Researching Remedies

The tradition of research that turned an organic approach into a model backed by serious scientific evidence is thriving in the School of Nursing and, by extension, the MUHC system, between which there are few borders. Nursing research is a relatively young field, and the landscape is rife with unexplored questions, many rising directly from the hospital wards and community clinics.

Among the 14 full-time faculty based in Wilson Hall, many are world-renowned researchers: Dr. Carmen Loiselle on accessing health information, Hélène Ezer, BSc(N)'68, MSc(A)'77, on families coping with chronic illness, Dr. Margaret Purden, BSc(N)'75, PhD'95, on recovery from heart attack, Dr. Anita Gagnon, PhD'95, on the health of refugee populations, Dr. Celeste Johnston, BN'70, DEd'79, on understanding and abating infant pain, to name only a few.

"Any profession needs to know what they are doing and needs to have good evidence why they're doing it. Actions should be based on something more than just tradition and intuition," Johnston says. "At the same time, we don't want to throw away the baby with the bath water. We don't want to give up that caring role of nursing. But even the act of caring is a paradigm that is being examined scientifically to learn how it leads to positive outcomes."

If funding comes through this spring from the Newton Foundation and several government agencies, Johnston will co-direct the Montreal Inter-University Group for Nursing Research. This collaboration between McGill and Université de Montréal researchers will study whether nursing interventions during times of patient transition - birth or death in the family, coping with a stroke, beginning physiotherapy after a surgery - actually make a measurable difference. Once established, the group will then develop strategies to filter the results into practice.

Johnston says this all-hands research project will enhance a rich culture of inquiry developing among School of Nursing faculty and students, from the doctoral level on down. Even undergraduate nursing students take a research course in their first year and are encouraged to work as research assistants. "When our students get involved in research they come to understand the scientific method and other methods of inquiry," Johnston adds. "And when they understand these, they can problem solve better. When they are confronted with patient care, it's not by rote, it's a scientific way of approaching it."

Montreal General Hospital School of Nursing graduates from 1895.
McGill Archives

In the small conference room just off the Intensive Care Unit at the Royal Vic, a group of second-year nursing students is taking a respite from their twice-weekly clinical practicum to decompress and discuss their patients, each coping with a litany of physical and psychological complications. Not halfway through the School of Nursing curriculum, the students are vigorously conversing in the exotic language of "iatrogenic illness," "septicemia" and "vasoconstriction," the net effect being the sensation of attending a medical training film directed by Robert Altman.

But then, as in classic Altman, a provocatively simple line emerges clean and clear from the fugue. "I'm getting good at reading lips," reports Isabelle Hubert to her approving cohort.

It's a comment that begs elucidation. Madeleine Buck, the group's clinical advisor, steps in to explain that most patients in the ICU are sedated, intubated, breathing via tracheotomy or barely conscious, often leaving them able to communicate only by moving their lips a little.

In their hearts and in their minds, Buck says, "nurses have to know all kinds of things."

Odd Man Out?

Owen Egan

Dr. Franco Carnevale, BSc(N)'78, MSc(A)'83, MEd'86, PhD'94, MSc'97, won't want to see the topic of men in nursing shunted to a sidebar. For the growing number of males who join the traditionally female ranks of nursing, it's not the separate issue it was, say, in the 1970s, when Carnevale enrolled in the McGill School of Nursing, much to the bewilderment of his family and friends. "I felt like quite an oddity at the school," he recalls. "There was no male faculty and only one male had passed through before me. It was weird not having a gender role model. How do you be a nurse as a guy?"

Carnevale figured it out pretty well. Today he is head nurse in the Pediatric Intensive Care Unit at the Montreal Children's Hospital and an associate professor at the McGill School of Nursing. His gender makes up five percent of the nursing workforce in Canada, but ten percent in Quebec. At McGill's School of Nursing, men represent about seven percent of the student body. An obvious role model to male students, Carnevale is happy to field questions, but he says he doesn't get that many. "My approach tends to be more passive," he explains. "I'm hoping that guys develop a sense that this is okay, to say, ‘Here is a guy and he has been fairly successful,' so that it sort of de-stranges the whole thing."

But to the general population — especially the anglophone population — the role of men in nursing has not yet been de-stranged. Carnevale recalls addressing a class of second-graders about careers in nursing a few years ago and avoiding the expression "male nurse," since it seemed obvious. "But when their hands went up for questions they asked things like: ‘What does a male nurse wear?' ‘How is a male nurse different from a doctor or orderly?' ‘What did your parents say when you wanted to become a male nurse?' I obviously stood out as odd."

Odd or not, Carnevale argues that gender equity would enhance not only nursing, but every profession. "My belief is that every discipline should have a diverse body of people, because then you have a wider pool of talent," he says. "I think it's phenomenal that in medicine you see many more women, and I hope there will be more women going into management and politics so that they may enrich those fields with different ways of thinking. That's the possibility for men in nursing."