Multicultural relationships in supervision

Posted on May 7, 2013 by admin

Here’s an excerpt from a chapter I wrote on culture/ethnicity and supervision, the paragraph seems more than apt these days.

“We don’t colonise, these days, through the barrel of a gun, but through the comfortable words of those who change the hearts, minds and spirits of people” (Waldegrave, 2001).

Supervision provides a powerful learning environment that helps in the maintenance of integrity and is therefore a critical factor in practitioner development for learning to work with diversity. Freshwater (2005, p109) suggests that supervision provides a space for the “preservation or restoration of integrity in caring” and as such a supervisor needs to have integrity themselves. Supervision provides us with an opportunity to look at ourselves and resource ourselves so that we can then re-engage with our work in new ways, with new knowledge and skills and strategies. This revitalising quality of supervision allows us to then return to our work refreshed. With the impact of neoliberal policy and increasing demands for quality and outcomes, the importance of having someplace to replenish ourselves takes on new urgency. Nowhere is this more apt than in working with people of diverse cultures, where policy has not kept up with practice so that few of us are resourced for working with difference in time stretched, resource poor systems. Supervision is one of the most powerful and intimate of learning environments and as such it needs to be a safe one, so that the work of learning can take place and enhance the delivery of care and support. The supervision experience can be a powerful facilitator of the development of knowledge and skills that meets the therapeutic needs of diverse groups. With our changing demographics, supervision needs to be more inclusive, not just in terms of working with diversity but also regarding worldviews from different locations and positions.

DeSouza, R. (2007). Multicultural relationships in supervision. In D. Wepa (Ed.), Clinical supervision in the health professions: The New Zealand experience. (pp. 96-109). Auckland: Pearson Education.

Sisters, friends or whānau?

Posted on August 2, 2012 by admin

This is a lengthier version of an editorial published in this month’s Kai Tiaki New Zealand Nursing Journal. It is based on an invited address I gave at the 10th Annual Conference of the Women’s Health Section:’Divine Secrets of the Sisterhood’ on April 26th 2012.

I recently spoke at the NZNO Women’s health conference about sisterhood. Not that I don’t care about men (I do deeply), but as one of three sisters and as a woman who has spent most of my adult life working in the female dominated profession of nursing, relationships between women are of great personal and professional interest. The call to action in the women’s movement almost thirty years ago emphasised sisterhood and demanded the end of oppression and the commitment to women as a social group (Klein & Hawthorne, 1994). However, the movement also raised questions of difference. Many suggested that in order to understand what women had in common they also needed to pay attention to what they didn’t have in common such as race, gender and sexuality. Focusing on similarity erased and overlooked important differences, but only focusing on difference led to the “othering” of others, stereotyping and pushing people away.

I believe these questions remain important for nursing, because I think our differences can make nursing stronger. An understanding of our differences can help us to better understand our similarities. As Audre Lorde points out “it is within our differences that we are both most powerful and most vulnerable, and some of the most difficult tasks of our lives are the claiming of differences and learning to use those differences for bridges rather than as barriers between us”. So I believe an important question for nurses is how can we capitalise on the energy and movement in difference and resist the coercive force of sameness?

One of the challenges is that differences raise critical issues of power, because differences are often institutionalised (Crenshaw,1994, p.411). Take the idea of the implicit ideal nurse-typically the ideal nurse is female, white, middle class, heterosexual, able bodied, nice, obedient and nurturing (Giddings, 2005; Reverby, 2001). Those nurses that fit the norm experience privilege and those that don’t are marginalised. Internationally, women of colour are present in practice settings with less prestige, lower wages, less security, and less professional autonomy (Gustafson, 2007). While, a disproportionate number of white men and women are ensconced in nursing management, academia and research, whose world view is supported by the dominance of white, Western, biomedical interpretations of health and illness. Grada Kilomba defines whiteness as “a political definition, which represents historical, political and social privileges of a certain group that has access to dominant structures and institutions of society”. As Ang-Lygate (1997, p,2) points out “political sisterhood is suspect unless those sisters who enjoy privileges denied to other sisters are seen to share the responsibility of dismantling the differences”.

This dominance of whiteness in our workforce and our ideas about health and illness are present in nursing in New Zealand too. We are undergoing a period of unprecedented diversity. Transitioning from largely New Zealand-born European to being increasingly ethnically diverse, our dependence on overseas-born migrant nurses is evident in their composition of 29% of the workforce- one of the highest proportions in the OECD. At the same time Māori and Pacific Islands nurses are under-represented in our workforce while these communities experience the greatest health need. This inequity is challenging and as Margaret Southwick notes provides “justification (if one be needed) for the claim that nursing needs to take seriously the challenge of working with diverse and marginalised groups within society is to be found in the health status of these very same groups of people.” (Southwick, 2001).

So given the diversities in nursing and the health inequities that confront our communities, new strategies are necessary. I’m proposing moving away from sisterhood which implies the shared experience of being a woman and experiencing gender oppression to consider a new metaphor that allows greater consideration of our differences so that we can better articulate our similarities (Simmonds, 1997). There’s friendship for a start, a relationship based on equals who have affection, and interest in each other (Friedman, 1993, p.189). Its etymology is in the word free. It means to love, to love our own freedom, and to love and encourage the freedom of the other (Mary Daly, 1987). Friendship allows us to work in each other’s interests because part of what is compelling is our differences.

The notion of friendship as an alliance within the context of difference can be seen in this brilliant blog post entitled Queer Sisters Keep Saving Me: The Brilliantly Selfish Act of Being an Ally by Black Artemis

Heterosexual people especially women owe a tremendous debt to the LGBTQ struggle for some of the sexual freedoms we enjoy…the boundaries queer people bend and bust at the risk of their own lives in many ways expand our heteronormative privilege. Their radical decision to be simply who they are makes it much safer for the rest of us to redefine who we may want to be. We have a broader range of acceptable sexual expression because of the queer liberation movement for every time they push the envelope, they set a new “normal,” and it’s not even they who benefit the most for their courage. Rather it is those of us whose sexual identity is already validated.

If we are going to use the metaphor of sisterhood we consider the idea of a “chosen family” used by LGBTQ communities or the Māori concept of whānau. It too is based on love rather than biology and includes people as who are a source of love and support outside the heteronormative idea of family.

I’d like us to strengthen nursing by strengthening ourselves, for creating space for all nurses to be able to come together with our diverse traditions and values, to be united based on solidarity not sameness. I’d like us to be able to articulate our shared beliefs and practices while acknowledging how we differ.

I’m proud to be a nurse in New Zealand, I value the shared commitment to caring and to social justice in the shape of cultural safety. I’d like to build on our legacy and see nurses critically examine the values, goals, and intents shaping our profession. I’d like us to have some challenging conversations about power and privilege, to deconstruct our own classism, racism, and homophobia and to think about recognition and reparation. I leave my final words to Audre Lorde:

So this is a call for each of you to remember herself and himself, to reach for new definitions of that self, and to live intensely. To not settle for the safety of pretended sameness and the false security that sameness seems to offer. To feel the consequences of who you wish to be, lest you bring nothing of lasting worth because you have withheld some piece of the essential, which is you.

References

ANG-LYGATE, M., CORRIN, C. & HENRY, M. S. 1997. Desperately seeking sisterhood: Still challenging and building, London, Taylor and Francis.

CRENSHAW, K. 1994. Mapping the margins: Intersectionality, identity politics, and violence against women of color. In: FINEMAN, M. A. & MYKITIUK, R. (eds.) The public nature of private violence. New York: Routledge.

DALY, M. (1978) Gyn/Ecology: The Metaethics of Radical Feminism, Boston: Beacon.

FRIEDMAN, M. 1993. What are friends for?: feminist perspectives on personal relationships and moral theory, New York: Cornell University Press.

GIDDINGS, L. S. 2005. Health disparities, social injustice, and the culture of nursing. Nursing Research, 54, 304.

GUSTAFSON, D. L. 2007. White on whiteness: Becoming radicalized about race. Nursing Inquiry, 14, 153-161.

HAWTHORNE, S. & KLEIN, R. 1994. Australia for Women: travel and culture, New York, Spinifex Press.

LORDE, A. 2009. Difference and Survival: An Address to Hunter College” Rudolph, New York:, Oxford University Press.

REVERBY, S. 2001. A caring dilemma: Womanhood and nursing in historical perspective. In: HEIN, E. C. (ed.) Nursing issues in the twenty-first century: Perspectives from the literature. Philadelphia: Lippincott, Williams and Wilkins.

SIMMONDS, F. N. 1997. Who Are the Sisters? Difference, Feminism, and Friendship. 19-30. In ANG-LYGATE, M., CORRIN, C. & HENRY, M. S. 1997. Desperately seeking sisterhood: Still challenging and building, London, Taylor and Francis.

SIMMONDS, F. N. 1997. Who Are the Sisters? Difference, Feminism, and Friendship. Desperately Seeking Sisterhood: Still challenging and building, 19-30.

SOUTHWICK, M. R. 2001. Pacific women’s stories of becoming a nurse in New Zealand: A radical hermeneutic reconstruction of marginality. Unpublished Doctoral thesis, Wellington: Victoria University of Wellington.

Questions haunt nursing student

Posted on June 3, 2012 by admin

In 2007 a student nurse called Lisa Kenyon wrote to the Kai Tiaki asking questions about nursing. I’ve reprinted her letter here and then my response. It seems relevant at the moment

I am a year-one nursing student from Waiariki Institute of Technology, doing my bachelor of nursing at Windermere in Tauranga. I have recently been out on my first practicum for three weeks and have come away with a multitude of questions. I am a 34-year-old married woman with a child, and consider myself experienced in the traumas and joys that life can bring. After finishing my practicum, which I thoroughly enjoyed, I was left reflecting on my personal experience with the elderly.

I cared for a dear man who unfortunately died in my second week of being his student nurse; I was so privileged to have spent that time with him and his family. But I was left with a list of questions and thoughts to which I have no answers. Maybe there are no answers and maybe, with more nursing experience, these questions will make sense, but for now I want to share my thoughts and wonder how other experienced nurses or student nurses have overcome these difficulties.

The questions that bother me are: Can a nurse “care” too much? Don’t patients deserve everything I can give them? How do I protect myself and still engage on a deeper level with the patient? How do I avoid burnout? Why can’t I push practice boundaries, when I see there could be room for adjustment or improvement? Isn’t it okay to feet emotionally connected to the patient? Don’t I need to continually ask questions, if nursing is to change, or will that just get me fired?! Finally, am I just being a laughable year-one student, with hopes and dreams and in need of a reality check?

I would really appreciate feedback from other student nurses who have felt the same or from experienced nurses with some insight into these questions, as I am left doubting what kind of nurse I am going to be.

Lisa Kenyon, nursing student, Waiariki Institute of Technology, Tauranga.

My response below:

I was pleased to see Lisa Kenyon’s letter, Questions haunt nursing student, in the December/ January 2006/2007 issue of Kai Tioki Nursing New Zealand (p4). The questions she has reflected on indicate she is going to be an amazing nurse.

I believe nursing is both an art and a science, and our biggest tools are our heart and who we are as human beings. I was moved by her letter and thought I’d share my thoughts. The questions she posed were important because the minute we stop asking them, we risk losing what makes us compassionate and caring human beings.

Let me try to give my responses to some of the questions Lisa raised–I’ve been reflecting on them my whole career and continue to do so.

1) Can a nurse “care” too much?

Yes, when we use caring for others as a way of ignoring our own “issues”. No, when we are fully present in the moment when we are with a client.

2) Don’t patients deserve everything I can give them?

They deserve the best of your skills, compassion and knowledge. Sometimes we can’t give everything because of what is happening in our own lives, but we can do our best and remember we are part of a team, and collaborate and develop synergy with others, so we are resourced and can give our best.

3) How do I protect myself and still engage on a deeper level with the patient?

I think we have to look after our energy and maintain a balance in our personal lives, so we can do our work weft. We also need healthy boundaries so we can have therapeutic communication.

4) How do I avoid burnout?

Pace yourself, get your needs met outside work, have good colleagues and friends, find mentors who have walked the same road to support you. I’ve had breaks from nursing so I could replenish myself.

5) Why can’t I push practice boundaries, when I see there could be room for adjustment or improvement?

I think you can and should, but always find allies and justification for doing something. Sometimes you have to be a squeaky wheel

6) Isn’t it okay to feet emotionally connected to the patient?

Yes, it is okay to feel emotionally connected to the patient, but we also have to remember that this is a job and our feelings need transmutation into the ones we live with daily.

7) Don’t I need to continually ask questions, if nursing is to change, or will that just get me fired?

Yes, you do have to ask questions but it is a risky business. Things don’t change if we don’t have pioneers and change makers.

8) Finally, am I just being a laughable year-one student with hopes and dreams, and in need of a reality check?

No, your wisdom and promise are shining through already and we want more people like you. Kia Kaha!

Ruth DeSouza RN, GradDipAdv, MA, Centre co-ordinator/Senior Research Fellow, Centre for Asian and Migrant Health Research, National Institute for Public Health and Mental Health Research Auckland University of Technology

How to conquer anxiety and even enjoy giving a presentation

Posted on November 11, 2007 by admin

Published in Kai Tiaki: Nursing New Zealand 13.10 (Nov 2007): p20(2).

It is 11 years since my first conference presentation and I remember that day vividly. I had prepared carefully for the presentation; friends and family came to support me; but a tricky question at the end of my presentation took me by surprise: “Ruth, thanks for that interesting presentation. How does what you say relate to postmodemism?” I was mortified and fudged an answer. It’s a wonder that anyone presents realty! Why would you expose yourself in this way and what is the purpose of a presentation?

In this article I attempt to summarise some of my learning and share some strategies and ideas, in the hope of prompting readers to consider embracing the performance that is presenting. I am going to ask you first to think about who was the best speaker you have ever heard and what was good about them. Now, think about what presenting might have to offer you. Why should nurses think about presenting or public speaking? It is a good career move. The pay off is personal satisfaction, peer esteem and building your career. It is a good skill to develop–you might need to present research at a conference, in-house or at an interview. These experiences help you become a better presenter and increase your visibility.

Conferences, for example, provide an important arena and opportunity for people to exchange views and communicate with each other. They are also useful for linking up with the people who are most interested in your work.

What makes a good speaker?

What makes a good speaker? In my view, a good speaker begins and ends their presentation strongly; you are hooked from the first word to the last, by their brilliance, humour, wisdom, provocation and ability to entertain. They also know how to tell good stories, but they never read from their speech. They capture your attention because, not only do they know their own work, they also have a clear message.

So how does one go about speaking? I have developed as a presenter over the years from being flustered and over-prepared, to having far too much to say, to now beginning to feel natural and comfortable when I present at a conference or gathering of peers.

When I was a group therapist and facilitator, I had to speak to several people at a time and this helped me grow in confidence as a speaker. Then I was asked to facilitate a function attended by 250 people. This prompted me to do a Toastmasters course, where I learned how to recover from mistakes in a presentation. I also realised that when I was anxious, I lost my ability to be natural and humorous, but if I could manage my anxiety, then all would be well

In terms of conference presentations, I prepared by reading previous papers and began networking, so I got to know other people in my research field, which helped me realise I had something to offer.

Preparation crucial

Preparation is crucial to presenting well Three aspects need to be addressed: the purpose, structure and content of your presentation. In considering purpose, it is important to know the key messages you want to convey. It might help to start at the end and work backwards–every presentation needs a destination. Then consider what you need to say to assist the listener to get those key messages. Is there a context you need to introduce? How much can you assume your audience will know already? So to the structure. I tend to work on the basis of four parts to a presentation: the introduction, the body, the guts and the conclusion.

The purpose of the introduction is to motivate the audience, which you can do by having a warm up or a question. I also use this part to introduce myself and define the problem or issue, and set the scene. Then you can introduce the context, such as terminology and earlier work. At this point, I would also emphasise what your work contributes to the topic or area, and provide a road map of where your presentation is going. This normally takes around five minutes. The next part of the presentation outlines some big picture results or themes and why they are important. This is followed by the “guts” of what you want to say, where you present one key result, carefully and in-depth.

The conclusion is where many presenters (including myself) run out of steam. The conclusion involves rounding off your presentation neatly and linking everything you’ve said. This can be a good time to mention the weaknesses of your work, and it can help manage questions at the end. It is good to find a way to indicate the presentation is over. I do this by thanking the audience and asking if there are any questions.

Now to the content. Many people use PowerPoint presentations. Use slides like make up–sparingly and simply: common advice is don’t have too much on them; and don’t have too many. (I’m still working on this one.) Six words per bullet point and a maximum of six bullet points per slide is recommended.

The slides are merely an adjunct to your talk, so please don’t read them word for word (my pet hate). The purpose is to highlight key points for the audience and to prompt the speaker. In considering the number of slides to have, keep in mind that each slide takes about a minute and a hail or two minutes to read and fully understand?? If you have 87 slides for a 25-minute talk, like someone I was on a panel with recently, you are likely to overwhelm your audience. Take care with formatting your slides and make sure the spelling is correct. Lastly, be sure you’ve saved your presentation to two types of media. Practise your presentation, ask for a second opinion and get some feedback. Practising helps fine tune your timing.

On the day itself, make sure you are prepared and took and feet good. Ensure you take the media you are going to use and take a hard copy of the presentation to refer to. Say your presentation out loud. At the venue expect nothing to work and scope the technology. Address your anxiety. I do this by practising my presentation, going for a brisk walk and taking deep breaths. I also like to get to the venue early and mingle with those attending the conference, so I can develop some allies in the audience. Focus on being yourself and focus on giving.

Connecting with the audience

Now to the actual presentation. Make sure you project your voice to the very back of the room. It is important to know the audience and pitch your message accordingly. Make eye contact if possible–this is easier if you had time to meet people beforehand. Find a way to involve the audience and make sure you have a good opening. Use repetition to reinforce your message: tell them what you are going to tell them; tell them; then tell them what you told them, but repeat it in different ways. Make sore you are standing in the right place so you aren’t blocking your slides or other visual aids.

Remember that once you get involved in what you have to say, then the nervousness will go away. Don’t be afraid to pause, and you can pause for emphasis. If you get stuck, just move on to the next part of your presentation (others won’t notice). Be spontaneous, considerate and inclusive. I like to move around and I tend to focus on entertaining. If you can generously link in with what previous speakers have said, or affirm later speakers for continuity and reinforcement, that is all to the good. Whatever you do, don’t go over time.

Congratulations, you’ve finished. Now, let’s talk about feedback and questions. Feedback is critical to Learning how to improve your talk and for future presentations. Solicit feedback, if it isn’t freely given, but be prepared for some negative comments! Ask for written feedback, if appropriate.

Managing questions is important. Repeat the question so everyone can hear. It is important to be both prepared and polite. Keep your answers short where possible. If you get drawn into a Long discussion with a questioner, for the sake of your audience, offer to discuss the issue tater. Don’t be afraid to say that you don’t know. Find a way to turn criticism into a positive statement, eg “thanks for mentioning that, it’s given me something to think about”, rather than being defensive.

Different types of questions

In my experience there are four types of question: the genuine request; the selfish question (which is realty about the questioner saying “Look at me”); the malicious question (which is designed to expose you); and the question that has absolutely nothing to do with your presentation and makes you wonder if you and the questioner were in the same venue!

Presenting requires a delicate balance–preparation is important but so is being yourself and being spontaneous. It is important to have content and structure, but the more you have of both, the less room you have for questions and spontaneity. It is important to be inclusive, but be careful with humour and jokes or your own stories, unless you can Link them with your talk well. Lastly, be entertaining, know your material, keep it simple, be prepared, be creative and have fun!

How is your Central Helping System?

Posted on September 9, 2007 by admin

First published in Mindnet Issue 11 – Spring 2007
Recently I’ve come through a series of life changing stresses and learned what true love; friendship and personal strength were about. In particular the words of wise Rabbi Hillel, a Jewish scholar & theologian who lived from 30 BC – 9 AD have been a source of inspiration for a previously uncharted journey: “If I am not for myself, who will be for me? If I am not for others, what am I? And if not now, when?” Dan Baker and Cathy Greenberg suggest using these questions to prompt you on a daily basis. Despite being written so long ago, these words have stood the test of time and got me thinking about how we can maintain good mental health amidst transition and change. Two transitions that have occupied a great deal of my energy and interest have been the transition to parenthood and the transition to living in a new country.

If I am not for myself, who will be for me?

Starting with question one, If I am not for myself, who will be for me? Baker argues that we have to take good care of ourselves and begin by having a good relationship with ourselves and being our own best friend. There are some things that only we can do for ourselves and some things that we can delegate. They recommend asking yourself further questions every day: such as what I have done to take care of my body, mind and spirit today? Both new parents and new migrants experience the loss of otherwise familiar reference points. New mothers face the demands of an unpredictable gamut of demands for a baby whose needs are all-consuming and leave little time or energy for focusing on oneself. For a migrant, the loss of a “village” and familiar things, places and processes often leads to a quest for belonging and clarification of values and purpose. Both transitions offer the potential of transformation provided resources and support are in place, but accessing them can often be difficult.

If I am not for others, what am I?

Question two leads us from taking care of ourselves to taking care of others. If I am not for others, what am I? Research evidence is growing that social support is critical to successful coping through enhancing resilience, buffering the impact of stress and assisting in the maintenance of positive mental health. Social support encompasses four key attributes emotional (e.g. providing empathy, caring, love, and trust), instrumental (e.g. aid in kind, money, labour, time, and modifying environment), informational (e.g. advice, suggestions, directives, and information) and appraisal (e.g. affirmation, feedback (Toljamo & Hentinen, 2001) and results in improved mental health (Finfgeld-Connett, 2005 ). Often support starts with one’s immediate family and then to friendships termed ‘central helping system’ by (Canavan & Dolan 2000 cited in (Pinkerton & Dolan, 2007)) and often it is only when this support is exhausted, weak or unavailable that people approach more formal sources of support.

In terms of my two professional interests, I have found that when people migrate they frequently lose their support networks and when people welcome a new baby into their family they frequently have to develop alternative support networks. Social support is characterised by reciprocity and mutuality and involves the exchange of resources between people that enhance the well-being of both. When we are supported and become part of a network of communication and mutual obligation we can begin to believe that we are cared for, loved and valued (Hupcey, 1998).

If not now, then when?

Question three asks us “if not now, then when?” This is where a focus on the present moment becomes highlighted. For so many of us the focus is on the future. For the new migrant it can be about “when I get the job that recognises my qualifications and worth then I can start enjoying my life in this new country”. For a new parent it might be “when I can sleep through the night I’ll start enjoying being a parent”. How can we feel good in ourselves, when things feel out of control, unresolved and unresolvable? Mindfulness, a Buddhist concept based on becoming aware of the moment and living fully in it regardless of how pleasant or unpleasant it is can lead to transforming that reality and your relationship to it (Kabat-Zinn, 1993). Ultimately there is very little we can do about what has already happened or determine the future, but the likelihood of a wonderful future is enhanced by thoroughly enjoying the present.

Mental health awareness week

Which leads me to the theme of this year’s mental health awareness week, good mental wellbeing can come from:

Celebrating our uniqueness
Connecting with each other
Supporting others in their journey
Sharing our stories

So how can we celebrate our uniqueness when there is little to support our identity? How can we connect with each other, when we are isolated? How can we supporting others in their journey, when we ourselves are un-resourced? How can we share our stories if there is no one to listen?

Key points to consider for mental health and health promotion workers and organisations.

There is a need for mental health service providers to both safeguard quality care and ensure continual improvement of the quality of their services by creating an environment where they, their colleagues, their clients and family members can flourish. One of my own favourite strategies is supervision which helps me both with my self-care, self-development and ensuring I get the support that I need. It also helps me develop and increase my knowledge, understanding and skills. Again I’d like to reiterate Rabbi Hillel’s first question. How can we truly care for others if we don’t care for ourselves? Self-care is so under-rated, but if you are a mental health worker ask yourself: How do we I look after myself and cultivate my own wellness? And how can I practice what I preach?

In terms of your own support network. How can you avoid working in isolation? How can you get the support that you need? If you aren’t thinking about this it can be difficult to consider the needs of people and groups that require support to remain socially included. How do you encourage clients/tangata whai ora to use and enhance their own personal support networks? In reflecting on Hillel’s third question, consider how can you be fully present with your mahi. How can you be so fully engaged in your work that it provides a well of energy that is renewable and deeply satisfying so that you don’t get burned out. How can you ensure that your work and efforts are sustainable? For me it goes back to attending to myself regularly, meeting my own needs, considering my own health and well being.

My central helping system undergoes continuous refinement but what I have realised is that it requires me to first have a relationship with myself. Only then can I have an effective relationship with anyone else. Then ensuring that I have a support network in which reciprocity reigns and lastly being fully present with myself (not always easy). Rabbi Hillel’s questions provide a useful starting point for considering our own mental health and of those who are part of our lives personal and professional. Attending to these three questions provides us with accessible resources for mental well being.

REFERENCES

Finfgeld-Connett, D. (2005 ). Clarification of social support. Journal of Nursing Scholarship 37(1 4).

Hupcey, J. E. (1998). Clarifying the social support theory-research linkage. Journal of Advanced Nursing 27(6), 1231.

Kabat-Zinn, J. (1993). Mindfulness meditation: Health benefits of an ancient Buddhist practice. In D. Goleman & J. Gurin (Eds.), Mind, body medicine : how to use your mind for better health (pp. 259–276). Yonkers, N.Y.: Consumer Reports Books.

Pinkerton, J., & Dolan, P. (2007). Family support, social capital, resilience and adolescent coping. Child & Family Social Work, 12(3), 219.

Toljamo, M., & Hentinen, M. (2001). Adherence to self-care and social support. Journal of Clinical Nursing 10(5), 618.

Advice to a student nurse

Posted on February 11, 2007 by admin

My response to a student nurse who was haunted by questions about becoming a nurse. Published in Kai Tiaki: Nursing New Zealand 13.1 (Feb 2007): p4(1).

I was pleased to see [x} letter, Questions haunt nursing student, in the December/ January 2006/2007 issue of Kai Tiaki Nursing New Zealand (p4). The questions she has reflected on indicate she is going to be an amazing nurse.