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Dr. Leigh Chapman, the new chief nursing officer for Canada, at Bevel Up, a consumption and treatment service available at Regent Park Community Health Centre, in Toronto on March 11.Tijana Martin/The Globe and Mail

Leigh Chapman describes herself as an unlikely choice for Canada’s chief nursing officer. As someone who helped establish an unsanctioned safe consumption site in downtown Toronto, and who spent years criticizing the official response to the opioid crisis, she didn’t ever expect to be welcomed into government’s inner circle.

But, in many ways, her career achievements and personal experience with trauma and tragedy make her the ideal person to be her profession’s national voice at a time when so many nurses are struggling under the weight of a crumbling health system.

The situation, which has been bad for some time, is now dire. Critical nursing shortages, exacerbated by the pandemic and its resulting stressors, have forced some hospitals to temporarily close emergency rooms, delay surgeries and postpone appointments. Many nurses report seeing little relief on the horizon, as demands on the system grow, leading to unsustainable working conditions. One survey released last summer by the Registered Practical Nurses Association of Ontario found 86 per cent of nurses are experiencing mental health distress as a result of work, and nearly half are considering leaving their jobs.

Addressing these challenges is central to Dr. Chapman’s mandate as chief nursing officer, a role that has been brought back in this time of need after being eliminated in 2012. She will be responsible for ensuring nurses have a seat at the table during important health policy discussions – and for working with governments and health leaders as Canada contends with the staffing shortages and rising levels of emotional and physical exhaustion among active nurses.

“Ultimately my goal is to make nursing a profession of choice in Canada,” Dr. Chapman said. “If we don’t improve the work lives of nurses, and the working conditions, then they will either leave the profession or leave the public sector.”

Dr. Chapman, who was raised in Toronto and lives in the city now, has already been in the chief nursing officer role for about six months, and has had the chance to visit with nursing leaders and professionals in more than half the country. While the 49-year-old is well-versed in the challenges facing the work force, which comprises nearly half a million people, even she wasn’t fully prepared for the levels of despair she witnessed.

The most startling encapsulation of the state of the profession came for Dr. Chapman when two nurses from two different provinces coincidentally told her they fantasized about getting into a car accident – not a major one, but serious enough to cause minor injuries – as a way to get a break from the unrelenting demands of their jobs.

“It is horrifying,” Dr. Chapman said in a recent interview. “There’s a real moral injury that nurses are experiencing, and a level of trauma that I don’t think we are prepared for as a profession in terms of how we address it.”

Much worse than normal job stress, “moral injury” is a term used to describe deep psychological damage that occurs when people are forced to witness, or take part in, events that go against their core beliefs, such as failing to provide adequate care for patients.

While provinces have put forward some solutions, such as commitments to hire more nursing-school graduates and streamlining the process for internationally-trained nurses to be able to work here, experts and advocates say those solutions don’t go far enough. What’s needed, they say, is for governments and health care systems to prioritize nurses by providing better working conditions and pay – as well as modernizing the regulatory system by adopting a national licence that would allow nurses from one province to work in another area of need with ease.

While Dr. Chapman isn’t in a position to mandate wage increases for nurses, she wants to use her influential leadership position to ensure issues like better pay and improved working conditions are at the top of the agenda for change.

“I think there’s almost a lack of awareness about what nurses do, unless people have had a really deep interaction with the health care system,” she said. “There’s a real need to reconsider the role of nurses and the vital role nurses play.”

Nursing wasn’t Dr. Chapman’s initial career path: her first university degree was in Spanish and anthropology. But after graduating, she took a job as an emergency department clerk at Credit Valley Hospital in Mississauga, Ont., a position she held for several years, which spurred an interest in pursuing health as a career.

She obtained her nursing degree at McMaster University in 2003. After graduating, she worked in the critical care unit at Hamilton Health Sciences Centre and taught at McMaster while pursuing a Master of Science in Clinical Health Sciences degree from the university. She then moved into roles at the College of Nurses of Ontario, followed by the Registered Nurses Association of Ontario.

In 2010, she had a son and, the next year, began her PhD, juggling motherhood, her studies and work in a new role at VHA Home HealthCare, a non-profit organization. But it became too much, prompting Dr. Chapman to leave her job to focus on her doctoral work. Then life took a terrible turn in August, 2015, with the death of her brother, Brad, following an overdose in Toronto. Less than six months after that, her father died.

“It was a really difficult time,” she said.

After taking a break, she would eventually complete her PhD at the University of Toronto’s Lawrence S. Bloomberg faculty of nursing in 2019 – but her brother’s death sent Dr. Chapman in a new direction.

A few months after Brad’s overdose, she heard about growing opposition to a shelter in her Toronto neighbourhood that would serve men experiencing homelessness. The opposition struck a nerve, as Dr. Chapman was trying to come to terms with the circumstances of her brother’s death. She soon found herself giving an impassioned 10-minute deputation in support of the shelter to a city committee.

In a Toronto Star article reporting on the January, 2016, meeting, Dr. Chapman is quoted as saying a shelter for men could have been a haven for Brad, and possibly could have “provided the opportunity for it to be safe for us to re-establish a relationship as brother and sister.”

The city approved the establishment of the shelter.

That success led Dr. Chapman to press further into the issue, becoming a leading advocate for safe consumption sites and better access to harm reduction.

In 2017, she co-founded the Toronto Overdose Prevention Society, an organization that operated an unsanctioned safe consumption site in Moss Park, a green space located in a low-income, under-resourced pocket of the city that is often used by individuals experiencing addiction and homelessness.

“That is hard work that you’re not going to be rewarded for, and the neighbours may not like it, and maybe the cops are going to arrest you,” said Tali Magboo Cahill, the eastern Canada board member of the Harm Reduction Nurses Association, who has worked with Dr. Chapman. “It’s courageous.”

Having someone like Dr. Chapman, who understands the complexities of pressing health matters, in the chief nursing officer role is a huge win, Ms. Magboo Cahill said. “Here’s someone who is a leader and can speak to what the system needs to improve health care for Canadians – and it’s a nurse.”

Dr. Chapman’s term as chief nursing officer is set to last two years, with the possibility of an extension. For however long she remains in the role, she said she’s dedicated to doing what she can to improve the system to help her colleagues, who are helping to hold up the system even when it costs them personally.

“They have taken on more than we probably ever could have imagined possible, and they’re still showing up to provide excellent care under the duress of the current health care system,” Dr. Chapman said.

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