Tina Buckle, Community Health Nursing Coordinator, Nunatsiavut Department of Health and Social Development
In Nunatsiavut, we use Community Health Aides to support nursing staff in remote communities. We have a challenge recruiting and retaining nurses, and the aide position has allowed us to manage with fewer nurses. It’s a model that borrows from Labrador in the past and from Alaska in the present, where community health aides, local people from the community, help to deliver health care in remote communities. In Nunatsiavut, the community health aide has a role in both public health and home and community care.
In the Home and Community Care program, the community health aides function as the nurses’ “right hands.” They manage the home support workers, go with the nurse to client visits as needed, order equipment and supplies, schedule appointments, sterilize equipment, complete month-end reports, and anything else that doesn’t require a nurse to do. The nurse is then able to concentrate on direct client care. The aides also do independent home visiting to support the programs, both when a nurse is in town and when the position is vacant.
Just as important, the aides are the cultural advisors to new nurses. They are so trusted in the community that any new nurse is immediately accepted if accompanied by the aide. From a senior care perspective, the aides have the ability to spend more time with seniors than the nurses do; also, they have personal connections and speak the language. We have also given the community health aides tours of the regional health and long-term care centres in Happy Valley-Goose Bay so that they can describe them to seniors and their families and help them become comfortable with the transition.
It’s hard to quantify or even to put into words the value of community health aides —essentially, we would not be able to deliver care without them and clients would not be as willing to receive care. It’s hard to understand why this model hasn’t spread to other parts of the country, particularly since it’s also well known in Alaska. I think there’s almost a strange fear that by allowing this kind of practice we’re encouraging people to be community health aides instead of going into the health professions, but that’s not what it’s about at all. There is an incredibly valuable role for these people at the community level that no one else can fill like they do.