I embarked on this project because I was convinced that nursing students need to learn how to write, not only within the discipline of nursing with its particular limitations, but also to learn to write creatively, to explore their ideas and understanding of the world, to gain the confidence to be able to express themselves in a public and a private voice. We hear so little about the experiences of nurses, and they often feel unable to contribute to public discourse, or are passed over for more confident or outspoken health care colleagues. From early on nursing students need to learn to value their experiences, to value the subtlety of the interactions they have with people at often vulnerable times in their lives, to value their very particular knowledge as nurses, and to value their own reflections on the small details of the very human and intimate communications they have with patients and families. The WAC/WID project I hope will help students to feel more comfortable holding a pen in hand and writing down their thoughts and growing understanding of human nature and function, but also of themselves. The more we can encourage them to write, the easier it will become for them, and the more legitimate this form of expression will be to them.
The aspect that I had not anticipated as part of this project but which has been a big preoccupation in my teaching is that of helping students to read difficult texts. Our students have a notoriously vast amount of reading to do, and huge range of diseases and conditions to learn about. They not only have to become familiar with the physiology and biology of human beings, but also to be comfortable in their understanding of human development and the human mind in all its idiosyncrasies. If I can help them find ways to draw meaning from their readings, but also improve my own understanding of what kind of readings can be most useful, then that will be a major accomplishment in this project.
B. Informal Exploratory Writing Reading Difficult Texts I:
This was an assignment I posted to students prior to their class on Environmental Hazards. It seems to be quite common that students do not do the readings prior to class. There is no textbook chapter that relates to this class, and so I chose an article that seemed to give them some of the ideas I wished to convey about the role the nurse might have in incorporating environmental health into their practice, as well as giving some good information about vulnerabilities of children in relation to environmental health hazards, and discussion of 3 particular health hazards in the home, and how the nurse worked with a family to reduce exposure to these hazards. There was also a Powerpoint presentation by my guest speaker about Lead exposures and children’s health that I posted prior to class for them to review, and to download to help them in note-taking during class.
This was not a successful assignment, as not all students looked at the Moodle/Lea site prior to class. I will however try this again, and try to ensure that all students receive this assignment well in advance of the class. I could take class time at the beginning for students to do the writing as an alternative to having them post it in a forum, but I would like to try again to see if I would have more success next year, when students are more used to this type of idea. If students posted to the forum, there could be discussion via the forum, and some discussion in class.
Reading Difficult Texts II:
This was an assignment that I tried in order to help students do the readings for a class on Diabetes. The readings from their textbook were pre-assigned in the course outline. It is often the case that students do not do the readings ahead of class. I try to focus the readings on what is most crucial, but this time I thought that I would ask the students to read and to write questions based on what they considered to be important in understanding Type 1 Diabetes in children and adolescents. This was a successful activity as a first attempt. There were 14 students out of 30 who posted questions. During the class I presented half of the questions which we did together as a ‘pre-test’ (I provided the correct answers), and at the end of the class we covered the remaining questions as a ‘post-test’. At the beginning of the class there was a mixed reaction as to whether this was a useful exercise, but at the end students seemed to have enjoyed the process, and found it to be helpful. Another class could also provide potential for this, as seen below.
C. Formal Assignment: Nursing Care Plan
This is one of the 2 formal assignments used during the paediatrics rotation. Students complete one of these assignments based on their clinical experience in the hospital. They have one patient (and family) to care for, and in this assignment which is based on the Orem model of Nursing, they need to find out background information about the child and family (Basic Conditioning Factors), as well as medical information, and they need to organise a plan of care based on the child’s developmental level. A major focus of the paediatrics rotation is to understand growth and development in children from infancy through adolescence. They must think about what the developmental needs are in their patient in relation to their illness and hospitalisation, and created a plan of care that aims at meeting these needs. The plan is based on the Nursing Process which is the universal process applied when organising nursing care. It is composed of 4 steps: Assessment, Planning, Intervention and Evaluation.
D. Nurses Care about Writing: The Dawson Nursing Literary Competition
For some time an idea had been germinating in my mind as I thought about my students and the drive that I so often saw in them to care for others, in the beauty of their sense of purpose in doing so, and in the optimism I felt in observing this. In working closely with students in both the clinical area and at the college I observed their struggles in gathering the skills they needed to match their ambitions, and in combating their emotional and spiritual distress at seeing patients in moments of crisis. The dichotomy between the experiences these students were having, and the popular perception of nursing was striking. These very real and meaningful experiences were so different to how nursing is so often portrayed in the popular media. Nursing is often overshadowed in the rigid hierarchy of our health care system, and suffers even more from a poor image created through false media portrayals.
As our department underwent its own reflections on revision, it seemed an opportune time to give a new forum for students to tell their stories. As a result, a new committee in January 2009 was formed. The Dawson student nursing writing committee, composed of both nursing and English faculty met together with a common purpose: to find the way to give our nursing students the opportunity to create their personal narrative about their real life experiences as student nurses in the clinical setting. It was decided to start a creative writing competition for the nursing students so we could encourage them to undertake a very different form of expression than is typically demanded of them in their science-based formal assignments. This competition would solicit student creative writing in order to encourage their writing skills, their literary expression and to provoke reflection on the art of nursing. We wanted to give students a voice and give meaning and validation to themselves as nursing students but also in some small way to bring a greater understanding of the profession to a wider audience.
We held a public launch event in the department with refreshments and 2 short readings from well-known nurse authors, and invited all student nurses to apply. We also unveiled the competition poster that detailed the process of application. Thanks to the support of the Student Success we were able to offer monetary prizes for winning entries, as well as book prizes from Paragraph Books and Nicholas Hoare, and to our great satisfaction we received 11 entries, a mix of prose and poetry. The only small cloud on our horizon was the lack of a single entry from first year students, possibly deterred by our overambitious specifications (namely asking for APA format). The next step was to choose the winning entries. This was done through an initial individual judging process, and then a second collective discussion. All entries were judged ‘blind’, so the identity of the student was not known. Winners were proclaimed for first and second prize, and a decision was also made for an unorthodox entry which we felt deserved special status for its cleverness and humorous look at the ‘Osces’ i.e. our clinical exams. Prize certificates were presented to students at the end of the Academic year attended by all faculty, as well as our department dean and Academic dean of the College.
This was not the end however…and in fact one of the most rewarding and exciting aspects of the prize was the process of collaboration we undertook with Fine Arts to produce a booklet of submissions. It was strongly felt that we must include all entries in the booklet with the descriptions of significant moments, of empathy, compassion, and humour. The result was a stunning booklet of artwork from Fine Arts students interspersed with nursing student writings. Did we accomplish our goal? Yes even more than we had expected. We have the tangible evidence in our hands that given the opportunity, our students will participate in a creative writing project, and as we prepare for our second next year I feel immensely proud of the accomplishments that this booklet signifies and the collaborative process that helped bring it to fruition.
E. Writing, Critical Thinking and Nursing: An Introduction
A Powerpoint presentation by Fiona Hanley and Mary Puddington created for the Dawson Ped Day, Oct. 2010.