UBC Nursing students provide Diabetes education to UGM staff


The Union Gospel Mission (UGM) provides meals, shelter, and substance recovery services to people living in the Downtown Eastside (DTES) every day.

To better serve their guests, UGM requested training from the UBC School of Nursing on how to manage hypoglycemia in guests who have diabetes. For our N344 Synthesis Project, a team of students (Rebecca Burns, Brittany Kliment, Katelyn Newell, and Shelby Slater) developed a training module, hypoglycemia kits, and a foot care poster, the latter to be used during foot soak clinics. The module provides an overview of diabetes, common diabetic complications, signs and symptoms of hyper- and hypoglycemia, and a protocol for managing hypoglycemic episodes. Our team also prepared hypoglycemia kits for UGM that each include a copy of the four-step hypoglycemia protocol, as well as a bottle of Dex4 glucose tablets. Finally, we created a foot care poster that includes tips that are applicable to all UGM guests, particularly those with diabetes.

On February 9th we presented our final products to UGM staff and discussed how they could be implemented. UGM plans to include the diabetes module on their internal website and as part of staff training. They also plan to share the module and hypoglycemia protocol with the UGM location in New Westminster, as well as with select other organizations working in the DTES. This project helped to fill a knowledge gap at UGM and gave staff the information they need to better serve guests experiencing hypoglycemia.

Stop spreading germs through hand washing!

Kindergarten teaching as a part of clinical practice with community and population


Fluorescent Germ Experiment

On February 9th 2017, one of the student nurses in my clinical rotation group and I got to meet 22 little health promoters at David Livingstone Kindergarten. We provided them with a fun learning experience regarding to how best to stop spreading germs, “hand washing”.

In the beginning of the clinical practice, the school of nursing had offered us a variety of teaching opportunities with various health topics such as sexually transmitted infections, nutrition and healthy food choices, baby massage, and hand washing. As I have learnt that health teaching is one of major public health interventions, I considered this teaching practice as a highlight of this clinical rotation.

Generally, health teaching in community and public setting aims to build the community and public capacity to put health in their agendas and perform health promotion and protection strategies; to provide up-to-date accurate health information; and to empower individuals and families’ self efficacy so that they can elicit the best personal health practices and coping skills in their lives. Making sure to keep these points in my mind, my partner student nurse and I chose to teach kindergarteners hand washing to help them build the healthy habit. While developing a teaching and learning plan, we referred to the program called ‘Do Bugs Need Drugs?’, an educational program of Alberta Health Services and the British Columbia Centre for Disease Control (2014) and adapted a glo-germ activity.

Teaching Characteristics of Germs and Proper Handwashing Skill Before the Actual Hand Washing Activity

To meet the students’ learning objectives, we utilized multiple teaching strategies; power point slides to deliver knowledge with visual effects; role playing to show how germs can easily spread and make others sick; singing a handwashing song to help them acquire a proper hand washing skill; putting yellow sticky notes on which students believe germs are to help them understand that germs are everywhere; coloring sheets to reinforce their memory; and actual handwashing activity using glo-germ powder and black light to show the spread of germs and the difference before and after hand washing using a soap. Consequently, students seemed to be content with the learning experience and aware of the day’s lessons as evidenced by their best performance to get the glo-germs off through proper hand washing! I hope that they remember the importance of frequent and thorough hand washing and keep playing a role as little health promoters in their families, schools, and community.

References: Retrieved from http://www.dobugsneeddrugs.org/

G.O. Day – Girls Only Lifestyle Expo 2016


While on my UBC nursing preceptorship at Richmond Public Health I was able to participate in health teaching at G.O. Day. In collaboration with various community partners, I was able to speak to Grade 9 girls about healthy eating habits and the importance of leading an active life. This day opened up the opportunity for Grade 9 girls to see what community health activities are available to them, highlighting activities that are actually fun and exciting. Alongside, some UBC nursing students, I participated in Belly Dancing, Barre, Pilates and Life coaching. It was inspirational to engage with young girls and yet take moment to think about my own self-care goals as a busy student and future health professional.

Facilitating difficult conversations and deepening perspectives of discriminated populations: A personal account from Elder Don


“I had the pleasure of meeting Elder Don while UBC Nursing students were engaged in health promotion teaching at the Turing Point in Richmond. Elder Don and I quickly established a trusting friendship as he shared life stories. I invited Elder Don to the N336 classroom to share his lived experiences of being in residential school, foster homes and  living in marginalized conditions in the Down Town East Side (DTES) Vancouver. Through his stories Elder Don encouraged students to  become kind compassionate non judgmental health care  practitioners. On behalf of the N336 class ( Rotation A 2017) and UBC SON we thank Elder Don for so willingly to share his life story to enhance student learning”. –Ranjit Dhari, N336 Course Leader 2017


“Bevel up,” a street nurse says to a young man in an alley of Vancouver’s Downtown East Side (DTES) in a documentary by Nettie Wild. The nurse is pointing to the side of the needle he should insert in his arm when injecting drugs. The outreach nurses interact with residents of the DTES in an attempt to increase health care services and build trust with a population where many have been failed by our health care system. The documentary revealed there exists a population of people unjustly profiled, mislabeled, and mistreated by health care professionals here in British Columbia.

Without an understanding of the pathways to homelessness and addictions, the factors that contribute to the intergenerational trauma of First Nations communities and ongoing structural systems in place that keep the oppressed, oppressed; student nurses run the risk of perpetuating the mistreatment of marginalized populations. Elder Don, a Dene First Nations Elder, brought his amazing story of hardship and perseverance to illuminate the challenges he faced while experiencing addiction and living on the streets of the DTES.

“People don’t necessarily want to confront these issues…it forced students to hear something that is hard to hear,” said one student. “People talk about truth and reconciliation and they want the reconciliation but not the truth. It’s too hard.” they continued, baring a sensitive dichotomy that exists concerning First Nations issues in Canada.

Across Canada, depending on their upbringing and school curriculum, students may not even learn about residential schools. Kait Kilyk from Fonthill Ontario found the presentation illuminating and inspiring. “My knowledge of residential school prior to the presentation was quite limited. I was aware of some scenarios from previous documentaries but never had the opportunity to discuss with someone their experiences in the school.”
Elder Don was taken from his family and community, forced into residential school, and then placed into foster care. First Nations children in residential schools had their hair cut, were punished when they spoke their language, segregated from their siblings and too often were sexually, emotionally and physically abused. Today, First Nations children still suffer. A report in 2011 by Statistics Canada revealed that First Nations children make up 48% of children in foster care in Canada, grossly over representing any other group in care. In 2016, the Canadian Human Rights Tribunal ruled that the Canadian government is discriminating against First Nations children by providing flawed, discriminatory and inequitable health care services which is a violation of the Canadian Human Rights Act. To date, Prime Minister Trudeau announced a 5-step plan to implement the Tribunal and the Truth and Reconciliation Committee’s call to action, however progress is slow and in the meantime First Nations children bear the brunt of the inaction, many ending up homeless. Creating a safe space to answer our questions, Elder Don challenged our preconceptions about homelessness and offered insight to First Nations culture.

“Why did you sleep outside?” a student asked Elder Don during the presentation.

“Shelters are crowded, a big room full of beds, with bed bugs and scabies and you have no personal space. I preferred living outside under the stars, I didn’t mind it.” Elder Don replied, sharing some downfalls of the systems in place meant to be salvation for homeless individuals.

Seohee Lee, a global citizen from South Korea related to Elder Don in her desire to work coming from a place of love. “He is doing the same thing by making [medecine bags] and giving them to people who need strength. I guess this is how he appreciates his life, being spiritual and recovering himself. He powerfully inspired me to be a nurse with heart.”

The Cultural Competence and Cultural Safety in Nursing Education framework manual published by the Aboriginal Nurses Association of Canada offers 6 core competencies to incorporate into nursing education curricula. At the top of the list is walking through the nursing journey with an understanding of the legacy of residential school and recognizing barriers to health equity that continue to impact First Nations, Metis and Inuit communities. One of those barriers is the absence of Indigenous perspective in health care.

“Elder Don showed people there is a different way to think about things. Like how he only uses traditional medicine. How he gets his strength and mental health through traditional practices… the medicine wheel encompasses well being- something that I think nursing is trying to do but hasn’t [accomplished] yet,” one student thoughtfully contributed.
Moving forward with nursing education necessitates sharing the truth of residential schools in order to develop a culturally safe practice. Do not wait for a challenging situation to learn this truth. We know that students retain the most information by hearing, seeing and doing. Incorporating opportunities outside of readings is integral to equipping nursing students with a holistic, critical and relational practice.  Using traditional practices embedded with First Nations teachings, Elder Don reaches out to struggling individuals on the DTES and the greater Vancouver Area. Nurses are also in the position to help this population. For student nurses it can feel overwhelming to know where to begin. Here are some strategies student nurses can use, beginning now.

Learn about the territory you are in and acknowledge the community that existed pre-colonization. Normalize acknowledging territories during formal meetings and presentations to reduce feelings of discomfort that can arise. Be curious and ask questions with an open heart and genuine compassion, only after you have listened and observed. Seek out resources, partnerships and get involved! Lastly and perhaps most importantly, it is about treating each patient contextually to this particular place and time. In the clinical setting weighted by systemic structures, long hours, and staffing shortages, it can be easy and reactionary to hastily profile a patient or client.  Kait pointedly summarizes how to address this reaction:
“Something that Elder Don said during his presentation has stuck with me. He said that he will never judge someone who is on the street because you never know what got them there, and what they may have overcome being there. That is something that I will carry with me.”

UBC Nursing Students: Getting the Information Across!


Sexual health education and its presentation to students in schools can be a very controversial topic. Many teachers, participants working with school boards, and parents have mixed views on when and what they want their children to be introduced to. Regardless, this information is imperative for our youth to understand and utilize, when and if they are proceeding in sexual activities. With this information, students can make informed decisions regarding their sexual health and do so in a safe manner. They will also have increased awareness on where to access health services. A study in the Canadian Journal of Public Health identifies that adolescents report their main sources of information is from peers and the media. However, they also knew this information was not always accurate. Additionally, the participants in the study reported not knowing where to access health care services and want improvements.

UBC nursing students took the initiative of teaching sexual health education across various Richmond and Vancouver schools. We approached the lessons in a diverse, open, and inclusive way. This helped to ensure that students were comfortable taking part in the class, asking questions, and increased their understanding that there are many ways to practice safe sexual activities. We used multimedia presentation, activities about statistics, and case scenarios to keep the students engaged and identify correct information. We also stressed where the students could go and call if they had any concerns. Overall, we received great feedback and hope that this helps encourage the dissemination of knowledge by students to peers and aids the students in their future endeavors!

DiCenso, A., Borthwick, V. W., & Creatura, C. (2001). Completing the picture: Adolescents talk about what’s missing in sexual health services. Canadian journal of public health, 92(1), 35.