Canadian Nurse

https://www.infirmiere-canadienne.com/blogs/ic-contenu/2021/08/12/une-ip-au-nunavut-source-despoir-pour-la-communaut

Aug 12, 2021, By: Laura Eggertson

Diane Batchelor sees her job as one of two nurse practitioners in Pond Inlet, Nunavut, in simple terms.

She provides hope.

In her own primary care practice, and as a support to the hamlet’s seven other nurses, Batchelor assesses and treats people with a wide range of illnesses, including complex advanced infections, pneumonia, tuberculosis, undiagnosed cardiac disease and cancer.

When she’s on call, two to three times a week for 12- or 15-hour shifts, she responds to heart attacks, stabbings, suicide attempts, physical abuse, and overdoses.

Despite its small size — Pond Inlet has a population of about 1,800 people — there is a high rate of trauma here.

There are no doctors living in Pond Inlet, the northern-most community on Baffin Island.

One community-based physician arrives each month to see patients referred by Batchelor and the other nurses.

Batchelor and one other nurse practitioner, the supervisor of health programs at Pond Inlet Health Centre, respond on their own to most medical problems and crises. When a medical problem is beyond their scope, they consult with doctors in Iqaluit.

At 71, with 50 years of nursing experience, Batchelor has traded in a formerly “elegant” lifestyle as an immunology specialist in the Netherlands for a fulfilling life north of the Arctic Circle.

Stunningly beautiful

‘I can always make people feel better and give them hope. That’s the beauty of being a nurse.’

Surrounded by mountains, Pond Inlet — known as Mittimatalik in Inuit — is one of the most stunningly beautiful places in Canada.

It’s also a climate of extremes. The average temperature in winter is -32°C, and 24-hour-a-day darkness lasts from mid-November until near the end of January.

But from early May to early August, the sun never sets. Like the unquenchable daylight, however, Batchelor’s spirit is undimmed by the challenges.

Here, she’s a trusted resource for her colleagues and her patients.

She can’t always make the people she treats better.

“But I can always make people feel better and give them hope,” she says. “That’s the beauty of being a nurse.”

One of Batchelor’s strengths is symptom management, she says. That’s where the hope comes in: keeping people symptom-free and keeping even chronic illnesses under control.

“I’m the first to consult if I don’t know, but with 50 years of nursing experience and knowledge, I can provide extensive, complex care before I have to consult with a doctor,” Batchelor says.

Manages symptoms

Her previous work delivering developmental drugs to end-stage cancer patients in clinical trials enabled her to develop interventions, including drug cocktails, to manage pain, nausea, vomiting and diarrhea.

“Most of the time the interventions really work,” she says. “That gives me so much professional satisfaction and pleasure to see people feeling better. Because we are all going to die at one point, but we want to feel good every day, and that’s what it’s all about.”

Hope is critical in Pond Inlet, as well as other parts of Nunavut. The territory has a constellation of social and economic challenges, spawned in part by colonialism and residential schools, that could otherwise defeat its residents.

Some succumb. The territory has a suicide rate seven times that of the rest of Canada. Young Inuit men are 40 times more likely to die by suicide than their southern Ontario peers according to the Inuit political organization Inuit Tapiriit Kanatami (ITK).

A housing shortage that results in 10 to 20 people crowded into the same small space has proven particularly risky during the COVID-19 pandemic. Fortunately, the community hasn’t seen any cases so far, and there has been a high rate of vaccination against the virus.

Nourishing laughter

“There is a lot of poverty and food insecurity, but there is a survival instinct and a love of life and lots of laughter that are just so nourishing for the soul,” Batchelor says. “The beauty of the land and its people — it’s incredible.”

Batchelor is also inspired by the Inuit youth who are combining traditional knowledge with new technology and advocacy.

“There’s a whole group of young men and women that are growing up who are just vibrant.”

Batchelor had already worked for eight years as a recovery room nurse in the Bronx, New York City, another 16 years as a research nurse coordinator at the Netherlands Cancer Institute and as a cancer care consultant for nurses throughout Holland before she signed on with the Government of Nunavut.

She’d also spent three years as an advanced practice nurse at the Cancer Centre of Southeastern Ontario.

She was a nurse practitioner at the Queen’s Family Health Team in Kingston, Ontario, in 2017 when a colleague asked her to help develop an advanced health assessment course for community health nurses in Nunavut.

Batchelor wanted to experience work in Nunavut first-hand before developing the course.

She began working stints in Pangnirtung, Goa Haven, and then Pond Inlet. She was teaching and orienting new nurse practitioners to their practice.

She quickly fell in love with the people, the landscape and her job.

All about nurses

“Up here, it is all about the nurses. I just found my niche as a clinical leader,” she says.

On any given day, Batchelor sees patients whose cases might discourage practitioners in the south. Recently, a woman with chronic pain from two bullets lodged in her back returned because the spinal surgeon Batchelor referred her to said surgery was too risky to perform.

Undaunted, Batchelor simply shifted her approach to start the patient on new pain medication and other strategies to keep her comfortable.

“Now we know it’s no longer possible to treat it medically, we have to treat her symptomatically. So we started that today,” she says.

She also carries out home visits and provides palliative care. Easing people into death without suffering is a rewarding part of her practice.

Living in the community full time has helped her to adjust her southern values.

She was prescribing a light diet of scrambled eggs, soup, rice and bananas to one 72-year-old patient with abdominal pain when he stopped her.

“He said, ‘I only eat fish. We don’t have that other food in our house,’” she remembers.

“Now I just ask people, ‘What have you eaten in the last 24 hours?’ and that gives me a better idea of what’s really happening.”

She also hands out food from a food closet at the clinic when her patients haven’t eaten and tries to help them access other services they need.

Inuit-led health care

Although Batchelor is adopting Inuit cultural practices as best she can, she’s conscious of the need to incorporate more community leadership in health care.

“We need to train more Inuit people in the communities to provide health care for patients because these southern values and health-care delivery principles just don’t fit all the time,” she says.

On the scarce weekends when Batchelor is guaranteed time off, she often goes out on the land with another colleague and an outfitter who shows them how to harvest seal and catch a glimpse of polar bears.

She’s also adopted a Jack Russell/Corgi mix named Emoji, and looks forward to the fall, when her son will be teaching school full time in the community.

After completing a video production course at Toronto Film School, Batchelor also hopes to profile the community and its members.

“Coming to Pond Inlet, I feel like I’m in touch with nature,” she says. “I may be less elegant on the outside, but I’ve been able to share a wealth of knowledge with people I just love — both the nurses and the patients. What a way to end your career.”

Laura Eggertson is a freelance journalist based in Wolfville, N.S.