The Future of Nova Scotia – and the Role of Nova Scotia’s Registered Nurses as Leaders in That Future

(Edited version of keynote presentation to the College of Registered Nurses of Nova Scotia, May 10, 2018)

I’m very honoured to be here with you this morning at the Annual General Meeting of the College of Registered Nurses of Nova Scotia. I’ve been asked to speak today about the future of Nova Scotia as well as the role of Nova Scotia’s Registered Nurses as leaders who will help make a better future for our Province.  Since my own field is education, preparing this talk has given me a chance to think my way into a different professional field, and I’ve enjoyed that opportunity.  Some of my reflections will likely be obvious to you as insiders to your profession, but I hope that my perspective as an outsider will complement your own vision of your work and its importance in shaping a vibrant future for our province.

When I moved to Nova Scotia from Ontario in 2010 to become president of Mount Saint Vincent University, the only connection my husband and I had to the Province was the fact that Bill, who’s from Ottawa, had done his undergraduate degree at St. FX, had worked here as a geologist in the field every summer during those years—and loved every rock and outcrop in this part of Canada.

But I also felt a deep connection to what I knew of the Mount and its vision of social justice and responsibility.  The Mount was founded by the Sisters of Charity 145 years ago, expressly to open up pathways to education for girls and young women. In 1873, of course, women couldn’t vote, in most cases couldn’t own property, and if they didn’t have a father or husband to support them, they were consigned to low-paying, menial positions in order to earn a living—unless of course, they had an education, which gave them access to good professions such as teaching and nursing.  The Sisters of Charity—who in my opinion are feminist to the core—believed in educating females so as to give them access to choices in their lives—including professional employment and economic independence.

The Mount is, of course, co-ed now, but its focus on outreach, accessibility, and preparation for employment has been as valuable to its male students as to its females. Small wonder, then, that my seven years at the Mount were immensely joyous ones.

And now, after almost eight years of living in Nova Scotia, my feeling of ‘rightness’ about our choice to come here is greater than ever—and so is my excitement about our decision to stay after my retirement last summer.  Simply put, I feel at home here. I’ve been fortunate to meet people from a great diversity of backgrounds—

  • leaders in Nova Scotia’s Mi’kmaq communities as well as young people from those communities who have come to the Mount to study;
  • quilt-makers, artists and poets;
  • Cape Breton business leaders along with Cape Breton fiddle-players;
  • immigrant families who are deeply grateful to be in Nova Scotia, safe from the ravages of war in their home countries;
  • African Nova Scotian Senator Wanda Thomas Bernard as well as Mi’kmaq Senator Dan Christmas, both recent appointments to Canada’s Senate.
  • Volunteers young and old who give countless hours working on behalf of poverty reduction, better mental health, protection of our environment, strong neighbourhoods, and food security for all.

I’ve had the privilege of attending the annual awards ceremony held to honour the accomplishments of “youth in care” –children who have grown up in foster homes or group homes—where I listened to the incredible stories of resilience in the face of hardship that these young people have demonstrated.  And then I had the joy of seeing some of these ‘youth in care’ enrol at the Mount to begin a university degree. I was proud to learn that Nova Scotia was the first province in Canada to continue financial support for ‘youth in care’ throughout their postsecondary studies if they chose to go on to college or university.

I’ve also served on the committee to select recipients of the Order of Nova Scotia and been humbled by the diverse accomplishments of the nominees and their extraordinary service to their professional fields, their communities and to the Province. Only five are selected each year to receive the award, but I found every nominee to be worthy of honour—along with their nominators, who devoted such generous time to preparing the nominations.

And I’ve had the great good fortune of being connected to Nova Scotians who have their sleeves rolled up and are determined—whatever the obstacles—to make a difference for future generations—to be bold enough to seize visionary ideas and take risks to make them a reality.

I do understand that the road for Nova Scotians has often been a rough one.  If you pick up a report predicting our future in the 1930s, ‘40s, 50s – on up through the Ivany Commission Report in 2014—you’ll find a common thread in all their analyses.  To quote the Ivany report, “Two interdependent factors—an ageing and shrinking population and very low rates of economic growth—mean that our economy today is barely able to support our current standards of living and public services.”

We face demographic and economic headwinds—both of which, of course, have a direct impact on our healthcare sector—and we are challenged to find safe passage out of the storm.

So, with this knowledge of the hard realities facing Nova Scotians, why have I chosen to stay here?

I believe that we are capable of “turning a corner” at this time, and I’ve seen enough evidence in recent years to make me want to be a part of the change we’re capable of creating. In June of 2012, I attended an all-day meeting of people from across our province who came together to consider just one thing—the future of Nova Scotia and how to make it better.  Out of that meeting grew a non-profit organization called Engage Nova Scotia, whose Board I joined and have chaired for the past four years.

It’s largely because of my connection with Engage Nova Scotia that I was asked to speak with you today, and I’m really pleased to have this chance to talk about the work of Engage NS and why it excites me. As you might guess from the name of our organization, its most fundamental premise is that the change we need to bring about to create a better future for Nova Scotia is going to require all of us to engage together in finding solutions.

The mission of ENS is to help in creating “a more vibrant, inclusive and resilient Nova Scotia,” and our belief is that citizens can and should take on a bigger role in building our future. We want Nova Scotia to be a place that lives up to its potential, preserves and builds on its advantages, and has a clearer sense of its purpose and direction.

To get to that goal, we’ve set an ambitious work plan that commits us to “engage Nova Scotians in forums and discussions about who we are, where we want to go, and how to get there.”   As we’ve moved out into communities for these consultations, we’ve raised and had meaningful dialogue about questions such as

  • “What is already special about Nova Scotia?
  • What is the foundation we want to leave for future generations?
  • What are our untapped economic, social, and cultural advantages?
  • Who needs to be part of the building?
  • What innovations in leadership, collaboration, and opportunity are possible?
  • What can be our unique place in Canada and the world?
  • What holds us back?”

And finally – “What is the Nova Scotia we want?”

One event we hosted in 2015, called Stepping Up, can give you a sense of the energy and excitement generated when people come together to consider these questions.  830 people from across 12 communities connected via videoconferencing—with another 800+ watching on computers, tablets and phones—to join in a conversation about not only ideas but practical, hands-on strategies that could shape a better future for our province. I’d like to show you a short video clip that captures some of the excitement and sense of hope:

One place where change can happen most productively is at the municipal level, in our towns and cities.  Engage NS has been working with the Union of Nova Scotia Municipalities and with individual towns, cities and counties across the province to explore innovative techniques that can help energize local residents and bring them together to solve their community’s problems collaboratively and constructively.  Traditional “town hall” meetings can end up with the loudest people dominating the mic and others left on the sidelines, apathetic or alienated from the process. In September of 2014, Engage NS staff in partnership with the Union of Nova Scotia Municipalities led a group of 45 mayors, councillors, and senior municipal staff members through a day-long workshop on approaches to citizen engagement that can bring people together in productive and positive ways.

A couple of months later ENS worked with a group of municipal and community leaders to design and deliver Engage Inverness County—a two-day conference that focused on how the people of that region can build a practice of coming together to tackle their economic and social challenges.

Since then, similar workshops and seminars have been supported by Engage NS and held in:

Barrington where municipal leaders worked on ideas for economic diversification in their region

Cumberland County where business leaders wanted to find ways of mobilizing the community in response to the Ivany Report, focusing on concrete actions that could be taken to improve the economy without government assistance

Hubbards where the Hubbards Area Business Association in partnership with ENS sponsored an event for local residents to meet, network, and talk about their future; interestingly, 70% of the attendees saw themselves as informed, willing and able to make a lasting impact on the future of our province

Stellarton where organizers from 5 different Stepping Up conference locations got together for a North Shore Conveners Gathering to share what they had learned about catalyzing change in their communities

Amherst where more than 200 people spent an evening at the town Fire Hall talking about the future of their town, identifying their 6 priorities as business growth; expanding tourism; youth retention and attraction; downtown revitalization; trails and recreation; and ways to build an age-friendly community. In a follow-up meeting, participants formed six committees that identified available resources, hurdles, solutions and next steps and then signed up to continue the work on these priorities, with ongoing logistical and technical support from the Town administration.

Pictou County/Pictou 2020 where ENS joined the group Pictou 2020 for an event that featured 30 2-minute stories of local success from Pictou County residents. Among the “take-aways” from that evening were that sharing positive stories is a powerful inspiration; people who take pride in what they do seem happier; and collaboration builds community

Kentville which featured councillors and staff from Kentville, Kings County, West Hants, Windsor, Berwick and Kingston coming together for a day-long “engagement clinic”

Mahone Bay where municipal staff and councillors from the County of Lunenburg, Town of Lunenburg, Bridgewater, Chester and Mahone Bay took part in a similar “engagement clinic” that was focused on the importance of telling our stories

Meteghan where teams from the District of Digby, Clare, and the Town of Digby explored 3 concepts – Where are we at right now? What can we do more of or do differently? Who can help us/whom can we help?

Shelburne where staff and councillors from Argyle, Barrington, the County of Shelburne, Queens County and Lockeport worked on engagement strategies through an Engagement Case Study approach

Port Hawkesbury where Engage NS facilitated a two-day event for municipal and Mi’kmaq leaders called One Cape Breton: A Future Forward Leaders Summit; and where a commitment exercise at the end of the two days resulted in a strong core of leaders and supporters stepping up to make sure that momentum on shared priorities wasn’t lost

And most recently in Antigonish, where two gatherings this year, in January and in April, were designed to consult residents on the future they want and seek their input on the development of a community strategic plan.

So, as these examples should demonstrate, right across our province we can find people who are ready to be more collaborative, inclusive, and adaptive to change.  These are people with energy and hope, with a willingness to let down their guard and take risks, to reach out across boundaries such as race, class, and geography to find common ground and purpose.

Another example of this willingness to reach out has been the response of Nova Scotians to a project called Share Thanksgiving, launched in October of 2014 as a way of making newcomers—recent immigrants and international students—welcome at a special Canadian holiday time. Engage NS has matched more families with newcomers than anywhere else in the country that took part in the Share Thanksgiving initiative. More than 400 people here in Nova Scotia participated as dinner hosts and guests that first year and that number has continued to grow every year, totalling well over 4,000 for the four years of the initiative.  Here’s a short video that should give you a sense of the Share Thanksgiving spirit:

Not only does Share Thanksgiving make me feel a sense of pride in belonging to a province that makes newcomers welcome, but it also points towards a solution to one of our province’s most pressing problems—an ageing and declining population.  Our ability to attract immigrants, make them welcome, and retain them here in our communities is a positive indicator for our future, and Share Thanksgiving proves that we have the “right stuff” to make this happen.

When the Ivany Commission Report was published four years ago, its authors commented that, for the future of Nova Scotia, “Overcoming the psychological barriers of division, distrust and discouragement may be just as important as raising capital, producing new products or finding new markets.  Indeed, we may need to accomplish the former transformation before we can make much progress in the practical aspects of economic development.”

In other words, the Ivany Report points to a healthy attitude as a necessary precondition to other changes our province is seeking.  Throughout the stories I’ve shared with you of work being done by Engage Nova Scotia, I’ve found examples of Nova Scotians who are busy setting aside those “psychological barriers of division, distrust and discouragement” and replacing them with collaboration, inclusiveness, trust and openness to change—the kind of attitude needed for us to build a strong future together.

In a blog post last November by Danny Graham, the CEO of Engage Nova Scotia, Danny puts the matter very eloquently, and I’d like to quote him at some length:

The call of our time is to open our minds wider and discover what those least like us might have to teach us.

At its core, this gets personal. It requires us to accept each other — especially when we disagree — and connect in tough conversations.

Pick your wicked Nova Scotia problem: racism, clear-cutting, economic dependence, size of government, inequality, youth outmigration, voter apathy or real estate development. None of them are quickly fixable. They can only be resolved at the speed of trust. . . .

Our organization, Engage Nova Scotia, has been working with Nova Scotia communities to build trust through better public engagement because we believe it’s harder to distrust someone “up close.” Attitudes are formed in families and communities, and global change starts there. . . .

Imagine a Nova Scotia where citizens regularly came out to community meetings, felt heard, built understanding with opponents, and supported bold leadership to find new social, economic and environmental opportunities.

These are just a few of the things we are undertaking, in partnership with people and organizations from one end of the province to the other who believe in this place and are ready to build a Nova Scotia that is more unified, inclusive and adaptive to change.

The US presidential election and the miserable splintering our “cousins” are experiencing represent a wake-up call to improve our ability to the come together. Let’s not waste it.

Danny concludes by saying:

I believe we are up to the challenge. If ever there was a candid and tolerant culture that can navigate these channels, Nova Scotia is it.

As you can tell, Danny is as optimistic about our ability to be “up to the challenge” and steer successfully through the headwinds as I am – in fact, his optimism, as a born and bred Nova Scotian, has been a great source of inspiration and learning for me.

I want to share one more example of the work Engage NS is doing before I venture to make some connections to your work as leaders within the nursing profession. We’re currently undertaking, in partnership with the developers of the Canadian Index of Wellbeing, a project designed to measure and, over time, seek ways to improve the quality of life for Nova Scotians.

“Wellbeing” as defined by the Canadian Index of Wellbeing is “The presence of the highest possible quality of life in its full breadth of expression focused on but not exclusive to [the following eight domains]:

  • good living standards,
  • robust health,
  • a sustainable environment,
  • vital communities,
  • an educated populace
  • balanced time use
  • high levels of democratic participation, and
  • access to and participation in leisure and culture.”

The CIW shifts focus from the standard economic progress measure of Gross Domestic Product (GDP) to look more broadly at “how well our population is faring as a whole.”  We know, for example, that economic growth can come with “costs such as environmental degradation, loss of farmland, growing income inequality,” so it’s important to look at a more comprehensive set of indicators to get a true picture of how well we are living—and to know where to focus our efforts to improve our quality of life.

The Nova Scotia Quality of Life project will, in its first phase, identify trends in our wellbeing over the twenty-year period from 1994-2014 and compare them to the Canadian average.   Phase 2 will involve gathering, through an extensive, province-wide survey, original public opinion data about Nova Scotians’ lived experience in the eight domains of wellbeing – providing Nova Scotians with a wealth of data that can guide local decision-making across the province for years to come.

This Quality of Life research is designed to create a common language and space for us both to celebrate our successes and to tackle gaps in policies and programs so that we can better adapt to the future. With an advisory group from organizations such as the United Way, the Halifax Chamber of Commerce, Nova Scotia Community College, Dalhousie, Sports Nova Scotia, the Ecology Action Centre, and Phoenix Youth Services, we have an extraordinary opportunity to help shape positive outcomes for the future of Nova Scotia.

One Quality of Life domain that I believe will be of particular interest to those of you here today is, of course, the one dealing with robust health or “Healthy Populations,” which looks at the physical, the mental and social wellbeing of our citizens.  Not surprisingly, the domain considers not only the overall health of the population—“health status”—but also what are known as “social determinants of health”—broader factors such as how food is distributed and priced, how houses are constructed and located, how urban transportation is designed, how accessible health care and recreational services are, and how we interact with the natural environment.

Within Canada, these social determinants of health are defined more specifically to include

  • income and social status;
  • social support networks;
  • education;
  • employment and working conditions;
  • social environments;
  • physical environments;
  • personal health practices and coping skills;
  • healthy child development;
  • gender;
  • race;
  • disability;
  • food insecurity;
  • and housing.

For those working within the health sector, I can imagine you might feel a sense of “disconnect” between your own scope of practice—what you are able to influence—and the long list of determinants that influence how your patients will cope and thrive.  But here is the connection between the work of Engage Nova Scotia and your professional practice.  You are not only nurses but you are “nurse leaders”—as indicated by the key themes of your conference.  You have an exceptional opportunity to engage both as citizens and as professionals in fashioning outcomes that will help ensure the future wellbeing of Nova Scotians.

Nurses are trained and positioned to see connections across all facets of our lives, to recognize the myriad determinants of health and the complex ways in which they intersect. You can bring your informed voices to the table within the communities where you live, advocating to help ensure that the choices we make as a society reduce the burden on the healthcare system and improve the lives of Nova Scotians. Conversations about quality of life are happening across our province, among Nova Scotians who believe in the possibility of change and of a better future for us all. I hope you’ll find ways to bring your expertise into those conversations.

I do recognize that, within the practice settings where you work, you face challenges particular to the healthcare sector.  We read daily about the pressures on Nova Scotia’s healthcare system and the difficulties encountered by professionals who care deeply about their work and are frustrated by substandard working conditions, by the bureaucracy, by political infighting, by lack of resources. The future of your sector matters immensely to all Nova Scotians, not least because we know that either ourselves or our loved ones, or both, will need your skills and expertise at some point in our lives.  But, difficult as these problems are, I would argue that there are solutions to be found.

And this is where my own professional background intersects with yours.  Nurses, like educators, work to improve people’s lives and need many of the same traits:

  • respect for your patients
  • compassion and caring
  • analytical skills
  • people skills
  • an understanding of and respect for “difference” – including cultural differences that may be a barrier to your patient’s ability to access care
  • the ability to teach
  • and the capacity to listen and learn

These were among the qualities I felt called upon to develop as I made my career in higher education—qualities that were driven by my own passion for social justice and inclusion.  These qualities are equally strengths for you to exercise as you lead change on behalf of a workplace that is inclusive and equitable, both for its employees and for the clients they serve.

The conversations that Engage Nova Scotia is having with communities across the province demonstrate powerfully that collaboration and openness to change can be nurtured in a setting where people sit down together with a commitment to listen to, trust, and learn from one another. Each one of us can make that commitment.

A thriving and healthy future is possible for Nova Scotia.  Creating that future is within our own hands. I look forward to what we can accomplish together.