Inside a healthcare meltdown in a northern community

New documents tell a more complete story of how a nurse was suspended and ultimately left a Northwest Territories community after an MLA led a campaign against her.

Jennifer Patterson, nurse-in-charge at Fort Resolution’s health centre, was suspended with pay in late 2022 over allegations of racism. Tu Nedhé-Wiilideh MLA Richard Edjericon had led calls for her to lose her job.

An investigation into Patterson’s conduct by outside lawyers spent 81 days interviewing 27 witnesses, many of whom were selected by Edjericon – an intervention that disturbed Patterson’s union.

The 1,052-page investigation report found none of the nine allegations against Patterson could be substantiated. Her colleagues said the allegations amounted to a “witch hunt” against a dedicated and professional nurse. The community’s chief supported her.

Patterson never returned to Fort Resolution. The investigating lawyers said at least one person they interviewed had threatened to assault her if she did. According to those lawyers’ notes, the nurse said she was “not safe professionally or personally in the community” and her “reputation as a professional is defamed in the community and territory.”

Healthcare workers, union representatives and labour experts have condemned the NWT health authority’s handling of the issue. The Union of Northern Workers filed a grievance.

A labour arbitrator said the health authority believed its investigation was a “reasonable response to legitimate and serious community concerns.”

The arbitrator disagreed. She called the health authority’s treatment of Patterson an “abuse of power” when basic due diligence, she said, would have raised serious questions about the allegations against the nurse.

The campaign against Patterson began shortly after she had “undertaken some performance management of an Indigenous staff member closely connected” to Edjericon, the arbitrator stated, citing evidence presented to her.

Asked about the arbitrator’s conclusions, Edjericon said he would not comment on an independent judicial process out of respect for the parties involved.

Edjericon was fined $2,500 and reprimanded after the territorial integrity commissioner ruled in 2024 that he had acted inappropriately in leading a campaign to have Patterson fired.

(Another NWT MLA was the subject of a separate integrity report last week after trying to have a principal sacked, though this time the politician was exonerated.)

“The Legislative Assembly has dealt with the findings of the integrity commissioner and that process speaks for itself, including my acceptance of the findings and public apology,” Edjericon stated by email last week.

Healthcare workers told Cabin Radio the Fort Resolution episode left them believing their employer would offer no support even if they suffered months of abuse at work.

“It’s a huge part of why I didn’t want to work there any more,” said Brody McGee, a nurse who worked alongside Patterson and watched events unfold.

“Who’s next? Do I piss off the wrong person and then it’s a series of letters and I’m gone?”

Patterson told Cabin Radio she could not comment as, though she has left the territory, she technically remains a GNWT employee “bound by their media communication rules.” Her remarks in our reporting are drawn from interviews she gave to investigators, internal emails, and her testimony to the labour arbitrator.

In a four-part series, of which this is part one, Cabin Radio will examine what happened at Fort Resolution’s health centre by relying on the contents of internal emails, public reports and interviews with residents and healthcare workers.

We’ll also set out what we heard from Edjericon, the NWT’s health authority, the investigators, the union, the territory’s current and former health ministers and the chief of the Deninu Kųę́ First Nation as we looked into the case.

The state of things as 2022 began

Jennifer Patterson started working in Fort Resolution in 2018. As the nurse-in-charge at the community’s health centre, she worked six weeks on and six weeks off, alternating with one other worker.

The health centre is small. Patterson was supposed to manage two nurses alongside some support staff but in practice, with staff hard to find, there was often just one other nurse. Meanwhile, a revolving door of five regional managers in four years supervised Patterson and her team.

The case that was ultimately formed against her hinged on allegations related to racism, which is a significant issue in northern healthcare.

Indigenous patients across the territory have complained about misdiagnosis, discrimination and neglect. The territory is still actively working to fix this, issuing a 13-step plan this summer toward improving healthcare for Indigenous residents.

In Fort Resolution, relations between some residents and the health centre had been fraught for years. Officials concluded the primary reason was a GNWT policy around how patients get to the centre for treatment.

Residents sometimes wanted nurses to come to them, or at least bring them to the health centre. Territorial policy forbids that. If you’re a health centre nurse, you work there – you’re not a paramedic. Some health staff do go to houses to offer pre-arranged home care, but nurses are told not to leave the health centre to respond to emergencies.

The community government or local Indigenous government is expected to provide an ambulance service, if it can afford one. Otherwise, RCMP sometimes find themselves stepping in as a last resort.

This is a source of confusion and frustration in multiple NWT communities. The issue of how patients get to health centres was central to a 2024 coroner’s inquest in Tuktoyaktuk.

Fort Resolution, like Tuktoyaktuk, has no ambulance service.

Some nurses bend the rules, one healthcare worker told Cabin Radio, requesting anonymity to discuss sensitive details of their employment. Patterson, however, was considered by colleagues to be a model of professionalism. “Her decisions were always 100-percent policy supported. Always,” the healthcare worker said.

Patterson told the labour arbitrator this mix of policy and approach generated a lot of verbal abuse and aggressive behaviour from patients. Meanwhile, the health centre also got the blame if patients didn’t get the medical travel support they hoped for – which is outside the control of health centre nurses – or if residents were prevented from seeing someone’s private health records on request, which nurses ordinarily can’t allow.

“I think in the past, staff might have acquiesced more easily to unreasonable requests because of fear or pressure. Jen just didn’t do that,” a former colleague said, similarly asking for anonymity.

“For example, nurses in the past would often go into homes to bring people in, and there’s a solid policy against that. And Jen wouldn’t. So people suddenly felt like she was not caring for them the way the other nurses did, when in fact she simply was upholding policy that wasn’t hers to decide.”

Meanwhile, signs at the health centre warning patients of a zero-tolerance policy regarding the abuse of staff had been taken down and not replaced. The health authority said the signs had been removed as some residents found them triggering.

In their place, Patterson put up a simple sign of her own. “You respect us and we will respect you.”

Filling out an RL6

The NWT’s health authority has forms for when something goes wrong. Each form, known as an RL6, gives management a chance to review what happened and take action.

In Fort Resolution, staff say they were filling out an RL6 multiple times a week to document abuse.

For example, one RL6 from the health centre in 2022 describes a person reported to have called and said: “You refused to see my girlfriend when I called you last night and now she is dead. I’m going to have you charged.” The RL6 states the person had not actually called the night before.

Another RL6 documents Patterson calling back someone who left a voicemail in which she said they told her: “You are so fucking lazy, you can’t bother to call people back.”

The patient kept swearing during the ensuing call, the form states. Patterson says she told him his language wasn’t acceptable.

“You give everyone else tests in two days but we have to wait five days for you to respond. You fucking pick and choose who you are going to take care of,” she documents the patient saying in response. “We all know you’re a fucking cow and we need to make sure you are fucking gone from your job.”

A response from management to this RL6 stated: “Staff involved are fine after speaking with me about the incident. No further action needed at this time regarding this patient.”

Harassment through the night

People who worked at Fort Resolution’s health centre do not believe the NWT’s health authority prioritized their wellbeing.

The health authority’s chief operating officer at the time, Lori-Anne Danielson, testified to the labour arbitrator about what she did to help staff who felt they were being repeatedly abused by some residents in Fort Resolution.

Asked why nurses were not empowered to turn people away who were abusive to staff, Danielson said the health centre was the “one place where people can get health services in the community.” She said staff are trained to end a call if a person is abusive by telling them to call back once they have calmed down.

Patterson told the arbitrator she could not recall a week going by without filling out an RL6, but said Danielson only visited Fort Resolution a “couple of times” and only twice offered to speak with a patient who had been abusive. (Danielson said she “frequently” asked if regional managers had followed up. The NWT’s health authority, asked for comment on the arbitrator’s findings, said it was learning “important lessons.”)

Staff in Fort Resolution assumed they were on their own.

Every healthcare worker with whom Cabin Radio spoke said a routine, horrible experience would be harassment by phone in the middle of the night.

The on-call nurse would take the phone home so they could respond to out-of-hours emergencies. Instead, staff described often receiving abusive call after abusive call.

On-call nurses are obliged to answer every call they receive.

“Oh yes. Two o’clock. 2:15. 2:30. 2:45,” said one worker, asked about this.

“I have to answer that phone. When I hear it’s the same patient, I have to assume they’re calling with a good reason. I need to know why they’re calling. Are you simply calling to wake me up? Do you have an actual reason to call?

“Over the years in healthcare, you get really good at biting your tongue and not saying the nasty thought you would want to, but it is certainly frustrating. It interrupts your sleep and makes it hard to focus the next day when you’re actually caring for patients.”

If nurses follow the health authority’s policy, a series of calls during the night also cuts down on the hours nurses are available to work the next day. Technically, nurses must allow themselves a minimum period of rest. If they are kept up at night by calls, two healthcare workers said, they are expected to compensate by shortening clinic hours the following day.

“There is a longstanding history of mistrust with the health centre. Whether it’s warranted or not, that’s the reality of what it was,” said McGee, who for a time was the other nurse-in-charge in Fort Resolution, rotating into the role whenever Patterson left for her six weeks off shift.

“Being on call could be very, very taxing,” he said.

“You’d never know what kind of calls you were going to get. There’d be people calling and harassing the nurses. And for a long time there wasn’t any… it didn’t seem like anybody really cared.”

‘The MLA can write up a complaint’

In April 2022, Richard Edjericon – a former Yellowknives Dene First Nation chief who now represents Fort Resolution and three other communities in the NWT legislature – began to voice concerns to territorial government workers about how patients were supposed to get to the health centre.

Without any ambulances, he was told transportation was up to the First Nation or the RCMP.

“The MLA can write up a complaint,” a regional manager at the health authority wrote to a senior manager in an internal email at the time.

“It shows the need for transportation. Enough complaints will hopefully push the community to come together and provide a ground transport service.”

What actually ended up happening was very different.

The second article in this series will examine a key newspaper article that triggered an open letter to Fort Resolution, how healthcare leaders responded to that article internally, and how events escalated into a major investigation.

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