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Barbara Anderson
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Mary Kjorven is a Clinical Nurse Specialist (CNS) in Geriatrics and a Nurse Continence Advisor (NCA) in the Interior Health Region of British Columbia.  She has a small continence clinic in the Central Okanagan Seniors’ Health and Wellness Centre in Kelowna, B.C.   Mary obtained her NCA certification in 2012 when she recognized the great need for services specific to bowel and bladder health for the older adult population.  She incorporated the NCA role into her already existing CNS role and has been advocating for a more robust inter-professional continence clinic for her region, one that serves all populations.

Mary’s current clinic is a component of an out-patient inter-professional specialized assessment clinic for older adults.  Other members of the team include a Physiotherapist, Social Worker, RN with a specialty in geriatrics, Dietician, Occupational therapist, Respiratory Therapist, Speech and Language Pathologist, Primary Care Physician and Geriatrician.  Because Mary’s clinic is relatively small the wait list is high.  As a result she is not able to provide the full spectrum of NCA services.  Mainly she provides a comprehensive continence assessment, offers behavior modification interventions and consults to other professional services.  These services include both public services within the Seniors’ Health and Wellness Centre and community private partners such as Physiotherapists with postgraduate certification in pelvic floor function.

Mary has been fortunate and continues to be grateful to have excellent CNCA mentors from other regions and provinces who continue to provide guidance for her practice.  Without this collegial support it would not have been possible to build and maintain her clinic.  Everything from sharing business plans of existing clinics, clinical decision support tools and the evidence behind them, education and learning modules have proven invaluable.

In her words: “Even though I was the only NCA in the region I didn’t feel like I was alone.  I had enough knowledge and support to get started.  We need to focus more on possibilities and opportunities, in other words, look for ways we can instead of can’t.  If we have the evidence to support our practice we are better prepared when those opportunities present themselves.  For example, organizations have come to appreciate that incontinence is a major risk factor for residential care placement.  Often NCAs can make a difference and that provides possibilities for improving outcomes for everyone”.


Mary Kjorven