Special partnership supports safe baby and mom care — north and south

Forty-six minutes into her first shift in the labour and delivery (L&D), Registered Nurse (RN) Charlene Linklater had already watched a childbirth, an intrauterine resuscitation due to fetal distress and—a first for her—manual removal of the placenta.  Her reaction at the end of the shift?  “I knew I was in the right place.”

Last month, Linklater travelled 840 kilometres south from Moose Factory to Kingston Health Sciences Centre (KHSC) as the first of a group of nurses from the Weeneebayko Area Health Authority (WAHA) slated to rotate through KHSC's L&D and postpartum care units, buddied up with KHSC nurse mentors, to develop and refresh their obstetrical nursing skills.

For the past three or four years WAHA has been unable to support an L&D unit so it has been sending low-risk pregnancies at about 36 weeks to KHSC.  Now, the refresher training comes as WAHA gets ready to repatriate low-risk deliveries once it opens a new regional health campus that will include an L&D unit. 

“Queen’s University and KHSC, as a referral site, have long supported WAHA’s Indigenous communities through the Queen’s Weeneebayko Program,” says Dr. Graeme Smith, Head of Obstetrics and Gynaecology at Queen’s University.  “We’re very committed to making WAHA services as safe as possible so providing this refresher training is the right thing to do as they get ready for a new hospital.”

"Every shift I just kept seeing more"

A 20-year nursing veteran who practices in inpatient medical/surgical, dialysis and emergency units at Weeneeybayko General Hospital, Linklater certified in obstetrics nursing 15 years ago.  She jumped at the chance to make sure her skills weren’t rusty.

“That first hour threw everything at me,” she says, “and every shift after that I kept seeing more—inductions, epidurals, fetal monitoring, C-sections and even caring for a COVID-positive patient. I was lucky to be in the right place at the right time.”

Linklater’s WAHA colleague, Simon Smallboy, certified in obstetrics nursing just four years ago but he landed at KHSC to pick up experience he has missed since then.

“The WAHA birthing unit closed before I could start practicing my skills,” he says.  “I asked to come to KHSC for firsthand experience with everything.  I’ve been involved in some precipitous or very rapid deliveries up north but what I’ve found especially helpful here is the preparation that goes into planned deliveries like scheduled C-sections and induced labour.  Now I have a much better sense about the planning and monitoring required and about how to make the mother more comfortable.”

As much as their units allowed—babies keep to their own schedules, after all—the mentor RNs, JoAnne Houston and Alex Stewart, kept Linklater and Smallboy on their toes with as much obstetrical action as possible during their two-week training stints.  For both KHSC nurses the north-south connection was mutually beneficial.

“It was more like a partnership with Charlene,” says Houston.  “Like her, I’ve worked in a rural hospital that calls for a wider scope of practice, so we compared notes a lot.

“I was also impressed with how easily she built relationships with patients. She was very genuine and warm with them.  That’s fundamental to nursing.  It comes with time and experience, and watching her gave me more perspective on my own practice.”

Working seven shifts with Smallboy has actually piqued her interest in practicing up north, says Stewart, a move she considered earlier in her nursing career. 

“It’s clearly a very close-knit community,” she says.  “Even during his short time here, Simon ran into several people he knew from Moose Factory who were at KHSC for medical reasons. It was nice for them to see a familiar face in this setting. 

“That only reinforced what he told me about how excited people are about reopening the birthing unit.  It will mean so much to families to be able to stay close to home for their delivery.  We know how much having loved ones close by benefits the mental well-being of laboring and new moms. It’s just good patient and family-centred care.”

The big takeaway for Linklater and Smallboy?  Much greater confidence in their L&D skills, in helping mothers with breastfeeding, in postpartum care and more.

“It was also a valuable workplace experience,” says Smallboy.  “We all know there can be stress in nursing but the L&D and postpartum teams at KHSC work so well together and support each other. It was nice to watch such teamwork in action as well.”