Debates of March 14, 2019 (day 71)

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Statements

Question 700-18(3): Health Centre Practices regarding Acetaminophen

Thank you, Mr. Speaker. I would like to follow up on my Member's statement to the Minister of Health and Social Services. First off, I know the department has been doing a lot of work with communities, especially on cultural safety. What kind of questions and concerns has the department heard about the use of Tylenol or similar drugs in their own health centres, including issues like the one raised by my colleague from Mackenzie Delta, where people are getting sent home with a few pills? Thank you, Mr. Speaker.

Speaker: MR. SPEAKER

Masi. Minister of Health and Social Services.

Thank you, Mr. Speaker. After the Member from Fort Providence raised his questions initially and even before that, and since the Member has raised his questions, I have ask the authority to check to see how many official complaints or concerns have been raised with our quality assurance staff around Tylenol, and, unfortunately, the answer is actually zero. Nobody has actually officially filed a complaint. Now, we do see concerns being raised on Facebook and other social media platforms, and the Member and the Member from Fort Providence has also raised those issues specifically with me around Tylenol, so we do hear it. We haven't seen any official complaints. I would strongly encourage the Member that, if he is aware of people, not only to bring it to my attention but to also encourage people in your communities to approach quality assurance so that we can look into these situations where Tylenol may have been prescribed, if they feel that that was not the appropriate thing to do. We need to learn from our experiences. We want to be a learning organization. Quality assurance is the mechanism to really help that happen. Thank you, Mr. Speaker.

Speaker: MR. SPEAKER

Masi. Member for Deh Cho, he is referring to instead of Providence.

Thank you, Mr. Speaker. I thought I was moving to another region. I am glad we got that cleared up.

I agree with the Minister, but sometimes they don't feel comfortable in bringing it forth, and we have been trying to work with the Minister on those types of things, and I thank him for this information. Mr. Speaker, what policies or other rules are in place to make sure health centre staff do some basic safety checks for all distributing of Tylenol or other similar drugs? For example, I am asking about alcohol use, liver health, and other factors that may affect dosage.

I do have to remind the Member that all of our nurses are licensed professionals who maintain licences through competencies and training and that they are trained to deal with exactly these types of situations. When a client does present to any healthcare setting with a physical complaint, nurses and other health professionals are required to basically complete an assessment along with inquiring about the relevant past medical history. This is part of the basic nursing education, and this occurs in any setting where nurses are involved with dispensing medications. The Clinical Practice Guidelines and the Northwest Territories Health Centre Formulary are documents that are used in the community health centres by nurses. These documents provide a reference for a standardized approach to clinical care to assess and treat. Nurses are required to seek additional consultation from other healthcare practitioners if they feel that it is needed.

Mr. Speaker, I think these questions go to the questions that were asked yesterday by the honourable Member for Yellowknife Centre about the types of questions that are being asked and how we are making sure that people understand why certain questions are being asked, in particular around things like alcohol and the negative impacts of interactions with certain drugs and alcohol that somebody may have consumed. We obviously want to continue to improve in this area. I think our Cultural Safety Action Plan speaks to this particular issue, and trying to make sure that we are asking the right questions at the right time, and have people understand why questions are being asked. As a note, Tylenol is the appropriate diagnosis or the appropriate treatment in some cases, so it is not always the wrong or the inappropriate decision, as may be suggested by some.

I thank the Minister for that education. I didn't know nurses were, you know, licensed. I never knew that, but I thank him for that answer here today. I understand that, but, when all we are hearing is "Tylenol, Tylenol, Tylenol," that is an issue. I have other questions about the policies and practice around Tylenol and similar drugs. There have been a lot of studies about how racial face affects how healthcare professionals deliver services, even when they are found to be unconsciously, for instance underestimating the Indigenous people's account or experience of pain. How is the department working on cultural safety tracking, especially how healthcare professionals hear and assess patients account for pain?

I feel like this question goes to the very heart of the work that we are doing around cultural safety to make sure that all interactions with healthcare providers are done in a respectful way and recognize both the individual biases that an individual might have, but also the cultural realities that exist within their communities and many of their clients. As part of our work on culture safety, the department is working on piloting different training that encourages healthcare providers to actually reflect on their own experiences and how their own biases may affect the views of individuals in their care, so that we can move beyond that and focus on the human being rather than biases or expectations or beliefs that may exist. We want to provide the best care for our residents.

Speaker: MR. SPEAKER

Masi. Oral questions. Member for Nahendeh.

Thank you, Mr. Speaker. I thank the Minister for his answer. The cultural safety that his department is doing, I think it is great. I honestly believe we as a government should all be doing that, but I understand we're trying to work to make sure it works well before moving it on. Now, I know the Minister has talked about this a lot, but it's important for people to know, so I think it's worth hearing again. If people feel that they're not getting the care they need at their local health centres, where can they bring their concerns? Thank you, Mr. Speaker.

There are actually a couple of different ways that individuals can interact with the system. We currently have a network of designated client contacts and quality assurance staff who, if somebody has a problem with the system or the services they receive, they can get in touch with. This often is after the fact, when something has occurred, so that we can actually look into it to make sure, if something would arise, it doesn't happen again. We also have a system navigator so that, if someone is actually having trouble navigating a system and they have some concerns and they have a complex case, we would strongly encourage them to turn to the system navigator, who might be able to help them focus their journey through the healthcare system in ways that will actually give them maximum benefits.

On top of that, I do encourage people to ask your practitioners questions. If you're not sure what they're telling you, ask them for clarity. Our professionals want to be there to help. They are prepared to answer questions. If you don't feel like you're getting the answers that you need, or you're not getting an understanding of what is being explained to you, we have an obligation to do our best to make sure that our residents understand what is being said. If that doesn't happen, you can always go back to quality assurance. I know I talk about it a lot. This is something that we've only been bringing in in the last couple of years, but it is something that will be a game changer over time and allow us to really learn from the challenges that exist in our system, to make sure that these types of things don't happen. That's a responsibility of not just the healthcare system, but everybody who engages with the healthcare system, to share your frustrations with us so that we can learn from them and make sure they don't happen again. Thank you, Mr. Speaker.

Speaker: MR. SPEAKER

Masi. Colleagues, I'd like to draw your attention to visitors in the gallery. We have with us today Carmen Moore. She is our very own chief of protocol within our government system. Thanks for being here with us and doing a fantastic job. Masi. Oral questions. Member for Frame Lake.