This semester I am teaching a course, “Nursing older people.” One of the assignments I have for my students is to write a reflective journal about any issue pertaining to elderly people and elder care, to be submitted at the end of the semester.
I thought it was an easy enough assignment but, to my surprise, my students do not think so. They tell me it is a burden to them. Quite a number of them say that they don’t know what to write about or how to write it. Again, this is a surprise, because these are third-year students, and reflective journals should not be new to them.
In response, I have modified the assignment with regard to it being a requirement, but have not removed it as part of the course assessment. To me, it is important when studying gerontology to cultivate sensitivity toward elder care issues. The best way to do that is not to write a paper or take a test, but to reflect, over time, on issues pertaining to elder care. Gradual sensitization to elder care issues through the writing of journals will help students develop awareness and insight about care of older people and, I hope, enable them to develop their own perspectives about the study of aging.
But this is not an age that encourages reflection. We humans like to fill our world with sounds. We are so uncomfortable with quiet moments that we try all means to drown our senses.
We need to be entertained every single moment. As soon as we arrive home or check into a hotel room, we turn on the radio or TV. We are defined by the latest electronic gadgets and games, by the PSP, iPhone, iPad and so on. We must have music constantly, whether it comes from an iPod or any other means. We can’t be bored.
We also can’t bear not being connected, even for brief moments. We have the Blackberry, 3G phones, WiFi, etc. Everywhere we go, we want immediate access to the Internet.
Because we are so busy entertaining ourselves, engaging in dialogue with people we know or don’t know, being reached and reaching out to othersand accessing information for all realms of our lives, the time that remains for reflection and recollection is very limited. Although Schön’s seminal article on reflective practice was published in 1987, more than two decades ago, fostering reflective practice nowadays runs counter to modern techno currents—not a very promising battle.
Personally, I need a lot of time to myself. I like people, but I also like solitude. Getting together is good to foster relationships, but getting close to myself and knowing how I feel and think is crucial to living a life that is meaningful to me.
I hope my students become, through repeated learning opportunities, better reflective practitioners.
For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.
18 February 2011
04 February 2011
Signs and symptoms of having had cancer
I thought having cancer hadn’t changed me much. But, as time goes by, I notice that, indeed, I have changed, although in less conspicuous ways.
Symptom 1: Becoming sentimental
I have become more sentimental. I notice that I am very much into taking pictures nowadays, much more so than before. I carry my camera around a lot. As time goes by, I realize that it is because I try to capture glimpses of my life, knowing that every small chunk of time is but a fleeting moment. These fleeting moments will, one day, add up together to make my whole life.
Symptom 2: Becoming more sociable
I have become more geared toward having parties and social gatherings. In the past, my project teams would just meet to discuss things. I rarely called for parties and get-togethers. But now I do. I used to enjoy time with myself—doing household chores, listening to music, reading books and magazines, watching television. Now I make more effort to be with others, and I make mental notes to remind myself how nice it is to be around people.
Symptom 3: Becoming more forgiving
Things students do that irritated me in the past are no longer as offensive. For example, I can’t tolerate it when students keep chatting while someone else is speaking, be it a guest speaker, other students or me. I consider this to be very rude. These days, however, when students still happily chat away in class, I am not as mad. I still ask them to please take turns to speak—between the speaker and audience, that is—but I don’t get upset like I used to.
I would say that these changes are for the better. And they are changes I did not quite expect. They must be linked to a reframing of my perspective on life after having cancer.
I hope they stay.
For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International (STTI).
Symptom 1: Becoming sentimental
I have become more sentimental. I notice that I am very much into taking pictures nowadays, much more so than before. I carry my camera around a lot. As time goes by, I realize that it is because I try to capture glimpses of my life, knowing that every small chunk of time is but a fleeting moment. These fleeting moments will, one day, add up together to make my whole life.
Symptom 2: Becoming more sociable
I have become more geared toward having parties and social gatherings. In the past, my project teams would just meet to discuss things. I rarely called for parties and get-togethers. But now I do. I used to enjoy time with myself—doing household chores, listening to music, reading books and magazines, watching television. Now I make more effort to be with others, and I make mental notes to remind myself how nice it is to be around people.
Symptom 3: Becoming more forgiving
Things students do that irritated me in the past are no longer as offensive. For example, I can’t tolerate it when students keep chatting while someone else is speaking, be it a guest speaker, other students or me. I consider this to be very rude. These days, however, when students still happily chat away in class, I am not as mad. I still ask them to please take turns to speak—between the speaker and audience, that is—but I don’t get upset like I used to.
I would say that these changes are for the better. And they are changes I did not quite expect. They must be linked to a reframing of my perspective on life after having cancer.
I hope they stay.
For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International (STTI).
18 January 2011
Modes of suicide in the East and West
My students were miserable and complained about having no ideas to write about for their reflective journals. To help them reflect on elderly care issues, I taught them to use newspapers to identify possible topics.
I started searching for news clips in the papers. Within a day, there were six different news items about older people. One was about a couple leaving a baby in a pram in a mall. After failing to locate the parents for more than an hour, the security staff reported the incident to the police. Eventually, the couple—husband, age 67, and wife, 28—got their baby back from the police station. Next, a senior was knocked unconscious by a vehicle. Third, a fire in a nursing home warranted emergency evacuation of its residents. Then, there was a senior who got drunk and injured himself. Last, two elderly people with chronic illness—a man and a woman—jumped to their deaths.
Common means that elderly people resort to when ending their lives in Hong Kong include jumping from a height, hanging and burning charcoal in a closed room, resulting in death from carbon monoxide poisoning. These methods of suicide are somewhat culture-specific. With space at a premium and the majority of our population living in high-rise apartments—and I mean more than 20 floors and sometimes as many as 60 or 70—choosing to jump as a suicide method is probably out of convenience and ease of availability. Of course, in the West, hanging is also a way to commit suicide, but it is more common among the Chinese. Burning charcoal is becoming more common but, in the past, hanging has been a popular choice.
I wasn’t aware of the cultural difference until I was studying at the University of Toronto and a classmate asked me about it. She was curious and concerned as to why older Chinese people she had come across at work had resorted to ending their lives by such a drastic act as hanging. She was a social worker, you see. At that moment, I became aware that something I had thought was ordinary was, in fact, not so in another culture.
To us Chinese, or at least Hong Kong Chinese, there is nothing drastic about death by hanging. We have learnt about this method of committing suicide since we were small. We watched it in movies and traditional Chinese operas. Whenever a hero or heroine (usually a heroine) in a tragedy wanted to commit suicide, he or she would throw a string or a piece of long cloth through the main wooden frame that held the house together, tie a knot, climb onto a chair and finish the business.
Mostly, these were scenes created for the drama. Sometimes, they were about a heroine fighting against a family that forced her to marry into riches and fame and forget about the guy she loved. Also in these films, if the emperor wanted one of his concubines to die, he would order his officers to throw a long piece of silk cloth at her. Traditional Chinese movies are not graphic at all. So now you can see why killing oneself by hanging is not seen as something drastic in the Chinese population.
I found this revelation quite interesting (not that suicide attempts are interesting, but that observing the differences is). People in different cultures differ not only in how they live their lives, but also in the ways they choose to die.
For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.
I started searching for news clips in the papers. Within a day, there were six different news items about older people. One was about a couple leaving a baby in a pram in a mall. After failing to locate the parents for more than an hour, the security staff reported the incident to the police. Eventually, the couple—husband, age 67, and wife, 28—got their baby back from the police station. Next, a senior was knocked unconscious by a vehicle. Third, a fire in a nursing home warranted emergency evacuation of its residents. Then, there was a senior who got drunk and injured himself. Last, two elderly people with chronic illness—a man and a woman—jumped to their deaths.
Common means that elderly people resort to when ending their lives in Hong Kong include jumping from a height, hanging and burning charcoal in a closed room, resulting in death from carbon monoxide poisoning. These methods of suicide are somewhat culture-specific. With space at a premium and the majority of our population living in high-rise apartments—and I mean more than 20 floors and sometimes as many as 60 or 70—choosing to jump as a suicide method is probably out of convenience and ease of availability. Of course, in the West, hanging is also a way to commit suicide, but it is more common among the Chinese. Burning charcoal is becoming more common but, in the past, hanging has been a popular choice.
I wasn’t aware of the cultural difference until I was studying at the University of Toronto and a classmate asked me about it. She was curious and concerned as to why older Chinese people she had come across at work had resorted to ending their lives by such a drastic act as hanging. She was a social worker, you see. At that moment, I became aware that something I had thought was ordinary was, in fact, not so in another culture.
To us Chinese, or at least Hong Kong Chinese, there is nothing drastic about death by hanging. We have learnt about this method of committing suicide since we were small. We watched it in movies and traditional Chinese operas. Whenever a hero or heroine (usually a heroine) in a tragedy wanted to commit suicide, he or she would throw a string or a piece of long cloth through the main wooden frame that held the house together, tie a knot, climb onto a chair and finish the business.
Mostly, these were scenes created for the drama. Sometimes, they were about a heroine fighting against a family that forced her to marry into riches and fame and forget about the guy she loved. Also in these films, if the emperor wanted one of his concubines to die, he would order his officers to throw a long piece of silk cloth at her. Traditional Chinese movies are not graphic at all. So now you can see why killing oneself by hanging is not seen as something drastic in the Chinese population.
I found this revelation quite interesting (not that suicide attempts are interesting, but that observing the differences is). People in different cultures differ not only in how they live their lives, but also in the ways they choose to die.
For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.
04 January 2011
About mental space
As an academic, I write a lot. I write research papers, discussion papers, speeches, funding proposals, program documents, consultation reports and so on and so forth. So I am not new to being a “writer.” After starting this blog, however, I have been introduced to one of the worlds of a writer that I had not thought about.
I have not been up close and personal with people I do not know. Such particulars about myself, I typically only share with friends and close acquaintances. I know to whom I have spoken and why I would have told them about myself. But I feel strange knowing that someone about whom I know nothing can come to know my intimate thoughts and feelings. I need time to get over this.
I already know about cultural differences from back in my student days, when I was in England learning to become a midwife (studies I never put into practice, as you are probably aware, if you’ve been following my blog). It was my first trip away from home and, therefore, the biggest culture shock I ever experienced. I was somewhat taken aback that people would share their life stories with strangers they met on the street, or in places such as train and bus stations. I didn’t think—and still don’t think—that a regular Joe or Jane in the Chinese population would do something like this. It is not about whether readiness to share details of one’s life with strangers is good or bad. It is just that there are cultural differences with regard to how we relate to other people.
I thought the British were more reserved, but my first-hand experience as a student midwife in England told me otherwise. Chinese people are more “reserved” with strangers. And it is not just about keeping “face.” As I become more exposed to the world outside my hometown, I am coming to realize that there is, indeed, such a thing as “national characteristics.” Sometimes, it may be an over-generalization but, at other times, you will notice similarities and differences between cultures. Well, with modernization and globalization, we are behaving a lot more like each other, no matter whether we live in the East or the West.
Back to my musings about writing a blog. So this is what a blogger will have to come to accept, that there will be people who know his or her personal particulars and innermost thoughts, even though the writer doesn’t know those people at all. To me, it takes a person who is very comfortable with him or herself to be a blogger. Then again, maybe not. I am new to the experience.
I start analyzing why I don’t feel secure having people I don’t know knowing about me. I ask myself why I don’t readily give the URL for my blog to students and acquaintances. I think it is because I have been a rather private person all along, and I am one of those who need a lot of space between other people and myself, including those I love or am fond of.
Yet again, this is a lesson for me to learn. Why not take it easy? Why not accept it as it is? We are, after all, living in the age of the Internet. As I reflect on this, I realize there is a fundamental difference between me and those who have no reservations whatsoever about making friends over the Internet, who incorporate the cyber world as an integral part of their regular world.
Maybe I can further contemplate this idea and use it to help me better appreciate the differences between Generations X, Y and Z. After all, there is no better way to learn something than firsthand.
For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.
I have not been up close and personal with people I do not know. Such particulars about myself, I typically only share with friends and close acquaintances. I know to whom I have spoken and why I would have told them about myself. But I feel strange knowing that someone about whom I know nothing can come to know my intimate thoughts and feelings. I need time to get over this.
I already know about cultural differences from back in my student days, when I was in England learning to become a midwife (studies I never put into practice, as you are probably aware, if you’ve been following my blog). It was my first trip away from home and, therefore, the biggest culture shock I ever experienced. I was somewhat taken aback that people would share their life stories with strangers they met on the street, or in places such as train and bus stations. I didn’t think—and still don’t think—that a regular Joe or Jane in the Chinese population would do something like this. It is not about whether readiness to share details of one’s life with strangers is good or bad. It is just that there are cultural differences with regard to how we relate to other people.
I thought the British were more reserved, but my first-hand experience as a student midwife in England told me otherwise. Chinese people are more “reserved” with strangers. And it is not just about keeping “face.” As I become more exposed to the world outside my hometown, I am coming to realize that there is, indeed, such a thing as “national characteristics.” Sometimes, it may be an over-generalization but, at other times, you will notice similarities and differences between cultures. Well, with modernization and globalization, we are behaving a lot more like each other, no matter whether we live in the East or the West.
Back to my musings about writing a blog. So this is what a blogger will have to come to accept, that there will be people who know his or her personal particulars and innermost thoughts, even though the writer doesn’t know those people at all. To me, it takes a person who is very comfortable with him or herself to be a blogger. Then again, maybe not. I am new to the experience.
I start analyzing why I don’t feel secure having people I don’t know knowing about me. I ask myself why I don’t readily give the URL for my blog to students and acquaintances. I think it is because I have been a rather private person all along, and I am one of those who need a lot of space between other people and myself, including those I love or am fond of.
Yet again, this is a lesson for me to learn. Why not take it easy? Why not accept it as it is? We are, after all, living in the age of the Internet. As I reflect on this, I realize there is a fundamental difference between me and those who have no reservations whatsoever about making friends over the Internet, who incorporate the cyber world as an integral part of their regular world.
Maybe I can further contemplate this idea and use it to help me better appreciate the differences between Generations X, Y and Z. After all, there is no better way to learn something than firsthand.
For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.
21 December 2010
She's a nurse!
This past August, Asia, if not the world, was seized by the news of the Hong Kong tourists held hostage by a dishonorably discharged policeman in the Philippines. Now, we all know that it ended up as a tragedy, with eight Hong Kong citizens being killed. As I write this, we are still not sure whether they were killed by the gunman or by the rescuers, the Philippines police force having been shown to be disappointingly deficient in resolving a hostage crisis.
Well, all this is in the past, but there was one particular event I would like to mention here. Before the gunman lost control of himself, some hostages—seniors and children—were released.
About 90 minutes into the crisis, a woman called Tsang Yee-lai was told to leave the tour bus with her two children, ages 10 and 4. Tsang told the gunman that another boy on board the bus, 12-year-old Jason, was her relative; she asked to take Jason, too. The gunman agreed and so Jason was freed. Jason, of course, was not her relative.
The people of Hong Kong praised Tsang for her calmness and sharpness in saving a life. Her heroic deed saved Jason, but she lost her husband, and her children lost a father. Jason’s older sister, age 15, was saved, but both of their parents were killed. The incident has been emotionally draining for the people of Hong Kong.
Tsang is a geriatric community nurse working at the Kowloon Hospital in Hong Kong.
For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.
Well, all this is in the past, but there was one particular event I would like to mention here. Before the gunman lost control of himself, some hostages—seniors and children—were released.
About 90 minutes into the crisis, a woman called Tsang Yee-lai was told to leave the tour bus with her two children, ages 10 and 4. Tsang told the gunman that another boy on board the bus, 12-year-old Jason, was her relative; she asked to take Jason, too. The gunman agreed and so Jason was freed. Jason, of course, was not her relative.
The people of Hong Kong praised Tsang for her calmness and sharpness in saving a life. Her heroic deed saved Jason, but she lost her husband, and her children lost a father. Jason’s older sister, age 15, was saved, but both of their parents were killed. The incident has been emotionally draining for the people of Hong Kong.
Tsang is a geriatric community nurse working at the Kowloon Hospital in Hong Kong.
For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.
07 December 2010
Seniors and fast food
As a Hong Kong Chinese, I did not associate seniors with fast food until about 10 years ago, when I moved into an apartment from which, if I needed to get to the train station fast, I had to take a short cut through a McDonald’s.
Every morning I made that trip, the scene never failed to amaze me—lots of seniors having breakfast at McDonald’s. Maybe it is a myth, after all, that Chinese people are particular about food. My—or our, if I can claim that I represent a certain segment of our society—belief used to be that Chinese seniors would not like fast food. They preferred congee to burgers, jasmine tea to coffee. But, obviously, I learnt something new when I moved into that apartment.
When I was taking a course for my doctoral program, my professor told me that she had been to Hong Kong and that both she and her husband were totally surprised to see that McDonald’s was such a favorite spot for children in an Asian city. She predicted that this generation of Hong Kong youngsters would have the same kind of cardiovascular problems as those in her country, the United States.
When I saw the large number of seniors having breakfast at McDonald’s, I remembered what she had said and thought, not only will we have a generation of young people with cardiovascular problems, we will also have a generation of seniors with those problems, as in Western countries.
I remarked about this to a friend, and she suggested it could be the free coffee refill that attracts seniors. This may be one of the reasons, but probably only one. To this day, although not so amazed as before, I am still puzzled. Maybe one day, I will do a survey on this, trying to find out seniors’ perceptions of fast food, and why they patronize these restaurants.
My speculation is that fast-food restaurants treat everybody the same. Our seniors enjoy the same kind of “freedom” as anyone else. They can sit for as long as they like, in spite of buying little, and not be driven away or given strange looks by waiters and waitresses. They don’t have to abide by the rules of a regular restaurant. This, then, is a good aspect of fast-food chain restaurants. They are a place for any age group; there is no age discrimination.
For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.
Every morning I made that trip, the scene never failed to amaze me—lots of seniors having breakfast at McDonald’s. Maybe it is a myth, after all, that Chinese people are particular about food. My—or our, if I can claim that I represent a certain segment of our society—belief used to be that Chinese seniors would not like fast food. They preferred congee to burgers, jasmine tea to coffee. But, obviously, I learnt something new when I moved into that apartment.
When I was taking a course for my doctoral program, my professor told me that she had been to Hong Kong and that both she and her husband were totally surprised to see that McDonald’s was such a favorite spot for children in an Asian city. She predicted that this generation of Hong Kong youngsters would have the same kind of cardiovascular problems as those in her country, the United States.
When I saw the large number of seniors having breakfast at McDonald’s, I remembered what she had said and thought, not only will we have a generation of young people with cardiovascular problems, we will also have a generation of seniors with those problems, as in Western countries.
I remarked about this to a friend, and she suggested it could be the free coffee refill that attracts seniors. This may be one of the reasons, but probably only one. To this day, although not so amazed as before, I am still puzzled. Maybe one day, I will do a survey on this, trying to find out seniors’ perceptions of fast food, and why they patronize these restaurants.
My speculation is that fast-food restaurants treat everybody the same. Our seniors enjoy the same kind of “freedom” as anyone else. They can sit for as long as they like, in spite of buying little, and not be driven away or given strange looks by waiters and waitresses. They don’t have to abide by the rules of a regular restaurant. This, then, is a good aspect of fast-food chain restaurants. They are a place for any age group; there is no age discrimination.
For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.
02 December 2010
Life and death in education
I am still into experiential learning. My definition of experiential learning is that someone has actually gone through an experience; not a simulated experience, such as just pretending you are blind by putting on a blindfold.One thing that bugs me is the tendency of the social and health service sectors in Hong Kong to be crazy about getting into the latest trends. First, it was reality orientation (RO) that became really popular. Every agency was trying to conduct RO. Then it was reminiscence, life-story work, music therapy and so on and so forth. The latest is horticultural therapy. Once a craze begins, everybody tries to get a head start.
As a researcher and educator, I am appalled at the lack of planning for all of these activities. Because the trend in question is not well understood and has not been studied, it leaves little room for researchers to examine whether there are therapeutic effects from these interventions. And if there are, what are they? In what ways do they have an impact? These questions often remain unanswered, because there are no baseline data. Also, it is hard to “unteach” myths and misconceptions about what certain therapeutic interventions can or cannot deliver. People have gone too far to embrace the ideas.
But I digress. Another trend of the city’s health and social service sector is life-and-death education. I recall a news item about schools cooperating with non-governmental organizations (NGOs) to organize experiential learning on life and death for elementary school children. They go into a psychedelic (my description) space (room or passage) and play games that ask spiritual questions about life and death. Supposedly, it is thought provoking for the youngster, so that he or she will not shy away from matters of life and death, and accept them as a part of life.
How odd and unnatural for school children to learn about life and death in this manner! How artificial our society has become. Everything has to be structured for our learning. Do we really believe that our children will better grasp matters of life and death after going through this kind of exhibit?
I believe our youngsters would learn a lot more if they had more opportunity to grow up with their grandparents and their grand-aunts and -uncles. Wouldn’t it be nicer to have carnivals to bring generations together? Life-and-death education is something I have learnt about experientially. My friends’ and relatives’ deaths have taught me about life. I believe in learning in a more naturally occurring context. Of course, core family units in today’s highly mobile society are scattered far and wide, with some family members miles apart from others. But the Internet, Facebook, Skype and other technology applications can keep us together. Learning about life and death cannot be left to exhibitions and teachers alone. It has to come from those who really “live” with us, and have a place in our hearts.
For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.
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