Nursing Week is recognized annually across Canada during the first week of May, with International Nurses Day falling on May 12. This week shines a light on the importance of nurses within the health care system and the incredible work they do on a daily (or nightly) basis. This year’s theme is “Changing Lives. Shaping Tomorrow.”, emphasizing the immense impact of nursing work on the lives of individuals in their care, families of patients, their communities, and the health care system overall.
At Kinark, there are a wide range of different treatment settings and experiences that our nurses work within, including live-in treatment and community-based mental health, as well as the secure treatment program Syl Apps Youth Centre. Across Kinark, staff work a variety of nursing roles, including Registered Nurses, Community Mental Health Nurses, as well as a Nurse Practitioner.
A Registered Nurse (RN) provides direct nursing care to patients and is regulated by the College of Nurses of Ontario. They may administer medications, monitor vital signs, provide assessments (both mental and physical), provide consultative services, provide therapy, give compassionate care, update families, develop seamless discharge plans, and much more.
Now, a Nurse Practitioner (NP) is in its own extended class of registration, with a much wider scope of work above that of a registered nurse. An NP is able to prescribe, treat, diagnose, perform procedures, and order and interpret diagnostic tests, providing more of a holistic type of care in the realm of diagnostics and treatment. For instance, if a youth is suffering from a urinary tract infection, an NP is able to assess, diagnose and prescribe treatment immediately.
At Kinark, Salena Mohammed is the one and only Nurse Practitioner, and she works out of the Syl Apps Youth Centre. Syl Apps is a provincial program that provides 24/7 care to youth in two secure, court-ordered programs for youth ages 12 and older.
At Syl Apps, nursing has an important role to play in orientating a youth to the facility, helping them to recognize physical and mental health concerns within themselves, and provide ongoing education on healthy living, sexual health, and diversity. As a 24/7 facility, staff at Syl Apps provide care to youth around the clock, and support is also offered to families. Salena works as part of an interdisciplinary team comprised of many roles including Child and Youth Workers, Social Workers, Native Service Workers, Nurses, Psychologists, Psychiatrists, Recreation Therapeutic Recreation staff, Art Therapists, and Educators.
Salena’s day typically starts off by touching base with the nursing team, receiving updates on the youth from overnight. Team huddles are an essential aspect of care coordination for youth at Syl Apps, where the multi-disciplinary team briefly meets to discuss the daily plan for each youth.
The majority of her day is spent coordinating medical care, admissions and discharges, completing focused physical examinations, and health teachings for youth. Another aspect of the Nurse Practitioner’s role at Kinark is attending leadership meetings to discuss client needs, engaging in quality improvement and assurance initiatives, as well as providing guidance and mentorship to Syl Apps Nurses and staff.
The Nurse Practitioner role is critically important not only at Syl Apps, but also throughout the agency. Salena works with Kinark’s Registered Nurses to support the coordination of care plans across Kinark, supporting our child and youth mental health programs and autism services. Recently, a youth who was starting in one of Kinark’s autism programs had a device for seizures and required a unique care plan. As a Nurse Practitioner, Salena was able to utilize her medical expertise to develop a care plan for these complex care needs and coordinate a smooth transition into the program. This is just one example of the many ways that Salena uses her training to support clients across Kinark’s programs and services. Salena’s role also extends into community settings, coordinating care for Syl Apps youth with community partners such as OTMH, McMaster Children’s Hospital and community treatment centers.
When asked what the most difficult aspect of her Nurse Practitioner role is, Salena simply wishes she had more time with the youth. “You just wish you had uninterrupted time with each client, to sit with them and get to know them. To get a better understanding of their traumas. Working with an interdisciplinary team and fabulous RNs, we ensure all clients feel safe and supported.”
The children and youth entering the treatment program at Syl Apps need compassionate care, which, in Salena’s words, “starts from day one”, actively creating an environment that is non-judgmental, open, compassionate, and caring. While every young person might not recognize this right away, Salena feels that continuing to show up as open, honest, and caring every day makes all the difference. “Coming into a new environment, can be very scary. A new facility with new faces, but in my role, I remain a consistent and friendly face for the youth. I’m here with them when they receive their medications. I talk to them. I don’t focus my care and compassion solely on wellness and health – I also visit with them to chat, play a card game, and really get to know them.”
Creating a safe space where trust can grow is paramount when connecting with children who have experienced trauma. “It’s really important that you reinforce confidentiality, but you’re also upfront in saying to the child that ‘when you disclose something about your safety, I need to be able to tell others’,” says Salena. “When you share this up front, you’re saying to them ‘I care about you, I’m going to make sure I can help you or share this with someone who can’ and it sets the stage for an open and honest relationship with our youth.”
Nurses like Salena are passionate about the work they do, “At Syl Apps we support the most complex youth when it comes to mental health clients in Ontario where no less intrusive program is appropriate. It is a privilege to be able to provide care, compassion, and treatment for these kids because there is nowhere else for them to get this kind of care. That’s what makes us passionate about being here”.