I Dare You to Drink the Vinegar

Strong leadership is a key component to the success of any type of organization.  Extensive research supports the importance of conceptualizing leadership as a social group process emphasizing the importance of people skills, in contrast to traditional management-oriented styles that focused on completing tasks as directed by a single leader (Avolio, Walumbwa, & Weber, 2009; Crevani, Lindgren, & Packendorff, 2009; Daft, 2011; Pearce, Manz, & Sims, 2009).  There is a wealth of leadership research and theory that may be utilized to effectively guide one’s practice.  Effective leadership in today’s diverse society involves clear understanding of preferred leadership styles, behaviors and how these may differ from those preferred by others to minimize misunderstandings and misinterpretations (Ayman & Korabik, 2010).  In order to effectively integrate leadership knowledge and successfully hone leadership skills it is imperative to reflect on one’s subjecti...

I am not sure if it is the influence of movies and television (I'm looking at you Grey's Anatomy ) or if this is something that is modeled in the workplace but I have been noticing more and more the tendency for some nurses to have conversations of a personal nature in front of their patient(s) as care is being done. My observations are multi-instance: in the Care Team Station, in patient's rooms, in the common dining area. As such, my conclusion is that this is not a serious of isolated incidents (is that an oxymoron) but a rapidly changing trend.  There is a fine balance, especially in mental health nursing, of trying to role model pro-social behaviours, and maintain a therapeutic atmosphere amid the rule and structure of the inpatient setting in order to create a safe and comfortable space for the patient. I think that nurses cross a line when the content of one's conversations begins to include anecdotes about personal life that have nothing to do with patient care....

I think that sometimes mental health practitioners do expect something in return for the services that they offer, often in terms of verbal appreciation of the client, their family, other co-workers, and/or the organizations that we work for. We all want that "thank you," the pat on the back that indicates to us that we have done a good job, that we have made a difference. However, I think that, in my experience, as I develop my therapeutic skills as a mental health nurse the reward that I get in the care that I give is more intrinsic, in terms of me being satisfied by knowing that I have done that best that  I can do regardless of the outcome. I think that because the population of clients that I work with, in some of the areas of mental health services that I have worked in, there is a range of responses from clients from being appreciative of the service to being dissatisfied with the service provided. I think that when we have conversations with our clients in a co...

I think that we can demonstrate compassion to our clients/patients in many different ways, such as through respectful actions and words, seeking to learn more about their experiences, and listening to their stories from a perspective of genuine curiosity. I believe that compassion can also be demonstrated through simple actions and behaviours of the clinician, like maintaining punctuality of appointments, letting clients know when we are going to be late or when we may be short on time, and focusing on the client when we are with them rather than checking email or letting other coworkers interrupt our interactions. I believe that compassion can be clearly conveyed in more overt and more subtle ways.  I think that the language that we use with clients also demonstrate compassion, using the words that they use and reflecting the seriousness of certain situations if they feel like something is important or relevant to them. I think that compassion can also be demonstrated in being t...

What do nurses do? I think this is a question that anyone going into nursing school needs to resarch before they accept their seat in a nursing program. I have to admit (I am fairly certain I have admitted this before) that I registered for the Bachelor of Nursing program in 2006 because I was kind of lost. I just returned to my parents house after a failed attempt at living in Vancouver. When I started the program I was not even sure I would ever practice. I did not feel like nursing was for me until close to completing my medical/surgical rotation in my second semester. This is when I started to understand that being a Registered Nurse was about more than simply completing list list of medical-type tasks. I do not think I fully appreciated the profession of nursing until I started graduate school. I do not think I fully understood the role of a mental health nurse until I started working as a mental health educator when I lived in Calgary in 2013 and this was probably mostly the resu...

I think I forgot that I wrote this blog again, until a nursing professor from a university in the US emailed me to ask permission to use an entry as a recommended reading for a class they teach. Blogs are such an interesting thing for me. I love writing and for some reason I think that I will have a excess of free time to write. I have written many since I was 16 and discovered them in the vast expanse of the Internet. I have a few on the go right now that I most use as a means of reflecting on my nursing practice and also reflecting on being a parent. I do not think I ever expect anyone will actually read my ranting and sometimes academic thoughts so it was a pleasant surprise and welcome reminder that someone in the world may be reading this and that it may be helping fellow nurses in some way. Yesterday I had a conversation with a student about what the appropriate intervention is when a patient that is being discharged openly tells the nurse that they will be going directly from ...

Life is short. If you blink, you might miss it.  The earth has existed for millions of years, but we will only be here for less than a century. Sometimes I look at my children and think about how the time that my partner and I have with them as children is finite.  Time seems to be passing by like a flash of lightning; it seems like they were babies and then I blinked and then were toddlers and then I blinked again and they were able to make their own decisions and understand conversations that once upon a time were in secret code that they could in no way decipher.  I adore their infinite cuteness that I cannot get enough of.  I marvel at how sweet their tiny little faces are and hope that I will always see them this way. Sometimes I feel totally weird thinking about how some people do not have children, never having the chance to nurture tiny little people that look and act like them.  I realize that reproduction is not everyone's goal, and I also realize th...

The following is something I wrote when I was 22 years old, having recently moved from Calgary, Alberta to Vancouver, BC. I am a second generation Canadian of mixed ethnic heritage. I was born in the early 1980s in the city of Toronto. Toronto is a densely populated and culturally diverse city located within a large and culturally diverse Canada. Looking at me, I swear you would not know it know it, but I'll let you in on a little secret; I’m not really White. I am a second generation Canadian. My mother immigrated to Canada from the Philippines and my father immigrated to Canada from the former Czechoslovakia. My mother has brown skin. My father had white skin. They both have incredibly thick accents that I never noticed until someone pointed it out. Despite the fact that I believe that most people probably consider me Caucasian when looking at me, I assure you that have personally felt the impact of racism. Though perhaps today I could pass for “white”, when I was a child I...

Do you ever wonder if there is any practical application to the reflective journal assignments that are assigned in undergraduate nursing programs? The assignments that we may have been quick to dismiss as the "fluffy stuff", in favour of the the "real nursing", like taking a blood pressure or changing a complex dressing. I think that the answer to this question depends on what one's understanding of Registered Nursing is, and also, what the role of the Registered Nurse is in practice.  If you believe that Registered Nursing is comprised of a series of tasks that are completed throughout the day to help sick people, then it may be that the value of engaging in reflective journaling to improve one's practice may be a hard activity to sell. However, if you believe that Registered Nursing is a complex process involving assessment, diagnosis, planning, implementation and evaluation, then you might believe otherwise. I am going to try to explain the utility of wh...

Did you ever watch the show Perfect Strangers? If you have not had the privilege, search for it on You Tube and I promise you, you will not be disappointed.  Much of my childhood was spent watching television. I am reflecting on this right now, as I watch my two oldest running around the bedroom chasing a half-inflated balloon as Batman and Robin meet Scooby-Doo plays in the background. I am not certain how, but I am pretty sure that the mass amount of television that I watched in my childhood helped me develop my love of both pop culture and social interaction. Love, Michelle D. 

I think that I forgot this blog existed. Baby brain is the shits, and it continues way past the birth of the baby because sleep deprivation lasts for the next 18 years of the child's life (or so I am told)...it could also be early onset dementia but it is 23:36 right now and I slept only a handful of hours last night due to baby Gus's unrelenting baby screams (he's teething I'm sure...or he just deeply dislikes my mom, who was trying to console him so I could try and sleep).  Today Gus will only sleep in his little jungle baby swing. According to the Internet you're not supposed to let a baby sleep the night in those swings, but that's the only place he will sleep. Please give me some suggestions other than letting him cry it out, because I tried letting him cry it out for over an hour this afternoon and he didn't seem that tuckered out when I finally gave in, woke the other two from their nap and brought him downstairs to socialize with the rest of us. Mayb...

I felt like work-life balance was much more manageable when I was working 12 hour shift work rather than Monday to Friday 0745-1600. In retrospect working in the Vancouver area was actually pretty good. There was so much more potential there than I could see at the time, perhaps because I was a bit burnt out and not as invested as I could have been. Or maybe, in the my current position of employment, I just have more time to reflect on my practice then and compare it to what I see now now. The inpatient mental health and addiction world is kind of a sad place that oddly enough holds so much hope of being a better place. I find that I have much more time now to reflect on the practice of mental health nursing in general. That being said, here are my goals for 2013: 1) Incorporate reflective practice into the lives of staff nurses in a tangible way 2) Encourage more thought about how human rights issues are challenged by current inpatient mental health practice I find myself thinkin...

Happy Canada Day. Take a minute to reflect on what this means to you. If you are a newly landed immigrant this might mean something vastly different than a seventh generation Canadian descended from British immigrants, and again something vastly different than someone who is Aboriginal. I have been noticing lately that many of the forms and surveys that I have been viewing and completing are using the terms gender and sex incorrectly. This is very irritating to me. However the definition of gender does not seem to be common knowledge. Perhaps this is knowledge that I gained through my sociology degree (with a concentration in gender studies). The definitions of both terms are as follows:      ""Gender" refers to the socially constructed roles, behaviours, activities, and attributes that a given society        considers appropriate for men and women."      ""Sex" refers to the biological and physiological characteristics that...

The experience of exam writing is something I became quite familiar with over the course of my psychology, sociology, and nursing degrees. When I was doing my first two undergrad degrees in sociology and psychology more than a decade ago one of my favorite evaluation tools was the multiple-choice exam. In that time period at the University of Calgary, all first, second (and often third-year) sociology and psychology classes were so large that the primary evaluation method was multiple-choice testing. I was very familiar with them, I wrote a lot of them, I was good at them in the sense that I frequently got most answers correct.  Mastery or False Confidence?  I mastered writing multiple-choice exams as a necessity when I was a second-year student trying to get into the competitive faculty of psychology because demand was so high and it was so competitive. The mastery increased in my third year because class sizes were so large and multiple-choice exams were the go-to evaluation...

"It's time to teach our daughters that their ability to be good people depends on their being good people, not on whether or not they're sexually active (Valenti, 2009)." I am far beyond the point of remaining silent when I hear someone else's prejudiced opinion, especially when it is in front of someone who is impressionable to these distorted and stigmatizing attitudes, especially a young woman who, through this type of talk is learning about how to feel shameful for decisions that may differ from traditional, outdated and violent notions of what it means to be a woman, and consequently how to shame other women because of this. And, as a woman who believes in social justice for women, I will always choose that hill to die on because that is how important the issue is to me.  I very much understand that I cannot change another person's beliefs, but I can certainly share my own. I very much believe that I can help to inform others, challenge traditional gend...

Three weeks ago Kelly and I made the decision that we will be moving back to Calgary as soon as possible. This decision was made for personal reasons but, as I started the process of updating my resume, applying for jobs, applying for registration in Alberta and going through the job interview process I realize that working and living in Calgary will be a much needed break from the Lower Mainland. I received my first job offer today for inpatient psychiatry. I am excited. I am looking forward to working in what I remember as a more cohesive health care region with more money and more resources. I am hoping that after some time working in Calgary I can return to working in the Lower Mainland in the area of nursing that is nearest and dearest to my heart, concurrent disorders.

Yesterday I went to work and noticed that there were flyers up for a memorial service for a client. I later learned from a co-worker that this client died earlier in the week. I found out that this client had broken some bones in an accident and made the decision to not seek medical treatment. I was unclear about what exactly led to their death but I assume it was related to the fractures and complications related to their compromised health status. This is the first client that I have personally known, in my almost 5 years in nursing, that has died. Working in mental health and addictions I know that there are definitely clients that I have cared for who have died.  When I worked as a care-aide during the first part of my nursing undergrad degree I witnessed people's deaths; I participated in the process of wrapping the body. But this experience was different, this was the first person that I actually had a health care professional-client relationship with, someone I knew, who die...

Working in mental health and addictions in Vancouver is tough. I think that there are many challenges to trying to "fix" the "problem" of the downtown eastside. And I'm pretty sure the answer isn't gentrification, pushing the visibly homeless further east or pouring more and more money in to the supply side of the illegal drug trade. This is not a novel idea that I have. If you do not believe me, think about this: There are many different stores that sell high calorie, low nutritional value foods that taste great. If one store that sells these products closes down, even a big store, like Safeway, the demand for these items does not decrease. People will still want to buy junk food. You severely decrease the supply, but people will still crave junk food and will probably go out of their way to seek it out. So why wouldn't a good entreprenuer step in and provide this product for those who want it? They make money, the public gets what it wants. Everyone wi...

Last night I attended the BC Nurses Union update dinner. The members of the BCNU will have a ratification vote on October 18th, 2012 for the proposed contract. From what I understand it seems that the bargaining unit did a good job. The new contract had some gains, uses very clearly worded language that is easy to understand and implement, we will be returning to a 37.5 hour work week and there will be 2125 new full-time equivalent (FTE) jobs added provincially. Some people at the dinner seemed happy with this and some people at the dinner seemed frustrated by the lack of gains. However, I think that we have to understand that ultimately, it is not the failure of the bargaining team that is the result of seemingly wishful gains like a cost of living wage increase, more money for education and safer staffing province wide, it is the public and the tax payers collectively that decide what we are worth. I think that many people complain when taxes go up, when they have to pay sales tax ...

How much "free time" do you percieve you have when you're working a shift? How much do you believe that it is part of your responsiblity as a professional Registered Nurse to nurture students, new graduates and new employees in your workplace setting? I remember when I was pregnant with my first child I worked in a community health centre as an addiction nurse. This was a temporary position that I took over from a nurse who had only been in the position a couple weeks and was asked to stop working there during my first orientation shift. My orientation (or lack thereof) left me bewildered about what the position actually entailed. With a little less than two years of experience as a Registered Nurse and my first position working semi-independently in a community setting I did not have complete understanding of what I was supposed to be doing. I spent most of my shifts waiting for phone calls from potential clients, taking stock of the nicotine replacement dispensed and p...