RN advocates for our tiniest citizens

Leanne Tyler remembers a time when she worked with newborns in northern Ontario who had been exposed to inhalants such as gas while still in the womb. She observed a shift in the 90s, when the drug of choice was alcohol. Now, Tyler says she’s noticing babies are coming into this world addicted to narcotics like the powerful painkiller, OxyContin.

As clinical co-ordinator for the maternal-child and medicine units at Sioux Lookout’s Meno Ya Win Health Centre, a role she has since vacated but still dabbles in from time to time, Tyler teaches moms – new and seasoned – about baby safety, breastfeeding, family planning and risk management. Providing care for mothers who are addicted to narcotics also means conversations about their history of drug use and what, if any, steps they’ve taken towards recovery.

Trying to create a rapport with a new mother is a key part of the role, says Tyler. Time is the most important tool for nurses who are working with addicted moms and their babies: time to watch the child, and time to help mom through feelings of guilt or remorse, she says, adding that advocacy is another means to ensuring an infant’s safety.

Nurses must “stop thinking about the specific substance being used, though it is important for planning care, and look at the bigger picture, which is addiction, and how we can help individuals, families, and communities through this.” Babies are our future, Tyler says, especially in the north. They already face unique social and economic challenges in rural and remote communities. Giving them a healthy start is the best way to ensure they stay healthy.

Advocating for the tiniest members of society who cannot yet speak for themselves can be a delicate task, but Tyler says she feels comfortable in this environment. In fact, she’s humbled by the strength of some mothers who face challenging circumstances as they try to wean themselves off the drugs they’ve come to rely on. “These are women going back to…two or three families living in a house without water or heat,” she says of living conditions on some northern reserves. These conditions “…would crush the rest of us, and they’re able to do it.”

Socio-economic challenges may have contributed to an initial decision to use OxyContin, but helping women to make a conscious choice not to continue for the sake of their children is where Tyler comes in. Education and support are vital, she says. A five-bed in-patient withdrawal unit has boosted capacity in Sioux Lookout, but she suggests there is still a need for more community support. Specifically, Tyler thinks using the telemedicine network for community-based follow up for clients, and clinical support for community-based workers and programs will address some of the challenges.

Tyler knows the value of support through difficult times. As a child, she acted as her grandmother’s hands and feet as the elderly woman battled rheumatoid arthritis. It was this experience that she would draw on when she decided to pursue nursing as a career. “I think I was a nurse long before I was a nurse,” she muses. Tyler graduated from Niagara College of Applied Arts and Technology in 1991. She immediately boarded an airplane for Attawapiskat to work.

Initially, she provided long-term care to eight elders, plus in-patients. Originally from southwestern Ontario, Tyler has stayed in the northern part of the province since, and, last September, took on the role of clinical co-ordinator for ambulatory care and chronic disease management at Meno Ya Win. She’s not working with babies and moms as much as she was, and admits she misses it.

Recently, a mother at the centre asked “are you still working in maternity?” Tyler, who had delivered one of the woman’s babies, replied no. The encounter made her miss the tots and their families even more. “I really see each one of those little individuals as the future of our world,” she says. “They’re a beautiful gift.”

She says she’s passionate about chronic disease management, but Tyler won’t rule out a return to working with babies: “I would never say no.”