What Are You Working On?
What Are You Working On? is an ongoing series aimed at getting to know exceptional UBC staff and faculty who are doing anything but the typical day to day as they contribute to making UBC an inspiring place to be.
Susana Caxaj is an Assistant Professor in the Faculty of Health and Social Development, School of Nursing, UBC Okanagan Campus. As a nurse and educator, her research primarily concentrates on community health and wellbeing for diverse populations. Her findings focus on an array of topics such as mental health, cross-cultural belonging, Indigenous health, and intersecting identities.
She quips that in her youth, she was a “philosophical teenager” concerned about how to make a living while still contributing meaningfully to society. That’s when she found nursing and decided it was the vocation for her. She went on to pursue her BScN at Queen’s University then earned her PhD at the University of Western Ontario. Along the way, Susana discovered that not only is nursing a vital part of the health care system, it has the power to change and shape how populations are perceived and supported.
UBC Communications and Marketing had a chance to talk with Susana about her ongoing research and teaching in global health and nursing.
As an Assistant Professor in the School of Nursing, much of your research involves community mental health. What is something important you have discovered through this research?
SC: I am constantly amazed by the inner strength and creativity different communities have towards supporting one another. This is the case no matter how much a community might be discriminated against, marginalized or made invisible. This isn’t to say communities don’t need more support. It means that educators, clinicians and public workers need to recognize all of the knowledge and capacities that are already there in the community before they step in to propose solutions.
What motivates you to discover culturally safe solutions for the health and wellbeing of diverse populations?
SC: Research that is focused on building cross-cultural or culturally safe solutions for health and wellbeing of diverse populations needs to start from a recognition and appreciation of difference. Many people in Canada have been taught that it is shameful or inappropriate to talk about difference but when you don’t talk about difference, you end up erasing the ways that people are unique and truly spectacular. The ethic of ‘we are all the same in every way’ also reinforces this idea that if we can’t relate to somebody 100% that there is something wrong with ‘them’ or there is something wrong with ‘us.’ This position can spark a lot of discriminatory attitudes and beliefs.
Could you explain “Relational Nursing?” Why is it important in the context of our health system?
SC: To me, relational nursing is about developing strategies for the awareness of self, others and wider factors that will shape every interaction we have with a patient. A relational nurse knows that a patient’s past experiences, current social realities or supports, and wider political and economic history cannot be separated from their current health concerns. A nurse practicing relationally, for instance, would assess a patient’s comfort with a hospital setting, spiritual values, familial support or gender preference and consider these factors as just as important as a patient’s blood pressure.
If these experiences and identities that a patient carries with them go unacknowledged, nurses are more likely to reinforce stereotypes or discrimination because they lack awareness and appreciation of their patients’ differences. They may fail to see the ways that ‘standard care’ fails a particular patient, or the ways that further flexibility or creative solutions could support their clients.
Nurses of course need to be supported to be able to practice relationally. Nurses stand to gain from this type of practice and are more likely to develop meaningful relationships with their clients which will, in turn, make their work more fulfilling. This is important because as a profession we lose many great nurses to burnout.
What do you hope sticks with your nursing students at the end of a class with you?
SC: I think that in life generally, and the medical system is no exception, we revere professionals as people who have all the answers. Saying “I don’t know” as a clinician can feel risky because we internalize that pressure to be know-it-alls. But in reality, new research challenges old ideas that we were sure were true a few years ago, and our practice is changing all of the time to respond to new evidence. So, it makes a lot of sense that we have moments we need to say “I don’t know.’ I tell students in my research class that I find this to be a very reassuring statement made by a clinician as long as it is followed by “I will look it up!”
I don’t know shows humility and a great deal of responsibility. Besides, patients and families are the most knowledgeable about their preferences and priorities. Curiosity, in terms of what unique priorities patients have and the most evidence-informed ways to approach their practice, is definitely one of the most important things I hope students gain from taking a class with me!
What’s something unexpected about nursing that people may not know?
SC: How versatile it is! When people think of nurses they think of a very specific clinical environment and a specific type of nursing but nurses have many roles. We work in communities, in research, in prevention, health promotion, the public school system, rural areas, urban areas, with homeless populations, immigrant populations, seniors, incarcerated populations, newborns… you name it! Our knowledge base is also incredibly unique. We draw as much from the social sciences as the natural sciences. I think that is one of the things that makes nursing knowledge so special. We straddle both of those worlds to develop knowledge, practices and policies that improve the health of individuals, families and communities.