Nurses at the Forefront

Inspired by her mother’s caring example and two aunts who were nurses, Catherine Little knew nursing was the path for her.

“I was moved by these three women, ”she says,“ to pursue a career that would allow me to show kindness and empathy towards others.” Ms. Little has worked as a nurse for more than two decades – the entire time at Horizon's Saint John Regional Hospital, and for most of that time in the ER, providing front-line care to thousands of New Brunswickers and their families.

“I love my job. I love the patients. I love the different situations I encounter every day and the different opportunities I have,” she says. “I have the opportunity to care for patients when they come into the world and when they leave the world,” she says. “You see all aspects of their journey.”

With nurses working to keep people healthy, safe and comfortable, the impacts of their care and compassion are felt across the community.

“Nurses are everywhere,” Ms. Little says. “Within our families, social circles, neighbourhoods, schools and businesses. We have the privilege of being educators, mentors, confidants, coordinators, and life-saving caregivers to every single patient we meet.”

The public has never been more aware than they are now of the contributions nurses make and the challenges nurses face. Horizon Health Network's Vice-President and Chief Nursing Officer, Brenda Kinney, sees a once-in-a-lifetime opportunity to transform and rebuild nursing for the better.

“Everybody from government officials to the regional health authorities are really invested in improving our nursing workforce,” says Ms. Kinney, “so it's a time of incredible opportunity and openness for ideas and innovation.”

Ms. Kinney’s job is itself an indication of the unprecedented attention nurses are receiving. While the position has existed for years, it used to be part of another job. This year, for the first time, it became a stand-alone role.

With more than four decades of nursing experience behind her, Ms. Kinney assumed the post last January. Ms. Kinney is a problem solver by nature.

Ms. Kinney spent nearly 20 years as a manager in the New Brunswick Extra-Mural Program, during which time she got her bachelor’s and master’s degrees in nursing. In 2009, she joined Horizon as a director, moving on to an executive director role and then to her current position as Chief Nursing Officer.

“It’s a wonderful honour,” she says. “And it’s a wonderful challenge because nursing is very much at the forefront at the moment.” These days, it’s especially clear: nurses are essential to the well-being and recovery of patients.“Everybody has realized the significant impact on the health-care system when you don’t have enough nurses,”Ms. Kinney says. “Nurses are on the frontline of COVID. Nurses are the ones who are with patients 24-7. It just raises the awareness of how critical nurses are to good patient care and good outcomes.”

She points to a seminal Canadian study, “Nurse Staffing Models as Predictors of Patient Outcomes.” Published in 2003, it examined how nurse staffing models affect patients – including their functional health, pain control and satisfaction.

In the study, conducted in 19 teaching hospitals, the researchers found a positive connection between the number of nurses on a unit and how well patients did when discharged from the hospital.

Working alongside stakeholders in government, academia and other health authorities, Ms. Kinney is out to find ways to bolster nurse staffing. She says there’s more collaboration now than ever around the issue.

“A big part of my role is to make sure that we’re engaging with all of the stakeholders and working together as opposed to in silos,” she says. “It’s really positive.” Along with a big focus on recruitment, especially to attract more internationally educated nurses, there’s also a push to increase the number of seats in New Brunswick nursing schools.

Beyond that, Ms. Kinney says the time is ripe to reconsider the roles and responsibilities of nurses. “It’s also about finding more efficient ways to maximize their specialized skill sets,” she says. Some tasks that nurses currently perform may be better handled by other team members. “The bottom line is that we need our nurses where their essential skills are most important.”

One of the most important ways to support nurses is by providing quality professional development opportunities.

The Saint John Regional Hospital hosted an annual conference for its nursing staff for several years before the pandemic. In 2021, there were plans to host a larger event for nurses from across Horizon Health. That expanded event, delayed due to COVID, has been rescheduled for 2023, with a focus on nurses rebuilding and recharging.

For more than two years, all training or professional development for nurses has been virtual. The chance to gather live will make the event extra special, Ms. Kinney says. “I think it will be a wonderful opportunity for nurses across Horizon to get together again, to benefit from networking and personal communication and connection.”

The event is being funded by the Saint John Regional Hospital Foundation, which also supported the conference in the past. The Foundation recognizes the essential work of nurses and has plans to direct more resources to support them, through professional development and other initiatives. Ms. Kinney says the support is “absolutely awesome.”

“The Saint John Regional Hospital Foundation sees the value in supporting our nurses,” she says. “It sees the value in education and the importance of that for the growth and development of our nursing staff for the betterment of patient care.

She appreciates the Foundation’s multi-faceted approach to improving health care by funding different “pillars,” including innovative technologies, research, specific department or unit upgrades, and investments in attracting and, crucially, retaining healthcare workers.

“You want engaged staff. You want staff that are up-todate and current,” she says, “so investing in our team is critically important as we move forward.”

As New Brunswick’s largest tertiary care hospital, and home to a number of provincial programs, the Regional “depends on having not just top-notch physicians,” Ms.Kinney says, “but also really top-notch, engaged nursing staff and other professionals.”

The public may not fully understand just how educated nurses are or how complex and advanced nursing is today, Ms. Kinney says. While a warm bedside manner is important and caring is, as ever, at the heart of the job, nursing is a highly skilled profession that’s grounded in science and research and constantly evolving.

The old image of nurses as angelic bedside handmaidens is outdated, she says. “It is a really good thing that the profession is being recognized for its value and its worth,” she says. “Nurses aren’t just there to sit and hold your hand or give you a bed bath. Nursing is much, much more complex than that.”

Since assuming the role of Chief Nursing Officer for Horizon, Ms. Kinney has spent a lot of time talking to nurses across the health authority. One of the things nurses, particularly ones early in their career, are asking for is more structured mentorship.

“We haven’t had a good mentorship program for years, and with new staff coming in, they have different needs,” Ms.Kinney says. “They have different support requirements, so we’re going to be initiating a regional nursing mentorship program.”

Ms. Kinney knows first–hand the crucial role a great mentor can play. It was her own mentor, fairly early in her career, who first encouraged her to pursue leadership opportunities, and to go after a nurse supervisor role, which led, ultimately, to her current leadership role.

Ms. Kinney says there will also be a mentorship program tailored to support the unique needs of the increasing number of internationally trained nurses that are being recruited.

And, as always, nursing offers incredible diversity. “Nursing provides opportunities like no other profession,” Ms. Kinney says. “You can be an educator, you can be a
researcher, you can be a manager or a leader. You can work directly with specific patient populations. There’s almost no other profession in the world that you can go into, and come out with so many options as you progress through your career.”

“The opportunities are endless.” At the upper levels of the profession, there’s a recognition that nurse managers and other leaders are spending too much time trying to find resources to fill shifts. Ms. Kinney says they are looking at creating new support positions to help ease the strain, so these senior leaders can focus more on supporting front-line nurses.

As Ms. Kinney and her colleagues and collaborators work to address the challenges and reimagine nursing in New Brunswick, she feels optimistic about her profession’s future.

“It’s a wonderful career,” she says. “Yes, it’s hard work. But it’s so rewarding. If helping people is something that you value and have an affinity for, there’s no better career than nursing.”

For Liam Sipkema, who has been an RN in the Regional’s cardiac unit since graduating in 2018, nursing blended his interest in science and medicine with the human touch.

“The human body is just an amazing thing,” he says. “And then you have the social aspect of caring for people, which is very fulfilling.”

He works with patients before and after heart surgery, educating them and their families on what to expect, running pre-op tests and providing post-op care, which typically lasts five or six days for a bypass patient.

“It’s nice because our patients have a problem, and it usually gets fixed,” he says. “After a near-death experience, we get to see them get better and go home.” He loves the teamwork on his unit, and the chance to help people when they are at their lowest.

Nurse Catherine Little can’t imagine doing anything else. As she goes about her work, she feels her first duty is to be kind, considerate and empathetic to every patient and their family, to show them patience in what is often a stressful or painful time.

“When people come to the hospital, they’re very vulnerable. I'm all about kindness. The most important thing we can focus on is being kind to patients and being kind to each other right now,” Ms. Little says.

“My goal is to treat my patients with the same respect and dignity that I would want my family to receive if they were in hospital.”