Bye bye Bangladesh and a little bit of Cassandra

Well, I’ve had my final Nurs 221 class this afternoon. I gotta say, it’s been an incredible journey. Sigh (I literally paused to take a breath there). Let’s see where to begin.

When I arrived in Bangladesh 7 weeks ago, I was nervous, intimidated, excited, apprehensive, shy (a bit), and slightly lost (literally and figuratively). When I was told that I was to teach the diagnostic lab tests of the Nurs 221 Med-Surg course, I was so scared. And worried. I looked over the content from previous years and realized that it was WAY beyond my own knowledge but was told that I could restructure the course with a nursing twist. The previous course was formulated by Med lab students who know so much about their lab tests (rightfully so). So I had a vision (partly poached from PBL). I went through the previous course material and wrote down what labs had been covered. Then I assigned the students 2 labs to look up each. They needed to put into a template (which I created for them) what the test was for, what the normal ranges were, what high/low levels indicated, and what some nursing interventions would be for high/low levels.

I gave them their assignment and gave them a week to do it (not unreasonable by BCIT standards). When I received them, I was so excited that everyone submitted their assignments on time! That sounds kind of ridiculous, right? It was kind of a personal accomplishment, that I was firm with them and said that I had very little tolerance for late submissions (it’s true and I hold myself to that as a student). Then I began editing them all and thought to myself, ‘Why am I doing this? Is it MY responsibility that THEIR assignments should have been done properly and coherently?’ Partly yes and mostly no. Because I began holding Saturday lab classes (they had a shortage of RNs to supervise them in the hospital), I was able to have them review and edit each other’s work. I was so thrilled when they came up to me and said, “Ma’am, I don’t understand what they are trying to say here.” Cuz I smiled, looked at them and said, ‘Me neither. You get to look up the answers now!’ They were able to feel the joys of being a teacher (and nurses are teachers), the trials and tribulations of delivering material in a comprehensive manner! This is learning! Don’t worry, I’m not ALL mean, I could tell when they were getting restless and we played some trivia games, too! Competitive students exist EVERYWHERE – I’m not the only one who gets riled up in trivia, fyi – clinical and PBL members, thank you very much. Haha.

So they all looked over each others work and made suggestions and corrected them. But, they all submitted them to me (so I have the master copy) but I’d already made comments on the document, so I sent it to them to look over. One thing you should know about me is that I don’t like giving answers out freely. I make you work for them. So my comments were more guiding questions to lead them to the answers. I will admit, this was slightly mean of me. I kept the master copy with all the answers and only gave suggestions and hints on the document for them to look over at home. It’s ‘mean’ but it will also help them in the long run. The more exposure you get to this information, the better it will stick! I don’t pride myself in being tough, ok? That’s not me. If you know me well (which you hopefully do by now), you will know that being mean to students makes me feel just as bad, if not worse, ok! But I only do it out of love and hope that they will learn!

They all presented, in partners, on 2 patho conditions and the labs you would use to diagnose this condition. That happened last week. I was pretty upset after last week. The amount of disrespect I saw from them towards each other really made me angry. I told them from the start that I have a zero tolerance policy on talking through someone else’s presentation and instead, they passed notes. And some were reading through their own presentation notes. I had to threaten them that I would be taking off marks before it got better. I ended up taking off 2 marks for note-passing and 5 marks for reading through your own notes. The presentation was out of 40. Slightly harsh, but I gave you fair warning before it started. I should not be wasting valuable class time teaching about the importance of respect. That is not part of adult learning. I definitely was pretty affected by that and felt like I was being tested. Like, how far can we push the new teacher before there are consequences? I do realize that students all over the world do that, but I guess it was the fact that my blatant ‘I can see you passing notes’ looks were ignored and continuance that bothered me.

This week, I wanted to incorporate PBL techniques – group process and discussion. We sat in a circle and discussed what the potential problems would be for every patho condition. From this, they need to submit a careplan around the potential problems and what their nursing interventions would be. I think I was unclear about this part of the assignment and I will have to make note of it when I leave all my documents behind. I’ll have to wait to see how the careplans are before I finalize my comments and make suggestions for the future Nurs 221 instructor.

You have no idea how excited I was to see them talk things out. I sat there with a smile I tried my best to conceal. I failed miserably. Lol. I was just so excited and proud of them! We talked about tactfully delivering alternate viewpoints, the importance of NOT being defensive, and solving differences EARLY instead of late (preventing passive aggressive behavior). Visions of PBL came screaming back at me. Now, I’m ready to leave (except not really because I feel like I haven’t had enough time here) and head to Taiwan to see my aunt, HK to see my grams and family, and finally, home to my momma bear, sister, and the Henster, and of course beloved friends.

These blogs are merely the tip of the iceberg. This journey has been so incredible and I feel like I’ve learned so much and given a part of myself away.
Luckily, ‘myself’ is like the liver – it regenerates. I’ll be back as a whole by the time I’m home in beautiful Vancouver, BC.

Love you all, see you in no time!
Cass Ma

The realities of nice-ness

So much has happened since I’ve last blogged that I can’t even remember where I left off. I literally have to refer back to my older posts to jog my mind.

In general, I try not to get swept up in the little things. I don’t normally become stressed out with assignments and a heavy workload, but moreso with interpersonal relationships. I know myself, and I know that part of myself well.

I was told right from the beginning that I could not be friends with the students but they could be friends with me. I’ve been trying really hard to make the diagnostic lab course make sense for nursing students, so I’ve been pushing them. I’ll admit it. But I’ve also tried really hard to make myself available for help – I come into the office pretty early and stay until late (by Bangladeshi standards) just in case a student is still here and needs to ask a question. These are the assignment guidelines, maybe you can tell me if it makes sense:

Each person is assigned 2 lab tests to look up what it does, the normal range, what high/low levels may indicate, and what nursing implications come from the high/low levels. For example if someone has a low hemoglobin level, this could indicate anemia, so as a nurse, we would monitor for shortness of breath, fatigue, weakness, resp rate and O2 sats. I assigned these a few weeks ago and when I received them, I was having a hard time editing them all. So I’ve started to teach an extra lab session on Saturdays because there is no RN to take them to the hospital, I’ve done some reviews on the head-to-toe assessment and then had them look over someone else’s work as an editing exercise. I did this so that they could see the importance of submitting a coherent assignment. I had made track changes in the documents they sent me, but I asked them to edit as well so they would have some practice in researching and appreciate the work that goes into marking. So I can appreciate that there may have been double the work done (students and I both had to do this) but it was the principle that I was going after. So I get it, the students are very flexible and have been, for the most part, cooperative.

I gave them the presentation assignment on July 5 and they had one week to prepare for it. In PBL, it’s pretty standard. They were put into partnerships and each set of partners were assigned two pathophysiological condition (ex. Coronary artery disease and myocardial infarction). They are to present on the patho briefly and talk about the labs that are associated with the condition. (ex. What tests would be ordered to test for CAD?) Then they had to talk about the nursing implications. Most of the labs had already been assigned previously, so most of the work (after they make revisions) has already been done. To try and make it fair, I prepared a presentation, too, on diabetes.

The problem I’m facing is that students are complaining about me giving too much work and I’ve been receiving a couple of flippant comments. It makes me feel really bad. But on that same note, I know that I have a rationale for assigning this. If you give an assignment without rhyme or reason, then why assign it? I have been trying really hard to tie it into nursing. It makes my heart really heavy. I am trying to rationalize it by saying that these aren’t my friends who are dissatisfied with me, and these aren’t my friends who are complaining about me. I am here to be their teacher, to enrich their learning experience. You can’t win them all. I can’t win them all. I’m having a really hard time trying to be assertive and friendly at the same time. I guess I need to realize and demonstrate that even though I am still a student, that I am teaching their class, that I am leading their class. I can’t be friends with everyone. Push me hard enough and disrespect me in my class one more time and I will have to take action. Respect is a two way street, right? My sister swears I’m too nice to ppl even though I don’t see it, but I guess I still am.
My time is running out here. I have 11 more days and 3 more in-class sessions with this group. I say that not meaning ‘I only have to put up with them for 3 more days’ but ‘I will overcome this within the next 3 classes’. Watch me. If I can make it this far, I can make it through.

I’ve taught my first aid classes to the faculty. My first class fell sub-par, in my opinion. I felt very pressured for time and did more talking than practical, so I felt it was very boring and grew tired of hearing my own voice. I had another class the second day and was so determined to make it better. I wrote out what I didn’t like and how I was going to make the second class better. Then, I executed my plan and found redemption. The second class was much more interactive, fun, and just…up to my liking. I threw in trivia, lots of demos and practical, humour and trust me, grown ups like trivia JUST AS MUCH AS CHILDREN! Hahaha. This class was also bigger and had more questions, though, so that may have also played a part. It was great and really rewarding.

I have to set up my class now, so I have to cut it short, but some of the most rewarding moments I’ve had here involve struggling/difficult students. I have realized that I am big on the concept of ‘tough-love’. The more you try to get away with laziness, the more assignments I give you. Works for some ppl, not for everyone, but this one particular student (story is too long to type here) was being less than hard-working so I gave him an assignment. He did it poorly so I made him redo it. My happiness lies in the fact that he was able to, with some guidance, give the right answer in front of his class based on the assignment I gave him. Did that make sense? Basically he was able to recall the hw he did and he smiled one of reward and triumph.

11 more days here to make it count.

Love you all, thinking of you all (seriously)
Cass Ma