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Innovating Healthcare Strategies Driven by Nursing: A Call to Action

As the healthcare landscape evolves, the role of nursing must adapt to meet the challenges posed by an increasingly complex system. Innovative strategies that prioritize the nursing workforce are essential for delivering high-quality patient care. Central to this discourse is the establishment of safe patient ratios, which hinge on a healthy nursing workforce capable of providing the expertise necessary for optimal patient outcomes. However, efforts to bolster a dwindling nursing workforce often overlook a crucial element: retention is about more than salaries and the mere production of new graduate nurses. Historical Context: Lessons from Early Hospital Systems The early days of the hospital system provide valuable insights into effective nursing strategies. Initially, hospitals were staffed by student nurses who received education tailored to the needs of the institutions where they worked. This model fostered a deep commitment to patient care and a strong sense of belonging within t
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Addressing the Critical Nursing Shortage in Canada: The Need for PhD-Prepared Nurses to Lead Transformative Change

We are facing a critical nursing shortage in Canada following in the post-COVID-19 pandemic crisis (Tomblin Murphy et al., 2022) . Nursing shortages are not new (Cohen, 1989; Park, 1983; ‘The Nursing Shortage’, 1963) , but the impact of COVID-19 alongside global crises like climate change and war have spotlighted the significance of the problem at this historical moment (Peters, 2023) . I recently completed by PhD in Nursing at the University of Alberta. The journey was a long five years in which I had to navigate a pandemic, raising 4 kids, working full-time a nurse leadership and in direct hospital-based care in one of the largest urban centres in Canada, and significant family crises. I love the diverse opportunities that my nursing career has brought me. I feel a strong connection my professional identity as a nurse and appreciate the monumental impact that the discipline and profession have had on shaping the healthcare system and shaping the health of people in Canada. However, i
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The Heart of Nursing: Compassionate Care in a Complex World

 In the demanding world of healthcare, where the head and the heart must often find a delicate balance, nurses play a vital role in shaping patient experiences. The journey of self-discovery within nursing isn't just about acquiring technical skills; it's about understanding the profound "why" behind our work. This article explores the importance of compassion in nursing, how it shapes our practice, and why it is essential for both patients and practitioners. Defining Compassion Compassion is more than a buzzword; it is a critical component of nursing that encompasses empathy, understanding, and a genuine desire to alleviate suffering. Compassionate care is defined as the ability to recognize and respond to a person's emotional and physical needs. This involves being present, listening actively, and providing not just physical care, but also emotional support. For nurses, a focus on compassion allows us to forge closer connections with our patients. When we take t
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Getting Past "Just Say No": Reflections on Adolescents and Substance Use

 As the death toll in North America from the opiate overdose crisis continues to rise nurses must re-think the approaches that are being used in the healthcare services that are supposed to be designed to best help youth. There are now decades of evidence that support the ineffectiveness of the 1980s ‘Just Say No’ drug strategies targeted to prevent youth from using drugs. In reflection on my nursing career, mostly in programs and services designed to provide care for people who use substances, I feel heartbroken about the slowness of change in inpatient settings.  As I near the five-year anniversary of my joining what was heralded as an innovative mental health and substance use program for youth, I also critically question the erosion of that innovation to conform to a rigid system with rigid values about youth who use substances and how to best provide care for them. Three years ago, I walked into the care team station, early for my night shift. I began my night shift ro
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My First Code Blue - When the Nurse Becomes the Patient

The first code blue that I took part in happened to my six-month-old child. The experience forever changed the way that I look at person-and-family-centered care. Nothing could prepare me for the moment that I heard the code blue being paged on the overhead speaker and made the connection that it was for my child, but my and my partner’s experience as nurses is what kept us together in those surreal moments when the outcome was uncertain.  I worked in a hospital every day. All kinds of codes were called on the overhead page throughout any given shift. As nurses, we are trained to work swiftly, thoughtfully, and calmly during a code to keep both the team and the patient working like a well-oiled machine to save the patient. I never imagined the feeling of helplessness I would feel, being in a hospital room with my baby gasping for breath. When my third child was six months old he had a respiratory virus. We thought we were over-reacting by taking him to the hospital, but, both my partne
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The Changing Tide - Nursing Shortages and Promoting Nurse-Led Innovation in Healthcare

I attended a union meeting the other day. It was filled with talk of problems that nurses in British Columbia (and across the country) have been facing for many years. The problems that were discussed in the meeting were the same as those discussed when I attended my first union meeting more than a decade ago. Issues like the shortage of nursing are new to nurses who are entering the profession today. But these issues are not new to the profession of nursing. In a 1967 issue of Macleans magazine Alan Edmonds wrote about the shortages in nursing . Again, in 1980 Ian Pearson wrote an article about the shortage of nurses in Canada . In 1997 Sharon Doyle Driedger wrote about the issue of nurses burning out by the increasing stressors of the Canadian healthcare system . And again in 2008 Kate Lanau wrote about nursing shortages leading to patient safety issues like medication errors . The shortage of nurses in Canada has been an ongoing issue since World War II. In the early part of the 20
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Electronic Health Records (EHR) Is the Future of Nursing

Electronic Health Records (EHR) are more than a repository of information. Health informatics requires nurses to break through the cognitive constraint of thinking about an EHR like a scanned paper document or a series of static saved Word documents akin to a static, unchanging paper chart. It’s not like pages in a book. This year I turn 40. I do not even remember life without computers. My dad bought my family’s first computer when I was 6 years old. It was a Commodore . When I started Junior High in the early 1990s I was surfing the net using AOL to find research for my school projects. When I started university in the late 1990s registration already moved to an online system. Professors were rapidly embracing the use of PowerPoint to create their lecture presentations. When I started nursing school in 2006 Calgary Health Region had just gone live with its first EHR system . I don’t remember a time without computers. I barely remember a time without the Internet. And (I’ll write it
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Power Imbalances in Mental Health Care

  In the attempt to make psychiatry a legitimate medical specialty diagnostic criteria were developed. In Canada, psychiatrists use DSM-5 diagnoses not just to organize, but also to justify treatment. In an era where we know about the importance of patients being active partners in their care, we must seek the input of our patients on their agreement or disagreement with diagnostic criteria. In practice, especially in the inpatient system where most people who are admitted are involuntary patients, the healthcare system maintains a culture of clinicians having power over patients. The imbalance of power sustains a system where clinicians, most prominently psychiatrists, are the ultimate decision-maker and nurses become stuck in a murky place of advocating for patients, exercising their own autonomy of holistic and person-centered care, while also acting on psychiatrists orders. The process continues to be a top-down approach despite attempts to embrace and implement collaborative care
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