Upstream Thinking

It wasn't long after I started my classes that I was introduced to the term 'upstream thinking'. We were told that as nurses, we must be 'upstream thinkers' and we all nodded our heads, pretending that we knew what the instructors were talking about. Finally, my Health and Healing teacher explained the term last week, and I can now totally understand why this term is used so much. It's important!

I'll explain to you what upstream thinking is the same way our teacher taught us last week:

Imagine a flourishing little village of happy indians that live on the side of great big river. Their lives are very simple and easy. The land they live on is lush and bountiful, they hunt and gather for their food and there is never a shortage. Everyone is happy.

Then one day, as the villagers were each going about their daily activities, they heard frantic cries from the water, and they all ran to the bank of the river just in time to see a small drowning child being swept along by the current! The entire village mounted a big rescue party. Running down stream, the men were able to grab the child before he went over the edge of the water fall. Whew!

Well, after this incident, it wasn't long until the very same thing happened again a week later. All the villagers were drawn to the river bank by the frantic screaming of a little girl, unable to escape the fast water. Again, the village went after the child and were able to snatch her out of the water just in time.

Again and again each week this same event occurred. The peaceful, worry-free lives of the villagers was disturbed by desperate attempts to save children that were drowning in the river. Some of the time they were successful in their mission, but other times they heard the cries too late and the little boys and girls went tumbling over the waterfall to their deaths.

This went on for so many years that nobody in the village could remember a time when their lives were peaceful and they didn't have to worry about saving children from the river. But they never gave up, and always went after the kids in need.

Finally, one day after a failed attempt to save a small boy, one young man that was very troubled by the event sat down to think about the village's woes. Then he asked a question that no one had ever asked before:

"Where are these children coming from?"

That question caused quite a stir. No one had ever thought to try and find the source of the children! So the village formed a search party, and the group of strong men went off up river in search of the place the children came from. After many days of hiking through the rugged forest, they came to a village much like theirs and saw there that the villagers let their children play much to close to the slippery bank of the river, and that the same boys and girls were slipping and falling into the water. The men quickly sought out the chief of the village and explained the situation to him. He was shocked! For many years the children in their village had been going mysteriously missing and no one could discover where they went. The chief fixed the problem immediately and built a wall beside the slippery river side so that the children would no longer fall in.

The men returned home and delivered the good news. Everyone was happy again and the village could return to their simple, carefree lives again.

This is a long story to explain a simple truth. Nurses must be like the young man that thought to ask, "Where are the children coming from?" Instead of just treating the problems again and again and again, we have to ask, "Why is this problem occurring?" because maybe if we do, we can stop the problem before it happens. That's upstream thinking.

AN EXAMPLE:

Bobby has an infected arm.

-Why?

Because he got a cut on his arm and it got infected

-How did he get the cut?

He was playing in the junk yard and he fell on a piece of jagged scrap metal.

-Why was he playing in the junk yard?

Because it's close to his house and he and his friends go there often to play together, unattended.

-Why is there a junk yard to close to his house? Why is there no one to watch Bobby and his friends?

Bobby lives in a low income neighborhood of mostly single, working parents that are jut getting by. His mother works 2 jobs and can barely make ends meet, like the other parents in the neighborhood.

By going to the source of the problem, nurses can be advocates for change in their communities. They can see problems and raise their voices for the people that don't have a voice.

Interesting, isn't it? Does the concept make sense to you?

To know yourself

On the first day of classes, all us first year nursing students (192 of us) were gathered on the field listening to the head of the department talk about the next four years of our lives. Among other things, she said something along the lines of, "In this first year it's going to seem like all you're doing is talking about your feelings, but there's a reason for this! For the first year you have to learn how to take care of yourself, then you can learn how to take care of other people." Hearing her say that made me feel really excited. I love talking about my feelings! And I could definitely see the truth in what she said.... couldn't wait.

My first class, on my first day, was a class called Nursing Practice. I walked in a tiny bit late (with an excuse that's too long to explain here) and instead of the expected rows of desks and chairs found myself in a brightly painted burgundy room with a circle of chairs in the middle, mostly already filled by my classmates. That class was 3 hours long and how did we spend that time? That's right - talking about our feelings. There was 16 of us, and we went around in a circle and we shared about ourselves: our interests, likes/dislikes, hobbies, reasons for going into nursing. And then we talked about what we were worried or nervous about, what we were excited for, our dreams and hopes. 3 hours. Talking. It was glorious.

Then, later that same week, I went for the first time to my RP class - Relational Practice. This is an entire class devoted to the sole purpose of teaching us how to have good relationships. Our course outline says that the goal of the course is to learn to know ourselves, and ourselves in relation to others, and that our objective in the class is to become more caring people. Better people. It seems like a dream come true... and the instructor is amazing.

And so this theme has carried on through the last 2 weeks that I've been back at school. In every class we take the first 20 minutes and go around in a circle to share about how we are each feeling and what our stress level is, etc. In my RP class she asked us to tell the group what kind of weather we were that day (I said sunny with a chance of showers in the afternoon). There really is a big emphasis on being mindful of yourself and testing what you believe and digging deep down into yourself for feelings and then talking about them with the class. It's cool, and I've enjoyed it... uuuuntil..... Wednesday. Wednesday I had my Professional Practice class, which was lovely and informative, and at the end of which we were given a journalling assignment (Did I mention that we have to keep a journal? Oh yes, it's so that we can write about our feelings and express ourselves :D ). The questions we had to write about was this: Why is it important to know yourself in order to be a good nurse?

Well, this got me thinking. Sure, I've been enjoying all this me, me, me stuff but I haven't had to think about why we're doing it yet! And as I sat down tonight, with a crisp new journal page before me, I couldn't think of anything to write. And let me be clear, this is not usually a problem for me. It took me a while before I could start writing, but once I did the words just kept coming. What a relief.

Why is it important to know yourself in order to be a good nurse? For me it became easier to answer when I made this questions a bit broader. Why is it important to know yourself in order to be in any relationship? It goes back to what the head of our department said on that first day - in order to be able to take care of other people, we must first know how to take care of ourselves. I think that can apply to more than just the physical, but the emotional, social, and spiritual as well. It's hard to be in any intimate relationship when you are unstable in some way.

In the profession I'm going into, I'll be seeing a lot of, well, troublesome things.

It could be something like cardiac arrest, in which case I will have to be strong both physically (performing life-saving procedures) and emotionally (staying cool and calm in high stress and pressure situations).

Or it could be something like a terminal cancer patient making the decision to leave treatment and live their last few months in their garden at home. I may feel that they are giving up and should stay and fight with the chance the radiation therapy will work, or grieved that this person is going to die. If I am not healthy emotionally in all this, I could burn out and grow depressed, etc.

In a job where I will always (potentially) be surrounded with death and sickness and horrible things happening to good people, a spiritual health is important as well. Leaning on God as my support and trusting in His divine plan will be an invaluable comfort to be in distressing times.

How do we become 'strong' in all these ways? I think it's by getting to know ourselves by questioning our assumptions, testing our beliefs, going where things feel uncomfortable. It's after we've done all these things that we really know what it is that's important to us. When we really know who we are and we're secure in that.

Hopefully that makes sense. Don't worry, my journal entry is much more clear and concise.

My Schedule (just so you all can sympathize)

MONDAY:
Anatomy & Physiology - 8:30-10:00
English Composition - 10:00-11:30
Nursing Health and Healing - 12:30-3:30

TUESDAY:
Nursing Resource Center - 8:30-11:30
Nursing Practice - 12:30-2:30
Praxis - 2:30-4:20

WEDNESDAY:
Nursing Professional Practice - 8:30-11:30
Anatomy and Physiology - 1:00-2:30
English Composition - 4:00-5:30

THURSDAY:
Nursing Relational Practice - 8:30-11:30

FRIDAY:
Anatomy and Physiology - 8:30-11:30


Brutal, hey? And where exactly do fun and relaxation fit in? How about time for exercise or enjoyable activities? Guess not... oh well, maybe in 4 years.

A little bit of panic

So here I am, midway through the second week, and I already feel like I've been doing this forever. I'm tired, and drained emotionally... and mostly I'm just really stressed. The first week's homework just kept building over the week and climaxed with my 3 hour Biology lecture on Friday where the prof dumped 3 quizzes, a pre-lab, and a worksheet on us for the following week. My weekend was spent cooking dinner for my over-worked boyfriend and plugging away at hours of reading. Sunday night I was up until 1:00 am finishing up the Bio homework for the next morning... and that was just week #1!! It can only build from here, right? Sick.
Well, Sunday and Monday (and the beginning of Tuesday) were spent thinking my life had ended and there was simply no way anyone could keep up with the work load of 7 full-time courses. Whenever I tell fellow classmates or friends about the number of courses I'm taking they gasp in shock and shake their heads in horrified sympathy. I was grumpy and depressed and distracted. Well, I still am. But in the last day and a half I think I've managed to shift into a slightly better frame of mind. Sure, the sheer magnitude of the amount of homework I have is overwhelmingly impossible to complete... but I can only do my best, right? There's no point in obsessing over the things I can't get done as long as I'm working to the best of my ability all the time and giving it my everything (which is all I have to give, so it had better be enough). Know what I mean?
My last class today was Biology (which is by FAR my more difficult - anatomy and physiology, dont cha know)and everytime I've come out of that class previously I've felt burdened and panicked... today was different. At the beginning of class we had a vocabulary quiz for which I had studied tremendously hard and I got PERFECT! This put me in a much better mood... and then at the end of class the instructor was handing back our worksheets and he held up mine for everyone to see, praising it's detailed diagrams and excellent coverage of the topic. He did this anonymously, of course, but I knew that it was mine and that's all that mattered. I left feeling great :)

So, all this to say, that it looks like I'm going to make it. I've realized that when everyone said that Nursing school is deadly difficult, they weren't joking and I'm no exception. It's tough... really tough. But the material is so interesting, and I love the people in my program and my teachers and the whole concept of nursing. There's no doubt that nursing is for me... now it's just the work load I need to figure out.

Until next time,
Brittany

An introduction

Hi there! My name's Brittany... this is my blog. Let me tell you a little about myself so you know whether or not you're interested in reading on: I live in British Columbia, Canada, on a little rainy island off the mainland. I'm 19 and live at home with my parents and younger brother, all of whom are amazing. Lastly, I'm a nursing student. Wow, that's still a thrill to say... you see, I just finished my first week of classes and so everything is still new and slightly confusing, but wonderful. Nursing is what I've wanted to do for years. There was always some indecision about whether it should be nursing or social work/counseling but Nursing won out in the end when I was accepted to the program at a community college close to where I live. Perfect.

Why am I writing this? Because I want to share what's going on in my life. Partially, it's for my family. We all live in different places and don't get the chance to talk that often, so I thought having a website full of updates on my life would keep them in the loop. Partially, it's for anyone out there that's thinking about going in to nursing, or is in nursing already that wants to hear that other people are going through what they are, or meet someone similar to themselves.

Whoever you are, wherever you're living, you are welcome to read this, even to comment because I just love comments. My program is 4 years long, and I've got one week done. Yikes... but they tell me that it flies by. I hope they're right :) I plan to keep this blog faithfully during my time in schooling, just how regular my posts will be has yet to be seen.

Thanks and happy blogging!