I Dare You to Drink the Vinegar

It is surprisingly difficult to find any information that does not support the efficacy and benefits of harm reduction. I am a supporter of harm reduction (in the sense that I tend to let scientific evidence inform my nursing practice). I am a Registered Nurse, meaning scientifically collected evidence guides my practice. My philosophical viewpoint is strong. And so, it seems odd that there is a reluctance to accept the evidence of harm reduction as something to guide policy change. Similarly, if harm reduction is not something to be embrace, it also seems odd that this is not so much based on research being conducted that shows that there may be problems with it and identifies better alternatives to current policy or how more of the same can somehow lead to improvement in the lives of people who use substances.  So here we go, letting something that those in positions of power and privilege feel in their hearts determine public policy. Not surprisingly, most of the information tha...

Abstract      The purpose of this paper is to challenge the dominant social order in mental health that upholds the use of seclusion rooms as a means of therapeutic intervention using a critical discourse analysis method. This researcher asks the question, why do seclusion rooms continue to be common practice on acute inpatient psychiatric units when they are not evidenced based practice? A critical discourse analysis is conducted using 13 research studies found on the Google Scholar and CINAHL databases using the search terms: seclusion, seclusion room, psychiatry, inpatient and mental health. Each article is analyzed to determine the paradigm that was used to guide the research. The text of each article was analyzed to uncover the power dynamics present in the seclusion literature and how these interact with cultural variables. The results show that there are distinct power dynamics evident in the literature that present the mental health client in a position of s...

This is it, the tricky first 12 weeks of a pregnancy where I have to try and not tell anyone that I am pregnant even though I want to tell everyone. Kel and I are waiting even longer because we don't want to tell Kel's family until after his cousin's wedding on Labour Day weekend. We'll see how effective that plan is as I will be 18 weeks pregnant by then thus the little fetus will likely be a noticable baby bump by that point. This is also the part of the pregnancy where I am constantly worried that I will have a spontaneously abortion before I make it through the first trimester. Right now I feel physically pretty good, exhausted but still have enough energy to go to the gym on my days off. I am having an overload of stuff going on right now between work, my three courses, Deia and now this new little fetus. Right now I am writing a paper on a discourse analysis of academic literature on seclusion room use. This is quite an interesting paper that is really informing...

This is a journey. As I progress through my Masters degree in nursing I find that I am continually challenged to organize all of those thoughts that I use in my daily practice into a framework that subsequently forces me to become more deliberate in my practice. Currently I am enrolled in my first of three courses on teaching. The first assignment I have completed is about my personal teaching philosophy. As I found it to be a useful tool in my reflective teaching practice I will share it here in the hope that it can help other nursing educators in the making begin to think about their own personal teaching philosophy and how it is applied to their teaching practice. Love, Michelle D. 

I have made a recent job change from community addictions to mental health rehabilitation. I find that challenge of working in a newly established program quite invigorating. Further, I find that the challenge of trying to forge a place within a multidisciplinary health care team has really enabled me to reflect on what I define as nursing and nursing scope of practice in mental health. I must admit that I have taken it quite personally when coworkers have shared that they view the nurses role as "pill pushers". This make me wonder, is there something that, as nurses, we are failing to do as perceptions, even within the health care system continue to view our role as very narrow and disposable. Little knots begin to twist and turn in my stomach as I hear coworkers say that they performed the role that they now observe is being filled by nursing staff. This again makes me wonder, how are we, as nurses, failing to forge our own role as distinct and necessarily filled by Registe...

The process of pursuing registered nursing in Canada is an interesting one. Nursing has clearly come a long way from the early days of apprenticeship schools (McPherson, 2003). Today Kelly went to UBC for his nursing school interview. I am sitting in the living room watching Desparate Housewives, Season 1 on DVD, and watching Deia in her playpen. She is hitting and clawing on the mesh side wanting to escape. She just picked up her pacifier and popped it in her mouth upside down. She is the most amazing thing that has ever happened to me. I love her more than anything. As I watch this amazing child that my husband and I produced I begin to think, work is quickly becoming a means to an end rather than the focus of my being as it once seemed 3 years ago when I embarked on my journey into my nursing career. I cannot help but think, is this thought the same one going through the minds of thousands of nurses across Canada, a united front of women who embarked on their journey in their early ...

In health care we can always use more funding. Looking at my own experience, I have found that sometimes funding is mismanaged, spent on programs that are destined to fail or diverted from successful programs towards something new that is perceived to offer the best solution to certain crises of the moment. To front line staff it often seems startlingly obvious certain solutions that are proposed will be an spectacular failure even before the policy and procedure is written, yet to those in decision making positions continue to forge forward. Is the problem that no one from the front line was consulted or that the interests of the people are secondary after designing elaborate and new "next best things" as a justification of spending, assuring that is occurs as quickly and efficiently as possible to prove it was necessary? M. Danda RN BN

In healthcare, we can always use more funding. It’s a simple truth, one that resonates with everyone working in the field—whether you’re on the front lines or behind the scenes. Healthcare professionals are constantly fighting for resources to meet the ever-growing demands of an aging population, rising health issues, and ongoing challenges in providing care. However, while the need for funding is universal, the allocation of these resources is not always as straightforward or as well thought out as we would hope. Looking at my own experience in healthcare, I have observed that, far too often, funding is mismanaged or spent on programs that are destined to fail from the start. These are initiatives that, despite the best intentions, simply do not have the required backing, infrastructure, or understanding of the real challenges on the ground. Worse still, there are instances where successful programs—those that have already demonstrated measurable benefits and positive outcomes—are cut...

     The role of pharmacology is integral in psychiatry. As nurses we encounter clients with mental health issues at all levels of health care from acute to community. With the development of effective medication to treat many psychiatric disorders there has also been an increase in use of medication as a first line of treatment (McCabe, 2004). The readings for this section made me reflect my role as a nurse and how use of psychiatric medication may be optimized for the best treatment of the client in a way that involves much more than simply having an order written by a doctor and hand out pills.           Intuitively one would imagine that because psychotropic medication is widely used in North America that there has been extensive testing conducted on both men and women to substantiate safety of medication. With my background in psychology it does not come as a surprise to me that historically most medication trials for...

      Throughout the history of mental health the dominant model used to guide patient care has been the medical model (Shanley & Jubb-Shanley, 2007). In recent years there have been alternative models proposed for providing nursing care in mental health. One model outlined by Shanley & Jubb-Shanley (2007) is the Recovery Alliance Theory. Application of this theory requires a paradigm shift away from the traditional medical model towards a strengths based humanistic approach. The theory resonates with my personal views of what constitutes good mental health nursing because it places emphasis on (1) humanistic philosophy, (2) recovery, (3) partnership relation, (4) strength focus, (5) empowerment and (6) common humanity. These constructs underlie the theory. From these emerge three main concepts that translate the theory into mental health nursing practice, (1) coping, (2) working alliance and (3) self responsibility.      I agree with Shan...