Neelam Ladhar knew from an early age that she wanted to study sciences. So upon graduating from Burnaby South secondary school in 1999, she went to UBC and did a degree in integrated sciences, studying subjects like microbiology and psychology. She enjoyed it, but her passion hadn’t truly been sparked. That all changed when she took part in an exchange program to New Delhi with Canada World Youth and the Canadian International Development Agency. For three months, Ladhar was immersed in India’s culture while learning about HIV and AIDS. She saw firsthand the struggles that those with the virus experienced as well as the kind of care they received from health workers, nurses in particular.
“There were nurses doing outreach, doing education; I realized how much nurses were doing on that front,” Ladhar tells the Georgia Straight in a phone interview. “It shattered the stereotypes of the standard bedside nurse, and I knew it was something I would want to pursue once I got home.”
In January 2008, she entered UBC’s bachelor of science in nursing degree program, a five-term course for students who have already completed a degree or a significant portion of one that takes just under two years to complete. (Like other schools, UBC also offers a baccalaureate program for registered nurses wanting to get their degrees.) Ladhar, who graduates this month and has been gaining work experience as an employed student nurse at Surrey Memorial Hospital, is optimistic that the job she’s applied for at another hospital will come through—news she’s expecting to hear any day now. She wants to work in the emergency department.
“When people talk about teamwork and interdisciplinary medicine—doctors, nurses, pharmacists, physiotherapists, occupational therapists all working together—I really see that happening in Emerg,” Ladhar says. “It can be stressful, because time is of the essence, but I really enjoy it.”
Despite the economic gloom that’s made job-hunting an exercise in frustration for so many lately, Ladhar, who is 27, has picked a field in which few, if any, grads will have a problem finding a job.
In fact, the demand for health-care practitioners is greater than ever, especially in British Columbia. According to the Canadian Institute for Health Information, B.C. has the lowest ratio of registered nurses per capita of any province in Canada (66.5 RNs per 10,000 people). Plus, B.C. also has one of the fastest population-growth rates in the country, coupled with one of the steepest declines in the number of registered nurses.
David Baxter, director of Urban Futures, a nonprofit research and consulting group, says that the need for nurses will only escalate.
“Clearly, with an aging population”¦the demand for nursing services will continue to grow,” Baxter tells the Straight. “The increasing demand will occur simultaneously with relatively slow labour-force growth from domestic sources.”¦This means good employment prospects for nurses, but also a continued reliance on immigration for additional supply of nurses.”
Bernice Budz, associate dean of nursing at BCIT, says that of the 80 students who graduated in June, none had trouble finding work; in fact, many had four or five job offers to choose from. The program, which gets about seven times more applicants than it has seats (168 spread over two intakes per year), strives to give students extensive clinical practice. Plus, the nursing school’s simulation lab has patient simulators, computerized, anatomically correct mannequins that breathe, bleed, and mimic real patients.
“Our grads are really ready to go to work, whether it’s in a hospital or in the community, and employers see that,” Budz says, noting that BCIT—where tuition for students entering the nursing program is about $2,700 per term, not including textbooks, uniforms, and other supplies—also offers specialized training for grads in such areas as emergency, neonatal, and pediatric critical care.
The vast range of career opportunities is part of what makes nursing appealing to so many. Just as Ladhar learned, nurses aren’t limited to bedside care. Rather, they can work in community or environmental health or go on to pursue teaching, research, health-policy work, management, or administration. Many opt to train as nurse practitioners—primary-care providers who do many tasks that have traditionally been performed by doctors, including assessing, diagnosing, and treating common conditions.
“The media image is that health care is going to hell in a handbasket and nursing is a terrible profession,” says Sally Thorne, director of the UBC School of Nursing. “But young people are seeing nursing as a viable career. Some have thought about how they can make a contribution. They are a socially conscious type who are involved in volunteer work and interested in politics, global justice, and global citizenship. They’re looking for a place to actively engage in the world and have come to the conclusion that nursing would be a way to do that.”¦For grads, it’s so easy to be optimistic about the future.”
Stephanie Howes, Kwantlen Polytechnic University’s program coordinator of the “graduate nurse, internationally educated re-entry program”, agrees that nursing is a dynamic field full of possibilities.
“Nursing is much more than what traditional media has portrayed,” she says. “There are so many different avenues grads can go to. It’s not just hospitals, IVs, and needles. It’s a really good career, it’s not just a job.”
Thorne, who’s “been a nurse forever”, says the significant role that nurses could play in people’s lives first really came to light during the Spanish flu epidemic of 1918 and 1919, a moment in history that’s relevant today because of the global threat of illnesses like avian and swine flus.
Like other nursing programs, the one at UBC (where tuition is about $5,300 for the first eight months) gets far more applicants than it can accommodate with its 120 seats—about five times as many. Students enter directly into third-year nursing classes, but first they have to make it through a rigorous application process, which includes an interview format that many medical schools have adopted and that can be compared to speed dating: aspiring nurses go through a round of up to eight brief interviews within a condensed period of time.
“They’re not expected to have specific medical knowledge, but to show the capacity to think critically; to recognize ethical dilemmas; to show judgment, motivation, and genuine interest in people,” Thorne explains.
Sharon Ronaldson, curriculum coordinator of the nursing department at Langara College, which has two intakes per year for a total of 160 students, says that nurses need good communication skills and have to be able to function both individually and as part of a team. Langara students, who pay about $2,400 in tuition in their first year, have the opportunity to gain work experience in places as diverse as B.C. Children’s Hospital and the Ross Street Temple.
“Our curriculum gives nurses the set of skills needed to be safe, competent, ethical practitioners,” Ronaldson says.
Kwantlen Polytechnic University, which offers a four-year degree program in nursing, has two intakes of 32 seats per year, with 25 percent of the seats reserved for students who are straight out of high school. The university has a partnership with Thailand’s Mahasarakham University, allowing students to gain international experience through exchange programs.
Jean Nicolson-Church, Kwantlen’s associate dean of community and health studies, explains that potential nurses must be self-directed.
“Our program fosters independent thought,” Nicolson-Church says. “Education isn’t based on formal lectures, where students are sitting and taking notes. Students are expected to be active and involved, to be client/patient advocates, to be professional and accountable, and to help facilitate changes in the health-care system.”
Kwantlen has joined Douglas College in offering a bachelor’s degree in psychiatric nursing. At Kwantlen, a quarter of the students in the program are men. In addition to core courses in nursing, students gain a liberal-arts education, studying anthropology, sociology, criminology, and even photography. “One project involves a photo novella,” Nicolson-Church explains. “It helps with clients who can tell their stories easier through pictures than through words.”
Michel Tarko, dean of Douglas College’s faculty of health sciences, says psychiatric-nursing grads are filling a gap in the health-care system.
“There’s a huge need for the services provided by RPNs [registered psychiatric nurses], given what’s happened with the downsizing of Riverview,” Tarko says.
Nursing students at Douglas College, which also offers a bachelor of science in nursing program with 132 seats a year (for which tuition is about $2,000 per year), train at the David Lam campus’s new Health Sciences Centre, which opened last year. Simulation labs in the $39.3-million building feature patient simulators, like those at BCIT, which display human responses to CPR, intravenous medication, ventilation, and other treatments. Simulation labs provide a safe learning environment that enables students to learn assessment, communication, psychomotor, and problem-solving skills, as well as develop critical and creative thinking.
Students practise scenarios—how to deal with cardiac arrest or anaphylactic shock, for example—and their responses are videotaped and uploaded to the program’s intranet, so that they can go over the scenes in the computer lab or on their laptop or MP3 player.
“They learn critical thinking, critical reasoning, and critical judgment,” Tarko says.
Nurses will need those kinds of skills given the pressure so many face in today’s cash-strapped health-care system.
Len Rose, spokesperson for the British Columbia Nurses’ Union and a 25-year nurse, says the union is particularly concerned about hiring freezes in certain health authorities as well as the nursing shortage; he notes the latter is expected to last another 10 years. According to Rose, it’s not uncommon for nurses to work short-staffed.
“It’s not good patient care, and it’s not a good way to care for our nurses,” Rose says, noting that the average age of nurses in B.C. is 50, and that about half of those currently employed will be eligible to retire within the next five years.
Ideally, Rose says, nurses would do more primary and preventive care so that health-care resources wouldn’t be so stretched dealing with those who are acutely ill.
One of the many things Rose loves about his job is that it offers lifelong learning. Student nurses and those doing continuing education have access to financial support through groups like the Registered Nurses Foundation of British Columbia.
Foundation president Mary-Ann Wythe, a long-time nurse who’s the coordinator of the Downtown Community Health Clinic in the Downtown Eastside, says the organization gave out $103,000 last year.
“We don’t want anyone to be denied what they want to do because of finances,” she says.
Lily Man, who graduates from UBC this month and will be working on a surgical ward at Vancouver General Hospital, says she’s prepared for stressful days but is still convinced she’s chosen the right path. She knew she wanted to be a nurse by the time she was 14, when her dad was seriously ill. She felt helpless, but was heartened by the care that nurses were giving him on a daily basis.
Man says nurses can turn to each other for support through organizations like Nursing the Future, a national nonprofit that assists new graduates during their transition to the workplace. Man, who is on the leadership team for the B.C. chapter, explains that besides hosting an annual conference and offering information and resources, the group also has a live-chat section on its Web site, allowing new nurses to connect with their peers across the country.
“You learn different approaches to resolve problems,” Man says of the benefits of looking to other nurses for support. “All occupations can be stressful; the most important thing is to be positive, to have hope, and to not forget the reason you got into this in the first place.”
Nurses are members of a global community too, one that Neelam Ladhar is only too happy to be a part of. In June, UBC sponsored her to attend the International Council of Nurses congress in Durban, South Africa.
“It’s important to think about not just what’s happening in a particular hospital setting, but about the bigger, international level,” Ladhar says. “I met a lot of African nurses there and heard about the type of problems they deal with over there.”¦They’re overworked and don’t have the resources to work in the capacity they wish they could.”¦It was humbling and educating to be involved.”
Ladhar plans to stay involved with local and global efforts to boost the nursing profession.
“It’s one of those professions that you can grow in forever.” -