Nurse Practitioners in rural and Indigenous communities during COVID-19: A grad nurse practitioner perspective

Talk Tuesday - July 28, 2020

Presenter

Michelle Weighell, RN(GNP) MN, Primary Care Nurse

Michelle Wieghell is a graduate nurse practitioner with a Master of Nursing from Athabasca University (January 2020), and a Bachelor of Nursing from Brandon University (2011). She currently works for Prairie Mountain Health and is honoured to work in the Canupawakpa Dakota Nation Health Centre and the Mobile Clinic at Birdtail Sioux First Nation, delivering primary care to both communities. Her role as an RN(GNP) also includes work at the Brandon COVID-19 Specimen Collection Centre. 

Her previous nursing experience includes rural acute, long-term care, and working as a direct service home care nurse. Most of her nursing career has been spent as a home care case coordinator in various rural communities in southwestern Manitoba. Michelle is passionate about delivering culturally sensitive, holistic primary care tailored to the individual, understanding that we are all unique beings.  It’s through this lens that she advocates for equitable health services for Indigenous and rural communities.

Summary

Michelle Weighell, a graduate nurse practitioner working in the Prairie Mountain Health Region shared her experience of planning for and navigating practice changes as a result of COVID-19. 

Michelle started by acknowledging the people who’ve supported her professionally and personally these last few very eventful months. Her graduation had initially been postponed because of the forest fires in Alberta but has now been cancelled because of COVID-19. Michelle’s first day as a graduate NP was Feb 3, 2020 and her first day working independently was March 4. Just as she was developing her routine, getting to know the people and processes that were new to her, they all started to change…

Michelle walked through the sequence of events from the March 11 when the WHO declared COVID-19 a pandemic, through the establishment of COVID-19 testing sites, the shift from primary care to COVID screening, and back again. She also noted and explained some of the challenges faced in rural and remote communities like poor cellular coverage, limited access to internet, restricted access to laboratory testing, stigma, workload, information overload and trying to balance these workplace realities with learning to homeschool. 

The support of colleagues and family helped her through the first few months of NP practice. She mentioned some additional resources available to healthcare staff including AbilitiCBT and EAP. 


Question and answer

1. Did you have meetings with leadership as well? How did you build relationships with community health staff?

Yes! We were in almost constant communication with health directors in both communities. Administration attended meetings with council and other community leaders and the discussion and decisions that followed filtered down to clinical staff. The clinical staff are constantly working alongside community supports. It’s been a bit different getting to know the people and processes when you can’t meet anyone in person but everyone understands things are different and are being quite gracious to each other.

2. What kind of challenges did you have working in First Nations during the pandemic?

  • The technology limitations were the most dramatic. Options that are available elsewhere just don’t exist in some places. Sometimes there's not even a little cell coverage and even if you can pay for it, the Internet isn’t available.
  • Another big barrier was transportation. Both of people to appointments but also of medications to communities without their own pharmacy, which takes up to a week during normal times.

3. What kind of preparations are being made in Indigenous communities for a second wave of COVID-19?

I haven’t heard anything formally though I would expect returning to more restricted access to communities again and possible withdrawal of external services to reduce the risk of importation of the virus.