Nursing workforce planning when everyone has a nursing shortage…

For quite some time academics have been predicting a severe nursing shortage in Canada and around the world. This was delayed because of the economic crisis of 2008 which caused many nurses to delay retirement and keep working. Unfortunately, our population has continued to get sicker and older and efforts to address the predicted shortage have fallen short. As a result we are now in the midst of the exact circumstances we were warned about: We don’t have enough registered nurses and those we do have are often working short-staffed and overtime. In some places it’s even become a challenge to schedule vacations because there just isn’t anyone to cover.

So how to solve the problem?

Option 1: Train more nurses. Considerations: nurses need full-time jobs when they graduate and governments and universities need to invest in nursing education (including hiring more educators for more students).

Option 2: Recruit nurses from other places. Considerations: Taking nurses away from places that also have a nursing shortage is unethical, not all nursing education is equal, and the process to get registered and licensed in Canada can take a couple years. In addition, bringing over foreign nurses to work below their scope of practice as personal care workers until they complete the process (if they can) is completely unethical.

Option 3: Let all nurses work to their full scope of practice (optimize use of health human resources). Considerations: In Northern and remote areas of Canada RNs are able to work to their full scope but in many hospitals and other health care organizations they work below their scope. For example, nurses have the expertise to assess wounds and make decisions about dressing changes but in some hospitals they need an order from a physician to make any changes. We are seeing LPNs (and RPNs in Ontario) starting to work more up to their full scope of practice which is great but all nurses should work to their full scope of practice. Appropriate staff mix is also essential (example: the ratio of RNs and LPNs should be different on different units).

Option 4: Health promotion and prevention (invest in public health and address social determinants of health). Heaven forbid we actually slow the flow of patients that need nursing care in the first place…but addressing the root causes of illness and disease would go a long way to decreasing use of the health care system in the long term.


Postdoctoral Fellowship Opportunity

Postdoctoral Research Fellowship in Health Technology and Seniors’ Care Innovation in partnership with CAHBI and NBHRF


The Institute of Biomedical Engineering (IBME) at the University of New Brunswick (UNB) is pleased to invite applications for a post-doctoral research fellowship position in health technology and senior’s care innovation. This position is supported by a research grant obtained through the New Brunswick Senior’s Care Strategic Innovation Fund, a partnership between the Centre for Aging and Brain Health Innovation (CABHI) and the New Brunswick Health Research Foundation (NBHRF).

The successful applicant will work with Dr. Erik Scheme and Dr. Emily Read, faculty members in the Faculty of Engineering and the Faculty of Nursing, respectively, on a research project to validate eChart Healthcare, a new health care technology to support caregivers working with older adults living in residential care facilities. Dr. Scheme is an Assistant Professor in Electrical Engineering and the New Brunswick Innovation Research Chair in Medical Technologies, whose mandate is to position New Brunswick as a world leader in the discovery, innovation and commercialization of health technologies. Dr. Read is an Assistant Professor in the Faculty of Nursing and an affiliate researcher at the IBME. Her program of research focuses on leadership and health services research with an emphasis on health human resources optimization, technology, and healthy aging.


Learning Environment and activities:

This collaborative research fellowship will provide the successful applicant with in-depth training and real-world experience in the fields of health care, health technology implementation and validation, health workforce optimization, public and patient engagement, entrepreneurship, and knowledge exchange. A special focus of this position will be on conducting mixed methods research involving the collection and analysis of longitudinal survey data and in-depth interviews with participants.

The IBME is a world-renowned, multi-disciplinary research institute that provides a rich training environment for graduate students and postdoctoral fellows. Working at IBME and the Leadership and Health Services Research Collaboratory in the Faculty of Nursing, the candidate will have an opportunity to thrive—a place to engage in meaningful work that makes a positive impact on the lives of older adults, their formal caregivers, and their families. You will work as part of world renowned team engaged in a broad spectrum of activities in biomedical and health technology innovation, health services, and aging research. We offer a multidisciplinary, supportive environment where you will grow personally and professionally as you learn from some of the most talented people in the field.


Duties and Responsibilities:

The primary duties and responsibilities of the successful candidate will include but are not limited to:

  • Collection and analysis of quantitative survey data
  • Participant recruitment; conducting semi-structured interviews; analysis of qualitative data
  • Leading the dissemination of novel findings through traditional and innovation knowledge translation and exchange activities



The ideal candidate for the position is an independent, solution-oriented thinker with a strong background in mixed methods research or strong skills in either qualitative or quantitative research and a willingness to learn new research methodologies and methods.

We are seeking someone with the following qualifications:

  • PhD in nursing, health sciences, engineering, psychology, business administration, or other relevant discipline
  • Expertise in health research focusing on aging, health technology, healthcare management, or health services research
  • Entrepreneurial spirit and eagerness to identify and solve real problems
  • Experience and competence in multivariate statistics
  • Familiarity with data science tools (SAS, SPSS, Mplus) and experience in creating and maintaining datasets
  • Demonstrated ability to work independently and as a member of a multidisciplinary team.
  • Solid writing abilities and excellent communication skills; a willingness and ability to develop and lead new collaborations is essential


Application Procedures:

To apply for this position, submit your application by email to Dr. Erik Scheme at by January 31st , 2017.

Please submit:

  • a detailed cover letter, including a statement of purpose
  • a curriculum vitae and transcripts
  • the name and contact information of three academic references

Additional Information:

  • The position will start May 1st, 2018 and end April 30th, 2019
  • The position will be funded for 1 year
  • Fellowship stipend: $50,000 per annum
  • We thank all applicants for their interest but wish to advise that only those selected for an interview will be contacted.

Mastering My Inbox with the GTD Method

For many people, managing emails has become next to impossible.  The sheer volume, paired with the diversity of their contents, and the expectation of an instant reply, has made this part of my job really challenging.  The worst part is that the time spent reading and answering emails really takes up time that could be used doing something more productive – or at least, something that feels more productive.

As a scholar of workplace relationships, I know that email communication is a part of the relational work that we do and they do serve a purpose (at least 85% of the time).  However, I don’t like feeling overwhelmed by my inbox and feeling like there are loose ends to go back to later.

Thankfully, I found the book “Getting Things Done” by David Allen  (generally referred to as the GTD method).  At the beginning of November I was selected to attend a New PI meeting in Montreal hosted by CIHR (given the almost single-digit grant success rates I was over the moon to be invited!).  Anyway, one of the speakers recommended this awesome book and it has forever changed my email management system (and, therefore, my life, obviously…only half kidding here…).

The system I used is quite simple. All I did was add 2 folders to my email: 1 for things that need action and 1 for things that I am waiting on something or somebody for.  Then I went through my entire inbox and sorted every message. They either went into one of these new folders, got deleted, or got archived.  Now I sort incoming messages in the same way and set aside time each day to go through the action items and the waiting on items.  Once they are dealt with, I archive them.

Again, this system isn’t difficult and it has made a huge difference in just a short time!  I feel in control of my inbox and am better able to triage the messages that are coming in.  GTD, where have you been all my life?!  In all seriousness, it is the best ROI I’ve had for a time management strategy for a long time. Highly recommended!

On Legacy and Goodbyes

I have many thoughts about my first year at UNB and as a nursing professor. Not unexpectedly, it has been a year of intense change, growth, and learning, but also of deep personal loss. In October 2016, just months after starting my career as an Assistant Professor, I said goodbye to my PhD supervisor the night before I walked across the stage in my beautiful purple robes to be hooded as Dr. Read and get my diploma. After leaving the hospital I broke down in tears and sobbed.  I still don’t know how to deal with this loss. The juxtaposition of experiencing one of the happiest and saddest events in my life at the same time was (and is still at times) overwhelming.

This experience has definitely influenced my perspective on my work as I begin my career. Heather was a nursing graduate of UNB where, serendipitously, I now work.  She influenced nursing research, practice, and policy nationally and internationally through her work on structural empowerment and healthy work environments, but arguably her biggest, broadest impact has been through her influence on her students and colleagues. Working with her was a one-of-a-kind experience and I feel so blessed to have had the time with her that I did.  Being a supportive supervisor and mentor for graduate students has become a really important priority for me because I know it matters, deeply.

In retrospect, I think I was in denial about the fact that she wouldn’t always be around.  As her illness progressed, she worked from home more frequently and we (her research staff) would run down to the dental circle to exchange documents and edited drafts with her when she pulled up in her car. It became the new normal and for better or worse she was able to keep working.  The best days were when she would come sit in the RA office with us, pull up a chair, and chat about research and life (and Roger Federer of course!). Despite her busy schedule and everything else, Heather was extremely generous with her time and energy.  Her high expectations and drive weren’t always easy to handle but she pulled out the best in me for sure and always said thank you for the work that I did for her.

God, this is so hard to write about.  What are you supposed to do when your supervisor dies and leaves you her laptop, a book chapter to write, an unfinished research study…? When you help clean out her office and see what’s left behind? The awards, degrees, books, and articles…. the artifacts of hours upon hours of work and intellectual capital.  When you witness her son saying goodbye to her and think about your own mortality and having to say goodbye to your own son down the road?  I’m not sure what the answer is but I see things a bit differently now.

Not that I was ever interested in doing things just because they look good on my CV, but I really do think about my work differently now.  Not to be morbid, but I am acutely aware that the impact of my own research and teaching is important and will live on after me.  Much of Heather’s ideas and knowledge have been passed on to her students and I am honoured to be part of that group of people.

My perspective on how I use my time has also changed and I cherish the time I have with my friends and family in this life even more, though admittedly I don’t spend nearly as much time with them as I would like. I don’t want to sacrifice relationships for my career and I have realized that I don’t have to. In fact, I am more convinced than ever that the relationships we have through our work are (or can be) an important part of our life.

Thanks for listening.





Working Out & Mental Health

Last week was Mental Health Awareness Week in Canada so my timing with this post is a bit off…though, why should we only talk about mental health on “green light” occasions like MHAW and Bell Let’s Talk Day? Sure, they’re great events and I am thrilled to see more discussion about mental health but it’s not like mental health issues don’t happen all the time.

I don’t often talk about my own mental health challenges – partially because they don’t define who I am and partially because I don’t think what I’ve dealt with is particularly unusual. I was a shy kid with my nose always stuck in a book and thankfully, I also loved playing sports. I didn’t fit in socially very well and I wasn’t particularly girly (in fact, I was given the nickname “Butch” by the guys I played basketball with at lunch time). I have always kind of been a bit eccentric and although now I appreciate my creativity and different way of looking at things, back then, I just thought that there was something wrong with me. I thought that if I changed my body I would magically fix everything, fit in, and have everybody like me.

Long story short, I over trained and under ate and developed an eating disorder that went on for about 5 years of hell. I also started binge drinking to deal with my social anxiety and kill my feelings because I didn’t know how to deal with them. My weight went up and down, I was depressed and anxious, and not a very nice person to be around. Honestly, sometimes I think it’s a miracle that I got through high school (with a 91% average, nonetheless). Through it all, sports and fitness played an instrumental role in helping me not screw up my life completely. I wish I had done some things differently but I cared enough about my team to go to practice, eat, not drink the night before games and practices, and go to enough classes that I could still play.

Eventually in my third year of university I hit rock bottom and quit school. I stayed in London and worked at the city pool until the spring. My only reason for getting up in the morning was that I knew the aquafit ladies were counting on me to be there. I will spare the details of my eating disorder but suffice to say it was just miserable.

For me the journey to recovery started with a decision to move back to Nova Scotia to live with my parents in Wolfville. I made a pact with myself that I needed to get better and decided that trumped my fear of gaining weight. I gained a lot of weight very quickly which was really difficult to deal with because my body image was so bad. I didn’t have a job or school so for a couple of months I mostly stayed inside, afraid to go out in case “people” (who I didn’t know!) saw me. Writing this now it’s hard to believe that it literally took me 6 hours to get ready and have the courage to go outside and walk 2 blocks to the post office to pick up our mail!

That summer I worked at Camp Glenburn and met some of the most incredible fun people ever who loved nature and really didn’t care about superficial things. Despite being at my heaviest, it was one of the best summers of my life and made me realize that being happy and having fun isn’t about being a certain weight or size.

From there things kept getting better and in the fall of 2004 I went back to school at Acadia (super awesome choice!). I started going to the gym regularly and this helped my recovery in so many ways. First, it made me feel good about myself, mentally and physically. This is supported by lots of research too. When you exercise, your body produces chemicals that make you feel happy 🙂 Working out is also a terrific way to release stress and deal with feelings. Triple awesome. Second, working out helped me make supportive food choices. I realized that my workouts felt awful if I didn’t eat enough or too much. Since working out was something I like to do and look forward to, I was conscientious about eating regularly and not being extreme. It also made me care about getting enough sleep. Finally, working out helped me gain strength and muscle and take my power back. My goals shifted from “I want to be thin” to “I want to be strong and healthy”.

Of course, exercise and regulating my eating were not the only thing that helped my recovery. I also stopped polluting my brain with unhealthy ideals of beauty by not reading fashion magazines or watching TV. I went to counseling. I talked about my feelings and wrote poetry. I learned coping skills. I found things that were more important to focus on than how I looked. It’s a process and it’s different for everyone.

Today, 13 years later, exercise is still an essential part of my mental health and wellbeing.  I wake up at 5am to work out before my work day begins and it is my time to get focused and energized for the day.  My nutrition habits also play an important role in my mental health. I also eat mostly whole foods and gave up my food guilt when I eat something more rich. Being able to really enjoy and savour a delicious piece of cake (or a chocolate chip oat cake from the UNB library…) and not feel angry or guilty or want to eat the whole darn thing because I interpret a food choice as bad or making a mistake is HUGE.

I also realized that there is not enough cake or pizza or alcohol or anything else in the world that will really make me feel better or take away the feelings I don’t want to feel so my emotional eating has decreased a lot (though not entirely).  I think being a nurse has helped me with emotional regulation too because dealing with the depth and breadth of emotions of the human experience is unavoidable in our profession and self-reflection and awareness is something that we actively work on developing.

These days my mental health is very good, though I find the Canadian winter can get a little bit depressing (who doesn’t!?) and sometimes I still get a bit anxious about social situations and going to Costco (again, not all that unusual). I think because it’s not a problem anymore I tend not to talk about my mental health too much – I have so many other things to focus on instead! However, I do think that it’s important to share my experiences so that people know that they are not alone and that it’s okay to ask for help – EVEN if you are a health care professional or an academic. Stigma shmigma! Despite the silly pretenses that a lot of people put on, nobody is perfect – heck, what does that even mean anyway?!

Unsolicited Advice for Writing a Research Article for a Journal

Writing research articles for peer-reviewed journals requires practice, patience, and persistence.  I am by no means a prolific scholar but I worked with one who was amazing (the late Dr. Heather K. Spence Laschinger) for six years and learned a thing or two about writing journal articles (and my record isn’t too shabby for an early career scholar either). I am also an award-winning peer-reviewer for several journals so I have seen a lot of excellent and not-so-excellent submissions which has made me a better scholar too.

One of the things I really love about this role is being able to provide helpful feedback to others that can help strengthen their work. Chances are I will never be your peer-reviewer (unless you are a nursing or management scholar) but I wanted to share some tips on how to present your best work and improve your chances of publishing your research. From a reviewer perspective I think this guidance is important too because we are volunteering  our time to review papers (yes, that’s right, we do it for free, mostly because we care and are mega-dorks) and trying to review a poorly written and/or disorganized manuscript is frustrating.

So, without further ado, here’s my unsolicited advice for writing a research article.

Select the journal first

But, how do I choose a journal?

First, read the aims and scope of the journal to make sure it is a good fit for your research. For example, if you did a study on job burnout, you might not want to submit it to the Journal of Applied Physiology. Burnout Research would be a better fit for your work. Journal-research fit, if you will, is super important because the editor wants to make sure that the articles are of interest to their readers.  You will not make it past the editor’s desk if your article isn’t a good fit for the journal so save everyone some time and do your homework before you submit (and even better, before you begin writing).

Ideally you should select 2-3 journals that are a good fit for your research and then compare them. Look at their impact factors and take a look at a couple of recent articles from each to get a feel for the kinds of studies they publish. Also look at the word length and author guidelines because sometimes that can be more important than impact factor if you need more space. I recommend always going for the best journal first and then keeping the others in mind in case your work gets rejected from the first choice.

Read the author guidelines and follow them EXACTLY.

Don’t waste your time writing a 10,000 word paper with 10 tables and figures for a journal that wants 5,000 words and a max of 4 tables and figures. Author guidelines are not suggestions – they are rules! Your job as an author is to make it as easy as possible for the editor to give your paper the green light to move on to the peer-reviewers. You also want to make it easy for the reviewers to focus on the content of your paper, not the writing, grammar, and formatting, etc. It is also worth repeating that the journal already gave you the guidelines!  It’s not rocket science, it’s attention to detail (and it’s important!).

Use a reference management software program.

While it is tempting to just use the copy and paste feature from Google Scholar, in the long run, it will save you a ton of time to save and organize your articles systematically. I use Mendeley (it’s free) so I will speak directly about that program. Mendeley has many cool features that make life easier for researchers and students.

  1. You can upload PDFs using drag and drop and the program will populate all of the reference fields automatically (always check for accuracy though because they are often imperfect).
  2. The program then allows you to highlight and make notes directly on PDFs of your articles so you don’t have to print them out.
  3. It has a cite and write feature for Microsoft Word that allows you to insert citations from your reference library while you write.
  4. It generates a reference list for you in the style of your choice. This will save you about a million years if your paper ends up getting rejected and you need to submit to another journal that uses a different referencing style (trust me, it is painful to switch styles manually if you haven’t experienced this).
  5. You are likely to reuse some of your references in the future for grants or papers so a reference management program keeps you organized (and again, saves you time looking up the same article 20 times).
  6. Your Mendeley library is saved on a cloud so you can access it on any computer. I love this feature because I can access my libarary at home and work and on my laptop so I never have to worry about where my files are.

Write the literature review/ theory section first.

Although not everyone emphasizes theory in their work I think it is really important. I am really not impressed by empirically-driven papers that dump a bunch of variables into a statistics program and tell me that they are significantly related to one another statistically. I want to know if those relationships are meaningful. In other words, why and how are things related and what are the implications? This is where theory and logic come in. Let’s pause here and think about an example: both ice cream sales and drownings increase significantly in the summer. Logically, we know that drownings do not cause increased ice cream sales or vice versa, but rather, both are related to an increase in temperature (when it gets hot people are more likely to want to eat ice cream and to cool off in the water). Another example: Mud and rain are positively correlated but we know that rain causes mud, not the other way around! In both examples, the data could support relationships that are not logical, demonstrating the need for theory-driven research. Don’t start with your data; start with why! (“Start with Why” is also the title of an excellent book by Simon Sinek, FYI).  If you are doing a qualitative study then theory is equally important in terms of identifying and explaining the paradigm and method that you are using. Helter skelter coding of interviews or focus groups doesn’t quite cut it.

Write the methods and results sections next.

These should be the easiest parts of your paper to write. In the methods section you simply explain what you did in your study and in the results you describe the findings. Writing these sections makes your paper feel like a “real” article and gives you the content you need for your discussion section and conclusions.

Your methods section should outline your study design, sampling procedures, data collection methods, intervention and control groups (if applicable), and data analysis methods. For quantitative studies, providing accurate information about your measures is really important. Describe each one and provide support for their validity and reliability.

A quick note about tables and figures here – make sure they are formatted the way the journal wants them and that they are easy to read and understand. I suggest using the full names of variables rather than abbreviations (e.g., “job satisfaction” is easier to understand at a glance than “jstotal” or whatever code name you came up with in SPSS or SAS).  Never ever copy and paste output from statistics programs!  Just don’t. As a reviewer it makes me cringe when people do this. You can easily copy it into a word document and reformat it to meet the journal guidelines.  When you don’t it looks like you either didn’t read the journal guidelines or you didn’t care.  For bonus points, if you have space to include a diagram that shows your model of how variables are thought to be related in your study, it is super helpful to reviewers and readers (and arguably to yourself).

Tackling the discussion.

The structure of this section is going to depend on your research and the journal guidelines but generally, it is a good idea to have an introductory paragraph that sums up the overall findings and then subheadings to discuss different key findings in further detail (keep it logical and organized). You should interpret the meaning and implications of your results and discuss how they fit with past research. This is one of the toughest sections to write because it requires the synthesis and integration of ideas from multiple sources. You should not just paraphrase or summarize what was found in other studies; you are explaining, linking, comparing, and analyzing your results and those of other studies.  You are pulling out the meaningfulness of your study.


Despite common limitations for studies with similar designs, most journals still require that you provide a limitations section. For example, obvious and common limitations include sample size and power, response rate, cross-sectional designs, common method bias, sampling bias, and social desirability bias. Pick two or three of these to address (not all of them!). If there is something particular that you think limits the validity or reliability of your results or their generalizability beyond your study, it is important to include it in this section and explain the potential implications or cautionary interpretation needed. As much as possible, keep this section short and sweet.

Introduction section.

You are almost there! Again, make sure you follow the instructions for authors for the journal because some of them are very particular about what to include in each section. Often the introduction includes a statement about the purpose and/or aim of the study and is the place where you need to introduce the reason why your study was needed. The introduction is an excellent place to use some key statistics that highlight the severity or reach of the problem at hand and grab the reader’s attention. At the end of the introduction it should be obvious what the problem is and how your research is going to address that problem.

Writing the abstract.

Think of your abstract as the profile picture of your article. People will decide whether or not to read your paper based just on this short blurb. Whether we approve of it or not, sometimes people only read the abstract because they don’t have access to the full article or they are pressed for time. Abstracts are also used in the systematic review process and for conference presentations so learning to write excellent abstracts is a valuable skill. The biggest challenge is fitting everything you want to say into 150-300 words (just look at the length of this blog post lol!). Not easy and again, every journal has different guidelines. Some want a descriptive paragraph but most have subheadings (e.g., Introduction, Purpose, Methods, Results, Discussion, Conclusion, keywords). Generally you have room for 1-2 sentences for each section so you have to be concise and edit a lot!  The best advice I have for this process is to start from scratch instead of cutting and pasting sentences from your paper (always too long and too detailed) and to write only one essential sentence for each section. Then you can add as needed and as room permits.


The last point I want to make is that it is essential that your entire paper is consistent from start to finish. If you are examining the effectiveness of a weight loss intervention on cardiovascular risk factors in overweight men, then the whole entire paper should focus on that. There shouldn’t be new surprise variables like vitamin D consumption or social support introduced in the middle of the paper! Likewise, your discussion and implications should be logical and realistic. One study never proves anything 100%. Recall that with hypothesis-testing research a significant result just means that you are 95% sure (or 99% sure, depending on your p-value) that your results didn’t happen by chance.  You are contributing to a body of evidence and an ongoing research conversation. To improve consistency, after your first draft is written take a break and read it from start to finish with fresh eyes. Read it critically and ask yourself if there is anything that doesn’t make sense or flow quite right. Talk about your variables in a logical order and keep the same order throughout your paper and in tables and figures. This creates less work for the reader and makes it easier to follow.  Once you are done editing, get someone else to edit it. If you are working in a team and different sections were written by different people, it is especially valuable to have one person edit the whole document and make it flow (everyone has a unique style!). If English is not your first language and you are submitting to an English-language journal definitely try to get it proof-edited by a professional for grammar and spelling before you submit.

Hope you found this helpful and if you are a nurse, please check out my new feature Nursing Research Summaries. I think you’ll find that helpful too!

Happy writing!

I Quit the Home Internet


This week I decided to quit the home internet. Experiment 1 of 2017.

Why would I do this?!

  • I don’t want to work 24/7. After many years of being in school and working and spending WAY too much time sitting on my butt on a computer, I want to have more of a life. More non-work time obviously means I need to spend LESS time doing work. Not having the internet at home means that I have to be more focused and more intentional with my internet use. I have made a list of “Internet Things to Do” and plan ahead. I can still read and write – distraction-free – at home if I need to.
  • I am addicted to Facebook and looking up random articles on my phone. I realized that the first thing I did in the morning and the last thing I did at night was look at my phone. Check Facebook. Read the news. Check the weather. Check Facebook….all while trying to get a baby velociraptor (who may actually be my preschool-age son) and a kitten to stop vying for my attention by sitting on top of me. Without the internet, I am not distracted by my phone so I no longer get sneak-attacked by these crazy animals. Don’t get me wrong, I do spend time off my phone too but it was getting to be a huge distraction.
  • Money. Internet is expensive in NB. $100 a month = $1200 a year and there are lots of other things that I value more than home internet. Maybe it’s just a case of “the Januarys” but I am trying to be more mindful of my spending this year and pay off some debts.  When I sat down to think about it, my list of things that I value more than home internet was quite long! Camping, rain gutters on my house, solar panels, a BBQ, new winter boots, etc.
  • There was life before the internet and it was AWESOME! I feel lucky that my childhood was internet-free. We played outside, read books, played sports, etc. There is SO much to do and really, life is too short to do it all – why waste time?

On Being an Academic Nurse

When I began my PhD I felt the need to be cautious about telling people that I was doing it. Luckily I worked with super supportive colleagues and they never made me feel like I was weird or not a “real” nurse because of my interest in research. In fact, many of them were more than willing to share their experience, wisdom, and insights with me when we worked together. I may not have 20 years of nursing experience but I am a hard worker and a caring nurse who is willing to help others and pull my share. I absolutely loved my time working in geriatric rehab as a staff nurse. There were times when I considered quitting the PhD and staying on there instead. I didn’t leave direct care nursing because I didn’t like it. I didn’t leave because I’m afraid of hard work. Or shift work. Or working holidays.

I’m not quite sure what people think academic nurses do but I honestly cannot remember the last time I took an entire 24 hours off from work. I think it was in May? In addition to teaching, research, and service requirements of most faculty, nursing faculty at many schools (mine included) also teach clinical nursing courses. This term I’m teaching second year students in the hospital which means not only 2-3 full shifts in the hospital every week but tons and tons of prep, organizing, evaluation, and follow-up with students. This is not like a lab where they are practicing on mannequins; they are working with real-life patients who are sick. They are interacting with nurses and physicians. Expectations and anxiety are high. I feel like a mother hen trying to protect them while at the same time give them learning opportunities and reasonable autonomy. Teaching clinical is rewarding in many ways but it is one of the most stressful things I have ever done.

I am also a course assistant for the nursing research course and need to prepare to teach a new-to-me course next semester. On top of this I have also been trying to establish my program of research, attend the meetings I need to go to, and get to a stack of article revisions and new submissions. I took a day trip to Ottawa for a conference between clinical days and it was awesome but also exhausting. Somehow I have managed to still spend quality time with my son, work out at least 3 times/week (although Thursday’s “workout” mostly involved staring blankly at the barbell trying to convince myself that it was workout time), and always have some (mostly) healthy food and clean laundry. It’s the small wins, right?

This is not the life I envisioned 11 months ago when I accepted this job. After working and going to school for a million years I thought it would finally be different. I thought I’d have time to have a life but the reality is that I am working constantly. I thought I’d love being closer to home but it’s not really close enough that I can see my family and friends very often. It’s not super helpful when I want to go do something either (“Hey, dad, can you drive 5 hours and babysit while I go to a movie?”).

It’s not all bad of course; I really love a lot of things about my job. I’m just not sure that I want my life to be my job. I realize that the transition to new job in a new province and a new city is a huge adjustment and that it will get easier as time goes on. My first term has been full of many wonderful things and a couple of not-so-awesome things. Highlights include the joy of seeing nursing students grow and learn, interacting with patients and their families and the staff on the unit, and being part of some inspiring research projects. The best thing of all has been looking at the stars with my son on those early mornings before clinical. In the quiet darkness before sunrise we get to share the awe and peace of the night sky together before the busyness of the day begins. These are the moments I cherish most.



Perplexed by the NCLEX in Canada


To most Canadian nursing educators, the NCLEX is about as welcome in Canada as Donald Trump. I am not alone in being royally PO’d that the provincial nursing regulatory bodies decided to nix the Canadian Registered Nurses’ Exam (commonly known as the CRNE)to replace it with the NCLEX in 2015.

In case you’re not in nursing or you aren’t Canadian, the NCLEX is the American nursing licensing exam that all American nurses must pass after their nursing degree before they can register as a Registered Nurse.  It is an adaptive computerized test that will keep asking tailored questions until the program is 95% sure that the candidate is above or below the passing standard.  To be clear, I think that this format and system of testing is awesome.  What isn’t awesome is having to teach my students content that is American so that they can pass the test (as if we don’t already have enough content!).  The French translation of the NCLEX is also so bad that many Francophone students are failing because they can’t understand the questions (I’m talking outside of Quebec of course because they wisely decided to keep their own nursing exam). Moreover, although French NCLEX practice materials are starting to pop up (after they realized that it was an issue), there aren’t nearly as many resources for French students and educators as for their English-speaking counterparts.  Two giant strikes for the NCLEX.

I have no idea why on earth the provincial nursing regulatory bodies made this decision or if they understood the implications of their decision.  Initially I was told that it would be a Canadian version of the NCLEX and maybe they thought so too. It is not. It is the exact same database of questions for all candidates in all countries. I could be wrong but I think the rationale behind this is that the NCLEX supposedly is “context-free”. I attended an NCLEX workshop for nursing faculty two years ago and the facilitator explained to us how the test worked and how the questions are designed.  She also proudly stated that “the NCLEX has no context”.  What she meant was that the questions are designed to be applicable to all contexts. I would question that. Is nursing really that black and white?  Maybe some things are but I’d argue that real life requires professional judgement calls too.

There are also huge differences between the US and Canada in terms of how we view health care (as a service to be bought through insurance versus as a basic human right).  Specific examples of the “Americaness” of the exam include “the five rights of delegation” and the scope of practice for an RN versus and LPN (Licensed Practical Nurse)[or RPN (Registered Practical Nurse) in Ontario]. In Ontario where I started my nursing career, I worked on a hospital unit with half RNs and half RPNs. We both had our own patient assignments and although the RNs were able to be in charge and dealt with the more complex patients, we were never assigned an RPN to delegate work to and have them report back to us. They had autonomy and we all worked together as a team (for the most part). In the US, LPNs report directly to RNs and the RN assigns patients or patient care duties to them. LPNs are not allowed to engage in patient teaching or any of the nursing process (assessment, planning, evaluation, nursing judgment). (See the Joint Statement of the American Nurses Association and the National Council of State Boards of Nursing here). Why does this even matter? Well, now we have to teach our nursing students about delegation in their own province and the rest of Canada (it is not exactly the same from province to province) AND America. If we don’t tell them that delegation rules for the NCLEX they are going to answer those questions incorrectly and it sure as heck isn’t because we don’t teach them about delegation in Canada.

Some have argued that it is not an American test, to which I respond, then why are Canadian-specific NCLEX prep books popping up?  Is it because we are just another market that companies want to exploit, or is it because there is American content that Canadian students need to learn in order to do well on the test?

So where does this put us?  Precisely in a giant head-lock. We have excellent nursing programs across Canada and in general our nurses have more education and better quality education than nurses in the US. Many of their students still take 2-year associate degrees whereas in Canada all RNs have to have a four-year bachelor’s degree. Every day I am impressed with the quality of the education that the students get at UNB and especially with the amount of real life clinical they get (over 1400 hours).  However, now we need to add in NCLEX-specific content to make sure that our students are prepared to take an American nursing test. Not to prepare them for their practice as an RN – we do that exceptionally well already!

Clearly I have strong feelings about the NCLEX and not everyone will agree with me but I don’t think that Canadian nursing students should have to learn American content in order to become nurses in Canada. I also don’t think that nursing schools should be judged by their NCLEX pass rates. Passing the NCLEX or not doesn’t necessarily reflect the quality of a nursing program, but, rather the “NCLEX test readiness” of graduates. Some schools are starting to make it a requirement for nursing students to write the HESI NCLEX practice test and obtain a certain score before they can graduate and write the NCLEX. This ensures that pass rates on the actual NCLEX are high because it increases candidates’ test-taking skills and ensures that they don’t write until they are ready (sometimes after writing the HESI numerous times).  As a result, high NCLEX pass rates are not necessarily a reflection of the quality of the nursing school, but of the readiness of the student to write the NCLEX. I don’t think that it is a bad thing to take the HESI per se, but I do think it is misleading to compare first-time NCLEX pass rates between schools who have a HESI score requirement and those who do not. Taking these tests (the HESI and the NCLEX), attending NCLEX review sessions, and purchasing NCLEX study guides are also very expensive so making the decision to require the HESI is not one to take lightly.

So there you have it. The NCLEX has made it harder to become a nurse in Canada and more challenging to be a Canadian nursing educator. Arguably, it has also made it easier for Canadian nurses to practice in the US (if you don’t mind working in a f0r-profit health care system). I’m not a fan and I think that it was strange decision. It is also possible that I am not privy to confidential information about why this decision was made and, thus, do not fully understand the rationale behind it. That being said, until the situation changes, it really doesn’t matter if I agree or not, no matter how logical my arguments are; the fact is that we need to do what we can to prepare our students for an American test.



Working Out is Non-negotiable

We hear it all the time now that work-life balance is a struggle for pretty much everyone.  My new job is awesome but I am also starting to realize that there is absolutely just not enough time to do everything that I want to do…at least not all at once.

I am excited for everything ahead but also trying to pace myself!  This fall I am teaching a clinical course in chronic care for the second year nursing students which involves 2-3 8-hour shifts every week plus individual student meetings, feedback, prep, and evaluation. I’m also helping with the third-year nursing research course (no sweat).  I am also submitting a couple of grant applications, working on ongoing studies, and getting acquainted with fellow researchers at UNB who have shared interests.  Of course, this is all awesome and I don’t think I could have asked for a better person-job fit!

I am also mindful of taking care of myself and making sure that I get enough sleep and prioritize my workouts. For me that means getting up at 5am to workout in the basement and going to bed by 9 or 10pm at the latest.  Although I’ve decided not to compete in powerlifting until next Spring or Summer when my workload calms down, working out is non-negotiable for my physical and mental health.

I may not be breaking any records lately or “show-ready” for a fitness competition but lifting is an awesome stress-reliever and it’s one of the few things that I do just for me.  I aim to get in 4 days/week (shoulders; bench; squat; and deadlift focused days) and have also been working more on my mobility because sitting at a desk most of the time isn’t exactly good for that. I also bought a treadmill which has made a world of difference since I can’t exactly leave my 3-year old at home to go for a run (one-arm stroller running is hateful and I refuse to do it).

It is difficult to make fitness a priority when you have other things going on, when you’re tired all the time, and your budget is tight (groceries in NB are crazy expensive!), I of all people totally get it. However, if you don’t take care of yourself first, you can be limited in your ability to be there for those you love and be effective at work. These are the things I think about at 5am when I don’t want to get out of bed…and then I get up and get ‘er done (most of the time).