Providence Care is leading the way in specialized mental health, rehabilitation, geriatrics, complex continuing and long-term care. By teaching new health-care professionals and investing in leadership within our organization – it is the community that benefits.
Community nurse has many roles
Providence Manor residents benefit from team approach
Study looking for new treatment for anxiety disorders
Providence Care hosts first annual conference on leadership
Leading the way in palliative care – for 20 years
Community nurse has many roles
 When nurse Sandra Monroe said goodbye to a client she had worked with for four years, who could now be discharged, she says she got a big knot in her stomach.
“You watch these people who have stumbled so many times in their lives, you watch them stumble and try again, until one day they walk out of your office on their own, and it is a good feeling,” Monroe says.
Monroe is a nurse with Providence Care’s Dual Diagnosis Consultation Outreach Team (DDCOT). Based in Belleville, she and other members of her team do assessments, consultation, and treatment visits throughout Hastings and Prince Edward counties.
Part of Monroe’s job is to link her clients up to other community services, after she has done a full history and assessment with the individual and their families. Monroe says many clients are transitioning from one living arrangement to another. Clients can have any combination of developmental disability, mental illness, behavioral disorder or autism spectrum disorder, and range in age from 16 to 80.
“In my job you wear several different hats,” Monroe says. “Nurse, teacher, mentor, counselor… the list goes on.”
Monroe herself is an expert in the field of developmental disabilities. She is the third nurse in Canada to achieve her Developmental Disabilities Nursing Certificate, and is now working toward her BScN.
“I am a member of a team of people who provide service to people,” Monroe says. “The family doctors, case managers, Ministry of Community and Social Services agencies, and DDCOT – we all have a good working relationship and through that, the clients get top level care.”
Providence Manor residents benefit from team approach
For the elderly, painful pressure ulcers can develop in just a few short hours – and take months to heal. The ulcers develop when constant pressure damages the skin and underlying tissue. The pressure can come from spending a long time in bed, on a stretcher at the hospital, or sitting in a wheelchair.
But at Providence Manor, thanks to a proactive and cooperative approach, the percentage of reported pressure ulcers among residents is 50 per cent lower than the national average – and still dropping.
“We are preventing these ulcers from developing,” says Gloria Hamel, Program Developer at the Manor. “We have a team of committed nurses, personal support workers, physical and occupational therapists, dietary specialists and physicians who are the guardians of our wound care program.”
Prevention methods include helping residents change position regularly, ensuring they have pillows for support, and choosing appropriate activities or equipment. Treating existing pressure ulcers depends on diet, wound care and relieving pressure from the affected site.
Hamel says everyone from administration to frontline workers at Providence Manor is aware of the need to be proactive to prevent the ulcers, as well as offer the best treatment to those residents who already have them. The wound care team was recognized by the Registered Nurses Association of Ontario in 2007 for implementing Best Practice Guidelines.
Study looking for new treatment for anxiety disorders
 A new, cutting-edge therapy to treat common anxiety disorders is in the trial phase of a research study at Providence Care. Dr. Roumen Milev, the clinical director of Mood Disorders Research and Treatment Services at Providence Care’s Mental Health Services, says post-traumatic stress, obsessive compulsive and generalized anxiety disorder are among the types of anxiety disorders being looked at.
“Anxiety disorders are the most common mental disorders,” Dr. Milev says. “They cause a significant burden to the individual, who may suffer from lost productivity and income as a result. This research could lead to a new treatment choice for these people.”
The therapy, repetitive Transcranial Magnetic Stimulation (rTMS), involves stimulating areas of the brain with a magnetic field. There is no surgery and no need for admission to hospital. The treatment could also prove to be a good alternative for those who cannot tolerate the side effects of prescription drugs.
“This is groundbreaking research,” says Ann Shea, study coordinator. “TMS has never been used for anxiety disorders before – it’s been used to treat bipolar disorder and depression, and now we want to find out if it is as effective in other areas.”
Shea says she admires the patients who volunteer to participate in psychiatric research studies, in particular those who say it doesn’t matter if the treatment works for them or not.
“Many patients say they want to know that they are helping us find new treatment options, and advancing the science. Their feedback makes research an inspiring field to work in.”
Providence Care hosts first annual conference on leadership
Only by working together will we move forward – that was a key message from Margaret Wheatley, the renowned author and speaker who addressed hundreds of Providence Care staff and community health-care partners at Providence Care’s first annual Leadership Conference in September 2007.
Wheatley’s day long seminar capped off a week of leadership and professional development opportunities at Providence Care. In her presentation, she addressed the need to cherish relationships and grow leadership at all levels of an organization.
“This conference was possible because our senior management has identified building leadership capacity within health care at Providence Care as one of our key strategic goals,” says Lauri Prest, Director of the Training and Organizational Development department. In 2007-2008, T+OD offered more than 35 courses and learning opportunities to staff. Participation is high – over 350 people have participated in the sessions over the past year.
“Providence Care is committed to building our place within the continuum of care and taking a leadership role in doing so. We have created learning opportunities to learn and dialogue with each other. The end result is our staff is equipped to excel in their jobs and give the best patient care possible,” Prest adds.
In 2008, Providence Care will welcome guest speaker Reverend Mpho Tutu, the daughter of Archbishop Desmond Tutu. Mpho Tutu will speak at the second annual Providence Care Leadership Conference, scheduled for September 26.
Leading the way in palliative care – for 20 years
Providence Care has a history of leading the way. It was the early 1980s when Dr. Ivan Stewart saw the need for a palliative care program.
Stewart, who is now a palliative care physician, says ironically, “It was hard to convince health care workers that palliative care was a rewarding field to specialize in. It was even more difficult to convince doctors that palliative care and pain management could be delivered more effectively than it was.”
But at Providence Care’s St. Mary’s of the Lake Hospital, Dr. Stewart found support, and in 1987 the hospital opened a two-bed palliative care unit. In 2007, Providence Care marked the 20th anniversary of the unit. Now with six beds, over the past two decades staff and volunteers on “2 South” have cared for hundreds of end-of-life patients and their families. Some of the inaugural nurses, such as Cathy Perrin and Donna Owen, who started on the unit – are still involved today.
Nurse Educator Ann Murray, who coordinated anniversary celebrations last year, says after 20 years, Providence Care is leading best practices in palliative care. Dr. Stewart agrees, but acknowledges it isn’t always an easy field.
“People who are truly interested in palliative care recognize we’re limited in our ability to alter outcomes,” Stewart says, pausing.
“But we can certainly tremendously improve the patient’s ability to cope with every day that God provides us.”
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