Change Maker
BEING THE CHANGE One of Christine Sorensen's biggest joys is spending time with BCNU members who are working hard to make positive change to happen in their regions and workplaces.
Christine Sorensen recalls the winter of 1998 when fear ran through the community she was serving. People had begun to fall ill, and it was soon discovered that someone who had recently returned from overseas had contracted meningitis.
Public health officials quickly sprang into action to combat the contagious disease. Education and vaccination sessions were booked at the local church and public health leaders wanted "all hands on deck."
Sorensen was one of the first nurses to volunteer for the weekend clinics. The program manager promised overtime pay to persuade staff to work the extra hours. But when management backtracked on this commitment, she took a principled stand and refused to drop her family responsibilities to work the clinics.
As the situation evolved, Sorensen recalls that the worst part was feeling judged and shamed by the manager for not sacrificing her personal obligations to work the long extra hours. "For me it wasn't about the lost overtime pay, it was about the broken commitment," she says. "Health-care leaders expect a lot from nurses and they need to know that we expect a lot from them in return.
"Public health nurses were working a lot of unpaid overtime as we tried to make a difference for far too many patients," says Sorensen. "Unmanageable case-loads were the norm at my worksite and at others across the province."
Despite the working conditions, Sorensen reckons she was like many public health nurses – not really aware of the union and just trying to do the best she could for her clients. But the meningitis outbreak and subsequent attempts to shame her into working overtime at straight time prompted Sorensen to read her collective agreement closely and learn about her rights and responsibilities.
"In the late 1990s community health nurses were just an addendum at the back of the contract," she says. "We didn't feel included in the union and being at the back of the contract felt symbolic. I needed to change that."
This decision started a chain of events that soon saw Sorensen become increasingly active in her union. She quickly learned that BCNU gave her a platform to advocate for better practice conditions for nurses and better health services for the sick children she served in her public health unit.
Sorensen's practice focused on two areas. She was involved with communicable disease control and providing health education, and she was a nursing support services coordinator supporting children with medically complex conditions.
"I loved working in all aspects of public health," she recalls. "But the most satisfying part of my job was supporting the sick kids and their families who were outside the acute care system."
"We make progress by building trusting relationships with people."
That part of Sorensen's practice increased her desire to advocate for sick children across the province. "Nurses are always advocating for individual patients, but there were so many patients that I couldn't advocate for them all.
"I felt that the best way I could raise patient-care issues at a higher level was by getting involved in BCNU and using that platform to influence health policy across the province."
Sorensen served as a worksite steward before being elected to the provincial bargaining committee in 2009. She was elected chair of BCNU's Thompson North Okanagan region in 2010, and was then elected vice-president in the 2012 BCNU provincial elections. She was re-elected in 2014 and 2017. Last year she served as acting president after BCNU Council placed then-sitting president Gayle Duteil on leave. Following Duteil's departure last May, Sorensen was acclaimed president under the terms of BCNU's constitution and bylaws.
In her early days as a provincial advocate Sorensen recalls feeling torn between remaining in her practice and taking on full-time advocacy roles. But that would soon change.
"One afternoon I was at the BC Children's Hospital ICU and the grandfather of one of my patients stopped me in the hallway. He gave me a big hug and said he was sad that I was no longer providing front-line care. But he knew I would make things better for sick kids across the province," she remembers. "That helped end any doubts I had about being a provincial advocate at BCNU."
MAKING HEALTH CARE BETTER – ONE ISSUE AT A TIME
"Nurses see how to make things better and we want to fix everything," says Sorensen. "But achieving lasting change in a complex health system means we need to pick our issues carefully and make improvements one step at a time."
Sorensen says that one of the things union members need to push back against is the false narrative from profit-driven groups who say public health care is broken and we need to privatize everything.
"I don't believe that at all," she says. "We need to fix our public system and reaffirm our commitment to it by returning services to the community. And when we do that we take pressure off emergency rooms which are the most expensive places to provide health services."
Sorensen believes that nurses are natural leaders because the public respects them, and trusts them to do what's right for patients and the health-care system.
"One of my priorities as president is encouraging governments and health employers to fully harness nurses' skills to improve the system," says Sorensen. "Employers know that we're great at assessing patients and developing plans to solve complex health problems.
"But nurses' abilities don't stop with the individual patient – we're also great at assessing care delivery models and developing strategies to improve the whole system."
Sorensen's years of work in her region and as union vice-present have prepared her to be a strong advocate for nurses. As the union's provincial lobby coordinator, she regularly mobilized nurse-activists across the province and planned strategies to engage elected officials – both provincial and federal – to ensure nurses' concerns informed the decision-making process in Victoria and Ottawa.
"Decision makers need to hear directly from nurses," says Sorensen. "When we see opportunities to influence public policy we send nurses directly to MLA's offices so they understand how to improve practice conditions and health outcomes."
The union's provincial violence-prevention campaign is the most recent example of the important work Sorensen is leading on this front. "Fifty-seven provincial MLAs signed BCNU's pledge to help reduce violence," she says. "And now we're continuing to lobby to ensure they act to make workplaces safer and support nurses who are impacted by trauma."
PROMOTING A CULTURE OF INNOVATION
"In my new role as president, I'm cautiously optimistic that public health care is on the cusp of change," predicts Sorensen. "My goal is to put BCNU and nurses at the centre of this change by encouraging the government and health employers to manage the system differently."
Nurses know that health care is often run with top-down leadership models that aren't open to innovation from front-line employees.
"It's a predictable model. Budgets are squeezed, consultants are hired, studies are commissioned, reports are filed and care-delivery models are changed," she says. "But in all of that I ask 'where is the front-line engagement?' because nurses have great ideas on improving health care without blowing up provincial budgets."
Sorensen is convinced that health-care organizations, including BCNU, can become "innovation generators" by using their "global brain." That means front-line staff should be encouraged to come forward with ideas, and those ideas must be evaluated on how they advance strategic goals. And good ideas should be implemented, she argues. They shouldn't just wither on the vine.
"Building a culture of innovation is tough. And there are reasons why organizational development specialists say 'culture eats strategy for breakfast,'" notes Sorensen. "We need to nurture work cultures that encourage new ideas and support leaders who might feel threatened by change to implement good ideas.
"Organizations that innovate tend to outperform those that don't. Right now I'm seeing positive signs at several health authorities, and I'm encouraging them to keep doing things differently."
Sorensen acknowledges that it will take time for nurses to grow in confidence and step forward into leadership roles because nursing has been subservient for much its history. But she says BCNU will be a cheerleader for that to happen.
"And I need to be candid about making this change as I lead my own organization," says Sorensen. "BCNU is also affected by the top-down culture in health care – we need to be better at innovation and be entirely focused on achieving what members value."
For Sorensen, change begins through sound governance.
"Last year BCNU Council spent a lot of time rebuilding, refreshing and stabilizing our union, and I led the development of a new, three-year strategic plan that was set in place in June 2017," she reports. "In the past we developed strategic plans on an annual basis, but I felt it was important to establish a longer-range vision. We're putting an emphasis on strong member advocacy, increasing transparency and accountability, and living our values."
Sorensen also sees a strong connection between employee engagement and achieving organizational goals. "One of the things I want to build at BCNU is a culture of empowerment and best practices. I won't be satisfied until our union is recognized as the best employer in the labour movement and in health care."
Sorensen argues that hiring, retaining and supporting the best people means that staff can better resource stewards and regional officers. This in turn will improve member services and increase success. "My job is to build the structures and the relationships to make that happen."
BUILDING ON EXCELLENCE
Sorensen credits her mother as being one of her biggest mentors in her early career. "My mom was a great example of a strong woman who could get things done," she says. "When you step out as a new activist it's important to know what success looks like, and my mom was an example of success for her whole career."
Sorensen's mother was head nurse at Kamloops's Royal Inland Hospital prior to her retirement. The younger nurse, now leading a provincial organization, says she often reflects on her mother's experiences and teaching throughout her career.
"Because I'm new in the president's role one of the things I worry about is making the wrong decision," she admits. "But I guard against mistakes by asking a lot of questions and consulting people who are subject-matter experts."
Sorensen notes that a former mentor and nursing instructor reminded her "that she didn't need to know all of the answers, but she did need to know where to find them." It's advice she still lives by. "I take comfort that, in the midst of not having all of the answers, I reach out to other BCNU leaders for clarity on health-care issues and to those outside of BCNU who are leading progress in their own organizations."
Sorensen knows that mistakes will happen, as they do for all leaders. But when something goes sideways the union's collective leadership will have contingency plans to soften the landing and mitigate damage.
COMMITTING TO HUMAN RIGHTS AND EQUITY
Part of an advocate's role is building confidence in others so that, in time, people gain the confidence to advocate for themselves. And that kind of structured encouragement is why Sorensen strongly supports BCNU's equity caucuses.
"BCNU human rights and equity caucuses perform a vital role in our union," says Sorensen, who served as chair of the union's Human Rights and Equity Committee and as a member of the Indigenous Leadership Circle (Sorensen is Métis). "Caucuses give members of marginalized communities a space to define what they need and harness the support of a strong union to advocate for it."
Sorensen stresses that BCNU's mission goes well beyond negotiating and enforcing employment contracts. The union must also fight to make workplaces fairer for members with disabilities, for people of colour and Indigenous people, and for LGBTQ people.
"We need to balance our careers with a focus on our own health."
As a young adult in Kamloops, Sorensen saw a lot of discrimination directed towards First Nations people, which made her sensitive to the concerns of marginalized groups. But she feels good work has been done in this area to acknowledge and honour Indigenous culture, the diversity of the population and recognize how it enriches society.
"Now there are Aboriginal celebrations, multicultural and Pride events in Kamloops and a lot of progress has been made on cultural healing and embracing diversity.
"We certainly need to go further, but in the meantime we are also seeing positive changes in health care such as the integration of Indigenous navigators into the system," she says. "They help clinicians deliver services in culturally sensitive ways and help First Nations people understand the system. It's a huge step forward."
'IGNORING THE HATERS' AND MAKING PROGRESS
All leaders are inspired by people who try to make the world a better place. Sorensen says that two of those people that she admires are Michelle and Barak Obama.
"I have great admiration for the Obamas, especially for Michelle. She's a woman who was always in the public spotlight and had to deal with a lot of racism and anger," she says. "But she stayed positive and encouraged us to ignore the haters and be positive in life.
"Michelle Obama also did symbolic things like planting a vegetable garden at the White House to promote nutrition and health. That simple activity led to healthy eating programs in schools and made a difference in national health outcomes for children," she says.
Michelle Obama also believes that incremental changes will eventually add up to big gains, says Sorensen. "I remember being at the union's convention several years ago and listening to a long list of things that BCNU had accomplished over 30 years. Individually the items didn't seem like they had much impact – but taken together they are huge gains for nurses."
INVESTING IN RELATIONSHIPS
Sorensen believes you can get a lot done by building trusting relationships with people.
"There are better ways of doing business than living in a world of conflict all the time," she argues. "We need to be firm about making improvements. But we make progress by building trusting relationships with people. Good relationships accelerate solutions."
This approach to relationships is informed by Sorensen's commitment to the principle of servant leadership. "I hope that BCNU stewards, staff and regional leaders see me as someone who won't ask them to do something I won't do myself," she says. "That might mean putting in long days to serve members, or filing a lot of grievances. My commitment is to build an organization that supports them and offers them satisfying relationships."
Sorensen wants to build BCNU into a centre of excellence in member services. She also believes it's important to invest in building the union's brand with the public. "I want the public to trust us. When nurses speak on health issues I want the public to believe what we say and take action when we need their support to improve health services."
She notes that the last few years at BCNU have been difficult, and says she's committed to repairing broken bonds. "But we need to go further than just fixing problems. I'm determined to build an organization that's rooted in our values of fairness and social justice – for members, for staff and for the public."
BEING THE CHANGE
"One of my biggest joys is spending time with BCNU leaders, especially those who are working hard in the regions and workplaces," says Sorensen. "I hope I can demonstrate that anyone can cause positive change to happen."
She says that activists' efforts to reduce workload and improve patient care will eventually produce results, and it's heartwarming that they never give up on those goals.
She also wants stewards and regional officers to know that we can lead powerful lives when we have personal experiences of making change happen.
"One of the innovative teams involved in great public outreach are BCNU members who volunteered this summer at the Pacific National Exhibition," says Sorensen. "They linked with people from all over the world and showed our profession and our union in a really positive light."
Sorensen wants nurses to know that they can make a difference in the life of each patient. But they need to take care of themselves first. "It's hard to give our best to patients if we're tired ourselves. So we need to balance our careers with a focus on our own health.
"We won't change the health-care system overnight. But we will make progress by supporting each other and building good relationships along the way."
UPDATE (October 2018)