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Podcast Episode 3: Housing as a Means of Health

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Podcast Episode 3: Housing as a Means of Health

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Podcast Episode 5: Adverse Childhood Experiences and Implications on Health

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Podcast Episode 5: Adverse Childhood Experiences and Implications on Health

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Peng, Y., Hahn, R. A., Finnie, R. K. C., Cobb, J., Williams, S. P., Fielding, J. E., Johnson, R. L., Montgomery, A. E., Schwartz, A. F., Muntaner, C., Garrison, V. H., Jean-Francois, B., Truman, B. I., & Fullilove, M. T. (2020). Permanent Supportive Housing With Housing First to Reduce Homelessness and Promote Health Among Homeless Populations With Disability: A Community Guide Systematic Review. Journal of Public Health Management and Practice, 26(5), 404–411. https://doi.org/10.1097/PHH.0000000000001219

Noble, A., Owens, B., Thulien, N., & Suleiman, A. (2022). “I feel like I’m in a revolving door, and COVID has made it spin a lot faster”: The impact of the COVID-19 pandemic on youth experiencing homelessness in Toronto, Canada. PloS One, 17(8). https://doi.org/10.1371/journal.pone.0273502

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Podcast Episode 1: Harm Reduction in Mental Health Nursing

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Podcast Episode 1: Harm Reduction in Mental Health Nursing

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Podcast Episode 2: Talk Therapy in Mental Health Nursing

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Podcast Episode 2: Talk Therapy in Mental Health Nursing

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Isobel, S. (2021). The ‘trauma’ of trauma-informed care. Australasian Psychiatry : Bulletin of the Royal Australian and New Zealand College of Psychiatrists, 29(6), 604–606. https://doi.org/10.1177/10398562211022756

Long, T., Aggar, C., & Grace, S. (2024). Trauma-informed care education for midwives: Does education improve attitudes towards trauma-informed care? Midwifery, 131, 103950–103950. https://doi.org/10.1016/j.midw.2024.103950

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Messina, N. P., & Schepps, M. (2021). Opening the proverbial ‘can of worms’ on trauma‐specific treatment in prison: The association of adverse childhood experiences to treatment outcomes. Clinical Psychology and Psychotherapy, 28(5), 1210–1221. https://doi.org/10.1002/cpp.2568

Gilbert, L. K., Annor, F. B., Brown, C., & Dube, S. R. (2024). Introduction to the child abuse and neglect special issue “epidemiology, risk factors, and impacts of adverse childhood experiences in low- and middle-income countries.” Child Abuse & Neglect, 150, 106748-. https://doi.org/10.1016/j.chiabu.2024.106748

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This infographic, produced by Johnson (2022) highlights some of the various adverse childhood experiences, the prevalence of ACEs within the population and some potential subsequent health complications. This was an important artifact to include as the ACEs study was frequently mentioned throughout my mental health placement, prompting further exploration.

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Artifact #3: Trauma-Informed Care Quote: "Recognizing the past while caring in the present."

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Artifact #3: Trauma-Informed Care Quote: "Recognizing the past while caring in the present."

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This image depicts the artistic visualization of trauma-informed care which was shared by the Roots Renewal Ranch (n.d.) as well as the quote "recognizing the past while caring in the present." I think this is an important aspect of trauma-informed care, as well as an important aspect of relational practice. This quote enabled me to further understand the concept of trauma-informed care, and the importance of the topic as a student nurse.

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Jurist, E. (2019). Saving Talk Therapy: How Health Insurers, Big Pharma, and Slanted Science Are Ruining Good Mental Health Care [Review of Saving Talk Therapy: How Health Insurers, Big Pharma, and Slanted Science Are Ruining Good Mental Health Care]. Journal of the American Psychoanalytic Association, 67(6), 1083–1088. SAGE Publications. https://doi.org/10.1177/0003065119897597

Nourisaeed, A., Ghorban-Shiroudi, S., & Salari, A. (2021). Comparison of the effect of cognitive-behavioral therapy and dialectical behavioral therapy on perceived stress and coping skills in patients after myocardial infarction. ARYA Atherosclerosis, 17(1), 1–9. https://doi.org/10.22122/arya.v17i0.2188

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This article, written by Dr. Brendan Johnston (2022) highlights the various adverse childhood experiences, such as suffering neglect and abuse within the home and how this can lead to increased risks of disability, early death, impaired social or behavioural cognition, etc. (Johnston, 2022). Furthermore, Johnston (2022) advocates for the use of ACE scores as the fifth vital sign, and argue the importance of assessing such in diagnosis various health disparities. Again, this was an important aspect of relational practice and inquiry when assessing patients' within my care in the clinical setting.

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Every day in the hospital, and during every visit to the clinic or emergency room, we pay scrupulous attention to your vital signs: heart rate, temperature…

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Artifact #2: Sexual Orientation Gender Identity Nursing Education Toolbox Certificate

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Artifact #2: Sexual Orientation Gender Identity Nursing Education Toolbox Certificate

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I chose to include my certificate of completion for the Sexual Orientation Gender Identity Nursing Education Toolbox as this was an important aspect of ensuring the delivery of trauma-informed care to patients in both the mental health clinical setting as well as in the maternal-child clinical setting. As a student nurse, it is important to ensure that we are consistently maintaining best-practice in regard to the delivery of trauma-informed care, which includes sexual orientation and gender.

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Artifact #2: Short Documentary by Cathy Crowe titled "Her Nurse Hands" (YouTube)

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Artifact #2: Short Documentary by Cathy Crowe titled "Her Nurse Hands" (YouTube)

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I chose to include this artifact as it displays Cathy Crowe's work, specifically her street-nursing work within Toronto (Cathy Crowe, 2019). The video also emphasizes the effect that homelessness has on health and how street nurses can intervene to improve health outcomes in at risk populations (Cathy Crowe, 2019). I can appreciate Crowe's sentiment regarding the fact that it is even obscene that we require such street nurses, because homelessness has been proven time and time again to be detrimental to a patients' health status (Cathy Crowe, 2019). The video also emphasizes that as time has gone on, the crisis surrounding housing continues to get worse, further solidifying that future nurses need to be aware of how to act on such crises (Cathy Crowe, 2019).

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I wanted to include this quote by Ann Voskamp that reminded me throughout my clinical experience of the importance of promoting talk therapy in a safe environment (The Reconnected, 2020). Throughout my own experience, as well as throughout my experience in caring for patients, it is incredible to see the amount of shame that can be reduced by simply talking to our patients or those within our community. In regard to talk therapy, such interventions and specialized therapies can be costly, and at times not covered by insurance companies (Jurist, 2019). In a facility setting, a nurse could potentially be able to provide such talk therapy, or simply just talking to patients' in order to reduce such financial burden in regard to accessing treatment.

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Artifact #1: Understanding ACEs with Dr. Nadine Burke Harris (YouTube)

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Artifact #1: Understanding ACEs with Dr. Nadine Burke Harris (YouTube)

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I wanted to include this video as Dr. Nadine Burke Harris provides a great explanation regarding adverse childhood experiences (ACEs) and the originally study which provided evidence regarding how these experiences in childhood can have a subsequent effect on our development and health (Office of the California Surgeon General, 2022). This is an important concept to understand in regards to relational inquiry, especially when understanding a patient's health history or current presenting status.

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Office of the California Surgeon General

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Understanding ACEs with Dr. Nadine Burke Harris

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Artifact #1: Trauma & Violence-Informed Care Foundations Certificate

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Artifact #1: Trauma & Violence-Informed Care Foundations Certificate

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I chose to include my certificate of completion of the Trauma & Violence Informed Care Foundations online course as it was an important piece of education to obtain during my placement in the mental health clinical setting. The knowledge that I obtained during this course was essential in caring for patients in both the mental health setting as well as in the maternal-child setting in order to prevent traumatization or re-traumatization from occurring.

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Artifact #1: Photograph of "Homeless Jesus" Statue Art 

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Artifact #1: Photograph of "Homeless Jesus" Statue Art 

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This was a photograph shared by CBC with a linked podcast regarding the backlash that was received following the erection of this statue (CBC Radio, 2016). This photograph resonated with me as the statue was erected during the time in which preventative measures were initiated in order to reduce those experiencing homelessness from sleeping on park benches or in public spaces (CBC Radio, 2016). This reminds me of the incredible need for advocacy in regard to social justice as a student nurse.

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CBC Radio · Posted: Aug 26, 2016 12:00 PM EDT | Last Updated: August 26, 2016

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Homeless Jesus sculpture sparks controversy | CBC Radio

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Timothy Schmalz speaks about his ‘Homeless Jesus’ statue, the philosophy behind it, and the reaction he’s received from people around the world.

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Artifact #1: Art Project on Talk Therapy 

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Artifact #1: Art Project on Talk Therapy 

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I created this artwork for our assigned project during this course to reflect the concept of talk therapy, mainly CBT/DBT, in the context of mental health nursing in order to support patients living with various mental health diagnoses. This artwork reflects the important therapeutic relationship that nurses can form with their patients through the intervention of such talk therapies like cognitive behavioural therapy or dialectical behavioural therapy in the clinical setting. Although this is an important aspect of mental health nursing specifically, therapeutic relationships and good patient rapport are a necessary aspect of the care of any and all patients. As evidenced by an article linked below, such therapies can even provide beneficial when the initial illness is noted to be primarily a medical concern, such as a heart attack (Nourisaeed et al., 2021). Therapeutic relationships with patients are an important aspect of nursing care, as defined by the College of Nurses of Ontarios' (2006) practice standard which is why this was an important artifact to include in this project.

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Understand Adverse Childhood Experiences (ACEs) was an important topic throughout my mental health clinical placement as well as an important aspect of relational inquiry in regard to a patients care and history. During my placement in mental health, I learned about the ACEs study and the relevance of such findings in the clinical environment, which prompted further research within this area. Understanding ACEs is an important aspect of nursing care in any speciality as well as in regard to relational inquiry and practice.

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The concept of trauma-informed care was essential during my placements in both the mental health clinical setting as well as in the maternal-child clinical setting. This topic allowed me to learn more regarding the implementation of trauma-informed care in nursing practice as well as the importance of avoiding traumatization of re-traumatization of patients that we encounter in the healthcare setting. Trauma-informed care is an important aspect of all nursing care, regardless of the speciality or service in which the nurse works.

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Throughout my own personal experiences and during my clinical placements, it was obviously apparent that housing and homelessness placed those within the healthcare system at a significantly higher risk for chronic disease, substance use/misuse, infection, etc. Due to the overwhelming relationship between homelessness and poor health outcomes, it was essential for me to complete research regarding the health disparity. Understanding housing as a means of health and the responsibility of nurses to advocate for social justice in regards to housing has been essential in my practice as a student nurse.

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Talk Therapy and other forms of therapy such as CBT/DBT in the context of mental health nursing has been an important aspect throughout my mental health nursing placement. I chose to include this topic in my project as the concepts of Talk Therapy directly support the College of Nurses of Ontario's (2006) guidelines surrounding therapeutic-nurse relationships and how to foster improved patient outcomes through enabling positive relationships with patients. Although at times we may think of nursing as very hands on or skill-based, we must remember the benefit that empathy and active listening elicits when supporting those in our care.

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Taylor, J. L., Johnson, S., Cruz, R., Gray, J. R., Schiff, D., & Bagley, S. M. (2021). Integrating Harm Reduction into Outpatient Opioid Use Disorder Treatment Settings: Harm Reduction in Outpatient Addiction Treatment. Journal of General Internal Medicine : JGIM, 36(12), 3810–3819. https://doi.org/10.1007/s11606-021-06904-4

Kolla, G., & Strike, C. (2020). Practices of care among people who buy, use, and sell drugs in community settings. Harm Reduction Journal, 17(1), 27–27. https://doi.org/10.1186/s12954-020-00372-5

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Artifact #2: Family Photograph at My Late Fathers Rehab Graduation Ceremony

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Artifact #2: Family Photograph at My Late Fathers Rehab Graduation Ceremony

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This photograph was capture by my Aunt Tracy in approximately the year of 2006-2007 (I could be very wrong, this is an estimate), at my Father's rehab graduation ceremony in which he maintained a certain period of abstinence from substances. At the time, I had never heard of the term harm-reduction and instead of such, my Father was congratulated when he was abstinent from substances and punished (by society) when he was using substances. In reflecting on this photograph for completing this project, this image emphasized the concepts and importance of harm-reduction in practice, and as Dr. Mate says, "meeting people where they are" (First Step Program, 2021). At times, I feel immense grief that such practices did not exist during the early days of my Father's addiction, thinking that such practices could have inevitably saved him. Later in life such practices become known and proven to be effective in evidence-based research and at such time, were implemented into my Dad's treatment plan - but what if that could have been done sooner? Although these are questions I often struggle with, it also proves the importance for why such practices should be implemented in caring for those with substance use/misuse and this personal experience has influenced my practice greatly in regard to showing compassion for others.

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Artifact #1: Gabor Mate on Harm Reduction (YouTube)

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Artifact #1: Gabor Mate on Harm Reduction (YouTube)

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This video provides some specific insight into the principles surrounding harm reduction and the importance of such practices from the point of view of Dr. Gabor Mate, who worked in Vancouver with patients who utilized substances, often living on the street (First Step Program, 2021). Dr. Gabor Mate has produced various books on mental health and substance use such as: In the Realm of Hungry Ghosts, When the Body Says No, etc. In this short clip, Dr. Mate emphasizes the need to "meet people where they are" regardless of substance use and promotes harm-reduction practices (First Step Program, 2021). Furthermore, he speaks on how we as society criminalize addiction and by implementing such harm-reduction practices, we can minimize shame and stigma within certain communities (First Step Program, 2021).

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Gabor Mate: The principles of Harm Reduction

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Throughout my own personal experiences as well as through experience in the clinical environment, the concept of harm-reduction in mental health nursing is extremely important when caring for those dealing with substance use and misuse. This topic is important to me as my Dad struggled throughout his life with substance use until his death and by implementing harm reduction into clinical practice, we can see that it does indeed save lives. This was important to include in my project as it allowed me to reflect on the importance of compassionate nursing care when working with those who utilize substances and promote safety and well-being.