I can’t believe this is the last homework assignment of my last class of nursing school. It’s so bittersweet to think that we are finally at the end. I’m more than ready to be an RN and start my nursing journey, but on the other hand, it’s so weird to think that I won’t be with the people that I have come to think of as family for the last three years. When we were told at orientation that these three years would go by fast, I didn’t believe it. And even during it, I didn’t really believe it. But now that we’re here, at the end of the road, I realize that, as much that has happened with us, it has sped by. We went from being little babies to the big sibling ready to leave and enter the world. Crazy.

I feel that our knowledge shot up this semester in critical care. We learned a great deal when we started in patho, and we continued learning in pharmacology. I feel like everything since that was based on those initial building blocks. However, this semester was where we really got to put everything into place as it was our pinnacle class. So much of what we learned was based on topics we were already knowledgeable in, and this was so beneficial to us in learning the more complicated aspects of critical care. This semester, to me, I really felt like a nurse as I took care of patients. There was much less reliance on a nurse or clinical instructor as we really took the reigns and pulled out all that we have learned in these past three years.

Additionally, it took me a while to adjust to this blogging aspect. I have run a blog in the past (now that I think about it, I wonder what happened to that blog?), but this is a new format that my previous host. And while I feel like blogging is a lot like writing a discussion board, I do find this more enjoyable than discussion boards. However, on the flip side, I wish that this would have been introduced to us sooner than our last semester. It felt like, at the beginning, we’re trying to adjust to everything that the final semester was throwing at us (graduation, job applications, critical care, NCLEX) while also finishing up our papers for Ireland, and then learning a whole new technological platform was added on top of that. It was stressful at first because of that, and I wish we had more time to work with it. I would’ve loved to have used it to it’s full potential, and I had grand pipe dreams of making this site into a virtual CV, but I didn’t want to spend all the time on it if we weren’t going to get to use it after graduation.

Overall, I think this course utilized greatly diverse learning methods which benefitted us greatly. I enjoyed the lectures with powerpoints, but I also enjoyed watching videos and acting out scenarios. I feel that, when we utilize more than one part of our brains, we really do experience greater learning that will benefit us in the long run.

So here’s the close-out to the last piece of homework. It’s been a great three years, and I’m going to miss everyone. Now, here’s on to the next big journey!

Haiti Earthquake

On January 12, 2010, a 7.0 earthquake struck Haiti and resulting in the loss of over 230,000 lives, and the country is still working to recover from these horrible natural disaster five years later (CNN, 2015; Laurent, 2015). The effects of the large earthquake were much greater due to the poor infrastructure of buildings – a great majority of them were not built to handle earthquakes (BBC, 2014). Since the country is extremely poor, with families living on as little as $2 per day, the money to redevelop after the earthquake was simply not there and, despite the billions of dollars received in aid, the country is still struggling to redevelop and return to its previous state before the earthquake (BBC, 2014; Laurent, 2015). As a result, more than 1.3 of the country’s population was left homeless and at least 300,000 people were injured while many of the hospitals collapsed in the quake (BBC, 2014). Today, individuals can walk into the country and still see damage waiting to be fixed – buildings which are still broken, and families (at least 85,000 people) are still displaced and living in “shacks” (CNN, 2015; Laurent, 2015).

In regards to healthcare, initially, as stated, many of the hospitals collapsed, leaving the primary source for medical care inaccessible (BBC, 2014). However, shortly after the earthquake, the worldwide community brought in resources: the Dominican Republic provided medical supplies and emergency water, many countries (e.g. United States, Iceland) sent in emergency rescue teams, the Red Cross arrived and set up field hospitals, the United Nations came to provide help, and individuals from all of the world donated money to help with the care of these individuals (BBC, 2014). Additionally, as a result of the earthquake and the difficulty in accessing safe water, there was a massive cholera outbreak in October of 2010 with over 700,000 people contacting this deadly bacteria (CNN, 2015). Since the outbreak, over 8,500 people have died from cholera (CNN, 2015). While aid was able to come and act as a primary intervention, the country is still struggling at rebuilding and providing healthcare for population (Laurent, 2015).

I feel that being a nurse in this country during a huge natural disaster such as this one would be extremely challenging. While I do feel that we receive training on how to handle disasters, the accessibility to healthcare resources makes a big difference. During a crisis like this, the ability to obtain clean water is definitely at risk (especially as seen by the cholera outbreak). So, the big challenge to nursing wouldn’t necessarily be handling all the patients (although that definitely is a big concern), but it would be nursing using the resources that are available.

“I don’t have any more bandages and this person is bleeding. What can I use?”

“There is no more clean drinking water. How should I proceed?”

“This person has a compound fracture. What is my best course of action?”

These are questions and issues that we don’t normally have to deal with in a developed country, even during a natural disaster. And yet, these are big issues during a natural disaster in an undeveloped country and are definitely an issue in providing care. As a result, we need to have a combination of training and intuition in how to handle these situations.

While I believe that developed countries are prepared to handle these situations, I do not believe Haiti is yet better prepared to handle another large-scale earthquake because they have not yet managed to recover from the first one. A big portion of their recovery has come from outside aid, and, while outside aid will come again in the event of another earthquake, families are still displaced and buildings are still not all repaired. The resources are simply not there to handle another disaster.

References:

BBC. (2014). Case study: earthquake. Retrieved from: http://www.bbc.co.uk/bitesize/ks3/geography/ physical_processes/plate_tectonics/revision/7/

CNN. (2015). Haiti earthquake fast facts. Retrieved from: http://www.cnn.com/2013/12/12/world/haiti-earthquake-fast-facts/

Laurent, O. (2015). Haiti earthquake: Five years after. Retrieved from: http://time.com/3662225/haiti-earthquake-five-year-after/

I think this was a very interesting assignment to complete because people really do have such a wide variety of knowledge of their medications. Some people report that they take a “water pill” because of their heart while others might say that they take spironolactone 10mg to reduce their blood pressure. Others might be aware of their medications but simply have too many to keep track of them. As a result, it is so important that we evaluate an individual’s knowledge regarding their medications before we assume they know what their taking and understand why they’re taking it.

Of the five family members and friends that I talked to, I was partially surprised to learn that all five of them were able to give me the name of the medications (both prescribed and OTC) they take and why they take it. On one hand, I was not surprised to find out they all knew this information because this is a medication that you are putting into your body, and you should at least know what it is and why you’re ingesting it. However, from the other point of view, I was surprised to learn that they did know these medications because so many people don’t know the names of their medications or why they’re taking it. They just know that the doctor prescribed it, so they need to take it. In a way, it puts a lot of faith into the healthcare system when errors can happen.

Once I delved into more detailed questions, such as what dose they take, what side effects there are, and what the safe dosage range is, more people started to be unaware of their drugs. One individual knew all the information as he had researched it in depth while a second one stated that she always reads the box before she takes the medications. A third knew everything except the safe doses. The last two knew how many pills they took, but not the dosage, side effects, or safe range. One even laughed and stated that she just always takes two pills, and it’s not a problem. One also stated that she uses herbal remedies in conjunction with her medications, but is not aware if they interact with each other.

The medications that people had lower knowledge regarding were the OTC drugs. The individuals who were taking prescription drugs had a much greater knowledge, and one was even able to tell me the safe dosage range. However, while the OTC knowledge was lower, I do feel that the knowledge about OTC was greater than I anticipated. Both individuals discussing OTC were able to tell me what the generic names were as well as side effects of them. The ability to tell me the generic name was definitely surprising because I feel that many people aren’t aware of generic names, which creates problems with people taking too much of the main drug (e.g. acetaminophen with Tylenol, cough/cold meds, etc.). I was definitely happy with that range of knowledge.

Overall, I feel that the amount of knowledge people knew about their medications did surprise me, but it could be improved. It’s important that people have this information about medications so they can better protect themselves in case changes happen. This could easily be done when we are discussing medications with our patients in the hospital (explain the medications, provide medication handouts, etc.) or our family and friends when they are given a prescription drug or go to take an OTC medication. It is our job to help educate the community, and while we’ve made progress, we can still help improve their knowledge.

In the article “Heart Implants, 3-D – Printed to Order” by Katherine Bourzac, Bourzac (2014) discusses how the science community has advanced to where they are experimenting with 3-D printing to enhance treatment of heart conditions. Scientists have recently used a 3-D printer in conjunction with various cardiac images to produce a 3-D replica of the desired heart (Bourzac, 2014). Using this replica heart, scientists are working on creating thin wrinkle-free sheets incorporated with greater sensing capabilities that will cover the individual’s heart to enhance monitoring (Bourzac, 2014).

It’s inspiring to witness how far science is coming in regards to the advancement of medicine. I greatly feel that the use of 3-D printing will enhance patient care because it will enable doctors to specialize equipment and treatment to the individual, allowing the necessary equipment to better fit within the individual anatomy and ensure that all anatomical areas are addressed. Additionally, as Bourzac (2014) explained, current implanted defibrillators only use a couple electrodes to monitor heart rhythm and could potentially make the wrong decision to shock the patient because of only two monitoring sites. With the use of sheets filled with sensors, hardware such as the defibrillator will receive input from many sites around the entire heart. This will allow more precise treatment that is based on feedback from the entire heart and not just certain aspects of it.

Overall, I think the potential of these scientific advances is astronomical to medicine. Although much can be determined about a patient’s heart from various medical tests and scans, creating a 3-D version of the heart to test theories and equipment and applying additional, individualized sensors on the heart takes more of the guesswork out of the treatment. Patients receiving this form of care will hopefully benefit greatly from this scientific breakthrough.

References:

Bourzac, K. (2014). Heart Implants, 3-D- – Printed to Order. Retrieved from:

http://www.technologyreview.com/news/525221/heart-implants-3-d-printed-to-  order/

I honestly cannot believe that we are already in the last semester of nursing school. I feel like I just blinked, and it was here. People told us when we first started that nursing school was going to go by so fast, but when you’re first starting, it’s hard to believe them.

I’m a little nervous for this course so far just because of all the technological aspects involved. However, I do know that this is going to be a great experience for us in the long run, and it’s just going to take some adjustment to get used to. I have a feeling that I’m going to like it, though. I’m already enjoying customizing my page, and I’m excited for all the different opportunities I can make from it!

One of the aspects that I really like about the course is the way the syllabus and weekly instructions are set up. It’s very organized and easy to understand. I really like how the different parts are hyperlinked for easy access and the homework is laid out for each week. I feel like this organization will definitely make the class better for all of us.

Looking forward to what this class is going to hold for us!

Alyssa

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