The vision of Labrador-Grenfell Health is of healthy people living in healthy communities.

Janet Cox, O.N.L., R.N., S.C.M., Clinical Research Assistant

A registered nurse and certified midwife, Janet Elizabeth Cox first came from England in 1970 to work at the Charles S. Curtis Memorial Hospital in St. Anthony. She began her nursing career as a staff nurse and midwife on the obstetrical unit and later went on to attain diplomas in Outpost Nursing and Public Health Nursing from Dalhousie University in Nova Scotia. She later served in various capacities throughout the Labrador-Grenfell catchment area, as well as along the Lower North Shore of Quebec.

During these years, Janet lived in small, very isolated coastal communities where she provided the only frontline health care presence. Over the course of her service in these communities she came to realize the very great impact that specific types of cancer were having on certain families. Janet’s relationship with the families, her detective work and her careful research and documentation of their medical histories led her to conclude that there was a genetic cause to the high incidence and premature mortality from colon cancer – Hereditary Non-Polyposis Colon Cancer (HNPCC). Members of families with this genetic cause are at risk of developing not only colon cancer at a young age but also many other types of cancers. In consultation with Dr. William Fitzgerald, she set about introducing screening programs for those at highest risk. This resulted in the discovery and surgical removal of many cancers at an early, even pre-cancerous, stage. What started as a registry of cases documented on index cards filed in shoe boxes has evolved into a computer-based program. Janet’s leadership in moving such studies from the realm of clinical research to practical clinical care has had a profound impact on the lives of countless patients and their families. She was not only instrumental in establishing this life saving screening program but she takes an active role in the day-to-day administration of the program. She arranges client appointments, accommodations, diagnostic studies and even social entertainment for those travelling to St. Anthony. She goes above and beyond to get to know every patient and today, more than 700 individuals are involved in the screening program. Her patients and the communities she serves continue to receive high-quality clinical and genetic services. The model that she developed of providing comprehensive and fully integrated family-based services was the basis for the 2010 introduction of a similar program province-wide. Janet is a caring, compassionate professional and a team player with a winning personality.

She takes pride in her calling and is a strong advocate for the interests and well-being of each of her patients. “I am very humbled by receiving this recognition,” she says. “I am just doing my job and what I believe in – prevention and early detection.”

Constance Howley, O.N.L., R.N., N.P.

Constance Howley, who was born in Montreal and moved to St. John’s at age seven, graduated from St. Clare’s Mercy Hospital in 1975 as a Registered Nurse. From 1975 to 1988 she worked as a staff nurse on medical, gerontology, gynecology, oncology, forensic and intensive care units in British Columbia, England and St. John’s.

In 1988, Constance became a research nurse with Memorial University, assisting in research for HIV clinical trials through the Canadian Trials Network. This position started her on a career path that would impact the lives of hundreds of individuals affected by HIV/AIDS in this province and abroad. She became a nurse coordinator of the HIV program in 1988, a time when there was an extraordinary amount of stigma and fear associated with the disease. Despite the discrimination she herself often faced because of her profession, she held the hands of those mourning the loss of spouses, partners, parents, children and friends. Constance played a pivotal role in the beginnings of what is now a provincial organization that provides a host of services to those living with and affected by HIV/AIDS, as well as to the general public. As a healthcare professional and voice in the community, she helped develop prevention strategies that would ultimately assist in controlling the outbreak of HIV/AIDS in the province in the early nineties. She also advocated for enhanced access to healthcare for those living in rural communities, establishing travelling clinics in areas such as Conception Bay North and Corner Brook. For this, she received the Health Care Corporation of St. John’s Purple Award for Innovation. Her other accomplishments include several honours including the Canadian Association of Nurses in HIV/AIDS Care Jill Sullivan Award for Excellence in Clinical Practice in 2003; invitations to guest lecture at over 100 HIV/AIDS presentations, as well as being a facilitator and consultant for various programs provincially, nationally and internationally. She has also co-authored multiple scientific papers, presentations and abstracts on HIV/AIDS and immunology. While continuing her HIV work, Constance also pursued full-time studies to become a Nurse Practitioner, all while remaining a dedicated single mother to her four children.

In 2007, she took a 14-month leave of absence from the provincial HIV program to work as a nurse clinician in southern Africa with OHAfrica in Leribe, Lesotho, where she provided care and treatment to people living with HIV/AIDS and consultation and education to local healthcare workers. In 2009, Constance resigned from her position within the HIV/AIDS program and joined Labrador-Grenfell Health as a Nurse Practitioner – Primary Health Care in coastal Labrador communities. She is currently working in Cartwright and continues to guest lecture on HIV/AIDS issues. There is no doubt that Constance’s achievements in the areas of nursing and research are vast, but it is the direct impact she has had on the lives of people in this province that is immeasurable. Her compassion, leadership and professional achievements have had a profound effect on countless lives. “This recognition is quite unbelievable and a huge reward,” notes Constance. She explains that it is all the more meaningful, noting that her patients were among those who nominated her. “Receiving this honor is a tribute to my parents’ influence and my HIV team’s support, which are pivotal in my ability to provide the care that I do.”

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