This text is part of the special Nursing Profession notebook
Innovative and avant-garde, the 2023 finalists for the Florence Prize in the Excellence in Care category each focus their practice on the patient and their family in their own way in order to improve their quality of life, despite the illness.
Lysanne Daoust: dedicated to the cause of children
“It’s a 34-year career dedicated to the pediatric cause,” humbly summarizes Lysanne Daoust. For 24 years, she worked as a clinical nurse in pediatric palliative care at the Sainte-Justine University Hospital Center (CHU). The nurse even participated in the development of this function in 1999. “It was a challenge when I started, because it didn’t exist yet,” she recalls.
For Lysanne Daoust, however, there was no doubt from the beginning of her career that “a sick child is the last person to defend”. With this conviction, she begins to work in a discipline that is still little known and a context that is not always easy. She faces certain prejudices. “We become a nurse to heal and care. We all hope for small miracles, but pediatric palliative care confronts the failure of medicine and the non-survival of children,” she says.
These sick children that she cares for are followed for a long time, “it’s not like for adults, where palliative care is over the last three months, we follow children as soon as they have illnesses serious, sometimes complex, then we are with them for several months or several years,” she explains.
What she likes about this discipline is precisely the fact of being able to concentrate on other aspects of care, such as the quality of life of young patients and their families as well as the relief of symptoms. “It’s about ensuring that what the child and their family experience is important to them, whether in the choice of treatments, care, or how to fully enjoy life,” she explains. .
Moreover, Lysanne Daoust says she no longer takes anything for granted after all these decades working in this service. “These children want nothing better than to grow old. And I now know that growing old is a privilege,” she emphasizes.
Its consulting team has supported medical teams, families and young patients over all these years. Follow-up that requires tact and empathy. “Living with a child in palliative care, experiencing a death, is something significant, and it cannot be experienced alone. It was part of my job to check on colleagues and make sure things were going well,” she says.
Lysanne Daoust has a passion for her profession and her eyes sparkle when she talks about it, already with a touch of nostalgia. Because since July, she has been retired. However, her head still remains with her colleagues, and she hopes that the team that has been set up will continue to grow.
The nurse can also pride herself on having been a pioneer in her field, notably by collaborating in the drafting of the Standards for pediatric palliative care of the Quebec government, which constitutes a reference for providing quality care. But above all she has been a model for her peers, passing on her knowledge to the younger generations who are now taking over.
Isabelle Milette: caring for premature babies
“Since my early childhood, I have always loved taking care of people, it has always been something innate in me,” says Isabelle Milette, nurse practitioner specializing in neonatology at Maisonneuve-Rosemont hospital since 2019.
After a brief stint in medicine, Isabelle Milette headed for a bachelor’s degree in nursing, where she discovered a true passion for the discipline. “I liked the humanist aspect, taking care of the patient, the relationship with them,” she describes.
She then continued her master’s degree in advanced practice in the United States before returning to Quebec to take the nurse practitioner exam. And she has since completed a master’s degree in developmental care. “Neonatology was my first calling, I think I always wanted to take care of children more than adults. A child who cries, for me, it’s clear that there is a problem, I also had to take care of my brother a lot in my youth,” she says.
For 25 years, she has provided medical and neurodevelopmental monitoring of premature newborns. Having passed through different neonatal units in Quebec and in pediatric intensive care, Isabelle Milette has a wide range of knowledge and practice. “We take care of sick premature newborns who are often with us for a very long time, we follow these children from admission until their discharge, we support the family through this ordeal. I like this aspect, we humanize care in an environment that is very intensive,” she describes.
She found her vocation in the 1990s, after attending a conference on newborn behavior presented by psychologist Heidelise Als. “She developed a theory of the language of premature newborns who, due to their immaturity, do not have the same language as a full-term newborn. We observe their behavior to better understand where they are in their development, how they express themselves, what they like or don’t like and what we can do to reassure them. This is called NIDCAP [un programme néonatal individualisé d’évaluation et de soins de développement]. »
NIDCAP has been proven to reduce the risk of major disabilities in premature babies, such as blindness, deafness, intelligence quotient deficiency and cerebral palsy. The practice also helps improve long-term neurodevelopment and avoid certain later disabilities, such as autism, language and learning disorders, or ADHD. The place of parents in the process is also important. “They are the ones who are going to be there for the long term, so the parent-child relationship must be strong; keeping them at their child’s bedside, for example, has positive effects in the short, medium and long term, because babies are less stressed, even in intensive care,” she assures.
Isabelle Milette became the first nurse in Quebec to obtain NIDCAP certification. The Maisonneuve-Rosemont hospital is the first in Quebec to have implemented the NIDCAP, and the unit will soon be certified by the Toulouse training center. Honors that make Isabelle Milette proud today, but what fulfills her even more is sharing her knowledge, she says.
The nurse provides professional support in Quebec, Ontario, France and Reunion, in addition to writing books on the issue for parents and professionals. “I believe that this will be my legacy at the end of my career, what I am most proud of. I hope that our certification will allow us to become the first NIDCAP training center in French in Canada,” she concludes.
Laurie Lechasseur: for more personalized treatments
It was after working in home care that Laurie Lechasseur decided to train in wound care. “We go to people’s homes alone and we have a lot of autonomy in our work. Wound care makes up a large majority of the work, and there are needs in the field, such as determining the treatment plan and prescribing care,” she describes. Very quickly, however, she noticed that she lacked knowledge in the field and decided to follow training. “I also learned that there were no enterostomal therapy nurses in my area, so I felt there was a need to fill, and this was confirmed when I contacted managers at the hospital in particular, to see the possibilities of positions later,” she adds.
The ostomy is the surgical deviation of a natural conduit, a sort of “short circuit”. It is often the result of the removal of an organ. In the most common cases, stools or urine are therefore collected in a bag or ostomy bag.
This intuition of Laurie Lechasseur bore fruit, since after following her training, she became an advisor to other nurses in her region, the North Shore. “Our reality is different, because we cover a large territory, almost 1,300 km. We don’t necessarily have a large population base, but often nurses work alone in a dispensary, so having a specialized person as a point of reference is important. » So she does a lot of clinical support remotely and in person, and answers colleagues who have wound care questions. “It’s really to better equip them that I’m here,” she says.
The nurse also provides basic training to her colleagues on the North Shore and has become a reference for them, remaining abreast of developments in practice. She also contributed to the creation of the first wound care program and the reference framework for professionals at the CISSS de la Côte-Nord, as well as to the revision of the recommendations of the guide on the subject prepared by the National Institute of excellence in health and social services.
Today, she says she is happy to see more and more requests and interest from her colleagues, because the implementation of individualized care is essential in her opinion. “If wound care is not appropriate, if the cause is not taken into consideration, we can end up with a chronic wound, which impairs quality of life. When the care is specialized, when the cause is taken care of and the treatment is adapted, this facilitates recovery and the patient’s quality of life afterwards,” she explains.
Eight years after putting on the coat, Laurie Lechasseur assures that she is fully flourishing in her vocation and hopes to continue to make her contribution in practice, in particular by continuing to support the resource nurses who will be trained over time.
This content was produced by the Special Publications team at Duty, relating to marketing. The writing of the Duty did not take part.