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Powerless to prevent a hurricane, Nova Scotia NPs join mobile clinic team to bring primary care to the people

Sue Battersby-Campbell and Deborah Blois share their ‘great adventure in nursing’

By Laura Eggertson
May 31, 2023
Courtsey of Nova Scotia Health
In September 2022, Hurricane Fiona slammed into northeastern Nova Scotia, causing widespread damage and power outages. The province rolled out a nurse-led mobile health clinic, which included a trailer and event tents, to help people get the care they urgently needed.

Sue Battersby-Campbell was pulling into her driveway in Sackville, N.S., after a full day’s work as a palliative care nurse practitioner when her cellphone rang.

Courtsey of Nova Scotia Health
Deborah Blois and Sue Battersby-Campbell were the lead practitioners for the mobile clinic.

The caller was Dawn Munroe, director of human resources, research, innovation and discovery with Nova Scotia’s Department of Health and Wellness. Could Battersby-Campbell pack a bag and drive four hours north to Sydney, Cape Breton, to staff the mobile health clinic they’d been talking about?

“Yes, absolutely,” Battersby-Campbell replied.

It was September 27, 2022.

Three days earlier, Hurricane Fiona had slammed into northeastern Nova Scotia, downing trees and power lines, flooding roadways, and leaving more than 400,000 people in the dark at the peak of power outages.

The province had been considering a nurse-led mobile health clinic for months, to relieve pressure on emergency rooms swamped by COVID-19, an early influenza season, and RSV.

Now Fiona had created a literal perfect storm.

Hospital swamped

In Cape Breton, the Nova Scotia region hardest hit by the hurricane, pharmacies, doctor’s offices and health clinics were closed. Not only was the electricity out, it was apparent it would be out for days or weeks.

People needing medical treatment, including for storm-related injuries, were relying on the Cape Breton Regional Hospital, which was swamped. Live wires and fallen trees were also making driving difficult, with some roads impassable.

“We needed to make sure people there had access to primary care,” says Gail Tomblin Murphy, Nova Scotia’s chief nurse executive and vice-president of research, innovation and discovery for the Department of Health and Wellness.

It was time to put the mobile clinic into action.

Battersby-Campbell, a 55-year-old nurse practitioner with experience in emergency, acute and palliative care, was ready.

Gathering her stethoscope, office laptop, and a few other supplies, she hit the road at 5 a.m. the next day.

Anxiously scanning her route for a gas station that was able to pump fuel, she also checked her messages whenever she stopped.

Colleagues would drive a fifth wheel trailer hitched to a pickup truck that would serve as their clinic to a subdivision under construction on the Membertou First Nation in Sydney, she learned.

Two hours farther north, Deborah Blois, another experienced nurse practitioner, was getting a similar call. Blois, 69, works part-time at an urgent care centre in Parrsboro, N.S.

“You’re lucky I have a sense of adventure,” Blois said, agreeing to help.

Courtsey of Nova Scotia Health
A conference room at the front of the trailer became an examining room.

Converted trailer to clinic

The two women would serve as lead practitioners for the clinic, supported by paramedics, two other nurses serving as clinical/organizational leads, and about 10 other redeployed NS Health staff members.

Over the next nine days, the nurse practitioners would see more than 350 patients in the trailer, formerly the Emergency Health Services’ mobile disaster communications centre. The first challenge was reconfiguring the trailer.

A conference room at the front of the trailer became an examining room. Battersby-Campbell, Blois and two colleagues hauled a hospital stretcher over a countertop to create an examining table and brought in chairs for the patients.

The nurses organized and shelved boxes of supplies, including blood pressure cuffs, otoscopes to examine ears, tongue depressors, bandages and swabs, a portable defibrillator and manual bag resuscitators they hoped they would not have to use. (They didn’t.)

Outside the trailer, the team set up event tents for triage and infection control.

They tossed away rocks and set out rubber mats to reduce the risk of slips and falls.

By early on Sept. 29, the nurse practitioners began seeing patients. Drawn by word of mouth and Nova Scotia Health’s social media posts, people arrived with respiratory illnesses, COPD and asthma exacerbations, migraines, musculoskeletal injuries, and COVID. Some needed urgent prescription renewals.

The paramedics took vital signs and triaged patients. Public health nurses screened for COVID and performed rapid tests.

Ruptured eardrums, chainsaw injury

Blois stitched up two patients, including one injured by a chainsaw he was using to clean up fallen trees; Battersby-Campbell treated five people for ruptured eardrums due to the changes in barometric pressure the hurricane brought.

“That’s more than I’ve seen in my whole career,” she says.

The nurses saw some elderly people, and others who had difficulty walking, in their cars. They referred patients to the hospital, with team members organizing an ambulance or other transportation as needed.

They connected anyone without a family doctor to the province’s virtual care system. Everyone left with a discharge plan.

They also left after telling their stories to nurses who cared.

Battersby-Campbell asked each patient she saw the same question: “How did you manage during the storm?”

Some had lost everything — homes and belongings. Others had holes in their roofs or had been washed out of their houses due to storm surges and flooding. Many of those they saw had little to begin with, even before Fiona struck.

“There were people that had no insurance on their houses, especially some seniors,” says Battersby-Campbell.

Despite the challenges of working long hours away from home where their own families coped with power outages, serving patients gave the nurse practitioners a sense of control in an otherwise vulnerable situation.

“I couldn’t prevent the natural disaster; I couldn’t turn the power back on — there were a lot of things I couldn’t do,” Battersby-Campbell says.

Courtsey of Nova Scotia Health
Not a single patient complained about waiting or about the makeshift nature of the clinic. “Thank God you’re here,” they told the nurses, repeating “Thank you for coming.”

Humbled by resilience

But Battersby-Campbell could help at the mobile clinic. The work made her feel both empowered and privileged, she says.

“I felt very humbled by the individuals, their stories, and their resilience. I’m not sure I could have coped in the way they were coping. That was beyond inspiring.”

Blois enjoyed the “wonderful” teamwork, and the satisfaction of leaving their patients feeling well cared for and supported.

“I really loved it. It was great fun,” says Blois, who describes the clinic as a “great adventure in nursing that I was proud and privileged to be a part of.’’

Not a single patient complained about waiting, or about the makeshift nature of the clinic. “Thank God you’re here,” they told the nurses, repeating, “Thank you for coming.”

“The patients were so grateful — how could you not just light up with that kind of welcome from the community?” says Battersby-Campbell.

Although Battersby-Campbell already has a full-time job in palliative care and is “not keen on overtime,” she would “absolutely” offer to work in the mobile clinic again, given its role in helping people with difficulty accessing primary care, as well as overburdened colleagues.

“All of us together as a group going a little bit above and beyond can make a huge difference in providing care,” she says.

Since Fiona, the province has continued to roll out the mobile trailer. It is also using the pop-up clinic model, staffed largely by nurse practitioners, in indoor spaces, on weekends and in spaces where primary care would not otherwise be available.

“I’ve been a nurse for 36 years, and the work in this mobile clinic has definitely been the highlight of my career,” says Shelley Orr, another RN and professional practice leader who worked at the mobile clinic in Sydney and pop-up clinics elsewhere in Nova Scotia.

“The staff are happy. Patients are happy. What more can you want? We’re wrapping our arms around the population and serving them, giving them the best possible care as they try to navigate our health-care system. It’s super rewarding.”

Laura Eggertson is a freelance journalist based in Wolfville, N.S.