Summary of the week in Atlantic
Monday, March 11, 2019, Springhill Institution, NS
13: 00 Visit of the health center and discussion with the staff
1. Work overload related to opioid antagonist therapy (OAT): 67 cases, nearly a hundred patients could benefit from the program according to the staff, but not enough staff to initiate and follow up treatments.
2. Health services operations 12 hours a day
3. Staff to print to always run to be able to perform their tasks
4. Phoenix problems are always present
5. Admission unit is not negligible in the workload of the care team
6. No visit psychology services for lack of time
7. No IT visit due to lack of time
8. There were no official visits to this Institution
14:00 Steering Committee on Mental Health Impairment
1. The training objectives for R2MR, ie at least 90% of trained staff in three years, has not been achieved. The Commissioner will be reminding Regional Deputy Commissioners to ensure that the necessary efforts are made to achieve the goal. Training will continue to be provided beyond the planned date so that the objectives are met and to ensure that staff have received the initial training before the second training to be offered soon.
2. The second training is scheduled to begin in May 2019. Learning and development trainers will be trained in April. There will be a training day for all staff and an extra half day for managers. It was requested that the unions take part in this half-day with the managers given the importance of the partnership already in place for the support of the employees and the prevention of mental health problems that we are seeking.
3. An App was developed for the Android platform; we are waiting for the rights to use it on the Apple platform. The use on both platforms will better analyze the results and make the necessary corrections. It is difficult to have a schedule at this time, but once everything is up and running, a two-month test period may be enough to complete the analysis.
4. Family Support Update: The process is on schedule. There are challenges related to the translation of documents, but the report should be available soon.
5. Peer Helper Program: The challenge of identifying actions on the ground as EAP actions or Peer Support Program is present. There is still room to better identify the type of help to complete the analysis, but at least the staff seems to have the support needed by either program.
6. A draft document of a support package: death of an employee was presented. The DG HR informed us that, although this document is in draft, it has already been shared in the context of the death of a NHQ employee. The participants welcome the initiative and all agree that this document could be reviewed after use even if the use is not desired (nobody wants the death of an employee).
7. Discussion related to the possibility of creating regional steering committees. The challenge of getting information out of the work done at the national committee was raised. Several exchanges on the subject and the relevance of one more committee at the regional level. Discussions will continue on this topic.
15:30 Informal discussion with health chief SI
1. Discussion of Phoenix issues
2. Lack of staff
3. Work schedule: comparison with other places
4. PNEP
Tuesday, March 12, 2019, Nova Institution for Women
8:30 am Meeting with unions and HQ representatives for PNEP
• PIPSC: 2 local PIPSC delegate, regional representative consultation and v-p national consultation
• USJE: local
• UCCO: regional and local
• AWO Grand Valley Institution, Kitchener
• Chief Health Services Atlantic Institution
• National Project Manager PNEP
• Regional Director, Health Services, Atlantic Region
1. Discussion on PNEP history.
In the courts, a judge agreed to suspend the decision following CSC's commitment to initiate the gradual implementation of PNEP.
Announcement of the project in May 2018 to the unions without prior consultation by the national health services.
June 2018, start of program at two institutions: Grand Valley Institution for Women, Kitchenner in Ontario and Atlantic Institution, Renous-Quarryville, New Brunswick,
January 2019, Fraser Valley Institution for Women, Abbotsford, British Columbia,
February 2019, Edmonton Institution for Women, Edmonton Alberta.
The goal of implementing the PNEP for March 25, 2019 at Nova Institution, Truro Nova Scotia.
2. We are also informed of the next meeting of 27 March 2019 in Drumheller regarding the "overdose prevention site" project, without further specification.
3. Grand Valley Institution's AWO informs us of the evaluation process.
A request must be sent to the health services. The health leader or delegate will have an addiction counseling session with the patient, as well as possible options for harm reduction. Following the meeting with the health services, if the patient still wants access to the PNEP, the health chief or her delegate will complete their part of the form used for the threat and risk assessment. Subsequently, the eligibility assessment is referred to the person occupying the AWO position to complete the threat and risk assessment.
The AWO then completes the evaluation by ensuring that certain exclusion criteria are not present in the file of the person who made the request. If a file is accepted, there will be an indication in the OMS (as for the Epipen) by the AWO and a contract will have to be signed by the patient before the delivery of the kit by the health services. The health services must advise the AWO when the kit is given to the patient, this information will be available to all staff who need to know to ensure their safety.
4. The Head of Health Services Atlantic Institution presented the program objectives:
- To reduce injection with previously-used needles, a practice documented to be associated with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) transmission.
- To reduce the number of non-sterile needles in circulation.
- To facilitate referral to available drug-dependence treatment programs including mental health services and opiate agonist treatment (OAT).
- To reduce transmission of blood-borne viral infections including HIV and HCV.
- To reduce the occurrence of skin infections related to injection drug use, to decrease need for health care interventions related to injection-site abscesses.
She also present the Pillars (4) of the Canadian drugs and substances strategy :
The four pillars of the Canadian drug and substances strategy are:
- Prevention (Preventing problematic drug and substance use),
- Treatment (Supporting innovative approaches to treatment and rehabilitation),
- Harm reduction (Supporting measures that reduce the negative consequences of drug and substance use), and
- Enforcement (Addressing illicit drug production, supply and distribution.)
She also presented new CSC statistics on ID for men and women.
5. UCCO submits that it would be appropriate for staff to be trained on the signs and symptoms of overdose.
PIPSC reports that few health professionals are currently appropriately trained on addiction education and counseling. To be successful with this program, we must ensure that teaching and counseling are adequate and up to date with street drugs.
6. PIPSC believes that CSC should instead consider reinstating good practices and associated harm reduction funding, including; adequately reviewing the OAT program and providing the coaching that was present at the program early 2010, with dedicated resources for nurses and correctional program officers associated with addiction and substance abuse.
7. We were presented with kits containing the following items:
- Transparent sealable container
- Syringe with sliding safety device
- Crucible for cooking drugs
- Vitamin C
- filters
We were told that at Atlantic Institution, all the kit with soiled equipment are thrown into the biohazard waste box, while in other Institutions where the PNEP is active; women must return the contaminated syringe to a designated place, at the health center to dispose of the syringe in an appropriate container under the supervision of a member of the nursing staff. Thereafter the clean syringe would be given to the woman who would return to her room. Dirty syringes and new syringes are currently transported out of the transparent sealable container. This way of transporting syringes out of the container is, according to the PIPSC, less safe for the staff, but also for the women in the facility and this approach should be reviewed.
It was further explained that it is the responsibility of each institution to participate in the development of standing orders to frame the PNEP according to their own reality, involving employees including local health and safety committees.
11:00 to 13:00, Lunch and Learn
1. Meeting with the members who showed up in the meeting room at our disposal. A pizza meal was offered.
2. Discussion on the PNEP following the morning meeting.
3. Phoenix related discussion and the various problems and attempts of CSC correction since implantation.
4. Explanation of the application of the collective agreement in relation to salary ranges for NU-HOS-03 and restructuring by zone, which allowed some members to better understand why there were delays in reimbursement retroactive payments.
5. Explain the importance of having local consultations to have a consultation process that meets the needs of members on the ground.
13:00 Tour of the Institution
14:00 Meeting with health, mental health, other departments and NHQ staff.
1. Same presentations as the morning
2. Questioning professional accountability vs. overdoses or other incidents that could lead to an investigative process. NHQ representatives mentioned that during an investigation, what is verified is whether the CSC, Guidelines, Policies and various CSC procedures have been applied correctly. There is no reason for CSC staff to be blamed if everything is respected.
3. Security Issues: It was said that it should be treated in the same way as Epipen or insulin pens.
4. The physical environment is being questioned for storage, procurement procedures and the development of the standing order related to the PNEP. This must be discussed internally.
5. The Regional Director of Health Services is trying to convince health professionals that they are positive elements in the success of PNEP implementation and that their leadership will help to inform the staff of the facility.
16: 00 Back to the day with local delegates
1. Local delegates are encouraged to keep in touch with the regional representative on the subject of the PNEP, but also for any other forms of questioning related to union affairs and consultation.
Note that our day ran from 6:00 to 18:30. So we decided to change the schedule and not come back to Nova on March 13th.
Wednesday, March 13, 2019, Moncton
10:00 Meeting at the Delta Beauséjour to begin the report of the last two days.
11:00 Meeting with pharmacists at regional pharmacy
Pharmacists, local delegate, regional representative and V-P national consultation
1. Phoenix discussion: few problems except backlog due to payroll errors
2. OAT discussion
3. Information related to PNEP and meeting of March 12
4. Discussion related to this round of bargaining
13:30 Continuity of reporting and planning visit Dorchester Institution
Thursday, March 14, 2019, Dorchester Institution
10:00 am Meeting with a local delegate, regional representative and V-P national consultation
11:00 am Dinner meeting (see local delegate's report)
THE Lunch & Learn WAS A SUCCESS!!
Fifteen staff members joined me, Richard Doyle and Susan Beaton at the Lunch & Learn held yesterday March 14th in the Unit 1 Boardroom at DP Medium.
Richard and Susan delivered a lot of excellent information regarding the needle exchange program, the safe injection sites, our pay rates, Phoenix stuff, staffing, and more. The group was very involved in the conversations, we shared lots of concerns and many questions were answered.
This information session was a positive experience and I am looking forward to organizing more for the PIPSC members.
Thank you for all those who helped making this Lunch & Learn a success!
Personally, I appreciated the participation of Dorchester members. We were able to follow up on our discussions last October during my first visit and discuss workplace wellness issues. We also took the time to make a collective awareness of how to make local claims and the importance of local consultation. The idea of having new delegates in the Institution was also raised.
14: 00 Meeting with the PS-03 of the minimum (see report of the local delegate)
I would like to say that they visited the Psychological department at Minimum and we had an excellent visit with them. The only times we have someone from PIPSC coming to visit the psychology department at minimum is when the National team is coming down for a visit. They were very concerned and they saw for themselves our reality her at minimum and all the empty offices! Our local and regional team have to take the time to visit us at minimum and see for themselves what is happening. We are also members of PIPSC! Often our issues are just ignored.
The day ended in Dorchester at 16:00. We also talked about the issue of workplace violence and informal conflict management. I want to point out that the members of the psychology department are tired and that I felt some distress in the discussion.
I will conclude this report by sharing my personal impression. As a union, we need to make sure we are closer to front-line members and listen to them. Emphasis should be placed on local consultations, but also take the time to be on site and better share institutional information. Support for local delegates is paramount in the process of recognizing the importance of the union to our members, who often question the usefulness of their union.
Local consultation must be encouraged more than ever before and presenting national issues can make it clear to members that if they do not get involved locally, all decisions and actions will be dictated to them without them having anything to say and that they can control certain aspects of their work. Our presence locally for the PNEP is also appreciated; we give the impression that there is effective follow-up on this issue, which concerns members and employees across the country.