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Touchpoints Oct 1, 2005

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 July 2005
UCJIPO I NTS
School of
Nursing
PUTTING    SCHOLARSHIP    INTO    PRACTICE
Global Citizens
Contents
1 Global Citizens
2 Raising the Bar
Quick Catch, Slow Release
3 New Faces in Research
Gliding into the Thick of Things
at UBC
4 Development
A Reason to Give
5 Undergraduate Profile
Teamwork Improves
Everyone's Scholarship
6 Graduate Profile
Promotion is the Cause
of Prevention
7 Leadership Development
Fostering Leaders on the
Front Line
8 Clinical Practice Innovation
Focussing on Families
Dr. Sally Thorne
The University of British Columbia's Trek 2010 is a document you are going
to be hearing a lot about. It articulates this university's commitment to be a
leader in preparing students to become exceptional "global citizens" capable
of promoting the values of "a civil and sustainable society." The School
of Nursing is an enthusiastic proponent of an educational climate that helps
all students and faculty members appreciate the contributions that we
can make, individually and collectively in making the world a better place.
Toward this end, we have been developing our international outreach
initiatives so that they become a core component of the work that we do.
This year, we have had a number of international undergraduate exchange activities. Last fall,
three students and one faculty member from
the Guru Nanak College of Nursing in Dhahan-
Kaleran, Punjab, India spent a month in the
School, working alongside our students and
faculty to learn more about the implications
of our distinct health care delivery systems.
Those students went home inspired and eager
to effect changes within their own local area.
This spring, faculty member Lynne Esson
and four basic undergraduate students spent a
month on a return visit to India. Their experiences have been powerful reminders that the
world is not an equitable place, and that
human creativity and conviction are essential
ingredients of meaningful social change.
In addition, through the creative and persistent
proposal development of some of our undergraduate students, we were able to send three
of them to Ghana. There, they worked in
extremely remote village health units, far from
cities and expert resources. Their experience
involved direct teaching and health promotion
as well as coping with emergent situations
that inevitably arise for people who live "where
there is no doctor."
These experiences came about through the
hard work and passionate commitment of
members of our faculty and the students themselves. On their return to Vancouver, the
students all have a commitment to spread the
word and share the insights they have obtained
through these experiences with their fellow
students and professional colleagues.
continued on page 4
.L3>
'uttmg basic nutritiona
•alth promotion
messages into lively songs in local dialect,
Mandy Reid and Chloe Elmire-Lemore have been
educating villagers in the remote Seva region
of Ghana. Ln this way, they teach children
that "mosquitos cause malaria" and mothers
that "breast milk is baby's best food. " They are
applying all of their principles of community
health "but in rural Africa instead of a suburb
ofiVancouver." Raising the Bar
Quick Catch, Slow Release
Mother gives birth. Midwife catches baby. Mother, midwife and baby make slow release.
Elaine Carty, professor in the School of Nursing and director of the midwifery program at UBC, is the 2005 recipient of the BC Health Association
Legacy Award. This award is offered annually through the UBC College
of Health Disciplines to someone who has made a significant contribution
to the development of health policy, health leadership or healthcare
governance in the province. Elaine receives it this year for her outstanding
leadership in the development of midwifery education in BC.
Over 25 years ago, Elaine along with Alison
Rice, School of Nursing assistant professor
and midwife, worked with other nurses, physicians and midwives to establish a pilot project
for midwives at the old Grace Hospital. "We
had the support of obstetricians we knew
and that helped," Elaine says. "We were doing
it on a volunteer basis. Eventually the nurses
who were trained as midwives at Grace
Hospital took over as part of their salaried
work and this was a shift forward for
midwifery in BC, one step closer to the regulation of midwives." But midwifery hadn't
always garnered such respect in Canada.
"When I was a student in New Brunswick and
first worked in maternity care, I knew almost
immediately this was my passion," says
Elaine. She studied at Yale under respected
scholar Ernestine Wiedenbach, and then
returned to New Brunswick excited to practice
on home turf only to discover Canada didn't
regulate midwifery the way the States did.
Wanting to do something to help legalize midwifery in Canada, she moved to Ontario and,
with others, formed the first Ontario Midwives
Association. "People didn't get it," says
Elaine. "Our association became an advocacy
and consciousness-raising group. We
publicized the value of midwifery for women
and talked to the government regarding the
implementation of regulation."
After working in labour and delivery at Kingston
General, and teaching at Queen's University,
Elaine moved west and joined the faculty at
UBC. In the mid-70s a group of midwives,
Elaine included, received preliminary funding
from Health Canada for a proposal for an
out-of-hospital birthing centre staffed by mid-
wives. Although attitudes were starting
to shift, there were still protests in the community about taking the process of birth
out of the hospital. A sabbatical back to the
States where midwifery was "normal"
provided Elaine with renewed energy to continue the push for midwifery in Canada.
After Elaine and Alison's successful pilot
project in the 80s, momentum started to
build. More women were writing to government
wanting midwifery legalized; an international
conference of midwives attended by 6,000
women met in Vancouver; the BC health minister at that time announced that midwifery
would be regulated in BC; midwives, nurses
and supportive obstetricians continued to
work with government; and then in 1998 the
regulation finally happened.
The offices of the midwifery program at UBC
have soothing olive painted walls, a waterfall
trickling amongst live plants, and a thematic
assortment of art, sculpture and traditional
birthing aids. Images of birth and motherhood
are everywhere. "It's important to balance
the science with the art," says Elaine. "This is
a fundamental human process that's been
told in art and literature for years."
UBC admitted its first students to the midwifery program in 2002 and graduated its first
advanced standing class this May. "Sixty per
cent of their education is clinical," says Elaine.
Students must participate to varying degrees
in a minimum of 60 births in order to
graduate (in 40 of them they have to "catch"
the baby themselves), and the curriculum
stems from three main themes: human growth
and development, pregnancy and birth transitions, and effective care. Competition to
get in is high. Only 10 per cent of those who
apply are admitted and 80 per cent of those
have a previous degree.
Midwives provide a continuity of care. Midwife,
after all, means with woman. "It's about
informed choice," says Elaine. As midwives
gain in popularity in BC and Canada (currently
midwifery is regulated in Alberta; regulated
and publicly funded in Quebec, Ontario, Manitoba and BC) Elaine hopes interprofessional workshops with nurses, medical
staff and midwives will grow. "We're all in
this together, she says. "We know we will
be a valued part of maternity care in BC."
For Elaine, watching the first class graduate
was like coming full circle. "It's been a long
haul," she says. "It's been a gift to work with
these students and to produce graduates,
when 40 years ago people didn't even know
what midwifery was." The School of Nursing
congratulates Elaine on her award and her
accomplishments in the field of midwifery, and
looks forward to watching Elaine's continued
effort in educating women about care during
the birthing process, and helping create an
even more welcoming health care system for
midwives and their clients. In France a midwife
is called a sage femme (wise woman), and
there may not be a more fitting title for professor Elaine Carty.
New Faces in Research
Gliding into the Thick of
Things at UBC
A quick glance at the research interests of
Dr. Colleen Varcoe, an associate professor
newly appointed to UBC after some years at the
University of Victoria, leaves one mystified
as to how one person can fit aboriginal health,
violence against women and health care economics, just to name a few, into her day-to-day
study. But for Colleen, these interests are not
as disconnected as they look. She says all her
work is interconnected to the question of "how
do we as nurses promote ethical practice in
the context of inequity?"
Colleen works on several research teams
and enjoys the two way exchange of information
and knowledge within and among the team
members. "I'm lucky to have exposure to these
people with such extensive expertise in
their areas," she says. And, coming to UBC
has only furthered her ability to work in
her areas of interest. "The School of Nursing
at UBC is a research rich environment,"
Colleen says. "There are highly experienced
people here to offer research advice, mentorship and leadership."
Her most recent project is in partnership with
others at UBC. Members of the Faculty of
Medicine and the Department of Educational
and Counselling Psychology, and Special
Education are working with Colleen, who co-
leads a study of rural Aboriginal maternity
care in Alert Bay, Bella Coola and Haida
Gwaii. "We're working with community-based
researchers, who are aboriginal women,
to look at their traditions and experiences of
birthing and their hopes for the future."
Colleen says birthing is being eroded in these
communities, women are increasingly
required to go to bigger communities to give
birth and thus the people are left with a
sense of being able to die, but not to give
birth in their communities.
The area of health care economics comes
into play with this study. "One day I was struck
by the picturesque quality of the fishing fleet
moored in Alert Bay and took some pictures,"
Colleen says, "but then I started thinking, 'the
fleet shouldn't be here, it should be out in
the water, catching fish so the community can
earn a living.'" The tax base this industry
generates is what supports birthing centres
or hospitals. It's all connected.
Colleen also spends much time focusing
on the area of violence against women, which
immediately led her to study racism. If there
are 12 patients in Emergency with no beds
and there are six more people waiting at the
door, it is hard to practice ethically, she
says. "I'd like nurses to be continually reflective not only on their own biases, values
and assumptions but also on the way in which
they engage with the context of their
practice—not only the unit, hospital, etc. but
the socio-political context as well." She
says nurses must act on more than the nurse-
patient relationship. "We need to act
collectively to improve not just the conditions
of nursing practice but also the social
determinants of the health care of the people
we serve. Ethical practice must take into
account all forms of violence and inequity,
including racism."
So, what does someone who has five
grants on the go, sits on three primary
research teams and loves teaching do in her
spare time? Colleen is a Hang Gliding and
Paragliding Association of Canada Instructor
and Tandem Pilot, and has flown in many
areas including BC, Mexico and parts of the
United States. We anticipate smooth
sailing with a lot of excitement in her research
career here at UBC. Development
A Reason to Give
The School of Nursing is thrilled
to be the recipient of a new award
for students available for the
first time in 2006/2007. Peter Peto
established the Steve and Therese
Peto Memorial Bursary in Nursing
in honour of his parents. "This is
my way of supporting a woefully
stressed health care system which
supported my parents in their time
of need," he says.
Among other factors, immigration, campus
life and first-hand experience fed into each
other to help establish this fund. The Petos
immigrated to Canada from Holland in 1951
and through hard work were able to prosper.
Peter believes his parents "would not have
had any objections if they could give something of value back to their adopted country."
When Peter worked as a post-doctoral
fellow in geology at UBC in 1975/76 he grew
to love the UBC campus and campus life.
And his wife, Judy Gurney is a graduate of the
UBC School of Nursing (BSN '83). Judy was
helped in her studies with scholarships and
Peter says "whatever financial support she
received helped her successfully complete
her education at UBC."
In their later life, Therese and Steve Peto
required nursing care. Therese lived in a nursing home for about 12 years and was
completely dependent on the nursing staff. "I
appreciated the professional and personal
care my parents received," says Peter, "and I
hope the endowment will go some way in
helping nursing students who are in need of
financial support." Peter looks forward to
a time when he can further supplement the
Peter Peto with his parents, Therese and Steve,
at their last event photographed together.
endowment with additional funds. "This is
just a small gesture of the gratitude I have
for the nursing profession."
The UBC School of Nursing is continually
indebted to friends like Peter Peto, who want
to help further the practice and education of
nursing with the gifts they have to offer. This
award will be an enduring contribution that
will not only honour the memories of Therese
and Steve Peto but will help the next
generation of nurses provide the high quality
care Peter's parents so appreciated.
Global Citizens
Continued from page 1
Although such experiences inevitably require
intensive demands upon students, both in the
preparation and in the visits themselves, often
in uncomfortable and stressful circumstances,
they return home with a very different sense
of the world and of the role that nurses
can play in the larger global health agenda.
We know that each of them will find a way to
continue that work and inspire others throughout their nursing careers.
International experiences such as these
require the concerted effort of many visionaries, and we are fortunate to have many stellar
examples among our faculty and friends. They
also require financial support, and we have
been lucky in that regard as well. Students
who participate in such exchanges always
contribute significantly out of their own pockets as well as fundraise to the best of their
ability given their demanding class and clinical
schedules. In addition, the international
experiences this year were also supported
through the generous contributions of the
Helen Mussallem Fund and the Kathleen S.
Wheeler Endowment Fund for Student Support.
We are deeply indebted to the visionaries
who have ensured that we have the resources
to make such powerful learning experiences a
part of our program.
As we move forward toward 2010, the School
will continue to receive international students,
post-doctoral fellows and visiting faculty members. The faculty will continue to collaborate
and consult with colleagues internationally.
And our students will all leave our programs
with an understanding of what it really
means to be nurses who enact their practice
as global citizens. Undergraduate Profile
Teamwork Improves
Everyone's Scholarship
You could say Graham McLean (BSN '05) was
practicing his scholarship before he'd formally
learned it. Before entering the advanced
standing program in the School of Nursing,
Graham was a Bachelor of Arts student at
Simon Fraser University, with a psychology
focus. However, his extracurricular activity had
more of a care-giver flare. He worked for the
School's Health, Counselling and Career
Centre and had lots of contact with psychologists, counsellors, nurses and other health
professionals. His graduation was upon him
and he was faced with the eternal question:
what now?
"I started talking to the health professionals
I worked with to explore my options," says
Graham. "I looked at my work history, my
goals, my education, and a degree in nursing
seemed to fit." And Graham had a range
of experience to choose from. He'd been a
manager of a 7-11 and had started his
post-secondary education in electrical engineering. But, the bulk of his experience
pointed toward work in the mental health
field. "I had applied for a Masters in
Counselling Psychology because I thought I
wanted to focus on mental health, but stopped
at the application stage. I wanted to work in
more areas and discover more opportunities."
Graham's final clinical preceptorship in his
UBC BSN program was with the Vancouver
Coastal Health Midtown Mental Health Team.
This community mental health service offers
assessment, rehabilitation and specialized
services to adults and older adults with serious mental illness, and to children with
serious behavioural/emotional disorders, living
in Vancouver. There, Graham was able to
develop and implement a group for clients of
the mental health team that combined all
three of his current major interests. Graham
worked with adult clients and discussed
issues of health promotion and mental health
with regard to weight gain and the risk of
diabetes, and the side effects of psychotropic
medications. "I've had a really positive experience at Midtown," says Graham. "My preceptor integrated me into the Midtown team and
drew on literature to help me understand
current issues. It was nice to see that once
out of school the learning doesn't stop.
I don't want to leave my research at school.
It's important to keep up to date."
The group Graham developed at Midtown
had positive results for those involved. "One
of the side effects of this kind of medication
is weight gain," Graham says. Through engaging his clients in medication education and
encouraging them to ask questions, three of
the original four people in his group lost
weight and two decreased their waist circumference throughout the process, just by
becoming informed. One client told Graham
his group was so helpful it should be taught
in the hospital before patients are discharged.
"A lot of them didn't know the side effects,"
says Graham, "and in an ideal world they're
supposed to know that." This is where nursing
can make a difference. "Nurses can take the
time and ensure informed consent."
Graham hopes to continue his work with the
mental health team to design intervention
groups for community and hospital. "I'd like to
help people look at the choices they can
make to mitigate the impact of side effects."
Some of the tools he uses are motivational
interviewing, education and informed choice.
"There are lots of teams out there," Graham
says and he hopes to communicate with
various groups to see what all the teams are
doing and how they can do something
together. "There are groups for depression,
psychosis and day programs for bipolar,
all run out of the hospitals," he says, "and
there are eight mental health teams in
the community, and outreach for people who
have been discharged."
In the near future, Graham would like to stay
with community health and continue his
development in mental health. "I like the interdisciplinary work and the autonomy within a
team," he says, but his dream job would
involve a case load of his own clients while
taking his group on the road as a travelling
road show, not only sharing information
and techniques with other mental health
teams but learning new skills from other
teams as well. "I'd like to make contributions
in the area of side-effect management,
bringing awareness around that and being
involved in making policy around this issue."
Graham has already published in the Journal
of Pediatric Nursing and co-authored a
position paper on personal counselling for the
Canadian University and College Counselling
Association. He was also the recipient of the
Dorothy J. Logan Memorial Scholarship. The
scholarship is awarded annually by the School
of Nursing to a student who demonstrates
volunteer activity. What with his volunteer work
providing social support to patients at
St. Paul's Hospital, working as a crisis line
volunteer, or giving a speech at Selkirk
College's 1997 Montreal Massacre Memorial,
Graham exemplifies the dedicated volunteer.
"Winning the award helped," he says. "I get
a lot of satisfaction from volunteering, without
thinking of it as a resume builder, but it is
definitely nice to be recognized."
And, as Graham continues his work in the
mental health field, specifically, for now, in
side-effect management, he will no doubt
gain further recognition and satisfaction for
his ability to practice his scholarship before,
during and after learning it. Graduate Profile
Promotion is the Cause
of Prevention
It's early in the morning and you're one of
the first in line. And you should be—you've
already been traveling for five hours in 30
degree heat to get here. Never mind the fact
you're in your mid-70s and this kind of
exertion's probably not good for your heart.
But, you heard there was a health fair
where nurses would check you over for free
and, since you can't afford to see a doctor,
you gladly make the journey.
Karol Ghuman attended this health fair in
India as a member of UBC's Guru Nanak
Partnership Project Advisory Committee. "My
heart went out to him," says Karol. But even
in Canada with a socialized system "where
we supposedly have everything, some of these
older people are waiting in a lineup to have
their blood pressure and cholesterol checked
and to talk to someone about their health."
With the current strain on the primary health
care system, many British Columbians don't
have adequate primary care. This is especially
true of those who are elderly or suffer from
chronic diseases or mental health concerns.
Karol Ghuman, RN, BSN, MSN '05, is congratulated
by Anne Sutherland Boat, Chief Nurse Executive and
Assistant Deputy Minister of Health Services,
Government ofBC, at a celebratory gathering in
honour of BC's new nurse practitioner graduates
and students.
When they do have a family doctor, he or
she is likely to have a very busy practice with
limited time to fully explore a patient's
symptoms, listen to his or her concerns, educate, promote health and prevent future
illnesses. "This is where nurse practitioners
will make the biggest difference," says Karol.
Nurse practitioners will assess, diagnose
and manage the common and predictable conditions and make referrals appropriately.
They will join the health care team and work
both independently and in collaborative
partnership with physicians and others. "I'm
not just looking at symptoms as of today,"
she says. "I'm looking at the whole picture—
the environment and family, and the whole life."
Karol, who graduated as a member of British
Columbia's very first graduating class of nurse
practitioners this May, wants to help patients
put it together for themselves so they will no
longer have to wait in line to get basic information while their blood pressure is taken, or
walk five hours to a free clinic on a hot day.
With her passion for helping in the South
Asian community, Karol knows that part of her
job will be to communicate and foster health
promotion and illness prevention among
people who have arrived from home countries
in which these ideas are not well understood.
Nurse practitioners are a new initiative in BC.
The UBC School of Nursing welcomed its
first class in September 2003 in answer to a
provincial call to improve primary health
services by introducing this new provider role.
Family nurse practitioners are advanced practice nurses who can assess, diagnose and
manage common conditions in persons at all
ages and stages of the lifespan. In order
to become nurse practitioners in BC, these
nurses require both theoretical knowledge
at the graduate level and specific, advanced
clinical skills training.
"I didn't realize how much I'd fall in love with
it," Karol says of the program. Karol already
had 23 years of nursing experience before
starting the NP program. From starting with a
diploma in psychiatric nursing to achieving
her BSN in 1999, Karol has worked in surgery,
intensive care, critical care, acute medicine
and in newly developed positions such as respiratory nurse clinician and clinical resource
nurse. Even with this variety, Karol felt a
strong desire to do more. Getting involved with
the Guru Nanak Partnership Project Advisory
Committee and teaching one term at UBC as
a clinical instructor gave Karol exposure to
many of the faculty at UBC. And it was in talking with Gloria Joachim and Sally Thorne
one day that she realized the nurse practitioner program would be a good fit. "I hadn't
thought of NP before—hadn't thought about
primary care after coming from a more
acute care background."
The increase in scope of practice, Karol says,
gives her more autonomy. She now sees
how nurse practitioners bridge the gap
between health promotion and curative care.
"Physicians are naturally constrained by time,"
Karol says. "And who loses out? The patient.
They need a listener."
Now that Karol has graduated she will take
her education and apply it to her area of
interest: the South Asian community. "I came
from India when I was 11," she says. "I could
see the struggles families went through in
adapting to a new system and thought there
must be something I could do as a nurse."
Speaking two languages and obtaining this
specialized education have placed Karol
in an ideal position to give back.
The School of Nursing is fortunate to have
graduates like Karol. In spite of the tiny voices
in their heads that say "I can't do more
school, I have a family, I'm tired," these nurses
find a way to come back to school, not just for
themselves, but for the greater good of their
community and the overall health care system.
Karol, and the other new graduates of the NP
program, will be the first British Columbia
nurses to sit rigorous comprehensive theoretical and clinical examinations this summer,
and subsequently become among the first NP
registrants of the College of Registered
Nurses of BC, which will have the legislative
authority to grant them the right to practice.
We look forward with great excitement to
watching Karol and her colleagues make a
difference to patients in primary care,
putting scholarship into practice as family
nurse practitioners. Leadership Development
Fostering Leaders on
the Front Line
The development of first line nurse managers
was one of the top five action priorities selected from the report of the Canadian Nursing
Advisory Committee (CNAC) by the BC Ministry
of Health Nursing Directorate. The BC chief
nursing officers (CNOs) and the UBC School of
Nursing eagerly responded to the challenge
by mounting a project to consider options,
then organizing and running the inaugural BC
Leadership Institute for First Line Nurse Leaders
at Harrison Hot Springs this past March. The
overall objective of the leadership initiative is
to build leadership and management competencies among first line (or entry level) nurse
leaders in BC, enhancing leadership and management performance and job satisfaction
among these nurse leaders. And the specific
intent of the three-day institute was to
support nurses who are relatively early in their
leadership careers, having taken up front
line nurse leader positions within the past
three years. "The chief nursing officers of this
province are highly enthusiastic about this
initiative" says Heather Mass, CNO for
Children's and Women's Health Centre, BC and
the Provincial Health Authority, and a UBC
nursing adjunct professor. "We need active
and creative support to ensure that there
is a new generation ready to take on the leadership of clinical nursing."
"The provincial government's Nursing Directorate
and the chief nursing officers of all six of
BC's Health Authorities were instrumental in
supporting a process to develop a program
to educate and support the nurse managers
who will be moving into more senior positions
over time," says France Bouthillette, RN,
DNS, lecturer at UBC and institute co-leader.
The political intent of this leadership
initiative is to address the negative impact of
the removal of head nurse positions during
this era of health care restructuring. This leadership gap has been identified as a key
factor in dissatisfaction among nurses. France
says that front line nurse leaders handle a
wide range of functions, from patient care to
managing the budget for the unit, "and
they need to be prepared. Just hiring a skilled
clinician and expecting they will know how to
do this job doesn't work. They need the
resources and the knowledge about what the
role entails if they are to be successful."
One of the public's major concerns with the
health care system is timely and safe care.
"Educating first line nurse managers will have a
synergistic effect on the delivery of safe
and effective care," says Maura MacPhee, RN,
PhD, lecturer at UBC and the other institute
co-leader. "If they know what they're doing,
these leaders will be better prepared to retain
and recruit nurses. People want to work
for competent managers," Maura says, "and
they're more apt to be satisfied with their
work environment because their concerns are
being respected and addressed." And, with
retention of staff there will be more informed
front line nurses and better communication
between the levels of hospital administration.
France and Maura both teach leadership
and management courses at the UBC School
of Nursing, so when the organizing team
searched for people with expertise in the area
of teaching management and leadership,
they found UBC faculty members eager and
willing to develop the curriculum and teach
the workshop. With funding from the Ministry
of Health Nursing Directorate, Heather Mass
began the process by leading a project to
identify and validate the baseline competencies managers should have. "Based on
reports that contained a thorough review of
the literature and feedback collected from
nursing leaders throughout the province, we
developed the core curriculum," says Maura.
Some of what these first line managers
expected from the institute workshop were
communication and organization skills,
skills on how to work better with staff and
new ideas and possibilities to network
with people in the same role. After the workshop, each first line manager was assigned
a mentor from his or her hospital who is either
in middle or upper management. "Support
networks are crucial for development," says
Maura. "We want someone with more
experience in their institution to provide support to these first line managers."
Together the first line manager and mentor
identify a project or issue to work on. For
example, the first line manager may want to
explore the integration of LPNs into an RN
unit or learn how to better promote professional development for staff. With the help of
their mentors, the first line managers will do
projects based on their area of interest
and will later create a portfolio highlighting the
project. "Teaching nurses how to put together
professional portfolios will showcase what
they've learned and how they'll use it," says
Maura, "but it will also help them develop
useful tools, have a visual of what they've
learned and help them feel like leaders."
There are long term plans for the Leadership
Institute. France says "the potential is there,
the political will is there and the resources are
there." The Leadership Institute is only one
of many creative initiatives underway to help
prepare nurses for leadership and management positions, which in turn will help to
sustain the nursing profession and the health
care system overall. The School is busy
developing a wide range of plans for future
developments to capitalize on the momentum
that has been created in nursing leadership
development throughout the province. Clinical Practice Innovation
Focussing on Families
"I hear this all the time," Clarissa Green, retiring associate professor from the UBC School
of Nursing, says referring to a phone message
she has just received. "He heard my segment
about aging parents on the CBC and now he
needs help with his mother." Last year, when
Shelagh Rogers aired a series on the effects
of aging parents on the lives of adult children,
who better to ask for information and stories
of personal experience than Clarissa, an
expert on the stress, dynamics and changing
relationships of mid-life children and their
aging parents.
Over her career, Clarissa has had an enduring
fascination with families at various ages and
stages. "Years ago I was working with family
members who had heavy burdens on their
hearts," she says. "They couldn't forgive dead
parents or couldn't ask for forgiveness and
I started thinking, how can families avoid
this?" So, with graduate work in mental health
nursing and post-graduate work in family
therapy, Clarissa focused her attention more
on the relationship between aging parents
and their adult children when the parents were
still alive and the issues could be more
actively dealt with.
From this came a specific emphasis on
multiple role women (career, mother, wife and
daughter) and the stresses to which they
fall prey. "Families have care-giving crises
along the way that I try to help them prevent,
or help them resolve as effectively as
possible," Clarissa says.
In her clinical practice, Clarissa works directly
with families to plan and implement a course
of action that is respectful of its members and
of the unique family dynamics. In the context
of the challenges and conflicts arising from
the needs of aging parents and their children,
Clarissa seeks to foster relationships that
help families as a whole, getting to know their
belief systems so that she can facilitate
their wishes and promote effective communication among members.
Clarissa describes one memorable situation
when she became involved with a mother
and daughter who lived together. The mother
became terminally ill and the palliative
care team got involved with the family. The
daughter was exhausted and struggled to
talk with the palliative care team. "She asked
me if I could talk to them," Clarissa says.
"Families find it reassuring to have communication among all the health care professionals."
As it turned out the palliative care nurse was
a former UBC nursing student. "We worked
together to discuss this family and she did a
great job with them. I laughingly told her
this was a good time to use all the skills she'd
learned in my class."
Clarissa and a team of colleagues built one
of the first family nursing courses in Canada,
which has been offered at UBC steadily since
the 1970s. For the last fifteen years, Clarissa
has also taught an advanced family nursing
practice course. Although she retired in June,
Clarissa says she will never stop teaching
in one form or another. "I'm passionate about
teaching families and students. Since
my youth, I've been fascinated by the creative
process of learning."
Clarissa's passion for teaching was acknowledged nationally when she was awarded
the competitive and prestigious 3M Teaching
Fellowship Award for excellence in teaching.
Clarissa Green, RN, BSN, MSN, retiring
associate professor, will soon have much more
time to reflect on the beach.
She continues to sit on the 3M Council as an
executive officer.
Taking those teaching skills out into society
after retirement will be easy for Clarissa. "I'm
interested in expanding the knowledge
health professionals and para-professionals
have with regards to aging families. Society
needs more people who understand aging
and grown-up children."
The next few months will see Clarissa getting
used to a new sense of time. Although she
will continue to work with families, her book
on the journey of the mid-life generation
as parents age and die will be a number one
priority. "The families I've had the pleasure
to work with over the years have taught me a
lot of what I know and I'd like to return that
gift through this book."
uc
hpo
NTS
Touchpoints is published by the School
of Nursing, Faculty of Applied Science,
The University of British Columbia.
Editor: Sally Thorne
Associate Editor/Writer: Julie Lees
Editorial Advice: Dr. Marilyn Willman
Design/Production: Tandem Design Associates Ltd
Printing: Rhino Print Solutions
The UBC School of Nursing
T201-2211 Wesbrook Mall
Vancouver, B.C.  V6T 2B5
Tel: 604-822-7417
Fax: 604-822-7466
www.nursing.ubc.ca
PUBLICATIONS MAIL AGREEMENT NO. 40681575
RETURN UNDELIVERABLE CANADIAN ADDRESSES TO
THE UBC SCHOOL OF NURSING
T201-2211 WESBROOK MALL
VANCOUVER, BC  V6T 2B5
EMAIL: INF0RMATI0N@NURSING.UBC.CA

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