued. Um, and then I came back and it was…you know, I was being asked to be on all these, you know, boards and community meetings.
[00:11:31] And, you know, I felt valued. My input was valued, um, just because I knew, um, the health centre in how it operated here and so I felt good about that. I felt needed and valued. Um, and still today, I, you know, people are encouraging me to take courses. People are encouraging me to, um, become an NP so that I can, you know, do the advanced skills that I need for working in the health centre.
[00:11:58] They’re encouraging me to be, you know, their nursing charge, but, you know, I keep telling them like I have my one goal and, uh, I’m just going to follow, you know, that. And so right now, I’m just focusing on getting at least couple of years of, uh, public health experience. Working in my home community has been great.
[00:12:17] Um, there’s a certain level of trust and just the friendship that we already had before. Um, I haven’t had very many people, you know, not want to see me because they knew me. Um, But I did have one, um, sort of cultural, um, trouble was, you know, I’m not used to, as a Native woman, I’m not used to telling my elders what to do.
[00:12:44] Uh, so that part was really challenging for me. I felt valued in my role here in my hometown. Um, and I can feel the level of I trust that I have working with the elders and the community members. I like working at home because this is where my family is. Um, and this, I know the land around here when we can see sightings of like grizzly bears, muskox, caribou.
[00:13:08] Um, there’s pretty good fishing around here too. So we’re always busy outside of work.
[00:13:13] Mary Wheeler: I’d really like to have then a conversation about what it means to work in the north. So we know what your role is. We, we heard how passionate you are about the work you do, how you love where you’re working, but there’s been so much about nursing in the north around recruitment and retention issues, um, you know, limited resources.
[00:13:35] So what is it that people need to know?
[00:13:38] Betty Strbac: There’s many challenges, probably more in Nunavut for Dianne then for me, um, we are connected by road to a nearest hospital. Uh, part of this road is the Mackenzie river. So during the breakup and freeze up the road is closed. Uh, so in case, so, and during those periods, um, the transport of patients to.
[00:14:08] Uh, the hospital it’s only available via plane, uh, medivac we call it., Um, other challenges, fear nurses working in a health center without a doctor is a phone call away, but it’s still only a phone call away, it’s not physically present in a health centre. They have doctor that comes three days a month, two and a half to three days a month.
[00:14:36] They’re always there to help. But sometimes you would just wish to have them present and the community, but there are storms, there are blizzards, there are, uh, situations when you have a patient in the health center for a day or two or three, because of plane can’t land. Uh, but there’s many positives.
[00:14:59] These are just the little challenges and, uh, many, many positives, uh, being in the north.
[00:15:05] The main challenge I find is, um, transportation. Um, so we, we do what we can in the health center here. Um, we know what we have here and we know how to use it. Uh, you know, whether it’s, I think, I think the biggest thing that I tell people up here is, um, we, the patients depend a lot on your assessment skills. So if you don’t have those skills, it’s going to make it very difficult for you to relay that message or the condition of the patient to the doctor. Whereas if you’re really good at assessments and stuff like that, and you get, you’re able to give a better history.
[00:15:47] And then if there’s a decision to, uh, transport the patient out, it’s only by plane. And sometimes those planes can take a while to come in. Um, they come in stabilize the patient and then it takes them a while to get back down to Winnipeg. The other challenge is, um, we do in the health centers, we do everything from like A to B. So if you’re coming in for blood work, for example, you’re doing everything from start to finish for blood work. Um, so you’re, you’re drawing the blood, you’re processing the orders, you’re processing, you know, everything you’re ordering, you’re spinning, you’re packing it up. And then our driver takes it to the airport.
[00:16:31] So I find people get a little bit overwhelmed with that process. Um, The other challenges are, um, getting proper equipment in. And, uh, when we talk about resources, um, but lately things have been pretty good. So we’ve always been patient with, um, you know, all our testing capacities to make it into the community and doing what we can till, you know, all those resources get to the health center.
[00:16:58] We have a lot of blizzards. Um, and so sometimes we have to let nurses know the seriousness of it is, you know, if you’re driving through a storm and you can hardly see in front of you, um, you could end up, you know, in a ditch or in a bank. And so we really tried to make nurses aware that this is the policy.
[00:17:22] Um, this is the storm policy and you have to follow it for safety reasons. Another challenge that I think we have with, um, recruitment and retention. I feel like some people do experience a little bit of culture shock. Um, so I, you know, it’s, it’s hard to, it’s hard to educate people from the south, um, because there’s so many different things to learn about the Inuit culture and the Nunavut government and the Nunavut territory.
[00:17:51] So I feel like sometimes some people who haven’t you know, gotten out of their own little bubble. Sometimes they get a little bit shocked as to, oh my God, what did I get myself into?
[00:18:02] Mary Wheeler: What is it that makes you thrive in this environment,
[00:18:06] Betty Strbac: But you just do it no matter how hard it gets, you just do it. And I I’ve been lucky that I’ve been working with some amazing, amazing nurses.
[00:18:18] You work as a team. Um, You’re tired, but you just keep going. You really do. Um, and, uh, unless, there’s nothing, I think there’s nothing that it will coming between me and providing a care for a patient. Sometimes we’ll have a plenty of nurses and sometimes they don’t and that’s the reality of it. And you work with the resources and staffing that you have.
[00:18:45] Mary Wheeler: And what about you, Dianne?
[00:18:47] Dianne Iyago: Um, what I’ve learned, uh, since I have been a nurse, is that nothing really phases me. Um, so I don’t get really worked up or I don’t get really anxious or I don’t get too excited about certain, but that doesn’t mean I’m not prepared, but I also have a lot of support. And when I know I have the support of my, um, my nurse in charge, you know, our regional directors, um, our CNO.
[00:19:18] I know that they’re there to listen if I need direction guidance. Um, sometimes I’ll go to them with, you know, my career choices. Um, so it’s just a really, um, great team that I’ve had.
[00:19:30] Mary Wheeler: Over the last year, what some highlight of your, on, on the leisure side, on the play side?
[00:19:37] Dianne Iyago: There’s always things we got going on. And I sometimes feel like that’s part of the culture shock that people get. Um, because usually when there’s something going on, it’s usually a big crowd. Um, and I know sometimes some nurses can be shy because I mean, the only way to say it is some cause sometimes they’re the only white person there. Um, but I find the community is very welcoming.
[00:20:01] Um, they want to show you stuff they want to, they want you to try new things. Um, so I feel like there’s always something going on. I mean, less since COVID, but… you’ll always hear, you know, music or whatever, coming from the recreational center. Cause we’re always having dances. Um, the elders, you know, they have their feasts and stuff like that.
[00:20:23] Um, we have our, um, our Hamlet days in the spring. Um, and we were actually able to do stuff this spring, the, um, in regards to COVID. So it was nice to see. So the community is really learning how to, you know, follow CPH orders and still doing our activities that we like doing. In, in a crowd, um, this summer, I just want to mention that, um, because Baker Lake is the only inland community we don’t get any other sea mammals or sea animals coming into our lake. So we did have one group of men who traveled by boat, um, to Repulse Bay, which is another community out, um, in the same region and they harvested a bowhead whale. So that was a really big celebration, um, at the end, at the end of August.
[00:21:17] So that was really nice. Um, so a lot of the community members were excited to try bowhead whale. Um, so that was really exciting. So there’s always things going on and, um, communities are supportive and they want people to try new things. Um, so if they see newcomers, we try to be really friendly. Um, no matter who you are, I feel like.
[00:21:41] So there’s a great sense of community there, there’s always a great sense of community.
[00:21:47] Mary Wheeler: So I wanted to thank the both of you. Um, it took a while to get this, this episode underway, uh, but it has been such a beautiful conversation. So thank you so much. I am blown away again by these two nurses.
[00:22:04] Gail Donner: I call whiz. I had incredible deja vu experiences because many years ago, I did, uh., some work for the Ontario government on the air ambulance service.
[00:22:15] Mary Wheeler: Right? Yes.
[00:22:16] Gail Donner: As part of that, we went up north in a Ministry of Natural Resources plane, and it was before says a long ago, but it was before GBS. So I went to these, some of these communities, like Baker Lake, where the only way in and out was by plane. So I just kept thinking about that because of course all these small communities talk to us about the weather and in and out and how the transportation was so important.
[00:22:48] But what impressed me was they seem to know that these are all challenges, Dianne and Betty, all reasons why you wouldn’t want to do this work for why you’d scared to death every minute you were doing the work and yet they have team. They have communities that have meaning for them. They have an attachment and I guess over our career work, what we learned is that’s all you need.
[00:23:23] You just need to feel it’s your place and you can do it. Even with all these challenges, I just was impressed with just their, their resilience and just the smiles.
[00:23:40] Mary Wheeler: It’s both their sense of adventure. So if you think of Betty who immigrated to Canada, then went to the Northwest Territories with family, um, and then decided to do nursing and found, found a niche and loved what she was doing.
[00:23:58] The other one is for Dianne, who was born in Baker Lake. So the difference of someone immigrating to Canada and choosing the north and Dianne who, um, was born in Baker Lake, went away to school and chose again, the north to go back to her own community. So it’s that sense of control over one’s life and career.
[00:24:24] And that I think is one of the characteristics of what makes us happy in our work that we do have choice and we are able to find different ways to make it, uh, make, make it work for us.
[00:24:38] Gail Donner: They have a lot of that ‘just do it’ drive, uh, you know, there’s yes, there’s this isn’t good. That isn’t good. We haven’t got this. We haven’t got that. We need that. The weather’s bad, whatever, but we just do what we have to do.
[00:24:53] Mary Wheeler: Yeah.
[00:24:56] Gail Donner: North south, wherever that’s a nursing thing. It was great,
[00:25:01] Mary Wheeler: I
[00:25:02] Gail Donner: loved
[00:25:03] Mary Wheeler: it.
[00:25:03] I hope you’ve enjoyed this episode of Nurses’ Voices. You can view and listen to Nurses’ Voices on a variety of platforms, including YouTube and Apple Podcasts.
[00:25:14] For more stories on northern nursing, check out the series called True North produced by the Canadian Nurse. And remember if you want to give us some feedback, please connect with us through nursesvoices.ca and remember to sign up for our e-newsletter.
[00:25:32] Announcer: Nurses’ voices is created by donnerwheeler. It is supported by the Canadian Nurses Foundation and the Canadian Nurses Association. Nurses’ Voices is produced by Cector Limited.