Newsletter No. 12, June 2005
I've been a street nurse in Toronto
for 15 years. In the spring of 2004 I received the Atkinson Economic Justice
Award which permits me to pursue, for up to three years, my passions for
nursing and working on homelessness and housing issues. In this
newsletter I hope to report on my activities, create a link to a broader
group of individuals who care about these social issues and encourage
In last month's newsletter, I talked about Nurses Week. This month, on June 9th, I was awarded an Honorary Doctor of Laws degree from the McMaster-Mohawk-Conestoga Collaborative Bachelor of Science in Nursing Program, in Hamilton. I thought I would share with you the speech I made that day.
Nursing is Attending to Meaning
Honorary Doctor of Laws (LLD)
Mc Master University, Hamilton, Ontario
June 9, 2005
This is truly a wonderful honour for me. Thank you Mr. Chancellor, Dr. George, Dean Kelton, Dean Catherine Tompkins and the entire nursing faculty.
I want to thank my own friends and family, and those of the graduates, for being here with us today. And most of all, I want to thank you, the Graduating Class of 2005; I want to thank you - for going into nursing.
I have been many different types of nurse in my career – a cardiac nurse, a public health nurse, a camp nurse, a nurse practitioner, and for the last 16 years I have been a Street Nurse. One of my hobbies is a collection of Harlequin style nurse books with job titles I’ve never had like “Cruise Ship Nurse”, “Peace Corps Nurse”, “Factory Nurse” and “Settlement Nurse”.
Regardless of the type of nurse you choose to be, there will always be something that unites each of us as nurses.
In my own career, whether I was bringing portable toilets into Tent City, or fighting for an inquest into homeless deaths, or marching in an anti-war rally calling for our government to build homes here, rather than support the bombing of them in Iraq – I was always doing nursing.
I want to share with you a definition of nursing that has meant a great deal to me. I’m not exaggerating when I say that this definition, and you could call it a theory of nursing, has stayed with me every single day since I first heard it, more so than the words of Rogers, Parse, Roy, Watson or Nightingale for that matter.
I don’t know who first coined this phrase but it’s the best definition of nursing I have ever heard and its only 5 words long: Nursing is attending to meaning.
I’ve had many self-doubts over the years, wondering what I’ve gotten myself into, whether I’m fighting against extra-billing by doctors, or leading Nurses for Social Responsibility during the “fallout” after the Chernobyl nuclear accident, or dealing with the problem of lead pollution in South Riverdale, or the man-made disaster of homelessness.
I would think about that definition, those five words, and I would always know that I was on the right track.
Nursing is attending to meaning.
Does that mean nursing is about the meaning of life? Well no, but it is about the meaning of living. Attending to meaning is about attending to the individual, attending to the family and attending to the community that you are nursing.
We, as nurses, stand front and center when tragedies happen and disasters occur. So we, as nurses, will know:
What it means for the person in pain, anxiously waiting for test results or surgery.
What it means for the individual and the family who lose a child or a loved one.
What it means when a warehouse fire in an industrial zone spits out toxic fumes.
What it means to be hungry and not have enough food money for your family three weeks of the month.
What it means to be homeless, knowing it is not temporary and you will probably be homeless for another 5-10 years.
What it means to give up a severely disabled daughter to the Children’s Aid Society so that she can obtain necessary care.
What it means to need real choices in health care and that includes safe access to abortion. I would like to thank Dr. Henry Morgentaler for giving us that choice, and in fact, one week today, he will be receiving an honorary doctorate from the University of Western Ontario, the same doctorate that you have bestowed upon me today.
Nurses know what it means to be a nurse when an outbreak like SARS hits and we are front and centre, providing care in a disorganized health care system. Who can argue when a nurse like Street Health Nurse Barb Craig says, “What if the first case of SARS had entered St. Michael’s Hospital? It could have entered the shelter system and it would have been impossible to contain.”
It was nurses who spoke up and made their voices heard. And that, more than anything else, is what attending to meaning is all about: speaking up and speaking out. This can be what we do best. My friend and journalist Michael Valpy says: “Nurses have the highest believability quotient among all health care practitioners.” And, as my dear friend Nurse Dorothea Jakob has always taught me: “witnessing what we see, explaining it, exposing it, telling the truth, that is inherent to being a nurse. “
Yet sadly, many of us know the meaning of being silenced. Our nursing voices are often suppressed – by doctors, by hospital bureaucracies, and by our own unpreparedness. In fact, I remember all too well, an experience I had a few years ago when I was forced to do a CBC interview on the subject of tuberculosis in the journalist’s car, in a dark alleyway instead of openly in my health centre. That experience made me really appreciate the complete and necessary role of nursing, to witness, explain, expose and tell the truth.
I would like to thank the Atkinson Foundation, who gave their support to nursing when they honoured me with the Atkinson Economic Justice Fellowship last year. I’d also like to thank the Sherbourne Health Centre for giving this “homeless” nurse a base, a “home” and support to continue my work for a national housing programme.
Our nursing voices are still spreading their wings and the risks to those who speak out can be real. But oh, when we do speak out, it is always a good thing.
I remember RNAO speaking out on behalf of former pediatric nurse Susan Nelles who, in what can only be described as a modern day witch-hunt, was charged with the deaths of infants at the Hospital for Sick Children.
I remember the Winnipeg cardiac nurses who exposed the high death rate of babies in a cardiac surgery unit.
I remember the public health nurses who helped to expose lead poisoning in children.
I remember the nurses who pioneered some of the cutting edge services in our country: in the free-standing abortion clinics, in the vans that took health care to immigrant women, and in the sexual assault care centres.
And of course, I remember MacSOC, the McMaster University Student Outreach Clinic that, since 1999, has been bringing badly needed services to the homeless, the poor and socially marginalized here in Hamilton.
Be proud that you are a nurse. You can walk into a room, a family home, a homeless shelter, a community meeting and say “I’m a nurse. What can I do to help you? – which really means what do you need, how can I support you and fight for what you need? And you can, and you will make a real difference in this world.
Nursing often gets described with “C” words, like caring, compassion, competent, and committed. There’s nothing wrong with those words but I tend to prefer the “P” words: power, politics, people and passion.
We are nurses and McMaster Graduating Class of 2005 I am so proud to be in your company.
On June 2nd, I was invited to the Canadian Museum of Civilization, where, believe it or not, my black bag will soon be on display as part of a year long exhibit called The Caring Profession/Une histoire de coeur. My black bag holds many meanings and memories for me.
A number of years ago, my friend and colleague Michael Shapcott asked me to bring my black bag to Ottawa for a press conference that Libby Davies, the NDP housing critic, was hosting in the press gallery at the House of Commons. Michael felt that it would visually bring our point home. I explained to the press, "Look this is what a street nurse has to carry in her black bag because her patients don't have a home." As I was pulling things out of the bag to show the media, I was flooded with images of the people I had known and I began to cry. I was pretty puzzled by that because I had not expected to get emotional. I later wrote an article for the Globe and Mail called "My Black Bag Made Me Cry" (see below). This led to many people learning about my bag. Film maker Shelley Saywell contacted me and made the documentary Street Nurse. Christina Bates from the Canadian Museum of Civilization contacted me and asked to see my bag. She then asked me to donate it to the museum. I believe it will be lovingly cared for and appreciated for the story it tells about the need for a national housing programme. I hope you'll have a chance to visit the exhibit in person (more information).
My black bag made me cry
A show-and-tell for adults that shows how bad homelessness really is and demonstrates the intimacy and horror of what nurses do
A trusted friend recently implored me to bring my nursing black bag (actually it’s a knapsack) to a very public event that we were planning to attend. He advised me, as only he can do: “People will find your bag so interesting they will learn a lot about what you do when they see what’s inside.” So I grudgingly lugged my 30-pound black outreach bag, which had given me nine months of a rotator-cuff injury last year, on a five-hour trip to Ottawa for its five minutes of fame.
It was a very public show-and-tell.
The last time I had opened my black bag so conspicuously was on the altar of a United Church in Toronto. It was the minister’s idea. She invited the children to the altar to sit with me, before they dashed off to Sunday school, at which point I would give the first sermon of my life to adults on the topic of homelessness.
One by one, the children were invited to put their hands into the darkness of my black bag to pull out a surprise. To each surprise, the minister asked each child: “Why do you think Nurse Cathy carries socks in her bag? Why does she carry granola bars and milkshake drinks and vitamins?”
The children, with sweet and innocent expressions of concern, quickly responded with all the right answers. Sadly, I thought to myself, they knew the answers.
This time, the show-and-tell was meant for adults. The message: See how bad homelessness is – I’m a nurse, but I have to carry socks, mitts, a blanket, vitamins, even food!
On cue, my hands nervously groped inside my black bag to find the right contents to demonstrate the intimacy and horror of what I and other nurses do every day. In a clinical fashion, I explained their purpose to the adults in the room:
“You see, we now see signs of starvation and malnutrition, so I carry Ensure.”
“We don’t have enough sleeping bags in Toronto, so I carry these space blankets.”
“The duct tap is for taping the soles back on shoes, but also for taping cardboard together for a roof.”
As I spoke, my heart raced. I wondered later – how had the contents of my bag and the way I nurse changed so much? To my surprise, I began to cry.
It is said that your body holds memories, and my nurse hands clearly remembered better days. My nurse hands once did more useful things.
They immunized the fat, healthy thighs of infants, they carefully measured cardiac drugs to administer to young heart patients, they bathed both the elderly lady after her surgery and the 24-year-old Italian-Canadian woman after her death. My hands once mixed linseed poultices, rubbed 20 backs a night before darkness fell and, by flashlight, checked intravenous drips, catheters and other tubing. They made hot milk in the middle of the night and then, later at home, soothed a child with too-frequent earaches.
I’m thankful, in retrospect, that my hands always felt needed. To help colleagues make 30 beds on a ward on a short-staffed Saturday morning; to write a letter for an elderly stroke victim to his long-lost sister; to shop for canned salmon and strawberries for the retired recluse that I was told to discharge from my public-health nursing caseload (“he was not achieving any goals,” said my supervisor).
More recently, they held on to a dying father’s hands.
These are good uses for hands.
My black bag is still at my friend’s house. Despite being so full, it feels so empty.
My bandages no longer cover the wounds of my patients. My vitamins will not prevent the white plague of tuberculosis from taking another victim. I cannot even help someone achieve one peaceful night of safety and sleep. Only roofs will do that. And I am not a carpenter.
Originally published: March 16, 2000, Facts & Arguments, Globe and Mail
A national conference on homelessness was held at Toronto's York University in May. I was reminded of the role of nursing in fighting homelessness when approximately 35 nurses from across the country came together for our first national street nurses meeting. Later in the conference, I'm proud to say that we passed a resolution to end homelessness in Canada. It's available on the TDRC website (click here). I encourage you to read it and determine how you can use it in your own community. Can you send it with a covering note to your MP? Can your organization also adopt it? Will your city council adopt it? Will your local newspaper do a story on it? Do you have other ideas? Please le us know.
Resolution: End Homelessness in Canada
adopted by the Canadian Conference on Homelessness, May 20, 2005
WHEREAS the provision of and access to adequate housing is a fundamental human right according to paragraph 25(1) of the United Nations Universal Declaration of Human Rights, which reads as follows:
‘‘Everyone has the right to a standard of living adequate for the health and wellbeing of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.’’;
WHEREAS in 1976 Canada signed the International Covenant on Economic, Social and Cultural Rights, a legally binding treaty, committing Canada to make progress on fully realizing all economic, social and cultural rights, including the right to adequate housing, as outlined in paragraph 11(1) of the Covenant:
‘‘The States Parties to the present Covenant recognize the right of everyone to an adequate standard of living for himself and his family, including adequate food, clothing and housing, and to the continuous improvement of living conditions. The States Parties will take appropriate steps to ensure the realization of this right.’’;
WHEREAS the enjoyment of other human rights, such as those to privacy, to respect for the home, to freedom of movement, to freedom from discrimination, to environmental health, to security of the person, to freedom of association, and to the equal protection and benefit of the law are indivisible from and indispensable to the realization of the right to adequate housing;
WHEREAS the measures required of State Parties to the Covenant arise out of paragraph 2(1) of the Covenant, which provides that State Parties undertake to take steps to the maximum of its available resources, with a view to achieving progressively the full realization of the rights recognized in the present Covenant by all appropriate means, including particularly the adoption of legislative measures;
WHEREAS the United Nations Committee has been highly critical of Canada’s failure to make progress in guaranteeing the right to adequate housing for all Canadians, in light of Canada’s relative affluence, a criticism made most recently in its concluding observations of December 10, 1998:
‘‘The Committee is gravely concerned that such a wealthy country as Canada has allowed the problem of homelessness and inadequate housing to grow to such proportions that the mayors of Canada’s 10 largest cities have now declared homelessness a national disaster.’’;
WHEREAS the United Nations Committee issued a specific recommendation that Canada implement a national strategy aimed at reducing homelessness and poverty, which reads in part:
‘‘The Committee recommends that the federal, provincial and territorial governments address homelessness and inadequate housing as a national emergency by reinstating or increasing, as the case may be, social housing programs for those in need, improving and properly enforcing anti-discrimination legislation in the field of housing, increasing shelter allowances and social assistance rates to realistic levels, providing adequate support services for persons with disabilities, improving protection of security of tenure for tenants and improving protection of affordable rental housing stock from conversion to other uses. The Committee urges the State Party to implement a national strategy for the reduction of homelessness and poverty.’’;
WHEREAS Canada’s wealth and national budget are more than adequate to ensure that every woman, child and man residing in Canada has secure, adequate, accessible and affordable housing as part of a standard of living that will provide healthy, physical, intellectual, emotional, spiritual and social development and a good quality of life;
WHEREAS Canada has historical and legal obligations to the First Nations People who have a unique and special relationship with the Crown and the people of Canada, as manifested in treaties and other historical documents;
AND WHEREAS achievement of improved housing conditions is best realized through co-operative partnerships of government and civil society and the meaningful involvement of local communities;
NOW, THEREFORE, BE IT RESOLVED, that
1) we call on the federal, provincial/territorial and municipal levels of government, in cooperation with people who are homeless and poor, civil society institutions – including, but not limited to non-governmental organizations, charities, faith communities, women’s organizations, people with disabilities, LGBTTTQ organizations, unions and racialized communities - and Aboriginal communities and organizations, to develop and agree to, as a matter of top priority (within six months) a national strategy to end homelessness with specific goals, targets and time frames including the adoption, by every municipality, with enabling legislation where required, a blueprint and implementation plan for the elimination of homelessness;
2) we call on the federal and provincial/territorial governments to provide the funding necessary to fully implement the national strategy and local, community-driven, community-based blueprints to end homelessness through a special funding package for (1) adequate housing, (2) adequate income support, and (3) adequate support services to implement the local blueprints; that a clear statement of responsibilities of different levels of government be defined (one that does not rely on joint funding); that an inter-governmental body be appointed to oversee compliance and progress toward the goals; and that this inter-governmental body have independence from the government of the day (such as the auditor’s offices) and that it be given a mechanism through which affected constituencies can be heard, complaints considered and inter-governmental conflicts resolved;
3) we call on local, regional and national civil society institutions across the country to mobilize support for the local blueprints to end homelessness and to help ensure that spending is allocated to this top social priority by all levels of government;
4) we call on the business community, large and small and local and national corporations, and national corporate lobby organizations, to actively join in with civil society organizations and governments in a partnership that ensures highest priority is given to ending homelessness and that adequate resources are allocated as a matter of top priority;
5) we affirm that a dedicated national effort can end the mass homelessness now common throughout Canada within five years and that the few remaining shelters necessary for emergency use in our communities will be used for very short-term stays.
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