The Western Regional School of Nursing (WRSON) offers students a vital chance to practice and refine their skills. Gabrielle Deveau and Shelby Thomas, two nursing students, explain that WRSON is also a place where students and instructors conduct research. This ranges from research for class papers, to research aimed at understanding practical clinical settings.
Thomas is going into their second year of nursing, while Deveau is currently in her third year of her degree. Both are doing work which helps them understand the future, and present, of health care in Newfoundland and Labrador.
“I’ve written papers about lack of mental health resources in Indigenous communities and negative impacts of elder displacement for long term care centres in Newfoundland,”
“as well, in clinical settings, we have to research our client to form complete health and physical histories.”
Clinical Research and Practice
Students are required to research information about their patients before going on clinical shifts Deveau and Thomas emphasized. This approach not only helps the students to assist with care but broadens their medical knowledge, as they identify new techniques and practices through studying specific cases. Students have the responsibility of understanding their clients’ medical history prior to their shifts.
“You look up [the client’s] date of birth, the reason they were admitted in the first place, and the diagnosis they’ve gotten since… After you’ve got all of the information you do a nursing diagnosis. Because as nurses we’re not allowed to give physician diagnoses. We can’t say ‘this person has hyper-tension,’ we can only say ‘this person has high blood pressure and that may be indicative of hypertension,’”
“So, a big part of that research is looking at how their condition is doing currently. You look at their blood pressure, you look at their temperature rates, a few days before you go in. So you know relatively where they are going to be… Let’s say you had a patient with a bowel resection who had a bunch of procedures that you’re not familiar with. It’s your responsibility to look up those procedures, to look up everything there is to know about their condition.”
While the word ‘research’ can bring up notions of a distant academic discipline, confined to universities or laboratories, Thomas emphasizes the interpersonal nature of the client research she conducts.
“I always start off client research by talking to the client. There is no one better to tell you their history than the client themselves. This can include all their medical, personal and family history,”
These interactions are backed up by an understanding of the latest research on related subjects. Best practises and methods are explored in the classroom and through individual research that students then share with their peers.
“With every clinical rotation that you do there’s a requirement that each student has to find a current research article that was done by nurses, for nurses, relevant to any topic that was relevant to what you learned on the floor,”
“For example, a common theme in my group was diabetic foot ulcers, because those are really common, and we see those a lot… One student found an article that showed the difference between patients that were doing little foot exercises, pointing your foot up and down and making circles with your toes, for patients who had diabetic foot ulcers versus those who had diabetic foot ulcers but weren’t doing the exercises, how extreme the healing processes were, and how much those movements helped their feet.”
The Big Picture
Deveau also notes that while student research at WRSON is heavily focussed on practice and papers, many instructors are also actively pursuing research aimed at publication. Some of this research was covered last March in the first issue of INSIGHT-FELL, the Grenfell Campus Office of Research and Graduate Studies newsletter. Additionally, policy makers at the hospital additionally conduct research on best practises that informs the approach taken by students at the school. Every aspect of how students interact with patients, down to the motion used when disinfecting skin before giving an injection, is informed by school policy, Deveau explains:
“It used to be that you swab in a circular motion, you start in the center and move outwards. But now you have to do a zig-zag [motion]. So little things like that, that you wouldn’t even think of. The school emails us these new policies and it’s the students’ responsibilities to stay on top of it.”
A lot of the research students conduct also takes the form of papers. Thomas has been able to gain significant insights into the issues affecting Indigenous and rural communities, and the elderly, through the papers she has written.
“The main issue in these smaller communities is complete lack of resources. For example, during the Attawapiskat suicide pact crisis there was only one nurse in the hospital that night and the only doctor had to be flown in. Nurses are having to practice outside their scope of care to provide health care in smaller communities because there are no doctors and not enough staff or nurses,”
“In terms of elder displacement, it is yet again [a matter of not having] enough resources. The elderly are having to wait months or years in hospitals waiting for a bed in a long-term care centre, because there aren’t enough long-term care centres, especially in Newfoundland. They are being moved into centres hours away from their homes and families. Family is the top support system for seniors [and displacement is] leaving negative impacts such as depression rising in these long-term care centres.”
Thomas believes that the future of the Canadian health care system is registered nurses and that Canada needs to send more nurse practitioners, and registered nurses, into these communities to provide better health and mental health resources and care.
More than 1,800 nurses have graduated from WRSON since its first class in 1971, and the School has received three seven-year gold accreditations from the Canadian Association of Schools of Nursing.
Additional information on WRSON can be found here.