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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

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

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

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

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

The Marathon Continues - An Update On My PhD Journey

 More than one year later this is what I have accomplished: Completed all my coursework Successfully passed my Comprehensive Exam (this happened in February 2021) Successfully passed my Candidacy Exam (this happened in August 2021) Received ethics approval from the University Ethics Board that I can conduct the oral interviews necessary for my study  What do these three things mean? It means I have made some progress forward in the last 14 months. It also means that I need to muster the energy and mental fortitude to charge on and do my study.  In personal reflection, I know that before I made it through these necessary steps of my PhD process I was filled with the same fear and self-doubt about being able to accomplish this goal. Logically I know I should be proud of myself for making it this far while also working fulltime and raising four children. But, I cannot seem to give myself that much-needed pat on the back. At this point, I'm seeing the glass as half-empty. Oh the feelin

Nurses are More Than Heroes: Saving Nurses in a Collective Health Crisis

The past 18 months has forced Canadians to navigate a health crisis unlike any most have seen in their lifetime. COVID-19 has challenged people around the world to change the way they live their lives to curb the spread of a deadly virus. Canadians were challenged to work together, and they did. In the fight against COVID-19 many gaps in the healthcare and social welfare system we illuminated. The more than  50 000 nurses  in BC are front and  centre  in this fight.  Erosion of nurse jobs is not a new phenomenon . For decades  public trust and value of nurses has been high , while funding cuts risk safe workplaces, adequate training, and support for competent practice within  nurses'  full scope.    A year ago, amidst lockdowns, and bombardment of new information about illness and death rates, the public was unsure and afraid of what the future would hold.  The collective health of the nation was in flux, and a collective voice stood together banging pots and making noise when heal