Nunavik nurses seek more training, recognition

Ordre des Infirmieres et Infirmiers du Québec, Quebec’s powerful nursing association, is lobbying for more recognition and additional training for nurses who practice in Nunavik and other remote regions of Quebec.

“It’s the nurses who give all the health care, who make the decisions, so improving the situation of nurses working in remote places automatically means there’s more access to care and better services for the population,” said Gyslaine Desrosiers, the association’s president, in an interview from Montreal.

What nurses in Nunavik say they need is similar to what nurses in Nunavut want, but Quebec nurses have more money and clout to fight on behalf of its 65,000 members than the Registered Nurses Association of the Northwest Territories and Nunavut.

Desrosiers said nursing in Nunavik will stop being a “forgotten practice” when there are more specialized nurses, or what’s called nurse practitioners.

And if more value is attached to nursing in remote regions, she said more nurses will decide to practice in Nunavik and stay.

At the same time, Desrosiers wants to see more Inuit nurses trained and practicing in Nunavik.

“We have to work on this,” she said.

During her visits to Nunavik, Desrosiers said she met local officials, urging them to lobby for a nursing program for Inuit in Nunavik, offered either through institutions in Quebec or in collaboration with an outside institution, as is done at Nunavut Arctic College.

For the past two years, the association has been consulting nurses and traveling around Quebec’s remote regions.

Last month, Desroisers unveiled a package that’s intended to attract interest in Quebec City. It contains a brief on nursing in remote regions, a list of recommendations and information on each region.

Materials in the package, available only in French, are illustrated with many glossy, colour photos of Nunavik and Nunavimmiut.

“The Inuit communities are often forgotten, similar to the nurses, so we wanted a document that was well-illustrated and very visual to show the situation,” Desrosiers said.

The section dealing with Nunavik outlines the region’s geography, population, health policy and organization of services.

Nurses in Nunavik deal with a heavy load of illness as well as with injuries that are often related to substance abuse.

“It takes a lot of maturity,” Desrosiers said. “The difficulties that a community faces have a direct impact on a nurse, who must find out how to be useful without being paternalistic.”

Nurses in Nunavik are often overwhelmed when people return from treatment in the South and still require extensive treatment or care. The “premature return [of mental patients] creates fatigue among nursing personnel,” according to the brief.

Communication difficulties and a lack of resources and support from auxiliary services further complicate the situation.

Among other problems cited by nurses who work in Nunavik are: a lack of compliance by patients with treatment, transportation problems, crowded clinics, lax security, substandard housing, and, in the case of Akulivik, an aging nursing station.

“Generally, I found the nurses dynamic,” said Desrosiers. “The problem is to succeed in preparing them because arriving in the North without preparation doesn’t work. They all told me they wanted a special preparatory course similar to what was once offered in other provinces for ‘outpost’ nursing.”

Desrosiers said this course would have to have a strong cultural component.

“Health, life and death – these are all closely linked to the culture,” she said. “If not, we can’t take the right approach.”

Quebec’s Liberal government and health minister Philippe Couillard have voiced support for many of the association’s recommendations, but there are still some obstacles to overcome.

Doctors, for one, worry that nurses throughout Quebec will want the same benefits as nurses in remote regions.

“That becomes a political battle,” Desrosiers said. “We need Couillard to stick to his guns.”