Nuanced. - 57. Dr. Shelley Canning: Healthcare, Nursing & Ageism

Episode Date: May 24, 2022

Aaron sits down with Dr. Shelley Canning to learn about careers in nursing, the challenges health care professionals face, and what improvements can be made. Dr. Canning highlights her research on quality of life, perceptions of seniors, the Gero Nurses podcast, and agism.Dr. Shelley Canning is an Associate Professor in Nursing at the University of the Fraser Valley. She is the coordinator of the University of the Fraser Valley's (UFV) Centre for Education and Research on Ageing (CERA), and a research associate with the Health & Social Innovation Hub (CHASI). Shelley completed her doctoral studies in the School of Nursing at UBC where her dissertation research explores issues of engagement, meaning, and quality of life for older adults with advanced dementia. Shelley obtained her BSN (hons) and MSN from UBC, and prior to this completed a BSc and secondary school teaching certificate at the University of Victoria. Her nursing practice background includes palliative oncology and community health. Dr. Canning has been a faculty member at UFV since 2006 primarily teaching gerontology content. Shelley has been involved in a variety of departmental and institutional committees. She is currently a member of the Board of Governors, Senate and the Senate Research Committee. Additionally, Shelley is the director of the Gerontological Nurses Association. Her teaching is geared towards developing professionalism and supporting best practice with a focus on care for older persons; she also strives to integrate an understanding of the importance of research in supporting evidence informed practice through teaching students in Directed Studies.Connect with Shelley Canning on LinkedIn: https://www.linkedin.com/in/shelley-canning-0a145289/?originalSubdomain=caConnect with Shelley Canning on Twitter:  https://twitter.com/shelley_canning Send us a textSupport the shownuancedmedia.ca

So I'm Shelly Canning. I'm a nurse, and I'm a nursing professor at the University of the Fraser Valley. So that means I teach nursing students how to be nurses. I also have a role as the director for UFV Center for Education and Research on Aging. So the university has several research centers, places where faculty with like-minded research interests come together and partner in collaborations, brainstorm, think of, help each other explore whatever those research avenues are that they share.

And CERA, our research center, is pretty multidisciplinary. So we've got faculty from a variety of different disciplinary backgrounds. And I came to UFV. I've just realized I've worked there longer than I've worked anywhere else. So I came from practice, which most nursing professors have done. And in 2006. So it's been, yeah, it's funny to think it's been the longest, but it's been the longest. And I worked in acute care, which is we kind of look at our clinical practice arena

as acute versus community or other places. So I worked in acute care in Vancouver in oncology at BC Cancer and then moved out to the valley because my husband is a teacher and so he was able to get work out there and we were starting our family and I worked in community health. Actually, I started in Chilliwack and then ended up in Abbotsford and then at the university. Right. I'm really interested to understand nursing more, particularly because we've just come out of a pandemic or we're coming out of one. And I feel like we talk about nursing, we talk about health care, but I feel like I have a very surface level understanding of all the different avenues. Like you say nurse, and that's like a whole field of work.

It's not just like when you think of like a general practitioner doctor, usually you can kind of fit the box of like where you expect to find this person. With nursing, it seems like they can be in homes and seniors' homes. They can be at a hospital. They can be in so many different areas of a person's journey through the health care system. I don't think we maybe understand their role and the impact they play in our health care services as deeply as I think we kind of say when we say, like, we should care about our nurses. Could you walk us through some of the different avenues you would find a nurse, where the different roles they might play throughout the person?

process. That's a yeah, that's a really interesting question because I think I have been a nurse during a period of a huge transition in our profession. So when I began nursing, it was a lot more clear who was a nurse and where nurses were, I think. And now there are, as you say, there are many places nurses are and there's many preparations where people are, people are educated to be nurses, but in fairly different roles. So within nursing itself, we have licensed practical nurses, registered nurses, which is the registered nurse is sort of typically what I think most people think a nurse is. So that's the four-year bachelor's level preparation at a university program like the one

at the University of the Fraser Valley where I work. The licensed practical nurse evolved out of, used to be a practical nurse and then a licensed practical nurse, a one year preparation, now a two year preparation. So just a little bit of a different skill set and scope in the work they do, but they work alongside the registered nurse in virtually all the same settings with fairly minimal distinction now. So there's a bit of tension, I think, between that because you've got different educational preparations,

but very, very similar scope and responsibilities, not quite, but pretty similar. And at the other end, you've got nurse midwives prepared at a master's level, nurse practitioners prepared at a master's level. I have a PhD as an academic and researcher, but I'm a nurse, and you'll see often And that idea, being a nurse is not only a profession, but it's often an identity. So I'm one of those who has that as an identity. So I think of myself as a nurse researcher, not a researcher. And my title, I always have RN right after my name because I think that means something to people and it means something to me.

The places that we work are really varied, and we see ourselves, I think, more increasingly in some new roles. So again, historically, primarily a hospital setting, or maybe more informally in a home or a community setting. And it was always that the majority of nurses were working in the hospital, and that's where I think nursing students envisioned themselves and novice nurses went. they're first to become more skilled and confident before having a more independent practice. So if you're working in the community, say, like my own experiences, there you get in a car, you drive to someone's home, and you're on your own, which is quite different from being on a hospital unit where you can turn to a colleague or there's any number of resources right there within a few steps. When you're in someone else's home, they, you're,

dealing with all their rules and their, it's their place, it's their environment and you're a guest and you don't have access to all that immediate resource. So it's a different, it's a really different place to be. And now I think we're seeing nurses and certainly students are coming in with some ideas around global health, international issues, so the world's become a smaller place. and we see that we might have a role in far-off places where there's huge health issues. And so now I think there's so many nursing roles, and we see ourselves kind of everywhere. It's, I think it's hard for new students to come in and know where they're going to be and where, really, what is a nurse?

I think our identity is shifting and maybe in ways that we have. hadn't anticipated. For the better or worse, do you think? I think there's some tensions and problems in it. I do think there's, I think there's a value in having a more clean identity and role. There's, healthcare is so dynamic and complex and there's many of us all in there. But I kind of think that that cleaner rule of the nurse, that the public, typically is expecting of us. I think that's a really important role and I think it's not to be

dismissed. That embodied rule where the nurse is there for long periods of time over a, whether it's an eight hour or 12 hour shift and where the real focus is that clinical care relationship. Right. The danger, I guess, is that with doctors, they have such a load already that it seems like nurses are often kind of placed at that second tier or something in comparison to a doctor in general people's eyes, not necessarily that that's the case, but when people think of like, oh, you'll see a nurse, then you'll see a doctor. In people's minds, they go, oh, I'll see a regular human being and then I'll see the expert. That's the kind of sense that they get.

So it seems like it might be almost easier to overload that person with responsibilities, the nurse. or diversify their role because people don't exactly know what it is that they do or all the different kind of avenues they already maintain. And so it seems like it might be easier in comparison to a doctor to expand the responsibilities and perhaps more cost effective. Am I on the right track? Some of that is definitely the right track. And I think that hierarchical piece is there's lots of history to that as well.

But I would say in my practice, I had, you know, even I'm not at the bedside now, but when I worked closely with physicians and patients, even then I would say it was much more of a partnership, not, I never felt that I was a physician's assistant or that I was less than. And see, that's, I think, where the identity comes in. I had a pretty clean identity that I had a really specific set of skills. and expertise to offer in a clinical setting that allowed me to partner with a physician, not to be part of the physician's role, but to really collaborate. And I felt, yeah, I think that that wasn't the same experience for every nurse and every physician, for sure. I think vestiges of that kind of class system and hierarchy

that exists, you know, it was in the beginnings of health care and has existed, and I'm sure there's still some of it, but I'm sure that medical students today are educated differently because when I'm around new, younger physicians, I don't feel like they're looking at us at nurses as being just an assistant to what they do. I think they're understanding that we have a particular skill set, and we have our role, they have their role, and it really meshes together. And when it works well, then you really begin to meet the needs of the patient in a meaningful way. That's brilliant.

One of the interesting things is, like, what do you see when you're working with students now? Do you see that that role is expanding into outside of the hospital more and more? And do you think that there's challenges that are going to come with that where, like, they're not in a setting that's familiar where they have all their perhaps utensils, all the tools, all the resources? is that going to create longer-term challenges? If you're driving perhaps your own car, that's a very strange role. I'm just wondering if you could elaborate on that a bit. I'm thinking, I'm not quite sure if I'm answering your question, but there is a, I think we're coming to a bit of a crossroads with nurses

working in the acute hospital setting versus a myriad of other, exciting places that you could be. Like I said, global health nursing, when I talked to students in our program, lots of them are interested in issues of social justice. So maybe working with disenfranchised vulnerable populations in the community. So the idea of perhaps being in the downtown east side or, you know, those are our early career choices that nursing students might be thinking about. as opposed to when I went through and I graduated in the late 80s that it would have been you go and you work in the hospital and you hone your clinical skills and then you might specialize in either a different working with a smaller population group say maternity patients or in mental health and then because that's how we would

have seen it in those days that the bulk of patients are medical surgical patients and smaller populations are pediatrics medicine. And we would have looked at that time as looking at mental health, we would have seen it as psychiatry only. So a very biomedical kind of look, and I know we've moved. But so that was kind of the goal and the direction. But now students, they don't all want that. And they don't really see that acute care experience as part of their career. And what happens is then they enter other avenues, but they've never had what, and I know this, not everybody thinks this way, but this is just because it was my experience and what I've seen. There's so much that the hospital has to offer, and it's the place where most of us work, and it's the place

where most people seeking health care, you know, that kind of emergent health care are there for these short, hopefully short periods of time. They're in, they're out. And it's a place where, again, you're surrounded by resources, so you have a lot of people to draw on. We're in the middle of a nursing shortage, so I say that with that caveat. There should be a lot of resources there. There should be a range of expertise that new nurses can draw on in the hospital and truly get skilled and get confident in assessing and understanding intervention and even understanding the whole healthcare team because everybody's there. Physios, OTs, pharmacists, doctors, social the workers, counselors, everybody's in there.

And then you see the team, you see the scope, I think, before you go into a more isolated kind of a practice where you're more on your own. That's one way to look at it. Others see it differently. They think there's perhaps maybe that route into where you really want to be isn't necessary and that you can just go directly into a more specialized type of practice and just become expert over time in that arena without kind of knowing the acute

place. I think there's value in, it can work both ways. It depends on the student and how it depends on their skills and abilities and personality when they come out. You have to be pretty self-directed to be able to go into some of the specialty areas right away. And not everybody is. Some people take a little longer to learn.

A nurse doesn't graduate really as a nurse. A nurse graduates as a new nurse or a novice nurse or a beginning nurse. And there's a whole body of nursing scholarship around that journey from novice to expert. And it's not, you're not finished in four years. You're just really ready to start. and the real learning happens after. Yeah. So that's comparable, I guess, to police officers, because police officers, they're expected to, like, maybe get a criminology degree or get some sort of education,

and then you have maybe five years of general duty, where you're getting to see all the facets of work, homicide, you're getting to see gang work, you're getting to see all the different players and all the different kind of tiers. And what you're saying, it sounds like, is we need to make sure that nurses have an understanding of the other players, that there's a risk perhaps in specializing too quickly because then you don't know the other players, you don't know the resources, you don't know maybe the system as well as you could, and that there's risks to that. And I think sometimes we like the specialization. We get fascinated by someone who's an expert in just this one little thing, but if that person isn't able

to pull back and zoom back out and say, this is what's going on, this is how to navigate the whole system, then there's detriments to that because then you're not really firing on all cylinders. Yeah, I think that's a really good analogy. And again, for some, they do go directly into a specialized rule and it's a really successful career. It's just that there are some risks inherent in it. And I think sometimes we dismiss the value of working on a basic medical or surgical unit because that seems a bit old school. It's not as exciting as the newer nursing avenues that have kind of opened up. And so I think sometimes that gets dismissed. And when I think back to my early years working on medical units, fairly traditional kind of a model, there was a tremendous

amount of learning. And it's a bit, you know, there can be high stakes because things in the hospital happen quickly, change quickly, decisions have often a greater impact right away. But it's, I think there's value in learning to deal with that too. By the time I moved into community health, which would have been a more specialized role in those days, I had a good knowledge of the bigger pitcher and I think I had I developed confidence and decision making and there was lots of times where you know I still had to learn a lot because working by yourself is very different and working in people's homes is very different because there the power imbalance has switched in the hospital you can pretty much get people to do what you want you're the boss it's your place

and you go into someone's home and they're very quickly you learn they're the boss and really it's their place and the environment is foreign to you but it's it's their home and they've set it up and there's particular ways they do things and you have to figure out how to work with that not how to make them do your particular things your particular way that seems like it would be a challenge and it seems like working with people like people right now think other people are narcissistic it's very common to think because of social media that we're more self-absorbed we're more interested in ourselves than ever before and the comments are like well you take photos of yourself all the time and you post them but i don't know if i agree with that analysis

because it seems like the biggest challenge is getting people to take care of themselves Like the statistics that I've seen is that people are more likely to renew their dog's medication or their cat's medication over them renewing the medication for themselves or even completing their own medication. And so on the one hand, yes, maybe we're more superficial in some ways, but that actually caring about yourself and that like wanting to be healthy, it seems like that would be the challenge that so many nurses face. Yeah. I think that, you know, our goals are around achieving health, achieving good outcomes. Nursing has a very holistic value set. And so we look at health, broadly, quality of life and well-being. And things we're focused or we value health promotion and prevention. So there's a lot of work done, particularly community health nurses, on trying to go. encourage people to manage their own health better and prevent long-term problems by doing some of those health promotion things that we know can make a difference. That's really hard to do. People, as you say, they're not, they may be more inclined to do other things than the things that we know or we hope will be really good interventions or make some difference. And yeah,

I'm not, some of the things around looking after your own health, they're, you know, frankly, they're kind of hard to do. So in improving your exercise, changing your diet, dealing with any kind of, you know, whether it's addictions around substances or behaviors or making fundamental changes in the way we typically have done things. I think most of us get into a pattern and we find it really hard to, to make changes to that. I definitely agree.

I think that you need to change your perspective if you're having trouble, taking care of yourself in those ways, because the mindset is like, I've heard smokers say, I'm not going to, like, what's 10 years of my life? And that's an error because you're thinking of only yourself. If you put that in the context of that's 10 years less time with your kid. That's maybe you don't get to meet your grandchildren. Maybe you don't get to work as long so you can't save as much money

so you can't pass on finances or support to your children when you pass on. Maybe your funeral is super small because you didn't save money for this. Maybe your ability to pass on and make sure your children go to post-secondary is limited now. There's consequences to living that way. It's not just you're not alive anymore. And that's often the cop-out. Maybe you could have been picking up garbage in the Fraser Valley and cleaning up and making the world a better place. but you're not because you're bedridden because you chose to live a life that was super selfish

and I think that when you only view it through that lens of it's just me it's super easy not to take your medication not to take care of yourself but when you start to think of like if I did go outdoors how do I make it something that I'd want to do instead of like I need to go for a 15 minute walk where would you go if you needed to like do you need to go see a waterfall in order to get yourself out of bed what do you need to do to make this something that you would actually excite you And I think that I'm really excited to see, I don't know if you've heard of Andrew Huberman, but he has a podcast and he's a neuroscientist. And it's incredible to have him break down, like, how do you improve your memory? How do you improve your sleep?

What does this look like? And he goes through each topic and he spends like three hours breaking down all the literature on improving your sleep. And I find him inspirational for a few reasons. One is that people who don't see themselves within the university are listening to him all the time and going, I love neuroscience. and it's like you are, if we looked at like the data on who likes neuroscience, it's surprising to see who he's pulling in. But then on top of that, people are interested in improving their health. But it's because he breaks it down and like, these are the 10 things to do to improve your sleep. Why should you improve your sleep? Well, you're more cognitively aware during the day.

You're able to make better decisions. You're able to make better impact. Like some of the statistics suggest that we spend like maybe 30 minutes of quality time with our family. If you're well rested, if you've eaten well, that time is going to be higher quality and you're going to be able to spend more time where you want to be because some people fall into like they're scrolling their phone at work and they're not doing any work. And then they're staying late at work and then they're like, sorry, I couldn't get home. I was busy at work. And it's like you weren't doing anything and you weren't maximizing that time. So you could be home with your family. And I like that COVID has kind of shown people they can work from home and maybe what does this look like?

I don't think it's an untrammeled good, but I think it's given people this like, what would it be like to spend more time with my family? You spoke a little bit about the development of a nurse. For lawyers, we have this like a five-year call, which means you've been a part of the bar for five years, and then you're a 10-year call, and then your 20-year call, and it's a way of us sort of measuring the expertise in the experience. What is that like? What is the development of a nurse over 20 years? And, of course, it's going to differ depending on the area, but what does that overall development look like? I think it's really, it's really varied.

And for many nurses, once they graduate, it's a career of this journey from novice to expert in terms of their being a clinician. Some nurses have their whole career in one particular area. If you're working in the acute care setting, there's many different areas you can go to. So you could start on a medical unit. You could skill up. So there's extra training courses that people could take to work in a more specialized place like critical care or emergency. Could you describe those a little bit more?

I am not that. I haven't taken that particular. route, but so working, there's a tremendous nursing shortage. So right now the whole picture is a little bit different. So I think the system is happy to take almost any nurse, almost anywhere, and then hopefully add the skills to them while they're in that place. So different places, if we're looking at the hospital, different units require different skill sets. So if I was to work in emergency, I would need to be able to kind of hone those

really critical quick assessment skills and thinking about the types of patients who typically come in. Lots of cardiac patients, lots of falls, lots of older people, lots of trauma from accidents. So nurses that work in those areas see those things all the time and they need to have the particular skill set to deal with it. For me, when I worked in an acute area, I was working with cancer patients only. Some of them by default might have had some cardiac issues, but I never took extra courses in cardiac care or medicine because that wasn't a priority. But if you were working in other areas, certainly in critical care units, there's they need to understand at a deeper level that particular branch so there's um there's

extra courses that you can take bc it offers a lot of them um so there's different institutions that provide that kind of upskilling so nurses do a lot of upskilling on the job to match whatever the requirements of the area they're working in not every place has the need for those kind of upskilling courses so for some nurses they just become more and more expert as they get into their role and they they have more and more experience um the the journey to there there's a few different paths some nurses will take uh they'll have worked for a while as a clinician whether it's hospital or or community um and then they might decide they want to be more in administration. So there's pathways that nurses take within the system to be,

there's sort of these additional roles. They could be a clinical nurse educator on a unit where they specialize in educating nurses with some of these continuing education opportunities to either upskill or maintain skills and to move as things change equipment and policies, procedures. There's nurses that work in more of a sort of a lead management rule. Historically, we had had nurses that were kind of the, it's almost like being the principal of a school, if you will. There, you know, there's that one person on the unit who is responsible for sort of the overarching running of the unit. And that role has changed a lot over time. And so the patient care coordinator is sort of that person who's in charge of the

unit. And then there's nurses that go into higher level administration. We actually have the call out for, well, I'm not going to be able to remember the exact title, but for a national director of nursing or I'm not remembering the title and that's not good but having a nursing voice at the federal tables having a nursing voice at the provincial table so when you're discussing the health of a province or a nation you need to have that that voice and that lens is really critical so so that's been a positive thing actually that's come out this last year. The rule that I have is one that requires a little bit of advanced education. So there's actually a shortage of nursing professors. So many of us are towards the end of our

careers. So you would have worked for a while as a nurse and then spent some time maybe in the middle area of trying out a few other roles. and then decide, oh, I think I'd like to teach nursing students. That's kind of often the journey people take and do a master's degree award. And then do not all nursing instructors or nursing professors have PhDs. It depends on the school. But many do that would be a standard. So it's that, you know, a nursing degree, much like any other degree,

there's expectations that students have theory, have research, knowledge, have obviously clinical practice is the center of it, but it's at the University of the Fraser Valley. It's a Bachelor of Science and Nursing. So it's in the health sciences faculty. When I was doing my education, I was at UBC. So it was in the applied sciences faculty. So nursing and engineering together. And it's kind of a nice fit because it really is an applied science. So yeah, I'm not sure if that captured it, but we, We, there's a lot of learning through experience. And then there are these other roles and some, some education, but nothing quite as formal as you described with the journey of a lawyer. Right. So could we perhaps maybe differentiate between an experienced nurse and a doctor? I don't know if this is common for other people, but I find nurses to be broadly speaking more thoughtful, compassionate, perhaps able to take

a little bit more time. And so I don't know if this is an overall feeling that patients have, but there's a feeling that, like, I'd rather just deal with the nurse. Like, the doctor is not maybe the person that people are going to and being like, yeah, I can't wait to get a doctor, maybe I'm wrong, like,

I'm sure that there's a vast different experiences, but the overlying kind of understanding I have is that people prefer to deal with the nurse. Of course, they have different specializations, but could differentiate between what you see as the main differences between a really strong nurse and a really strong doctor? I think if you have a really strong nurse and a really strong doctor, you would look forward to either of them coming into the room and be able to and really

feel that you've been cared for by both of them. Nurses, because of the structure of the work we do, like even whether, and I can speak mostly to community health and acute care. If I was going to someone's house, I might be planning a short visit because I have my number of visits booked out, but I'm also able to stay if everything all changes. And I'm finding that it's an unpredictable visit. I'm going to stay and do what needs to be done. There's something around the length of time that we're with people. When you're in the hospital, typically nurses are working eight or 12-hour shifts.

You have a patient ratio. Again, the caveat is right now we're in a nursing shortage, and they have far too many patients to look after. But typically you would have a ratio of patients, so you would have your four to six patients, or depending on the, it's unit dependent. But you would. you have the opportunity to know them.

And for a patient, a day can be a really long period of time, that 12 hours can feel like 12 years. And so if you have a really, in my mind, a really strong, skilled nurse, they're skilled relationally. So it would be important to that nurse to know each of the patients, to know their names,

to know some little thing about them, that they can use in their interactions to try to make the day go better, to make sure you can get the work you need to do as a nurse done, but also to acknowledge what's going on in that patient's mind or life as they go through their day. We have a role or a, we have a job that allows us to do that. physicians, that's not the model of care for them. So sometimes I think patients set physicians up a little bit because they expect something from them that isn't really possible.

They can't be just around the corner for 12 hours like I can be. You could see me walk up and down the hall or sit at the nursing station or so you can see me all day long potentially. But the physician, maybe it's a surgeon who's come in to do. do your surgery, they come in, they're fairly specific, they come in to make sure either pre or post-surgery. And once their rule is done, they're, they're off to somebody else. And it's not that they're just going home when they leave you. They've got many, many people to see. We've just got a handful that we're looking after in the same time frame.

And so I think some of what you're talking about comes from this idea of being able to have the time to build those relationships. And when we're teaching and nursing, you know, for me it's really important to teach that we're trying to help meet health and to some extent some social needs. We're not social workers and we can't or counselors. We can't follow people forever after. But we are skilled at therapeutic relationships. We're skilled in terms of communication. And so we can develop a relationship for the time that we're with them, within that context of whatever their clinical issues are,

where we can make a pretty profound difference. And a lot of that is driven through communication skills and this idea of a therapeutic relationship. And physicians have, they just have a different model. But I know so many physicians that are also very skilled communicators and very relational. It's just their whole model and their whole role is different. And I think it's just important that people don't, I had an experience as a caregiver over the last few years looking after my mom who died three years ago now. And like often happens with an older person with health issues, you just get more intensely engaged in the health care system.

So we ended up together in emergency and then on a specialized cardiac unit and then in palliative care and then finally in hospice and she died in hospice. And so I was with her all along the way, and I was so impressed by the physicians that looked after her in every place. They all introduced themselves by name. They spoke to her, so they didn't ignore her. As often happens when you've got an older patient, you might defer to the daughter. They spoke to her. And again, I didn't see them for long periods of time, just a snapshot, but they were clear and they were really kind. And I would say that often I was actually happier to see the doctor than the nurse because some, and this is, I think, back to what I was talking about with identity of, you know, our identity, I'm not sure that we all feel that same kind of pride and passion in being a nurse.

I would never have walked into a patient's room and not said, Hi, I'm Shelly, I'm your nurse, and I'm going to be here all day. I'll be here till whatever, seven. There's a bell. You rang if you need me. Just making that connection. Often, and again, we're in a really different place in nursing right now with the, the nursing shortage, and it isn't only because of COVID.

So my experience with my mom was pre-COVID, but we were still in a nursing shortage. It just wasn't really, everybody didn't know it at that point. So, you know, nurses were struggling for sure, but I think there's also a piece that we're just struggling to hang on to in nursing around identity and role and, and having some pride in it's going to be harder now because of what's happened with COVID. And I know for sure the nurses that are working so incredibly short-staffed day after day after day

and feeling really unsupported systemically. They're so, it's hard for them, really hard for them. And so, yeah, I'm not sure where we're going to go with all this, but we've got to move in a positive direction because really that's the only direction to go. Right. I remember that I think it was the Stephen Harper government that cut back a lot of medical spending and investment in health care during the 2000, after the 2008 recession to try and save money. I'm guessing, but I think it was around the $30 billion mark that they had cut back spending. Do you, and then now more recently with COVID, do you have any idea on where the roots of this nursing shortage starts from? Is this, like, I don't, for my understanding, UFE usually books up their whole nursing community and that that's that way at all schools.

And so it doesn't seem like it's a problem, perhaps with the education system. Do you have any idea on where these roots take place? I think maybe, and I'm, this for sure, I'm not an expert. So I'm just thinking on the spot here. But really, I think we anticipate things will go long much as they are. And so there haven't been probably the kinds of visionary strategic planning. I know there will have been some, but quite clearly it hasn't been accurate. Now, I don't know that we could have perhaps predicted the pandemic, but we certainly have had

increases in population, bringing increased needs, and we haven't seen big increases in the numbers of seats for nurses or physicians. We've got a huge physician shortage, too. So we haven't seen those seats increase in anticipation of what was happening. And I think there's competing, there's. There's always competing, there's always competition for whatever the amount of tax dollars are. So you've got, depending on whatever the biggest issue of the day seems to be, perhaps, you know, all focus goes there. But in health care, certainly, we haven't seen big increases in seats.

So we've seen some changes in some of the preparation. So again, a few more seats for licensed practical nurses, increasing their rule, having some nurses, opportunities for nurse practitioners has changed things. But ultimately, there's still just a need for more nurses. And that's what we've seen. And that for whatever reasons wasn't anticipated. or was anticipated poorly

and now it's a scramble to and you can't you can't turn out the amount of nurses we need right now in a year so all of this is going to take quite some time right so to prepare a nurse for the complexity

of what the role really requires now is four years and so we're not really going to see the benefits of whatever we're doing now until the future time, which tells us that the nurses in practice now are going to be overwhelmed for the next four years. So it puts you in kind of a funny place when you're someone like me who's preparing young men and women

to take on that mantle. And I'm a pretty passionate and proud nurse. And I'm, you know, go and make a difference every day. But you know you're sending them into a, some start a beginning place that's far more challenging than my beginning was so i was able to consolidate my idea of what a nurse is and who i was as a nurse and and this idea that i can make a difference every day has been kind of central to everything i've done as a nurse i had the privilege starting place that allowed that to happen i'm not sure that for these new nurses it's going to be

quite that easy. I really like that and I really like how you're highlighting the importance of identity within these roles because one of the challenges I'm seeing from like I come from a criminology and criminal justice background is this desire to send in like healthcare workers into like homeless populations and I absolutely understand the the deep roots of not wanting law enforcement to punish homeless people like I completely understand but the challenge you face is that often these people are using substances or struggling with some sort of mental health issue, that this is not the time or the place to bring in, like, a psychologist. This is, if you're, like, they've created these care teams to go out into the community,

and from everything that I've heard, they've been relatively unsuccessful, because this is not the place that many of these people are ready to receive the care that that person would be able to provide. And so there's this sense of, like, police shouldn't do this. And I just interviewed Bud Mercer, who is a Chilliwack City Councilor, but an ex-R-CMP officer. And I think he has an apt description that when you start to see problems, it ends up in the police's hands. When something's being mismanaged in another area or another field, then you start to see police having to deal with it. And I completely agree, not the right people to deal with it, but you kind of have this like, that's not your role, but you have to fill this role because there's this problem.

And I think you're kind of describing something similar, which is we're expanding what it means to be a nurse, and that can feel good when you're talking about collaboration, and we're going to have these people make bigger differences, and we're going to expand our understanding the horizons of what it means to be a nurse. And that sounds warm and fuzzy, but there's consequences if you go too far, if you start to go beyond the starting place of everybody having these similar roots. because then within nursing, you don't know your colleagues. Oh, you're an expert in, oh, I've never heard of that. I didn't even know that was a thing. And then there's a less sense of community. And within, like, even if you're just a private in the military, you get to create a sense of community.

And understanding that we're all on the same team, and this is our kind of shared goals, and we all have these kind of same roots. And it doesn't need to be identical, but it needs to be consistent enough where you recognize your colleague and their role in this system. And I think that that's a challenge when we're short-staffed.

And I feel like this problem has been ever-growing. And I totally understand, like, everybody always says, like, health care is, like, not perfect, and, like, we can't expect perfection. But from what you're kind of describing, we're not maybe moving in the right direction when we're talking about short-staffed physicians, which was a problem for a long time. Now we're starting to see short-staffed nurses. And then it sounds like what we're doing is, a, overworking them. So they have to take on even more tasks, which means 12-hour shifts, which I just cannot even imagine from a legal background.

We don't usually have to rock those 12-hour shifts. Maybe there's a file that's bigger that takes your whole night, but that's maybe one or two nights in a whole week. That's not your schedule. And so that's probably not the schedule for all nurses, but when you have that type of work, that's a lot to take on. But then you have this, what it sounds like, a devaluing of certain levels of education, which, maybe it doesn't have a gigantic effect, but it's discouraging. You got this four-year degree. You worked hard.

You paid a lot more money. And then there's somebody beside you who is doing great work as well, but didn't have to go get the same educational background. And then you kind of go, why did I go get that four-year degree if you didn't have to? And I had to spend $20,000 more than you. And this is a lot more work. And like that sounds like it would be discouraging even in that letter. So do you have any thoughts on that?

So, yeah, I mean, I think what's happening for nurses and practice is that they are feeling discouraged. The role is a hard role. There's no question. Even in good times, it's a hard rule. So in bad times, a hard role is really hard. It's not that I think we shouldn't have some, have, you know, expand. the role of nursing into other areas. And to be honest, a lot of, the role of the LPN,

so while it's a shorter preparation, they provide a lot of help and support in anywhere where they're working. And many of them, after they work for a little while, decide that they actually want to come back to school and bridge in so that they have just, the opportunity for some of the educational pieces that they didn't get in a shorter program. And it also opens the door to a few more job opportunities for them, too.

So that kind of a bridge between those two happen. And I think the nurse practitioner can fill a really important role, as can nurses that are master's prepared. and working as clinical nurse specialists or in other kind of a little bit more specialized role. I think there's an importance for all of it, but we have to still remember kind of the core of it. And I think that's the word that you used. And I think that's the important piece and this idea that it's developmental.

there's a there is a journey that you go on to to be able to find your way to some of these other areas that nurses do and again not all nurses take that journey some love exactly what they're doing in that more um you know in the acute care setting where it may seem like the more traditional role for a nurse and they may stay there their their whole career um Yeah, it's a very developmental thing. It takes a while to, because we're so, it's such a broad role. So we've got one foot in science, one foot in the arts. It's, when you look at the kind of work that happens in gerontological nursing,

which is where I've found myself now, we talk about a person-centered approach to care, and we also think about the biomedical approach. And nurses have to do. be able to navigate both of those. So having this understanding of the body and of pathology, pharmacology, the science that that is part of health care and a critical part, the medications we use, the treatments we use, that collaboration with the physician,

looking for cure when it's possible, looking for symptom management for sure, all from kind of a scientific lens. But on the other side, we've got this relationship, the therapeutic relationship. We've got this other piece that and understanding of maybe the historical context that this person arrives to our practice with the family that plays such a critical role. It's not just the patient. It's a person with a family and a history. And so we navigate between this lovely tension between these kind of two approaches to health care. And I mean, that's the thing I actually really love about nursing is that I see kind of both. So, you know, many people,

people don't think of nursing in terms of kind of the art of nursing, but there's a huge piece of what we do. There's an art to nursing and intuition plays a role. It's not a, but we also have this biomedical lens too, and we kind of navigate between these worlds. So nurses, I think, have, again, back to our identity. We have this, we're so well positioned to meet so many needs and have a really, you know, a really successful career. And yeah, right now we're just at such a challenging place. So that's, you know, for me as a professor, those are kind of inspirations that I hope I can share with my students, that I can talk to them about what has been potential before, what has been possible before.

And what they need to be looking at. Now, now I encourage them, you know, they have to be advocates and they have to be brave. And those are probably two adjectives or adverbs. I wasn't thinking of before. We always talked about advocacy and nursing, you know, advocating for the patient. But now they need to advocate for themselves. We need to advocate for the profession. We need more nurses on the ground yesterday.

And so we can't let up on that. And you need to be brave to make those arguments, right? We interviewed for our Gero Nurses podcast, a new nursing grad. And she graduated from UFB in the middle of the pandemic. So she finished her education during the pandemic. she graduated and began her practice during the pandemic. And she talks a lot about how as a novice she's been forced into this really strong advocacy role. And she can do it because that's part of who she is.

But it can be more developmental for other people. So they get into the profession and maybe they're not brave to start. And they just feel overwhelmed by the system. and it's hard for them to be able to find their voice and be able to say, no, this isn't good enough and we need more and we need better and we're going to keep saying it until we get it. That's incredible.

So part of my interest with nursing is that my mother was a part of the 60 scoop. She was born with fetal alcohol syndrome disorder and she was taken to Coqualee to Indian Hospital. And at that hospital, the nurse, Dorothy Kennett, saw the care she was going to need, the challenges she was going to face, she had both of her eardrums pop, and so she had a lot of health conditions that were extensive that needed long-term care and support. And so she actually decided to adopt my mother and raise her as her own and support her. So I love that tie-in with the art and that intuition and that feeling of this child

may not make it if I don't get involved and if I don't care for her. And I think that that's really admirable to know that there is an art to this and it's perhaps that is the differentiation between typical physicians is it definitely more of a science and it's got less of that art piece do you feel like there are solutions that are low hanging fruit that can address some of these problems like of course more nurses but one of the arguments that you kind of see pop up every once in a while is this idea of like paying for further health care or that there should be more on the individual's freedom, because the challenge that I think everyday Canadians maybe feel is that they want that top of line care. In those moments, they want the top of the line care, but there's

no avenue to go about receiving more care or making sure that their nurses aren't overwork and underpaid. Like, that's a, in a moment of crisis, you want the team working with your grandma or your family member to be able to be focused and firing on all cylinders. And there's this fear, I think in some people's minds when they have to go to the hospital that your nurse has been working 12, 15 out, like they're burnt out, the physician's tired, they want to go to sleep, and then they're coming in and checking on you, and you're like, oh, I'd like you to get a nap in before you look into these issues. What are your thoughts on that idea of, like, perhaps privatizing a part of health care? Is that nonsense? What are the arguments against it? No. I think it's a short-term, it's a short-term vision for a fix that has ramifications down the road that would fundamentally change Canadian health care. So I think the slippage that can happen is would be tremendous and and there's so many issues around equity um when you look at privatizing

you have only to look even now right because with indigenous people like we just had i think a report come out that said that like i think doctors or something were like laughing at uh like indigenous people's like care so like there was something going on with the judgment of indigenous as people in health care. Yes. Yes. I think it was an issue around stereotypes and sort of predictive game playing in an emergency unit.

Yeah. So those problems would be exacerbated if we privatize because then the most wealthy would be able to pay for whatever service they want. And then the most vulnerable, like, that's the concern, right? is that, like, the best doctors would go, oh, I can go privatize and make way more money working for just private people, and then all you're left with is kind of everyday people, maybe they're not specialized, maybe they're not experts, maybe they're just average joes, and they're the ones now taking care of the vast majority of Canadians.

So, yeah, I think there's various models that get presented, and they can look really good where only little bits of the system get privatized and perhaps there's some way of applying an equity lens through that. I'm not quite too sure how at all. There's ways of positioning this kind of pseudo-private or semi-private bits and pieces to make it look as though it actually supports the greater health care needs of society. But I think there's just tremendous risk with that. And I think that it doesn't really help us solve the problem.

So we have a mostly public system. It's not all public, but for the better part of it, one of the problem areas is in seniors or aged care because that's not captured under the Canada Health Act. And that's, there's a lot of issues with long-term care that have been brought to the fore because of what we've seen with the impact of COVID disproportionately impacting the long-term care system. So our older people and the care that's been provided in those settings. But I think the issue is that we need to fine-tune and fix. our public system rather than, and I'm not, honestly, I'm not a, I don't have a huge political

bent or business bent, but that's how I see it. We need to have nursing programs and medical programs. There's so many young people looking for a career in medicine or nursing or the allied health professions. I'm the faculty, I'm in health sciences, Kinesi, Is there? Lots of those young men and women want to be physios, OTs, kinesiologists, and have, you know, come into the health care system from that venue. And I think that we need to make sure that we're offering educational experiences so that we can credential all of these young people to roll out into those, fill those gaps in the system and make sure that we have a, have a, a system where we have enough of those folks in all those roles. It costs money. We're going to have to have increased seats.

There's been, I think, 602 new nursing seats recently were announced by the Ministry of Health here in B.C. So, 602 new nurses will be very helpful. Again, it takes a little while, but you have to start somewhere, right? You can't be hopeless and say, well, it won't be four years until they come. Well, get on it. Do it now. Because the four years will come, right? And we want those nurses. And the same with physicians. There's a shortage in physicians. There's a shortage with physicians working as GPs. So instead of looking at private or different options, to me, the obvious thing

is to say, this is really what we want and we need more of. What are the barriers? Do we need more seats in medical schools? Do we need to have a different model? Like what are the barriers to people choosing to be a GP? And again, it's not my world, but it's got to be doable when you dissect the actual problem and look at what would solutions to the problem be, not creating a parallel system. I don't know that that is actually the answer. Yeah. I completely agree. And from all of my understanding that is the biggest challenge within the United States is that they've created a two-tier system that disenfranchises some from even believing that they could enter a hospital without having hundreds like thousands of dollars worth of bills to leave with and so there's there's lots of

challenges with that but right now we're in this really weird time where I've heard of people calling their general practitioner and they're like having them schedule an appointment just have their like their medication renewed so that the doctor can charge for that so they can make and so we're just in this weird time where it feels maybe from a patient's perspective that they're a utensil to other people already and so that seems like it's it's already a challenging system and I'm interested in your thoughts and like we want to fix this problem but the challenge maybe is that most people aren't in need of care and they only realize the problem. problems when they're in the hospital, when they're calling their doctor, and then once their

problems dealt with, it's gone. In comparison to something like maybe policing, if you see an issue, and you're like, oh, like, there's all these problems on the street. You see it every single day, and it's on the front of your mind. But one thing that's really interested me is trying to keep up with the Chilliwack Hospital and understand what's going on with their funding, because from my understanding, they're mostly funded privately. People are paying and donating money to try and have them have equipment and that just that wrinkles my mind because it's like what if these people weren't philanthropic like what if we didn't have that community what we just have a bad hospital with no equipment like that seems crazy and so it's been just interesting to me to kind of look

into this world and start to see that the challenges that exist and I'm just interested in your thoughts on like how how do we mobilize people to start to make sure that this is addressed Because it sounds like there's some things taking place. But as you've kind of described, we need a shift in our thinking. And that might, we need to galvanize more people to say, hey, I want proper care for my grandparents. Like, we know that there's an increasing elderly population. And they're perhaps the most vulnerable to not getting the care they need.

So we kind of need to, this is the focus. We're going to commit to this. And we need to, as a society, kind of agree on that. So what are your thoughts on, like, galvanizing that support? It's hard because there's, again, so many competing asks at the same time. So as you're describing the hospital and the role that kind of auxiliary and volunteer groups play in fundraising and buying equipment, it seems ridiculous that we don't fund hospitals with exactly the right equipment that they need to meet all of the needs of the population that come in. But it's not dissimilar to the education system where you've got PACs, parent advisory committees or groups that raise money because they need to buy whatever for the school, books for the library, or make sure that there's something on the playground that's safe for the kids to use equipment for the gym, that we don't actually fund education and health and the criminal. justice system with the tools they need because those are kind of three areas that we they touch on

all our lives at some point um but police don't really have to fundraise like specifically or the like the judges don't have to fundraise for anything and so they're in a unique uh there are challenges but usually that's within the non-profit sector of having enough community resources or something like that where they don't have to stress about that and so it's a little frustrating because I think health is more personal to people if you ask them like what is your priority is like do you want a better end of life care for your family member or do you want more police officers? It's not to say that we don't need more police officers but I think it's more personal to people. They'd rather see their community get proper care and that's I think what frustrates people so much is that that's that's in question right now. Whether or not you're getting the best care is in question and I think that that's more personal to people on average than perhaps.

Perhaps whether or not police have the next AK-47 or whatever utensils they need to do their job, the concern is that your doctors are overworked and exhausted and then they're coming in five minutes with you. So how do you galvanize that? I mean, I think it's about keeping, you know, maybe we're keeping the lens on that particular issue because we're going to be asked to deal with the environment, with climate change. We have to deal with what, you know, the tragedies for our farmers. We're all of these things become a news bite for a short period of time. But they all stay as issues that need to be addressed.

So I don't know that I know the answer. I think it's probably quite multifaceted. I think wherever there is a bit of some power or expertise or venue. So I would say, you know, programs that teach nurses. So the nursing schools to have to coalesce into sort of a singular voice. And we do do that on different issues, but to do it in a more purposeful, intentional way right now, to really look at the nursing shortage and the role that we play. To look at partnering better with the places we send our nursing students or new nurses too.

So to look at Chilliwack Hospital, A-A-R-H, that's probably where the bulk of our grads end up to start with and to look at ways that we can better support them. Now, we don't have a lot of resources, but you're looking at the, you know, partnering in maybe more intentional ways than we've done before between the two players and bringing government in. There's a lot of advocacy work done, and there are different groups that are asking for a voice at those tables where the policy and financial decisions are being made. So, you know, again, back to having a nurse's voice at a federal table, a nurse's voice at the provincial table. There are conversations happening right now around dealing with long-term care. The actual physical environments have been outdated, unsafe, poor models of care for a long time.

So you can look in any of our local communities and see buildings that really are, They're not condemned, but it's not what you would want your grandmother, your mother, your partner to be living in. If you look at the actual, just the physical environment, they have needed to be, many of them have needed to be updated, torn down, and rebuilt using the new knowledge that we have, our new understandings of really the best kind of environment that people at that end of life with that complexity of care. what would really help to give them the best quality of life for that period. So we know well what's needed. We just need to have it done. So those conversations are happening and to have nurses at the table that are really do understand that frontline work, to have families and to have residents,

people that live there, to have all the voices from the ground out. I think those conversations are happening and it speaks again to the need for nurses to be able to be advocates. So to have, you know, for us, we have that responsibility as professors to make sure that our nursing students can come out and hopefully some of them can join those conversations where they advocate to make the differences that we need. nothing is going to be a quick fix it's about keeping i think keeping the light on the issue keeping the conversation going not giving up um it's easy to give up and say it's it's hard to do it'll never happen it'll take too long um it's always been like this but there's got to be a few people who think well okay that being said we're still going to keep the conversation going because what's the alternative?

Yeah. Yeah, for, like, for me, I'm hopeful because, and I'm sure you've heard of it, First Nations Health Authority was a huge development within, for people who don't know, we actually have like our own kind of provincial system that's able to be adaptable to each First Nations community, and each community gets their own resources, their own system navigators, so somebody will come into the community, make sure those community members are getting the service they need. It's a huge update. It's the first one in all of Canada to have a more localized approach. So they kind of operate very similarly to Fraser Health. They're

able to be adaptable to the Fraser region or the coastal region or the interior. And so that was a big step because originally everything went through this national system. It was super slow. They weren't getting all the resources they needed. It wasn't able to be as quickly adaptable to one community's needs over another. So First Nations Health Authority is a huge. huge innovation in healthcare for indigenous people. And so during COVID, they were able to send out a bunch of resources to try and block off communities because indigenous communities are more likely to cross over and have different transmission. And so they were able to just send out the resources and make sure the communities were able to kind of cut off ties with other communities

to make sure everybody was protected during the pandemic. And so that's one example to me that stands out as like a huge kind of innovative moment in health care, particularly for indigenous people, but it means it can be done. One thing you kind of described was this infrastructure change. I just listened to an Andrew Huberman podcast where he was talking about how being in like a blank white room or yellow room, it actually slows down your perception. And so it means that you're kind of chopping up time differently because you're able to take in so much more. So when you think of like reading a book, you're chopping up time because you're reading each individual word perhaps. And so time is sort of slowing down perceptually for you because you're breaking something

down in comparison to a hike or a run where time feels like it goes by so fast and 30 minutes is gone like that. And so he was kind of just explaining that there's two different ways of breaking down time typically. There's more of like a focus mode like when you take a photo and it's a portrait mode and you've got this focus versus like a landscape and you're taking and a whole bunch of information super quickly. Is that one of the updates that they're talking about, hopefully? Because that's the challenge is that when you're in a hospital room or when you're in a hospital in general, it's white walls, it's very dry.

It feels like time goes by slower when you're in those environments because perhaps there's no color and there's no brightness and there's nothing that would make you happy or positive. And we do know that some of those things have effects on people's ability to recover faster. So the hospital is intended that people are in and out, not that they stay for a long time. And that being said, some people end up staying for a long time because we don't have the right place or resources to help them shift out to wherever it is they need to be. but assuming that people are in and out the hospitals are designed all around function and efficiency and I'm kind of okay with that for the most part it shouldn't be unpleasant but it's the

focus is definitely efficiency and function there is a budget though within each of the health authorities for art. And so they have art installations. So to have nice paintings or I'm thinking of paintings mostly. And again, this isn't my area, but I do know they have a budget for this. And they bring in art and they rotate things around to a, not to a large degree. It's not an art gallery, but still. If you look at a new. hospital. So the newest one in our region is Abbotsford Regional Hospital. And it's got that kind of large, it has that kind of large foyer area where, yeah, you can sit and have a coffee. And I don't know if you remember the old MSA, the hospital that ARH is replacing. It would never have had that kind of lovely sitting area. And there's a piano at one end. And so there is some thought given to the aesthetic of the place and health. It becomes even more critical, though, when you look at long-term care, because the actual intent is that it's a long-term care home. So that means people have moved there and will likely not move anywhere else.

And so often people talk about, well, it's not really their home because their real home is somewhere else. I'm like, actually, it is their home. I've lived in many, many different places. And each time I lived in a place, it was my home. I had my family of origin home where I grew up. I've got the home that I've raised my kids in, but I've also had other homes in between, and I'm quite sure I won't stay where I am forever.

So every place you're in is your home. And it doesn't mean it's your favorite home, but so it's their home. They're living there, and they will almost all die there. Very rarely does somebody leave long-term care? So if that is where you are going to be all the time and you actually have your own bedroom and your kitchen or eating area, you want that to be aesthetically pleasing. So there it becomes even more critical what we do with the environment, especially knowing that almost everybody living in long-term care has a diagnosis of dementia. or in a mild cognitive impairment that is perhaps the first stage of a dementia developing.

So if you've got those kind of cognitive and sensory changes, your physical environment is critical. So colors, patterns, space, use of space, all of that, again, that's this idea that we know more. now than we knew in the past. In the past, long-term care came out of the idea that the hospital couldn't house people who needed housing. So they kind of built a hospital model. So it was very institutional. So it was multiple people in the same room. It was long hallways. It was that kind of fluorescent lighting and nurses station at the end. So it was very much institutional. In fact, some of them were ward built. When I was a kid, I worked as a nurse's aide in the summers in Victoria.

And there was in a care home that turned out, it was a Catholic nun's care home. And my mom, it was an RN. And so she was the head nurse in this care home that turned out to be the first government-funded long-term care home in BC. So Wanda Fuca hospitals, I believe it's. still is that name. But prior to that, it was run by a Catholic order, and it was called Priory Hospital, I think, out towards Colwood on the island. But there people were older people, and I think they were all women. There weren't any men living there. And I was a teenager in high school, and I got the job as a care aide with absolutely no training just on the job. And

all these women, that was the way they came to it as well. So they were care aids with a couple of nurses, my mom and a couple of others. And then the nun, Sister Patricia, was also a registered nurse. She was an Irish nun, and she came to Canada to run this Priory Hospital. But if you can imagine, it was a renovated building. I'm not sure if it was originally a home or not. It was by the golf course in Calwood. And there must have been eight, ten, twelve people in the same room.

And they were all hospital beds, not like today's hospital beds that are electric. So everything was manual. I'm sure the mattresses were terrible. And these were people, it was before the days of having a mechanical lift so you couldn't actually get people in and out of bed unless you physically lifted them. So we would physically lift people from the bed to the wheelchair. Again, not a wheelchair like today's wheelchairs that are ergonomically designed and padded. And we couldn't get everybody out of bed.

So some people simply lived the rest of their lives in bed in these rooms with many other people. So when I, sometimes I think back to, it's kind of interesting that I had that very beginning look at it and I wasn't planning to be a nurse at that time at all. It was just a really good summer job and my mom worked there and I knew the place because we'd go there as kids and the sister Patricia would have a birthday party for all these women whenever it was their birthday. and she would buy a big store-bought bakery cake that had the rosettes on the corners, which we never, ever had at our house. So my sisters and I would go and all the other staff, all the kids would go. So Sister Patricia would have this birthday party, and all the kids from the staff would come.

So these rooms with maybe 12 very frail women in these beds, it would be full of kids and then balloons, whoops, and then we would sing, happy birthday, and I remember, you know, kind of skipping around. And so all of a sudden, you'd have this kind of tremendous young life with this very much end of life group of people. So, yeah, it just conjures up this really interesting kind of image in my mind. And I'm sure it was a piece of where I've come to in my career, but completely unexpected at that time. Anyway, so when I think about long-term care, you know, we know a lot.

now that we did not know then. The beginnings were a place to start. And I would also say that it showed me the importance of the relationship because I don't think those women who are being cared for there were being poorly cared for. The equipment was really poor. It would have been nice for them to have some privacy. but the care was incredibly caring and there was enough

care raids to come around like we were there all the time there was nowhere else to be so you were in the room looking after these women all day long nobody was off on a computer filling out forms or

there wasn't any of that it was just being there and maybe it's a romanticized memory, but I don't think so. Like, my mom and I talked about it over the years, and she really felt like all things considered there was a lot of care. That's really beautiful that you're able to try and make sure that you're not seeing things from just one perspective, that you recognize that it could be romanticized.

And I believe you're, I think it makes it more credible when people are able to say, It could be this, but I don't think it is. I just think that that adds a level of credibility. One of the other reasons I was excited to sit down with you was because I'm really interested in learning about indigenous culture. I believe in capitalism. I think that it is effective in a lot of ways, but I don't think there's anyone who disagrees that it's a flawed system.

One of the areas that I think it was Martha Dow that said it, but I could be incorrect on who exactly said it. But they made this comment that people in a capitalist system, we look at it. them as like tools, um, that you serve a purpose, that the whole point of your adolescence is to get you prepared to go to university. The point of university is to get you prepared for a job. The point of your job is to make you money and to serve the society for 35 years. The point of retirement is to basically spend your money and die. And so like, we have this like process of what it means to be a person, um, kind of, uh, it underlies. We don't talk about it,

but it kind of underlies how we look at people. Indigenous people don't live. look at their elderly populations as if they're just a tool or if they're done now, they can go disappear and die and pass away. But it seems like through the COVID-19 pandemic, we've really gotten to see where's, like, put our money where our mouth is and realize that we don't care about our senior populations the way that we should. And I've made this comment in other interviews with people, but you're the expert and being able to tell us about what went wrong.

where are these challenges that exist? Why, like, indigenous people, we have an elders lodge here in the Fraser Valley for our elders. I've watched clients who are in prison look to their elders for wisdom and sage advice and for a sense of understanding of who they are. I would compare perhaps elders to, like, a priest in their respect within our communities, that we honor them and we don't look to them necessarily for intelligence. for facts for our medical fact on exactly what like a nucleus is but we look to them for wisdom how do you live a good life what does that look like how do you how do you make a difference

in your community what is community what like what is how can you be a good person and and how do you play that out it seems like we may have forgotten that when we when I was sent to elders homes like a senior's homes growing up it was like go paint them a picture and then leave like it wasn't like listen to these people because they might know something they've seen world war one they've seen maybe world war two they've seen the great depression they know what it's like to have to be frugal because there's no other option they know what it's like to wonder if nuclear annihilation is right on the precipice it's right around the corner and we're back in many of these positions today we're worried about climate change we're worried about what's going on with russia and ukraine

we've got these concerns but it feels like we're forgetting to talk to the people people who've actually already experienced these things. Like my grandmother was a nurse during World War II. What would that have been like to know that, and speaking with Scott Sheffield, who's also a UFE professor, he describes we were just this close from having the war come to Canada and picking up war efforts here because we were about to lose Europe. And that's how close we were to being in a whole different society where we don't have these freedoms that we sort of take for granted today.

And so you are passionate and interested in. the care that seniors receive. And so I'm just interested, when did you start to recognize that this was an issue? It sounds like you had some childhood experiences, but can you kind of give us the lay of the land on what's taking place? Wow. Okay. Big ask.

I would say my own journey started kind of surreptitiously, and I look back now and I think I'm not a fatalist, but I think, oh, it's kind of funny how life takes you in these particular ways. I was going to do a few different things, and then I've kind of felt some pressures to do something. So maybe that kind of societal way of being that we have, a bit neoliberal, you need a purpose, you need some, you know, you need money, you need you need to be able to look after yourself and be independent, right? So in looking for a career to have a bunch of things happen, good decisions, poor decisions, ended up going to nursing school. And I think, you know, certainly having a mother who was a nurse, it was a familiar type

of role. So I did know something about what it might be like. Of course, it was completely different once I got there. but when I graduated again, I worked at BC Cancer as an acute care nurse, and I thought I was focused on cancer care, and that is the expertise that BC cancer has for sure, but what was completely lost on me was the fact that really the main risk factor for cancer is increased age, and absolutely the majority of the patients I cared for were older people. I didn't think of them as older people, I thought of them as cancer patients, but really I was

developing the ability to engage and interact and just the kinds of expertise and knowledge that a gerontology nurse has, I was starting to get a bit of a foundation of that then, because that is who I cared for. Coming out to the valley, we ended up out here, and I actually tried to get a job at MSA hospital and I had a master's degree by that time and yeah there was nothing for me and so I thought oh okay sorry what is MSA hospital oh that was the old hospital in abysford it was called matskwesumass abbotsford hospital but that was before um abysford regional hospital was built so when I moved out here that was the hospital I tried to get a job there because of course I was

a hospital nurse and there was nothing so I ended up in the community and again that same thing I thought I was learning to be a community health nurse. So I was learning, you know, a lot more about promote health promotion and prevention and all the kind of tenets of community health. But really, almost everybody I saw was an older person. So when I then came to UF.E to teach, the vacancy was in the first year where they do that kind of foundational learning that the nursing students do. And the clinical placements were in long-term.

care and kind of the beginnings of a medical experience in the hospital. And so that was where I ended up. And then I was kind of like the penny dropped. I thought, yeah, actually, these are my people. This is who I care about. Not that I, this is, this is a particular group that I have just a special feeling for. And maybe I'm, maybe I'm actually good at it. Like, maybe I can connect well with these people. And so I began to see myself from that lens and kind of hone any of my scholarship looking at gerontological nursing. I joined the Gerontological Nurses Association of BC, and that's a provincial organization with chapters around the province. And it's a group that looks at providing educational experiences for sort of educational opportunities for gero nurses in the gero field, supporting them to get.

There's a national certification that nurses can get. So back to a few conversations prior when we were kind of looking at the journey of a nurse. Once you decide on a specialty, you can be certified with the Canadian Nurses Association, the overarching kind of federal professional organization that we have. And so I'm a certified gerontological nurse. Can you define gerontological for us? So we, it's really a focus on the Karen issues that are specific to an older population. And when you look at medicine, their more biomedical focus would be geriatrics.

So it's kind of just, again, a little bit of that separation of the art and the science. So the gerontological nurse is still understanding the pharmacology, the clinical aspects of the care of an older person. but we're also focused on on the social side of it, too, the social health needs, if you will. And nursing has a fairly strong foundation in the theories of the humanities. So we draw from sociology, anthropology, and psychology in our own theoretical models and certainly in our research frameworks. So saying that nurse,

Research is evolving too, so we've moved away from only drawing on those research frameworks, but nursing does, we do have that as kind of some of our foundation. So it's not, that's where we're not really geriatric, it's just a little bit more broad. And so gerontology, that field of older people, it's not unique to nurses, so you'll see social gerontologists like Darren Blakeboro, one of, my colleagues at UFV. He's interested in social gerontology. So, yeah, that's kind of, we use, I would call myself a gerontology nurse, not a geriatric nurse. Right. And so how has this developed since starting at UFE?

Like, from everything that I've heard that we have an increasing elderly population, it's growing to be the biggest part of our population. And from what I'm hearing in this conversation, we have reasons to be concerned that we're having a growing population that's going to need nurse care, that's going to need facilities. But we, A, don't have enough nurses. And B, we're still trying to figure out exactly what the standard of care needs to look like to make sure that they're cared for. And perhaps C, we don't always recognize the value of seniors. we sort of once they're in a bed it's like we treat them like they're like my grandmother had dementia before she passed and one of the thing like you could think was she's lost her ability to have like a regular conversation but the thing she didn't lose that I really loved all the way up

until the end was she gained even more of a sense of humor and it was part of the thing that I just decided like I'm not going to ask how she is I'm not going to ask what she's up to I'm not going to ask what I consider stupid questions. I'm not going to ask what she did 20 years ago on a twos. Like, this would be madness. I'm going to gear the conversation towards her. And I'm going to take an interest in what she's interested in. And we're going to laugh together because this is something, like she would be in, like,

at a family dinner, she would be making jokes or like making comments that were really funny. And it felt like other people weren't catching that. And it's like, this is the beauty of her soul. This is the, this is the shining light. This is, she's not just someone to sit down and just, oh, we had grandma over for dinner. It's like, what value can we find if we just slow down and treat this differently than all the other family dinners that we don't carry on business as usual? Let's, let's enjoy what she can provide. And it might not be what you thought of her as 10 years ago, 20 years ago, 30 years ago.

But there's something there, and it seems like slowing down is something we struggle with. We have our routines, and so we perhaps don't know what to do with seniors because we think, well, and maybe it's the same problem with children, is that we sort of look at them like, well, if I'm taking care of you or if someone's taking care of you, then you're not doing anything. And we sort of assume that maybe there's nothing going on in their head if you're not doing the dishes and doing the laundry and that you have no, no way. interesting things to say. And I think that that's a huge error that we just, we keep making it. And it seems like maybe throughout history, we didn't make that, that error as much, that we were more that, like, when you'd go see grandpa or someone throughout history, that you'd go and you'd hear his stories, his war stories, the challenges he faced. It seems like that's maybe something we're missing. And I'm just interested in your thoughts on our seniors care.

Lots of thoughts on our seniors care. And I think what you're describing is, is the way we interact with each other. When you're in those kind of middle adult years, young, mid, young, old, or whatever kind of categories you want to put, we do change. But we can kind of read each other and adapt the way we're going to be,

whether it's the conversations we're going to have or the activities we're going to do together. we are able to kind of adapt and get each other. We don't get kids all the time. Sometimes they don't seem to make sense. And if you're not intuitive, if you don't slow down, if you don't actually purposefully try to get what's going on for that four-year-old, you end up expecting them to behave in a particular way that's easier for you to deal with.

I think it's the same at the other end. When older people experience different types of loss, particularly cognitive loss, we find that really hard to deal with because we struggle, especially if it's a personal relationship, to shift our expectations from what we're used to them being like and being able to do to doing what you just described with your grandmother, actually being open to take your cues from them, knowing they have experienced changes, and take your cues from them, and then build some new patterns and ways of being with them. It doesn't mean everything has to be new or everything has to be different, but we do it all the time at earlier points in our life. It's just easier then, and there's a bit more of a back and forth. your grandmother wouldn't have been able to navigate you as easily.

Ageism, I think it's really at the heart of much of what is concerning. And the World Health Organization has just put out a global report on ageism in March just recently. And looking at this demographic change across, really across most of the world, much of the world, there is going to be a large increase in the number of people who are over 65, a large increase in the number of people who are over 80. And I think Stets Canada's, recently the centenarians, people over the age of 100, were one of the fastest, growing groups in Canada. So it's a small number, but it's a fast-growing number. So it tells us that society is going to look a little bit different.

So I look at my nursing students and I look at the kids in the K-12 system. And I know that when they are in their mid-career, it is going to be a society with a disproportionate number of older people. And so you see some of the negative stereotypes and, you know, a bit of fear mongering around silver tsunami. Sorry, what is that? There's descriptors you see in the media that describe this demographic change in a little bit of a frightening way. And one of the things that gets written about sometimes is this silver tsunami. It's a wave of old people that are going to wash across society.

And I think the underlying fear is that they're going to take up all the monies. All the resources we have are going to be thrown into trying to meet their care needs. And it's going to be impossible and difficult. And everyone will end up with dementia. It won't, you know, it's just going to be the absolute worst. So there is a tendency sometimes to look forwards at, at what problems will come of this. I think for me, I just look at it as this is,

these are the numbers. This is being kind of realistic about what the facts are telling us currently, that there will be a lot of older people, okay, then what do we know about older people? What will they need? How will society shift and make some thoughtful changes? so that we'll be able to, you know, we'll be able to carry on in a fairly positive way. I think the reason why we get so kind of frightened by the idea of a lot of old people and particularly old people who live with dementia is because at a glance they can seem so different from us

and different in ways that are negative and kind of problematic. So living in, again, you know, we kind of talked about living in a society that's fast-paced, we value independence, we value purpose, we value ability that's understood in kind of the typical ways. And when you look at an older person, so I can think of my own grandparents or my parents as they got older, I actually have a 98-year-old auntie who's living in a sort of a semi-independent way in mission, in an assisted living. And I help her, but she does a lot of her own decision-making, and she truthfully calls the shots with me all the time.

So I do as I'm told, as a good niece would do. But for many, it looks so different. And I think we have kind of this innate fear of whether it's what if it was us or maybe it's a fear of I just don't know how to be with people that seems so different and even can look very different. So physical changes towards the end of life, you know, we gravitate towards people that appear symmetrical, big, even eyes. you know, kind of symmetrical faces, we find a lovely rich head of hair is attractive. Straight posture, you know, all of these things are physically attractive to us. And that things change a lot when you age. You don't have a thick, rich head of hair.

Often your faces aren't really symmetrical. Teeth get old and brittle and fall out. So there's some physical changes that sometimes can be off-putting, certainly with kids. Often they, like little kids when you describe being little and maybe going to draw a picture in long-term care. There's a place where kids are so small, they don't see difference. And then they get a little bit older and they see difference and they need to know how to deal with that and that the difference is okay. And then kids can learn that. And then they move along and they're like, that's okay.

it's just they don't look exactly like me but they really are like me we're just all people um so i think this this ageism is born of of a lot of internalized fears we certainly have fear of death and we know as you get older your much death becomes a much closer eventuality than it does at our ages i'm not thinking about death a lot i would be very surprised that my 98 year old aunt hasn't thought about it in a much more meaningful way. So the trouble with ageism is that it's so normalized. And when we make ageist comments or age's jokes, it doesn't resonate in the same way. We're kind of waking up to racism and gendered issues.

and there's a bit more of a kind of hits us a bit more quickly. But when you make a comment or about an older person, it slides off a little easier. Ageism is understood just as the most kind of normalized and socially accepted form of discrimination and stereotyping. so I think at the heart of everything there's this ageism and some of it is a lot of it is just we don't even know we're doing it but if you're to look at well why is seniors care why was it not included in the Canada Health Act why did we not really have a good plan for once we began looking at at housing people in long-term care homes

why was there not a great plan for that? And so we're in a catch-up now. Like we've realized, gee, it's actually not good enough. And at the same time, we've got a demographic pressure that's coming. There's this imperative that we do more. We understand ages and better. We understand the needs of the health needs and the social needs of older people better. and now we actually know that there's this demographic imperative.

So it's time for all of us to kind of get to work now. And things need to change in some pretty fundamental ways. Yeah, the thing that I don't like is I'd call it like anti-human rhetoric, which is like I know David Suzuki, brilliant thinker, he made a comment that was like humans are like a cancer on the planet. And I don't like those comments because a lot of the problems we see with climate change when we're talking about it is like a hundred years ago there were research papers that said we couldn't overfish the oceans if we tried. Now, again, those people didn't realize the increase in humans that we were going to see over the next hundred years. So we can't be too hateful of ourselves that we're kind of in this predicament.

And I want the garbage patches in the oceans addressed. I want cleaner air for children. I want conservation efforts to continue. But we have to give ourselves a bit of mercy that we had no idea that humans were capable of where we are today. Like even when you think of like audio and video recording, it's so much more accessible than it was 20 years ago, 30 years ago. You couldn't have expected something like long-form interviews to come about 30 years ago. And so here we are. A lot of the things kind of catch us by surprise.

And it's unfortunate when we talk about seniors' populations as just. waiting for them to pass on or silver tsunamis because again it's like you're not recognizing the value of life that these people would have had various experiences whether it's again fighting in a war understanding the like different challenges in economics whether it's trying being some of the people who would have been fighting for like a women's right to vote like we don't think of those moments in a person's life when we're looking at them maybe at the end And so we miss out. And my least favorite part of these interviews have been when people make comments like, I'm going to age myself when and then they say like, I went to school in the 1990s. And it's like, I don't care. Like who who's judging you for like, isn't, shouldn't that be a good thing that you've lived a life, that you've made accomplishments? And it's just, it's always the disheartening part to me because it's like you're this brilliant person who has this narrow minded view of what it means. means to live. Like, I am by no means afraid to age. People say, like, oh, you look young. And it's

like, I don't care. I'm at this point in my journey. My goal is to just every day to make a difference. And then one day I'm going to be 50, 60, 70, 80. And I'm going to keep trying to do that. And I love the idea. It was Neville Ravikin, who's like a philosopher who kind of described when you're younger, you're like an apprentice, you're working, you're learning. Then you move into kind of being the leader of whatever organization or business that you're a part of, or you're kind of showing your skills, and then you move into being a parent, and you're trying to support your children in their educational journey, then you become a grandparent, and maybe you take on a political role and you help guide your community, not because, and this is the

really unfortunate thing about politics, is we look at them as a good job, where I really miss the idea that you were a politician because you had a responsibility to your community, rather than you wanted the social capital of being known in the community, that you, like, I would argue for a world where perhaps politicians don't make that much money because it's a responsibility you have to your community if you have something to contribute. And when you think of people like Bud Mercer, the thing I admire is that he's got 35 years of like police experiences. He ran the Winter Olympics. He understands crime and community safety at a deeper level than others. And so he's going to bring that to the role and that's admirable if you're willing to do that and I'm sure

he's not doing that for the paycheck because that's nothing in comparison to what he would have made as an RCMP officer and so there's confidence I have in people like that more so but it's like then you become a politician and then you become like a philosopher or within an indigenous culture it would have been an elder and then you play a role in that and you put on different hats but there seems to be this pervasive fear of aging that you're supposed to look like you're 20 years old until you're like 55 years old. And I'd be interested in your thoughts on this because I don't want to be judgmental, but it seems like perhaps women feel this weight more than men. The primary comment I get around aging when I've done interviews is primarily with

women being worried about aging themselves. And when I see people that I know wearing a lot more makeup later in life, it's like just embrace how you look. Like I don't think you need, I don't think, A, I don't think makeup is as necessary as people make it seem, but I, and I understand that I can't change that, but it seems unfortunate when people feel the obligation later in their life to look like there's something other than they are. And I find that, like, it's maybe on both sides, like, there's a fear of aging within the person, but there's also a judgment, like my grandmother, amazing woman, would tell my mom, she needs to wear makeup. And that was like a top-down approach. And my mom was always like, I think I look fine. I don't think I need to

wear this. And she never was able to relate to why she needed to wear makeup. And it was sort of a disconnected that always existed. And so I'm just, where do you think this fear comes from? And where do you see perhaps avenues out where you've seen people kind of go, you're right, I'm at peace with this, or is that rare? So there's lots in there. I think. There's a few things that happen. We know that as we age, there are losses. There are physical changes that happen. So we know there's physical, typical physiological changes that happen.

There's typical cognitive changes that happen. And we have some idea about what we all will be like at a particular age. so at the same time society really values ability and beauty perceived beauty or attractiveness youth so so there's some of these pressures that happen as you age to to stay youthful to stay attractive and certainly to stay able um i think it is a bit gendered and when you look at at media um you have representations of women with gray hair maybe looking a bit doubty as an older person and then you have the distinguished man with the salt and pepper hair and a beard and um looking more vital yeah the george clunies yes and and you know you certainly have

So these are kind of messages that that we get as we grow up. And then you've got kind of markers like at 65 at the age of retirement. And so you should. It's not based on ability or purpose or goals. It's just a chronologic number. And it's not to say that a lot of people around the age of 65 may find that that that is a good time to retire because perhaps they do have health issues

or maybe they're just in a great financial place and it makes the right decision at the right time somewhere around there. But there is no perfect or exact age where you're suddenly not able to work anymore or you suddenly don't want to work anymore. So it's really arbitrary, but we have that idea in our head. And I'm struck by the woman who is the head of the EU right now.

We're seeing her in the news a lot. I think she's from the Netherlands and her last name is Banderlaine or something like that. I'm sorry, I can't remember it. But I know I looked her up. So I kind of did a little examination through Google of who she was and what she was doing because I was just so impressed with how professionalist she was and she was clearly a, you know, middle-ish to young, older woman in a sea of men at a time of just critical world importance, standing up and being listened to because her voice is really critical right now. And when I read through her background a little bit, I think she's got seven children. and she's in her mid-60s.

And she is, I would suggest, nowhere near retiring today and super able and with a really important role to play. So it just kind of was in the face of a lot of stereotypes around women, around work, around mothering, around age. It just kind of, she captured a few of those things for me all at once. So I think that we get very hung up on all of these things. And one of the things when you look at combating ageism, which is something I'm very interested in doing, committed as an educator and as a researcher to doing, is we forget how diverse old age can be, how diverse old age is. So I've described my 98-year-old auntie. She walks with a walker. Many things about her are what you would make an assumption of a 98-year-old to be like.

But she also has a uniqueness. So she's a 98-year-old who is still independently mobile, who still watches the news every day, remembers and comments on world affairs, so very engaged. She gathers all her own tax documents. I'm just the messenger because I can easily get in and out of cars and I'm very mobile compared to her. I can do a lot of things.

So I'm the hands and the feet. But she's the decision maker, the driver. Sometimes I need to help a little bit more than others, especially health issues I help with. but so so that's a 98 year old that is different from i could walk into any of the long-term care homes here and i'm sure i'll find some folks that are in their late 90s early hundreds and they would be physically and cognitively and functionally have more losses than my aunties so so there's a tremendous diversity there when you say 98 there isn't only one picture that should come into your mind when you say 65 there's not only one picture

It's the same as when you say 25. My daughter teaches in a grade 3-4 classroom, and I've been doing, I'm on a sabbatical this year, so I've been doing a research study that has this overarching goal of combating ageism by first understanding better what kids know and think about age and dementia, and then integrating some educational modules into the classroom. Tell us about that. So, well, first I'll say that's diverse, you see, and older people are no different than any other group. We are, each stage is really diverse.

So when you take that lifespan developmental kind of understanding of the world, you sort of think that there's just only certain ways to be at certain stages. And that's very limiting. Those are kind of typical ways that many of us experience those stages. but not the only ways. So her grade three and four class, there's some very tiny, tiny little grade threes. There's some much bigger grade fours. Very diverse, diverse culturally.

She has several First Nations, Métis kids, South Asian, Vietnam, China, Ghana, European backgrounds. So a lovely, rich diversity. And the study that I'm doing for my sabbatical is premised with an understanding that this ageism exists. And we know, one of the things we know about ageism is that it begins quite early. So ideas about age begin at home.

And so children come to some understandings through their family of origin, understandings based on perhaps grandparents, great-grandparents. We also see a lot of representation of age on TV or movies or in books. Some of it is positive, some of it is negative. And all these things kind of filter in and kids then learn more and more and more,

obviously, as they kind of move through their journeys. So what I wanted to do, was kind of take a look across the grade levels and see what are kids thinking and what do they know. Particularly I'm interested in dementia. What do they know about dementia? People living with dementia have some unique issues. Age is also the prime risk factor for dementia, but it's not the only risk factor. And there are certainly young onset dementia. People living with young onset dementia and but the vast majority of dementia

has happened in in later life. So I'm partnering with Dr. Candice Coos, who is an artist and a professor in I can't remember the name of her department

within the Faculty of Arts at UFV and so she's partnered with me because we know that you can use language to express yourself, but art is a really nice medium to express what are sometimes abstract understandings or complex concepts. Sometimes it's hard to find the words. And so for us to really try to access what are the perceptions of children at these different grade levels, age and

dementia are kind of big ideas. So we're asking them to draw a picture of a person who is old and then to draw a picture of a person who is living with dementia. And in grade one, they got busy right down to work drawing. And we asked them then, tell us about your drawing. Who are you drawing and, you know, what's special about it? Many of those kids in grade one, they drew their moms because mom is an older person. One of the little girls drew her sister holding a cell phone. because her sister's 16 and when you get older,

you can have a cell phone. So it's very logical. It makes sense. Age for those kids was someone older than them. Yeah. That's beautiful. Yeah. Then grade three and four,

they began to have a little more of the kind of the things that we might have expected. They drew mostly grandparents and a lot of gray hair, a lot of wrinkles, some kind of cranky faces. They weren't sure about dementia. There was only some of them, so they had the option. If they didn't know anything about dementia, if they just didn't have any idea about what to draw,

we just said, that's fine. You can just work on your first picture because we wanted a naive piece of art. We didn't want to have our perceptions, or whatever their thinking was. And we did the grade 12s, and that was really interesting. The picture of the older person was quite,

was sort of more or less what we would have expected, again, a higher level of art, obviously. Some really beautiful work. There was one young South Asian girl that drew her grandmother with a green scarf, and it was, yeah, it was just beautiful. But when we asked them to draw a person living with dementia, They had a much more abstract approach to it.

One of the drawings was kind of the paper was cut in half, and there was two identical houses, and there was a little figure of a woman moving this way and that way. And when we asked her what she was drawing, she described a scenario where her grandmother had gotten lost in the neighborhood and went to the wrong house. So when she thinks of dementia, she's thinking of this experience of her grandmother.

Another student drew a brick wall with this kind of swirling mass on one side of it. And it was to represent this memory block that he thinks of when he thinks of dementia. So your brain is trying to reach past this block to find the memories. Way more artistic than me. So, yeah, we were really, Candice and I were really. excited when we were looking at them. And we still have to get into the grade seven class. So that's coming up.

But next week, we're starting with some learning modules. So we've got a series of four lessons that we're teaching the grade three and fours. And an introduction to age and dementia, a look at cognitive and sensory changes, a look at physical changes. And then the last class, we're hoping to introduce the idea of. quality of life. So to not to sidestep that things happen. So yes, you know, there's a loss of muscle strength. There's balance changes, sometimes memory and thinking can change, vision, hearing. So all of these things we can touch on. We're going to give the kids some take homes of things they can do if someone couldn't see well or hear well,

just some simple ideas, face the person, speak lowly, slowly. Be patient. You know, that's one, you said that when you were talking about your experiences with your grandmother. So simple,

but it's so critical. We're not patient with older people. We're not patient with someone who has any disability or different ability. And really, patience is probably one of the most critical things you could do, be patient, take your time, try to figure out what is needed and understand

them a little bit better. I think that that should be taught more in university because I see it as the biggest challenge between people who attend university and people who don't, which is like the people who know things sort of enjoy plorting that over people who don't, or at least that's what I've kind of seen. Maybe it's not always conscious, but there's this feeling of like, I want to say more complex words in a conversation because I know them. And then for people who didn't go, like, I've heard from lots of people. I didn't want to go to university because I don't like them talking down to me. And that's the, it's, it's not everybody, but it's a pervasive issue, which is that if you know more, like if law is, it's a real challenge in law

from my perspective, which is like lawyers and people who have gone to law school, they just love lording a case over you or talking about, like, oh, you wouldn't understand. This is very complicated. You wouldn't understand. My friend who's actually at law school right now was told by a lawyer he was working with for a case that he shouldn't go to law school because he won't succeed because he doesn't have what it takes to be a lawyer and had no idea of the grades that my friend had received or the experiences or the abilities he'd bring to the position. But it's just this feeling of like I'm I'm here maybe you're down here I know more than you so just just slow your role and so I think that that that patience with people if you know more than someone tell them

break it all down for them and it's why I admire sitting down with people like yourself is because there's there is an appetite to share knowledge and sometimes I think that there's maybe a currency and feeling like your years of education were worth something and now you know more than people And so I don't have time to break it all down for you. And it's like, well, maybe you don't, but maybe there's a space we can create to hear and learn and understand. And I think podcasts create that space for people who didn't go to university to go, maybe I am interested in biology or hearing about neuroscience or stuff like that. And so please continue with what you were saying. I just, I think that that patience piece is, it's critical.

So, yeah, I've got to comment to it in a second on what you. you said so I got to hang on to that idea in my head um so yeah that that's kind of in a that's where we're at um and we're going to have a um an art exhibit next fall october 1st is the international day of the older person so candis is taking the lead as the i'm a person who i love research for many reasons and it it if you're a person that just kind of constantly gets these ideas in your head that oh that would be a great thing to do oh we should do that oh that would be that would be fun but it would also be important um and that's kind of my drivers around research so when i was thinking about this project and i thought it would be really nice to get that art and you know

it's not a unique idea i know that but um having them kind of seeing this kind of development of art across the grades, I think that positions any impetus to create education or provide education. It gives a bit more of a sense about where you might target it and what you might be targeting. So I thought, great, let's do this. And then in the fall, as I got things kind of organized, I started thinking, yeah, we'll do an art exhibit.

That's what you do when you gather hundreds of pieces of art, which I'm going to have at the end of this. And then I thought, I know nothing about an art exhibit. I really know nothing about art. I'm a nurse. So I just looked around UFV and I thought, okay, let me look and meet some of these art props. So that's how I met Candace and it's been brilliant.

She's just a lovely person and she's a fabulous artist and she's really interested in representations of health through art and so it's been this perfect partnership which is what one of the things I really love about research is you get people with different skill sets but you all kind of have the same goal and you can make a small thing bigger and and better um one of the things about research is exactly what you're talking about when you have knowledge you need to be able to share it. And so all of these areas we have, sometimes we have a particular language.

Like in law, you have a language. So if you're speaking to another lawyer, you can talk about something using that language and you both understand it and it works well. But if you talk to me about the same thing, I don't share that language. So you need to be able to communicate in a different way and break it down just as you were saying.

into whether it's more simple terms or just more commonly understood terms so I can get it too. Same in healthcare. Nurses and physicians and allied health, when we work with patients, we can't use the same language all the time that we use with each other.

We have to not make it all so simple because everyone else is ignorant. We need to make it the shared language. Accessible. Yeah, that we all know. And it's the same thing in research. So you, as an academic, you get, you get a problem that you want to work on, a question to answer. And again, nursing research, because we're an applied profession, our questions come from the ground.

They come from practice. And they should have a very clean application right away, right back to practice. that's that's what much of nursing research is about so you you have a question and you whatever the findings of your research are you have to be able to share it back right so there's no point in me doing something and never sharing back what I learned or found out it's about creating new knowledge and and it's not the only knowledge I'm not the only person that's interested in older people or representations of art or educating children or intergenerational work, any of the things I kind of like to do.

But whatever I learn, I need to make sure that I share because it just adds another little piece to what we already know, and it's got to be in an accessible way. Research is one of those dangerous terms because it intimidates people who don't really know. Right now, it's like people say like, oh, I research something by looking on Google. And so I think it's a really dangerously misunderstood term, but I agree with you. I love the idea of legacy, and I hope it's a term that becomes more commonplace because I feel like it's one that's less used, the idea of taking on someone's legacy or understanding their journey, because with research, you leave a legacy behind.

It's something if you do good quality research, you will be cited past your time as an academic. Perhaps we still look to, like Charles Darwin, not alive anymore, we still look to him for his foundational understandings of issues. You think of like Stephen Hawking, not around anymore, contributed great degrees and left a legacy for other people to begin to understand these things. I think entrepreneurs do something similar when you think of the Hudson's Bay Company, not the founders aren't around anymore. Canadian Tire, another interesting example of a Canadian-based business where one family still owns the majority shares of that business. I didn't know that.

Yeah, very interesting. It's, I think, the largest family-owned business that still has the majority shareholders as the founding family. And I think entrepreneurship, there's a way of going about that with indigenous culture, there's passing on of stories.

And so this idea that people have information to share with you that helps you have a deeper understanding, I think is so valuable. Like, I'm not that interested in birds. I didn't think I was, but my grandmother loved birding. She loved going out and traveling the world and seeing the different types of birds, and she knew all of them. I actually have her bird clock here, and so I decided to reach out to Birds Canada,

and I ended up doing an interview with Chris Koo, who loves birds. And the idea I had behind it was, I want to see what she saw. But if I pick up a birding book, I'm going to have the same attitude I had before, which was I'm not that interested in birds, but being able to sit down with somebody who has that passion and understanding will give me a glimpse into what she saw. And he was, we went through his photography of the photos he's taken. And it was a blast because he brought that authenticity, that genuineness that she had towards the topic. And so I got to see her passion through somebody else's lens. And I enjoyed that. And it's the same with sitting down with you. She was a nurse. And I don't know

what it's like to be a nurse, but being able to sit down with you. Oh, it's pretty cool. Yeah. And I get to see what that work is like and what the difference is like. the journey to become a nurse from somebody else's perspective because I can't ask her why she chose nursing because she's not here anymore. And so being able to learn from other people's legacy is I think something that can enrich people's lives. The other person in regards to age that I'm interested in your thoughts on is Betty White. I find her and the whole Golden Girls show really interesting, unique. Maybe there's a bit of ageism because they we're all active and doing things.

But I think Betty set like an example of like how to live a life because she was at one point a singer and on TV and singing, but then at a certain point, her vocal chords don't work the way they used to. So she switched gears and she found something else she enjoyed. And she shared her love of stories and she loved animals. We watched this documentary with her where she was sitting right next to a grizzly bear and feeding the grizzly bear marshmallows. And it was like, whoa, she loves animals more than anything else. And that's the legacy. She wanted to leave behind. And it seemed like there was a moment where we all

recognized the value that she had when she passed away. And there was just this outpouring of love. And during such crazy times with COVID and what's happening in Ukraine, it felt like there was just a moment where we were all, like, this person lived a good life. And I'm just, just interested in your thoughts. Do you think that maybe she sets like an unreasonable example for others? Do you think that she helps us break down these barriers? I'm just interested in your thoughts on what that show was and on sort of her legacy. And obviously not defaming her. I'm sure that's not. No, no. I did watch the show a bit. I like I've seen it in the past. I can't and I can't really remember I probably didn't watch it a lot but I know the basic premise of the I think three friends and one of their mothers so four women in a house and I mean that alone was probably pretty groundbreaking to have four women leads carry as you know carry a series so for that

alone thank you to all four of them and the trick is I guess in looking at you know representations of of older people older women and making sure that always you know stereotypes aren't based on nothing they're they're based on some things that we see a lot but then we take it out of context and we usually take it to the extreme right so then it becomes the only way that someone is every old person um has dementia every old person has wrinkles every old person has gray hair and it it moves us away from understanding diversity which is i think becomes problematic because then we only have one lens we have one approach we have um and we miss the broader picture and we miss

opportunity and potential um so i think I think that the show, I'm sure, played some really good roles in breaking barriers. Betty White herself, I actually love it that she lived a long life and a full life. And that alone is evidence that, yes, that's possible. And there's a whole bunch of Betty White's actually out there. People are living longer, driving longer, working longer. Certainly in a profession like I'm in as an academic at a university, it's not necessarily hard physical work that people kind of age out of.

It's a lot of cerebral work. And so you'll find active professors, whether they're professors or whether they're professors emeritus or whether they're still actively teaching. but you know so there are older people engaged in work long past what typical ages of retirement are and that's what betty showed us she stayed an actor um in new series so she's not just remembered for the golden girls i can't remember what her more recent ones were but i know she was in more recent series and she was a guest on late night tv all the time so she was a valuable um she was seen as a valuable celebrity to have either in a show or a a guesting thing and so

you know i guess she in that alone she shows that it's it's possible and um and the trick was to do it without making it always about how old she was so that it's not just betty white at 70 Betty White at 80 oh my goodness look now she's 90 she's 95 yeah we we can celebrate a bit because we know not everyone gets to 95 but she's not only her age she's more than that and so it's about those other pieces that you're saying that legacy she left was that she was a huge advocate for animal rights and um i'm sure there were many other things that she was able to champion and that have carried on because of that. So it wasn't only her age and it's not to say that we don't acknowledge it. I think that's fine. Like I do look at my auntie at 98 and I think,

wow, that's, you know, it tells me a lot. I mean, as a nurse, I'm thinking about longevity and what is the chance for me. What are the longevity genes in my background? Am I going to be in my 90s? Well, I have a pretty good chance there. Maybe if I have something similar to what my mom and my end have had. So I'm really interested to know if this is ageist or not, because one of the things I'm starting to be interested in is like body and health optimization, brain optimization. I know John Hopkins is coming out with research on psilocybin and its effect on things like dementia and Alzheimer's and trying to, I know men at past 50 are starting to take testosterone

own to reduce some of the detrimental effects of losing testosterone, because I think it's just a steep drop off at a certain age, so they're able to keep some of their vibrance and their energy higher. I know healthy eating is becoming more commonplace for people paying attention to the quality of foods they're eating, making sure that you're exercising. There's a lot of research that suggests you can prevent a lot of the detrimental effects of aging if you don't just become a couch potato and sit around all day. But I want to make you. sure that I understand and I'm moving forward in the right direction when we're talking about am I being, am I making it negative to have those qualities by wanting to make sure that I live

because that's the argument for like I'm living a full life because then maybe I'm optimizing my health but then I'm trying to, I'm still trying to avoid those stereotypes in some sort of way. So I'm just interested in your thoughts on sort of that journey. If I'm looking at when I'm 80 years old, taking something like psilocybin to prevent memory and cognitive loss, am I saying that those things are a bad thing just through my action of working to avoid it? So, yeah, there's some interesting bits in that. So I think it's natural to want to be healthy at any age. And some of those, there's a particular set of interventions that would be recommended at any age

for almost preventing any health issues. So exercise is probably the biggest one. So exercise has... And sleep probably, right? Sleep is important too. Yeah. So that kind of activity and rest, restorative, paying some attention to that. Exercise can make a difference, even small increases, you know, whatever the time frame is.

You can make a big difference, but just being more active overall will make. a difference. So overactive, being well hydrated, being well-nourished, sleep and restorative. Avoiding some things, we know cigarettes, alcohol, there's certain products that we use that can be, that can, you know, increase your risk of all these other things. So avoiding those, doing those kind of very basic things. When you think about your body kind of as a machine, right? Think about how you nourish it. Think about how you maintain it. And they make a difference for everything, whether it's diabetes, arthritis, heart disease, cancers, mental health, you name it. They're just kind of general things that are good to do. And I think if you do those general good things all

through your life, you will just decrease those risks of things that become more high risk as you age. So to me, it's a natural thing that you would want to do that. On the flip side, you have to, I think, be a little bit cognizant of some of those concepts like successful aging. There's some interesting terms that get used. Because for some of us, having the kinds of chronic health issues, we can have done all the most healthy things. Every way we could mitigate risk, we've done it. And yet we still have a diagnosis of cancer. We still develop diabetes.

We still end up with heart disease. And I have seen that a lot over the years of being a nurse, where someone will say, I can't believe it. I did everything right. Did everything right. And look at me. and yet my brother or my whoever smoked and drank and never did all the things I did

and yet they're, look at them. So there is a piece that we know is genetic, environmental, and there's a piece that we just don't know too. And so sometimes folks try as hard as they can and they still have a lot of challenges in older life. And so that idea of successful aging, which we hear and even terms like you have it's just the way you you interpret like aging well it's finding the right way to to encourage just what you're suggesting mitigating risks and

promoting health the best you can but knowing that again some of it is out of your control too it doesn't mean don't mitigate the risks but you have to recognize that for some people their journey will not be as successful or they won't be in their mid-60s speaking at the EU. They'll, you know, they may be living in a long-term care home much earlier than anyone would have guessed, or they may be coping with a cancer diagnosis that has a fairly short lifespan attached to it. That is really well said. Can you tell us about your podcast? Can you tell us about how that sort of got started?

some of the guests and how people can find it. So I was really thrilled that you asked me for this podcast because I've been doing a podcast as well. It's called Gero Nurses Tales from the Front. And it really was, the impetus for the podcast was one of my colleagues and really good friends, Dr. Lillian Hung. So Lillian and I met at UBC doing our PhDs, both gerontology nurses. so we were both members of the provincial gerontology nurses group and both, yeah, we just, you know, when you, you just connect. So we sat there at UBC in class the first day, and I think we just, yeah, a really lovely connection, and we've been good friends since. We've traveled to conferences, and she has just stepped down as the president of the,

GNABC, the gero nurses group, and I had been the president-elect, and I'm now actually stepping into the president role. So one of the things Lillian wanted to do, she said, well, quite a while back, well, why don't we do a podcast and do something to kind of highlight the great work that gerald nurses do, especially in the face of COVID, where all we've seen is the negative stories coming out of whether it's the care of older adults in hospital or community, or long-term care, it's all been bad. Let's, you know, can we do something?

And at that point, I'm not sure that she was working at UBC yet, but I thought, gee, let's do something with Sierra. Let's see if UFB can collaborate. And Darren Blake Bro, who I mentioned earlier, he's a social gerontologist in the social and cultural. I don't have the title of it. It's just escaping me. Anyway, Faculty of Arts.

So Darren is just a fabulous person, and he did a small documentary with me a few years ago on a different research project. So I asked him, would you produce a podcast for us? And we got some funding from UFV. And so Lillian, Darren, and I have formed this podcast trio. And we have interviewed. We began with interviewing.

Darren interviewed the two of us to kind of position the podcast, I guess, against the backdrop of us. And then we've interviewed nurse researchers, gero nurses in practice, in acute care, in long-term care. And one of the most recent ones I had mentioned earlier was a new, a new gero nurse and her experiences in the middle of COVID. So the goal was, yeah, fairly broad just to highlight the work that these nurses do. Often we get pretty excited when we see a nurse in an OR or in ICU. And then the nurse looking after the older person, it might seem a little less technical or a little less prestigious. But they're a very complex group of people to work with. and there is a unique set of skills that go along with it.

And there's just some tremendous benefits too. So we have really, yeah, enjoyed being able to do that. I think that's incredible. And it's always been my position that I want to see more podcasts with people like yourself sitting down and talking about what they're interested in because that's the difference, I think, for so many people, is that we look maybe at traditional forms of media and we feel like maybe we can get more out of it or something like that.

And I think that that's sort of, that's exactly what you're doing, is you're creating a space where people can learn about a topic. It's conversational in nature. And they can hear a different perspective, an area that they don't know much about. And through that, they can develop tools and understanding of, like, if they do have to go to the hospital, sort of what the lay of the land is in a new way that they maybe didn't have before. Because I know people complain about weight,

times. They complain about the issues going on. But when you get to hear the back end, the challenges that these people are facing behind the scenes, it gives you a little bit more humility. It makes you more grateful. I know that when my grandmother was in a long-term care home, I felt she received great care and that the people there were thoughtful. They knew our names. They knew when we were coming to visit. And when their story doesn't get highlighted, you don't have a good way of encouraging good behavior. There's a sense of like, I did good work, but who's ever going to remember? And particularly if you're working with a community that might not be able to recall things as well, that your work really can go unnoticed. It can go. And I think that that's discouraging

because it's not that they need, I'm sure they do, but a pay increase. But having recognition for those days is so important. And I think that that's what you're doing. Yeah. And my secret wish is that by highlighting this work and in the hierarchy of nursing roles, the care, there's a lot of ageism within nursing, within the healthcare professions. So the care of older people has often been seen as less attractive care to do, that you need less skills to do it. So it's been kind of the last pick for people. It's sometimes been seen as a place where nurses might just before they retire, they might kind of work on a unit with older people because it's easier, that's really not it. And so my secret hope is that by highlighting some of these things, these stories and experiences of really great Gero nurses, maybe more students get encouraged to think about that as a potential as, you know, after they graduate, or maybe the nurses that are working in that area now, hear the stories of their colleagues and think, yeah, you know what,

it's really hard, but it is good and it's necessary work. And I think I can stick it out and try to make it better. Yeah. That is so encouraging and I'm so grateful to hear UFE doing such great work in supporting your podcast, in supporting your research. I'm a huge fan of them and their support for new innovative approaches. Can you tell people how they can find you on. Twitter, LinkedIn, how they can find the podcast?

So, yeah, the podcast is on Spotify, Podbean. It's on all the traditional streaming platforms. That's what Darren has told me. So, yeah, it's Gero Nurses. So I know for sure if you just have a look on Spotify or Podbean, it's right there. Perfect. And your handle on Twitter and maybe LinkedIn? Sure. It's, I believe, on Twitter, it's Shelley underscore Canning at UFB. Oh, I'm not sure.

And then, Erin, I'm not sure. No problem. And then when is your art exhibit taking place? October 1st. Perfect. And where is that taking place? At the art gallery at UFV. Amazing. Shelly, it has been such a pleasure to understand this field more, to hear some of the stories and the journey that you got into nursing with, the work that you're doing to try and address ageism and to understand perhaps the disconnects in our culture more and to

shine a light on it so that people can sort of reconsider their preconceived notions and move forward in a better direction because as we're looking at how we treat other people and how to be perhaps inclusive, how to accept diversity, having older people at the table is also something that's equally important and something I agree that I have not heard that much about other than people like yourself shining a light on that important work. And it just inspires me because I do see the value in my grandmother and the Betty Whites of the world. And we should shine more light on good people who've lived meaningful lives. And I think that that's the work that you're doing.

And I think that that's just inspirational to remember that growing, getting older, this is all a part of the journey. And it should be embraced. It shouldn't be feared. And I think that you do a good job of laying out the strong arguments. why we should look at the world that way. Well, thank you so much. It's been a real pleasure for me to talk about the things that I am interested in. And I'm super impressed with your breadth of knowledge.

So great questions and really, really nice insights. One of the things I always say about age is it's nobody's fault. Sometimes it feels like you've done something wrong. Oh, you're 65 or you're 75. it feels like, I'm like, it's nobody's fault. It's just every 365 days, if you're lucky, away you go, another birthday, you know. Absolutely. And we just did two and a half hours.

Oh, gosh. Thank you, Shelly, so much for coming on. Thank you.