Jun 08, 2020
From tent camps to die-ins: the importance of activism for nurses and patients
In his first seven days as the only health professional at a Victoria tent city erected during the coronavirus pandemic, Corey Ranger responded to nine overdoses.
All nine people survived, thanks to the nurse’s foresight and experience. He brought his own naloxone when he showed up as a volunteer to provide primary care at the encampment, which housed 250 homeless people in British Columbia’s capital.
When the tent city was hastily created after shelters closed or reduced their capacity in mid-March, it was a week before residents had sinks with soap and water.
Another 10 days elapsed before people had access to showers, says Ranger. The conditions made the public health measures required to prevent the coronavirus from spreading—frequent hand-washing and physical distancing—virtually impossible.
Neglecting to offer these essential tools to people during a pandemic is emblematic of the stigma surrounding substance use, mental illness, and homelessness, Ranger says. So he spoke up and joined the front lines.
Combatting that stigma and striving for equity and pragmatic public policy have been Ranger’s goals for much of his career …
“It boils down to not being able to create the same sense of urgency for one population that we’ve created for every other population,” he says. “It has not been an equitable response.”
Combatting stigma crucial
Combatting that stigma and striving for equity and pragmatic public policy have been Ranger’s goals for much of his career, including during the overlapping COVID-19 pandemic and opioid crisis.
After graduating with his diploma in practical nursing from Medicine Hat College in 2011, and then a Bachelor of Nursing degree in 2013 from the University of Calgary, Ranger, 31, worked in Alberta and BC in geriatrics, surgery and post-operative care, harm reduction, mental health, and detox and stabilization.
He found his calling during his third year of nursing school in Calgary, when his class watched Street Nurse, a documentary about Toronto nurse activist Cathy Crowe.
“It was about the advocacy she had done and how she had helped improve the living situations for people who don’t often get a voice at the table,” Ranger says. “I saw her confronting Toronto Public Health during a TB outbreak and advocating for housing as front-line protection. It astounded me how she rallied to uplift the rights of people who experience institutional oppression, and I knew that’s what I wanted to do.”
During a preceptorship at Streetworks, a nursing outreach program in Edmonton, Ranger learned about harm reduction, the social determinants of health, and anti-oppression practices. The experience solidified Ranger’s desire to work in the field. His nurse colleagues taught him the importance of delivering health care through relationships, and the need to advocate to ensure that nurses can deliver health care, including through supervised injection sites and other harm reduction programs.
“People really overlook the power of establishing bonds and trust with people who are traditionally left out of health care,” Ranger says.
Relationships are critical
He measured success by the number of people who asked for him specifically, rather than the number of services he performed.
“It really made me focus on the humanity of nursing and patient-centred care—actually understanding people’s needs, not making paternalistic judgments,” he says.
Often, health systems still prefer that nurses do their job but keep silent about change …
His Streetworks position led Ranger into a job providing harm reduction at an STI clinic. He later delivered an HIV program, used cognitive behavioural therapy to help clients with mental health challenges, worked as a team lead on a medical detox unit, and taught pharmacology and mental health nursing, and supervised clinical placements at Medicine Hat College, among other positions.
Currently, Ranger manages a project for BC’s Ministry of Mental Health and Addictions. He’s developing, implementing, and evaluating a provincial curriculum and standards of practice for peers with lived experience in mental health and addiction. He wants to ensure they are better paid and valued.
“I’ve witnessed peers having the hardest job, often shouldering the most emotionally and physically difficult parts of the work while being paid the least or often not being paid at all, being tokenized, and not being heard,” Ranger says.
He took a leave from the project to work at the tent city because of what he calls a “slow response” by governments to create an appropriate safety plan for people struggling with homelessness and addiction.
Activism gets results
As a consultant on the Victoria Inner City COVID Response Team, with a seat at the City of Victoria’s Emergency Operations Centre, Ranger and his colleagues helped to persuade governments to obtain hotel space and move people into a place where they could self-isolate.
“Nurses need to be an integral part of policy development … . We have to be at the forefront, and we need to be driving it,” Ranger says. “We’re there all day with people on the front lines, not behind our Zoom calls making policy changes.”
Often, health systems still prefer that nurses do their job but keep silent about change, Ranger adds. “There’s still a lot of gaslighting in nursing.”
Despite his natural inclination to confront people when he encounters discrimination, Ranger has learned to be patient. When a surgeon was reluctant to treat a patient who was HIV-positive, for example, Ranger brokered conversations. He educated the doctor enough that the surgery took place and the physician and patient developed a friendship.
When more direct action is called for, though, Ranger doesn’t hesitate. In February he returned to Alberta to help lead a day-long “die-in” at the legislature to advocate for supervised consumption services.
Ranger’s partner, Kimberly Ranger, gives him the time to work demanding jobs and to volunteer. During the pandemic, she reduced her hours as a communications manager to care for their children, Mackenzie, 5, and Benjamin, 3. Her role was even greater because Ranger moved into a tent in their garage to prevent any possible COVID-19 infection.
Kimberly is one of the many women in Ranger’s life who have inspired him, he says, including his mother, Debbie Ranger, an operating room nurse. He looks forward to returning to a time when his family can enjoy more hikes, practise their French, and see extended family members—the reason they moved to British Columbia from Alberta.
Meantime, he’ll continue to speak out as an advocate and incorporate equity into his policy work.
“If you’re going to implement a new policy or program for people who are homeless or using drugs, they need to be part of the planning or policy process, so they can tell you what’s going to work and what’s not going to work. We need to honour the lived and living experience of peers.”
For more information, Corey Ranger can be contacted by email at: email@example.com.