Nursing in Nunavut

May 2009   Comments

Surprising opportunities in a vast and remote land
Nunavut. The word means “our land” in Inuktitut. It’s a place full of mystery and the possibility of adventure. For the territory’s some 220 nurses, it’s home. But what is it that would bring someone from southern Canada, or anywhere else in the world, to Nunavut to practise?

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For starters, an independent spirit. Or a yearning for a simpler way of life. Nunavut is big, in size if not population. The territory spans two million square kilometres, crosses three time zones and covers one-fifth of Canada’s total land mass. With approximately 30,000 residents, 85 per cent of whom are Inuit, it holds the distinction of being the youngest and fastest growing population in the country; 53 per cent are under the age of 25 and the birth rate far exceeds the national average. All communities, not just the larger ones, are experiencing growth. As a consequence, the need for health-care services is growing too.

The territory is divided into three regions: Qikiqtani (Baffin), Kivalliq and Kitikmeot. Each region’s largest community has a main health centre that acts as its health-care hub, but there is also a community health centre in each of the territory’s 25 communities. Baffin, consisting of Baffin Island and the northern islands, has 13 communities, including the capital city of Iqaluit; Kivalliq, in central Nunavut, has seven communities and a regional centre in Rankin Inlet; and Kitikmeot, on Nunavut’s western boundary, has five communities and a regional centre in Cambridge Bay. The regional centres provide medevac services to the nearest major hospital — in Ottawa, Winnipeg and Yellowknife, respectively. Not surprisingly, medical travel costs can take up to a third of a region’s entire health-care budget.

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Qikiqtani General in Iqaluit is the only hospital. It opened a new facility with greatly expanded services in 2007 and includes two OR theatres, an outpatient clinic, three negative pressure rooms for tuberculosis patients, two secure rooms for mental health patients, a laboratory, an X-ray and ultrasound clinic, and a rehabilitation clinic. Only 20 of its 35 available beds are open — not because of a lack of staff or funding but as a result of current demand.

The centres in Rankin Inlet and Cambridge Bay are also new. They were built with future capacity demands in mind, and today provide many of the services that residents could previously get only by leaving the territory.

With 45 nursing positions, Qikiqtani General is the territory’s largest employer of RNs; 39 work in general duty, emergency, operating room, and specialist clinics; four are nurse managers; and two are clinical instructors.

Nunavut draws its nurses from the territory, from across Canada and from countries around the world and has had to rely on agency contracts to fill some short-term positions. Last year, the Department of Health and Social Services embarked on an aggressive campaign to recruit Nunavummiut into nursing (see page xx). A four-year BScN program has been offered since 2004 at Nunavut Arctic College in partnership with Dalhousie University; 18 students — nine of whom are Inuit — have graduated so far.

The backbone of the territory’s health system is the community health nurse; each community, with the exception of Grisefiord, has at least two. With support from their regional health centres, they are responsible for treating and assessing a wide range of ailments. Many communities also have home care and public health nurses.

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The variety of nursing roles available in Nunavut can be attractive to a nurse who is looking for a change. But practising in a remote territory comes with challenges. One of the biggest is the simple fact of physical isolation. There are no roads into Nunavut and none between the communities; travelling anywhere means taking an airplane or a boat. The cost of a return flight from Iqaluit to Ottawa is about $1,900 — and seat sales are rare. For most southern nurses, trips to visit family and friends are limited to once or twice a year. The cost of living is another issue. Nunavut’s nursing salaries and bonuses include a Northern Allowance and are higher than the national average, but groceries, household goods, housing and entertainment are substantially more expensive.

It can be difficult to adapt to the arctic weather or the fuzzy boundaries between night and day. Nunavut is cold for much of the year, and snow is not unheard of in the summer. Sleep habits and moods can be affected; many communities experience up to 24 hours of daylight from May through August and as many hours of darkness from November through February.

There are also cultural differences. One is the generally more relaxed pace of life. For example, many Inuit stop whatever they’re doing at noon each day to go home to eat and spend time with their families. This custom is such an entrenched part of life that patients waiting to be seen at clinics and health centres will invariably get up and leave at noon. For nurses used to the urgent, 24-hour cycle of life in an urban centre, the sight of an empty waiting room at lunch time can take some getting used to.

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For all of its many challenges, Nunavut offers those who are up for it an opportunity they won’t find in many other places. In addition to the excitement of living in such a vast and untamed landscape, there is the satisfaction of being able to work to their full scope of practice, a wealth of experiences to be gained, and the knowledge that they can have a real impact on the health of a community. For the right person, Nunavut is a rewarding place to live and work — for a short-term adventure or a long-term investment.

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