Jennifer Honey and Leane Mathias, Nurse Practitioners

Today we are pleased to highlight a dynamic duo of nurse practitioners (NP) with Vancouver Coastal Health (VCH)! Palliative care is an approach to care focused on enhancing the quality of life for individuals living with advanced stages of a life-limiting disease.

Jennifer and Leane work on a team with seven palliative care physicians out of Lions Gate Hospital (LGH) in the Palliative Symptom Management Clinic and at North Shore Hospice. “We provide parallel care alongside family practice providers and other specialists services for pain and symptom management including emotional and psychological support for individuals with life-threatening illnesses and their caregivers,” says Jennifer.

Leane’s nursing background is in oncology and palliative care. While as an NP student at the University of Victoria, she learned that the North Shore Palliative Care Tem was dreaming up a role for an NP to work in the community. “I joined the team as a student, then as a new grad and I haven’t looked back!” she says.

Leane tells us she enjoys being in the community and meeting patients and families where they are at, both physically and in their palliative journey. “I get to develop a special connection when I meet and care for them in their own environment,” she says.

For Jennifer, she exclusively does home visits for her clients and patients. “Over time, I strive to build relationships of trust so that as things change for people, I can help them make meaningful medical decisions as they near the end of their path,” she says. “It is an honour to walk alongside families at such an intimate time of transition towards the end of life.”

Jennifer shares that she is constantly inspired by the rich cultures in the communities she serves. “There are so many rituals and practices that are meaningful to different people and cultural groups,” she says. “Currently I am part of a group that is working closely with our Indigenous partners to foster culturally-safe palliative care services both locally and regionally across VCH!”

Leane tells us that she is inspired every day by the strength, love, and resilience that patients and families demonstrate when they are faced with a terminal illness. “The literature suggests that most people would like to die at home,” she tells us. “The reality is that this is not always possible but when families come together to make this happen for their loved ones, it is truly an amazing thing.”

At VCH, we embrace the values of We Care for Everyone, We Are Always Learning and We Strive for Better Results.

Jennifer tells us that the VCH core values dovetail nicely with her personal ones. “[The NP] practice environment allows for professional growth and development daily in both a very structured and also a more nuanced way,” she says. “Our team both seeks learning opportunities as well as creating them thru the Division of Palliative Care and the Department of Nurse Practitioners.”

Leane exclaims that it is an exciting time to work as an NP, especially in palliative care as there are significant changes taking place. “In 2014, it was out of scope for NPs to prescribe controlled substances. This was limiting to the care I was providing to patients in the community which involves symptom management and end-of-life care. The NP leadership team has worked tirelessly to broaden our scope of practice in the short time I have been working.”

The implementation of Medical Assistance in Dying (MAiD) in Canada has also been introduced since she started working in palliative care. “This involved not only learning new legislation and processes but working with colleagues to determine how we would navigate conversations and respond to patients and families inquiring about MAiD,” says Leane.

The COVID-19 pandemic has kept people close to home and has led to a higher acuity of care in the community. Allied health staff is taking care of sicker people for longer in their homes and health professionals have become innovative and nimble. “We had to push the boundaries of what we ever thought was possible before,” says Jennifer. “What I have witnessed is that our allied health team is stronger than ever in providing impeccable care for frail folks in the community who need in-person care despite pandemic restrictions. Seeing people come together every day for the greater good is what is continuously encouraging.”

Leane emphasizes that their work in the community has been busier and more important than ever as the hospitals have been stretched and at overcapacity. “We have worked to maximize resources in the community to allow patients to remain at home with adequate supports,” she explains. “COVID has made patients hesitant to return to the hospital which results in some tough conversations and decision making related to their health and care goals. We have had to be creative with the limited resources we have. We are constantly bringing new situations to the table and collaborating with families and allied health professionals to achieve the best possible outcomes for patients.”

Leane tells us that she feels well supported in her role at VCH. “The leadership team is great”, she says. “My physician and nursing colleagues support one another – collaboration, communication, problem-solving, debriefing, and socializing when time allows and restrictions ease. Working through a pandemic has highlighted the importance of working alongside a great team.”

Echoing the same, Jennifer says the pandemic has highlighted brightly ‘stay for the team’. “My practice group is amazing,” she says. “We have worked, played, and cried together for years. The leadership group at VCH is second to none.”

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