Embracing Opportunities for Growth and Seeking your Passion
Talk Tuesday - June 2, 2020




In today's healthcare environment it is easy to get discouraged and burdened by resource limitations and the complex challenges our patients face daily. Covid-19 has impacted us all, both personally and professionally. There is no better time than this to gain clarity on what we are passionate about in order to open ourselves up to future opportunities for growth so we can discover our dream role. The nursing profession has endless opportunity to embrace one's passion within traditional and innovative roles. Dream big and step out in faith to embrace the nurse you want to be. Join Cindy as she shares lessons learned through her 25 year career from medical-surgical unit to nurse leader pioneering new NP roles within and outside the public healthcare system. 

Presenter

Cindy Fehr RN, MSN, NP, Nurse Practitioner Association of Manitoba CEO 

Cindy Fehr is an experienced Family Nurse Practitioner passionate about a personalized approach to optimal wellness, enhancing one's natural inner and outer beauty, and providing holistic comprehensive care. Cindy practices in primary care, hospital practice and aesthetic medicine within rural Manitoba while also exerting a leadership role through her CEO position with the Nurse Practitioner Association of Manitoba. Cindy holds a Master of Education degree in Adult, Community and Higher Education as well as a Master of Sciences degree of Family Nurse Practitioner. She is a lifelong learner and currently pursuing Canadian Board of Aesthetic Medicine certification.

Summary

Cindy Fehr spoke about her journey from working on a medical surgical ward as a registered nurse to accepting the role of CEO of the Nurse Practitioner Association of Manitoba. She described her career as being built around seeing opportunities for growth and walking through open doors. 

She acknowledged that medical/surgical, palliative care and gerontology aren’t usually seen as glamorous areas but they allowed her to develop fundamental, foundational nursing skills, an appreciation for how life can change in an instant and how people can live well despite illness and even the dying process. 

After an injury she was offered the opportunity to participate in ICU training as a way to return to work. This was a lot of work but, “as much as you put in is what you get out” and that deeper understanding of pathophysiology has supported her throughout the rest of the nursing career. 

One of Cindy’s favourite parts of working in ICU was spending time with students. With the goal of teaching in a nursing program she pursued a Masters in Education and did her thesis work in how to model mixed mode learning for nursing. She taught for a time, but missed clinical practice and wanted to look upstream at preventing illness, disease and disability rather than trying to fix things in acute care so she obtained certification as a nurse practitioner. 

At the time she graduated there weren’t any full-time jobs for NPs in BC so she came to Manitoba where she worked first in a Quick Care Clinic and then in creating a mobile primary care clinic. The program development content she had in her Masters degrees was useful preparation for outfitting and then creating the practice model to go along with the empty bus that came to be the mobile primary care clinic.

Cindy acknowledged feeling vulnerable while she worked through these new opportunities but encouraged nurses to consider why they were being offered opportunities and keep in mind that nurses navigate through and around challenges every day - we are trained for it.

Another episode of vulnerability was when Cindy was asked to consider taking on the position of CEO of the Nurse Practitioner Association of Manitoba. This was a big leap, but the role has brought her into community with people in politics, unions, and other organizations that have allowed her to influence change, not just for NP’s but for Manitobans. The changes may be small but they add up. 

Wrapping up, Cindy encouraged nurses to get involved in professional associations explaining that learning how they work, and through them, how the wider systems work, is crucial to being effective in any job we do. 

Do you have any experience with or thoughts about interprofessional or team competencies?

Interprofessional is the name of the nursing game. That’s how we’re trained, to work together, with other professions and with patients and communities. Understanding the training and scope of practice of the professionals we work with is so important for a respectful and effective working relationship.

How do you remain motivated and follow your passions when you continue to hear no? When you’re qualified but not given opportunities?

My philosophy has been to always look for different paths and go into interviews thinking the interview is for the interviewer. They may or may not offer her the job but if they don’t they’d be missing out. And if they don’t offer her a job it’s clear that their philosophy and goals aren’t aligned with hers as an applicant so that would be a draining place to work anyway.

I am a nurse who graduated early, I’m in my early 20’s, and I’m finding it hard to feel competent moving up in my career. I’m often scared of what the older nurses would think though I believe I’m competent, any advice?

It was difficult when I got a job in critical care, I was told I only got it because it was a workplace accommodation, I didn’t deserve it, shouldn’t be there etc. It was hard to hear and made me work twice as hard so I could feel less vulnerable to these criticisms. It was hard to put those opinions to the side but confidence came as I worked and studied. Speaking of those who may be critical, “They’re going to be there whether you are or not so you might as well do your thing, just go for it!”

How long did you work in acute care before you felt confident to do ICU?

I worked medsurg for 3-4 years before my ICU training but that shouldn’t discourage people from applying earlier. When I graduated from nursing school students were able to do their practicums in ICU’s and get jobs when they were done.

 

How do you feel about OSCE’s for NP licensure?

I did it and survived. But given an individual has trained and been tested on theory and clinically at an accredited institution I don’t think it’s necessary.

Do you think having a pass fail system in our nursing education undergraduate and graduate programs would create a culture of support?

This has been debated for so long, yes in an ideal world it probably would. It would be a tough transition because the whole academic world is built around grades - your undergrad grades matter if you want to move forward to graduate studies. In order to qualify for scholarships, bursaries, other funding...you need grades. Those same grades don’t usually matter when you apply for a job but…

You mentioned the word competent a few times, what are your thoughts about competency based nursing education in Manitoba, similar to medical schools in Canada? Would that be a step in the right direction re: CRNM RN/NP competencies?

Yes, I think that there is a competency based foundation under the current nursing education system though it does feel overshadowed sometimes.

Are there any times when you miss being a bedside nurse now that you’re an NP?

Sometimes when the weight of diagnosis and decision making feels bigger or more burdensome yes but that’s what the training was for. The hard work is more mental than physical these days so the toll is a bit different but still there.

As a new grad, new to the acute setting, I feel there is a lack of mentorship, I find that junior nurses are pushed to be in charge after only 3 months… how do new grads access mentorship and get the backbone to say, “I’m not ready”.

Yes, being in charge is a big weight. One piece of mentoring is identifying who you connect with and sharing with them your admiration for their work, or the way they handle situations with patients, family or colleagues. These might not be the nurses who have students all the time. It’s okay to tell these nurses you’ve noticed and admired their work and ask if they’ll have coffee with you and you could ask them questions or ask them to tell you about strategies they’ve found useful for managing their workload / time / professional relationships.