I Dare You to Drink the Vinegar

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 ...

  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 ...

 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 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 stoo...

And so it begins. This is my journey through the dissertation process. This is my opportunity to share with you the highs and lows, the success and the failure, the sweet victories and the painful obstacles that I face.  This is August 2020, the month when I begin to lay the groundwork for the proposal that I will write. August 2020 is the month when I increase the amount of literature I read on the topic I have chosen. Here we go.  Website of Interest  Canada's Human Rights History: Eugenics Eugenics Archives Relevant Archives  New Westminster Archives Online Royal BC Museum Archives Peace, Michelle D. 

Life is fluid. Change is an inevitable in health care because of multiple factors including development of new technology (Atter, 2008), clinical practice changes (Callaly, & Minas, 2005; Piat, Sabetti, & Bloom, 2010), changing client demographics (Atter, 2008), scarce financial resources (Erwin, 2009), staff shortages, and many others. Mental health nursing in the hospital setting is a prominent area of change because of the shift from the custodial care model prevalent in the early and mid part of the 20th century, to a client-centered recovery-oriented approach that gained popularity in the latter part of the century.  This shift required a drastic paradigm shift from caring for to caring with patients and their families.  Compounded by the additional workplace stress of de-institutionalization, the result was fewer inpatient mental health beds and shorter lengths of stay (Lloyd, et al, 2009).  Unfortunately, change can be a major cause of workplace stress (O...

Something clicked in the last couple of weeks when a friend (who is also a nurse) and I started to pick up some steam on a nursing project that we started . The project started as a fun podcast last June and has blossomed into something that seems to be growing much bigger. And by bigger, I mean a project that is taking more time and money than I originally anticipated. But, by bigger, I am also learning that many of the skills that I have learned throughout my academic endeavors, professional nursing career, and life as a parent are now converging on a moment where I realize that project management is not an abstract concept that is learned in a specialized post-secondary program. Project management is something that we have been learning our entire lives, from we began grade school.  Perhaps you are scratching your head, wondering why exactly is it useful to recognize that life is a series of projects? Because these are transferable skills. If you can manage to get through school...

I have been a Registered Nurse for more than a decade (since 2008 to be precise). One of the ongoing challenges that I have experienced is the nursing shortage. What does this mean? In supply and demand terminology it means that the supply of Registered Nurses, Registered Psychiatric Nurses (in provinces that have them), and Licensed Practical Nurses (or Registered Practical Nurses if you live in Ontario) is less than the number of positions that are needed. In practical terms, this means there are not enough nurses to provide the care needed for all people in Canada utilizing the healthcare system. Only recently have I learned that the nursing shortage is not unique to the 21st century, and it is a global issue. This is clearly a huge issue. Let's take a little journey to think through this issue with a focus on Registered Nurses in Canada.   A Short Exercise in Thinking Through the Issue Background and Overview  There is a critical shortage of many health care prof...

These are difficult times, when our identities are defined by the things that we own. The relationship between people and technology is increasingly necessary to contemplate. As a nurse working in a major city a developed nation the role of computers in healthcare is paramount as not only a tool for documentation, but as a tool of enacting health care practice. What is the relationship between nursing and technology, between nursing and computers?  How is computer technology embraced and integrated within the healthcare system in a way that enhances nursing care, rather than becoming a nuisance or getting in the way of what we think nursing care looks like? Peace, Michelle D.

The feeling we have when we can share suffering with another (or many) human beings. This is a gift of being human, this is an essential part of being a nurse. As we fumble together to find the best way that we can share this suffering, we grow as human beings, we grow as professional nurses. How can we conceptualize compassion in such a way that embraces it’s importance in nursing, and, in health care? I think that an unfortunate result of an increasing push to be more evidence based there is a push for nursing to be more technical, more empirically based, and less focused on the fluffy stuff. But, isn’t what some consider the fluffy stuff the foundation of nursing care? Is nursing about curing an illness, or is it about helping people and communities organize the conditions to maximize health? And how do we do this if the focus is the micro and the individual rather than the macro and the collective? And, how do the human and non-human co-exist? Discussion Questions: 1) What does...

The first time one of my children was admitted to an acute care hospital changed my perspective as a nurse, in a way that I never imagined it could change. 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 partner and I are RNs and we knew, better safe than sorry because children, especially babies can decline fast. When he was first admitted to the hospital in 2014, it was to a pediatric unit in a general hospital. Clinical staff would come in to assess him, not always introducing themselves. My partner and I were often left looking at each other and wondering, was that an RN or an LPN, and what kind of assessment were they doing?  A Surreal Code Blue  As my son's condition worsened we often found ourselves sitting in the hospital room wondering, where was the nurse? As he became more lethargic and his work of breathing increased my partner (who is also an RN) replaced the oxygen sat...

The profession in North America as we know it today was borne in the time of the proliferation of the American Hospital System . Nurses were the hand-maidens of the physicians who assumed the top of the hierarchy in the system. That is our history. Accept it. Embrace it. Change it.    The nursing profession in Canada is comprised largely of women. I am a woman. And this is my story. As the thoughts spill out of my head and come together as written words this is a cathartic process through which I am attempting to gain clarity of where I am in my career. And, make no mistake, nursing is a professional career that we work hard to build. Nurses are the heart of the healthcare system, and we are the brain.  Geez Louise, I am on a roller coaster of a stretch of work. And, I feel exhausted. You may have similar sentiments if you have been an inpatient nurse for a number of years. All the days blend together, and the definition between night and day becomes a little less clear....

 I like to write. I envision myself as an extremely talented and highly skilled observer of the world. Each day I am like a ripe fruit of some type, just bursting full of practical genius that I fervently feel needs to be shared with the masses. For example, right now (picture me tapping my index finger emphatically on an oversize antique desk as you read that).  It's only lately that I am questioning the profoundess (is that a word? I ask because Spellcheck does not seem to agree) of my written words. I'm questioning not only my smarts (take that Grammarly ) and also the desire of people that are not my spouse or children to read the life-changing writing that I produce without restraint each day. But, fortunately, sometimes I read my written gems of the past (blog or on paper) and I cannot help but think, I am one deep mother trucker, and also question, does the world does need to be repeatedly graced with the dazzling magic that is my life musings (and perhaps sometimes in ...