This article was originally published in Hospital News.
By Claudia Blume
Most of Sein Youn’s work experience as a nurse has been in remote northern communities in British Columbia, such as Port Simpson, Kitkatla, Telegraph Creek and Anahim Lake. Her work at nursing stations in these communities entails a wide range of responsibilities: emergency and primary health care, health promotion and community capacity building. For much of the time, she and her colleagues are left to their own devices. Doctors only come to the communities for a few days each month, and are available for phone consultations the rest of the time.
In 2015, Youn applied to work overseas for Doctors Without Borders/Médecins Sans Frontières (MSF), and eventually went to Pakistan on her first assignment. She found that there were a lot of similarities to her work in the Canadian North. “Both jobs involve great responsibility and a lot of autonomy, and in both settings I had extensive protocols and guidelines to help my practice,” she says.
Juniper Gordon, another nurse with extensive experience in northern BC, has also worked overseas with MSF since 2013. Among the similarities she found is that nurses in both contexts often have to make do with limited resources, and that access to higher levels of care can be challenging. “You need to be quite flexible when working in either setting. Things rarely go as planned and you have to roll with it,” she says. She adds that both contexts involve working in isolated areas, which means mainly socializing with work colleagues. In addition, access to internet and TV is often limited. “You have to get pretty comfortable with your own company and be able to manage the stress of living in isolation,” she says. Gordon points out that her northern experience has also taught her how to manage stressful situations and cope with a high workload in the places she has worked in with MSF, such as South Sudan, Jordan and Myanmar.
Juniper Gordon, pictured centre, says that her northern Canadian experience has also taught her how to manage stressful situations and cope with a high workload in the places she has worked in with MSF, such as South Sudan, Jordan and Myanmar.
'I can better support my patients and the communities I work in'
Dr. AnneMarie Pegg first started her medical career as a community health nurse in Fort Simpson in the Northwest Territories, and later moved from nursing to medicine. She spent part of her medical training in remote northern areas and has for the past few years divided her time between practising medicine in Yellowknife and going on assignments overseas with MSF. Since 2008, she has been working in humanitarian projects around the world, from Haiti to Syria. She says that what humanitarians and medical staff in northern Canada have in common is not only flexibility but also professional courage. “It’s like going outside your comfort zone in order to practice,” she says. “I am not talking about cowboy-style medicine. But if you are part of a small team, in either context, you need to be prepared to face situations you have perhaps only seen once or twice before.”
While there are many similarities, some aspects working with MSF are quite different from the northern Canadian experience. “The context and the kind of injuries and illnesses you see when working with MSF are quite different,” says Gordon. Another difference is that contracts with MSF are often longer, a minimum of six months, and that the salary is lower. For many nurses, the main difference is that working with MSF involves a stronger management role compared to the more hands-on-work in Canada. “As a northern nurse I would be in charge of the clinic’s daily activities, and of managing two to five colleagues. In Pakistan I had to manage two departments with 25 to 30 staff,” says Youn. “And as the medical team leader, I also had to manage the supplies for an entire hospital!” This is one of the reasons why many medical staff alternate between working with MSF and practising in Canada. “My work with MSF is now mainly management, so I don’t get so much hands-on clinical nursing experience at times. It’s nice to be able to come home and keep up my nursing skills,” says Gordon.
Many medical aid workers say that the management skills they have gained overseas make them better nurses and doctors back home. “I can now better support my patients and the communities I work in,” says Gordon. “When I am mentoring new nurses, I can better support them in managing the challenges of working in isolated settings with limited resources. Ultimately, I think my MSF experience has taught me the importance of taking the time to ask questions and to listen to people’s stories.”
Dr. AnneMarie Pegg, right, with MSF in Syria. “It’s like going outside your comfort zone in order to practice,” she says. “If you are part of a small team, in either context, you need to be prepared to face situations you have perhaps only seen once or twice before.”
In high demand
Owen Campbell, field human resources manager for MSF Canada, says that nurses and doctors with work experience in Canada’s north make ideal humanitarian aid workers, and are in high demand by the organization. “We see a definite positive relationship between the quality of the work done in the field and prior experience working in remote, northern communities.”
The organization is looking for medical staff with a broad mix of experience, ideally with a specialization in neonatology or pediatric intensive care, ER and trauma. Bilingual candidates are preferred. Campbell says the organization is recruiting on an on-going basis and that there are opportunities for a long-term career with MSF, with professional development opportunities and the possibility to take on leadership roles.