By Debra Huron
Optimizing the role
Drawing on skills and experience as a clinician, an advocate, an educator and a leader, David Byres is crafting recommendations he hopes will be used to guide nursing in British Columbia into the future
The opportunities David Byres has had in direct care roles in mental health and addictions and in high-profile leadership jobs at Vancouver’s Providence Health Care (PHC) have fulfilled many of his career goals. Then, last April, his phone rang.
Lynn Stevenson, B.C.’s associate deputy minister of health, was calling. She wanted to know if he would be interested in an 18-month secondment to the ministry as chief nursing advisor.
Byres said yes and stepped into the new role in July. As head of the Nursing Policy Secretariat, which he is responsible for developing, he will be making recommendations that will help determine the future of nursing in his province.
During a final round of negotiations last spring, the Health Employers Association of British Columbia and the Nurses’ Bargaining Association agreed on the need for a policy secretariat devoted to nursing practice. “The secretariat became a mechanism by which they collectively agreed to address some issues,” Byres explains.
The main focus of his job is to develop policy recommendations on nursing practice, education, regulation and leadership for the ministry to then consider implementing in the years to come. “I certainly feel the responsibility and the accountability to make sure we do this effectively,” he says. “It’s still early days, but it’s been quite inspiring. It’s a huge honour for me to meet with so many smart, exemplary and passionate nurses from across the province.”
Born in Prince George, B.C., Byres completed a nursing diploma in his hometown in 1994, followed by a baccalaureate and a master’s degree in nursing from the University of British Columbia (UBC). When inklings of the new job first came to him, he was in the final stages of completing a doctorate in nursing practice, with a focus on executive leadership. He was awarded the degree in October. He has been an adjunct professor with the UBC school of nursing for a decade.
Before he started at PHC — an organization comprising hospitals, residential facilities, clinics, outreach programs and a research institute — Byres worked on a mental health emergency services team, partnering with a police constable. This led to roles as patient care leader and then director of PHC’s Mental Health Program.
In 2015, as PHC’s executive vice president, clinical integration and renewal, Byres was given the task of leading the redevelopment of St. Paul’s Hospital on a new site in the downtown core. Earlier in his career, he had been clinical nurse leader in the hospital’s emergency room. St. Paul’s serves the Downtown Eastside — a neighbourhood that has made national headlines for high rates of opioid addiction.
Back in 2013, while he was vice president of acute clinical programs, he found himself at the centre of a high-profile legal challenge that PHC and five patients in the landmark Study to Assess Long-term Opioid Medication Effectiveness (SALOME) launched against Health Canada. Byres was involved in managing his organization’s response to the controversy over whether patients with severe heroin addiction could continue to receive diacetylmorphine after leaving the clinical trial. Then health minister Rona Ambrose had changed the regulations of the federal Special Access Programme in a move to stop those patients from receiving it. Byres describes the drug as life-saving.
“Once the clinical trial ended, the patients had to return to methadone or other treatments we already knew were not effective,” he says. “They were becoming increasingly frustrated they could not continue the treatment that had made such a dramatic difference in their lives.” Byres says he knew of patients who returned to using heroin, overdosed and died.
Letters to Ambrose from PHC and other health organizations asked her to reverse her decision. “We tried many different avenues,” Byres remembers. “Eventually, I worked with our CEO and our board chair and our general counsel to bring a motion to our board to ask them to approve us challenging Health Canada in court. The board approved it, and everything ensued.”
“Everything” refers to the Supreme Court of British Columbia granting an injunction in May 2014 against the federal ruling. “It was a clear win for these patients,” he says.
He is a huge believer in the effectiveness of nurses’ advocacy in helping people find hope, regain their dignity and achieve better health.
Byres will be on the road a good part of the time as chief nursing advisor, meeting with nurses, students and health-care leaders. He spends a few days each week in Victoria, where the ministry is located, while continuing to live in Vancouver.
When he has some free time, he visits with family members on Vancouver Island or travels to a new region of the world that he wants to explore. He also tries to attend monthly Scotch whisky tastings to learn the history of the drink, joking that he comes by this interest honestly because of his Scottish ancestry.
However, it was his British maternal grandmother who influenced his choice of profession. She was an RN who helped establish the College of New Caledonia nursing program in Prince George, where Byres got his initial nursing education. “She believed strongly in the power of education, so that has certainly been instilled in me. I have no doubt that the reason I have continued to pursue further education is in large part because of her.”
10 questions with David Byres
What is one word you would use to describe yourself?
If you could change anything about yourself, what would it be?
I can be lazy at times
What is one thing about you that people would be surprised to learn?
I am incredibly shy and still work to both overcome and embrace it
Where did you go on your last vacation?
Name one place in the world you’d most like to visit.
What was the last good book you read?
The Alchemist by Paulo Coelho
What was the best piece of career advice you’ve received?
Listen to learn and learn to listen
What do you like most about being a nurse?
The impact you can have on an individual, a population and the system
What do you like least about being a nurse?
That the knowledge and expertise of nurses is not recognized or employed as optimally as it should be
Name one change you would like to make to the health system.
I’d give nurses more control and influence over their practice and ensure they have a strong voice in shaping health policy