I cannot believe that pinning is just around the corner. It feels so unreal. I cannot believe I will be walking down the line for graduation, my goals are slowly being accomplished. Such an amazing feeling. When I came back to the program after taking a break due certain reasons, I was nervous because there was no time to fool around since I would not be getting a second chance. I knew I had to do well. To be very honest, I was also nervous about going into a new cohort and I knew I would miss my old cohort very much; but, everyone in 2015 are very friendly and I felt like I was part of their cohort. I want to state how lucky I am to have been part of two amazing nursing cohorts (2014 and 2015). I enjoyed the supportive and friendly nature of both cohorts. My motivation to finish this semester strong is my son because I want to be able to provide a future for him.

Since I haven’t done patient care for over a year, I knew I had to slowly merge into what it meant to be a nurse again. The first day, I made sure I could handle the care of a patient, documentation, and looking at the patient as a whole. I gained some very valuable experiences during the critical care rotation and when I got into the swing of things again, I knew that nursing is what I am meant to do. Not only was I able to practice my nursing skills such as Foley insertion and IV insertion, but I also wanted to assess other aspects of my patients by providing holistic care even just for a day. One of my patient’s thanked me for listening to his story and for not assuming that he was a chronic smoker. This patient had a permanent tracheostomy and people would always asked if he smoked; which was not the case. This clinical rotation enforced therapeutic communication and the importance of just listening even for 10 or 15 minutes. Also, I always told my patients when I would be back to check on them and I stuck by my word. I think it’s very important to assess the patient’s other needs when their physical needs are being met, or assess the physical needs that are not being met outside the home. Our reaction to our patient’s slight physical chance in vital signs, mental status, or other body system changes really do pave the road of recovery for our patient.

The assignments provided for critical care were valuable because it allowed you to dive into how you think and how you process the information. We also got to see how our peers would handle the situation. I want to be the type of nurse that provides safe, effective patient-centered care by focusing on my patient as a whole, looking at aspects on them and being mindful of changes in the patient’s status.

Overall, this semester has been a great experience. I am really happy about the path I chose to take and the obstacles I had to overcome; I have no regrets. I will truly miss cohort 2015, but I know we will all flourish and become great nurses. Not only were my peers supportive, but all the instructors who helped us grow as nurses and taught us to follow our own path. I want to take all the instructors because they helped us spread our wings and fly; they did all that they could to help us keep our wings from being damaged along the way. The nursing program has become another family for me that I will truly miss.

Doctors from Scripps Memorial Hospital La Jolla conducted on the validity of using a Zio Patch to monitor heart rhythms on emergency room patients who may have a possible arrhythmia. A Zio patch is a wireless, ambulatory cardiac monitor that adheres to the skin for 14 days. The purpose of this study was to improve patient care and a way for emergency room patients to avoid unnecessary follow-up care, but also it’s a way to detect patients who have a dangerous arrhythmia in a comfortable manner and is less invasive. Of the 285 patients from Scripps, Stanford Hospital and Scott & White Memorial Hospital in Temple, Texas who entered the emergency rooms with possible arrhythmia signs and symptoms were given a Zio Patch. After the Zio patch is no longer adhering to the skin then patient’s were instructed to mail it back with a prepaid envelope given to them. The doctor would then study the data and follow up on patients who had threatening or different types of arrhythmia. It is also compared to the Holter monitor which is a wired, cardiac monitor; however, it limits the things and is uncomfortable for patients. Furthermore, the Zio Patch is able detect arrhythmia better than a Holter monitor.

The advancements in cardiovascular technology alone is amazing. I did not only look at this website, but others as well from fellow classmates and it is amazing to see how far we are coming. I think that using technology to improve patient care and outcome is important as long as we do not forget to continue to see our patients as humans and not machines. Furthermore, it is important to continue to deliver compassionate care as well. I think that the combination of technology and human compassion will benefit the healthcare industry and consumer satisfaction as long as we do not forget that we are all humans are not seen as the machines (the machines that are or will be keeping us alive). I think as nurses and future nurses we should be aware of the technological advancements that are out there and the advancements in health information applications that are on smartphones. We should review the applications on the mobile devices before we recommend or offer the application as another resource of information for our patients to ensure it is understandable and accurate information.

Reference

http://www.scripps.org/news_items/4217-scripps-doctors-study-novel-new-device-to-diagnose-irregular-heart-beat

On February 2, 2015 I had:

• 1 bowl (about 1 cup) of Reese’s puff cereal with whole milk: Serving size of Reese’s Puffs is 3/4 a cup. Without the milk, total fat is 3g and sodium is 160 mg. 1 cup of whole milk is 9 g of total fat and 130mg of sodium.
• For lunch:
  • half a steak and white cheddar cheese panini sandwich from Panera bread: total fat 18g and sodium is 910mg
  • 1 regular sized (20 ounces) iced green tea. Total fat is 0g and sodium is 10mg.
• Dinner: 1 1/2 cup of homemade Ham soup. I do not know the Fat content and sodium but most of the fat and sodium content would be from the Ham. No extra salt was added. Other ingredients (Carrots, onions, celery, potatoes, and elbow macaroni noodles).
• Snack: 1 bag of mini nutter butters: 115mg of sodium and 6g of total fat
• Other Beverages besides water: Arizona Green tea: 16 fl. oz. has a total fat of 0g and sodium 20mg

After looking through the American Heart Association Website, there are different recommendations on how to change lifestyle habits such as nutritional habits and exercising. The website also offers different languages such as Chinese and Spanish. Looking at what is recommended for a healthy lifestyle in relation to nutrition and exercise, the recommended sodium intake is 2,400 in order to reduce cholesterol; however, the recommended intake for lowering blood pressure is 1,500 mg. Looking at what I had yesterday, if I had eaten a whole panini sandwich for lunch, I have already eaten more than my recommended sodium intake if I were on a low-sodium diet. Furthermore, my patients may not only have poor blood pressure control, but may also have heart problems such as heart failure that may decrease the recommended sodium intake to about 1,200 mg. I think we ask a lot out of patients, to suddenly make changes in there life especially when it comes to eating habits or exercise. I think it is important to understand that we are asking them to make lifestyle changes and that it takes times. I think including the patient into plan of care is important because it will affect them in the long run. Asking them what they will be willing to cut down and what is possible for them to do now. Making smaller strides to conquer the huge milestone. I do not think I could change into a low-sodium, low-fat diet in one day. I think it would take time, but it’s important to find creative ways in order to conquer the smaller strides. For example, I do really exercise as much as I should and I noticed I would have a lot harder time breathing after a short walk up stairs. Also, my 4 year old sister could not walk far and would constantly complain. What I did, was I decided to walk to the farthest park in my community with my sister and son. After about a week, my sister would not complain walking to the far park nor after we played at the park to go home. Not only did I help build her endurance, I built my endurance back up as well. Maybe, our patients have a hard time walking and can only do minimal exercise, and that is where we as nurses have to be creative in order to help our patients make those small strides.

Also, on the American Heart Association website, to maintain a healthy diet, control blood pressure and cholesterol, and maintain a healthy weight, a variety of fruits and vegetables should be consumed daily. Looking at my meal list, I need to tackle that better because there will be some days I eat a lot of fruits and vegetables and on some days it is very minimal the amount of fruits and vegetables I eat. Exploring the website, I have gained a better understanding the changes we are asking our patients to make and things that I have to take into consideration such as the patient’s culture and lifestyle.