Winnipeg Free Press

Winnipeg Free Press (Newspaper) - May 3, 2025, Winnipeg, Manitoba A4 ● WINNIPEGFREEPRESS.COM NEWS I FRONT AND CENTRE SATURDAY, MAY 3, 2025 Residents deal with gloom of staffing shortages, burnout, inadequate facilities but signs of progress glimmer in distance N ISICHAWAYASIHK CREE NATION — On a recent snowy April morning, Wanda and James Bunn packed up their ice-fishing gear and hit the road, never suspecting how much their lives would change within the next 48 hours. James was experiencing chest pain before they departed, but the couple — born and raised on the northern Manitoba First Nation, high-school sweethearts and now in their 40s and married for 19 years — dismissed it as heartburn. As the afternoon passed on the wind- swept ice of Footprint Lake, the frigid breeze did little to ease the pain. “James wasn’t fishing, so I should’ve known something was wrong then,” Wanda said in a recent interview. Worried about his health, she called Nisichawayasihk’s nursing station to tell staff the couple were on their way in. At the health-care centre, nurs- es hooked James up to an EKG and consulted with a doctor over the phone. The diagnosis: a pulled muscle. Nurses gave him an anti-inflammatory shot before sending him away. Wanda wasn’t convinced. Three years earlier, her mother went through a similar situation — despite experi- encing chest pain, she was improperly assessed and sent home, Wanda said. Her mother later returned to the nurs- ing station with chest pains, which was diagnosed as a second heart attack. Unlike many residents in Nisi- chawayasihk (also known as Nelson House), the Bunns had a vehicle. They drove an hour east to the emergency department at Thompson General Hos- pital to get a second assessment. After a series of tests and blood work, doctors confirmed James had suffered a heart attack. He was airlifted the next day to St. Boniface Hospital in Winnipeg, where a stent was inserted. Doctors told Wan- da if James hadn’t received treatment when he did, he likely would have suffered a fatal heart attack. “The doctor told him that artery is called a ‘widow-maker.’ So, I would have been the widow,” Wanda said. The Bunns’ story is common among northern First Nations. Throughout the North, health care is delivered primarily through community nursing stations — mostly small facilities with limited examination space and basic, often outdated equipment. Additional challenges, such as staffing shortages, inadequate housing for fly-in nurses and even a reliance on outdated paper medical charts can result in a substandard level of care. In Nisichawayasihk, two to four nurses are often on call at a time. When James Bunn sought treatment, three were on rotation. Residents have access to primary and emergency care, but the station lacks critical diagnostic equipment. While critics may argue over who is ultimately responsible for the crisis, they agree more must be done. “If the government can’t treat the First Nations people the way that they need to be treated, certainly, the staff and the nursing that goes in there is at a disadvantage already,” said Lorena Clace, co-president of consultation for Indigenous Services Canada, the feder- al department responsible for operat- ing nursing stations in First Nations, Inuit and Métis communities. Clace, an Indigenous nurse and member of Ontario’s Lac Seul First Nation, has spent more than 20 years with the department. She has worked in multiple First Nations in northern Ontario. N IKI Ashton, longtime New Democrat MP for Manitoba’s Churchill—Keewatinook Aski riding, argues Indigenous Services is part of the problem — a product of chronic underfunding. “The reality is that a lot of these nursing stations are staffed directly by Indigenous Services Canada, and Indigenous Services Canada is failing First Nations when it comes to making sure that there’s enough nurses and health-care staff to run the nursing stations,” she said. Ashton, who represented the riding from 2008 before losing the seat to Liberal candidate Rebecca Chartrand this week, is familiar with stories like the Bunns’. “People say they don’t go (to nursing stations) even if they’re sick, because they feel that they’re not sick enough. Or there are people that go and there’s concern that they’re not always getting the attention that they deserve,” Ash- ton said. Pam Spence, a longtime resident of Nisichawayasihk, said her husband waited for hours April 18 with symp- toms of pneumonia before leaving the station due to lack of care. Though he is now OK, she wondered what would have happened if the situation was more dire. Spence, 54, and husband Morley, 68, grew up on the First Nation. They have faced these issues with the nursing station for years. “The rule is you’ve got to call and make an appointment before anyone will see you, unless you’re dying, bleeding out — whatever emergency,” Spence said. Spence doesn’t drive, which means she doesn’t have the option of taking her husband to Thompson for care. “They always say ‘elders first, chil- dren first,’” she said. “It’s just kind of concerning that the people that don’t have resources get declined for basic health care.” Despite the limited capacity of the nursing station, Spence and the 2,400 residents of Nisichawayasihk have no other reliable alternative. The result- ing high demand makes staff burnout inevitable. Nurses are often flown in to work on rotation in the North. Once they arrive, they face their own set of challenges. Nurses are housed in staff accommo- dations while working in the commu- nity, but Clace said the conditions are sometimes inadequate. “The housing for the nurses is terri- ble,” she said. “There’s just no R&R for you, there’s no respite from work.” Clace said nurses often have to share homes with their colleagues. Even with separate bedrooms, the tight quarters leave little room for privacy and no opportunity to disconnect after a long day of work. At a news conference in Winnipeg in July 2024, Nisichawayasihk Chief An- gela Levasseur criticized the federal government’s response to the commu- nity’s health-care crisis. “What we’re most worried about with this crisis situation being ignored is that the two or three nurses that we have on a day-to-day basis are going to walk out,” she said. With inconsistent wait times and a rotating staff of nurses, residents like the Bunns who have access to a vehicle choose to travel for medical care — either an hour east to Thompson or an eight-hour drive south to Winnipeg. Elders with limited mobility and no access to transportation have nowhere else to turn. They rely on community support to get them where they need to be, advocates said. Joel Spence, who works with the nursing station providing transport for patients to Thompson, manages multi- ple trips a day for dialysis patients. The day begins at 5 a.m., with the first group of patients. Their treatment takes four hours. After a short rest, he picks up a second, wheelchair-bound group at 10 a.m., takes them to lunch, then to dialysis. He brings the first group home, rests again, then goes back to take the afternoon group out for supper around 6 p.m. They return home between 7 and 9 p.m., depending on how busy the restaurant is. The driver may be off as late as 10 p.m. by the time each patient has been dropped off. “Seventeen-hour shift,” he said with a chuckle. The time commitment is still the same even when patients need to travel for only brief, routine appointments. “Telehealth would probably suffice,” Spence said, referring to appoint- ments conducted over the phone. “It would probably be a big help, rather than the patients just going for a five-minute appointment where the doctor doesn’t need to physically touch them or assess them.” When it comes to infrastructure, there are signs of progress. In August 2024, a $157.9-million health centre opened in Norway House, complete with emergency, in-patient and palliative care and dialysis. A similar facility is slated for con- struction in Nisichawayasihk by 2028. The new NCN Health Centre aims to alleviate the burden on the nursing station and will include the same tech- nologies as Norway House. Potentially, it could include electron- ic health-record systems. The nursing station still relies on paper records, which, according to Clace, is typical in northern First Nations. “We just had a situation in Ontario where the nursing station burnt down to the ground. When that happens, you’ve just lost all your pa- tient records.” Lost charts mean lost medical his- tories. When patients are often seeing a different nurse each visit, access to these charts are crucial for providing continuity of care. The system is so outdated that when nurses come from larger centres, they are completely unfamiliar with paper-based charting. Clace said that puts nurses at a disadvantage in an already high-pressure environment. Due to the ongoing nursing shortage, ISC is sometimes forced to hire staff from non-emergency backgrounds. Many become overwhelmed with the demands and leave, observers said. M ARCEL Moody, deputy chief of Nisichawayasihk Cree Nation, said the com- munity needs to address the problem by training nurses locally. “The demands, they’re getting great- er. So we need to train more people that want to stay up north. Doctors typically don’t want to travel all the way to northern Manitoba or live in northern Manitoba,” Moody said. “We need to maybe train our own people to fill those positions right now.” Changes are underway to address those concerns. In fall 2023, the NCN Family & Community Wellness Centre — a facili- ty focused on improving community health — partnered with Brandon’s Assiniboine Community College to launch a practical nursing diploma program. Currently, 27 local students are enrolled. The goal is to train young residents to become nurses, with the understand- ing they will return to contribute to the community. Though they may disagree on where blame rests, both Ashton and Clace maintain the nurses themselves are not at fault. “Nurses that are working in commu- nities across the region are doing their best,” Ashton said. “What we’ve been pushing is for Indigenous Services Canada to live up to its obligations. It runs nursing stations across our region. It has contracts to provide nurses and they’re not living up to those contracts.” Clace does not dispute more needs to be done and emphasized how import- ant the nurses are to the communities. “(The government needs) to under- stand what a valuable service that the northern nurses provide, how different it is from many of the other nursing jobs that are out there. Nurses need to be respected, and they need to be valued for what they do,” she said. Ultimately, it’s the people in these communities who are left to pick up the pieces — to bear the weight of a system that doesn’t always work. “In the North, I think that it’s basi- cally the luck of the draw what kind of care provider you get and how fast you can be assessed,” Wanda Bunn said. “I’m just glad my husband’s alive today.” fpcity@freepress.mb.ca BRETT NICHOLLS Only two to four nurses are on-call at a time at the nursing station on Nisichawayasihk Cree Nation, which is west of Thompson and has 2,400 residents. HEALING NORTHERN NURSING STATIONS PHOTOS BY BRETT NICHOLLS / FREE PRESS This hallway leads to the three clinical rooms in the facility. ;