A warm welcome to my students and other visitors. I will offer you the occasional insight as to the potential of your future, career directions, and encouragement. I know what you would like more than all that I share about the future, at least for now, you want the insights in to how to prepare for exams and the like. The most valuable thing I could share with you is to get more than enough sleep. The approach to “cramming” for exams actually sabotages far too many.
In the weeks to come it is my intent, to provide guidance, in how best to “think” about nursing care that you would provide for clients. In short, the “critical thinking” that you hear from your instructors and professors, is exactly that invaluable, and is what you will need to “get your head around” in order to demonstrate on paper and in clinical scenario’s.
So please return and engage in the converstion, comment or blog,…expand your community of support here in this forum, and reap the rewards.
Talk soon,
Dave
Second entry
Now that you have made the wise decision to visit on a regular basis, then I must get on with the intent to share my wisdom. The “approach” to study and research will be shared, but like any good teacher would do, is to be interested in your well-being, as much as your learning. So hear is the next pitch about assuring your success in your courses.
Eating nutritiously and strategically. What I really want to stress, is that you begin your day with a healthy breakfast and “graze” the rest of the day. You’ve heard this before and I am just re-enforcing it here as both a wellness expert and teacher… lots of fruits and veggies, for their water and fibre content, as well as the vitamins, minerals and anti-oxidants that promote health. The fibre will assure a slower absorbtion and less “peaks and valleys” from blood sugar levels changing. Not all fruits are created equal, apples and pears for example will have more postive glycemic index than say banana’s. Note that I used plural banana’s as from a personal experience watching the consumption of say two banana’s cause they are a favorite. One hardly will make a dent, while two or more per sitting and nothing else, will act much the same as sugary snack. So, in short it is all about moderation and variety (heard that a million times, yes?)
The next important urging that you will hear form me is on the issue of exercise. This too can have a dramatic impact on health, yes, while there can be some sabotage of mental focus, associated with how much, and when we choose to exercise. If our approach to exercise is to take it in one daily large dose, than the drop in blood sugar needs to be curtailed by when and what we eat. Perhaps after exercise would be the best time to indulge that love of bananas, or small and reasonable “treat”. Just like small frequent meals offers stability of blood sugar, the same applies to exercise. Many of the students that I have coached to healthier lifestyles and academic success, who do exercise, appreciate when I share how the “extended periods” of exercise,( more than one hour), can actually work against them. Visiting the other sites I list under New Paradigm, will help illuminate these realities and suggest optimal health strategies. You can also click here.
till next time
BE well,
Dave
Entry three,
The “balance” we need to achieve. There is the fine balance of activity and rest, study and rest, play and rest, and avoiding the impact of too much stress and sense of urgency. Stress, as you have already experienced I am sure, has the potential to sabotage study time and performance on exams and written assignments. Failure to concentrate and anxiety, are not easy to overcome once they set in. Prevention is the only reseasonable “pro-active” approach, Avoiding Procrastination, enhancing time management, and again, maintaining restful, energetic and focused states is essential for optimal performance academically.
It can begin by our approach to “minding” and managing our own brain chemistry. I spoke of the benefits of sound nutritional approaches and exercise, and it goes beyond the aspects of the physical body. With the right amount of sleep, solid consistent avoidance of those things that challenge brain chemistry, and the food and exercise solution, you will perform better and feel better, both on a physical well-being sense,…but also feel better about your grades, and future dreams and goals. It is well reported and written about, in terms the issues that students (some as far back as grade school), who are plagued with anxiety and depression. If you feel that you have been experiencing any level of depression at all, help must be sought. I can suggest here what are some powerful approaches to reducing or eliminating anxiety, but depression can become a chronic debilitating state, not easily resolved. While there are medication approaches that have been effective for many, there are those negative side effects, many have had to contend with as well. You must be treated as an individual “whole person”, working toward resolution of the underlying issues, not just cover them up with medications. Many should not be introduced to the medications that have been responsible for weight gain, or hyperglycemia and potentially Type 2 Diabetes. No one should progress out of depression and anxiety without counseling, life skills education, relaxation training and approaches such as Cognitive Behavioural Therapy, or supportive self-care therapies such as EFT (Emotional Freedom Techniques). Neuro-linguistic Programming has been effectual for many also. Collectively I like to refer to these therapies collectively as Cognitve Conditioning Therapeutics (CCT).
Look for more instruction on the CCT approcahes, deep breathing or meditation here
One of the most highly recommended systems for stress management, healthy living, a powerfully effective form of exercise that I teach is Yoga,…see here.
Hi, welcome to February 10th entry,
Hope you enjoyed the first of many Yoga video’s I intend to post. Second,…thanks for the continued inspiration from all of you. The stress of the ‘newness’ of the semester is starting to let up, and more of you are recognizing that I do care and you can share anything. I wish not to lose any of you over a debate about what is the best approach to life as a student, but rather know from both experience and the fact that I have evolved to be a wellness and quality of life ‘broker’ of sorts. I always critically appraise the info I wish to pass on, and remain evidenced based. This is not to say that I am perfect. I often say that about 80 % of a book you may read, that suggest it is truthful,…is indeed right. It is the critical appraisal that we hope we can see what is the 20% that is wrong. If only I can be right 80% of the time, I will continue to feel good about that,…you can help enlighten me on my 20% error factor…but gently please.
Okay now on with the topic of the week. I have meant to say something here and I have hinted a little, and more than once, my feelings about ingestion of caffiene as a pick me up to keep you alert in clinical or while you study or produce those assignments and papers.
I have been in a ‘weaning phase’ for over a year now, as I was progressively caught up in the enjoyment of the French Vanilla, Mocha’s and English Toffee, as much for the taste as for the “buzz”. There is no question that performance can be enhanced through the additional mental focus,…but, it may come at a very high price if it is a regular activity (daily). The major price is the impact on “quality, restorative” sleep.
As we develop a tolerance, more caffiene is consumed, and the ‘cycle’ begins. Since caffeine impacts the central nervous system, many cells are impact, many glands and organs get stimulated besides the brain. If you relate at all to the previous post on anxiety, than the warning is that much more meaningful. Full blown panic attacks are not pleasant, and with each occurence, it becomes easier to slip into one. They are quite disabling, and I get reports of significant fear that can be attached, Racing heart rates (arrythmias) can be quite detrimental and reflectice of issues with the heart, of may be benign “induction” from caffiene and/or stress. Stress being the reality as it is in school (University especially), we need to do every thing we can to be pro-active (never procrastinate), and practice some relaxation techniques (such as deep breathing or Yoga) and to avoid stress enhancing consumption.
Eat smart,…exercise daily (prefferably in frequent small doses), limit or avoid alcohol,…and avoid/limit or time caffiene consumption for mornings only,…and only mornings where you really need it. The sleep issue is big….I know, I’m really beginning to sound like a nag,…or a parent,…oh yeah,…I am one,…of a nursing student,…Hi Jess.
BE well,
Dave
I will post this here, but it is my hope to change the format somehow, so that students will not have to scroll though the old posts to see what new has been said, but for now,
Wed March 14th post.
This comes after some enlightened reflection,…much of it after reading some of your reflective journaling, they really do have an impact on me. I plan on using the “Dave’s Top Ten” that I have shared with some groups of students while maybe not with others, and I often and not aware who I deliver a certain message to, so I do hope you forgive me for the repeats, if I think I shared something with another group.
I will be rolling these concepts into the course I hope to peddle to the University’s as an elective and a possible consideration as part of core cirriculum.
The title of the course: Person Centred Care: Nurse as Healer
So here is Dave’s Top Ten essential considerations for being the best nurse possible.
1. Mindfulness- cultivating this will completely transform the way you approach your practice. If you do this everything else will fall into place. Be mindful of who you are there for in the clinical setting, it is so not ‘all about you’,… but you are there for the patient, the family and their optimal well-being.
2. Treat every patient (and their family) as if they were as highly esteemed family member. I know you have heard this before, and I often said that I would try to do this consistently. It has returned as my mantra, as this experience with my father has truly and deeply sensitized my feeling that, we should want every outcome for each individual we meet, as much as what outcome we would want for our father or our mother, our child or our spouse. The patient is always someone’s spouse, child, or someone elses parent. Treat the familhy with the same dignity you would show your own family if you all were facing crisis.
3. Wash your hands, Wash your hands, Wash your hands (and sometimes your elbows), and daily our lab coat, jacket and any other garb that was in a clinical area. You pose the threat of being the most infectious agent in the health care setting. We know this stuff, we see the videos at orientation. We do not see the incredible coverage of germs that exist everywhere, including our clothes, our shoes our name badge. We have staph on our bodies and strep in our throats, we know that, and we do not so often ever sense or feel a thing. We are contagious without being sick, and when we do have symptoms probably more so. Recognize that the “superbugs” of MRSA and VRE were incubated and continue to be perpetuated in Health Care facilities,…spread primarily by the employees more than patients themsleves or theri visitors. I trust I can be a better role model than I have been,…please, Wash your hands, wear the gloves, leave all items used (discard) in the room, wash the hands before leaving, that room,…even if you only touched a curtain bed rail or table. We can and will make a difference here, the statics on poor practice are hugely dissapointing,…be a positive role model yourself and do not let others influence you from “doing the right thing”.
4. Know the consequences of medication administration and med errors. This is a significant problem, as was shared by one of the student’s and this was much appreciated (Kudo’s Becky). Kudo’s also to Vicky who was bold enough (and thorough) enough on her paper and presentation of polypharmacy and The BEERS list of drugs that should not be administered to the older population (those over 65). I know it is a challenging position to be in, that there are soooo many medications, and there seems to be a lack of consideration toward following the recommendations of limiting medications that are risky or outright dangerous, and we as nurse are expected to pass out whatever is ordered. Perhaps with greater level of advocacy from nursing and the public, then health policy could change, and/or prescribers will be more concientious about what they are prescibing and to whom. the determinant of health ‘AGE’, is much more of an issue than it seems to be appreciated. Older bodies (health age based on lifestyle choices) should always be recognized to have older kidneys, older livers, older brains in whihc these drugs impact. In presentation of Delerium in the ER or hospitalized older adult we should always consider it way well be effects of medication along with the clinical presentation. Example Atrial Fib equals decreased cardiac output and decreased oxygenation, add anemia,…then drugs to these older oxygen starved kidneys,…devastation,….probable damage, possible death.
5. While of greater importance as you can prevent medication effects, by not giving them when not necessary, I post this after I suggest the ultimate possibility of drugs is death, I give you this as your first consideration for every clinical presentation.
Institute any and all non-drug interventions before turning to drugs!
Case in point is the application of a temperary pacer in the ER when someone is bradycardic and with a low blood pressure. You cannot get the drug back once ingested or injected and there is always a possiblity of allergic response, adverse effects (such as lower blood pressure further, or stimulating the heart to beat too fast). So the Valsava Maneuver should be known be all, that purse liped breathing coached can facilitate increased oxygenation in COPD, for Labour, For those that whould not bear down for a bowel movement, to the Heart Failure patient getting up out of bed or exercising to any degree,…and it decreases pain perception and reduces anxiety. Think prevention,…be pro-active, before the choice of being a drug pusher.
6. Healing intent: To be a healer you need to think as a healer, the therapeutic use of self applies here. I know th e realities of nursing as much as anyone. There is the time to touch an arm, hold a hand, evev for a moment. Make time to connect with the patient and family. Talikng and other forms of communication such as touch can have huge healing potential,…think back about if this was your mother, or your father, you child,…what would you want other to do for your loved ones. Demonstrating genuine love and caring,…think of (read up on it if necessary) Jean Watsons ten carative factors,…altruistic Caring-healing,…and more ( I’ll post at another time). No greater calling, nurse as healer.
7. Heal thyself - before you can be good for anyone else, you have to be good to yourself and for yourself. You must find and practice self-love and travel the journey to which you will be well, loving and available in the best condition that you can ever possbily do for yourself. We are to follow Florence Nightingales advice to “put the patient( and the environment) in the best condition for nature to act upon”, and this applies to us also. We must advocate for a positive emotional environment (and culture) as well as focus on healthy life ways, (healthy eating, daily exercise, smoke free (inclusive of second-hand smoke)…you know all of this. I will soon be offering a video “Yoga for Nurses”, which will be inclusive of principles of healthy body mechanics,…and partnership to a healthy back,…many hands make light work,…and there is always the mechanical lift,…etc.
8. Relationship Building, this applies to the team work as mentions and the positive culture and connecting with patients and family, but applies to one’s personal life also. We are happier and healthier with strong healty relationships. Healthy relationships to food, to the natural world, to pets, the environment and and even to management/administration. Our attitude toward people begin, from the inside, and it is our inner environment that has the greatest potential of health, healing or harm. Invest in time, books, counselling, coaching or courses on how to be a relationship expert. This is so very important to lay a strong healthy foundation, history and legacy upon.
While it may be a challenge to convince others that I am a relationship expert, I give you this simple reflection. Was I to expect the best grade possible from a teacher to whom I did not have a positive relationship with, or to whom I did not demonstrate respect, of to whom I did not seem to care what they had to say,…not! Think about it, this applies to any person in your life.
9. Along the same stream Attitude, is it one of service to others and intent to positive personal development or is it an attitude, “they owe me something”… “I expect gratitude…and a better paycheque.”
Examine what are you thoughts, beliefs and values,…are you mostly a positive person,…to what degree and how often are you negative. Do you have the insight to appreciate how your attitude and everything you choose to say has an impact either mostly positive or mostly negative, in most any situation.
Wear a smile,…less muscles used than a frown, and people will like you, and you have healing potential with a smile, not so with a frown.
10. I am going to reflect on this and be open to the suggestion of others, you could be a student or you could be a nurse or you could be anyone who has ventured onto this site,,….but do submit your suggestion(s) under comment below.
Thanks Dave
Hi, its November 26…one month from “Boxing Day” and if you are like most…consider the “SALES” events of the year…before the New Year ushers in and along with that another ritual…New Years Resolution.
Well I can not wait for the New Year to share “predictions” of things to come…and how they may effect you, or what you may “resolutely” decide is an area of interest and further study.
So I give you this site…and many more to come…please consider the HUGE role nursing needs to play in Pharmotoxicology, Pharmo-pathology and advocates for the ever neglected and dismissed BEERS list.
and conceptualize all the negative outcomes of what we thought were “therapeutic choices”. Only an “informed choice” should be considered ethical, further, how many kids, and unsuspecting “patients” with mental illness and/or disabling conditions such as autism and developmental challenges get put on meds to “control” behaviour that is deemed unacceptable to society, to teachers or to parents and family members.
So, please investigate and study neuroleptic syndrome, serotonin syndrome and what I have provided previously on polypharmacy, psychoneuroendocrinology and psychoneuroimmunology…and make the important and “critical” connections…
Dave