Strategic practice

October 2015   Comments

With pleasure, I read the article in CNA Now (June) defining primary care and primary health care. I completely agree PHC has not been implemented to its fullest potential, which may be partially explained by institutional barriers, knowledge deficit and even attitudes. As a nurse educator/researcher in community health, I teach nursing students about the crucial importance of a PHC approach for their nursing practice. Witnessing CNA take up PHC as a philosophy and approach to practice validates educators’ work tremendously and offers us further resources and credibility for those students who say they just want to work at the bedside in acute care, so PHC doesn’t apply to them.

I have one comment on the principle of accessibility. It must be expanded beyond its current definition to include attitudes. I teach students that their attitudes during interactions with individuals seeking care may be access barriers or facilitators. For example, if individuals feel they will be treated with respect for their inherent worth as a human being, they will be far more likely to use that clinic than another, even one just down the street from where they live, where they have experienced racism or judgmental attitudes. We don’t always realize how much our attitudes influence accessibility!

– Candace Lind, RN, PhD
Calgary, Alta.

First, let me compliment Philippe Voyer on his Ask an Expert column (June). His tips on communicating with people with dementia match what I am teaching my students. It is nice to have this clear short article to share with them.

Second, CNA’s new strategic plan is great, but I am concerned about follow-through on two of the core principles of primary health care: active public participation, and cooperation and collaboration. I find that nurses are not always allowing people to be at the centre of their health care, particularly when someone requests complementary therapies.

I know that some will say these treatments are not scientifically proven. But we know all in health care/medicine is not scientifically proven. When people receiving care in hospital or nursing homes ask for complementary therapy, why are they told they cannot contact the therapist, even when they know the person? If therapists do make visits, they have to sign their life away or the treatments are interrupted with no thought for how this disturbs the patient. We are much more accepting of complementary therapies in palliative care.

I have been a nurse for 45 years. I am also a complementary therapist in Therapeutic Touch and reiki. I have seen the wonderful effects of these therapies on people in the palliative world.

– Mary Hughes, RN, BN
Stratford, P.E.I.

An excellent article about how to interact with those with dementia (Ask an Expert). Too frequently these patients are written off and ignored when they can no longer verbally communicate. Paying attention to them would certainly alleviate any angst they may have.

Late one afternoon, I happened to walk by a personal support worker who was speaking to a female resident in long-term care. The resident was clapping her hands with a big smile on her face. The PSW wanted to get the resident to the dining room for dinner. Remembering a concert had taken place there earlier in the day, I asked the resident if she had enjoyed the event. She nodded her head as she continued smiling and clapping. The PSW picked up on this reaction, helped the resident up from her chair and started talking about the concert as she led the obliging resident into the dining room.

People with dementia may not be able to react as quickly as we do. Sometimes we need to look more closely at their world and adjust the way we approach them, to make life more manageable for them and to help us, too.

– Jill L. O’Donnell, RN, DPH, CSSA, BA
Toronto, Ont.
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