Registered nurse (RN) Jocelyn Dunphy remembers looking out the window of the plane. The air ambulance from Leaf Rapids to Thompson, Man., was running just over the tops of the trees, as she tried to feed a two-month-old who had never seen a bottle.
The baby’s mother was on the flight, having overdosed and been brought into the medical centre where Dunphy was working. It became a race to the larger hospital — not the first for the RN, nor her last to save a patient.
Dunphy worked a two-year stint in northern Manitoba, beginning in 1984, but the majority of her career has been in Newfoundland and Labrador. She has worked in rural clinics and the province’s largest facilities, in emergency and in long-term care.
Last week, she sat down with The Telegram, to reflect, having officially retired from Eastern Health as of December 2017.
Among other things, she believes the introduction of nurse practitioners was positive for health care in the province. But she also feels more nurses are needed generally to meet changing demands in the system.
Training and early tests
Nursing has changed over the decades.
Dunphy began as a teenager with a three-year training program at St. Clare’s Mercy Hospital school in St. John’s in the late 1970s. Today, RNs are usually required to have a bachelor of nursing and take the qualifying exam faced by all RNs in Canada. And there is an annual requirement for continuing education.
Dunphy said her early challenges on the job were mental and emotional ones, and she doesn’t think that’s changed for nurses starting out today.
She remembers she was still in her initial training when her father was diagnosed with cancer. His health quickly deteriorated and he died within the year. She says his loss affected her entire career. “I looked at every patient as my dad,” she said.
When she graduated in 1978, there were plenty of nursing jobs and she has never faced a time when there weren’t options for an RN in Canada. She started with offers at St. Clare’s, the Janeway and the cottage hospital system in Grand Bank.
By then, she had met her husband, Gord Dunphy, from St. Lawrence. She was from Marystown, and wanted to be close to her mother and youngest brother who still lived there. She took the job on the Burin Peninsula.
“You had to land on your feet and be thinking all the time,” she said, of her first days at the roughly 40-bed facility in Grand Bank where she started out.
“You might be in one room helping someone deliver a baby and someone’d call out: ‘The ambulance is coming. Missus is having a heart attack!’ So, it was multi-tasking,” she said.
Her shifts could include a patient with pain from an ingrown toenail to someone who sustained severe trauma in a car accident. Some cases were more emotionally exhausting than others.
First losses and new trials
The first patient to die in her care was in Grand Bank.
She said her mother gave her the advice she needed to keep going.
“Mom said to me, she said, ‘You know something? You can’t get upset over that. You just have to do the best you can with what you’ve got.’ And I always remembered that. And that’s sort of been my motto. You do the best you can with what you’ve got,” she said.
After a year, she moved to St. Lawrence and began working at the larger health centre there, and stayed until 1984.
With four children by this time, she and her husband decided to move to Manitoba, finding higher pay in Northern positions. He had job prospects, and with a phone call she found a new position.
The medical clinic where she worked was about an hour and 15 minutes by air ambulance to Thompson. That’s how she found herself on an emergency flight, trying to care for that infant.
She recalled another memorable flight, with a woman who went into labour. “You know those little screens that are on the windows on a plane? She tore those off the windows,” Dunphy recalled, mimicking the action with a half-laugh, now, at the memory.
On the road again
In 1986, the family was back in St. Lawrence and Dunphy was working at the U.S. Memorial Health Care Centre, typically 12-hour graveyard shifts: 8 p.m. to 8 a.m.
As an RN, she would lead the response to an emergency, handling whatever came through the doors and calling in the doctor as needed. She vividly recalls the regular ambulance rides to and from St. John’s, with hundreds of trips out over the highway.
“As RNs you just took your turn,” she explained. It could be a patient with an unexplained trauma requiring more advanced assessment tools, or who needed to see a particular specialist in town.
The ambulance went regardless of the weather. Dunphy remembers an ambulance sliding down a hill sideways on one occasion, with ice and blizzard conditions, on the Burin Peninsula Highway. “But you had to get those people in there. They would have died,” she said.
There was a ritual each time she reached home. She tried not to let anyone come near until she had showered and dumped her dirty work clothes into a hamper. She’d give herself a chance to cry if she needed to, given she tried to keep emotions from hard days to herself on the job.
Late shifts and sudden trips meant a lot of odd hours and challenges for family life. And that made a recent tribute — from her daughter Allison Dunphy, shared on social media — all the more significant.
“Being a nurse is not an easy job,” it reads. “It means you often miss Christmas, birthdays, concerts, basketball games. My mom is an absolute superhero. She found a way to be 100 per cent present in both her family and working life. While working full-time shift work and raising four children, my mom found a way to make sure we all felt unconditionally loved and taken care of. To say I am proud of her today (as her retirement is announced) is the biggest understatement. She has taught me work ethic, multitasking, compassion, empathy and her kindness genuinely makes me want to be a better person every day.”
Dunphy continued for years in an environment without consideration for the physicality of the work. Today, lifts have been introduced, for example, but that work used to be carried out on the backs of health-care staff.
In one instance in St. Lawrence, Dunphy recalled, there was a woman who was moved several times daily using a bed sheet, with staff sometimes injured in transfers.
And while new protocols for aggressive patients have been introduced, aggressive patients remain a challenge.
Dunphy said her body was starting to feel it another decade in, with muscle injury, wear and tear. When a management position opened up in 2001, her husband told her she should consider taking it and she agreed. She became a nursing supervisor.
Between 2001 and 2006, she took on more of an instructor and mentor role.
Among other things, she advocated for greater availability of certain drugs, as availability can depend on where you are in the province. The facility in Grand Bank was not the same as St. Lawrence, for instance.
In 2004, she recalls, a new clot-busting drug was introduced and demanded throughout the peninsula. And within the week in St. Lawrence, it had proven its worth with a patient. “That made the difference in saving his life,” she said, remembering.
The Dunphys moved to St. John’s in 2006, in connection with Gord Dunphy’s career in the trades. Jocelyn Dunphy took a job in long-term care at the Hoyles-Escasoni complex, later aiding in the move of patients to the new Pleasant View Towers.
She volunteered for a pilot project while in the old building — bringing patients on ventilator units who were stable out of the main hospitals and into long-term care. She was trained on the new “vent unit” as the nurses called it and, by the time of her departure, had been training other nurses for more than six years in the machinery and troubleshooting, within the RN’s scope of practice.
Before for her retirement, Dunphy took a pair of short-term contracts in Nunavut, in 2011 and 2012, before returning to St. John’s. She said the staff were top-notch, with several hailing from Newfoundland and Labrador. The patients have stayed with her, like so many over the years.
“I interacted with every person and I took something back, too. I feel that made me the nurse I was, and the person,” she said.
“It’s all like pieces of a quilt, it all comes together. And that’s my career – not only my career, but my life. That’s what I’ve done,” she said.
She hasn’t ruled out more nursing, including another short-term contract in Nunavut or Manitoba. But for now, she’s retired from Eastern Health, and is planning a trip across the country to see her grandchildren, spending more time with friends and family, and tackling a few crochet projects.