Teaching Tip: Using reflective writing to learn about beliefs and baggage

We often think of writing as a way to present our ideas to others, to answer questions, and to illustrate what we know.  However, Laurel Richardson suggests that she writes in order to LEARN!

I write because I want to find something out. I write in order to learn something that I didn’t know before I wrote it.  I was taught, however, as perhaps you were, too, not to write until I knew what I wanted to say, until my points were organized and outlined.

Reflective writing helps students to become more aware of their “beliefs and baggage” – personal beliefs, their issues, values, preferences and fears, about dying, working with the dying, and their history with dying.

Student might find that reflective writing can help the writer bridge the inner and outer world, and connect new knowledge with practice. They might find that their writing helps to create new meaning and results in personal and professional growth.

Students may be new to caregiving and may be concerned that they have “nothing to write”, that they have “no work experience” in this area.

A person burdened by their beliefs and baggage

When you are unaware of your beliefs and baggage, they can weigh you down

Students are invited to write reflectively.  Naomi Goldberg (Writing Down the Bones) provides the following guidelines for writing practice, that can be adapted here for reflective writing:

  1. Keep your hand moving
  2. Lose control
  3. Be specific
  4. Quell the critic (silence the critic)
  5. Be easy about spelling or grammar
  6. Feel free to write junk
  7. Go for the jugular

Instructors will need to help students understand that this is not about right or wrong!  In fact, inform and remind them that reflective writings are not marked for content, but only for participation.  Students will need to adjust their mind set, to simply look at the statement or the question, and just write whatever comes to their mind.  If they want to take a notebook, they might find that writing without stopping for ten minutes provides more opportunity for issues and ideas to come forward than writing for just a few lines.

Sort your beliefs and baggage

Learn to sort through your beliefs and baggage with reflective writing

Instructors can go through the Workbook exercises with the learners and brainstorm reflective responses to the different questions posed.  Some questions such as, “list what you think would be a good death, a bad death for you” student respond to easily.  They may have experience with a loved one dying, a pet dying, or their experiences may be limited to death as they have seen it portrayed in the media or how they have imagined dying might be.  Any or all of their thoughts would be more than appropriate to write.  “I don’t know” and “I have never thought of it” are reasonable answers.  I would then ask the student to follow Naomi Goldbergs directions for writing, and see if any other ideas come forward.

Students may request permission to write their responses in their native language.  This would be fine.

As students reflect, it is hoped that they will become more aware of themselves, their concerns, fears, issues, values about dying, death, caregiving etc..  With the increased awareness of themselves, they may be better able to focus their care on “the other”.

An image that may be helpful: airport and many suitcases.  If you know which one is yours, you can pick up your own baggage.  But if you are not sure which baggage is yours, and which belongs to someone else, you may mix up the bags.  The analogy is, that if you are not aware of your baggage, you can trip over it, while trying to care for someone else with different baggage and different needs.

Baggage sorted and put aside before caregiving

Sorting your baggage prevents your beliefs from weighing you down

Please note: Students may have much experience with death, loss and grief. For a person who has immigrated to Canada, it may be that their experiences with death and dying occured in their home country before immigrating to Canada.  These may be extremely painful experiences and be painful for the person to recall and difficult to explore. Instructors can support students by offering support as they work through their experiences as they prepare to care for people who are dying in Canada.


University of Birmingham offers a “short guide” to reflective writing here that details different methods for developing a reflective writing practice. I encourage you to read it and share with your students as a way to help them consider the various methods of tapping in to their beliefs and baggage.




Learning with ELNEC in Hawaii

At the memorial

At the War Veterans Memorial in Honolulu, with Jeannie White

A few weeks ago, Ted and I had the privilege to be invited to attend the ELNEC 20th Anniversary Summit in Hawaii.  ELNEC, the “End-of Life Nursing Education Consortium (ELNEC) was launched in 1999 to improve palliative care. In the past 20 years more than 24,000 nurses have attended one of the ELNEC Train-the-Trainer courses and have then taught more than 726,000 nurses and other healthcare providers worldwide.

Dr. Betty Ferrell has been the visionary leader of ELNEC while Pam Malloy has filled the immense role of Project Director. Pam is preparing to retire in January and she will be missed. I have cherished my connections with Pam and Betty over the years. They have shown great generosity of spirit to Life and Death Matters, have provided testimonials for our nursing texts and resources, and continue to support our work in Latin America.

I delighted to meet again with Polly Mazanec who is working with ELNEC undergraduate, Diane Parker. Diane is helping promote palliative care in Uganda as well as being a dynamic force inmoving pediatric palliative care ahead in her home state. And of course, it was wonderful to meet other faculty and participants from all over the states.

I attended the CORE-ELNEC course, witnessed the challenge of trying to share a large volume of material in a two day course. I was impressed with the binders that each participant received, including materials to teach other nurses.

I look forward to continuing to work with ELNEC, supporting their courses, and being supported in our work. Thank you #ELNEC. And best of best wishes to you, dear Pam, as you explore what retirement will be for you.

Photos below – I really enjoyed meeting up with these incredible people!

With Betty Ferrell, PhD, MA, CHPN, FPCN, FAAN

With Diane Parker

With Pam Malloy, MN, RN, FPCN, FAAN We’ll miss you!

September …..

Illustration by Joanne Thomson


The end of summer, the beginning of a new year (school), and for some… a time when the time felt like it stopped and life changed. My heart and prayers go out to the many people affected by the wild fires, the floods and the other disasters and dangers. As I sit in my beautiful garden, it is difficult to begin to comprehend the devastation, losses, upheaval, transitions, changes, hassles and far reaching consequences. My initial thoughts went to the practical things like shelter and food. Then, after talking with people who were affected, I woke to the practical realities for people who organize and teach in health care worker and nursing programs, the associated practicums and the many students affected. I thought of this image from the PSW text, that shows the practice of providing casseroles for people when they are grieving. I send my thoughts and hopes, and wish I was able to bring a nice warm casserole or a beautiful fresh salad to provide support!

Conferences and Connecting

The spring and fall are usually busy with conferences and visits to schools and hospices. This fall we will be in Prince Edward Island, Canada, Ottawa, Ontario, California and Austin, Texas. We look forward to reconnecting with colleagues, and hope to visit some of the colleges as we go. Check the conference calendar – if we are in the same place, let’s connect and have a cuppa!

Addressing Thanatology in Public Health

The idea that death, dying and bereavement need to be addressed as a public health issue resonates strongly with me. The Public Health Palliative Care International Conference is in Ottawa this year. In addition to a strong focus on policy and community partnerships at the conference, the workshops will address ways to build compassionate communities and creative strategies for teaching the public. If these concepts are dear to your heart, I encourage you to consider this conference while it is in North America. For only a few more dollars, you can also attend the Canadian Hospice Palliative Care Association Conference!

Nurse’s Text – Errata

We are honoured by the positive feedback received about  the nurse’s text, Essentials in Hospice and Palliative Care: A Practical Resource for Every Nurse. Our heartfelt appreciation to the nurses, nurse educators, students, and colleagues for their feedback and encouragement. Based on the feedback we collected, we have integrated some changes into the nurse’s text. If you have already purchased the text, contact us to obtain your copy of the Nurse’s Text Errata.

Centennial College is the first community college to integrate the nurse’s text into their nursing program. We look forward to meeting with their students later in the fall to hear their feedback on the text.

Calling Hospice Aides

Are you a hospice aide? I am gearing up to present a series of webinars, specifically for hospice aides, with the National Hospice and Palliative Care Organization (NHPCO). In preparation for the webinars I am interviewing several hospice aides to hear about their experiences. If you would like to be interviewed, please email me.


In closing, I will be sharing notes and insights from the conferences this Fall through Facebook.  If you do not have to have a Facebook account  you can still access these notes by clicking the above link or typing in: www.facebook.com/LifeAndDeathMatters/. Hoping to connect with many of you, renewing ties, and maybe grabbing a muffin and cuppa together along the way.

5 Key “Do Not Miss” Concepts from the HPCO, SLPNA and CLPNA Conferences

  1. Find meaning when caring for the dying – David Irvine, author of “Caring is Everything, spoke about providing care and supporting his brother Hal, a beloved family physician, from diagnosis through to death. His book contains exquisite reflections, compassionate tributes, and insightful learning about the importance of finding meaning while providing care.
    David has spent much of his career in coaching corporate leaders. We are fortunate that his focus is shifting, and he is now looking at the needs of people in the health care field, and how we might be reminded and supported to provide better care while also addressing our own needs.
  2. Rekindling your sparkPatricia Katz spoke about Mid-Life Malaise. She identified the challenge that many of us feel at times, when all may be well, but we are just not “feeling it.” Patricia reminded us through the activities and presentation, that it is possible create a spark that fans your fires. She divided us into pairs and, using a creative interview process, helped us explore our past and the present. Second, using guided imagery, Patricia helped us look to the future to identify what we might do to rekindle the spark in our own lives. In all, each of us was able to find a spark and learned how to dig for that spark when we needed it.
  3. Importance of connections and hugs in a legacyElizabeth Dougherty shared her reflections, quotes, stories, and an expressive arts project that expands on her concept of the importance of connection, hugs and legacy. Using only a bed sheet, markers and scissors, she created a “hug” that the dying person and family can treasure. She reminded us that tools don’t have to be complicated, technical or expensive.  Interested in learning how to create a “hug” Check out this similar presentation on her website.
  4. “MAiD – Is this a part of hospice palliative care?” Dr. Andrew Mai from Hospice Care Ottawa addressed this topic eloquently. He offered interesting points, shared a few difficult case studies, and then divided us into pairs to debate the reasons for and against providing MAiD within a hospice. There weren’t any easy answers. But maybe that wasn’t the point. It was affirming to experience a controversial and often discordant discussion within this group, without hostility or rancor appearing.
  5. Supporting children whose loved one is dying – Megan Sloan and Katt Brooks, (Roger Neilson House, a hospice for kids in Ottawa), and I presented, “Games, Cookies and Creativity in Addressing the Need of Kids while Caring for Adults.”
    If you are one of the many people who feel less than comfortable in addressing the needs of children while caring for an adult, we created a short follow-up video that may help you with your discomfort. (In Life and Death Matters Facebook, this video was posted on April 23rd).