Navigating the system

Almost half of the First Nations population within Interior Health is found within the boundaries of the Thompson-Cariboo-Shuswap.

That area, which includes 41 bands and eight languages, is served mainly by Royal Inland Hospital. People from some of the more remote communities don't always speak much English, they might live in a wood-stove-heated home without electricity and they may never have been admitted to a hospital before.

Since the Aboriginal Patient Navigator (APN) Program was piloted at RIH in 2008, First Nations patients and their families are getting help from someone who can spend time to explain what's going on around them in a system that's under pressure to be efficient and fast.

Joanne Mills, aboriginal health director at Royal Inland Hospital, said the program actually started at Cariboo Memorial Hospital in 2003.

At RIH, aboriginal patients have reported much higher satisfaction since the program there began.

"There are unique challenges between the aboriginal community and Western medical views," she said.

Traditional medicine wheel and sweetgrass-burning ceremonies aren't considered in a system that turns to surgery and drugs to solve health problems. The navigator program helps bridge the two, she said.

The navigators have to understand medical terminology and treatment, but put it into context of the aboriginal traditions.

"Sometimes the aboriginal community needs a little extra support to understand."

Deb Donald is one of two APNs who use the ninth floor offices as a base, but who don't really spend a lot of time there. They're scheduled so that there's always a navigator at RIH seven days a week.

"There are days where I can have four to 20 patients," said Donald, who has a degree in psychology and experience in mental health and fetal alcohol syndrome.

The calls come from every department of the hospital.

"The reason why I love this work so much is every day is different and you get the bad with the good," she said.

"My first week I had seven major traumas and two babies."

Her day can involve helping a family cope with a dying relative, putting together a discharge plan for a patient ready to go home, explaining information from a medical chart to a patient and relatives, or arranging a smudge ceremony.

"We ask and allow the medical staff to participate in the smudges," she said. "Sometimes it's closure for them, too."

She helps medical staff understand things that are important to aboriginals, like not cutting the hair of a patient who needs brain surgery or how to approach an elder who spent time in a residential school.

"They don't always have time to work with the families," said Donald. "Aboriginal families can be huge."

Gwen Campbell McArthur knew when she had to undergo surgery for breast cancer that she would need a navigator, especially to help her family members who were coming from Manitoba, Saskatchewan and Alberta to support her.

"I was hoping to get some good physical, emotional and spiritual support for my family members; for my sons," she said.

"I needed to be sure that my family circle was kept intact and strong. I couldn't because I was so sick."

By the time she underwent nine hours of surgery last month, she and her family were already connected with the navigators.

"They knew where I was and where to find me," she said. "The one thing - maybe the most important thing - is they listened to the needs and followed them."

They would offer her options and choices, but the final say was always hers.

"I made all of the decisions. That was hugely empowering," said Campbell McArthur. "To them, I'm not just a room number. I'm not a diagnosis."

She didn't like waking up alone in the dark after surgery, so she asked to have her son stay with her the next night. The navigators made it happen.

After her surgery, she wanted to hold a prayer circle with close relatives. It was supposed to take place in RIH's sacred space, but she was too sick to be moved. Instead, Donald - who worked most with her family - arranged to have it in her room.

"We did the prayer circle around my bed. It was a really powerful experience," she said. "My family trusted her enough to tell her what was happening with them emotionally."

Campbell McArthur's sister told her she saw Donald talking to some medical staff in the hall one day. One of them was quite distraught and Donald put her arms around him.

They aren't just helping the patients and their families.

"My sister felt she almost became a part of the family," she said.

"Even though I was sick, there was a lot of laughter. And even the aboriginal patient navigators were laughing with us."

© Copyright 2018 Kamloops Daily News