Northern Nursing in Canada

Hi,

My name is Courtney and I am typing this on an old dial-up computer while watching the sun slowly start to illuminate the snowdrifts outside my window. Right now, I am in a small settlement of about 80 people on one of the remote islands in northern Canada. And I love it. 

Two years ago I started travel nursing, almost by accident as I was moving to Vancouver and couldn’t find a job in the city. I was sent out to Vancouver Island to work in a new hospital opening up in Comox and absolutely fell in love. I thought I could spend the rest of my nursing career in that city, and I have felt that way about so many contracts since. 

Travel nursing for me is an opportunity to see new places, experience new cultures, learn new activities, and fulfill my intellectual thirst for nursing. One year ago I made my first foray into Northern Canada to try Community Health Nursing in remote indigenous communities. Since then these are the only contracts I’ve taken. Even picking up time at the ‘larger’ Inuvik Regional Hospital (16 beds) has been wonderful. The quality of people you work with is high – as everyone working all the way up here truly wants to be doing their job. You don’t find people coming all the way up here to nurse who are just trying to ride out the last few years of their career to get their pension. These nurses WANT to be here, and they all have amazing life stories. 

The best part about each new place I visit is being immersed in the culture. Every tiny community, even in the same region, has its own culture, accent, style of mittens, and so much more. This blows my mind as I think about how much crossover these communities have. Parents, cousins, siblings can live across communities and visit in the winter when there are ice roads, but still, each area is so different. 

My first community was on the Dempster Highway and was a lot less remote because when it wasn’t spring or fall, anyone could access the community by driving to it. I guess this sounds normal when you consider the south, but only 3 communities in this health region can claim that. I arrived in the fall when the ferries closed and the road was shut down while they froze a bridge. Immediately I was welcomed by locals – intent on showing me that as the night stretched towards 24h there was still plenty of activity. We went ice fishing and got together at the local school for volleyball 3 times a week. We watched fireworks and the aurora borealis at 3 am on New Years when they finally managed to snowmobile them across the closed roadway. There were visits and sewing circles and I learned how to embroider beads from an elder. 

They also taught me about traditional medicines and how they view healthcare as part of their lives. There are many traditional remedies involving spruce gum, fireweed, and chamomile – a few plants that are able to survive up here. The people here are used to living off the land, and even now with permanent settlements they will sled out and spend nights to weeks out there in the dead of winter. 

One patient I had told a story of a time his snowmobile went through the ice. He crawled out of the water and had to survive 8 days before someone came by and found him. Eight days in the 

freezing arctic soaking wet. This man caught a fox, skinned it, then used the pelt to keep warm and the meat to stay alive. He had a knife and no fire. At first, this story was completely unbelievable to me. How could anyone catch and kill a fox and then just crawl inside it? Foxes can be vicious creatures and I had recently had a standoff with one walking back to my residence after work. As I’ve spent more time up here, learning about trap lines and typical ways of life, this becomes more of a realistic survival scenario. It’s not like he hid behind a bush and jumped the fox. He would have set up a trap with old twigs and brush to catch the fox, killed it with a knife, and skinned it. All things that are routinely done by most men in these communities, the main difference being that he was a lot colder and didn’t have the more robust wire now used for snares. Still. I heard this story a year ago and it is my go-to for an example of the resilience of the people up here. I’m obviously very impressed. 

I guess I could also mention the nursing. That is what I had meant to talk about, but there are just so many things about the people that I find fascinating. The nursing here is also incredible. Working as a CHN (Community Health Nurse) is a complete 180 from medical-surgical hospital nursing. I run a clinic during the day and respond to emergencies at night, covering anything and everything. Have a wart on your foot? Come to sick clinic. 26 weeks pregnant? Come see me on Tuesday afternoons for prenatal clinics. Need palliative care? I’ll come to your house and set up a schedule with your family to work out the best way to care for you. 

In addition to acting as a small-town physician, I take the call phone home at night. The call phone is a dreaded instrument that every CHN has memorized the sound of and that induces terror in us even if we are down south and it is coming from the pocket of a complete stranger. It can ring at any time and could be anything from “My head hurts, can I take Tylenol?” to “My husband just came in bleeding from his head and collapsed.” The stress of this should be obvious, but never knowing if you are going to answer the phone and immediately have to be on high alert, all engines firing, is draining. It is also difficult to get back to sleep when the phone rang and your adrenaline spiked at 2 am after you forced yourself awake to provide health advice. 

The above being said it is the most fulfilling nursing role I have tried. I get to challenge myself and directly see the difference I am making in the community. I’ll see a patient for a prediabetes screening and two days later be over at their house for a potluck and they’ll joke about having sweets and breads for dinner. As a small community, you can easily see the small positive changes each person makes and be more able to understand and address the barriers they face. After so many years of just signing discharge papers and keeping my fingers crossed, it’s nice to be able to affect upstream change. 

So, as the wind blows straight through the multiple layers of window because I refuse to shut the blinds to this beautiful snowscape, I sit here in my puffy vest and fingerless mittens with my tea beside my desk waiting for the next client. I’m excited to meet this community, provide great care, and maybe even glimpse a polar bear. You never know what will happen in the north.

All photos belong to the author: @driftingmaple Courtney