Why did you decide to become a nurse practitioner?
I am originally from a small rural town in Newfoundland. I always wanted to be a nurse and was especially keen on working in small communities and having the ability to work independently. There used to be an outpost nursing program and it very much interested me. As my career evolved, I could see that NP training would allow me to get jobs that were similar to what this outpost nurse program offered. I was 22 years into my RN career when I decided to go back to school and I have been an NP since 2000.
How do you feel you help patients the most?
I think that in being a nurse I have a caring nature that allows me to take my time and listen to my clients. My advanced skills now allow me to assess, diagnose, treat and refer in a timely manner while addressing the patient’s health-care needs. I currently live in Pond Inlet, Nunavut, and I help patients navigate through the health-care system more efficiently. I advocate for clients to get them through the system in a timely manner. It is all about access. I help remove the middleman — I can act independently, so my patients do not need to wait until a doctor flies in once every month or more to receive primary care. I know how the system works, I know the people in the community and it is very much a family-centred nursing practice.
Where I work we have a five-nurse station (one nurse in charge and four community health nurses). The CHNs have similar advance practice authority as NPs, but they do not have the autonomy, advanced training, or diagnostic, prescriptive and consultative authority. I supplement community health nurses. They refer to me, and I also work independently with patients.
What is the most rewarding aspect of your job and what is the most challenging?
The most rewarding aspect is that I feel respected here in the community. I’ve been living here for several years and I also have a great respect for the Inuit community. The Inuit culture is different with regard to family, child-raising and respect for elders. Our community is 85 to 90 per cent Inuit and I feel very privileged to live here. There are still some elders who are unilingual, only speaking Inuktitut; most children are also taught Inuktitut as their first language. We have fantastic interpreters at the health centre. Often, if you’re working after hours when there is no interpreter available, family members come along to help translate. There is a sense of community here like nowhere else I have ever been.
The socioeconomic aspect of health here is very challenging. The Inuit culture has evolved so much from their previous nomadic ways. Traditionally, Inuit were born out on the land, lived in tents and in small family groups where they would never see other people other than when they were trading. When they were re-settled, everyone was brought into a big community — keep in mind that “big” here is 1,500 people. There has been a loss of culture that came with this change. Traditional Inuit lived off the land and hunted. Now, their ways have changed; for instance, if hunters go hunting they have to have a boat and engine. They were not used to trading with money. However, the Inuit community is extremely adaptive. For example, when I first I came up here there was no cellphone service. When cell service arrived, everyone embraced the technology immediately.
More about Colleen
I graduated from a three-year diploma nursing program at the St. John’s General Hospital in 1978. I then did the NP-primary health care diploma program at the Centre for Nursing Studies in St. John’s in 2000. This unique certified program was offered at a time when 85 per cent of the nurses in N.L. were diploma trained. That was before there was a pan-Canadian decision to require NPs to complete a master’s program. Although I do not have my master’s degree, I can appreciate the value of master’s trained nurses — I am not a researcher, I am a clinician, but I rely on evidence-based research in my practice every day.
At the time of completing my NP program I was fortunate to have a position funded by the N.L. government in my hometown of Glovertown. I worked there for eight years before deciding to come up to the North, where I first worked as a CHN in Nunavut. In 2008 the Registered Nurses Association of the Northwest Territories and Nunavut were phasing out the ability of CHNs to accumulate practice hours toward NP licensure. This meant I was at risk of losing my NP licence and wanted to be able to work at my full scope of practice. So I lobbied the chief nursing officer to get a working group together to create NP positions in community health centres. We formed an NP integration working group, and out of that group we lobbied the Nunavut Department of Health. This effort resulted in the establishment of an NP implementation pilot project. I started working with the pilot project in 2012, which successfully demonstrated the merits of NPs in community health centres and led to the creation of NP positions throughout Nunavut. I am very proud of all I have done to move the position of NPs forward in the North.
When you live in a remote community it helps if you become part of the community, appreciate your surroundings, the people and their culture, and the beauty of the land. I do feel privileged to be living in this community. Every Canadian should have the experience of visiting the North.