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During my time in both the mental health and maternity placements at PRHC, the combination of these two placements afforded me the opportunity to see and learn how mental health and maternity interact with one another. I learned that postpartum status can greatly affect a patient's mental health, and used both opportunities to try and look at a patient's health from a more holistic and all encompassing perspective, rather than looking at each individual health issue as separate from one another.

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During my time in my mental health placement in 2021, and in my time in 2001 learning about relational inquiry and the difference between "care and caring", I feel that building patient rapport in a mental health setting is a topic of great importance. This topic is important to me as I struggle with my own mental health struggles, and during my time in my mental health placement, I found myself trying to focus more on building therapeutic rapport with a lot of the patients during my downtime, which led to a noticeably brighter mood most of the time.

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During my time in my 2021 maternal health placement, an emphasis has been put on patient education surrounding breastfeeding from nearly all healthcare workers, including myself at this placement. I have learned throughout this placement just how important breastfeeding is to an infant and new mother's health, and the impact it can have on the future generation's health to come. I feel that patient education surrounding breastfeeding is an important topic that encompasses the mother's capability to successfully breastfeed her infant and that as such it should be further discussed in topic form.

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Throughout the learning of our units in 2001, I found myself gravitating towards the stories of indigenous mothers who had faced unnecessary discriminatory treatment during their pregnancies and towards their families, and as I learned more about this topic, the more angry and outraged I found myself becoming at the inhumane stories I had heard these families face. As such, I decided that because I felt so strongly about this subject, that I would make this a topic in this podcast.

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This is a drawing I made of an indigenous newborn swaddled in a medicine wheel with a caduceus and red cross behind it. This drawing represents the future goal of indigenous postpartum care for families to be culturally sensitive, integrated, and welcomed within the healthcare setting. Artworks or reminders like these in hospitals or healthcare settings could help to not only make indigenous families feel like they are seen and that the facility is a place of unbiased care, but could serve as a reminder to the healthcare workers within those settings to remember the ultimate goal of their care they provide to indigenous mothers and help them to remind themselves to reflect upon how they interact with patients.

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Artifact #2: Indigenous birth practice of smudging

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Artifact #2: Indigenous birth practice of smudging

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This chosen artifact is a photo taken of an indigenous mother and her newborn baby having a smudging ceremony done postpartum in a CBC news article (Goodyear, 2023). I chose this artifact for this topic as it showcases a culturally integrated maternal approach to providing postpartum care for a patient of indigenous descent. In addition, I thought this artifact showcased perfectly how even such a simple step of catering to the cultural needs of a patient can have such a large impact on the comfort and spirituality of an indigenous family.

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Goodyear, S. (2023, July 14). Nurse performs Halifax Hospital’s 1st Smudging Ceremony - for her sister’s Baby | CBC Radio. CBCnews. https://www.cbc.ca/radio/asithappens/halifax-hospital-smudging-ceremony-1.6907186

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By learning about the experiences indigenous mothers have had with discriminatory health care settings and throughout the time I have spent in my maternity placement, I find myself focusing on the need for trust between a healthcare worker and a patient in a healthcare setting. This specific topic has opened my eyes to how important it is for patients to trust their healthcare providers and for healthcare providers to provide care that is fair, trustworthy, open, and unbiased.

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References:

Allen, L., Hatala, A., Ijaz, S., Courchene, E. D., & Bushie, E. B. (2020, March 2). Indigenous-led Health Care Partnerships in Canada. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne. https://pmc.ncbi.nlm.nih.gov/articles/PMC7055951/

Bacciaglia, M., Neufeld, H. T., Neiterman, E., Krishnan, A., Johnston, S., & Wright, K. (2023, May 8). Indigenous maternal health and health services within Canada: A scoping review. BMC pregnancy and childbirth. https://pmc.ncbi.nlm.nih.gov/articles/PMC10165845/

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Artifact #1: An image of a nurse working with a patient to help their child breastfeed

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Artifact #1: An image of a nurse working with a patient to help their child breastfeed

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This chosen artifact is a photo of a nurse working with a patient to assist in their child's success in breastfeeding (Texas Health, n.d). This artifact showcases the connection and trust between the patient and nurse by allowing the nurse to touch and adjust the baby's position to better breastfeed. I chose this artifact as it shows the collaboration and fostered trust between the nurse and patient, allowing for the outcome of improved patient care to take effect, which when providing care is of the utmost importance.

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This artifact is an artwork of an individual putting information away into an ear (Australian College of Nursing, 2018). I chose this artifact as I think it shows one of the key elements of fostering trust, especially in a postpartum setting, which would be the nurse implementing the skill of active listening. I think that in order to better foster trust in postpartum settings that nurses should sit down with their patients, listen to their concerns, feelings, and views on their postpartum experience, in order to better foster trust between the nurse and patient, as well as the community the patient comes from.

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This chosen artifact is an infographic surrounding the reasons why breastfeeding is better for babies and how to implement higher rates of breastfeeding into healthcare settings and families everyday lives (1000 days et al., n.d). I chose this artifact because it showcases the importance of breastfeeding on a newborn's health and development as well as the impact it has on an infant's family and the society they are in as a whole. This artifact outlines all the reasons in which patient education surrounding breastfeeding is so important, and can act as a reminder for patients and healthcare workers to work towards the goal of improved breastfeeding knowledge and education efficacy.

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Texas Health. (n.d.). Types of breastfeeding support professionals. Types of Breastfeeding Support Professionals. https://www.texashealth.org/baby-care/Breastfeeding/types-of-breastfeeding-support-professionals

Australian College of Nursing. (2018, February 4). The Art of Listening. https://www.acn.edu.au/publications/the-hive-2017/the-art-of-listening

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This artifact is a video outlining to expecting or new mothers from (Health, 2022) on guidelines and information to follow once their babies have been delivered and how to properly ensure they are getting the nutrition they need when breastfeeding. I chose this artifact as an example of a supplementary resource for expecting or postpartum mothers to watch in order to expand their base of knowledge surrounding breastfeeding. I feel that this artifact is an important resource for new mothers as it serves as an accessible and easy way of learning more about this skill.

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Breastfeeding Education for Expecting Mothers

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1000 days, WHO, & GLOBAL TARGETS. (n.d.). Breastfeeding infographic. 1,000 Days. https://thousanddays.org/resource/breastfeeding-infographic/

Health, I. (2022, January 25). Breastfeeding Education for Expecting Mothers. YouTube. https://youtu.be/Ayqtm5Gt6k0?si=OHCE8It2yG-lGWaS

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This chosen artifact is a youtube video from ACOG explaining the effect that pregnancy may have on mental health (ACOG, 2023). The video walks the viewer through the baby blues, anxiety, OCD, and other mental illnesses that may occur during pregnancy and postpartum, and gives steps on how to move forward for those experiencing these issues (ACOG, 2023). I chose this topic because I felt that it could be a valuable self-identifying resource for new mother's experiencing these issues who may not understand exactly what is happening to them or what issue they may potentially be experiencing. I think that this could be a great resource for prenatal and postpartum women to be able to expand their base of knowledge on some mental disorders that can occur with pregnancy and postpartum, and what to look out for.

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ACOG Explains: Mental Health and Pregnancy

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This chosen artifact is a youtube video on the topic of why maternal mental health matters from TEDx Talks' youtube channel (Talks, 2013). This video walks the viewer through the experiences of the lecturer and her family experiencing firsthand the effects of postpartum depression and what that looks like in new mothers and families (Talks, 2013). This video also outlines the importance of postpartum mental health through the lecturer talking about the rates of adverse mental health outcomes in her research (Talks, 2013). I chose this artifact as I felt that this could not only be an educational resource for a pregnant or postpartum mother to watch, but that it could serve as an empowering resource within themselves to recognize the ways through which a family comes together to support someone with postpartum depression, the importance of speaking up, and that it is more common than is assumed.

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Why maternal mental health matters | Fatimah Jackson-Best | TEDxBridgetown

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References:

Kehinde, J., O’Donnell, C., & Grealish, A. (2023). The effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum: A systematic review. Midwifery, 118, 103579–103579. https://doi.org/10.1016/j.midw.2022.103579

Abdulahi, M., Fretheim, A., Argaw, A., & Magnus, J. H. (2021). Breastfeeding Education and Support to Improve Early Initiation and Exclusive Breastfeeding Practices and Infant Growth: A Cluster Randomized Controlled Trial from a Rural Ethiopian Setting. Nutrients, 13(4), 1204-. https://doi.org/10.3390/nu13041204

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References:

Landry, I., René, C., & Demontigny, F. (2023, June 12). Family centered nursing practices towards women and their families in the birthing context: A qualitative systematic review. Nursing open. https://pmc.ncbi.nlm.nih.gov/articles/PMC10416028/

Sripad, P., Merritt, M. w, Kerrigan, D., Abuya, T., Ndwiga, C., & Warren, C. E. (2022, April 21). Determining a trusting environment for maternity care: A Framework based on perspectives of women, communities, service providers, and managers in Peri-Urban kenya. Frontiers in global women’s health. https://pmc.ncbi.nlm.nih.gov/articles/PMC9069110/

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ACOG. (2023, November 27). ACOG Explains: Mental Health and Pregnancy. YouTube. https://www.youtube.com/watch?v=0WCwC-3nTdg&t=9s

Talks, Ted. (2013, December 16). Why maternal mental health matters | Fatimah Jackson-Best | TEDxBridgetown. YouTube. https://www.youtube.com/watch?v=m97UjpughrM&t=1s

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This chosen artifact is an art piece that showcases an individual having someone reach out to help them, this artwork was provided by (Coughlan, 2021). I chose this artifact for this topic as I felt that it embodied a healthcare provider reaching out to a mental health patient to better support them through their mental health journey. I feel that this artifact showcases the beginnings of building trust and rapport in a mental health setting between a nurse and patient.

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This chosen artifact is an artwork of a group of people all holding each-other and supporting one another's backs from (Bridgeland & Richards, 2021). I chose this artifact for this topic of building patient rapport in a mental health setting as through my eyes, patient rapport between a nurse and patient can only be built if the relationship is viewed in a humanitarian aspect, rather than through the eyes of norms and biases surrounding those with mental health. I chose this artifact to better support that message as I believe that the building of patient rapport and trust in a mental health setting is simply supporting another human being through the trials of life, and should be treated as support rather than viewing the interaction as a task to be accomplished.

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Bridgeland, J., & Richards, F. (2021, May 11). Where does social-emotional learning go next? (opinion). Education Week. https://www.edweek.org/leadership/opinion-where-does-social-emotional-learning-go-next/2021/05

Coughlan, S. (2021, April 17). Would universities call parents in a mental health crisis?. BBC News. https://www.bbc.com/news/education-56763189

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References:

van der Zee-van den Berg, A. I., Boere-Boonekamp, M. M., Groothuis-Oudshoorn, C. G. M., & Reijneveld, S. A. (2021). Postpartum depression and anxiety: a community-based study on risk factors before, during and after pregnancy. Journal of Affective Disorders, 286, 158–165. https://doi.org/10.1016/j.jad.2021.02.062

Suryawanshi, 4th, & Pajai, S. (2022). A Comprehensive Review on Postpartum Depression. Curēus (Palo Alto, CA), 14(12), e32745–e32745. https://doi.org/10.7759/cureus.32745

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References:

Butt, M. F. (2021). Approaches to building rapport with patients. Clinical Medicine (London, England), 21(6), e662–e663. https://doi.org/10.7861/clinmed.2021-0264

Hartley, S., Raphael, J., Lovell, K., & Berry, K. (2020). Effective nurse–patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance. International Journal of Nursing Studies, 102, 103490–103490. https://doi.org/10.1016/j.ijnurstu.2019.103490

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Podcast Segment #3: Relational Inquiry add on

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