Fatality Prevention: Grim But Necessary

Today I went to an OEASA workshop called Preventing Fatalities in Nature Based Outdoor Activities. Yes, it was as morbid as it reads. I knew when I signed up that it was going to be quite a confronting day and really challenging emotionally. But I also knew that conversations around preparing for the possibility of deaths are important! 

We had some pre reading to complete before the workshop - one paper covering 4 cases that have occured for whole group discussion this arvo and one case that was specifically designated to me to share with the group. I really enjoyed having this prep time beforehand, as it gave me time to process some of the information, reflect on the scenarios and how I would have responded in them and also complete some further research about what could have been done to prevent/reduce the possibility of the tragedies. I also felt like I was back at uni, which I loved because I love learning!

The key things I took away from the pre-reading were;
- Competitiveness can have significant impacts on young people's choices and ultimately their safety. The word 'challenge' therefore, should be used carefully!
- "Adolescents tend to wrongly assume something is safe if they try it and experience no adverse consequence" (Reyna & Farley, 2006). We know that assuming generally has it's own consequences...
- There shouldn't need to be a near miss or incidents to occur for people to act on it/prepare for the possibility of something occuring. This shows the importance of having discussions about a variety of scenarios that could occur, no matter how low the likelihood is.
- Prepare for the worst case scenario in any setting - and prepare the students for this too. They need to understand that the teachers/facilitators/instructors are vulnerable in the outdoors too, so at some point they need to be the 'leader'!

A large section of the day was sharing the narrative of the case we were given, and then discussing how the fatality could have been prevented. In all of the cases, something could have been done. Majority of the cases were water based - mostly drownings. Many of them were also based in New Zealand, which made me super uncomfortable (but I had an early colleage, Adam, in my mind saying 'be comfortable with the uncomfortable!'). I found the discussions with the group incredibly valuable too though, because people were able to see things from different perspectives as well as share their own experiences. 

My case was about a young boy who drowned only a few metres away from the edge of a lake with his peers and teachers closeby. Truly devastating. Unfortunately there were several steps that could have been taken to prevent (or at least significantly reduce) this fatality from occuring; more active supervision, education for the students, flotation aids available, greater knowledge about the depth and colour of the water, aquatic knowledge and skills taught, risk managament discussion and plans for this swim (this was not an aquatics camp or a planned activity), confidence and competence checks of students in, near and around water and more efficient procedures in first aid scenarios (such as faster contact with emergency services). See below the quick drawing I created while I was explaining the case with the group (it's a bit messy, but I find visuals to give more context! The x's represent people, and there were others that I did not include). Honestly, it was gobsmacking to read and gut-wrenching to recount.

Throughout the day we had a lot of great discussion - it was so eye opening for me. There were parts of some of the scenarios that I thought 'how on Earth could you make that dedcision', but then other times I was left thinking 'I actually could have been in that position'. I feel like I will certainly be a lot more aware of fatality prevention and will certainly include this in my prep with students too. Here are a few things I was left thinking more about:
- Just because you have safety considerations, does not mean that you have fatality preventions. RAMS often consider low to medium level possibilities, but I don't think I have actually ever seen one that specific considers the possibility of a death.
- If there is an incident or tragedy - what measures could have been put in place to prevent this? (Note this can be any situation, not a personal one!)
- Many of the scenarios discussed today were the 'same story with different actors' - so they could have been prevented.
- "Experience is an unreliable guide to fatality prevention." Assume you know nothing.
- The use of real case/scenario based learning in class is helpful to prepare students for the possibility they find themselves in that situation. This rang particularly true with the fatality case of a student passing from anaphylaxis and another student wasn't sure if they could use an Epipen on them.

If you are wanting to learn more, check out this paper by Andrew Brookes, who was our workshop faciltator today. With regard to safety, you can never learn too much!

Tourniquets in 'Timbuktu'

Over the last three days I was fortunate to complete a Remote Area First Aid course facilitated by St John Australia. Because I have started teaching my own Outdoor Ed classes this year, I thought this would be valuable, especially for camps. When I arrived I quickly realised most of the other participants were freelance outdoor instructors or tradies working in remote areas. I felt a little inexperienced and out of place as a result, but knew to get experience you need to start somewhere! 

Across the three days there was some repetitiveness across basic first aid courses, which is never a bad thing! I liked that most of the second half of the course were hands-on practical demonstrations and practice runs of a variety of scenarios that we could be faced with though to mix it up. Although the scenarios were as realistic as they could be in an office space, I do think that the course would be much more beneficial, rewarding and enjoyable if they were actually based in an outdoor setting. I was hoping that I would go on a course like this and actually be camping / in a remote area. 

The most lifelike experience was a fake arm with an open wound that water could be pumped through to replicate blood gushing out. On this we needed to practice stuffing the wound to slow the bleeding and encourage a clot and then place a tourniquet. It was incredible how many gauze pads needed to be stuffed into the wound to even slow down the 'bleeding'. I can only imagine if you had to do that for real for someone!

There is an array of evidence to show that the more people know, the more confident they feel and the more empowered they feel to respond to a medical emergency. As described by First Aid Melbourne, "a study conducted by the Red Cross showed that a staggering 59% of deaths from injuries could have been prevented if only first aid had been given in the first few minutes of the incident before an ambulance arrived". So, even though I feel I still know very little there is to know about first aid in the grand scheme of things, every little bit helps. I've been lucky to only have been involved in a couple of responses that would be considered mild, and hope I never have to respond to someone in a critical or dangerous scenario. Therefore, I encourage everyone to complete at least a basic first aid course - please don't hesitate! 

I do hope to get the opportunity in the future to learn about more preventative strategies, as the last few days have mostly had a focus on responses. I have heard about a course based around preventing fatalities in the outdoors that I may try go to - watch this space! Finally, as I have previously blogged about, first aid is more than a broken leg - mental health first aid is another great course to complete.

First Aid Is More Than A Broken Leg

Over the last two days I have completed a Youth Mental Health First Aid Course facilitated by Mental Health First Aid Australia. This is something I had heard about several years ago but the stars never aligned for me to complete a course. I was grateful to finally get the opportunity to attend. 

The other participants actually ended up getting COVID or being sent into isolation, so I ended up being the only one! This meant for a great 1:1 experience, but I also felt that I missed out on conversations with others a little. One thing I like about attending PD is to be able to compare stories and experiences with others. There was lots of scenario based learning across the two days though, which helped to solidify the learning a little.

This specific course was designed for youth because the median age for depression is 25, the median age for anxiety is 15, in 2020 480 Australians under the age of 24 died by suicide and 1 in 4 people experience a common mental health illness in one year. These stats really surprised me and were quite confronting. This really reinforced the importance of quality mental health education in schools (as well as the importance for as many adults as possible to be mental health first aid accredited). Check out some of my previous posts related to mental health here. Just like physical first aid, mental first aid should help people to have preventative strategies, rather than an ambulance at the bottom of the cliff. 

Beverley introduced me to the mental health continuum below. She encouraged me to consider these questions while observing young people; 
- To what level has someone moved towards 'illness'? How long have they been at this point of the continuum and how quickly did they get there?
- Are they bouncing back to 'health', staying where they are or moving closer to 'illness'? 
- Does the place on the continuum change at school, home and/or hobbies, or remain much the same?
These questions can help to gauge a students 'wellness', but also help to form a conversation with them and/or their caregivers. It is also very important to note that mental health is not the same as mental illness.

One thing that stuck with me, which shouldn't be surprising, was the comment "the more that we can support the brain in any illnesses they are presenting, the more likely they are able to learn". When we are having challenging mental days as adults, we generally aren't as productive, might not focus much or could have a shorter wick than usual (these are certainly my observations of myself). So of course if a student is feeling stressed, down, anxious or all of the above then they too may not be as productive as usual, may not be as focused or have a shorter wick. Teachers can see these as signs of disrespect or defiance, but really they may be signs that the student needs some support in that moment. Signs to look for and to ask the student about.

Here are several points that left me thinking a little further and for you to also ponder;
- Teachers should be modifying tasks like we would in a practical sense. We wouldn't ask someone with a broken leg to play a sport, so why would we ask someone with anxiety to 'keep on trying'?
- Empowerment is important for young people to make their own decisions about themselves. the feeling of powerlessness can significantly impact on mental health, so people need opportunities and tools to make decisions for themselves.
- "It is important that during the first response [to the person] we do it well, so that there is a positive result for them long term".
- Dendrites in the brain are responsible for neuro pathways and severe mental illnesses can impact on these pathways such as thickening them. Medication can help with repair of these dendrites, which can then help someone to have clearer thought processing and decision making. BUT medication is NOT the first answer for majority of people.
- We can recognise in student language, artwork, texts, interactions etc possible expressions or depictions which may indicate the student needs support.

Finally, the acronym ALGEE was referred to several times throughout the course. Like the WARM acronym for restorative conversations, ALGEE is a structure to create a conversation  and an action plan with someone as a mental health responder. To gain my accreditation, I had to demonstrate this structure through practice discussions in a range of scenarios. 

Even before completing this course I knew student mental health was just as important to understand and know how to respond to as physical health. Now, I feel even more so. It blows my mind that physical first aid courses are compulsory for all teachers in South Australia but mental health first aid is not - here's hoping that changes in coming years and that NZ mandates too!

Teacher Wellbeing & Manaaki Orewa

During the holidays I was involved in an online wellbeing workshop facilitated by PPTA and Worksafe Reps. The overall aims of the workshop were to develop greater understanding of how to increase positive workplaces and what bullying and harassment actually is. To sign up to one of these workshops, as there are several more, please see more info here.

I created the alongside sketchnote throughout the workshop, summarising some of the key things I took away from the session. The things that left me thinking. Overall, I was naturally left pondering my own teacher wellbeing. More specifically, what am I doing to balance my own bucket? How am I helping my colleagues to balance theirs? Is there any more I can be doing to show the importance of teacher wellbeing? 

I feel that taha tinana/physical wellbeing is generally considered to be a more significant risk within health and safety policies, especially for employees. However, it is positive to note how there is a clear shift towards a greater focus on the other dimensions of Hāuora in NZ (and globally), particularly taha hinengaro/mental & emotional wellbeing. This was evident in the Positive Education conference I attended last year, and lately in the national budget from our government. 

At the end of the workshop we were asked what action we were going to take, after learning and reflecting throughout the day. Because I was thinking frequently throughout the day about our school values, Manaaki Orewa, and how these support student wellbeing, I thought I could create a visual to be shared with the staff related to the values and teacher wellbeing. Manaaki Orewa (Respect Myself, Respect Others & Respect the Environment) is embedded within the school culture of Orewa College, but is often discussed more specifically around how the students can display Manaaki. Hopefully this is shared around our staff and can become a print that is displayed in teacher spaces as a small reminder!

Clearly, putting up this visual around school, and implementing some of these strategies for teacher wellbeing won't be able to happen until we are back at school though. During this time of uncertainty, the lines of work and home are even more blurred than usual. Maintaining our own wellbeing is incredibly important for the safety and welfare of ourselves, our whānau and our students. 
If you would like to read more about self care and wellbeing whilst at home (and some general tips), see some of the below microblogs shared by Andy Milne for #microblogweek.

Three Tips for Self-Care as an Educator (Pran Patel)

Looking For Sticks (Mel Hamada)

Managing Your Self-Care During the COVID-19 Pandemic (Mary Jo Geddes)

Shoot For The Moon (Andy Milne)

Making Lemonade (Brenda Carbery-Tang)

Don't forget - be kind to each other, but be kind to yourself too!

Aquatics Unit, An Awesome Experience

Last year I queried why there wasn't an Aquatics programme at TC, especially as there is a pool 100m down the road. No one had taken the lead, so there hadn't been any opportunities for the students historically. So, I developed a water safety site and shared a short screencast showing what I had created. The purpose of the Y10 unit was to increase student confidence in, on and around the water, as opposed to a swimming unit. 

I worked alongside a representative called Mark from Drowning Prevention Auckland (formerly Water Safe Inc.) to create my programme and website. When it came time to delivering the unit late Term 3 this year, Nicky, another DPA representative supported myself and the other 10PE teacher. She was incredible. Very organised, very passionate, and really increased our confidence to teach water safety. She took the lead for the first couple of lessons, and then Doris and I took over once we felt more confident.

NICKY'S FEEDBACK

• "This opportunity that you’ve provided them may make the difference between a bad decision around water and a safer decision as through the theory you’re getting them to think critically about their behaviours and attitudes around water."
  
• "Your enthusiasm and dedication to get this programme going will make learning so much more authentic to those who did participate in the water but also those who were “non-participants” could still learn and also see that the lessons were less about ability but more about confidence and being safe in the water."
  
• "Those who didn’t get in the water but were still there, some were still engaged and helpful and were good at answering questioning – think in reflection that will be a key thing, including them more with station cards or whatever it may be so they can take responsibility for some of the learning."

WHAT I HAVE LEARNT/TAKEN AWAY

• As this was the first time I was the Teacher in Charge of an EOTC activity, it was also the first time I created RAMS forms and was responsible for Health and Safety. I was blown away how much I needed to do and know, and how many people I needed to facilitate with. However, this was a great learning experience for me, and I look forward to more EOTC events!
  
• The unit demonstrated having theoretical and practical lessons was effective for student learning. I was able to see the progression in confidence and knowledge when students were present in both students and reflected on their practical learning. Therefore, although we had some difficulties encouraging students to bring their togs and get involved in theory lessons, this unit was a great start.
  
• Following on from this, the site I created was a great teaching and learning tool within the classroom. I found there weren't enough current articles on the site though, so I would like to add a page which I can continue to add news articles to. This would ensure the readings and clips are as up to date as possible. 

STUDENT LEARNING

This Google Form was used at the start of the unit and the end of the unit. Students' answers were recorded in a Google Sheet, which I analysed to determine where students' confidence increased, and still potential gaps. My findings included;

• 4/61 students at start of unit identified importance of water safety as keeping safe around water, prevention of drowning and to keep safe. This gave a good starting basis to build from, and encouraged an emphasis safety in on and around water, as New Zealand have high drowning statistics, especially for Māori and Pacific people.
  
• 22/61 students were unsure what the red and yellow flags were at the beginning of the unit, which is also a place many of the students identified as a place they swim. So, there was an emphasis on beach safety in the second half of the unit. At the end, 8/30 students were still uncertain what the flags meant, therefore there needs to be more exploration and discussion about beach safety next year. I think this would be most effective if a day was facilitated with Surf Life Saving New Zealand as a beach day.
  
• At the beginning, majority of students identified lifejackets as a flotation device but by the end other flotation aids were identified including noodles, the HELP position and floating on your back. These are important for students to know if they were underprepared for the water, or are bystanders for others in, on and around the water. Many students were surprised how much they could do as a bystander! 

STUDENT FEEDBACK

The table alongside shows the increase in student confidence from the start of the unit to the end of the unit. Students were asked to rate their confidence from 1 to 5 (1 representing the least confident) before the unit, and again at the end. These percentages demonstrate a large increase in confidence. Of particular interest was no one rated themselves as 1 at the end, and only one person rated themselves as a 2. For future water safety programmes, I would like to aim for 75% of students to rate themselves as a 4 or 5, and the remaining 25% a 3 or higher, to have a greater impact on student safety and learning.

Some comments at the start of the unit to describe the rating they gave included;

1 - Last time when I was swimming (Probably a year ago) I almost drowned, I can only put my feet in the water now as Iam scared

2 - Because I'm confident in the pool but not the beach

3 - Because not pretty sure how to get out of rips & how to save others when in deep waters

Post unit, some of the descriptions for students' self ratings included;

3 - Because I'm confident to go in the water but then the people that make fun of others distract my confidence of the lesson.

4 - Because I now know if I was stuck in a water situation I would be able to know what to do.

4 - Because I am confident to help my self if I need help.

Therefore, the water safety unit was a great first step for a new initiative within the school. I hope the programme continues to grow, to increase student confidence further to support their safety in, on and around water. Most importantly, I hope future water safety programmes help to reduce the high statistics of drownings in New Zealand waters.

Problem Solving in the Workplace

At the beginning of this week I attended an employment relations two day course (Mahi Tika 2) funded by the Post Primary Teachers' Association. This was the second stage of the first stage I completed last year (see my reflection here). The purpose of the course was to gain a greater understanding of our rights and obligations as teachers in the workplace, through scenario based learning. I left the sessions feeling like I had absorbed a substantial amount of information that is important for me to know, and to share with others, especially problem solving skills.

I have reflected on the importance of my worth and value as a teacher within my school after this course. I have thought about the expectations I need to have, of how my colleagues interact with and treat me, and however I interact with my colleagues. Sometimes I feel as if we are giving 110%, but not noticed. I also sometimes feel like I am the bottom of the hierarchy, which I think is natural as a beginning teacher. However, I have now realised that we don't need to feel this way or be recognised, as long as my students are engaged and successful. We, teachers, do need to be respected by staff and students though. So, I feel grateful for this intense course, as it as made me realise my worth, and how to resolve some possible potential workplaces issues.

One section of the course was focused around Health and Safety. I feel this is an area I need considerable more knowledge and understanding about, especially as I am leading the aquatics programme soon. I have found myself attempting to complete RAMs forms, but still have a million questions I need help answering! Some of the key things I took away from the session was the managing risks cycle, and identifying the risk values of different situations. 

My group focused on water leaks as a low level risk and then physical fights between students as our examples to calculate the risk level of the situations using the below tables. A low risk can procede with monitoring and controls. A medium risk must be reviewed and managed. A high risk, which there appear to be many more than we realise, require immediate attention to eliminate or minimise risks as reasonably practical. These tables started lots of interesting discussions, including ways to minimise violence, how to reduce risks from becoming present and the importance of a Health and Safety Committee. I feel like I have lots of things to think about after this session in particular!

I have considered going to the annual PPTA conference, as I am interested to hear about what is on the cards for education, teachers and the union in the future. Watch this space...