Providence Health Care Nurses Come to Saskatchewan’s Aid in Battle Against HIV Infection
Vancouver, BC — A group of Providence Health Care (PHC) nurses experienced in working with HIV patients in marginalized populations have responded to the huge rise in HIV infections in Saskatchewan and are sharing best practices with their provincial counterparts.
BC is leading the way nationally — not just in research and the science of HIV — but in the way HIV care is delivered. It is the only province in Canada seeing a consistent, steady decline in new HIV diagnoses. New HIV infection rates have decreased 60 per cent since 1996 while the rates of every other province remain unchanged or continue to climb.
According to Saskatchewan’s HIV Strategy 2010-2014, the prairie province has seen a substantial increase in new cases of HIV since 2003 and, as of 2010, has the highest rates in Canada at twice the national average. In 2009, 75 per cent of new HIV cases were predominantly associated with injection drug use. Aboriginal women under age 30 account for a disproportionate number of all new HIV-positive cases in the province.
With a focus on ensuring that people with HIV everywhere get the best care, the PHC team – who are also members of the Canadian Association of Nurses in AIDS Care (CANAC) — has created the Pacific to Prairies Partnership with Regina Qu'Appelle Health Region (RQH). Supported by PHC, RQH and the BC Ministry of Health, the team has undertaken exchange study tours, reaching a wide audience of nurses, social workers and physicians in Saskatchewan, and passing on expertise and ideas for improving care.
“There may be many barriers to good care, but the Rocky Mountains aren't one of them.” said Scott Harrison, PHC program director, urban health & HIV/AIDS, and president-elect of CANAC. “Nurses have joined hands across provincial boundaries to share best practices in HIV care. It makes sense because, on a smaller scale, North Central Regina bears many similarities to the DTES of Vancouver — poverty, marginalization, high drug use and a large urban Aboriginal population. As a result of the valuable knowledge they can share, our front line staff are becoming front runners in the fight against HIV.”
PHC’s participation in the Pacific to Prairies Partnership is yet another example of the leadership and collaborative role the health organization continues to play in the treatment of HIV patients. PHC recently joined forces with Vancouver Coastal Health in the launch of the “It’s Different Now” social marketing campaign about HIV, and a pilot project offering routine HIV testing to admitted hospital patients who consent.
“The opportunity to share knowledge, lessons and experiences with PHC nurses has created a unique situation for the nurses in RQHR — we are not alone nor are the individuals for whom we provide care and support. The people at risk for and acquiring HIV in Saskatchewan are often highly complex, requiring intensive support. Scott and his colleagues have been able to share their successes, offer advice regarding initiatives that had little positive effect, and allow us to build capacity by modeling what nurses are able to do for one another. Truly, there is no support like the support from one's peers,” said Susanne Nasewich, RQHR HIV strategy coordinator.
Some examples of the best practices and/or lessons shared include:
• Team around the patient – using the skills of the team to the best advantage of the patient. HIV care cannot be delivered in a cookie cutter fashion but, instead, must be tailored to the needs of each individual patient;
• Outreach – in the fight against HIV, nurses need to visit communities to meet people where they’re at;
• Acceptance that some people are not ready – nursing interventions and trust-building help prepare people for treatment;
• HIV care is more than antiretrovirals (ARVs) – it is about addressing safety, food security, trauma and mental health issues;
• Emotional and mental health care – many HIV patients have depression, trauma or other significant mental health problems that must be addressed if HIV treatment is to succeed;
• Reducing barriers to treatment – barriers are often placed in the way of patients such as set appointment times rather than a drop-in system for people who find it difficult to keep appointments, and expecting them not to use drugs in hospitals. Professionals need to learn how to keep the door open to people who use drugs or engage in behaviours that society doesn't necessarily condone;
• Harm reduction – people can be engaged in the conversation about harm reduction if it is done well and with sensitivity;
• Cultural safety – Aboriginal clients need to feel safe before they will trust caregivers, engage with them and follow their advice. Caregivers need to be aware of the impact of colonization and the shadow of Residential Schools and Indian Hospitals. While those institutions are long gone, the memory of them is still very much alive in the minds of Aboriginal people.
CANAC is a national nursing organization for nurses and health professionals working in HIV/AIDS. CANAC has a large presence in BC with many active members working in the PHC HIV/AIDS Program. At its upcoming 20th Annual National Conference in Victoria, CANAC has partnered with the Centre for Aboriginal Health Research at University of Victoria in presenting a full day session on “Supporting Cultural Safety: From training to implementation”. For more information about CANAC, go to http://www.canac.org.
To find out about the cultural safety session, go to http://cahr.uvic.ca/programs-research/programs/cultural-safety-healthcare.
About Providence Health Care
Providence Health Care is one of Canada's largest faith-based health care organizations, operating 16 facilities within Vancouver Coastal Health. Guided by the principle “How you want to be treated,” PHC's 1,200 physicians, 6,000 staff and 1,500 volunteers deliver compassionate care to patients and residents in British Columbia. Providence’s programs and services span the complete continuum of care and serve people throughout B.C. PHC operates one of two adult academic health science centres in the province, performs cutting-edge research in more than 30 clinical specialties, and focuses its services on six “populations of emphasis”: cardiopulmonary risks and illnesses, HIV/AIDS, mental health, renal risks and illness, specialized needs in aging and urban health.