https://www.infirmiere-canadienne.com/blogs/ic-contenu/2024/08/06/zachary-matieschyn
Zak Matieschyn will build trust, lead through relationships
By Laura Eggertson
August 6, 2024
Courtesy of Zak Matieschyn
“I think the nursing profession would like to see a nurse speak to what’s going on for the nursing profession, instead of always the minister of health,” Zak Matieschyn says. “It’s important that the nursing profession sees itself in government. That can’t help but be a morale booster.”
A year into his job as provincial chief nursing officer for British Columbia, Zachary (Zak) Matieschyn is fine-tuning the art of pragmatic leadership.
“I ultimately serve the province and the ministry and the government, as opposed to serving the profession, which is a tricky nuance I am still trying out,” Matieschyn says. “Not everything is a hill to die on, and there’s a long play here.”
For Matieschyn, a nurse practitioner who previously served a term as president of the Association of Registered Nurses of British Columbia, learning to check his advocacy hat at the door has required a strategic shift.
When leading the association, he developed his communications, policy, and government relations skills. Now he’s putting those to work to try to improve the province’s health-care system without burning bridges.
“The scorched-earth lever is something you can pull once and get your way, but after that, people might not listen to you again,” he says.
Build trust
As the chief nursing officer, Matieschyn has adopted a relational leadership style. His intention is to build the trust of his political masters, so that they allow the public profile of the chief nursing officer to grow, he says.
“I think the nursing profession would like to see a nurse speak to what’s going on for the nursing profession, instead of always the minister of health,” he says. “It’s important that the nursing profession sees itself in government. That can’t help but be a morale booster. It can be hard toiling away on the front lines and feeling like nobody cares.”
At the same time, Matieschyn is keeping the needs of the entire health-care system in sight – not just the nursing profession.
He does, however, champion his team’s novel ideas and policy options through a nursing lens firmly embedded in his current front-line practice.
Once a week, despite his government responsibilities, Matieschyn runs an addiction/opioid agonist therapy clinic in Nelson, B.C., where he had a full-time family practice for 12 years before joining the Ministry of Health in 2019.
It is difficult juggling his practice with his public service role and his family life as a spouse and father of two young children, Matieschyn acknowledges. But it’s an advantage to know patient concerns, to understand the current pressures on nurses, and to be embedded in the health-care system’s ongoing challenges, he believes.
“I still feel what’s going on in the frontlines, in the real world,” he says.
Valuable addiction resource
Being one more nurse practitioner who can prescribe methadone, suboxone and other opioid agonist therapies is also a valuable resource in a province facing a toxic drug crisis.
In 2023, 2,511 people died of suspected illicit drugs in British Columbia — seven a day, according to the B.C. coroner’s office. In announcing the unprecedented milestone, former chief coroner Lisa Lapointe, who retired in February, cited fentanyl as the major culprit and called on the province to expand harm reduction services. She urged the provision of accessible, evidence-based treatment and recovery programs, rather than “policing and punishing in the guise of public policy.”
Matieschyn’s role as the province’s chief nurse means he can’t directly comment on or critique the government’s policy direction.
“The numbers are simply tragic,” he says. “In B.C. we saw the death rate start to drop in the six months before the pandemic, but it then quickly reversed and worsened, irrespective of new initiatives that have been tried.”
What Matieschyn can convey is his pride in British Columbia’s decision to allow registered nurses and registered psychiatric nurses to prescribe all oral opioid agonist therapies for people with opioid use disorder, a decision his team has facilitated by supporting regulation changes. B.C. was the first province to expand nurses’ scope of practice this way.
“It has substantially increased access to these therapies, particularly in rural and remote areas,” Matieschyn says.
“Crisis breeds opportunity, so that really has forced decision-makers to expand scopes of practice, and it’s proving to be safe. We haven’t broken the system; another profession isn’t in the poorhouse collecting food stamps; and it turns out there’s enough for everyone to do.”
In addition to the toxic drug crisis, the problem of declining number of nurses and other health-care professionals looms large in British Columbia, as it does in every other province.
Focus on recruitment
Matieschyn and his team focus on how best to recruit nurses, including finding ways to streamline the pathway to practice for nurses who earned their education outside of Canada.
“That is a focus of ours, looking at the [international nurses’] pathway, questioning every step along that pathway, blowing up sections if they need to be blown up, and remaking them with a new process that cuts down the time, if it’s unnecessary,” he says.
“I like blowing up stuff that doesn’t make sense and has existed for decades, and nobody knows why.”
The chief nurse also likes his team’s decision to shorten the amount of time it takes nurses to become specialized during their bachelor of nursing sciences degree, through a specialist pathway initiative. One of his colleagues has also led the charge to enact minimum nurse/patient ratios, so over the next few years, the province will fund health authorities to ensure there is a one-to-four ratio on medical and surgical units, and a one-to-two ratio in high-acuity settings like intensive care.
“The theory is, if you build a system that is safe and enjoyable to work in, and well-supported, nurses will come back in from retirement, or if they were burnt out, they come back in middle age, and it motivates that new generation of people to get into nursing,” Matieschyn says.
Over the next three years, “it will seem like a shinier proposition to get into the nursing profession,” he predicts, citing the $237 million the province has budgeted to retain nurses.
Money helps
Matieschyn is taking on his role at an opportune time because the health-care system’s challenges mean the government welcomes innovative ideas and is willing to pay to enact them, he says.
“Austerity isn’t going to work, so that opens a lot of possibilities. Not that money can do everything, but it certainly helps.”
Although there is a “substantial” amount of work at the feet of the chief nurse and his team, “a lot of it is very innovative and exciting,” Matieschyn says.
One of the opportunities he most looks forward to is working with Canada’s chief nurse, Leigh Chapman, who shares a similar passion for and background in substance use nursing. He also hopes to collaborate with his provincial/territorial counterparts to share not only successes, but also failures.
In his limited downtime, while not spending time with his wife Michelle and trying to keep up with their three-year-old daughter Vivianne, and six-year-old son Zavier, Matieschyn combs garage sales to add to his vinyl library and reads science fiction and history.
“As I’ve hit my mid-40s, learning about longevity science and research has taken up a fair bit of my reading bandwidth,” he adds. That new knowledge has reinvigorated his commitment to fitness, getting outside, and eating better.
He’s also committed to continuing the work of Indigenous reconciliation, and to meeting practising nurses, nursing leaders, students, and faculty as he travels throughout the province.
“Workforce constraints and pressures are incredibly acute, and I have a heavy heart to know the struggles that many nurses are facing,” Matieschyn says.
“The solutions are there, but they take a medium- to long-term [time frame] to implement. A very wicked problem to manage and address; but we need to keep working on it and doing the next best thing.”
Laura Eggertson is a freelance journalist based in Wolfville, N.S.
#profiles
#addictions
#career-stage
#harm-reduction
#health-system
#leadership
#opioids
#recruitment-and-retention
#substance-use