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A Christmas contradiction
Dec 11, 2019, By: Barb Shellian

The holiday season is upon us and for me and my family. We celebrate Christmas. I love Christmas; there is just no two ways about it. Always have and always will. I am the person who starts playing Christmas music in October, has the lights up on my house before my neighbours, and opens most of my presents before Christmas morning! Christmas to me is a time of hope, reflection, and family.

But a Christmas in 2016 had an additional theme for me—contradiction. And in many ways, I was never the same person after Christmas 2016.

I sing in the Bow Valley Chorus, and of course we always have a Christmas concert. In 2016 it was a rip-roaring success, and we closed our concert with the Hallelujah Chorus—complete with a full brass section, percussion, and organ—thrilling! A standing ovation ensued, and I was breathless at the end with the emotion of singing this glorious music (it may also have had something to do with the feeling that I had blown a tonsil on those high notes, but nonetheless it was awesome). This opportunity to sing “King of Kings and Lord of Lords, hallelujah” catapulted me into the Christmas feeling with a smile on my face and a song in my heart.

Two days later, I met angels.

I was invited by the nursing association in British Columbia to attend an emergency forum on the opioid crisis that has gripped their province and our country. The leadership that the nurses in BC have demonstrated is transformational—they know that something needs to be done, and they are working tirelessly to save lives and advocate for the human beings who are in the midst of this terror. They also know that harm reduction works, and it is sad that funding and support for this Canadian heartbreak is even questioned. The forum was productive and action oriented, and I left committed to keep working with nurses to intervene and lend support in the opioid crisis.

But then came the angels.

After the forum I had the opportunity to buddy up with an outreach nurse who works in the Downtown Eastside of Vancouver—a place that is avoided by many well-meaning folk but is also the location of the heartbeat of the opioid crisis. The number of overdoses and deaths in the DTES has become a staple of Canadian news reporting—we see resuscitation efforts in alleyways and on street corners. But what I saw was harm reduction in action.

The nurse I was with made her way through the community, showing me the safe injection sites where no one has died. I saw her put her hands on people who were slumped in doorways to make sure they were breathing and just sleeping—not overdosing.

I saw her make visits to people in hotels to remind them to take their HIV medication and to assess their wounds.

I saw her speak to workers in shelters to see that they had harm reduction supplies, naloxone, and airway management supports.

I saw her looking in the neighbourhood for clients whom she had not seen for a while because she was worried about them.

Resiliency was my lasting impression. The resiliency of the people who are living in the DTES and how they manage every day, and the resiliency of the nurses who commit their practice to making a difference in that setting. They know that harm reduction saves lives, they know that more safe consumption sites are urgently needed, and they know that each person—each Canadian—living in the DTES is a valuable human being worth the effort. There was no standing ovation or shouts of hallelujah—just plain hard work. To see it for myself was a Christmas present of unspeakable worth.

The Christmas Contradiction became apparent to me when I came home. I am pretty solid in my personal social determinants of health—I have a nice house, a great family, employment, education, good health—and my Christmas will be a celebration. My new friends living in the DTES have gaps in their social determinants of health—poverty, homelessness, lack of access to mental health services, limited opportunity for education, broken family structures, lack of employment—and their Christmas will be a different celebration—survival.

We are all Canadians; we are all human beings with hopes and dreams. I hope the Christmas Contradiction is soon diminished, and I know that there are nurses working every day to make this happen.

I have always been proud to be a registered nurse, and it is a privilege for me to stand alongside the nurses in the DTES and call them my colleagues. This is primary health care in action, nursing knowledge and skill extraordinaire, and advocacy for the social determinants of health.

I am standing up and clapping. Hallelujah.

Editor-in-chief Barb Shellian is a registered nurse committed to nursing practice, health care reform, and people. She is the immediate past president of the Canadian Nurses Association. She is also Director of Rural Health, Alberta Health Services—Calgary Zone and lives and works in Canmore, AB.


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