Anna Adjemian was the Project Administrator of the SBNH Partnership Grant from March 2020 to July 2022, responsible for supporting the SBNH Leadership Program, coordinating the Knowledge Mobilization and Intellectual Property committees, and for maintaining the SBNH communications channels. For this profile, our Project Officer Tina Gelsomini spoke to Anna about her most memorable experiences on the SBNH Partnership, her hopes for the future of SBNH, and her pursuits in midwifery.
Tina Gelsomini: Could you please give us a short summary of who you are and what you do professionally?
Anna Adjemian: I completed a BA in English at a private college in the US, and started out teaching literature and writing to grades 6-8. I absolutely loved teaching, and that age group has a special place in my heart. From teaching I moved to educational administration, where I spent the bulk of my career, primarily in communications and development (fundraising). Despite my focus on and love for education, I've had a life-long interest in healthcare, and always planned to move into the field at some point. My role on the partnership grant has been an amazing learning experience and a source of deep inspiration. Although I am sad to leave the grant behind, I'm excited to make the move toward clinical practice as I begin the Midwifery Program at UBC in the fall.
Why and how did you get involved with this project?
Anna: As I was getting ready to apply for midwifery school, starting to take prerequisites, I wanted to start moving towards healthcare. I applied for this position and read enough about the project that my curiosity was piqued. I was really excited to take the job, and nervous because nursing was new to me, healthcare was new to me, research was new to me. It was all brand new, but I was excited to have the learning opportunity.
In education, I felt like I understood the world that I worked in, especially having begun as a teacher. So, when I transitioned into this role, I didn't feel like I could do the job in earnest without understanding what we were doing. I really wanted to be able to understand the language, the philosophy. It's been incredibly rewarding. As I go into midwifery training and eventually practice, I feel like SBNH has given me a foundation from which to build. I have a mindset, a frame of reference, language, the values – and all of that is going to inform the way that I study midwifery right from the start.
You touched on this a bit already, but what does SBNH mean to you, especially as you begin your own healthcare education and midwifery program?
Anna: SBNH resonates deeply with me personally, as well as professionally. That's part of what has made this job so rewarding. I've spent a lot of my life witnessing and being a part of my parents navigating healthcare systems. My mom has a complex chronic illness. My dad had a degenerative neurological condition, and I was an active participant in his care. We went through rounds and rounds of support specialists, working within the hospital, with the CLSC, and then went through palliative care. I've seen firsthand the difference between care that checks off a box versus a practitioner who is committed to caring for the whole person, hearing the whole story, who is strengths-based, who says ‘What is present in this picture? Who do you have around you? What do you have within you? What do you want? How can we bolster that?’ There's such a difference between care that just tries to meet the physical symptoms and care that takes into account our mental health, our social health, our relationships, our community. So, from that personal place, SBNH really resonates.
From the professional angle, midwifery care is, I think, inherently Strengths-Based. It looks to offer person-centred care that honours the uniqueness of the birthing person. That’s SBNH language, but once I had that language in my mind, I can't think of it any other way. It is exactly right. I think that perinatal care is a really clear microcosm of some of the issues that our deficit based and paternalistic health care system manifests. Because you take a condition, pregnancy, that is a healthy condition. A pregnant person has the strengths, the capacity within their body to sustain the pregnancy and to give birth one way or another. But obstetrical care can, for the sake of efficiency, often pathologize pregnancy. There's not necessarily enough time to build the relationships, honour the needs of the individual. Midwifery is built specifically around the idea of informed consent with the client as the partner in care.
SBNH just kind of blew my mind when I started reading about it. I think that holistic and collaborative models of care are going to lead the way in healthcare reform. I see SBNH as one of the many solutions that we need for an overburdened healthcare system, as well as an opportunity to create a model of collaborative patient-centred care. There's so much to be done to fix our healthcare system for healthcare providers, as well as for those receiving care. SBNH provides a toolkit to address both parties and have them collaborate in creating a system that is humane and sustainable.
What does this project mean to you? What do you hope will come out of the work that you've put into it in the last two and a half years?
Anna: This project has come to mean a tremendous amount to me. It's really one of the most exciting professional experiences I've had. It’s been such an honour to know that my work has helped to advance something this important. I really don't believe that you can create a healthcare system that meets the needs of patients without a healthy workforce. You cannot provide a high level of person-centered care if you yourself are not cared for.
It will be a long road to fixing our healthcare system. It can be overwhelming to look at the systemic barriers, but I really believe that a lot can be done on the interpersonal level to create a shift in culture, a shift in values, a humanized environment for healthcare workers. The level of honesty and compassion that we've seen consistently in the SBNH-L Program faculty, mentors, and peer-to-peer discussions has given me so much hope. The leadership program is a really powerful grassroots tool to train up leaders and empower them to practice and to lead their teams in the way that they want to. We're not going to escape the mess that is our healthcare system right now, but you can have tools to work within it, to forge a path toward a better way. One leader, one team, one patient at a time. I have this stubborn hope for a radical change within our healthcare system, a hope that we're going to see a shift to one that is human-centred, compassionate, and prioritizes the health of the caregiver as well as the patient. I hope that the little part that I've played in supporting these two cohorts of leaders across Canada can be a part of that movement.
As you reflect on your time with us, what are your biggest takeaways?
Anna: I started this job a week before lockdown [due to Quebec’s first wave of the COVID-19 pandemic in March 2020] and it really threw me for a loop. But the power of a Strengths-Based team is incredible. I can't imagine how I would have done any other job throughout the pandemic, because the values of SBNH have been real on a day-to-day basis. You, Laurie Gottlieb, and all the co-investigators show up to work with that Strengths-Based lens and see each person.
I was already committed to showing up to my next job with my full humanity and my full life. But I felt so welcome to do that, and had it modelled for me in these people in very demanding high-power positions doing the same thing, saying, ‘This is what I'm struggling with today, but I'm still doing my job’ or ‘I need to take a minute’ or whatever it is. It was just an incredible experience to see how that really worked. If everyone showed up with their full humanity, they could expect to be met by the rest of the team and the gaps could be bridged for one another. The emotional support was there, and the work could still get done. In fact, the work could get done better, with a better quality and probably better efficiency than if we were all just trying to put our heads down and pretend that we could muscle through this. This has been an incredibly supportive environment, not just professionally but as a person. That's a big takeaway - the power of a Strengths-Based team to make people feel safe, validated, and able to meet the needs of everyday life even when things are hard.
What are the most memorable, powerful moments that stand out for you?
There are a couple moments that stand out. It was tremendously powerful to me during the lockdowns when our consulting filmmaker Kitra Cahana and her father were interviewed on the CanadaLand podcast. I was going to interview Kitra for her partner profile soon after that, so I listened to the podcast. Kitra’s father is an incredible person and Kitra is also just amazing. In our interview, she mentioned the concept of tikkun olam in Judaism – the idea that each of us in our life has a role to mend the world. I found that tremendously powerful as a guiding principle. And Kitra’s father was speaking from the perspective of someone locked into a room in a long-term care centre. He was still empowered to mend the world. Kitra, in her work, always highlights the voices of populations that are vulnerable or oppressed. By bringing light to these people and places and by amplifying their voices, Kitra’s art is working towards mending the world. In the same way, I think of the individual nurse, the individual leader who is bringing this compassionate lens and doing their part to mend the world.
Also, every single open discussion within the SBNH-L Program was memorable. I felt so privileged to be allowed to be in that learning space and to hear these people. Inevitably, as soon as someone opened that door of vulnerability, the conversation deepened instantly. There's so much love and determination for the work that they do and the people that they serve, so much resilience within the challenge of the past couple of years. Each of these leaders deserves to be to be cared for and supported and met with measures to lift them up, but they are still intent upon improving their care, improving their leadership, the care for their team, their hospital. It has just been an incredible space. Seeing their resilience and strength gives me hope for how this work can really make an impact. It's tremendously humbling and it's tremendously mobilizing. It motivates me to continue working in whatever capacity I can to move this forward.