Seeing Hope
Aphone rang in the intensive care unit at BC Children's Hospital. The call was from a rural BC hospital and they needed to transfer an eight-year-old boy to the Children's ICU right away.
Bonnie Christie was a senior RN on duty the evening the boy arrived. "I started removing his bandages and blood began flowing like a waterfall," she recalls. "He had been ripped apart at the legs in a car accident while he delivered newspapers to his neighbours." Staff were unable to stop the bleeding and he died shortly afterwards.
Christie saw a lot of death and injury in 21 years of pediatric nursing. She remembers when two young girls were brought to the unit covered in third-degree burns. Their mother died in the fire as her estranged husband tried to burn down their house.
Christie remembers another young girl arriving with burns so severe they had to transfer her to a specialty hospital in the US. Other staff members told her the girl's mother set her on fire while intoxicated.
She also remembers a young boy who was admitted with head wounds. When she took off his bandages part of his brain fell on the floor. His father had hit him with an axe.
Christie recalls other children who were sick and injured. And she remembers some who died horrible deaths.
"Nurses don't treat our patients as detached observers," says Christie. "We also feel loss when people die in terrible circumstances."
Christie has a long and distinguished career as a pediatric intensive care unit (PICU) nurse. After graduating she started her PICU career at Winnipeg's Health Sciences Centre Children's Hospital. At 21 she was the youngest PICU nurse they had ever hired.
After three years in Winnipeg she joined the BC Children's Hospital PICU team and worked there for 18 years. At Children's she was a preceptor, a clinical resource nurse and taught the clinical component of the Pediatric Critical Care Program at BCIT. Along with the medical director she created the hospital's Continuous Renal Replacement Therapy program to help children who can't tolerate regular dialysis.
"Being a PICU nurse was my passion," says Christie. "But as l look back I can see I was in distress as early as 2009. I thought that moving to lower acuity units would help, but my symptoms only got worse."
In 2009 Christie transferred to a number of lower-acuity units at the Royal Columbian Hospital before eventually moving to an office environment at the Patient Transfer Network.
"I hoped that moving out of acute care would reduce my anxiety, but listening to patients' stories and histories over the phone was more than I could take," she explains.
In 2014 Christie started having nightmares. She dreamt of pools of blood and people hanging on chain link fences with hooks through their scalps. She had constant panic attacks.
In 2016 her doctor diagnosed her with work-related post-traumatic stress disorder, submitted a WorkSafeBC claim and referred her to a psychiatrist who confirmed the diagnosis. But WorkSafeBC's claim evaluation process took four months and required Christie to re-live many of her traumas.
"To get my WorkSafeBC claim accepted I had to re-tell my story over and over," says Christie. "And every time I did that I re-lived what I went through. During that time I was crying all day long and had so much anxiety I couldn't leave the house."
"I wanted him to feel the trauma that I felt, and I wanted him to make commitments that other nurses would never go through what I did."
In 2018 firefighters, peace officers, paramedics and correctional officers were given an important WorkSafeBC protection called the Presumption of Mental Injury. That means they don't need to prove that a mental injury is caused by workplace trauma – it's assumed to be work-related once their doctor gives a diagnosis. But nurses were excluded from that legislation.
In 2018 Christie met BCNU Executive Councillor Adriane Gear who was leading the union's campaign to get nurses added to the list of occupations protected with the presumption of mental injury.
"Extraordinary things rarely happen by accident," says Gear. "And one of the great privileges of my career was meeting Christie and having her take a leading role in our campaign to get the provincial government to give nurses the presumption of mental injury."
During the fall of 2018 Christie told her story to hundreds of nurses at BCNU membership meetings. And in response to her story members sent about 2,000 personal emails to Premier John Horgan and Labour Minister Harry Bains asking them to grant nurses this important protection.
"I want to thank members who sent those emails because they paved the road for Christie to meet with Labour Minister Bains in October 2018," says Gear. "We also had a lot of support from Green Party Leader Dr. Andrew Weaver who pushed the government to add nurses to the legislation."
Last October Christie and BCNU President Christine Sorensen went to Victoria to meet with Labour Minister Harry Bains. But first, Green Party Leader Andrew Weaver wanted to formally introduce Christie to the BC Legislature and tell her story to members of the assembly.
"It was very emotional for me sitting in the public gallery and hearing Dr. Weaver tell my story," says Christie. "I was afraid that it wouldn't have an impact. But as he started talking, I could hear the noise level go down and saw legislators turning their heads to focus on what he was saying."
Later that day Christie entered the labour minister's office to make her case for nurses getting the presumption of mental injury.
"Meeting Minister Bains was very tough, but I was determined to have an impact," says Christie. "I wanted him to hear what I went through trying to prove my injury to WorkSafeBC while I was in the middle of acute PTSD symptoms. I wanted him to feel the trauma that I felt, and I wanted him to make commitments that other nurses would never go through what I did."
In that meeting Christie talked for almost an hour and as soon as she finished Bains made the commitment to include nurses as soon as he could change the law. [The law was amended on April 16, 2019.]
"Gaining this protection is an important achievement for nurses," says Gear. "Our union will never stop advancing solutions to prevent violence and help nurses who are harmed by workplace traumas."
Christie can never work in health care again, but she now has hope that her colleagues won't go through what she did with WorkSafeBC.
"Now that we've gained the presumption of mental injury we need to push for better clinical services for people who are injured by trauma," she argues. "I'm going to take an extended break to focus on the next chapter of my life, but if the Labour Minister needs more encouragement to improve WorkSafeBC services I'll be happy to twist his arm again." •
UPDATE (July-Aug 2019)