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Are you SKexperienced?
           4th CANAC Western Canadian HIV Nursing Symposium
                           March 15, 2013
Brett Dow MN – Manager Access Place and Outreach Services
               Prince Albert Parkland Health Region
Greg Riehl RN MA – Aboriginal Nursing Student Advisor
  Saskatchewan Institute of Applied Science and Technology (SIAST)
Outline
 • Current Scenario –
     – What is happening in SK
 •   Role of Nurse
 •   Role of our clients
 •   Discussion
 •   From your piers to our
     peers, what a great way
     to collaborate!
HIV is a Great Story
“One of the things that is destroying
  people with AIDS is the stigma which
      we attach to it. When a person
  realizes that they’re suffering from a
   disease which is shunned by friends,
  by parents, they feel ‘I’m a castaway’.
   Then they lose the determination to
    fight. One thing we must avoid is
   allowing people to lose hope for the
                  future.”




  The HIV/AIDS epidemic has become yet another disease Aboriginal peoples contract at accelerated
 rates, and at younger age, than in non-Aboriginal populations. Many of the social determinants that
    contribute to risk of HIV infection for Aboriginal peoples are associated with disempowerment,
poverty, forms of abuse, lack of education, and discrimination. Aboriginal women are infected at a rate
   far higher than in non-Aboriginal populations. In turn, their unborn children are at higher risk of
 infection. Prevention, education, open discussion, and acceptance of infected or affected persons in
                              Aboriginal communities, are urgently needed.
                          Healing Our Spirit BC Aboriginal HIV/AIDS Society Statement on HIV/AIDS
Our Health Regions and our
First Nation Treaty areas
What’s happening?
Stats from HIV and AIDS in Saskatchewan 2011, SK Ministry of Health, Nov 30, 2012
What’s Missing?




Above: HIV and AIDS in Saskatchewan 2010, SK Ministry
of Health, Nov 30, 2011

Right: HIV and AIDS in Saskatchewan 2011, SK Ministry
of Health, Nov 30, 2012
What should BC know about SK?




      We like to collaborate!!!
Are you Skexperienced?
Harm Reduction
Nursing Education Program of
  Saskatchewan NEPS 325
       February 2013

                     http://www.slideshare.net/griehl
We are challenging the next generation of Nurses
Culture

• Harm Reduction is new to First Nations.
• HIV is still pretty taboo in a lot of communities.
   – BCR??? What the? Are you serious?
• Leaders hold the power to help.
• The problematic use of drugs is not the
  “problem”, it is a symptom of much broader
  social problems that face First Nations, Inuit
  and Métis in Canada
http://www.skhiv.ca/index.html
SK HIV Strategy 2010-14 Goals:
                   Reduce the number of new HIV Infections
              Improve quality of life for HIV infected individuals and
                Reduce risk factors for acquisition of HIV infection




Community Engagement                  Harm Reduction   Clinical Management    Surveillance
   and Education                      and Prevention                         and Research

 http://www.health.gov.sk.ca/hiv-strategy-2010-2014
SK HIV Strategy 2010-14 Successes:
         We are currently looking at our success, that is the plan
    BUT, we need to focus on lived experiences, not just the numbers




Community Engagement                  Harm Reduction   Clinical Management    Surveillance
   and Education                      and Prevention                         and Research

 http://www.health.gov.sk.ca/hiv-strategy-2010-2014
Advocacy Silver, Gold, Platinum
So...



        FIX IT!
FIXED!
What?
• Improved access to
  mental health and         How & Why?
  addictions services
                            • Multi-sectoral
• Improved access to
                            • Multijurisdictional
  clinical services
                            • Community and
• Improved access to harm
                              leadership support
  reduction
                            • Client centred
                            • Holistic (physical,
                              emotional, mental,
                              spiritual)
Are you Skexperienced?
Above: The HIV/AIDS Medicine Wheel
By Albert McLeod
http://www.catie.ca/en/positiveside/springsummer-
2004/wheel-turns
Right: The Seven Sacred Teachings
http://www.thesharingcircle.com/sacred_teachings.html
Thank you
Contact information
                                                Greg Riehl RN BScN MA
Brett Dow RN BScN MN
Manager of Access Place and Outreach Services   Aboriginal Nursing Student Advisor
Prince Albert Parkland Health Region            Aboriginal Nursing Student Achievement Program
Access Place                                    Saskatchewan Institute of Applied Science and
101 - 15th St E                                 Technology (SIAST)
Prince Albert, SK, S6V 1G1                      Room 150.1 Wascana Campus
Phone: 306-765-6542
                                                4500 Wascana Parkway, PO Box 556
Cell: 306-960-3201 (25D5F531)
Fax: 306-765-6543                               Regina SK S4P 3A3
Email: bdow@paphr.sk.ca                         Phone: 306.775.7383
                                                Cell: 306.550.8176
                                                Email: greg.riehl@siast.sk.ca


   You can find our Professional Practice
   Group here, please like us -
   https://www.facebook.com/pages/SK-HIV-
   Hep-C-Nursing-Education-
   Organization/259234590779534

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Are you Skexperienced?

  • 1. Are you SKexperienced? 4th CANAC Western Canadian HIV Nursing Symposium March 15, 2013 Brett Dow MN – Manager Access Place and Outreach Services Prince Albert Parkland Health Region Greg Riehl RN MA – Aboriginal Nursing Student Advisor Saskatchewan Institute of Applied Science and Technology (SIAST)
  • 2. Outline • Current Scenario – – What is happening in SK • Role of Nurse • Role of our clients • Discussion • From your piers to our peers, what a great way to collaborate!
  • 3. HIV is a Great Story
  • 4. “One of the things that is destroying people with AIDS is the stigma which we attach to it. When a person realizes that they’re suffering from a disease which is shunned by friends, by parents, they feel ‘I’m a castaway’. Then they lose the determination to fight. One thing we must avoid is allowing people to lose hope for the future.” The HIV/AIDS epidemic has become yet another disease Aboriginal peoples contract at accelerated rates, and at younger age, than in non-Aboriginal populations. Many of the social determinants that contribute to risk of HIV infection for Aboriginal peoples are associated with disempowerment, poverty, forms of abuse, lack of education, and discrimination. Aboriginal women are infected at a rate far higher than in non-Aboriginal populations. In turn, their unborn children are at higher risk of infection. Prevention, education, open discussion, and acceptance of infected or affected persons in Aboriginal communities, are urgently needed. Healing Our Spirit BC Aboriginal HIV/AIDS Society Statement on HIV/AIDS
  • 5. Our Health Regions and our First Nation Treaty areas
  • 6. What’s happening? Stats from HIV and AIDS in Saskatchewan 2011, SK Ministry of Health, Nov 30, 2012
  • 7. What’s Missing? Above: HIV and AIDS in Saskatchewan 2010, SK Ministry of Health, Nov 30, 2011 Right: HIV and AIDS in Saskatchewan 2011, SK Ministry of Health, Nov 30, 2012
  • 8. What should BC know about SK? We like to collaborate!!!
  • 10. Harm Reduction Nursing Education Program of Saskatchewan NEPS 325 February 2013 http://www.slideshare.net/griehl
  • 11. We are challenging the next generation of Nurses
  • 12. Culture • Harm Reduction is new to First Nations. • HIV is still pretty taboo in a lot of communities. – BCR??? What the? Are you serious? • Leaders hold the power to help. • The problematic use of drugs is not the “problem”, it is a symptom of much broader social problems that face First Nations, Inuit and Métis in Canada
  • 14. SK HIV Strategy 2010-14 Goals: Reduce the number of new HIV Infections Improve quality of life for HIV infected individuals and Reduce risk factors for acquisition of HIV infection Community Engagement Harm Reduction Clinical Management Surveillance and Education and Prevention and Research http://www.health.gov.sk.ca/hiv-strategy-2010-2014
  • 15. SK HIV Strategy 2010-14 Successes: We are currently looking at our success, that is the plan BUT, we need to focus on lived experiences, not just the numbers Community Engagement Harm Reduction Clinical Management Surveillance and Education and Prevention and Research http://www.health.gov.sk.ca/hiv-strategy-2010-2014
  • 17. So... FIX IT!
  • 18. FIXED! What? • Improved access to mental health and How & Why? addictions services • Multi-sectoral • Improved access to • Multijurisdictional clinical services • Community and • Improved access to harm leadership support reduction • Client centred • Holistic (physical, emotional, mental, spiritual)
  • 20. Above: The HIV/AIDS Medicine Wheel By Albert McLeod http://www.catie.ca/en/positiveside/springsummer- 2004/wheel-turns Right: The Seven Sacred Teachings http://www.thesharingcircle.com/sacred_teachings.html
  • 22. Contact information Greg Riehl RN BScN MA Brett Dow RN BScN MN Manager of Access Place and Outreach Services Aboriginal Nursing Student Advisor Prince Albert Parkland Health Region Aboriginal Nursing Student Achievement Program Access Place Saskatchewan Institute of Applied Science and 101 - 15th St E Technology (SIAST) Prince Albert, SK, S6V 1G1 Room 150.1 Wascana Campus Phone: 306-765-6542 4500 Wascana Parkway, PO Box 556 Cell: 306-960-3201 (25D5F531) Fax: 306-765-6543 Regina SK S4P 3A3 Email: bdow@paphr.sk.ca Phone: 306.775.7383 Cell: 306.550.8176 Email: greg.riehl@siast.sk.ca You can find our Professional Practice Group here, please like us - https://www.facebook.com/pages/SK-HIV- Hep-C-Nursing-Education- Organization/259234590779534

Hinweis der Redaktion

  1. It pushes all the news buttons: it is a health emergency, it has a human face, it has elements of science, medicine, religion, it has deep grief and moments of extreme joy.It often has enemies: governments, the church, religious bodies, the fraudsters and snake-oil salesmen.It has heroes: the people living with HIV, community groups and NGOs fighting on the frontline of the epidemic, the scientists and researchers working for new treatments, a vaccine, a cure, and the doctors and nurses caring for the sick and dying.It is clear that HIV and AIDS is more than a disease that infects individuals.It is a social, economic and, in some countries, security crisis.
  2. - Biggest obstacle is still fear/stigma/discrimination – no matter what the approach/initiative (expand briefly relating to FN communities)
  3. http://www.health.gov.sk.ca/health-regions-maphttp://esask.uregina.ca/entry/aboriginal_treaty_rights.htmlhttp://www.aadnc-aandc.gc.ca/eng/1100100016346/1100100016350
  4. Current state in SKProvides knowledge, insight, understanding etcWhat else can it do? re separating data on aboriginal specific...Note 2010 to 2011 for next slide Can an event or condition ever be said to have a single cause? So, when HIV prevalence is reported for Aboriginals in Saskatchewan, what does this mean?In most cases, HIV prevalence cannot be accurately determined from reported cases because many infections are undiagnosed or unreported. The best estimates are mainly based on the results of surveys of large groups of people.
  5. -comment on why stats changed-how does this affect challenges previously referred to?
  6. SK will most likely never have a safer injection site/ ~2000 people are using injectable drugs in RQHR, about the same in Saskatoon RQHR provides ~2 million needle/year, SHR less Injected drugs of choice in RQHR: cocaine, morphine, dilaudid, oxycontinRQHR distributes and collects more needles that SHR and has lower HIV and HCV rates!People from SK like BC, we like to visit, we like to move to BC, but like Newfoundland, we like to come home…The success of the strategy will mean that, over the next couple of years, we will see increased HIV rates due to increased testing and tracing. It is expected that the HIV rates will decline in years three or four as the intervention/prevention initiatives start showing effectiveness. Letter to Mark Lemstra Greg and Scott
  7. Role of SK Nurses in the SK HIV/HCV Nursing Education OrganizationThe mission for the Saskatchewan HIV/HCV Nursing Education Organization is achieved through:Providing accessible and affordable education and learning opportunitiesCreating a network of members by which support and mentorship can occurServing as a provincial voice for issues related to HIV and Hepatitis nursing careAdvocating for the rights and dignity of people who are living with HIV/AIDS and/or HCV, or who are vulnerable to these infectionsSupporting a collaborative professional practice environmentPromoting professional growthImproving patient/client/resident outcomes
  8. Saskatchewan has seen a significant increase in new cases of HIV since 2003 and currently has the highest rates in Canada at twice the national average. (20.8 vs 9.3/100,000) The epidemiology of HIV in Saskatchewan is different than the rest of Canada, with new HIV cases associated predominantly with injection drug use (75%) with First Nations and Métis women under age 30 accounting for a disproportionate number of those cases. What is the government doing to prevent the spread of HIV? Why is it up to the government?What is it/we doing to help those already infected?Does it have a program to provide antiretroviral treatments and drugs for opportunistic infections for people with HIV?Does it involve people with HIV, along with scientists, researchers, doctors, nurses and community groups in the development of its HIV Strategy? Does it even have a strategy? Is the Strategy an actual Strategy?How much money does it devote to HIV? What about sexually transmitted infections, which are often a precursor to HIV? What about NEP?Does it promote the use of condoms and encourage safer sex campaigns that accurately reflect the reality of people’s sexual lives?
  9. -brief development description-all SK implementing, etc
  10. We need to include stories and the voices of those providing care and those clients, individuals, families, groups and communities who receive care.
  11. http://theprospectorsite.com/blog/?p=2753http://www.forbes.com/sites/afontevecchia/2011/11/15/is-gld-really-as-good-as-gold/ http://bizmology.hoovers.com/2012/02/22/anglo-american-reviewing-platinum-business-despite-record-2011/stacks-of-platinum-bars/ Silver – what you do not want done to yourself, do not do to others Confucius or One should not treat others in ways that one would not like to be treatedGold – do unto others as you would have them do unto you. Platinum – do unto others as they want done unto them, basically treat other people how they want to be treated. This is really what we are trying to do with all people working in the HIV Strategy.
  12. -refer to need to look at all types of different approaches – including those outside healthcare-show video
  13. 3 examples of identify the problem/issue – and fix itNot quite that simplisticRefer to themes of 7 teachings when discussing the how & why (love, trust, humility, courage, respect, wisdom, honesty)
  14. https://www.facebook.com/injectingadvice
  15. -go figure....-so when I’m asked questions by people about how to achieve success in FN communities my reply is “ask them – they are the experts...”