Denise Gaudet, MSN ’92

It is great to have an opportunity to reflect on all of the valuable yet invisible tools gained during my MSN program that I have taken with me in all of the roles that I have held since leaving UBC in 1992.

First, I was a Clinical Nurse Specialist (CNS) for the Nephrology Program at St. Paul’s where I experienced my first programme evaluation (with Dr. France Bouthillette, who used to teach at UBC School of Nursing) and served for many years as a member and President of the Canadian Nephrology Association.

In 1998, I was recruited to take the clinical lead as a CNS in a small tertiary hospital in New Brunswick for the development and implementation (and evaluation) of a telemed programme in hemodialysis. As this pilot project came to an end, I attended workshops, looked for gaps and created my own business in “health services.” I was able to demonstrate how my work and practice met each standard of practice articulated by the Nurses Association of New Brunswick.  Essentially I did contract work as a national study coordinator for an international study in hemodialysis (Dialysis Outcomes and Practice Patterns Study). At the same time, I became Director of Nursing Practice, Education and Research, then Director of the Nephrology Programme in that same tertiary hospital.

I retired at age 56 but not completely, as I have had the great fortune of being involved in a number of exciting projects on a contractual basis, all the while maintaining my own company. The projects that remain most motivating to me, to this day, are those where I lead the evaluation piece. The process and results may not be perfect (I strive for excellence, not perfection!), but in the end, it brings about positive, credible change. The reality is that there just aren’t the resources (human or technical) to support exact measurement. Yet, I am the first person to say to my group, that if we are going to put energy into this initiative we need to be able to answer the “so what “question — so what difference did all of that effort make, for the patient, for us and for our establishment?

And now, another fun fact, I am working as a project officer at Correctional Service Canada (CSC), Atlantic Region. In 2015, I was asked to help with the introduction of a new role, the Nurse Practitioner (NP),  to work within scope (primary health) in the correctional setting. My first thought was to reach for the PEPPA framework, an evidenced-based evaluation tool that I had attempted to use for the first time when was responsible for the CNS group as a director in my previous job. And so, I used this framework here at CSC four times with the hiring of an NP at four penitentiary institutions, each of which was significantly different from the others. There were so many lessons learned! Here again, I thought that if only I had a more formal link with the academic world, what a difference it could possibly make. Just imagine PhD students introducing and testing models of care or conducting research with the NP and care team in health promotion, chronic illness detection/prevention & management programmes!

I feel that CSC is now ready for NP students in clinical placements. Naturally, all of our NPs were clinically competent practitioners but I felt that the context and roles needed to be clearly understood, as this is a very different context of practice.  To this end, early on I led the development of a schematic depiction of the NP Practice Model at CSC. It now serves as an easy talking tool from which NPs can explain their role. It also can provide an avenue to obtain feedback from others as their role and expertise evolve in direct and indirect care. Again, there is plenty of room for improvement and evaluation.

I remain focused and passionate about nursing and believe in the collaborative contribution nurses can make, at all levels, to the well-being of people, including the offender population. Primary mental health issues and chronic illnesses – the most prevalent offender population health conditions as determined by our population health assessment activities –  are absolutely within the realm of the NP’s scope. Our hope is that, what was once a pilot project, will be rolled out nationally within CSC. It has been an exciting initiative. And there are other just as exciting projects that are in the early stages of development. You can be assured that I will be the one to raise the Evaluation flag!

So you see, a piece of the UBC School of Nursing is here with me, has been and always will be. I have enjoyed reading the Amazing Alumni stories of colleagues I knew during my time at UBC and admire the wonderful directions their careers have taken since our formative time together.

I am so proud to be a nurse –  a critically thinking nurse!