I Dare You to Drink the Vinegar

 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...

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 pa...

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) 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...