I have known Marilou Gagnon for 12 years. She is an award-winning nursing educator and an outstanding researcher whose program of research focuses on social justice and the advancements of the rights of marginalized communities. In addition to this, she is known for her ability to engage in public debates and bring nurses together to advocate on issues related to HIV, harm reduction, drug policy, and health equity. In recognition of her advocacy work, she has received the 2015 Outstanding Advocate Award from the Canadian Association of Nurses in HIV/AIDS Care (CANAC) and the 2018 Leadership in Political Action Award from the Registered Nurses Association of Ontario (RNAO).
At the end of August 2017 she joined Overdose Prevention Ottawa (OPO), a group of passionate advocates who implemented a volunteer-run overdose prevention site in downtown Ottawa. This site was opened as a direct response to the overdose crisis and the rising number of deaths in Ottawa. Between January and October 2017, there was a 76% increase in overdose deaths in Ottawa (the months of July and August showed the highest numbers of overdose deaths in that year). In response to the lack of action at the municipal and provincial levels, OPO opened the first safer consumption site in the city on August 25 with the goal of preventing overdose and overdose deaths. At the site, volunteers were trained to prevent overdoses by actively monitoring and stimulating people who were heavily sedated. They were also trained to provide first aid to people who overdose. Guests who used the site could also access naloxone, harm reduction supplies, and fentanyl testing strips.
The site remained open for 78 days. Every day, volunteers would set up the site, provide the service for 3 hours (between 18:00-21:00) and would take down the site (see picture). Rain or shine, volunteers repeated this process through the months of September, October and November. The site was forced to shut down on November 9 due to the weather and lack of support from local and provincial authorities. A total of 3667 visits were recorded. Naloxone and rescue breathing was used 5 times to resuscitate people who had overdosed and stopped breathing. In addition to this, OPO estimated that between 78-234 overdoses were prevented by actively monitoring and stimulating guests who were heavily sedated.
Being the only nurse on the core organizing team, Marilou was responsible for developing protocols, securing medical supplies, training all the volunteers (> than 120), supporting the volunteers (including the nurse volunteers) during their shift, and acting as the clinical lead person for questions, issues, and media interviews. She was also a key member of the team, doing on average 3 to 4 shifts a week on top of her full time position at the University of Ottawa. As a nurse volunteer with Overdose Prevention Ottawa, I can attest to the fact that her contribution was simply outstanding. She had a direct impact on hundreds of volunteers by mentoring, training, and supporting them – in addition to designing a service that worked efficiently and safely. I was most impressed by her ability to mentor other nurses who were new to harm reduction. She would sign onto shifts to train them one-on-one and encourage them to take initiatives, ask questions, and reflect on their role as nurses. She would follow-up with them after their shifts, send regular email updates, and debrief after difficult situations. She went above and beyond to support nurses who responded to overdoses and was available 24/7 to help them cope with that experience.
She also had a direct impact on hundreds of clients who use the service by being available to answer their question, help them connect with health care providers, assessing them when they were unwell and even saving their life, which she did one more than one occasion. On September 19, she was training a nurse on shift when they had to respond to an overdose after a guest immediately stopped breathing and lost consciousness. After two doses of naloxone and rescue breathing, the guest regained consciousness and had stable vital signs. By the time the paramedics arrived, she was back on her feet. On multiple occasions, I have seen Marilou assess guests who were unwell and needed help: a young guest who was anxious and paranoid after smoking cannabis, a guest who was short of breath and coughing at the bus stop, a guest who was presenting symptoms of a stimulant overdose, one of our regular guests who was feverish and weak and another one with complex wounds, just to name a few examples. Every time, she would find a solution and work with other volunteers to connect guests with health care services while respecting their wishes and preferences.
There is no doubt in my mind that what she accomplished with Overdose Prevention Ottawa makes her a nursing hero. I cannot think of another nurse who is more deserving of this Nurse Hero award.
Quotes from Overdose Prevention Ottawa volunteers, organizers, and guests
“Marilou Gagnon always goes above and beyond for the community, as well as for the team at Overdose Prevention Ottawa. She is an ideal example of a leader. She continually worked hard in order to improve the care and services that were offered at the OPO site. She is distinguished by her professionalism, remarkable leadership and communication skills. Also, her leadership entails her as a very approachable person. Marilou is a talented and caring nurse, it was a pleasure to work with her and see how she always puts the clients and our team’s best interest above all.” Gabrielle Charron, RN (OPO nurse volunteer)
Being aware of the overdose crisis, not only across Canada but also in Ottawa, Marilou could have chosen to remain in her university professor role. Instead she was instrumental in initiating Ottawa’s first safe consumption site run entirely by volunteers. From a grassy block of land no bigger than an urban lot, tents were erected and equipped, volunteers gathered, food and supplies arrived and Overdose Prevention Ottawa (OPO) was born. Despite public, emergency service, and political objections the project started, continued and grew under Marilou’s guidance and leadership. People who use drugs were drawn to the site, and lives were saved, rather than lost. Cynthia Kitson, NP (OPO nurse volunteer)
“While politicians were hiding behind bureaucratic procedures letting our patients, neighbors, friends and family members die by the day, Marilou stepped-in with her OPO team to provide a safe space where people who use drugs could feel respected, dignified and empowered. Marilou inspired me as a nurse to embrace my role as an advocate and to speak up against inhumane laws that contributed and perpetuated the deaths of thousands of Canadians. It is Marilou’s exemplification of patient-centered care and her contagious passion for advocacy that makes her a nurse hero! I will be forever grateful to Marilou for having contributed to making me a better nurse, a better advocate and a better person. Thank you!” Jean-Laurent Domingue, RN (OPO nurse volunteer)
Jean Daniel Jacob, RN, PhD
School of Nursing
Faculty of Health Sciences
University of Ottawa