Caring for and learning from our elders: a conversation with Renate Goodstriker

"There's a lot of love and respect for our elders, but for ourselves too, as  individuals. Generosity and humbleness and the teaching from our elders. I really like to look at them as our teachers in the way we care for people and how we treat people. It's a part of my drive to make sure that our elders are cared for in the best way."

Renate Goodstriker is a proud Blackfoot First Nations woman and a registered nurse who manages a licensed long-term care home for the Blood Tribe Department of Health in Kainai, Alberta. She feels honoured to care for her community and roots her work in compassion, respect, culture, and a deep love for the people she serves every day. 

Learn more: https://btdh.ca/program/long-term-care/

Learn more about the Strengthening a Palliative Approach to Long-Term Care project at: https://spaltc.ca/

Transcript

SPEAKER_00 0:00

Welcome to the Strengthening a Palliative Approach in Long-Term Care Alliance podcast. Exploring challenges and best practices and palliative care approaches for individuals in long-term care.

SPEAKER_02 0:15

Renata Goodstriker is a proud Blackfoot First Nation woman and a registered nurse who manages a licensed long-term care home in Kainee, Alberta. She feels honored to care for her community and roots her work in compassion, respect, culture, and a deep love for the people she serves every day. Welcome to the podcast, Renata.

SPEAKER_01 0:39

Hi, Nancy. Thank you for the introduction.

SPEAKER_02 0:42

I'd really like to start by asking you to tell me a little bit about your journey to becoming a long-term care manager.

SPEAKER_01 0:50

Well, actually, I'm going to start from when I was a little girl, actually. I used to always carry like a briefcase with paper, stapler, everything. And I always dreamt of doing exactly what I'm doing now: talking to a doctor, being the boss, and taking notes and just everything that I actually do today. Always caring about people and wanting to make sure people are good. And then further along in high school, I wanted to get into nursing, but at the time when I graduated, it was like to get into nursing was quite intense. I had my oldest son very early in my life. Then later in life, I had my two younger ones. And so I started in EMS. And I was on the ambulance as an emergency medical technician and also trained as a firefighter. I went into my first year of university with a nine-month-old baby. My son, he was a year old when I started nursing, and I honestly don't know how I got through it. Mind you, my oldest son, he was a rock in my nursing school and studies. The program is quite intense. And so he would help with his baby brother. And I remember some nights typing through the night and thinking, oh my gosh, I don't know if I can do this anymore. But it's always been my passion, and this is what I wanted to do. And I graduated in 2012. My last year of nursing, I found out that I was expecting. And I actually finished my last preceptor ship. I just made it by two days. I started with a pretty much a one-year-old and I finished with the newborn. And moving forward, I worked here casual as long-term care nurse on the unit. And then in 2019, I applied for a one-year term for a nurse manager here in long-term care. So then I started on my own in January 2020. That was my journey to becoming a nurse manager at long-term care.

SPEAKER_02 3:14

That's wonderful. What an amazing story. Your experiences working in emergency medical services, both in the ambulance and as a firefighter, must have really prepared you for so many things.

SPEAKER_01 3:28

It did, especially through COVID. One of the comments that I received from one of my staff members, she said, Renata, you know, through the hardest times when we were scared to go into those rooms where COVID was with one of the residents. She said, You looked so calm. And I knew being the leader, I had to go into one of those rooms first to show them that it could be done. Being on the ambulance, you know, mass casualties at an accident compared to the feeling of a day of COVID. There was no comparison, but it definitely prepared me to be calm. And as a leader, I really felt like that's what I needed to be.

SPEAKER_02 4:19

So tell me a little bit about Kainee and you're part of the Blood Tribe Department of Health. Tell me a little bit about where you are and what the long-term care home is like.

SPEAKER_01 4:32

So I am located about 35 minutes to the U.S. border. To the south of us is Cartston, and to the north of us is Fort McLeod, and then Calgary, two hours further north. And I'm located at Connei Long-Term Care Center. That's what our facility is called. And our department, our tribe department of health, consists of many programs. We have a pharmacy, a dentist, a clinic, home care, community health. We have a detox and long-term care. How many long-term care beds do you have? We have 25 beds that we have here in our facility. And we are long-term care type A, which is for more acute residents. Most of our residents are from our reserve, and we do have some that come in from off the reserve as well.

SPEAKER_02 5:37

Ah, so a different mix. Is there an indigenous approach to the way that you provide long-term care? Mm-hmm.

SPEAKER_01 5:46

I really believe that this would be individualized, where it would depend on the manager and what they feel would be best for the residents. For me, I like to include in my ways of growing up, my ways of respect for our elders, and my teachings from my grandfather and my mom, my great uncle, and you know, our elders. There's a lot of love and respect for our elders. Not only that, but for ourselves too, as well as individuals. There's sacredness in caring for our elders and prayer, which is very important to our elders, whether it was, you know, Christianity in their upbringing, because there was residential, you know, the that time that's really predominant. What I I guess what I like to steer away from because in our COVID during that time when we would have a lockdown, a lot of our residents it brought back memories of being in residential school. And the last thing that I want as a manager is for our elders to feel like it's residential school. And some of the stories that they shared, it's it's really heartbreaking. Yeah. And um so I'm really I really like to consider that in our center and in my ways of being a manager here. I also like to, you know, include prayer and kindness towards my staff and for my staff to care for the residents that way as well. Generosity and you know, humbleness and teaching of our elders. I really like to look at them as our teachers in the way we care for people and how we treat people. It's a part of my drive to make sure that our elders are cared for in the best way. We do have partners that come from off the reserve. And one partner, she said, I notice how your staff care for the residents. She said they care for them like they're people, and they talk to them very respectfully, they treat them like human beings. And um, that made me feel good that you know people do notice that because these elders are someone's grandpa, someone's mom, dad, you know, they're they're books of knowledge. It's very important to treat them with the utmost respect and the care that they deserve. Yes. In another way that I have here in long-term care is our language. Most of our elders speak our own Blackfoot language, and some of our staff understand it. We try to communicate more in our Blackfoot language because when it comes to an assessment, a question, or whatever it may be, if you can speak to them in Blackfoot or let them just talk, they're more descriptive, they tell you how they feel, and they really open up just with our language. So that's something that I like to keep in this long-term care facility, and I want to promote it. And you know, even our Blackfoot names, we have Blackfoot names, and you know, to call the residents by their Blackfoot names to them, maybe it might bring a happy memory of their grandpa or their mom and dad. They feel more at home when they can speak our language. Absolutely.

SPEAKER_02 9:46

Do some of the staff also use their Blackfoot names as well with the residents?

SPEAKER_01 9:51

Yes, we started putting their Blackfoot names on their doors. And so I'd like to encourage the staff to use their Blackfoot names. It gives them, you know, their identity and you know, like I said, good memories and you know, their purpose. So, yeah, some of the staff do speak it, but I think most of the staff do understand it.

SPEAKER_02 10:16

And I would think so much more comfortable for the residents who feel like they're fully understood.

SPEAKER_01 10:22

Yeah, for sure.

SPEAKER_02 10:24

So let's talk a little bit about family because you mentioned uh people wanting to be with their families and be felt like they're part of a family. How does family play into the approach that you have at Canae?

SPEAKER_01 10:40

We have case conferences where families are invited and we speak to all disciplines such as nutrition, occupational therapy, physiotherapy, recreational therapy, nursing, and we have the families involved in their care. Families do trust us to take care of their family member. And so I like to keep the families involved that way. And families are allowed to come anytime they want. There's no visiting hours. We have a facility here on site if they want to have a family gathering so that the family member doesn't actually have to leave the building. They can have a family dinner or we have a barbecue area, they can have a barbecue outside. So we involve the family as much as we can and as much as they want to be involved as well. But nonetheless, we are their family. They're cared for 24-7 by staff here. That's, you know, just caring for our elders and making sure that they're cared for to the best that we can.

SPEAKER_02 11:51

Yeah, it's a hard thing because you're dealing with end of life quite often. And I would think for staff that's difficult. Are there certain rituals or things that you do to to help both staff and family?

SPEAKER_01 12:06

Yeah, I think that's one that's a pretty big challenge and something that's really difficult. I really commend my staff for caring the way they do and giving the resident their all to make them feel loved and cared for, knowing that one day they're gonna be leaving. And I really feel that you have to be a special person to be that person because honestly, how do you prepare somebody to know that they're gonna be leaving? Yes. So if they're residents here and they do become palliative, we keep them and we can manage them here with the services that we do have with the 24-hour care. They feel comfortable, right? Mm-hmm. And they can, you know, smudge and we accommodate the families and the residents as much as we can to make sure that, you know, they're cared for holistically until they leave.

SPEAKER_02 13:12

What do you think are the biggest challenges you face in long-term care?

SPEAKER_01 13:18

I find that having consistent staffing has been huge since COVID. I don't know where the staff went, but finding nurses to come work here, like consistency in staffing. Seems like since COVID, like I don't want to always go back to COVID, but I've noticed that we've had a hard time, you know, having like HCAs, even applicants for LPN and RN. We've had a lot of applicants that had a little bit of a hard time, you know, under like there'd been language barriers. So yeah, staffing was one. And I'm really lucky for the resources that we do have. We have on-site occupational therapy, we have physiotherapy, recreation therapy, and we have our physician that comes on site at least once a week, or if not twice every week. We have a dietitian that can be on site at any time. We work closely with Alberta Health Services, and so we have access to whatever we need for meeting our long-term care health service standards. What do you think would improve long-term care in Canada? Definitely more staff. I feel more funding focused on elders' needs. Um anything in long-term care, we have to fund ourselves, which includes medication, any equipment that's needed, maybe funding more focused to equipment. Speaking from First Nations, I feel that culturally grounded care models would be nice. I had a staff member that I hired. She was First Nation and she worked in a surrounding area. And when she came, she said, Is it okay if we, you know, really talk closely with the elders and get to know them and maybe put my hand on their shoulder? I said, of course. And she said, you know what? When I worked in a facility, I was brought into the office, and I was told, you don't do that. You don't, you don't get close to them because you know they're gonna be, you know, this is their last place, they're gonna be. And that broke my heart because that person is still a human being. And I told her, you know what, they are human beings, they need touch, they need someone to, you know, put their hand on their their back, talk to them, and you know, get to know them. What's the favorite part of your work, Renata? I'm gonna say spending time with the residents and being a nurse and being able to go onto the floor, talk to my staff and making sure they're all good, especially the residents, at the end of a long day that's been stressful. I could sit with an elder and learn from their stories. They can share, you know, stories from their past, giving them a hug, making them smile is one of my favorite parts and making them laugh. In our culture, we have a lot of humor. And so making jokes with them and you know, with the staff. I guess for me, another really big part is making sure that everyone that I have here at long-term care are empowered to be the best of who they can be. I like to share with my staff that when we come to work, we leave everything negative behind the doors. To me, I take it as wanting the best for our elders to have good energy here to make it a good place. And I always tell myself, every day that you leave, I want you to leave this place like you made someone happy, you made someone's day, and that you did a good job. And so I like to empower my staff. I've heard from other staff members that they like to come to this side of the building, you know, they like to come in and see the elders and they feel the happiness of the staff and the camaraderie and you know, good communication is important. I think I just try to try to do everything to make sure that we have a healthy holistic work environment. I like to feel that our care is rational and not institutional. That's very important. And I did mention that the elders are knowledge keepers, and that's something that I keep in mind from an indigenous approach. Holistic wellness is a goal. I believe it just comes down to treating someone as a human being. Everybody has their purpose, has their story, and I really feel that's something that we all need to remember.

SPEAKER_02 18:32

That's wonderful. Well, thank you so much. I've really appreciated the conversation, Manata. I really appreciate you taking the time.

SPEAKER_01 18:41

Oh, thank you for having me.

SPEAKER_00 18:44

You've been listening to the Strengthening a Palliative Approach in Long Term Care Podcast. For more information about our project, visit spawnltc.ca