Introverts make excellent nurses, too!

I don’t know about other countries, but here in Hong Kong, as part of the selection process for admitting applicants to baccalaureate programs, some universities have adopted use of admission interviews. Interestingly, I have never asked my international peers if this is done in their countries. I must do so in the future.

Nursing is a popular profession in Hong Kong with a huge number of applicants wanting to get into our programs. We admit about 180 students in each annual cohort, but there may be nine to 10 times as many applicants. Obviously, we can’t interview each one.

For a number of years, we have conducted group interviews in which approximately 10 applicants are collectively interviewed for 45 minutes and each applicant is given one minute to tell the interview panel about him or herself. The group is then given a topic to discuss on its own. There is no assigned leader, and the group just runs itself until the prescribed time is up.

As you might expect, only those who are outspoken, confident, and articulate get the higher ratings. In retrospect, the group interview process reveals some systemic biases. For example, applicants who exhibit the attributes of extroverts have a better chance of getting into the program. Extroverts are important in the nursing profession. We need leaders, change agents, advocates, and publicists in nursing. Outgoing people often fit into these categories. But we also need other kinds of nurses.

iStock/Thinkstock

We often say it takes all kinds (of people) to make the world. But we are only preparing certain types of nurses to look after all kinds of people. That does not sound logical to me. I have come across students who are quiet—they were fortunate to have gotten into the program—but are gentle and kind to patients. I have also come across students who are sociable and assertive but don’t necessarily connect well with people.

The profession needs introverts as much as extroverts. We need nurses who are reflective practitioners. I am not saying that extroverts do not make reflective professionals, just that we need to be more thoughtful in our admission practices to ensure that, as we recruit the next generation of nurses, we admit as diverse a group of individuals as possible. Only through diversity will we grow. It’s not unlike a gene pool, where the more diverse it is, the stronger will be succeeding generations.

Through diversity, we learn about tolerance and the value of accepting people who are different than us. Through group heterogeneity—our profession—we are stimulated not to take things for granted just because those are the norms, but to be creative in meeting the health-care needs of a diverse world.

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

Learning to observe

I learn how to care for older people in practical ways by observing my mother. I notice how she can easily become tired—progressively so over the years. I see how she has become reliant on others for things she has been doing all her life without help—toileting hygiene, for instance. By watching her, I have come to see what her needs are. I also learn about caring for others by observing people in various circumstances. I take note if they are exhausted, annoyed, sad, or in pain.

As a teacher, how do I help my students value the power of observation, to notice the needs of others? Since we are in a helping profession, how do I teach development of observation skills to students who are engrossed in their own world most of the time?

How do we teach students to really "see" people?

I use public transport to go to work. In fact, I use public transport all the time. Because Hong Kong is such a compact city, I get around easily without a car. On trains and buses, people are engrossed with their smartphones, tablets, and what not, captivated with what these gadgets have to offer. Few people see an older man or woman board the train, much less offer him or her a seat. The same is true for those who are disabled, in the latter weeks of pregnancy, or carrying a baby. Few relinquish their seats, probably because most are busy playing video games, texting, watching movies, and so on. They attend to their own business, oblivious to the needs of those around them.

On those rare occasions when I do see someone offer his or her seat to another, I am sorry to say that, most of the time, the person who does so is middle-aged, not the age bracket of my students. What have we, as a society, done wrong? How do we teach our young—at home, school, in society at large—to care about others?

You will recall that I have made journaling an assignment for one of my courses. The exercise wasn’t as successful as I had hoped. Many students wrote “reflections” of what they had learned in a lecture—exactly what I asked them not to do. Despite including this assignment in my overall assessment of their performance, most students remained unobservant and unresponsive to what was happening around them with respect to elder care. Some did make excellent observations and reflections, but many did not.

My students are essentially good people. I know this when I hear them talk and get better acquainted with them as individuals. But I need to think of effective techniques to help my students “see” what is around them, not just “look” around and then go about their business.

I feel I am struggling against the current. Technological advances have changed our ways of relating to one another. As an educator, I love that technology helps me teach and engage my students in innovative ways. Yet, I am also watchful and wary of the impact that modern communications may have on how we interact with each other—whether we even “see” each other.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

Intended vs. actual outcomes: Puzzles of a teacher

In a previous post (13 March 2014), I mentioned that, to help my students become more observant of age-related issues, I ask them to write a journal. A natural follow-up question is, “So, how useful is that?” All I can say is, “I’m not sure.” Actual outcomes may be very different from intended outcomes.

When reading my students’ journals, I’m sure that some of them must have been written over a very short period of time, shortly before the due date for submitting them. I also read journals that are purely post-lecture reflections. That is, the entries are discussions of concepts I taught in class, which is not what I asked for. I wanted them to think about elder care outside of the classroom. Sometimes, I read journals that are superficial, mere recounting of what a student has read or heard in the news, but without personal reflection. Such entries are distant and somewhat “cold.”

sjenner/iStock/Thinkstock

So, how to teach elder care? How to ensure that students have learned something? These are intriguing issues.

Through group seminars (oral presentations and discussions), written papers, and tests, I know how my students have performed academically and what knowledge they have mastered. But I can never be sure whether I have prepared them to be better nurses in caring for older people.

Have I helped them develop the right attitude for interacting with older people? In the relatively few clinical practice hours required by the Nursing Council (the regulatory body for registered nurses in Hong Kong), have my students been able to translate what they have learned in the class into actual practice? Have they developed a deeper understanding about older people as unique beings? Do they care about older people who come under their care?

I have no answers to these deeper questions. By interacting with my students, I know for sure that some of them have developed such understanding and care. But, as a teacher, my goal is not to teach just a few; I have been given a class.

My students may have performed satisfactorily in their course requirements. Knowledge can be acquired, but attitudes develop over time.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

Wet markets: Not super, just better

I love wet markets. I guess many of us do. Wet markets are extremely colorful, full of scents and sounds. A wide variety of goods are on display for sale. Our eyes try to make sense of the myriad colors and textures. Our noses are suddenly awakened to a complex mix of aromas. Our feet move along with those of others in the crowd toward the spots with the greatest commotion. All of these are wonderful moments, making one feel very much alive.

The wet market is a social place, not just a market.

Nowadays, grocery shopping in supermarkets is the norm—clean, highly organized and efficient, but never as attractive. Older people love wet markets, where they can chat with the person selling the goods, some of whom may have become their friends. As “older” customers, they enjoy perks and special privileges. Day in and day out, they make trips to the wet market to buy fresh food to prepare meals for their families. The wet market is a social place, not just a market.

For the younger generation, supermarkets may be the preferred choice. I must confess that I sometimes prefer a supermarket to a wet market, too. I like the fact that, most of the time, I can trust the origins of the foods I buy, that the vegetables I purchase will not rot so easily, because they have not been excessively sprayed with water. Also, the scales work properly and won’t cheat me.

But when I am not in a hurry, when I am in a good mood, I, like our Hong Kong seniors, love to go to a nearby wet market to get the groceries I need. I enjoy seeing people making an honest living out of labor. The wet market is so much more human. You can talk to the person next to you without worrying about whether or not you are observing proper social etiquette. In fact, you are expected to chat with those around you.

The supermarket will never replace the wet market. Just as canned soup will never compare to a mother’s homemade soup.

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

The long wait finally over?

Years ago—eight or more—some nursing homes in Hong Kong partnered with local hospital teams to provide medical consultations via a telecommunications set-up. It never has worked.

The equipment was set up as planned. Nursing home residents who are too frail to travel and wait long hours in an outpatient department sit in front of a computer in the nursing home. But hospital doctors’ schedules are rather unpredictable, so residents and nurses still have to wait.

After a long wait, residents need to go to the bathroom, or are too tired or in too much pain to remain seated, so they ask to go back to bed. Or the nurse has to answer an urgent phone inquiry, or it’s time to give out meals or medications, and so on and so forth. In the end, the resident or the nurse is not there when the doctor finally shows up at the other end of the telecommunications set-up.

Now, it’s the doctor’s turn to wait and, of course, his or her schedule is too filled to wait for long, and residents are usually not fast enough to connect with a doctor who is always on the go. That’s why this mode of telemedicine doesn’t work.

With smartphones, all these nightmares will disappear. Apps allow residents and others to connect immediately with doctors, and vice versa. Problems associated with lack of portability of telecommunications equipment is no longer a deterrent to the timely consultation needed by seniors, no matter where they are.

Although I am not personally a fan of smartphones, I applaud the advance of technology and all those who put so much effort into popularizing their use.

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

Fast lane not always quickest way to go!

Life is busy. Busy people can accomplish more within the same period of time than non-busy people, but being busy doesn’t equal being diligent or proficient. Being busy does not mean getting lots of things done well. Being busy seeing people doesn’t necessarily increase our social network or win friends for us.

One thing for certain, a busy life makes our entire being tense up. We frequently look at our watches, checking the time, making sure that nothing has been missed. We go faster and faster until things spin out of control. Our actions become brisk and abrupt, and we become short-fused.

As I grow older, life in the fast lane doesn’t seem to be taking me to places faster. Rather, it makes me bad-tempered. I get upset when people who work with me do not understand me fast enough. My speech gets faster, but I don’t always make myself clear. Being busy can mean that I am not being thorough. More often than not, being busy means that I am hard pressed for time, and I become rude. I easily forget my manners. Regrettably, as E.M. Forster wrote, “Rudeness poisons life.”

Are we missing something?

Hong Kong is known for its efficiency, and because we are so busy—and therefore short of sleep—some of us sleep standing up. Do we know what we have missed by being so fast? What have we sacrificed to be efficient?

Wake me when I get there!

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

Life in waiting

Sometimes, I think about a relative, who is disabled, and his wife, who also uses a wheelchair. I never imagined how different the pace of life could be when one is disabled, compared with the pace that I am used to. It was only when I went for a day out with them that I came to realize that people who are disabled have much less flexibility in managing their lives. Not only that, they have to spend a lot of time waiting.

To go out using the Rehabus (a vehicle with a hoist for wheelchair users, organized by the Hong Kong Society of Rehabilitation), they have to book in advance. And if the time and date they need the bus service are not available, they have to wait for the next suitable time slot. Otherwise, they can’t go to whatever event they intend to attend. Unlike those with healthy bodies, they can’t always take the bus, the underground or any other form of public transportation.

Yes, they can book a private taxi with a hoist that accommodates two powered wheelchairs, but there are not many taxis like this, so they are not always available. Also, they are relatively expensive, which is an inhibiting factor for many people who are disabled.

Over the years, my relatives have adapted to a way of living in which waiting for their turn has become a part of life. As an able-bodied person, I am always on the go and in charge of my time. If I need to get to a place for which no bus service is available, I will catch a taxi. I will explore whether a place I need to visit is served by other means of transport, how I can get there the fastest—subway, ferry, minibus, etc.—what the connections are and how long it will take. Then off I go. But my relatives have to arrange for transportation well ahead of time. Mostly, they request Rehabus to come and pick them up at a prearranged time and place. There is no such thing as a spur-of-the-moment outing. Choices are much more limited.

Before we went on our outing, we planned the day in advance. We estimated how we would spend our day. But they were only estimations. Although it was possible that we would finish our excursion ahead of schedule, there was nothing we could do to save time, so we went ahead with our plan. All we could do was wait. We waited for a pick-up after movies, after going to the mall, after a family meal, and so on.

The Rehabus schedule dictates their pace of living whenever they go out. If they book transport to pick them up after dinner at a family gathering, they may need to leave midway through the event. As much as they would like to spend more time with everyone, they have to leave, because the Rehabus only runs up to a certain time in the evening.

Through spending time with my relatives, I have come to appreciate how people with disabilities go about negotiating the pace of their lives. It is only through these experiences that I have come to realize that independence has different meanings to people with different levels of physical ability.

I have also come to realize that it must be the same for all vulnerable populations in our society. Not only do people with disabilities have their life schedules governed by external factors and timetables outside their control, but they must make adjustments to their planning and wait their turn. For example, say the elevator can only take one wheelchair at a time. Because they may not be able to run up the stairs, they have to wait for an elevator that is empty enough to take them to their destination floor. In a way, Darwin’s theory still rings true: Those who are fittest get it all.

Three people in wheelchairs wait their turn for an elevator.

What considerations should we bring to the forefront when designing infrastructure for an all-inclusive society?

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

Rhythm of life

Today, I had a midday appointment with my traditional-Chinese-medicine doctor. Afterward, I went to a local teahouse to grab some lunch. The place was crowded, and people were lining up for seats or to pay their bills. After 2 p.m., the crowds began to ease. The official lunch hour for white-collar employees in Hong Kong is between 1 p.m. and 2 p.m.

Hong Kong teahouse

I finished my late lunch, then went to a fast-food restaurant. I had arranged to meet my friend in about an hour, so preferred not to go home and then come back all the way again. I brought my computer and decided to do some work in this restaurant, where I could stay for as long as I liked.

The place was quiet; there were plenty of tables for me to choose from. I worked for about an hour, until 3:45 p.m. Again, as in the teahouse, streams of people were gathered near the cashier. Yes, of course, I reminded myself, local folks, particularly those engaged in hard labor, traditionally have a break at 3:45, and this fast-food place—affordable—has become their haven for a break.

Rhythm of life in a city.

Such is the rhythm of life in a city. If I had not been there, I would not have felt it so strongly. There is rush hour on campus, too, during lunch, but the afternoon break is never observed so strictly. This is so very interesting to me. It reminds me of the times in the past decade or two when the construction industry was very strong in Hong Kong.

Yes, I am kind of reminiscing. Just so you know, research has shown that age has nothing to do with the preference or tendency to reminisce.

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

City landscapes

My city is a fascinating place. Pardon me for saying so, although I believe everyone must feel more or less the same toward their own town or city. Beneath the glamour of the central district in Hong Kong, the city is very Chinese at heart.

Shatin, the town where I live, has a population of 600,000 to 700,000. A huge town by any standard, it is one of the earliest developed satellite towns in Hong Kong. Despite its development, it is rather rural at heart in many aspects. 

We have a wet market in the town centre. Every day, you can see lots of older men and women sitting in the small gathering places outside the wet market to socialize. They like to go into banks to speak with the teller in person, rather than using machines. You see them wearing traditional outfits. (I am not referring to traditional Chinese clothing, but the way traditional older men or women normally dress— in an old-fashioned way.)

Corner of a wet market

Sights in Shatin are not the same as those seen by tourists in downtown Hong Kong. Shatin is more rural, its landscape more diverse. It is not quite the concrete jungle that Hong Kong is famous for. And, of course, there are other satellite towns that are similar to Shatin. That is why, to see the real Hong Kong, visitors should explore the suburbs.

The city landscape is as diverse as it can be. In the photos below is a “spider man,” a construction worker on bamboo scaffolding. This is how some construction is done in Hong Kong, using bamboo to build scaffolding, not steely cages made of nuts and bolts and iron rods.

A spider man

I hope you enjoy these glimpses of my city’s landscape, mostly with our eyes on Hong Kong’s seniors, of course.

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

Urban planning

It is projected that, about 25 years from now, one in four people in Hong Kong will be age 65 or over. Amazing! Have you ever imagined what it will be like when you walk on the streets or go anywhere in the city where you live, and every fourth person you run into is a senior? I have been thinking about that lately.

I think there will be more wheelchairs everywhere. Walkways, pavements, passages, etc., will need to be provided to cater to this need. They will have to be much wider. I visualize that elevators and escalators will be much slower than they are now, to allow for the slower reactions of older people. I imagine that public transport will have more special features that cater to the needs of people who require walking assistance, and for wheelchair users. And it will only be reasonable to have more resting places throughout buildings and public places, where people can pause and take a break.

Navigating stairways is a struggle for many seniors.

Activists are pushing hard for industries and the commercial sector to adopt the principles of universal design so that we can begin creating a more friendly environment for the old and disabled. By then, I don’t think we will need to fight that hard. Universal design will be incorporated in lots of places, maybe nearly everywhere. The sheer political force of the large number of seniors will make their voices more easily heard and their demands better answered.

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.

How should we relate to the misfortunes of this world?

I traveled with my sister after attending the board meeting of interRAI, an international health care research group, in Nuremberg, Germany. I am not a member of this group, but my teacher—my doctoral thesis supervisor—is. Thanks to her, I was invited as a guest. I thought this would be a good chance for me to learn.

After the meeting, I traveled with my sister to Vienna, Venice and Rome. I don’t know why, but the most disturbing thing for me on this trip was the panhandlers and beggars. There are beggars in all three cities. I am aware that I live a fairly comfortable life, sheltered and secure. I am also aware that there are many people who are very unfortunate. But I had no idea I would react this way. This was not the first time I had traveled overseas and definitely not the first time I had seen people who were very poor.

I believe that Hong Kong has no beggars who are from Hong Kong. We have homeless people, but no beggars. We used to have Hong Kong people who begged, but not anymore. I believe that the beggars we see on the streets of Hong Kong come from across the border (mainland China) to make a living. Because the social welfare system of the Government of Hong Kong has developed gradually over the years, no one needs to beg. For me, as a citizen of Hong Kong, this is an immensely comforting fact.

There I was in Europe, traveling as a tourist, enjoying myself, spending money as I chose. But there were people begging for money. I found myself not knowing how to relate, both to them and the situation. I looked at their faces, and sometimes our eyes met. I did not give to those I judged to be “professional” beggars. I gave a euro or two to those I thought might be in dire need. And then I moved on.

There were some old gypsy men and women in Rome who sat in front of churches begging for money. I knew in my heart that day in and day out, they sat there asking passersby for money. Begging has become a way of life for them. I didn’t give them any money, but I was so filled with remorse that I looked at them and apologized. I kept saying, “I am sorry,” “I am sorry.” Even professional beggars are beggars because they have the misfortune to be on a life path that, clearly, no one who had a choice would choose.

Phil Collins recorded a song called “Another day in paradise.” I am very much the person he described: Someone in the street “called out” for help but I pretended not to hear it. Streams of locals and tourists walked past these unfortunate people, just like me.

So what should I do? How do I relate to these people who are less fortunate than I am? Do I go back to my usual life and continue to live as I did, selfishly? Do I give up my limited resources and donate them all to charity? Do I take up charitable causes and live my life as a crusader?

I know I can’t do that. I can’t give all my money away. My sense of security is important to me. What then should I do? How should I live my life? I find my silly self asking the questions I asked when I was a young adult, passionately seeking a purpose in life. Should I not be past that stage by now?

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

So what do we do after retirement?

I used to tell my sister to keep working and not retire too soon. If we live until 90 or 100 years of age, which doesn’t seem so unbelievable, then retiring at 60 or so means spending a third of our lives not engaged in full-time employment. And that is a long time. Work has many advantages, as we all know. It keeps us in touch with the world, helps maintain social contacts, brings in income and daily gives us a sense of purpose and usefulness. If the job is also interesting and meaningful to us, so much the better.

In Hong Kong, the retirement age is 55 for civil servants and 60 for employees of most companies and agencies. There has been talk of deferring the retirement age to 65 for certain jobs, such as that of academics.

I think that women (or men) who stay home to raise their kids are wonderful. Their children are so blessed. It is an extremely important job but often not recognized. I think that women who try to be working moms are superwomen. It is not easy dealing with competing roles.

If I say that females are the tougher sex, will I be called a sexist?

Inventory on display.

Open and ready for business.

Waiting for another passenger.

May I help you?

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

Fast-changing images

My eldest sister used to live in Wanchai, on the island of Hong Kong. She died of stomach cancer in March 2010. Because she lived there for so many years after getting married—not in the same apartment but in the same district—I knew the area pretty well, too, because I visited her often, ever since I was a child.

I knew the streets, the buildings and the shops. I still go to my sister’s place, because that is where my cousins live. Because I visit the area quite often, I can usually follow the changes that are occurring in the landscape.

I wasn’t quite prepared for what I saw one day, though. Traveling on the tram from Central to Wanchai, I tried to look outside the tram window, through a packed carriage full of passengers, to see if I had reached my stop. I knew I would be close. I was somewhat taken aback by the view of an unfamiliar landscape. The shops and neon lights that met my eyes were unfamiliar to me. Where were the places I once knew?

As in all fast-growing economies, Hong Kong is one of the places in the world that undergoes frequent and rapid changes to her city landscape.

If I become sentimental about lost images in a city, what is it like for our senior citizens? Whenever I teach introductory concepts of age and aging, I ask my students to try to imagine what seniors in their 80s or 90s must have gone through. A senior who is 90 years of age would have gone through the First World War, the Second World War, the war against Japanese occupation (1937-45), the Chinese Civil War (1945-49) and the Cultural Revolution of China (1966-76).

I try to help my students understand why seniors like to save and not waste anything, and why they go a long way to save a few pennies. I hope that, through such reflections, young people will come to appreciate that such “odd” behaviors represent strengths, not weaknesses. However, I have never asked my students to imagine the landscape changes seniors have seen in their lifetimes.

If we consider for a moment what seniors have gone through, it must be a most amazing experience. They have been to places we have not and seen things we have not. We should know, therefore, that all seniors likely have something to teach us, regardless of their background or educational level.

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

Domestic workers, a godsend for Hong Kong women

If you go the Central (district) or Causeway Bay area of Hong Kong on weekends and public holidays, you will find masses of female (and some male) domestic workers gathering in parks, on designated pedestrian walkways, in the courtyards of huge commercial complexes and along the walkways of overhead pedestrian bridges. It is quite an amazing sight, and it forces you to realize the magnitude of Hong Kong’s foreign domestic workforce.

People grumble about all these spaces being occupied by immigrant workers because they, themselves, can no longer use them. Those who grumble have probably forgotten one very important fact: These domestic workers have freed the women of Hong Kong from the burden of being the main caregiver in their household.

The majority of domestic workers in Hong Kong are Filipinos, with an increasing proportion coming from Indonesia. Those from Indonesia are becoming more popular, as many of them can speak Cantonese, the local dialect, while those from the Philippines speak only English. A small proportion of the workers come from Thailand. While writing this , I learned from Wikipedia that foreign domestic workers make up approximately 3 percent of the local population. There were 284,901 of them in 2010.

We have been hiring domestic workers since the late 1970s. As I recall, they were initially hired to take care of babies and children in a family. In more recent years, many of them are being hired to look after seniors. Historically, women have been the main caregivers in society, and this is still the case. Women are expected to provide care to those in need within a family. For better or worse, domestic workers have set us free. For many, to support a family, both husband and wife need to work. Given the disappearance of large, extended families, the woman of the family often needs help if she is to work outside the home.

After having babies, Hong Kong women go back to work more frequently than women in Western countries. It is rather uncommon for local women to give up careers to stay home and raise their kids. The advantage may be more secure income for the family. The down side is that working parents sometimes over-compensate for lack of time spent with their children by spoiling them. Some of my friends and acquaintances may be highly educated, but they indulge their children just the same. To mitigate the guilty feelings they have for not spending enough time with their kids, they buy expensive toys and gifts, or allow poor choices of foods and games.

There may be many problems associated with having a domestic worker to help us run a home, but I still think that it is great for women in Hong Kong to have this option. A Hong Kong woman can live her life the way she wants. She can raise her kids at home but, if she chooses to have a career, she can hire a domestic worker.

Back to where I started—I think we shouldn’t grumble. We should be appreciative of foreign domester workers’ contribution to Hong Kong.

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