Being an Emergency Nurse in Nunavut

A personal account by Orett Brown of his stay in Nunavut from July 2015 to June 2016

Quick biography of Orett Brown: Orett Brown works as an agency nurse through Canadian Healthcare. His aspiration to become involved in healthcare stemmed from caring for his grandfather and the elders in his community as he grew up in Jamaica as well as his love for helping others. After immigrating to Canada in 2003, he graduated from York University and started nursing mainly as an emerge nurse since 2008. In his career, he has worked in more than 25 hospitals in Ontario. In involvement with Aboriginal communities started in 2013, allowing Brown to obtain a different perspective of nursing care through his partnership.

Nursing is an undervalued profession in healthcare - we often don’t notice its multifaceted nature. Orett Brown’s experience in Nunavut offers an exposé on the complexity of a nurse’s role through a rollercoaster of exhilarating stories. He details the differences between healthcare systems in Canada and comments on the complexion of the community he worked within.

According to Brown, the schematics of healthcare system installed in Ontario and Nunavut are polar and jarringly different. Brown first highlights the access to information, noting that Nunavut has a streamlined network compared to Ontario. In Nunavut, he can easily access patient information online, while in Ontario, all information must be faxed or accessed through the lab.

Secondly, Brown comments on the wait time, providing insight on the tedious procedure that rural communities face. Whereas an ultrasound will take a measly day in the city, it will expand to over three days for a rural community. Immediate access to healthcare equipment is stalled due to there being no hospitals in the community, resulting in a complex three-step procedure to access of care: flying out to the nearest hospital, staying overnight at a hotel, and finally reaching the appointment the next day.

The lack of healthcare resources is also reflected in Brown’s experience. In Nunavut, he is able to uptake more individual medical directive through actions like diagnosing patients. This medical directive is allowed due to the the lack of physicians and the need for more advanced skills. The polarity of patient demand between Nunavut and Ontario dictates variation in the delivery of care. On one hand, Ontario emergencies account for more patients alongside a significantly larger pool of medical personals (including residencies that create a need for physician facilitation). On the other hand, Nunavut sustains a high quality of care to their smaller patient population through higher qualifications in their limited medical personals, thus creating a stronger community interaction. Brown’s memorable anecdotes are that he was able to deliver babies without a physician and suturing. He is able to have personal patient feedback because of the nature of the tightly-knitted community. Brown’s narrative brings to light that the delivery care needs to be tailored to the needs of each community through the principle of hyper-localization, and that success in one system can be translated and adapted into another system.

Brown’s desire to work within Aboriginal communities started with a compulsion for adventure and a new outlook on care. He describes the connection he had with his patients and his integration into Aboriginal culture, but he also brings up mental health awareness and domestic abuse issues in Nunavut which, despite systems of care and prevention set up, seem to be significant issues in the area. Keeping in mind that every case is different, Brown delicately explains the nature of the issue. He stresses that the individual must be given the option to report in consideration for their external circumstance, and often reassurance and advise are all there can be done. External circumstances usually encompass financial support, parental rights, and housing stability. These personal accounts serve as a reminder that there are still holes in the system of care and prevention. For Brown, it is one of the difficulties in his occupation to see people suffer from the lack of resources that should be available to them.

Brown hopes to go back soon.

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