Jul 20, 2020
‘If you see an injustice you fight it … You find ways to unite people to do the right thing’
As COVID-19 raged through long-term care homes in Montreal, infecting residents and health-care workers alike, Natalie Stake-Doucet spoke up for nurses.
In radio, print and television interviews, Stake-Doucet — an RN, PhD candidate at the Université de Montréal and president of the Quebec Nurses Association — drew attention to the shortage of protective equipment and basic supplies.
She decried lower pay bonuses and collective agreements that had been suspended for nurses on the pandemic front lines, compared with doctors.
She highlighted years of underfunding of long-term care that nurses had warned would create conditions where pandemic infections could flourish.
She blasted Premier François Legault for devaluing nurses when he told doctors he “didn’t mean to insult them,” but he needed them “to come treat the people, wash patients, feed patients, to come and do the work of nurses” in long-term care facilities.
“I’m from a family of activists.”
“It was just such a blatant misunderstanding of what nurses do,” says Stake-Doucet. “It was incredible to hear coming out of a politician’s mouth in 2020.”
Speaking publicly for and with nurses and revealing problems in the health-care system is a critical part of a nurse activist’s role, Stake-Doucet believes. She doesn’t only bring a feminist perspective to her study of how organizational culture affects nursing: she lives her convictions.
For Stake-Doucet, a health-care system isn’t healthy unless research and activism are both vital components.
Now 37, Stake-Doucet attended her first protest march, for Quebec independence, as an 18-month-old in her parents’ arms.
“I’m from a family of activists,” she says with a laugh. “If you see an injustice you fight it, or you try, at least. You find ways to unite people to do the right thing. I was raised with that mindset.”
Drawn to nursing by the essential nature of the work and her desire for portable skills so she could travel, Stake-Doucet stayed in the profession because of the camaraderie among her colleagues and the relationships she builds with patients.
Her initial hospital work — first as an orderly, and then as a practical nurse on both surgical and mental health wards in rural Quebec and in Montreal — stoked Stake-Doucet’s awareness of how hierarchical hospital culture and organization affect nursing. At a small rural hospital, for example, Stake-Doucet felt part of a tight-knit team of physicians, nurses, orderlies, and other staff. She learned from an “incredible” manager who valued her nurses.
“It was a good place to start, because I did not feel exploited. It helped shape my vision of myself, my value as a nurse, and [reinforced] that when you work with a good team, it’s important to get paid and to get recognition.”
At one large hospital in Montreal, Stake-Doucet had a far less positive experience. Nurses on her unit had little support and no voice. Five colleagues left because of burnout, including one who was physically attacked by a patient.
“People were really traumatized because of the way the unit was run,” she says.
Stake-Doucet took a study leave and returned to school at McGill University’s Ingram School of Nursing, earning her bachelor of nursing. She went on to take her master’s degree as a nurse practitioner. She loved academia. “I loved learning and I met incredible people and profs … I felt I belonged,” she says.
Following her master’s, Stake-Doucet began her PhD at the Université de Montréal. Using a critical feminist lens, she marries her research into the way the social organization of hospitals restrains nurses’ scope of practice with political activism.
Stake-Doucet hopes her thesis will explain “why nurses feel so under-valued, why they are not recognized in their work, and how we can change that.”
As one example, she points to cultural norms, such as nurses being referred to by their first names and physicians by their title.
“There’s a lot of stuff that was frustrating for me as a nurse in a hospital that I’m finally able to articulate. This has been very cathartic for me,” she says.
Change is what drives Stake-Doucet. At McGill, she met fellow activists and in 2014 co-founded McGill Nurses for Healthy Policy. The organization gave nursing students broader exposure to political and social issues, and a forum to speak out about the health-care reform taking place in Quebec at the time.
Stake-Doucet’s work as a nurse and an advocate is exhausting, but also inspiring.
“We learned so much,” Stake-Doucet says. “It’s a group that still exists at McGill so I’m super proud of it.”
Her McGill activities led Stake-Doucet to join, and ultimately to become president, of another grassroots organization: the Quebec Nurses’ Association (QNA). All its board members work in the public health-care system.
“We want to never lose that connection we have to the daily grind,” says Stake-Doucet, who has continued to work as a nurse in Montreal hospitals part-time throughout her studies.
QNA fills a niche between the professional college and the union, she says. The organization’s goal is to decrease nurses’ fear of speaking out publicly and “to be a model of steadfastness, political clarity and integrity.”
Although QNA is not an official member of the Canadian Nurses Association, Stake-Doucet serves on the national association’s board and hopes the Quebec organization will soon be an official member.
Despite her differences with Quebec’s premier, Stake-Doucet answered his call for health-care workers to assist in long-term care homes for a few weeks during the pandemic. At one of the worst-hit institutions in Montreal, she struggled with shortages of basic equipment, including garbage cans and vital signs machines, that resulted from systemic underfunding. On one day, eight residents died during one of her shifts alone.
“It was brutal,” she says.
True to her nature, Stake-Doucet spoke out about the problems. Before most of the rest of Canada realized the conditions in long-term care homes, QNA issued a policy brief to the province’s health ministry.
Nurses and health-care workers “are currently communicating their distress over work conditions that do not meet the most basic needs of their patients and the lack of attentiveness to their clinical judgment on the situation in several long-term settings,” an article quoted the brief as saying.
It was one in a series of salvos and interviews Stake-Doucet gave to try to alert the public about the dangers of infection to residents and staff alike.
Stake-Doucet’s work as a nurse and an advocate is exhausting, but also inspiring, she says. She decompresses by reading science fiction, cooking, playing cards and watching movies with her husband Alexis Gutierrez. He’s a great sounding board for her speeches and campaigns.
Ultimately, activism is her best form of self-care, she says.
“Self-care for me is advocating for change in health and social policies and changes in our work and the conditions of our practice as nurses. I try to act politically; I try to act socially. It helps me gain a certain feeling of control over conditions where normally we feel powerless.”