Horizon Star - March 2021

Meet the Disability Management team Supporting employees with injury or illness Page 7

Special bond Sisters, sisters-in-law and sisters in transplant Page 9

Pandemic history through poetry How the past shapes the present Page 13

Issue No. 25, Vol. 6 March 2021

A publication for the staff of Horizon Health Network

On the map: How a group of internationally- educated nurses made their way to Horizon — and what they learned along the way Page 19

Friendship, Care and Dedication: Five nurses share experiences of working together for over 30 years Page 6 Stitched with love:Wife of Palliative Care patient quilts for future patients and families Page 10

Contents

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Special bond: Sisters, sisters-in-law and sisters in transplant

The Moncton Hospital staff give back to the vulnerable Join Horizon’s SANE team to help care for domestic abuse victims

A shot of hope at Horizon’s health care worker COVID-19 vaccination clinics

Friendship, Care and Dedication: Five nurses share experiences of working together for over 30 years

Meet Horizon’s Disability Management team and learn how they support employees with injury or illness

Research findings from Horizon’s Saint John Therapeutics project published in national journal

Stitched with love: Wife of palliative care patient quillts for future patients

Horizon, NBMS partner on physician wellness project at the DECRH Annual Sussex Health Centre PJ Drive a success

SOCIAL SHOUT- OUT Social Shout-Out 15

On the map: How a group of internationally-educated nurses made their way to Horizon — and what they learned along the way 19

Welcome to the Horizon Storefront! 20

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How the past shapes the present: A look at New Brunswick’s pandemic history through poetry

#ResearchAtHorizon: Collaboration wins top NBHRF honours

Helpful practices to promote self-compassion

Resilience among health care workers during COVID-19

New career, new work-life balance in New Brunswick

On our cover: From left: Colleagues Christina (Tina) Christopher, Janabelle (Jana) Pama, June Panadero and Kriselle (Ellie) Laude pictured at Horizon’s Saint John Regional Hospital in March.

In Every Issue Message from CEO Editor’s Note Colleagues’ Corner Look Who’s Shining

This magazine is published by Horizon Health Network’s Communications Department, and is distributed free of charge to Horizon staff, physicians and volunteers. A French version can be found online at fr.horizonnb.ca. Editor: GinaBeth Roberts Design and layout: Hudson Creative Agency Printed by: Advocate Printing Please send comments and/or story ideas to HorizonStar@HorizonNB.ca .

A welcome note from the editor

Dear Staff, Physicians and Volunteers, It’s hard to believe it’s been over a year since COVID-19 became part of our daily lives — personally and professionally. It was on March 11, 2020 that the World Health Organization declared a COVID-19 pandemic, and it was on that same day Dr. Jennifer Russell, our Chief Medical Officer of Health, announced our first presumptive (and later, confirmed) case. From there, much of the world went into quarantine — while you all stepped up to the unknown challenges in front of you in an ever-changing health care world.

A shot of hope

Welcome to the 25th edition of the Horizon Star! The 25th — or silver — birthday or anniversary of anything is quite a milestone, and I cannot thank you all enough for the support and encouragement I’ve received in creating 25 issues of this publication over the past five years. A huge thank you to everyone who has contributed to its success – everyone who has submitted, written, edited, translated, designed and read stories, and especially those who’ve agreed to be photographed. Together, we’ve created 453 pages of stories (double that, when you consider the French version), and without all of you, the Horizon Star would simply not exist. It is truly a Horizon-wide publication. With competing COVID-19 priorities across the organization over the last year, it wasn’t easy getting here: we’ve adjusted publishing dates, scaled back on pages, and removed some of the more interactive features. But, it was definitely worth it! Both analytics and anecdotal feedback tell me more of you are reading more of the Star than ever before, so I am so happy we can continue to share your stories with your colleagues across the organization, no matter the format. As we continue to respond to COVID-19 throughout 2021, we’ll keep adjusting as necessary. I hope you’ll continue to reach me at HorizonStar@ HorizonNB.ca with new ideas. Happy reading,

at Horizon’s health care worker COVID-19 vaccination clinics The Government of New Brunswick (GNB) announced in December its New Brunswick Immunization Plan for COVID-19.

Hospital, Saint John Regional Hospital and The Moncton Hospital. As of March 23, 2021, over 8,000 Horizon staff and physicians have received their first dose of a COVID vaccine. Thank you to all Horizon teams who are working together to make all of our vaccination clinics a major success, as well as our partners at Vitalité Health Network, New Brunswick Public Health and many more!

And since then, we’ve all had a role to play in getting where we are today: vaccinating New Brunswickers, ourselves included. Our vaccination rollout has really ramped up over the past few weeks and we’ll see this continue in the months to come, as set out in the Government of New Brunswick’s updated vaccine rollout plan. As of mid-March, we’ve sent 14,000 prioritized

Since then, Horizon has been busy establishing COVID-19 vaccination clinics and vaccinating employees and physicians (health care workers), when eligible, who are actively working in our facilities. Clinics for health care workers have been set-up at Horizon’s Miramichi Regional Hospital, Dr. Everett Chalmers Regional

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Karen McGrath President and CEO vaccination appointment invitations to Horizon employees and physicians (health care workers) who are actively working in our facilities. Thousands have already received one or two doses of the COVID-19 vaccine, and this number will continue to increase as many more clinics are planned. This is no small feat. We’ve also helped with clinics for staff and residents of long-term care and First Nations, first responders, allied health professionals and adults with complex medical conditions. While being vaccinated doesn’t change our Public Health and Infection Prevention and Control directives, I do hope it provides you a much-needed shot of hope. Despite this positive news, it’s normal to feel many different emotions – good and bad. In a video, the North American Center for Threat Assessment and Trauma Response explains how “trauma is stored in the body and that the body remembers anniversaries even if the conscious mind does not” and provides brain-based strategies for supporting your mental health and those around you. An interesting perspective, for sure. At next month’s Board meeting (April 15), Horizon will release its new strategic plan with three strategic priorities, each with several objectives. We will share more information with staff and physicians ahead of the Board meeting, as we recognize how important it is for staff and physicians at all levels of the organization to see where they fit within the plan. As such, you will hear much more about our strategic plan, priorities and objectives in the coming weeks and months. As you may have heard, I recently announced my plans to retire, which will be effective as of January 16, 2022. I announced my retirement intentions at this time to provide the necessary notice to government, so the recruitment process can begin. The goal is to have a new leader hired to provide a seamless transition for all of you and our patients and clients. I remain dedicated to you and Horizon and I still have many goals to achieve in the coming months before this transition occurs. Sincerely,

GETTING VACCINATED AT…

GinaBeth Roberts Editor, Horizon Star

Horizon’s Saint John Regional Hospital

Horizon’s Miramichi Regional Hospital

Karen McGrath President and CEO Horizon Health Network

Horizon’s Dr. Everett Chalmers Regional Hospital

Horizon’s The Moncton Hospital

Colleagues Corner

Friendship, Care and Dedication: Five nurses share experiences of working together for over 30 years In the field of nursing it’s common for

Meet Horizon’s Disability Management team and learn how they support employees with injury or illness

patient and their family.” Rita said she chose to be a nurse because three of her friends were going into nursing. “It turned out to be the best decision of my life,” she said. “I love my job as a nurse and teacher and I love taking care of people. Kindness, caring, empathy and compassion are part of who we are.” They share their wisdom and depend on each other’s knowledge every day and through it all continue to put their patients’ health and

well-being first and strive to make them feel comfortable, regardless of the injury or illness. Carol Mason noted that there are two things she loves most about her job: “The people I work with (and the way we work together and support each other) and knowing that I made a difference for someone when I go home at the end of my shift.” “We are very fortunate to have worked together for so long,” said Michele, “and we are proud to be St. Joseph’s Hospital Urgent Care nurses!”

Disability management is an intentional and coordinated effort to mitigate the direct and indirect impacts of disability on employees, their families and their employers. Horizon’s Disability Management (DM) team provides support and resources for staff who are ill or injured at work or outside of work, and who require accommodation support. “When injury or illness occurs, our team provides absence and disability management programming to assist with the overall health of employees,” said Michèle Rankin, Horizon’s Regional Disability Manager. “We are here to educate, empower and support all employees to successfully navigate their journey from illness or injury, to wellness.” Occupational and non-occupational injury / illness Occupational injury / illness is a physical or psychological illness or injury that arises over the course of employment. A non-occupational injury / illness is a physical or psychological illness, injury or personal medical condition unrelated to work. Disability Management focuses on absences from work as a result of both occupational and non-occupational illness or injury, and on the prevention of risks that cause these absences through accommodation, prevention, and support for recovery. Research shows early intervention helps prevent long-term disability. That is why Horizon is committed to assisting its ill and injured employees to recover by providing options to support on-the-job rehabilitation and provide safe, gradual return-to-work programs, like the Direct Referrals to Physiotherapy Program available through a partnership between Horizon, WorkSafeNB and local physiotherapy clinics. When an occupational injury or illness occurs, Horizon’s Disability Management staff manage all reported work-related incidents. Information is reviewed, and documentation is submitted to WorkSafeNB for injury or illness claims in accordance with the Occupational Health and Safety Act and WorkSafeNB policies. Short term absences due to non-occupational injury or illness are most often managed at the departmental level. When these absences grow in duration or complexity, DM is often contacted to provide support for both the employee and manager with absence management options, recover-at-work programs, and safe gradual return-to-work programs and accommodations. Duty to Accommodate Employers have a duty to accommodate. They are required by law to make every reasonable effort to accommodate an injured or ill employee. However, they are not required

Registered Nurses (RNs) to work in several different settings throughout their careers — there are often changes in positions, department and facilities. So, it is very special and rare to have five RNs that have been nursing together at one Horizon facility, in one department, for over 30 years! Carol Mason, Jackie Belyea, Carole Calnan, Rita Brown, and Michele Perkins-Stephen have been RNs at Horizon’s St. Joseph’s Hospital (St. Joe’s) Urgent Care Centre (formerly an Emergency Department) since the 1980s. This team of frontline heroes has worked together through many changes over the past three decades – most notably, the transition of their facility from a 24-hour fully-active Emergency Department (ED) to an Urgent Care Centre in the early 2000s. When they first began nursing at St. Joe’s, medical emergencies would arrive by ambulance to their ED. “Patients would come 24 hours a day to get the emergency care they needed and could be admitted to other units within the hospital,” said Michele. “That changed when the Emergency Department became the Urgent Care Centre (to avoid duplication of services with the newly built Saint John Regional Hospital).” It was a big adjustment for the team, Michele said, “but we adapted! Although our role changed, our commitment to our patients over the past 30+ years, and our desire to make a difference, has remained the same.” Gabrielle Smith, Nurse Manager, explained that like an ED, there are no “typical days” at the Urgent Care Centre — every day is unpredictable. Upon arrival, patients are assessed by an RN and given a triage number. Diagnostic procedures and medical treatments vary depending on the patient. Every patient’s needs are unique, and so are these five nurses. What makes them unique is not just their ability to adapt to this ever-changing environment, but their teamwork and friendship. “We have shared good times and bad, busy days and quiet days,” said Jackie. “My co- workers always have my back and coming to work is like coming to my second home. St. Joe’s is the best!” When asked what her favourite thing about working at St. Joe’s Urgent Care Centre is, Carole Calnan said: “the collaboration of care as a team, focusing on the well-being of the

From left: Robin Savoie, Disability Clerk; Michèle Rankin, Regional Disability Manager; and Brigitte Carter, Senior Disability Coordinator, Saint John Area, at Horizon’s Saint John Regional Hospital.

Graphic from: Government of Canada

to offer accommodations if it causes them “undue hardship,” taking into account factors such as financial costs, service disruption, health and safety concerns, and collective agreements. Although the employer has the primary responsibility to accommodate since the employer has control of the workplace, everyone has a role to play including the union and the employee: Employer: • Ensure employees are aware of their right to accommodation • Be informed on the employer’s legislated duty to accommodate and be able to review this with employees • Explore accommodation to the point of undue hardship and be willing to revisit and modify these as needs change • Demonstrate equal treatment of employees and respect employee confidentiality • Manage simple and straightforward accommodation requests independently • Consult with Human Resources or Disability Management on any questions that arise or to request assistance with more complex cases Employee: • Take preventative measures to ensure personal safety and wellness • Request accommodations when needed and suggest appropriate measures when possible • Provide medical documentation to support limitations and restrictions Union: • Provide employees with accommodation advice and guidance • Support accommodation measures regardless of the collective agreement, unless to do so would impose undue hardship The DM team offers guidance, tools and expertise to support employees and managers through successful recover-at-work, return-to- work and workplace accommodation plans by exploring a number of different options, such as modified duties, alternate work, and more. The DM team has resources available to provide assistance in each major facility across Horizon.

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From left: April Leet, Junior Disability Coordinator, Fredericton/URV &Moncton reas and Jaime Maynard, Senior Disability Coordinator, Moncton Area, at Horizon’s The Moncton Hospital.

Carol Mason, Jackie Belyea, Carole, Calnan, Rita Brown and Michele Perkins-Stephen have worked together as Registered Nurses and friends at St. Joseph’s Hospital Urgent Care Centre for over 30 years.

From left: Lacey Melanson, Disability Clerk and Kim Currie, Senior Disability Coordinator, Fredericton & URV Area, at Horizon’s Dr. Everett Chalmers Regional Hospital.

Lisa Connors, Junior Disability Coordinator, Miramichi & Saint John Areas at Horizon’s Miramichi Regional Hospital.

KimberlyWilliston, Senior Disability Coordinator, Miramichi Area at Horizon’s Miramichi Regional Hospital.

Front to back: Rita Brown, Michel Perkins-Stephen, Jackie Belyea, Carole Calnan and Carol Mason.

Want to tell your colleagues about the services you provide for patients and staff throughout Horizon? Email HorizonStar@HorizonNB.ca .

Research findings from Horizon’s Saint John Therapeutics project published in national journal

Special bond: Sisters, sisters-in-law and sisters in transplant

Linda Duncan, a nursing unit clerk at Horizon’s Saint John Regional Hospital (SJRH), jumped on the opportunity to go from being a Horizon employee to a Horizon patient. In 2020, Linda’s sister Sandy became ill with a recurring Clostridium Difficile Colitis (C. Diff) infection. When asked, Linda, who has been part of the Horizon team for 32 years, did not hesitate to help her sister. “When Dr. Jacquelyn LeBlanc, an infectious disease specialist asked me (to do a fecal transplant), I replied with, “Do you mean a poop transplant?’” Linda laughed as she said how unique it sounds. Linda and Sandy have a special sisterhood. They are sisters by blood, but they are also sister-in-laws, having married the Duncan brothers 47 and 49 years ago. Throughout the years the Duncan family has experienced a lot, but in March of 2020, they embarked on one of their most challenging experiences. For many, March 2020 brings back thoughts of the beginning of the COVID-19 pandemic in New Brunswick, but for the Duncan sisters the month also marks Sandy’s breast cancer diagnosis. In April, Sandy underwent lumpectomy surgery. “Since it was day surgery, she didn’t need to stay in the hospital, which we were thankful for, due to COVID-19 restrictions,” said Linda. “But in the months following surgery, Sandy wasn’t feeling well, and she needed to be admitted to the hospital in July for C. Diff.” C. diff can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. The Duncan sisters anticipated a short

call themselves to book an appointment at a time convenient for them, with high priority patients receiving priority appointments,” said Becky. “The small change made a big impact in administrative efficiency.” A few months into the implementation of OAB, a University of New Brunswick professor and applied psychologist, Dr. David Speed, who was looking to conduct advanced studies in the area of OAB, began working with Becky and Shelly Fyffe, former Horizon Process Improvement Facilitator, to analyze the findings of the OAB project, beginning with OT data. The goal of the study was to see if OAB improved administrative outcomes in OT. The study looked at the number of referrals, wait times for first appointments, whether there would be more rapid discharges, and whether there was a change in missed appointments. Becky and her team monitored raw data for number of calls, no shows and wait times to track the progress when using OAB.

Occupational Therapy (OT) data collected from Horizon’s Saint John Therapeutics’ Open Access Booking Model Project has been published in a national journal. Open-access booking (OAB) refers to the administrative system by which patient appointments are scheduled. In 2017, a need was identified to make scheduling patients in Therapeutic Services, including OT, Physiotherapy, Audiology and Speech Language Pathology in the Saint John area more efficient. Becky McCollum, Director of Therapeutic Services Saint John Area and her team wanted to reduce outpatient waitlists and increasingly long wait times experienced by patients for these services. Through a LEAN Six Sigma approach, the Saint John Therapeutics team transitioned to an open access booking model. “Patients were able to self-refer and could

The results of the study in OT found there was an increase in referrals from clients. Wait times did not necessarily decrease, however more clients were seen. It was found that patients were discharged faster, as they would progress more rapidly through the OT system with the same quality of treatments. This allowed therapists to take new clients sooner. There was no change recorded in missed appointments for OT, although this was seen in the data for the other disciplines involved. This work was published in Volume 87, Issue 5, of the Canadian Journal of Occupational Therapy 2020 in an article titled “Investigating Open-access Booking in New Brunswick Occupational Therapy” by Dr. David Speed and Shelley Fyffe. With the overall success in improving administrative outcomes, OAB will become a regional solution, set to roll out to Therapeutics in the Moncton, Fredericton and Miramichi areas in the spring of 2021.

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Sisters Linda Duncan (right) and Sandy Duncan (left) have many incomparable experiences in life, including marrying a set of brothers. In 2020 they added a fecal transplant to their list, which helped Sandy recover from ClostridiumDifficile Colitis (C. Diff).

hospital stay, however Sandy’s condition continued to worsen with many problems arising, including kidney failure. “While being in the hospital, Sandy missed her window of opportunity for radiation,” Linda said. “She has been through a lot, but was able to get better, and I am so happy that I was able to help.” When Linda started sharing the news that she would be doing a fecal transplant for her sister, many colleagues and friends expressed how they have never heard of the procedure. “Fecal transplant is recognized as a very effective modality for cure in patients who fail

standard therapy for Clostridium Difficile,” Dr. LeBlanc said. The procedure, performed by gastroenterologist Dr. Cory Gillis, was a success, and Sandy was discharged in October. Today, she is back to running errands and going about her routine. “We are so thankful to all the staff. Sandy spent time on many different units and everyone was great,” Linda said. “We wanted to share our story, so people can hear about fecal transplants and how for us it was a great option to help Sandy.”

Sisters Linda Duncan (left) and Sandy Duncan (right) have many incomparable experiences in life, including marrying a set of brothers. In 2020 they added a fecal transplant to their list, which helped Sandy recover from ClostridiumDifficile Colitis (C. Diff).

Becky McCollum, Director of Therapeutic Services, Saint John area (right) sits with Tracy Underwood, OT Manager Saint John Area, who played a key role in the success of the OAB project. The Saint John Therapeutics Open Access Booking Model Project won Horizon’s Quality Quest Award in 2019.

Stitched with love: Wife of former Palliative Care patient quilts for future patients and families

Horizon, NBMS partner on physician wellness project at the DECRH

“A bit of comfort in memory of Eldon Gilmore 2020” is stitched on the back of seven handmade quilts in the Palliative Care unit at Horizon’s The Moncton Hospital (TMH). Those simple words and the kind gesture behind them have provided much needed warmth and comfort to palliative care patients and their loved ones. When Rosemonde Gilmore’s husband Eldon passed away in the summer of 2020, after a month-long stay in the Palliative Care unit, she knew she wanted to do something to honour his memory. So, she began quilting. Quilting became an addictive hobby she picked up after retiring from her long career as a pharmacist. She learned most of her techniques through Victoria’s Quilts Canada, an organization that makes and donates quilts to people living with cancer in Canada.

“There are seven beds in palliative care, so I wanted to do (quilt) one for each bed,” said Rosemonde. In two months, she completed six quilts, each with unique fabric and pattern. A quilter friend offered one of her creations so Rosemonde could have seven quilts to donate. “The quilts have a positive impact on our patients, as they provide a home-like environment, warmth and comfort at a very difficult time,” said Lana Hebert, the unit’s nurse manager. “Patients and families use them to cuddle up with. They are wonderful for keeping patients warm at night.” Days and nights in palliative care can be long, and having extra comfort goes a long way. Rosemonde knows first-hand the difficult experience of sitting with a loved one in palliative care. “The quilts are for the patients and the family,”

she said. “Family members are sitting there for months on end. Just sitting there, day after day, and they get cold.” Lana and her team were surprised by the caring gesture. “This act of kindness and concern for other people going through a very difficult time is inspirational,” said Lana. “The donation helped staff realize how much the care they provide impacts not only the patient, but their family.” Rosemonde is overcome with emotion when she reminisces about her experience delivering the quilts to the palliative care team. “When I brought the quilts in, two of the staff came out and gushed over them,” she recalls. “These were the people I saw a lot when he (Eldon) was in the hospital, so it meant a lot to see how happy they were.” Eldon, of course, had his own quilt while he was a patient, but that one is stored safely at home.

When physicians at Horizon’s Dr. Everett Chalmers Regional Hospital (DECRH) in Fredericton approached the New Brunswick Medical Society (NBMS) and its Wellness program about supporting the installation of a bicycle rack at the hospital, it was a natural fit. “NBMS Wellness is here to support physician wellness initiatives, and this was a project that had been on the minds of physicians for some time,” says Lisa LePage, chief operating officer of the NBMS. “We saw great value in partnering with Horizon on this project.” Though it was delayed by the pandemic, a new bicycle rack that accommodates both modern bicycles and fat bikes was installed in November 2020 at the hospital’s physician entrance. The rack, installed on a new concrete pad, enables physicians to better secure their bicycles if they cycle to work. It has spots for 14 bicycles. “Physicians are extremely busy, so it can be hard to find time for exercise,” says Dr. Erica Frecker, head of the Department of Obstetrics and Gynecology at the DECRH who initially approached NBMS Wellness about this project. “Biking is a great way to clear my head between home and work.” Daniel Lynch, Manager of Facilities Management at the hospital, said the previous bike rack was older, less secure and did not accommodate some modern styles of bicycles. “This was on our wish list for a couple of years but when the NBMS reached out in support, we were able to expedite the project,” he said. “We had a lot of communication back and forth in terms of timelines. We tried to push it through quicker but given the year that we’ve had with COVID and delays securing a

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Dr. Erica Frecker, Head of the Department of Obstetrics and Gynecology at Horizon’s DECRH, and Dr. LiamHickey, Urologist, in front of the hospital’s new bike rack.

said. “I know I feel better when I am more physically active. With our busy schedules, finding time for exercise is difficult. Now that there is a reliable place to secure bicycles at the hospital, there is one less barrier for us to work physical activity into our commute.” This article was published in collaboration with the New Brunswick Medical Society (NBMS) Communications team.

contractor, it just wasn’t possible.” Despite the delays, he was glad to see it installed. Dr. Liam Hickey, a urologist at the hospital, believes health facilities play an important role in promoting healthy choices. “Encouraging and facilitating active transportation is a simple way to send a positive message to the public about making healthy choices,” he

Fourth annual Sussex Health Centre PJ Drive a success

Staff at Horizon’s Sussex Health Centre once again collected pajamas for the Sussex Salvation Army in mid-December as part of their fourth annual PJ Drive. Despite the pandemic, this year’s drive proved to be very successful, with 308 pairs of pajamas donated to the community. Estelle Arbing, an Emergency Department nurse, spearheaded the drive, which garnered support from staff, friends, family and community members. “With the current situation we’re in because of the pandemic we didn’t set a goal for this year’s drive,” said Monica Tays, Nurse Manager. “We felt that any amount would be a blessing.” The Sussex Health Centre PJ drive has donated 827 pairs of pajamas since 2016 to help keep the community warm and cozy and the team is already looking forward to their fifth annual drive in 2021!

PJ Drive Project Lead Estelle Arbing, RN, preparing to donate the 308 pairs of pajamas to the Sussex Salvation Army.

Two of the seven handmade quilts Rosemonde Gilmore donated to the palliative care unit at Horizon’s The Moncton Hospital.

The Moncton Hospital staff give back to vulnerable community members

How the past shapes the present: A look at New Brunswick’s pandemic history through poetry

Sometimes, it’s the little things that mean the most. But access to some of life’s little essentials can be hard to come by for the most vulnerable in our communities. To help ease the burden during the holiday season, staff from the Emergency Department and the Sexual Assault Nurse Examiner (SANE) program at Horizon’s The Moncton Hospital (TMH) worked together to help provide everyday essentials to those who need them most. “We decided to donate little gifts to help put a smile on someone’s face,” said Emmanuelle Landry, SANE Coordinator for the Moncton and Miramichi areas. “Throughout the COVID-19 pandemic, a lot of people have been struggling.” Emmanuelle and Trena Brown, nurse manager of TMH’s Emergency Department, reached out to staff asking for their help and collected generous donations. They were overwhelmed with the positive response from staff who wanted to contribute and received more donations than expected. “It always feels good to help others and to give back,” added Emmanuelle. With a goal in mind to help people who an underserved population, they decided to donate bags of essentials to people at Youth Quest Central and The Sanctuary. Youth Quest Central is a multi-resource centre for youth aged 16 to 24 who are either homeless or at risk of becoming homeless. The Sanctuary provides a positive and safe space for those who work in sex-trade by chose or survival reasons.

Glen Sheppard, Manager of Budgets and Reporting, Financial Services at Horizon’s Woodbridge Centre writes about how the Ministry of Health began in New Brunswick, and how its response to the Spanish flu laid the foundation for the province’s COVID-19 response, over 100 years later.

NewBrunswick Pride In 1917Dr. WilliamRoberts was elected to a Saint John liberal seat Twice he brought forth a Health bill, that resulted in defeat He tried again, with enough community support it could no longer be debated This is how the first Department of Health in the British Empire was created When the Department of Health first started it had a staff of two It was just created when NewBrunswick was hit by the Spanish Flu Dr. Melvin as the Chief Medical officer acting on behalf of the Crown First official act was a proclamation shutting NewBrunswick down In order to slow the spread schools, churches and theatres were closed People were not to gather in large crowds to reduce others getting exposed Masks were worn and travel by ferry and train was restricted Over 100 years later, the same advice, who could have predicted

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Emmanuelle Landry, SANE Coordinator for the Moncton and Miramichi areas, presents donations to representatives from Youth Quest Central. Bags contained several essentials, such as feminine products, shampoo, soap, nail files, mouth wash, toothbrush, toothpaste, nail polish and perfume. Access to essential items like feminine products or soap are a guarantee for a lot of people, but can be devastating for those who don’t have access to the items they need. Florence (Flo) Bastarache, Finance Department

Emmanuelle, with representatives of The Sanctuary

cashier at TMH added her special touch to the donations by providing handmade toques, scarves and mittens — much needed items to help people through Moncton’s cold winters. Emmanuelle had the opportunity to deliver the bags and said, even through the masks, you could see the huge smiles of recipients. Both organizations were thankful to be on the receiving end of kindness from Horizon staff.

The Spanish Flu you could feel fine in themorning and the next day be pronounced dead Still a small few defied the proclamation gathered and held dances instead

Sounds familiar, human nature, temptation, it won’t happen tome I wish some people paidmore attention when they studied history

Join Horizon’s SANE team to help care for victims of domestic violence and sexual assault Horizon’s Sexual Assault Nurse Examiner (SANE) program is looking for registered nurses (RNs) to join their team. The SANE program plays an essential role in the care of victims of domestic violence and sexual assault. Typically, they are the first person to treat a victim and hear their story. Training sessions take place throughout the year to prepare RNs for the role. RNs begin their SANE clinical work with a mentor who provides support and guidance.

Dr. Roberts andDr. Melvin contacted all the doctors and nurses Redeployed provincial staff to help stop the need for more hearses FHS home ec department was used by the Red Cross tomakemeals for the sick With resources all coordinated they could react to situations really quick Due to their actions, NewBrunswick had one of the lowest mortality rates Nothing like a real pandemic to help them to demonstrate It’s hard to believe how similar these pandemics really are With all our technological advances, we really haven’t gotten very far One NewBrunswicker full of devotion Set the Department of Health concept inmotion With some help from the Spanish Flu Made Canada and the world realize how important this concept is too

The SANE program requires staff to be on-call on a rotational basis, outside of their primary RN role. During these shifts, RNs will work one-on-one with victims, often during one of the worst times of their lives. RNs in the SANE program provide compassionate care, without judgement. They provide a head-to-toe, forensic examination. They provide consistent, uninterrupted and supportive care and treatment to the victim and collaborate with RCMP and municipal police forces, the legal system, victim services and other community-based support services. If this sounds like a role for you, contact the SANE coordinator in your area or email the SANE inbox: SANE.Coordinators@horizonnb.ca.

HORIZON’S SANE COORDINATORS Moncton and Miramichi areas: Emmanuelle Landry, 506-857-5686 or Emmanuelle.Landry@HorizonNB.ca Fredericton and Upper River Valley area: Robyn Kenney, 506-459-6540 or Robyn.Kenney@HorizonNB.ca Saint John area: Maureen Hanlon, 506-653-2926 or Maureen.HanlonE@HorizonNB.ca

#ResearchAtHorizon: Collaboration to improve outcomes for spinal fusion surgery patients wins top NBHRF honours Throughout 2020 the New Brunswick Health

S O C I A L S H O U T - O U T

surgeons Dr. Edward Abraham and Dr. Neil Manson, and the Canada East Spine Centre’s research team: Erin Bigney, Eden Richardson, Dana El-Mughayyar, Mariah Darling and Amanda Vandewint. Taking an integrated approach to treatment, the team examined how a prehabilitation program could improve patients’ outcomes following their spinal fusion surgery. It is thought that the pre-conditioning offered through cardiac rehab may improve patients’ physical functioning capacity and mental health at baseline, leading to improved post- operative disability and pain outcomes. Using the NBHC’s cardiac rehabilitation programming, patients in the study were randomly assigned to cardiac rehab and treatment, or treatment as usual without cardiac rehab. This study is currently in the enrolment stage. If the data supports the hypothesis that participation in the cardiac rehab program prior to spine surgery improves patients’ outcomes, then it will be offered provincially to at-risk spine surgery patients. There are so many impactful research projects being done in the area of medicine here in New Brunswick and with that in mind, CESC is incredibly honoured to have received the recognition of the Research Team of the Year from the NBHRF. This project would not have been possible without the financial support from the Saint John Regional Hospital Foundation and the McCain Family Foundation.

It is important when looking to improve patient quality of life to look at the patient holistically. Traditionally, in medicine, surgical specialties tend to only view patient care through the lens of their specialization, but this approach can result in failure to identify risk factors, or miss opportunities for preventative care. This project aims to improve patients’ chances of minimal adverse events while maximizing chances to decrease post-operative pain and disability, leading to overall improvement in patient quality of life. 2020 Research Teams of the Month Featuring Horizon Researchers: Pan Canada Collaboration Investigates Traumatic Cauda Equina Injury (March 2020) https://huddle.today/pan-canada-collaboration- investigates-traumatic-cauda-equina-injury/ The Reality Of Life Satisfaction Following A Traumatic Spinal Cord Injury (April 2020) https://huddle.today/the-reality-of-life-satisfaction- following-a-traumatic-spinal-cord-injury/ Looking Beyond Patient Averages: Steps Towards Personalized Care (July 2020) https://huddle.today/looking-beyond-patient- averages-steps-towards-personalized-care/ Giving Patients And Caregivers A Voice In Setting Research Priorities (August 2020) https://huddle.today/giving-patients-and- caregivers-a-voice-in-setting-research-priorities/ Research Team Looking To Improve Quality Of Care For Heart Surgery Patients (September 2020) https://huddle.today/research-team-looking-to- improve-quality-of-care-for-heart-surgery-patients/

Research Foundation (NBHRF) accepted nominations for the top health research collaboration in the province. Each month, a project showcasing work being done as a team was featured, highlighting that we are better together. In February, the Canada East Spine Centre (CESC) http://www.canadaeastspine.com/ received the first of what would become four awards for the 2020 competition (again in March, April and July). Research conducted by the CESC aims to translate into improvements in the care and outcomes for those who suffer from various spinal conditions. The dedicated team investigates ways to most effectively treat patients holistically. This involves exploring such topics as: the impact of psychological and social factors on patient outcomes following spine surgery; patients’ patterns of narcotic use to manage their pain; and strategies that can be employed in the peri-operative period to optimize patients’ response to treatments. Ultimately, it was the February submission (see article published by Huddle here) that garnered them the top honours as 2020 Health Research Team of the Year. The February 2020 team feature showcased a new collaboration between Dr. Robert Stevenson and physiotherapist Stephen Mundle from Horizon’s New Brunswick Heart Centre’s (NBHC) Cardiovascular Health and Wellness Program; together with, orthopedic

On Horizon’s social media platforms, we’ve heard frommany of your patients, clients and families about the professional, safe and quality care you provide. In this recurring feature, we’ll highlight some of these “social shout-outs.” If you see a social shout-out, tell us about it by emailing HorizonStar@HorizonNB.ca.

Troy Lifford @TroyLifford Up at the DECH for some x-rays. #COVID19screeners doing an excellent job. Keeping the line moving but asking the questions to keep everyone safe. @HorizonHealthNB 1:53 PM · Dec 9, 2020 6 Likes

Gale Allen A true compassionate leader. Thanks Rhonda, you help improve patients’ and staff’s lives daily. 2:26 PM · Oct 28, 2020 4 Likes Laura Mazerolle I am so happy for these dedicated nurses, doctors, caretakers, medical workers, and everyone helping, to take care of people! Kudo for being so dedicated and to help people’s lives, on a daily basis! You are ALL, so very precious and, we love YOU all!! Oct 28, 2020 @Carol_Reimer You are all doing a great job. Thanks to all of Horizon. All departments. All working together in a time of shifting data and plans for the health of all of us. So thankful to have you at the pivot point of care. Editor’s Note: Carol Reimer is Horizon Board member.

Kate @cummingsgoing

Good morning @HorizonHealthNB, I need to shout out the people at the DECH blood lab. In and out in 20 min even with COVID protocols. Super friendly, efficient, and painless. 9:09 AM · Feb 3, 2021 1 reply 8 Likes

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From top left corner, clockwise: Dr. Edward Abraham; Dana El-Mughayyar, Eden Richardson, Erin Bigney, Amanda Vandewint; Dr. Neil Manson; Dr. Rob Stevenson; Mariah Darling; Stephen Mundle.

Helpful practices to promote self-compassion

Resilience among health care workers during the COVID-19 Pandemic

Brandi Person, Clinical Psychology Intern

Megan Pollard, Clinical Psychology Intern

for others, prevents against compassion fatigue, promotes resilience, increases happiness, boosts self-esteem, and protects against mental health concerns. The good news is anyone can learn self-compassion and there are many practices that have been developed to help us comfort and care for ourselves in this way!

This past year has been incredibly stressful for many people. Managing the challenges of daily life while navigating a global pandemic is an enormous task and it’s easy to be critical of ourselves for not knowing how to do this. Today, I wanted to share some tips to help cultivate self-compassion. So, what is self compassion? Self-compassion is being open to your own suffering, experiencing feelings of caring and kindness for yourself, taking a non-judgemental attitude toward personal flaws, and recognizing that your experience is part of the common human experience (Neff, 2003). It means viewing your personal struggles in the same way you would a friend or loved one when they are struggling. Self-compassion has 3 key elements: 1. Mindfulness – which helps be present and separate us from our worry/fear; 2. Common humanity – which reminds us that we are not alone in our suffering and protects against the loneliness of social distancing/isolation; and 3. Self-kindness – which regulates fear through connection and warmth with ourselves. Self-compassion has many benefits. Researchers have found it fosters compassion

as humans during a time of social distancing and isolation. Luckily, we can provide this comfort for ourselves! Don’t be afraid to give yourself a hug or place a hand over your heart to feel the warmth when you need it most. • Compassionate Letter: Write a letter to yourself from the perspective of someone who loves you unconditionally. • Focus on a perceived “flaw” or “failure” you have been judging yourself for and ask yourself, “What would my friend say about this?” “How would they convey their compassion for me, especially when I am judging myself so harshly?” • Fill the letter with the sense of kindness and caring you feel from this person. • After writing the letter, leave it for a while then come back and read it later. Allow yourself to believe the words and feel the compassion and other emotions sink in. • Taking Care of the Caregiver: Health care workers need time to recharge and take care of themselves in order to take care of others. This involves giving yourself permission to meet your own needs. • Off the job self-care: Spend time outside of work doing things you enjoy — listen to music, do yoga, spend time with family or those in your bubble, take a bath, play a board game, etc. • On the job self-care: It can be hard to find the time during work to take care of ourselves. When you are stressed or overwhelmed at work try: i. Using self-soothing words (e.g. “I know this is hard and it is OK that you are stressed. Take a minute to breathe.”). ii. Soothing Touch – place one hand on your heart and abdomen, take 2 to3 deep breaths, notice the gentle pressure and warmth of your hands, feel your chest rise and fall naturally. I hope you find these practices helpful and thought-provoking. Remember: self- compassion is a skill and may require time and practice to reap the benefits. Imperfection is part of being human and self-compassion allows us to provide ourselves with the love, connection, and support we need to handle whatever challenges come our way.

As a clinical psychologist in training, I am eager to share howwe can borrow various psychotherapeutic principles to help build resilience inyou—our healthcareworkers (HCWs). The impact of COVID-19 Stress associated withmultiple recommendations from authorities, fear of illness for oneself and loved ones, social discrimination or stigma, financial instability, extended periods of isolation, and ongoing loss and grief is jeopardizing the mental health and resilience in the general population, but HCWs are arguably the most affected group of people in the fight against the virus. Unfortunately, you as HCWs face additional challenges that increase your vulnerability to distress and burnout. You must cope with rapidly changing policies, adapt to work outside your usual scope, manage fear and uncertainty about personal protective equipment (PPE), navigate moral distress and witness trauma. As a result, you are at risk for diminished mental health amidst the pandemic. In a recent study, just over half of HCWs surveyed reported depression symptoms (50.7%), while 44.7% experienced anxiety and 36.1% reported a sleep disorder. Promoting Resilience in Health CareWorkers Resilience can be defined as adapting to changes caused by stressful events in a flexible way and recovering from negative emotional experiences. It’s about our ability to withstand adversity. In health care, resilience encompasses being able to care for patients and oneself while enduring uncertainty and unpredictability. Now, there is the added stress of a global pandemic that has infiltrated our work life (and personal life). COVID-19 is a major threat to our resilience, and research shows we need to protect the mental health of HCWs during the pandemic. After all, maintaining the success of the health care system and provision of health care services depends on the well-being of you, our HCWs. According to the American Psychological Association, it is crucial to promote psychological resilience of during the pandemic so you may continue to work with the intensity and focus your jobs require. Because of your training in understanding wellness, distress, and psychotherapeutic treatment, psychologists are well positioned to respond to this need. Applying Psychotherapeutic Principles to Bolster Resilience Here are a few examples of psychotherapeutic techniques that can offer you the opportunity for reflection and validation, and for learning about the nature of stress, coping, and resilience: • Group Therapy: A group setting offers an opportunity to amplify existing connections

within the health care team. Group learning and discussion of shared experiences can promote collegiality, understanding, connection and belonging. Sharing success stories can help you find joy amidst chaos and can reinforce a sense of purpose. Challenges brought on by the pandemic can be openly discussed and problem-solving can become a team effort that offers valuable support. • Cognitive Behavioural Therapy (CBT) can illustrate the relationship between thoughts, feelings, and behaviors. It emphasizes that even when so much is uncertain and out of our control, we can remain in charge of our own thoughts. Identifying cognitive distortions can be a place to start. An example of such a distortion is “catastrophizing.” HCWs are trained to anticipate worst-case scenarios in the clinical setting, but this pattern of thought can lead to anxiety and fear when applied to other contexts. In terms of behavioural activation strategies, recommendations for behaviours that may have a positive impact on emotion (e.g., exercise, socializing virtually) can provide you with practical guidance. • Mindfulness-Based Stress Reduction can be used to facilitate stress management. Breathing exercises, body scans, and short, guided meditations are grounding. These techniques can be empowering when practiced individually or with patients. This practice may simply entail taking two minutes during each shift to focus on your breathing and give your body a break. An alarm can be set to remind you to take a moment to relax and refocus. • Interpersonal Therapy: Speaking openly

about the process of grief and life transitions can be normalizing and validating as we relate to others, especially when colleagues are grieving (e.g., working with dying patients and their families, losing loved ones to COVID-19, and experiencing the loss of typical social connection). A common role transition that has emerged during the pandemic is from clinician to “hero.” As society applauds the heroes working on the front lines, you may struggle with this new identity and how to navigate it, managing feelings of being an impostor, not doing enough, and not receiving adequate compensation to take on the new title. • Dialectical Behaviour Therapy (DBT) can identify gray areas where opposing ideas co-exist. Sentiments such as, “I am tired and scared and I do not want to go to work” and “This is my calling and I love my job” are common themes. DBT encourages us to hold these thoughts in mind and allow them to both be true, reducing the tension of having to choose. DBT can also focus on the ways you regulate your emotions (e.g. identifying how emotions escalate into distress and how you might de-escalate yourself). • Motivational Interviewing focuses on rolling with resistance and prompting change. It can be helpful in supporting HCWs who are struggling with maladaptive habits and behaviors imposed by the pandemic. To all HCWs: thank you for being resilient during these difficult times! I encourage you to seek support if you are feeling overwhelmed by the impacts of COVID-19.

• Take a Self-Compassion Break: Think of a situation in your life that causes stress and try to feel the emotions associated with it. Say to yourself: a) “This is a moment of suffering.” b) “Suffering is part of life.” (Put your hand over your heart to feel the warmth of touch.) c) “May I be kind to myself.” (Ask yourself what you need to hear in that moment and say it to yourself.) • Soothing Touch: It is more difficult to receive the physical touch/comfort we need

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For more self-compassion exercises see: self-compassion.org

Megan Pollard is a Clinical Psychology Intern working with Horizon this year. She currently works at Horizon’s Dr. Everett Chalmers Regional Hospital and Horizon’s Stan Cassidy Centre for Rehabilitation.

Brandi Person, Clinical Psychology Intern

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