Bevel Up: A groundbreaking professional learning resource for healthcare workers on the frontlines of the drug crisis.
WATCH THE FULL FILM FOR FREE NOW!
Bevel Up, is an award-winning documentary and learning resource to help healthcare workers deliver compassionate care to people who use drugs. Now, it is available for the first time as free online harm reduction content at NFB.ca
Created in 2007 by the outreach nursing team from the BC Centre for Disease Control (BCCDC) and co-produced with the National Film Board of Canada (NFB), Bevel Up is designed to give students and instructors in the healthcare field access to the knowledge and experience of pioneering practitioners. Watch and learn as street nurses in Vancouver’s Downtown Eastside deliver nonjudgmental, compassionate and trauma-informed health care to people who use drugs.
Still relevant today in light of Canada’s current overdose crisis, Bevel Up has been designed in a multifaceted format ideally suited to the web and social media using 10 educational playlists that include:
- The original 45-minute documentary
- 40 additional clips illustrating key issues and interviews with the experts — people who use drugs and healthcare practitioners
- A 100-page Teacher’s Guide
- A total of 4.5 hours of content
Bevel Up is a professional learning resource that follows street nurses as they deliver non-judgmental, compassionate and trauma-informed healthcare to people who use drugs and work in the sex trade on the streets of Vancouver’s Downtown Eastside.
People who have limited or no access to the Internet due to their geographical situation/location should contact the NFB’s Customer Service Line at 1-800-267-7710.
For the first time, Bevel Up, a documentary and teaching resource designed to help healthcare workers deliver compassionate care to people who use drugs, is accessible as free online harm-reduction content. Created by the outreach nursing team from the BC Centre for Disease Control (BCCDC) and co-produced with the National Film Board of Canada (NFB), Bevel Up combines art and science to inspire social change.
People who use drugs often experience stigma in the healthcare system, which creates barriers that prevent them from accessing care. Since the film was made in 2007, we’ve come to better understand that language matters when it comes to stigma. To deliver effective care, healthcare professionals should use non-stigmatizing and people-first language, such as “person who uses drugs” instead of drug “user” (a term that appears in the original project title, Bevel Up: Drugs, Users & Outreach Nursing).
What makes Bevel Up as relevant today as it was in 2007, when it was produced and launched?
The issue of stigma and discrimination against people who use drugs still exists among healthcare professionals, and people who use drugs still don’t feel comfortable accessing care.
Education begins in the classroom, for the next generation prior to them getting a job. Bevel Up provides a unique window into how to connect with people where they are at. You truly begin to understand the complexities that they face. We have dialogues within the classroom.
There will always be a new drug on the block. In 2007, the drugs of choice were crack cocaine and heroin. Now it’s Fentanyl. The street nurses’ non-judgmental healthcare in 2007 applies even more so in these times, when we are experiencing an overdose crisis.
The harm-reduction foundation of Bevel Up keeps it current—it was never about “chasing” a specific drug, but instead its intent is to show what non-judgmental healthcare looks like in practice. Stigmatization of people who use drugs remains a key barrier to providing healthcare to this community. How to address stigma in your healthcare practice remains central to Bevel Up, and now as we face the current overdose crisis, those lessons are even more relevant.
Bevel Up was ahead of its time in form as well as content. Its use of very short clips both on the streets and in interviews is now ideally suited for distribution through today’s newest technology in social media. These web-perfect stories explore the politics, health practice and ethics of harm reduction in 3-to-7-minute-long visual bites that are easily viewed in the classroom, on smartphones and anywhere social media can distribute them.
Who was Bevel Up made for?
Bevel Up was designed to give healthcare professionals, students and instructors the tools and knowledge to develop non-judgmental relationships. This is a fundamental first step in delivering successful healthcare.
How is Bevel Up online any different from the DVD?
The content is exactly the same, but the new digital format is easy to use and free, making it accessible to a much larger audience.
Why is Fentanyl not included in Bevel Up? Why are safe consumption sites not included?
Caroline Brunt and Nettie Wild:
For this relaunch, our focus is to have the original content digitized as a free online version. Other than recontextualizing, we did not change the content. Eleven years ago, Fentanyl was not the drug of choice. There was only one supervised drug injection site in Canada—Insite, on Vancouver’s Downtown Eastside. It was an era when a conversation that included harm reduction relating to people who used drugs was a difficult conversation to have.
Building on the legacy of Bevel Up, we are exploring the possibility of creating an interactive educational web and social-media experience in collaboration with UVIC, BCNU, VCC, FNHA and NFB. One of the first steps is to update the content in the context of the opioid crisis. Furthermore, it is expected to feature a section that can be easily updated and be responsive to any new developments in healthcare or on the streets. An example of new material will include health equity, cultural safety, peers, trauma-informed care, understanding the history re: drugs, managed alcohol, and latest treatment modalities.
How did Bevel Up originally come about and how what was it received?
Nurses were coming to the Street Nurse Program of the BCCDC from all over British Columbia, asking how the team communicated and connected with people who use drugs.
The Street Nurse Program did a needs assessment across the country, asking if harm reduction was taught in nursing schools in colleges and universities. The response? Very minimally and sometimes not at all.
Twelve years ago, having a conversation about harm reduction was difficult, and so was having a conversation about delivering care to people who used drugs—it was expected that people came to healthcare, not that healthcare should be taken to people.
Bevel Up was designed as an educational tool aimed at nursing students in colleges and universities, and professionals working in healthcare.
In 2002, I directed the feature film FIX: The Story of an Addicted City. FIX followed the birth of a social movement in Vancouver to open North America’s first supervised injection site. At that time, I wanted to film the extraordinary Street Nurse team working with the BCCDC, but could not. Their work taking health to the streets was so leading-edge, it was considered controversial. Five years later, their work was recognized as in fact leading the way to bring realistic and compassionate healthcare to people who use drugs.
When the street nurses approached me to direct Bevel Up, I realized I was being asked to film what non-judgmental healthcare looked like. This is what led to filming a series of vérité documentary scenes that would be the heart of the project. And then we augmented each one of those very real chapters with interviews in the menus that helped us realize the challenges that rippled through every story.
What is harm reduction?
There is no universally accepted definition, but harm reduction refers to policies, programs and practices, and is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. It is also a movement for social justice built on a belief in and respect for the rights of people who use drugs. Harm reduction is grounded in justice and human rights—it works on creating positive change by working with people without judgment, coercion, discrimination, or requiring that they stop using drugs as a precondition of support.
Does the BCCDC Street Nurse Program still exist? Are there other street nurse programs in Canada? Are street nurses the only people who can deliver relational healthcare to people who use drugs?
The Street Nurse Program has been renamed and no longer exists as it used to at the BCCDC. Health authorities have taken on the concept of Outreach and adapted it to their needs. Depending on the health authority, there are different combinations of peers, outreach workers, nurses and social workers that can deliver care to people who use drugs, reaching the person where they are at and helping them to access care.
In the context of the opioid crisis in Canada, how can science and art play a critical part in inducing social change?
11 people per day are dying [according to a recent Health Canada campaign] and science, art, corporations, non-profits, peers, the person next door all have an ethical, moral duty to be part of a solution and a support system for people who use drugs. Due to the Fentanyl crisis, we all have to reflect, dig deep, acknowledge and work together. If we are to provide care, it’s got to be wherever people are.
I believe that the more controversial our world becomes, the bigger the role that art has to play. Why? Because art, in this case cinematic art, is able to deal with the complexities of a gruelling overdose crisis. The nurses bring their extraordinary experience to the screen, allowing our camera to create a cinematic experience that can transport and move our audiences to new places and realizations that they have not explored before. The nurses provide the compassionate care and methodology, the filmmakers bring the storytelling. Together, I believe we can show what non-judgmental healthcare really looks like, and cut through the rhetoric of these controversial times and make a difference.
Who had the idea to relaunch Bevel Up?
Nettie and I believed it was still relevant and needed.
The relaunch of Bevel Up was driven by a very real need in the community. As the overdose crisis ramped up, nurses, teachers, healthcare workers and peers across the country were asking for Bevel Up and the lessons it teaches. But the DVD format and the high price tag were getting in the way. Caroline and I approached the NFB to respond to this need in the middle of a healthcare crisis. The NFB stepped up to the plate and mobilized an extensive crew of producers and technicians to rapidly digitize all 4.5 hours of Bevel Up, making it available for all to use on the web—and for free.
Bevel Up is a co-production between the British Columbia Centre for Disease Control (BCCDC) and the National Film Board of Canada (NFB), with financial support from Health Canada and the BC Nurses’ Union (BCNU), and was created in collaboration with Canada Wild Productions Ltd. The relaunch of Bevel Up is made possible with the original partners and by the additional support of the British Columbia Women’s Hospital & Health Centre, and the participation of the University of Victoria’s Canadian Institute for Substance Use Research (CISUR) and Vancouver Community College (VCC).
Dr. Jane Buxton, Harm-Reduction Lead, BCCDC:
“Bevel Up has the potential to change the experience of people who use drugs when they interact with the healthcare system. The resource offers ways for healthcare providers to deliver client-centred care and address stigma to reduce the barriers that prevent people from seeking help. These lessons are critical as every community in Canada grapples with the overdose crisis.”
Eric Cattoni, Medical Co-lead of FIR Square at BC Women’s Hospital + Health Centre:
“Stigma around mental health and substance use is a major barrier to proper health care. Establishing meaningful therapeutic rapport with our patients is only possible if judgement is left out. People who misuse substances have a medical illness that requires compassionate care and access to specialized treatment.”
BCCDC Info about reducing stigma from Toward the Heart + Poster
Claude Joli-Coeur, Government Film Commissioner and Chairperson of the National Film Board of Canada
“The relaunch of Bevel Up represents an opportunity to raise awareness about an acute public health issue that concerns all Canadians. As a public organization, it’s part of our mandate to take part in national conversations that can help foster dialogue and lead to positive change, through media and with innovative learning resources.”
“The BC Nurses’ Union (BCNU) was an original partner of the Bevel Up videos and tools that initially launched in 2007. Sadly, the current overdose crisis has created an extraordinary public health challenge that has made the need for these tools as prevalent as ever. Today, we are pleased to see the resources become available in a free online digital format, which will be accessible to healthcare providers in both official languages.”
Bernie Pauly (RN), Scientist, University of Victoria’s Canadian Institute for Substance Use Research:
“The issues of stigma and distrust as barriers to healthcare are as relevant today as they were when Bevel Up was first released. The role that registered nurses play in building trust and facilitating access to health and social systems is critical to addressing substance-use harms and death.” –
Stigma in Primary Care Project, which aims to reduce the stigma faced by people who use drugs when they visit a doctor.
Bulletin: Creating Culturally Safe Care in Hospital Settings for People who use(d) Illicit Drugs
The Canadian Institute for Substance Use Research (CISUR), located at the University of Victoria, is a network of individuals and groups dedicated to the study of substance use and addiction in support of community-wide efforts to promote health and reduce harm. Our research is used to inform a broad range of projects, reports, publications and initiatives aimed at providing people with access to happier, healthier lives, whether using substances or not.
Vancouver Community College (VCC) has been inspiring students to reach their career and educational goals for over 50 years, offering post-secondary training in over 120 programs, including bachelor’s degrees, diplomas, certificates, and apprenticeships. With three campuses located on Broadway, Downtown, and on Annacis Island, students can choose from hands-on instruction in culinary arts, business, design, health sciences, hospitality, transportation trades, and music.