By Leah Geller
No place like home
Julie Francis has a true understanding of the needs of her community
Two things became clear to Julie Francis during her first year of nursing studies at St. Francis Xavier University.
The first was that she would return to her Mi’kmaq home of Eskasoni to practise. The reserve, located along Bras d’Or Lake in eastern Cape Breton, is the largest community of Mi’kmaq people in the world, with about 4,000 living there.
“When I started university, I already knew aboriginal people had higher rates of diabetes and heart disease. But up until that point, I really had no idea about the relationship between the determinants of health, such as education, housing and employment, and high rates of morbidity and mortality. That’s when I knew I wanted to take everything I was learning back to Eskasoni.”
The second discovery was the lack of current research on what needs to be done to improve the health status of aboriginal people. “I’d be working on a project and have a really hard time finding up-to-date, peer-reviewed articles on aboriginal health-care issues,” Francis explains. “The reliable sources just weren’t there.”
Today, she is helping to fill that gap in knowledge through her work on Understanding Pediatric Pain in Aboriginal Communities, led by the Centre for Pediatric Pain Research, based out of Halifax’s IWK Health Centre, in affiliation with Dalhousie University. Francis is the nurse research coordinator and a community-based researcher on the team.
“There were numbers and rates about pain in aboriginal children, but no one was talking to them directly.” She has since interviewed close to a hundred of Eskasoni’s children and youth to explore how they express their pain and how the pain is interpreted by parents, teachers, elders and health-care professionals. The research team’s findings show that Mi’kmaq children tend to hide their pain; instead of describing its intensity, they will use storytelling to explain what happened to them. These stories, according to Francis, can sometimes be misinterpreted. “Health-care professionals need to evaluate pain differently when they’re working with these kids. Cultural competency is key for providing compassionate care.”
The team plans to produce a video to share the findings. Meanwhile, First Nations community health centres across Canada have shown interest in becoming involved in the study.
Francis fits her work as a researcher into an already hectic schedule, dictated by her full-time job as one of the community health nurses at the Eskasoni Community Health Centre. After just two years in the position, she appears to have developed a special talent for figuring out what the community’s needs are, and she is proactive in finding ways to address those needs.
When Francis returned to Eskasoni after graduating with a BScN, she began coaching high school basketball. She was surprised at how eager her players were to talk about social and personal issues like bullying and low self-esteem. “I thought, I want to do something for the girls in this community.”
While continuing to provide support to the girls on the team, Francis also approached the health centre’s director with an idea for a series of self-esteem workshops for girls in elementary school. Her director agreed and found funding for the project.
“I wanted to prevent some of the problems the teenagers were having. I knew that younger girls are often more open-minded and easier to reach, so I started with Grade 5 classes, with the thought of possibly expanding the project later on. We talked about ways of coping with stress and puberty, about the importance of respecting themselves and treating one another with respect. We got into discussions on Internet conduct and texting and even worked on cool art projects together. The girls had so much fun, and so did I.”
Francis has also been involved in strategies to slow the spread of hepatitis C and HIV/AIDS in Eskasoni. When people started finding used needles in public areas, she developed a proposal to put sharps containers in public washrooms. The approval came in, and she and her husband installed them. (Serge was her high school sweetheart, and they are expecting their first child in April.)
She’s also worked at developing relationships with people in the community who are at high risk. The health centre now offers needle exchange and a nutrition program for them: “It’s a place where they can get some healthy food, get their immunizations updated and talk with someone, in a completely non-judgmental and confidential environment. They can trust us.”
Francis is committed to her community and her practice and sees a bright future for both. She plans to enrol in a master of nursing program via distance education, allowing her to remain at home with her family. “Eskasoni has a lot of strengths,” she says. “You will always find support here, no matter what’s going on in your life. I wouldn’t want to work anywhere else.”
10 questions with Julie Francis
What is oneword you would use to describe yourself?
If you could change anything about yourself, what would it be?
My quiet voice
“If I had more free time, I would….”
Travel, and spend time with family and friends
Where did you go on your last vacation?
A group trip to Las Vegas for a wedding
Name one place in the world you’d most like to visit.
The Netherlands, to see where my grandmother was born
What is your biggest regret?
That I haven’t started working on my master’s yet
What was the last good book you read?
I love the prenatal books I’ve been reading
What was the best piece of career advice you’ve received?
Don’t take yourself too seriously, but take your job and your profession very seriously
What do you like least about being a nurse?
Not having my summers off
Name one change you would like to make to the health system.
I’d increase services such as youth centres and food and clothing banks that promote community health and well-being