nursingforsocialjustice

When We first moved back to the Lower Mainland in 2015, I was new to my job, new to the area I was living in, by myself of the first month and 17 weeks pregnant with our fourth child. I am a nurse, I completed graduate school, I just left a leadership position health care job in Calgary, and I had had 3 babies before (2 of them in the Lower Mainland). Still, the process of finding a new place to live, finding a new midwife (and I already started the process as soon as I was pregnant in Albert), paying for the visits (because my health coverage was still my Alberta health since I had not lived in the province for 3 months and the benefits for my new job were not yet active), re-connecting with old family doctor, being hassled by my employer about taking time off to go to my midwife appointments, it was all overwhelming. And, I was a person familiar with the system, who had a decent job, and reasonable financial means. At that time I came to better understand the barriers that are experienced to accessing what we often to refer to in Canada as free and equitable health care.

Last year, my 75 year old mother was diagnosed with cancer. Again, we experienced the barriers first-hand. My mother uses a wheelchair, she refused to see the doctor until one day she was in crisis and asked me to call 911. It was from that Emergency Department visit, almost 3 years after we moved, after 3 years of not being able to find a family doctor (I could not find one in the city we live in was taking new patients) that she was referred to a specialist. A year later she has had surgery, received a chemo, and radiation treatments that were all quite a burden on her and us. Did you know that chemo is a half-day (sometime all-day) event? Along with bi weekly follow up appointments and bloodwork? Did you know that radiation happens everyday for 25 treatments? And that follow up happens in a city that has a BC Cancer Agency? And that some of the appointments and treatments can happen in another, different city than that city, not close to the city you live in right now? My partner and I learned all of this. ‘Twas a tremendous learning experience, it happened, we mostly made it through. Between my partner, my brother (who came out from Calgary 3 times) and I, we helped and supported her through it. But I can only imagine how tough it would be for someone who without social support, without a car, without an understanding manager, to go through this process.

As Canadians, we do have access to healthcare. The choice to have a midwife or an OB, the choice to deliver a baby at home, quick access to cancer treatment (which is extremely expensive), is amazing. But I think we also have to acknowledge that there are many barriers to being able to access treatment and to successfully navigate the system. Healthcare is covered, but not transportation or parking, unpaid time off of work, or if you are new to the province and do not yet have benefits. I can only imagine what the experience is like for someone new to the country, who does not speak English fluently, someone who does not have a car or live near public transit, someone who does not have social support. We have to think about this if we want to system to change. The first step, is perhaps thinking about the rigidity of appointments and that sometimes feeling of frustration we get when our patient/client is late to an appointment or does not make the appointment. It might be worth it to follow up and find out how we can better facilitate getting whatever service it is, instead of giving them one more chance and saying “that was your choice,” patting ourselves on the back because they, after all, made an informed decision and if they really wanted to engage in the service then they would make it to their appointments. Perhaps it would be beneficial to ask them about what else is going on in their life, and make a connection, build our empathy and compassion by contextualizing their experience.

Peace,

Michelle D.