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Gail Donner: We are going to be speaking with two nurses from Alberta who have lived experience with mental health issues and who have taken action to do something, to help other nurses, who’ve also suffered with mental health and mental illness.
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Announcer: This is Nurses’ Voices.
This episode of nurses’ voices is generously sponsored by the mental health commission of Canada.
Nurses voices is supported by the Canadian Nurses Foundation. And by the Canadian Nurses Association.
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Gail Donner: Welcome to Nurses’ Voices. I’m Gail Donner.
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Mary Wheeler: And I’m Mary Wheeler.
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Gail Donner: In this episode, we’re going to meet Katrina and Sarah two registered nurses from Alberta with years of nursing experience and who have their own lived experience with mental health issues.
Katrina Stephenson is a registered nurse with over 15 years of experience, working with people with concurrent disorders, mental health, mental illness, and substance abuse and trauma. Katrina is vice president of the Alberta coalition for harm reduction and founder and CEO of Nurse to Nurse Peer Support.
Sarah Bohachyk is a registered nurse and a master of nursing student with over a decade of experience working in emergency department she’s co-founder of Nurse to Nurse Peer Support, and she is their advocacy and education director.
So welcome to both of you. We’re very glad to have you here. And before we begin, I want to thank you, especially for your courage and being willing to talk with us about your own experience with stress and stress induced mental health issues.
I’m going to start with you Katrina, if I could, and maybe start with you telling us a little bit about your own experience with work induced mental health issues. When did you first realize you needed help? Where did you go for help? That kind of thing. It’s your story so, however you’d like to tell it would be just fine.
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Katrina Stephenson: Thank you, ladies, for having us on here for having me on here and for acknowledging how stressful it can be. And a trauma triggering inducing to, to, to speak to this. I started my nursing as a registered practical nurse. So I did my initial diploma out in Ontario, and then I moved to BC and right away I went right back in to do my degree.
In Vancouver, I went to Langara College and there’s a big emphasis on mental health. And that’s the type of nursing I absolutely loved and went right into the downtown east side. I became an educator within the Providence Crosstown clinic, which was the first clinic in North America to offer safe supply. So I was the educator there.
While I was nursing in Vancouver, there was a lot of emphasis on trauma informed care, and that was kind of incorporated within the harm reduction model itself in 2013, my husband decided that he was going to become a firefighter and he made it to Edmonton. And so that’s what brought us here in 2013. So I was moving into a province that did not have a harm reduction policy at that time, at that point in time, they were working on it. I came to a province as a nurse, a harm reduction, kind of a specialist really, and was able to give the patients the tools that they needed. I could see people getting their lives back.
So the reason I’m telling you this is because it had a lot to do with my injury.
So working within that political climate and the social environment as well, that didn’t understand harm reduction, it’s a lot of grey that you nurse in– you know, that adds up the cumulative effects of trauma, right. That vicarious trauma, you know, seeing, seeing, um, violence, being bullied on the job, that happened to me too. Workloads with, with no, um, No change just kept coming, kept coming and you know, not being able to care for the folks that we want it to the way that we want it to.
Well, there was personal stuff too. We can’t forget that we’re human too. And Sarah says this all the time. We’re human. I had a miscarriage between my boys. It was traumatic and I had to go in to Emerg. I’ve never been in Emerg as a nurse, like worked in there, never been a patient. It was scary. It was awful. And you know, I was mistreated, um, and I was hemorrhaging.
So, you know, that was traumatic. I, I, shortly after that, I had my second son and, and just as he was being born, we had to go to Manitoba because my father-in-law, he, he died within a month. You know, there was those things that happened to all of us nurses. We have lives.
Just over time, I noticed I was having anxiety and I was like, oh, this is outside of my normal, just everyday worries.
And being a mental health nurse, I was hyper aware of these, these things it’s like working on a GI unit and we’re talking about our bowels or something, and we’re just hyper sensitized to those whatever area we’re working in.
In 2017, there was a violent event, um, with a patient that came in with some weapons and I’ll just keep it like that.
And I was in the room with him. I talked him down. I ended up getting, um, you know, the police and crisis team and myself went out after. Um, cause I, I convinced him to go home. Um, I couldn’t get a psychiatrist to see him, even though he was in a building full of them.
After that I started to not sleep. My eating: I could not eat. I was, had no patience with my family. I had no energy left to give to them. I could just, I could just get to work and I get home and, you know, I couldn’t do a thing. I started to check my windows, my doors. I was so hypervigilant. I was paranoid that someone was coming to get me.
And rationally, rationally I could tell myself that I, I knew what was going on. I knew what was happening, but I still had to do it. I know psychiatrists and I, um, you know, it just happened that it was a violent event. So WCB accepted that. And they gave me a psychologist. I had, uh, cognitive behavior therapy at that time with some mindfulness in there.
Then I, you know, I moved on to the supervised consumption service and, um, that was so politically charged. And so, you know, the first time opening one in Edmonton and just learning and, and I was the lead nurse and I was starting to have flashbacks in the bathroom. And so I was like: I’m not. I can’t.
Panic attacks were coming where I couldn’t stop crying at all with that work. And then I just, I had to leave, you know, just trying to survive the same time going through all that cognitive behavior therapy with psychologists, but never getting any kind of trauma specific, getting deep to those root traumas that were actually causing these symptoms to come bubbling up again.
My patients that I can remember and their symptoms that they used to tell me: I have a, like, a new found appreciation for all of those symptoms. But depression was the one that, like, I remember the mountains of laundry in my house. I remember the guilt and the shame around that. Um, and not, well, the guilt and shame just to leave my patients at work was so heavy. I would cry, you know, just thinking about them.
And my, and then leaving more work for the nurses that I cared about, you know, my colleagues. So it was 2019 when I finally went off for two and a half years. And I received, um, again, because I work in the system because I’m a mental health nurse that knows trauma. Um, I was able to reach out to someone I knew. A psychiatrist. And I went to see him and he offered me, um, is called transcranial magnetic stimulation. I’m a nurse. I give meds, I believe in meds, but I was like, I know this is an injury to my brain. I can, if this is something you can say that actually repairs the neurons within my brain, then can we just try the transcranial magnetic stimulation? If it doesn’t work, then I’ll take medication.
And, you know, we had a good deal. He said, okay. And it, it popped me out of depression and started to relieve some of the anxiety symptoms as well, in 30 days. I was on the Beck’s depression scale I was I think 32 and that’s severe depression, and I was a one.
And I would go every day of the week and weekends off, it was like going to the spa. It was actually very relaxing. I, it, but it was, I would meditate and, um, you know, it was this a little bit jolting. My eyes would water a little bit. It wasn’t too bad. So short-term went, and I was still not, even though I was getting pushed to go back to work. And this is important because this happens to so many nurses and so many people, not even nurses that go off with these types of injuries, they’re like, oh, you feel a little bit better, but like, you haven’t even received the trauma treatment. Like EMDR was the one that really got deep to the unprocessed traumas that I hadn’t processed throughout years, years, and years of nursing. And to this day, like I’m still doing it. It’s over a year and a half, and I’m finally kind of through all the nursing traumas in my life. It’s been quite the journey and, you know, I’m, I’m making my way back to work and it’s not pretty right now.
Cause I was injured before COVID and, you know, the the, um, you know, walking back into COVID is another, another whole thing as well.
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Gail Donner: Katrina how are you now?
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Katrina Stephenson: I have hope again in my life. I have drive. I have passion. I have energy for my kids. I have energy for my husband. I, I just feel grateful. I even feel grateful that I went through that experience because now I have, and I don’t want anyone else to have to go through this.
That’s my goal. But my goal, my, my, my I’m grateful because. Of the knowledge that I have gained going through this experience. And I want to take that and bring it to others to help prevent.
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Gail Donner: That’s been quite a journey. And, um, I’m glad to know that you’re feeling better. Uh, I wonder if we could switch to Sarah and hear a little bit. Sarah, tell us a little bit about what your experience, uh, uh, was.
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Sarah Bohachyk: Thank you for having us. This is a wonderful place where we can share our experiences and hopefully empower and educate others going through something similar so that they don’t have to experience the full experience Kat and I have gone through.
I have over 10 years of emergency department experience. Specialized in emergency. It’s my passion, my drive, my love. It was my life. And I knew it from my third year of nursing. I applied for a UNE position. So undergrad nurse, employee position here in Alberta, which they’ve gotten rid of now. Um, but so between my third and fourth year of nursing school, I worked in emergency depart.
And that was it. That was my love. That was my niche. And I knew it and I embraced it and I dove head first into it. So I spent 10 years of dealing with people in their worst days of their lives and the worst circumstances. And it’s not just the patient, it’s the family, it’s the whole dynamic. Um, and obviously emergency departments, you know, we are there to help you in that worst case scenario.
So we do see a lot of traumas. We do see injuries, attacks, everything, mental health, crisis, drugs, substance use, like we see the entire population and we’re the first point of access for so many people. So you don’t really know what kind of state they’re in, and how your day is going to play out with them. Um, but my first major traumatic experience was in 2016, home invasion, woman pregnant and accidentally got stabbed many times.
And I was her nurse taking care of her. And this was the same time of my life when my husband and I were talking about getting pregnant and we were doing very similar things and I could relate with this woman, I felt like it was me and it could have been me. And that was the first time I went home. After that night shift, I locked my bedroom door.
I didn’t even realize I did it until weeks later until I noticed I kept doing it, kept doing it, kept doing it, and I just kind of brushed it off I’m like “Oh, whatever, I locked, my bedroom door who cares”. Right. You just keep going. You’ve rationalized everything that you do. And then few more years later, another trauma, another kind of trigger, a little change of pattern.
Change for me personally. So I would notice I’d be a little hypervigilant watching, walking the dogs, I’d be extra cautious. I have a baseball bat that still, unfortunately’s next to my bed, um, for protection, even though rationally, as Katrina said, you know, you’re not in danger, you know, you’re saving yourself, we know this, but something, I just needed that extra little support because something in me didn’t feel right.
But as a nurse, When do you not have a terrible nightmare, right? When you not wake up to the morning, be like, oh my God, I forgot the water. Right. It’s constantly part of you. And you’ve rationalized things. You forget about them. You’re like, oh, well, who doesn’t have a bad sleep? Who doesn’t feel bad about it?
Doesn’t feel anxious coming to work. Right. And it just kept building and building and building. And I kept just rationalizing it because there’s guilt of calling in sick because he didn’t sleep. Cause you know, you’ll short shift your coworkers and you know, they may not get that staffing filled and you know how terrible it is to work short.
So you feel guilty calling in sick to take that extra time for you. So it just protects you. It’s the whole cycle that starts. And in 2019, December 18th, actually my most recent and, uh, expressive traumatic experience happened to the patient that actually reminded me of my mother. Similar birthday, they were reading the same book at the time.
Like it was uncanny. The resemblances is this woman had with my mother and she died traumatically in front of me a few hours after building a connection with her as you do with your patients. And that was it. I, my brain, something just snapped. I didn’t know. I couldn’t, I couldn’t function after I couldn’t close my eyes in the shower.
Cause I was terrified. Some would would be outside those doors to attack me. Even though I knew I was safe in my own home. I could not physically close my eyes with that fear, that paranoia, I couldn’t sleep for days at a time, barely ate, barely engaged with my husband. And to be honest, I don’t actually remember working the rest of the shifts in December.
I did. I worked, I don’t remember Christmas. I don’t remember new year’s. There is a complete memory blank from my injury. It’s gone. And which makes me fearful of, oh my God. I worked in, I remember. Right. Like, and that’s terrifying that feeling of like, oh, if I did anything when I was in that state and I didn’t even realize I would never forgive myself.
So finally, a month after I reached out to my doctor and my husband actually drove me to my appointment because I knew if I went there by myself, I may not actually walk in and say, I need help. I needed his support. And so my doctor, he agreed. He’s like, yep, let’s get you on some meds.. And let’s get you on a therapy and let’s do what we can do.
And I saw a therapist started the whole WC process, which that was an experience in itself because here in Alberta, January 1st, 2020, they removed nurses from the presumptive PTSD legislation in Alberta. So nurses used to be covered and receive supports from supportive therapies and WCB, um, much like firefighter police, EMS, military.
Those were not cut. Nurses were. I filed my claim 12 days after that happened. So I had to go through an entire process where they don’t believe that your injury happened at work. You have to prove it. And here my injured state, it took me a day and a half to read a page of paper WCB sent me, let alone fill it out. And my hands would be shaking so much ,I would have to reprint it and rewrite it multiple times. Cause it couldn’t even be legible. And they call me a week later after I finally got it done. Finally make it legible way that I thought made sense. They call me and be like, you filled out T 42 14 B, we need you to fill out T 42 14 A so you had to redo it.
And it was never a collaborative. It was never explanatory, it was, this is what you’re doing. Why are you taking so long? It wasn’t supportive. It wasn’t anything helpful. If anything, it felt punative. And it felt like, oh my God, now I lost my brain and I’m gonna lose my job, and I’m going to lose my money. What’s going to happen?
And you just feel in this hopeless, very dark, dark place. And mind you, this was right when COVID was starting actually. Oh, it’s a problem. Oh, it’s a global event. And so I was trying to get better because in the back of my mind, I saw those COVID-19 news updates happening and it’s coming to Canada. And now it’s in Canada and that pressure and that guilt kept mounting.
Uh, I had to do interview over 3000 questions and a four hour interview with a psychologist. I had not known that WCB for them to believe that my injury was not due to something else in my life for them to believe my traumas that happened at work and it caused PTSD were due to work. So that was quite the process.
And it would have delayed my therapy treatment, had I not had my husband. Who’s a firefighter. They have resources for mental health that are phenomenal, like even just the education and provide the list of psychologists, psychiatrists that can help better trauma informed that it’s all readily available.
Right there. If I didn’t have my husband’s resources, I wouldn’t have gotten help until after I got approved by WCB months later. So I luckily had my husband and his list of information and bypass that and started getting help for myself. Cause it’s my brain. I only have one. I’m not going to wait for WCB. I’m going to fix this now.
And that’s the Emerg mentality. There’s a problem. We’re fixing it now. May of 2020. That’s when COVID came to Alberta and the guilt, I felt seeing my coworkers go to work, I felt like, oh, at least I’m so what I’m injured. At least I’m safe. At least I’m at home. I’m better off than them. Cause they’re, they have to go to work.
The pandemic. This is what we do for nurses in emergency. This is what I was trained for. This is my job. And here I am at home crying when I see a commercial for the people clapping at seven o’clock for nurses thanking them, I would literally fall to the floor crying because that guilt weighs so much on me at the time.
So May, I decided, you know what? I think I’m good enough. I’ll go back. They need me. It’s a pandemic. I think I’m good enough. Right. And I convinced myself, I suppressed my symptoms. I was like, you know what, I’m fine. I’m fine. I’m going to do it. I’ll push through because that’s what nurses do. We put our head down and we keep working.
We don’t think about ourselves. We don’t put ourselves first. We think about the job. And everybody else around us. So that’s what I did. I went back to work for May. I was there for a month, part-time hours and in that month, my symptoms fully came back. I couldn’t sleep again, couldn’t eat. I lost 17 pounds in one month and I don’t have 17 pounds to lose.
So I spoke to my psychologist afterwards and she’s like, yeah, that’s not healthy. We cannot sustain this. I’m taking you off. So she took me off again. I was off work all the way until February. Um, and in that time I took part in a traumatic psychological injury program. And, uh, after four months of this intensive therapy program where I was doing exposure therapies with an occupational therapist, again, I was doing the by myself with my therapist on the phone asking me how I’m doing as I’m having a full-blown panic attack, putting on scrubs for the first time in months.
Um, but so at the end of the program, The psychologist decided that I cannot go back. I can not go back to the emergency department. You are now restricted from your license. You cannot work anywhere acute, no high mortality, no of high stimulus and whoa that was an identity crisis for me because this was my life.
This was my career and my husband and I, we struggled with infertility for years. So I really used work as my respite from my personal life. I had to now deal with an identity crisis of this was my life. And now I can’t go back, not even a choice and still dealing with that guilt of knowing my coworkers and the Emerg are still struggling. They’re still short. They’re still suffering. A lot of them are probably injured and don’t even know it because we weren’t provided with education. You’re not told, Hey, these are the symptoms of distress. These are the symptoms of anxiety, depression, PTSD. Maybe these are something to look out for that education’s never provided.
If it was a patient in front of me, I would know there was a problem. And I would know how to deal with it. The fact that it’s myself or a coworker, no idea, right? No education, if anything, it’s swept under the rug and he’s told to shut up and keep going. It’s not encouraged for you to look at yourself, make sure you’re healthy and make sure you’re ready or mentally set and well to care for others.
That’s not the priority and never once was that the focus.
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Mary Wheeler: It might be a good time to talk about then the nurse to nurse peer support, because what you’ve just talked about is that there are a lot of nurses who don’t have the education who are struggling, and I’d like to know a bit more about the program and how it started.
I think it started with you Katrina.
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Katrina Stephenson: That’s how Sarah and I met. So my background is, is, you know, harm reduction. Like I spoke to, so advocacy is one of my best skills. It’s a little different when you have to apply it to yourself, you have to learn how to do that. Our local union, nurse union, is UNA. I was going to write an article that was going to be published in their magazine, and it was about me and a nurse with PTSD.
And the article was like, we need to pay attention. We need, this is happening to us nurses. I had a healthy brain before nursing. And I love nursing and I you know, to this day, I still love it. I’m a little scared walking back into it. I’m not going to lie. It’s scary as hell.
I know EMS has a peer team.
I know the police here in Edmonton anyways, have a peer team.
All male kind of oriented, um, careers. Right. Um.
So I’d seen how that worked so well. So I wrote that, um, kind of piece in there, um, that, and advocating for peer support for nurses. I wrote the article. Sarah reached out to me. What did you say, Sarah?
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Sarah Bohachyk: Uh, I get it and thank you. Pretty much was the start, right?
Because I’ve read her article. I cried. Like, not even the cute cry, the ugly cry of like finally somebody else. Finally. Finally, you don’t have to explain it to someone. Finally somebody gets it. I was also compulsive of checking the doors and my locks constantly, had the weapon by my door, by my bed, you know, like constant paranoia, hypervigilance.
And it wouldn’t go away and explaining that to somebody of that. Like, well, you’re a nurse. Why are you worried about walking your door? You have no idea. Whereas Katrina and, I read her letter, and I just felt that instant connection of “ahh, finally.”, it was almost, you know, justified, I felt justified in feeling, I felt like I wasn’t wrong.
I’m not broken. I’m not the only, that’s not me. That’s the problem. Which at that point, all I felt is maybe to me, something’s wrong with me. Maybe I just can’t do it. Right. It’s that sink or swim mentality of nursing too like, oh, you can cut it or you can’t. And so maybe I was having a bit of a degree with that too.
So I reached out to Kat and I told her, I’m with you, whatever you need, whatever you’re wanting to do. I agree, we need to fix this and we need to fix it together.
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Mary Wheeler: So what do you do? What does the, I went onto your website. I took a look.
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Katrina Stephenson: We’re still in development phase. So the thing that came up first right away was, you know, there’s the development piece, but then there’s the emotional piece.
That’s when the peer circles, the peer support circles came to be. So within COVID, we could have the zoom, peer support circles that were trauma informed. Where we can provide a safe space, as much as possible, with guidelines and everything. Um, assisted an open online, anyone can come it’s free. You just have to sign up on our website and we just talk like this.
We just talk about. What’s going on. It’s a place that we can come and process those stressors that are bothering us and that we don’t have to feel alone.
We just had two new people come to the circle, just I’m like, oh, that makes me so happy. It’s like, you don’t have to be alone. And then you see them cry and you’re like, Oh, just, just cry. It’s okay. Just let it out. Don’t hold it. That’s just like toxins. Get rid of it.
That’s the beginnings of our nurse to nurse peer support. Just recently, a couple of us took a reintegration course with the Edmonton police service and we’ve connected with other nurses within our health authority here. And, you know, things are moving along kind of like, um, if a nurse is injured, Um, like Sarah and I were we’re walking back to work by ourselves.
There’s no one there to support us. Yeah. UNA, the union might be there, but it’s really like, do they actually know you? Do they understand trauma and my injury? Well, they’re not provided with the education around these injuries, either. Their resources are short. It’s a lonely, scary place when you’re walking back.
A lot of what nurses feel is a systemic oppression. And I can say it from my own experience as well, is that the system didn’t support us and we’d have to go back and work in it again. Is it going to be able to support us? We know it’s not. So we need to do something different. So nurse to nurse peer support wants to be a solution to what is happening to us.
And we want to be a place that safe that’s trauma informed that nurses can come to.
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Gail Donner: So now’s the chance for you to give a plug? How do people get ahold of you?
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Sarah Bohachyk: Oh, well, there’s a couple of different options. We’re on Facebook. Uh, we are a private group, uh, for nurses or, and when we say nurses, we mean nursing students, retired nurses, nurse educators, out of practice, right? Like it’s not just an RN that’s working. Any nurse, an RPN, an LPN. We all, regardless of the title or designation on your badge, you’re still in that room with us and you experienced, and you’re, you’re exposed to the same problems whether it affects you or not. That’s, that’s a personal thing, but we didn’t want to stipulate that this is only something RNs go through.
This is something, anyone in the medical field can go through. And we didn’t want to limit that. However, it was us being nurses. We wanted to focus on nurses to begin with and hopefully eventually expand to social workers, respiratory therapists, other medical professionals, but we needed to start with what we know, which is nursing.
And beyond the peer circles that we offer and you can sign up through those through our website at www.n2nps.com. We host bi-weekly peer support circles like Katrina said, but we also do one-on-one support. If you need, you can contact us via email. We also do system navigation for people who are making the claim through WCB or Canada life, they don’t know what to do.
It’s a very convoluted process that Katrina and I had to muddle our way through. So now we’ve learnt an extensive amount from that so we can offer assistance and make sure, make sure you do form A and B, not just B like I did it. Like we can provide that insight and help. That makes such a difference. And we’re also in a advocacy and education that for myself, um, we are definitely advocating for nurses wherever we can such as you guys are allowing us to today to open up the discussion. Uh, get rid of the stigma. We are human beings. We’re allowed to have emotions. We’re allowed to be overwhelmed. We’re allowed, and I shouldn’t have to say that we’ve have this permission. You don’t need permission to feel how you feel. But as nurses in an oppressed profession where we’re used to just putting our heads down, working, and then going home and cooking dinner and tucking everyone into bed, our jobs never really end.
As well I created a self-assessment workbook for nurses specifically to assess themselves with their substance uses and their mental health and like psychoactive substances from caffeine intake, even, to alcohol or drugs, whatever you need, because it’s still a substance that we are taking to survive our career. So I created a workbook for nurses to do assessment on themselves.
Be honest with yourself, and it’s private. You download it, you feel about yourself. You don’t have to share it with a single person, or you can share it with us. Whatever makes you comfortable. But to allow people to have that awareness and insight and just say, Hey, maybe I have been drinking a little more lately. Why is that been bothering me?
Right. Like what’s been going on? Why is that? And just opening that conversation in a safe, supportive, empowering way. Because that’s what we want to do. We want you to feel empowered. Because, right now, when you’re through a mental illness, you don’t feel empowered. You feel weak, you feel small, you feel broken. And you’re not. You’re human beings who’s injured. There’s a difference.
[00:30:36]
Gail Donner: If you had, you know, you were in the elevator and, you know, you had the one line the, the time and you had to say something to nurses across Canada, what they need to do about their own wellness.
What would you say?
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Sarah Bohachyk: You matter. And there’s no shame in admitting that you’re not okay. That was the hardest part for me. Asking for help. I’m the person people go to for help. I’m not the one that needs help and admitting that you know what, I’m not okay. That’s the hardest part. And if you can reach out to us, your doctor, your employee assistance program, whatever you’ve got available to you and say, I need help.
That’s the biggest, the scariest, the worst step you take in the rest, you know, it can only get better from there. So don’t be afraid to do that.
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Gail Donner: I hope you found this episode of Nurses’ Voices interesting, informative, and helpful. You can view and listen to Nurses’ Voices on a variety of platforms, including YouTube and Apple podcasts.
Also, we’d like to hear from you and we’d like to get some feedback from you. So please go to www.nursesvoices.ca. And remember to sign up for e-newsletter. So you can be the first to know when there is a new episode posted.
[00:32:05]
Announcer: Nurses’ Voices is created by donnerwheeler. This episode is sponsored by the Mental Health Commission of Canada. It is supported by the Canadian Nurses Foundation and by the Canadian Nurses Association. It is produced by Cecktor Limited.
