Ageless attire

Do you know of any attire that is truly ageless, or age-neutral?

You’re right. Jeans. There is another one. … That would be the backpack.

I love jeans and backpacks. These items are a regular part of my outfit. They are suitable for kids, teens, adults and seniors—not exclusive to any particular age group. Of course, the occasion is important. You can’t wear jeans to a black tie event.

They are gender-neutral, good for people of all shapes and sizes. Jeans have been marketed as a sexy commodity. Sexy or not, they are practical, and you don’t need to think or feel that you are sexy in order to put on a pair.

They are just great inventions. I wish there were more goods, ideas—whatever—that would transcend the age boundary. I hope that, in the world we live in, a time will come when age really doesn’t matter that much. That would be a world radically different from the one we know now.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Maintaining personal space: A new rule

I was doing my weeklong clinical update in a major regional hospital. The cafeteria was always packed during lunch breaks. I tried to have lunch after the rush hour, to avoid the congestion but, still, the café was fairly busy. There I learnt a new rule about interpersonal boundaries.

In general, people (mostly urban population) maintain an invisible personal space around them, which they expect others to stay out of. The distance that people keep from one another depends upon the relationship they have with the other person in an interaction, or the context of its occurrence. When we are in crowds, this personal space shrinks, and when we are in a more spacious environment, our alarm bells ring if someone who has no particular reason to do so gets too close to us.

Applying this rule in the hospital café (where everybody shares tables as in a Hong Kong fast-food restaurant), I would expect that, at a table for four, when only one seat is taken by me, the next person would come and sit diagonally opposite from where I am (Fig. 1), thus maximizing personal space.

To my surprise, someone came to sit right beside me, leaving the two seats on the opposite side of the table empty (Fig 2). Initially, I thought this was entirely random, but it happened to me more than once, so it had to mean something, and that got me thinking.

Interpersonal rules that I have learnt in the past dictate that, when I sit down diagonally opposite someone, I should ask whether the seat is taken. Even if, because of intense competition for space during lunch, I do not ask, I should look the person in the eye, nod and/or smile. By sitting right next to me, however, the person does not need to look at me or acknowledge my existence.

I find this both interesting and alarming. Have we become that alienated from one another?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Little acts of kindness

More stories from my clinical update experience (see previous post) ...

I have told you that, as an observer, I did not have any patient responsibilities, so was free to do anything I wanted to enrich my learning. I was able to go around the ward and observe ongoing procedures. I could also fill up patients’ cups with warm, boiled water. Older Chinese men and women do not like cold drinks, and we always drink boiled water. I could fetch a patient a bedpan or urinal if they needed one, or pass a request to the nurse in charge of their care.

During visiting hours, I also had time to talk to them and their families or friends. I was impressed by the families’ devotion to the patients and told them I appreciated how much they cared. I have had family members admitted into hospital, and I know what it is like to have to visit a close relative in hospital on a daily basis.

Anyway, that was all I did—just little things, really unremarkable, but even within the short period of time that I spent on the unit, these patients (as an observer, I can’t call them my patients) repeatedly complimented me on how kind and good I was. It was truly embarrassing when they loudly told me I was the best. I could only tell them that it seemed so because I was the only one who had all the time in the world there, without any particular responsibilities. I told them other nurses would act just the same in my position. I didn’t deserve those compliments.

To me, this clearly demonstrates that people do not expect us nurses to solve all of their problems. Nurses are ever so cautious when patients and their relatives ask how they, the patients, are doing. Surely we can do better than just saying, “This is a question for the doctor,” or “I will let the doctor know you are concerned.”

We don’t need to solve all of their problems. They know we can’t. They just want an acknowledgment of their pain and burden. They need a moment to vent and a pat on the shoulder to give them the extra bit of energy they need to go on.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

“A nurse must be caring. If you are not ..."

In June and July 2011, I did my clinical update in the medical and geriatric units of two different local hospitals. This is an unofficial requirement of all faculties in our school.

The visiting hour arrived. As an observer, I had a lot of time and freedom to do what I considered useful for my own learning. I went around talking to patients’ relatives. I saw this older woman feeding an even older woman and took an interest in them. It was a daughter visiting her mother in the hospital. As the daughter was giving sips of water to her mother, I asked for permission to take a picture of them. The daughter happily agreed. She started telling me that she had been on television and had been interviewed for radio programs before. She told me her mother was 101 and asked me to guess how old she was. She said she was 76. (She looks younger than her age.)

The lunch hour arrived, and I went to the canteen (café). There I met the daughter again, and we started chatting. Taking care of her mother had become her career now. She would leave home each day around 10 a.m. and arrive at the hospital well before 11:30, the first visiting time slot. Then, at 12:30 p.m., she would leave the ward and go to the café. She would sit in a distant corner until the lunchtime rush hour was through and then order her lunch. She would wait in the café until 5 p.m., the second visiting period, then stay with her mother until 8 p.m., when she would go home. She said it was her daily routine and that it was OK for her, because it was her mother.

She went on to tell me that she had studied geology in college in Beijing, that she used to work for the government of the People’s Republic of China and that her work was well appreciated by her supervisors. She took pride in the many projects she participated in, which were mainly related to irrigation and flood control.

And then we talked about care. We talked about nursing. I invited her to come and speak to my students in the coming semester. Without any prompting, she emphasized that there are a few things that are required of a nurse. “First, you must have a caring heart. You must love your job. If you don’t, you may as well not be a nurse. Second, as a nurse, you must treat the seniors you care for as your own relatives. Don’t choose this job only for the money.”

Nicely put.

I am humbled by her insights, her openness and her dedication to her mother. Yes, you need to be caring as a nurse. If you are not, you may as well not be a nurse.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

The simple joy of children

I was travelling in Vienna with my sister and a friend. We were going around the city on board a tram, with no particular agenda, other than to view different parts of the city. It was a great way to sightsee. We were able to feel the ambiance associated with each section of the city we visited. As the scenes changed, so did the pace of life, as seen in people walking along the streets and vendors selling their produce and products in shops. We also noticed how differently people carried themselves as they went about their business.

It must have been close to 3 p.m. or so when the schools finished for the day and a bunch of kids hopped onto the tram. One of the children caught my attention. He must have been around 8 or 9 years of age. He had blonde hair and a big grin, and was chatting excitedly with his friends. In his hands, he held a model. I didn’t have a clue what he was talking about, but his body language told me he was excited about his creation. He was busy explaining to his buddies how it worked, oblivious to what was going on around him in the tram. It is always very charming to see people passionate about their thoughts and deeds.

I gestured to ask him if I could take a picture of him with his model. He nodded without a moment of hesitation, and held it up for me to snap a shot. His smile was genuine, not intentionally posed for the picture. He was not shy, and his behavior told me that he was very trusting of people (even strangers). It was natural for him to respond to a stranger’s request this way. His face made a deep and lasting impression on me.

He was happy to accommodate my request for a picture.

Another child enjoying one of life's simple pleasures.

Such genuine happiness in a simple joy in life – there are few things in the world that can compare to such purity. We can find it often in children, if we look closely enough. With age, we tend to lose such purity of heart more and more until, one day, it becomes a novelty to us when we see it.

I think we should add another developmental task in older age—to reinvent the purity of our hearts in order to rediscover the simple joys in life. I believe this could be the key to happiness and contentment in old age. At least I believe so for now.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Life cycles of cities

Hong Kong has had its “glorious” moments. There was a time when China maintained a closed-door policy, and Hong Kong was the only gateway connecting China with the rest of the world. We prospered because of the unique role we played between China and the other countries. Since China opened up its doors under the government of Deng Xiao Ping, Hong Kong’s significance to China has slowly declined.

We used to be a great entrepôt. Not any more. Business routes between major cities in China and the outside world have become direct. Nothing needs to go through Hong Kong before entering China now. It used to be that there could be no direct contact between China and Taiwan. Therefore, people from both Taiwan and the Chinese mainland had to stop over in Hong Kong before moving on to either Taiwan or the mainland. This practice will soon come to a complete halt, as both the Taiwanese and the Chinese governments are eager to boost direct trade and cultural exchange between the two places.

Hong Kong construction worker scales scaffolding.

It is a well-known fact that Hong Kong depends on her mother country to prosper. As other cities in China become more developed and better connected to the global village, Hong Kong is losing its strategic importance. Our previous industrial and business orientations have changed from those of manufacturing to those of a service industry, manifested as banking, finance and tourism. Like other cities in the world, we are going through a cycle: struggle, development, prosperity, fading importance and struggle.

Members of a Hong Kong domestic workers union demonstrate.

Many a time, I hear visitors remarking that other Chinese cities are doing a lot better, implying that Hong Kong is lagging behind in many dimensions, losing its valour and glamour to neighboring areas and major cities in China.

Public housing estate in Hong Kong.

I am somewhat amazed that such remarks are being made. Just as families go through life cycles, so do cities. We have had our share of cheap labor in manufacturing. We were the production house for many developed countries for goods such as garments, toys and watches. Then, because of rising production costs, our factories moved inland to the southern part of China. Even in southern China, the situation is becoming more competitive now. Global manufacturers keep looking for cheaper places to produce their goods. Many production houses have been moved to Vietnam, Cambodia, and so on.

There are few cities on earth like New York, London, Paris or Tokyo, where the city never seems to grow old. Hong Kong may be progressing toward older age. But we are still bursting with life, with a population of more than seven million.

So Hong Kong will lose its attractiveness. But it is my hometown, where I have my roots and where many members of my family still reside. And there is no place like home.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Family values

When I visited Venice and Rome, I saw many older people walking in the streets, shopping or going somewhere leaning on the arm of another adult. I like to believe that those other adults were their family members or close relatives. I’ll call them the older persons’ family, because it makes me feel better. When these seniors paused to sit down at a sidewalk cafe, the younger adult would take great care to help them sit. They were patient and respectful. It was a heartwarming sight.

The situation is very different in Hong Kong. Here, the younger adults are busy working, and it is domestic helpers who take on the responsibilities of caregiving, day in and day out. Nonetheless, families do care about their elderly relatives in Hong Kong. In the housing estate where I live, there are many domestic workers who walk and exercise with seniors on a daily basis. You can see how well they relate to each other by observing how they interact.

Some domestic helpers talk amongst themselves—for example, a group of seniors and an equal number of maids gather separately each morning in the estate’s garden—while others stay close to carefully observe the seniors in their care. There are those who walk fast and drag the seniors with them along the way, and there are also those who allow the seniors to take their time. It is only during weekends and public holidays that you see more local adults taking care of their parents. You will find them in teahouses, parks, shopping malls and so on.

Filial piety has diverse manifestations in different countries.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.