An interview with Hélène Boussard
Hélène Boussard is a nurse who worked on a medico-social team at the Fleurimont Hospital Centre. She decided to pursue a master’s degree specializing in the needs of her designated centre’s team and to develop support tools for her team. We spoke with Hélène about her work in a designated centre, the tools she developed for her master’s project, and the care she takes of herself.
This interview has been edited for conciseness and clarity.
Gabrielle: Hello Hélène, can you introduce us to and specify your profession?
Hélène: I am a nurse… I studied in France and graduated in 2012. I worked for three years in France, in emergency care. Then, I moved to Sherbrooke and took up a position as a nursing advisor starting in 2016, a position I still hold. But I have been studying full-time for two years. I have been doing medico-social intervention since 2020.
Gabrielle: How did you become involved with the designated centre at Fleurimont?
Hélène: In 2020, I was back from my second maternity leave, and we were in the midst of a pandemic. I was aching to work, and I came across a news article about a young woman who presented at the Fleurimont ER and was not given access to medico-social intervention. At the time, I knew nothing about medico-social intervention. I didn’t know anything about this kind of care, but I wondered how it was possible that in 2020, someone can come to Emergency, not be able to access these kinds of services, and be received as if it wasn’t a priority. This also occurred during the #metoo movement, among other contexts.
So, since I’m a fairly curious person, and I had a hard time believing there was no context to explain this situation, I asked around a bit. No one was able to answer me. So, I called the department head directly and said to her, ‘I’m having a hard time believing what I just read. Can you explain it to me...?’ The team was hugely lacking in resources. They were needing to find nurses who could relay between various associates in the medico-social sector to support victims of sexual assault. That was on a Monday. By Friday, I was in training, and on Sunday, I began my first intervention.
Gabrielle: So, is it this same desire to understand and improve things that led you to do a master’s project on medico-social intervention?
Hélène: Yes. When I started …,I quickly realized that the training I had received until then was insufficient. It was 5 hours of in-house training that included a visit to the ER and using the clinical tools, software, on-call system operations, pagers, etc. Not 5 hours of assisting victimized people, but 5 hours in total. We live with the idea that nurses and front-line professionals can absorb this emotional load, without any more support than that.
Gabrielle: To guide your project, you called upon nurses, with what objective? And what did you learn?
Hélène: The objective of the questionnaires, of the focus group, and of semi-structured interviews was truly to assess the team’s learning needs.
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I came to realize that the designated centre’s team formed quite a heterogenous cluster, socio-demographically speaking. There were different kinds of jobs, different experiences, also different views of the practice, which could tend to be very focussed on the medico-legal aspect, as opposed to the clinical aspect or psychosocial aspect.
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A second point emerged: there was ambiguity in the perception that people had of the professional collaboration mechanisms. The protocol was quite vague, regarding each person’s roles and responsibilities, on the one hand, and, on the other, no competency profile was attached this protocol.
So, we more or less knew what we needed to accomplish together. But, exactly who does what? That, we didn’t know, and we were also largely unfamiliar with others’ areas of practice, and with their reference points. To be sure, the cultural reference points of male emergency doctor are not the same as a psychosocial counsellor who works at the CALACS and comes to the emergency room. But not knowing our associates very well, it becomes difficult to make the processes run smoothly. These, overall, were my major findings in terms of values and motivations.
I also found professionals who truly cared about making a difference. Even while exposing themselves to risks by continuing to handle cases with insufficient training, there’s an ongoing desire to restore a measure of social justice. That was a constant.
Gabrielle: As part of your project, you created training material and infographics for your team at the CH Fleurimont. What was the response?
Hélène: It was truly appreciated. What they told me explicitly was that they appreciated the aesthetic component. One colleague expressed it very eloquently in one of her written testimonies. She told me that, from a nurse’s point of view, there is a valuation of the profession as it is practised, which is not just about intellectual engagement, but also genuine experiential engagement, and which therefore also involves an emotional component. We’re not just talking about the aesthetics of the tools, but about the value placed on the work of health professionals. That exceeded my expectations because I was positioning myself from a cognitive standpoint. I was wondering if the tool made sense, if it was useable. Above all, it legitimized for some the importance of what they do. And that makes people want to engage even more.
These are my colleagues, and I wanted to produce something that fulfilled their needs, also the organizational needs. So, I had to engage in an ongoing dialogue and constantly adjust.
The goal was to develop tools and infographics in our own image, within the allotted framework, while also making it consistent with the changes we want to see.
Image Gallery
Please note that the content of these tools was created by Hélène Boussard for the designated centre at the CH Fleurimont and were not designed as universally applicable tools for designated centres. Neither do they reflect the official opinions of the MSSS or the OIIQ.
Gabrielle: Absolutely. One of the tools created was a local community of practice for the CH Fleurimont. For those who might be interested in a project like this, for their designated centre or their region, what are the involvements and challenges in creating and managing a community of practice?
Hélène: One of the challenges not to be underestimated is definitely the investment it requires, especially of time. Two things must be considered: the circulation of knowledge, and consequently, the production of knowledge. And since it’s also a knowledge management tool, it needs structure. That means it has to be built up, and then informed by reliable sources. We therefore have to think critically about the information we bring in, while making sure it responds to a need. After an initial investment to develop the structure, it must be brought to life. If it’s just sitting there and not alive, it’s not of much use. And I think that takes on more meaning within a culture of learning. A culture of lifelong learning. That’s not something you can achieve with a community of practice alone, with one or two resource tools. Really, it has to be worked on every day, which requires time.
Just before speaking with you, for example, I was placing the file for the affirmative approach in the community of practice. So, I have to start a new channel. Next, I put a little note in the News channel to say that I just posted this. How about you, what do you think? Do you have any questions? This logging doesn’t take that much time, but managing responses, etc., takes about fifteen minutes here and there. And I’m convinced it’s worth it.
Gabrielle: I fully agree with you.
The first time you contacted the Support Service was in 2021, and you had several kinds of questions to ask: you had technical questions about a case, but you also had questions about how to evolve on the issue of sexual assaults, not just as a professional, but also as a member of your community capable of reconciling these two aspects of your humanity. How have things changed since 2021?
Hélène: Yes, things have definitely changed since 2021. I can think of two major boosters that have helped me enormously. I’m not saying that things have been made easy on a daily basis and neither am I saying that I never experience challenges or things that unsettle me, but now, I nevertheless have two major resources.
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The first one, which I already talked about, is having gone back to school, having explored the issue and regained some meaning, and as result, having discovered resources and possible solutions. That doesn’t mean that now in 2024, everything is perfect, but there is hope. There is hope within my discipline, in the network of practice, and even in aspects other than healthcare and assistance. I am thinking, for example, of restorative justice. So, there really are things that adequately feed my hope on difficult days or during difficult interventions, those that make me want to bawl in my car on the way home, to be able to tell myself life is still beautiful.
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The second one is you, Gabrielle, who gave me a leg-up and reminded me that I am not alone. That’s why I still think back to that phone conversation: the reminders not to be alone, to seek out associates, to realize that there are many of us asking questions, many who at times are suffering. Because assisting sexual assault victims is not without consequence on the responders. Realizing I was not alone in this, that I could ask for help and get it. Even if that was just a listening ear, it makes a difference to be able to tell myself that I am not a bad professional because I feel like crying after an intervention. Or because I’m afraid in the streets, or I’m worried about my children. I am a critically minded and empathic person prior to even having a network around me. For me, that was a totally liberating learning experience, one that even happily spills over into several areas of my life.
Gabrielle: I am so happy to hear that, Hélène. So, what strategy would you recommend to others who may be at the beginning of their careers in medico-social intervention?
Hélène: Certainly, in one’s initial education, and then continuing education, one’s practice should be integrated in a network of practice; also, taking part in Support Service workshops, discussing with colleagues, debriefing, etc. These are two important points! Otherwise, self-care, I feel, is very important. Pascale Brillon has developed a lot of things on this, including tools that I also use.
Pascale Brillon has developed a lot of things on this, including tools that I also use. I take stock of my life with that, and I give myself reminders to take care of myself as well. The goal is not to be perfect in every sphere, far from it, but to connect with how I would like to nurture my sphere of physical well-being, to notice, for example, that it’s been a while since I last went to the spa. I might want to read some fiction, like Jane Eyre, an incredible story of emancipation written by a young woman of only 30!
Otherwise, there’s Pathways to Resilience, which I really enjoyed, by Rachel Thibeault, in which she doesn’t describe the spheres of self-care, but she does describe creative, contemplative, spiritual, and community activities. It lets me know when I’m feeling in low spirits, and what I can do to recharge without having to overthink. Because sometimes, when we are feeling swamped, it’s not easy to figure things out. So, good quality monitoring of one’s own well-being is important advice, I think.
Hélène Boussard
Gabrielle: Honestly, Hélène, I am really liking the idea of putting self-care in our schedules and not leaving it too late. With the trauma-informed approach, it’s about preparation and prevention.
Hélène: I would even add that it’s about being consistent with the victims we work with. We do a lot of work on emotional regulation and trauma-related stress management. Ultimately, it is important to be consistent with ourselves. I find that if we don’t do that, it puts us in the position of a victim. Whereas not taking care of myself and being not so available to relate to suffering makes it difficult to help rebuild the social bond, which is broken in situations of sexual abuse. If I am not available for that, because I myself am suffering and in a position of vulnerability, I won’t be doing a good job, honestly. And knowing we are not doing our job well also makes us suffer.
Gabrielle: No, we should not be suffering for the sake of our work, but neither should we be emotionally cut off, to the point of lacking compassion for our patients. So, Hélène, to conclude today, I want to say that you were one of the first field workers in a long time to engage with the Support Service in such a meaningful way. Even while the Support Service is in no way responsible for your success, I am very glad to have worked with you, glad to see the incredible results of your work and personal development since we spoke in 2021. Thank you so much!
Hélène: I was a great pleasure for me. And I thank you too, but I altogether must redress something. When you say, “the Support Service is in no way responsible for my success,” you’re forgetting that you have been there from the start, and that has made a big difference. Every time I had questions, I got answers, even if it was a listening- or validation-oriented answer. There was always someone there to answer. It made a very big difference in the undertaking. There is no individual success without collective success. There is no responsibility without co-responsibility. So, you are also responsible for the success.
Gabrielle: Thank you, Hélène, for your kind words and for talking with me today.
*Please note that the content of these tools was created by Hélène Boussard for the designated centre at the CH Fleurimont and were not designed as universally applicable tools for designated centres. Neither do they reflect the official opinions of the MSSS or the OIIQ.
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