Compare and contrast Hartrick Doane and Varcoe’s (2015) perspective of ‘nursing action’ in relation to Ebright’s (2003) perspective of ‘invisible nursing work,’

To strengthen early in the discussion, identify and define the lens you will use to analyze the data, it will anchor the discussion.

Thoughtful analysis, with careful attention to the principles, to strengthen make the connection between with the underlying professional standard/guideline, just be a little specific, actually demarcating your discussion with a subheading

Unfolding Stories of Covid-19

Within the hospital Doors:

An unnamed RN caring for patients with Covid-19 in a Toronto ICU speaking to a journalist, summarized her experience of caring for Covid-19 ICU patients:

I have to remind myself that it’s a person I’m dealing with but when they’re paralyzed and sedated and ventilated, with no family there it’s more difficult. (Knowing the patient and family) grounds me, centers me, reminds me why I became a nurse. To treat the person, not necessarily the disease. Now every patient is the disease and we can’t talk to family members. It’s that much harder (Arthur, 2002).

Beyond the Hospital Doors [Note you have been provided hyperlinks only as part of electronic referencing. To answer any question, refer only to the short summary below].

The Epidemiological Landscape: Covid-19 has impacted all aspects of people’s lives, across geographical and social/economic stratifications. By early spring, Canadian researchers in the fields of epidemiology and public health were releasing reports about the statistical outcomes of Covid-19 broadly in Canadian society. Chung et al., (2020), found that the most susceptible people to Covid-19 in Canada live in lower income neighbourhoods, frequently living in multiple family dwellings, and/or people with precarious housing. Frequently working in lower income jobs where social distancing is difficult. Furthermore, in areas with higher concentrations of immigrants and visible minorities. From a physiological perspective, people with higher rates of stress related illness (i.e.: high blood pressure, diabetes, cardiovascular disease) are at greater risk (Chung et al., 2020).

On the Ground of ‘Epidemiological Landscape’: Journalists Shingler and Stevenson (2020) reported that the borough of Montreal-Nord, had some of the highest numbers of confirmed Covid-19 cases in Montreal in May, and was referred to as “the epicentre of the pandemic in Canada.” The journalists note that the borough of Montreal-Nord is further characterized as a poor district with a median income of $23412 and an unemployment rate between three and five points higher than the rest of the island (Shingler & Steveons, 2020, May 15). Nicholas King a professor at McGill University in Montreal, an ethicist in public health policy, reflected he was not surprized, given Montreal-Nord residents work in jobs where “they are likely to be exposed to illness-stocking shelves or working with cash register in grocery stores, or at the bottom rung of the health-care sector, as orderlies and cleaners” (Shingler & Stevenson, 2020, May 15).

Dr. Amy Tan is a family physician in northeast Calgary and her concerns lie with supporting marginalized populations (Lee, May 12, 2020).

“I really want to ensure that people feel, in fact, safe to go to work… and that they’re able to voice their concerns.” (Tan quoted in Lee, 2020, May 12).

Note it is unclear how people like personal support workers, cleaners working in clinical areas are being tracked. Subsequently, Dr.Tan is writing notes to employers advocating for “patient’s rights to everything from personal protective equipment to proper distance rules” (Tan quoted in Lee, 2020, May 12).

Insights from Indigenous Physicians and Researchers: In Indigenous communities, Dr. Cornelia Wieman (psychiatrist) originally from Little Grand Rapids First Nations in Manitoba, stressed Indigenous communities have been shaped by Canada’s colonial practices (i.e.: Indian Act, Treaties) as evidenced by the impact of intergenerational trauma, increasing the vulnerability of Indigenous communities in moments like Covid-19—

Historically we have been harmed quiet significantly by pandemics in the past. So, theres this natural kind of anxiety about thatWeve had obviously a tragic history in Canada with the residential schools experience and ongoing colonialism like the Missing and Murdered Indigenous Women and Girls and the child welfare issues (Wieman cited in Forester, 2020, March, 26).

Ann Seymour a Ph.D. student, Social work and Indigenous Peoples at Carleton University challenges that while the federal government targeted $305 million Covid-19 package is needed short-term relief, the funding does not address the pre-existing system gaps:

Many Indigenous remote communities are without clean running water, safe affordable housing, education, health and robust economy that support a quality of life. In some remote Indigenous communities, there is a lack of infrastructure, mobility and accessibility to medical care (Seymour, 2020, April, 22).

Family physician Dr. Tanyi-Remarck, practicing in La Loche Saskatchewan’s Covid 19 ‘ground zero’(151 of the 199 total cases in Saskatchewan), notes community health is ‘hard and emotional work’ and requiring ‘compassion and love’ for people (Tanyi-Remarck quoted in Warick, 2020, May 12):

“We must plant seeds that will grow strong roots and bear fruit on all fronts: poverty, mental health and everything” (Tanyi-Remarck quoted in Warick, 2020, May 12). “This is a community that’s gone through quiet, a few different types of trauma. But this is also a community with a powerful culture. We have to be able to break down barriers” (Tanyi-Remarck quoted in Warick, 2020, May 12):

On the Ground of Long-Term Care: Based on the 2016 census, 425, 755 Canadians live in LTC or retirement homes and/or assisted living facilities, it is estimated between 6156–6519 (1.5%) are positive for Covid-19 and 1240 have died of Covid-19, LTC residents account for 16% of Covid-19 cases in Canada (Hsu & Lane, 2020). Ontario has the 2nd highest number of confirmed cases within LTC settings, with a case fatality rate between 15-29% compared to the over-all fatality rate of 4.9% (Hsu & Lane). The rapid spread of Covid-19 cases in Canada’s LTC facilities “highlights pre-existing and systemic issues” such as “shared accommodations and understaffing,” and “slow implementation of effective infection control” combined with system issues “chronic underfunding to the sector” in relation to the complex health needs of LTC residents who struggle often with multiple chronic diseases: heart/lung, vascular, neurological and endocrine like diabetes (Hsu & Lane, 2020, p. 12).  

References

Arthur, B. (2020, May 18).  Some ICU doctors and nurses are feeling fragile: numbed by Covid-19, tired of death. Toronto Star. https://www.thestar.com/opinion/star-columnists/2020/05/18/some-icu-doctors-and-nurses-are-feeling-fragile-numbed-by-covid-19-tired-of-death.html

Chung, H., Fung, K., Ferreira-Legere, L.E., Chen, B., Ishiguro, L., Kalappa, G., Gozdyra, P., Campbell, T., Paterson, J.M., Bronskill, S.E., Kwong, J.C., Guttmann, A., Azimaee, M., Vermeulen, M. J., Schull, M. J. COVID-19 Laboratory Testing In Ontario: Patterns of Testing and Characteristics of Individuals Tested, as of April 30, 2020. Toronto, ON: ICES; 2020.

Forester, B. (2020, Mar 26). “Stay calm and move forward’: Indigenous doctors on strength, resilience in the face of pandemics.” aptn National News. https://www.aptnnews.ca/national-news/stay-calm-and-move-forward-indigenous-doctors-on-strength-resilience-in-the-face-of-pandemics/

Hsu, A. T., & Lane, N. (2020). Impact of COVID-19 on residents of Canada’s long-term care homes—ongoing challenges and policy response. Report in LTCcovid.org, International Long-Term Care Policy Network, CPEC-LSR, 23 April 2020. https://ltccovid.org/2020/04/15/impact-of-covid-19-on-residents-of-canadas-long-term-care-homes-ongoing-challenges-and-policy-response/

Lee, J. (2020, May 12). Calgary doctor worries about vulnerable workers as some businesses prepare to reopen. CBC News. https://www.cbc.ca/news/canada/calgary/reopening-1.5565623

Seymour, A. M. (2020, April, 22). Canada’s unequal health system may make remote Indigenous communities more vulnerable to the coronavirus. The Conversation. https://theconversation.com/canadas-unequal-health-system-may-make-remote-indigenous-communities-more-vulnerable-to-the-coronavirus-134963

Shingler, B., & Stevenson, V. COVID-19’s devastating toll on families in Montreal’s poorest neighbourhoods. (2020, May 15). CBC News. https://www.cbc.ca/news/canada/montreal/montreal-low-income-inequality-covid-19-1.5570296

Warick, J. (2020, May, 12). La Loche doctor describes working in Sask.’s Covid-19 epicentre as ‘hard, emotional work’.  CBC News. https://www.cbc.ca/news/canada/saskatoon/la-loche-saskatchewan-doctor-coronavirus-q-and-a-1.5564962

Short Writing Assignment 1 (300 words): Re-Thinking Transitioning

The following quote came from an unnamed RN caring for patients with Covid-19 in a Toronto ICU:

I have to remind myself that it’s a person I’m dealing with but when they’re paralyzed and sedated and ventilated, with no family there it’s more difficult. (Knowing the patient and family) grounds me, centers me, reminds me why I became a nurse. To treat the person, not necessarily the disease. Now every patient is the disease and we can’t talk to family members. It’s that much harder (Arthur, 2002).

We know little about the unnamed nurse, but the RN has some experience working in the ICU unit.

Directions: Using Judy Boychuk Duchscher and Maryann Windey’s (2018) Stages of Transition and Transition Shock analyze the above quote. Even though the nurse is not transitioning into a new role, she is transitioning in response to the change Covid-19 brings to the ICU environment, and thus the practice of nurses, patients, and families. Thus, Boychuck Duchsher and Windey’s writings are informative. Be very critical about what aspects of the article authors discussion of ‘knowing’ that you apply to your analysis of the unnamed nurse (resist the superficial).

Question:  What can the unnamed nurse’s short statement about nursing practice, tell newly graduate nurses about ‘knowing’.

Reference

Arthur, B. (2020, May 18).  Some ICU doctors and nurses are feeling fragile: numbed by Covid-19, tired of death. Toronto Star. https://www.thestar.com/opinion/star-columnists/2020/05/18/some-icu-doctors-and-nurses-are-feeling-fragile-numbed-by-covid-19-tired-of-death.html

Boychuk Duchscher, J., & Windey, M. (2018). Stages of transition and transition shock. Journal for Nurses in Professional Development, 28 (4), 228-232. doi: 10.1097/NND.0000000000000461

Short Answer Assignment 2 (300 words): Re-thinking Nursing Action and the Invisible Work of RNs

Holding on to the unnamed RNs reflection on caring for Covid-19 patients in a Toronto ICU:

I have to remind myself that it’s a person I’m dealing with but when they’re paralyzed and sedated and ventilated, with no family there it’s more difficult. (Knowing the patient and family) grounds me, centers me, reminds me why I became a nurse. To treat the person, not necessarily the disease. Now every patient is the disease and we can’t talk to family members. It’s that much harder (Arthur, 2002).

The Lakehead University School of Nursing Curriculum is based on relational inquiry as articulated by Gweneth Hartrick Doane and Colleen Varcoe. These authors, view inquiry as a form of action, it is an active process of navigating, mediating, and decision making:

Hartrick Doane and Varcoe’s understanding of inquiry as a form of action is premised on Paterson and Zderad’s (1976) simple explanation of nursing as “an experience lived between human beings” (p. 3) that encompasses the active ways in which nurses ‘be, do, and know’ nursing (Hartrick Doane & Varcoe 2015, cited in Spadoni, 2020, p. 12).

Patricia Ebright (2003) using the language—“the invisible work of nurses.”

Directions: Compare and contrast Hartrick Doane and Varcoe’s  (2015) perspective of ‘nursing action’ in relation to Ebright’s (2003) perspective of ‘invisible nursing work,’

Question: How do these two-author’s work further enlighten the unnamed RN’s expression of caring for Covid-19 ICU patients?

References

Arthur, B. (2020, May 18).  Some ICU doctors and nurses are feeling fragile: numbed by Covid-19, tired of death. Toronto Star. https://www.thestar.com/opinion/star-columnists/2020/05/18/some-icu-doctors-and-nurses-are-feeling-fragile-numbed-by-covid-19-tired-of-death.html

Spadoni, M. (2020). N4050 Nursing Leadership Learner Manual Fall 2020. Author.  Unpublished Gray Paper.

Ebright, P. R. (2003). The complex work of RNs: Implications for healthy work environments. The online Journal of Issues in Nursing 15 (1), Manuscript 4.

Short Answer Assignment 3 (300 words): Re-thinking ‘Power’ in Nursing

Once more consider the unnamed RNs summation of caring for a Covid-19 patient in ICU

I have to remind myself that it’s a person I’m dealing with but when they’re paralyzed and sedated and ventilated, with no family there it’s more difficult. (Knowing the patient and family) grounds me, centers me, reminds me why I became a nurse. To treat the person, not necessarily the disease. Now every patient is the disease and we can’t talk to family members. It’s that much harder (Arthur, 2002).

Directions: Although, Schoales’ and colleagues (2018) focus on power was with Advanced Practice Nurses’ (APNs). Cathy Schoales’ in our class together, emphasized that [we] as BScN prepared RNs have power as well. Be very specific, about which aspect of Cathy’s discussion best fits the unnamed ICU nurses’ reflection when answering the question.

Question: Consider, the unnamed RN’s experience of caring for patients with Covid-19: What specific aspect of Cathy’s research findings help further understand the RNs reflections of caring for Covid-19 patients in the ICU, specifically, how in the RNs reflection does the RNs power arise?

References:

Arthur, B. (2020, May 18).  Some ICU doctors and nurses are feeling fragile: numbed by Covid-19, tired of death. Toronto Star. https://www.thestar.com/opinion/star-columnists/2020/05/18/some-icu-doctors-and-nurses-are-feeling-fragile-numbed-by-covid-19-tired-of-death.html

Schoales, C. A., Fothergill Bourbonnais, F., & Rashotte, J. (2018). Building to make a difference: Advanced Practice Nurses’ experience of power. Research and Theory for Nursing Practice: An International Journal, 32 (1), 96-116. doi.org/10.1891/0000-000Y.32.1.96

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