/ Maggi I. H., RN, BScN, CCRN
Key nursing terms: compassion,
accountability, holistic, biopolitical space,
dignity, respect
/ a quote
"It is a fair, even-handed, noble adjustment of things, that while there is infection in disease and sorrow, there is nothing in the world so irresistibly contagious as laughter and good humour." By Charles Dickens, A Christmas Carol
/ training, education, and professional credentials
Education & Training
Bachelors in Science of Nursing Degree, BScN | Ryerson University, 2012
Critical Care Nursing Certificate | George Brown College Continuing Education, 2015
Critical Care Response Team 2-day Provider Course | Lakeridge Health Education and Research Network, 2015
The Diabetes Educator Graduate Certificate Program | Michener Institute, 2017
Licenses
Registered Nurse | College of Nurses of Ontario, 2012
Certified Nurse in Critical Care Canada, CCRN | CNA, 2019
Basic Cardiac Life Support, BCLS | Heart & Stroke
Advanced Cardiovascular LIfe Support, ACLS | Heart & Stroke
/ professional organizations & resources
Professional Organizations I belong to:
- College of Nurses of Ontario (CNO)
- Registered Nurses' Association of Ontario (RNAO)
- Canadian Nurses Association
- Canadian Association of Critical Care Nurses
Ethics and Standards in Nursing & in Critical Care Nursing
- CNO's Standards of Care (2007)
- Practice Standards for Critical Care Nursing in Ontario
- CNA's Code of Ethics
Resources
- Michael G. DeGroote's National Pain Centre (McMaster's)
- Dignity in Care
- Integrating Palliative Care Practices in ICU
- Cochrane
- Roy's Adaptation Model (RAM)
- Public Health Notices (Government of Canada)
- Who Is Homeless?
/ profile
Hi there reader, my name is Maggi and this is my professional electronic portfolio. The purpose of creating this e-portfolio is to provide the end-user a look into who I am as a professional nurse as I navigate through my journey to acquire my Masters of Nursing degree. My e-portfolio will also be a way in which I can collect artefacts related to my program that I can share and to provide a way to network with others.
Professionally, I have been a Registered Nurse in Ontario since 2012, completing my Bachelor's of Science in Nursing Degree with Ryerson University that same year. I am currently pursuing my Masters in Nursing (generalist) Degree with Athabasca University with an overall goal to advance my career in nursing education, quality assurance, or administration. I hope to narrow this down further in the years to come. I didn't love nursing when I applied to nursing school but I grew to love it entirely when I started school.
After graduating nursing school, I was lucky enough to be a recipient of Ontario's New Graduate Guarantee Program in a Level 2 & 3 Intensive Care Unit at a teaching hospital. I was under the preceptorship of an experienced critical care nurse for 6 months. I then transitioned into working in their Critical Care Resource Pool, where I was able to continue to build on critical care nursing skills for about 2 years. In the years after, I moved to two different hospitals, working in Medical Intensive Care Units. I have been an RN now for 9 years (almost 2 years of the 9 was spent pregnant and on maternity leave) and I find that it becomes easier to be complacent with our practice the longer we work. I make it a conscious effort to prevent this by actively participating in continuing education.
Nursing is a passion for me because I love making connections with my patients and being there for them during their most vulnerable. It feels like a privilege to me. What other profession gets to be there at a person’s most vulnerable and have a chance to make a difference at that point in their life? I take pride in being a nurse because our profession is unique in that way. I also enjoy the education aspect of nursing - in particular, I feel a strong sense of responsibility to help guide nursing students gain confidence in their practice. Through my participation in preceptorship in my career, I always strived to provide the same level of support, guidance, and education to new nurses as I was given when I first started. As COVID-19 shed light on cracks that were overlooked in our healthcare system, providing and creating a supportive environment, to the best of our abilities, is especially crucial moving forward.
I hope you find in navigating through my eportfolio that as a professional, one of my core values that guide my practice is respecting human dignity. Under my profession's governing body, the College of Nurses of Ontario, I am able to uphold the seven standards of care to the public of who I service through compassionate caring.
/ professional reflection RSS
In a review by Nes et al. (2021), they found that technological literacy in education has been lacking and recommends there be an increase in bringing about stronger competencies in digital literacy for both educators and educational institutions. In an age of click-bait and misinformation, our opinion gets muddled and taken as truth, and driving it home are digital echo chambers, as brought up in our forum 1 discussion. Echo chambers are found to exist in different forms of social media platforms and have been described to drive an entire group with similar opinions to more extreme positions (Cinelli et al., 2021). In the cases of Gab, Facebook, Reddit, and Twitter, echo chambers have been reflected to dominate online dynamics (Cinelli et al., 2021). It becomes increasingly important that as nursing professionals, we become digitally literate and understand our social responsibility in our digital practices associated to our digital identity, especially considering how easily our personal and professional lives can intersect.
This eBook by Cheryll Brown is available to read through and is relevant to this week’s Open Our Minds learning activity. It puts you in a “learning perspective” seat regarding digital literacy and encourages you to reflect on your digital footprints, how digital literacy has evolved over the years and stresses its importance in order to become a digital citizen, and prompts you to explore your digital identity. What I found resonated with me was the call to action - to become a digital citizen. As a nursing professional, there are socially responsible digital practices that I need to continue to be open about in learning and mindful about when I engage in digital practices in my personal, work, and learning (like in this forum discussion) life. It covers terms like positionality, critical digital literacies, and topics like being a digital participant online and how that maps along the “Visitor and Resident map” which can show your digital identity engagement (White, 2013).
In regards to nursing professionalism on social media use, keeping your personal and professional online life separate becomes one way of upholding your profession and remaining accountable to the nursing profession and the public (INRC, 2016).
References
Brown, C. (n.d.). Chapter 1: Introduction to digital literacy. In M. Schwartz (Eds.), Digital Citizenship Toolkit [eBook]. Ryerson University. https://pressbooks.library.ryerson.ca/digcit/chapter/chapter-1/
Cinelli, M., Morales, G.D.F., Galeazzi, A., Quattrociocchi, W., & Starnini, M. (2021). The echo chamber effect on social media. PNAS, 118(9): p. 1-8.
International Nurse Regulators Collaborative [INRC]. (2016, Dec). Social media use: Common expectations for nurses. https://www.cno.org/globalassets/docs/prac/incr-social-media-use-common-expectations-for-nurses.pdf
Nes, A.A.G., Steindal, S.A., Larsen, M.H., Heer, H.C., Laerum-Onsager, E., & Gjevjon, E.R. (2021). Technological literacy in nursing education: A scoping review. Journal of Professional Nursing, 37(2): p. 320-332.
White, D. (2013, Sept 13). Just the mapping. [Video] Youtube. https://www.youtube.com/watch?v=MSK1Iw1XtwQ
Our hands are used constantly in our daily lives. In nursing, we use it to mix a patient's medication, to reposition a sedated and paralyzed patient, to suction down an ETT to relieve SOB, to wipe clean eyes, to help a patient stand up from bed to chair, and to hold a hand when it's needed. My hands are a means to communicate action, intervention, and support. My hands is here to advocate and fight for inequality and uphold social justice. My hands are here.
Nursing is an engagement between the nurse, nursed and their environment at that point in time, whether it be at the hospital setting or in the community, there is a synchronicity that allows meaningful connection that transcends our current reality (Lim-Saco, Kilat, & Locsin, 2018). The nurse and nursed is actively involved in creating, building, and maintaining the therapeutic relationship in order to fulfill the commitment to contribute to the overall wellbeing of the person (Lim-Saco et al., 2018). This active participation and recognition allows for a dynamic transformation in “real time” and contributes to the overall wellbeing of the persons and transcends the HST (Lim-Saco et al., 2018). The nursing process in engaging with the person’s being then allows the nurse to be dynamically present with the nursed in a technological environment, like ICU, “honours the self and others, sustains human dignity, preserves humanity and upholds human caring through the synchronous symphony of the caring elements” (Lim-Saco et al., 2018, p. 9).
References
Lim-Saco, F., Kilat, C.M., & Locsin, R. (2018). Synchronicity in human-space-time: A theory of nursing engagement in a global community. International Journal for Human Caring, 22(1): p.1-10.
[This is a critical reflection discussion post that I shared on my NURS608 Philosophy and Critical Foundations in Nursing course recently. It is a moment that I experience early in my nursing journey and one that I have often looked back on. I hope this entry provides a look into the kind of nurse and person I want to be for those who are under my care.]
I was placed in a Nursing Home during the Fall semester of my 4th year. I was assigned an elderly female resident with a history of dementia and tasked with handling her ADLs and nursing care under my preceptor’s guidance and supervision. Staff had told me that she had one son but that no one visited her. While I was taking care of her in her room, I saw that her bulletin board only had one card and it was a birthday card from the nursing home staff. I felt overwhelmed with emotion and had to step out of her room to cry. I imagined my parents or grandparents and how they’d feel. I felt loneliness and sadness overcome me. I knew at that moment when I cried that my emotions can compromise patient safety and asked my preceptor if she can take over the resident’s care so I can be excused for a moment.
I value patient safety and I felt that crying brought me to an emotional place that compromised my judgement and therefore the decisions I make. This would have placed the safety of my patient at risk. I realized that there was another side to empathy, like a double-sided mirror as described by Kesbakhi & Rohani (2019). Although there is the benefit effects of psychological satisfaction, it can cause negative effects like burnout, fatigue, and anxiety (Kesbakhi & Rohani, 2019). It became important for me to safeguard my emotional wellbeing not only for my patient’s safety but also for my own. Compassion fatigue or burnout is a common issue in nursing and that the ability to self-regulate emotions during empathic interactions can decrease the risk of burnout (Hunt, Denieffe, & Gooney, 2017). Being able to self-regulate during empathic interactions is personal and is still something I try to be mindful about.
This experience certainly didn’t deter me from bringing empathy and compassion into my practice - in fact, it guides my practice. I continue to connect with the patients and family that are in my care while trying to keep a healthy and professional distance. I naturally am empathetic towards the vulnerable and have learned that empathy bridges the gap between medicine and humanity because it adds an element of unconditional and excellent care that upholds the respect and dignity of a person.
References
Hunt, P.A., Denieffe, S., & Gooney, M. (2017) Burnout and its relationship to empathy in nursing: a review of the literature. J Res Nurs 22(1-2), 7–22. https://doi.org/10.1177/1744987116678902
Kasbakhi, M.S., & Rohani, C. (2020). Exploring oncology nurses’ perception of the consequences of clinical empathy in patients and nurses: a qualitative study. Support Care Cancer 28(6): 2985-2993. https://doi.org/10.1007/s00520-019-05118-z
NURS603 Facilitating Inquiry
Spring 2022
In this course, the goal of the student is to complete a research proposal. Currently, my working thesis statement for my research proposal is:
Understanding the concept of adjustment for COVID ICU survivors experiencing PICS can result in better continuity of care and improvement of ICU survivors’ perception of quality of life.
NURS608 Philosophical & Critical Foundations in Nursing / learning portfolio
Assignment #1: What Do I Think I know? My View of the Ontological Dimension of Nursing
This assignment was meant to encourage the graduate student to discover what being a nurse means to them and to formulate an ontological nursing stance. My ontological nursing statement is as follows: professionally providing quality nursing actions that holistically address and engage with the person’s being when they medically require it during their disease or illness trajectory. This paper introduced me to the philosophical term ontology and catapulted me into a new challenge in my nursing career: philosophical and critical perspectives of nursing.
I explored the difference between cultural competence and structural competence, applying it to a clinical scenario, and the use of emancipatory reflection to ensure quality healthcare provision for all.
Assignment #2: How Can I Think Differently? Nursing Theories Applied to Practice Scenario
This assignment was used as a way for the graduate student to describe their epistemological nursing stance, explore classical and contemporary nursing theories, choose one of each, then compare and contrast how they are relevant to their practice area. My chosen theories were Sr. Callista Roy's Adaptation Model and Dr. Harvey M. Chochinov's Dignity Model as they relate to delirium in ICU. My take away from this assignment was the use of Roy's Adaptation Model (RAM) in ICU. The RAM is a theory that I was introduced to in year 2 of nursing school and helped me see how the pillars of nursing (person, environment, health, and nursing) worked together for the wellbeing of the patient and family.
Assignment #3: What Do I Think I Know Now? My New Personal Philosophy of Nursing
This assignment's intention was to tie the course together for the graduate nurse to answer their: ontology of nursing, epistemology of nursing, and how they can contribute to the development of nursing knowledge as a nurse scholar. Although I did not complete this assignment as the course required, I was able to describe what nursing means to me as a critical care nurse. My statement regarding my personal philosophy of nursing is as follows: the provision of accountable and compassionate nursing care to the vulnerable in order to ensure that the personhood of the critically ill is not erased, but is upheld, in a biopolitical space, where professional nursing care focuses on quality nursing actions that address, engage, and alleviate the sufferings of the person during their disease or illness trajectory.
From my standpoint, I noted that in clinical, the way in which theory can thrive in clinical practice is to have it embedded in the orientation of the staff nurse. This will enable the bedside nurse to not only have theory inform their practice, but also build on the theory and identify gaps so as to encourage the development of knowledge from different clinical experiences.
Moving Forward
In all three assignments, I have noted my gaps as a student and it was in cognitively synthesizing my critical reflection and critical analysis. This is something I intend on working on. A plan I have in place is to read through AU's Write-Site and practice writing critical reflections using clinical events that occur in my area of practice. I did find that it takes me a long time to read articles, synthesize my thoughts, and articulate it in formal format for discussions and scholarly paper assignments. My intention is to strengthen my writing skills as well as critical reflection and analysis for personal growth and development as I progress through my Masters of Nursing program.
Articles of Interest
Bhattacherjee, A. (2012). Social science research: Principles, methods, and practices (2nd ed.). Textbooks Collection. Book 3.
Bender, M. (2018). Re-conceptualizing the nursing metaparadigm: Articulating the philosophical ontology of the nursing discipline that orients inquiry and practice. Nursing Inquiry, 25(3): p.1-9.
Burns, M., Bally, J., Burles, M., Holtslander, L., & Peacock, S. (2020). Influences of the culture of science on nursing knowledge development: Using conceptual frameworks as nursing philosophy in critical care nursing. Nursing Philosophy, 21(4): p. 1-11.
Chochinov, H.M. (2002). Dignity-conserving care - A new model for palliative care: Helping the patient feel valued. JAMA, 287(17), p. 2253-2260.
Chochinov, H. M. (2007). Dignity and the essence of medicine: The A, B, C, and D of dignity conserving care. BMJ, 335 (7612): p. 184-187.
Crandlemire, L. A. (2020). Unconscious bias and the impacts on caring: The role of the clinical nursing instructor. International Journal for Human Caring, 24(2): p. 84-91.
Cuchetti, C. & Grace, P. J. (2020). Authentic intention: Tempering the dehumanizing aspects of technology on behalf of good nursing care. Nursing Philosophy, 21(1): p: 1-7.
Davis, S., & O’Brien, A. M. (2020). Let’s talk about racism: Strategies for building structural competency in nursing. Academic Medicine, 95(12): p. S58-S65.
Georges, J.M. (2011). Evidence of the unspeakable: Biopower, compassion, and nursing. Advances in Nursing Science, 34(2): p. 130-135.
Georges, J.M. (2013). An emancipatory theory of compassion for nursing. Advances in Nursing Science, 36(1): p. 2-9.
Green, A. R., Carner, D. R., Pallin, D. J., Ngo, L. H., Raymond., K. L., Iezzoni, L. I. & Banaji, M. R. (2007). Implicit bias among physicians and its prediction of thrombolysis decisions for black and white patients. Society of General Internal Medicine, 22(1): p. 1231-1238.
Jensen, H. I., Halvorsen, K., Jerpseth, H., Fridh, I., & Lind, R. (2020). Practice recommendations for end-of-life care in the intensive care unit. Critical Care Nurse, 40(3): p. 14-22.
Kang, J., & Jeong, Y.J. (2018). Embracing the new vulnerable self: A grounded theory approach on critical care survivors’ post-intensive care syndrome. Intensive & Critical Care Nursing, 49: 44-50.
Kim, H.S. (2015). The process of nursing practice [e-book] (Chapter 7). In The essence of nursing practice: Philosophy and perspective. (pp. 105-127).
McAndrew, N., Schiffman, R., Leske, J. (2020). A theoretical lens through which to view the facilitators and disruptors of nurse-promoted engagement with families in the ICU. Journal of Family Nursing, 26(3): p. 190-212.
Orr, Z., & Unger, S. (2020. The TOLERance model for promoting structural competency in nursing. Journal of Nursing Education, 59(8): p. 425-432.
Reed, P. G. (2020). Moing on: From metaparadigm to midparadigm for knowledge development. Nursing Science Quarterly, 33(1), p. 38-40.
Stanton, A.L., Revenson, T.A., & Tennen, H. (2007). Health psychology: Psychological adjustment to chronic disease. Annu. Rev. Psychol, 58: p. 565-592.
Thorne, S. (2020). Rethinking Carper’s personal knowing for 21st century nursing. Nursing Philosophy, 21(4): p.1-7.