It is still hard for me to believe that Pinning is only 3 days away, and I will have completed nursing school! I have worked so hard for so long to achieve this goal and now it is within my reach! It is hard for me to imagine life outside of school. If I am not working on homework or attending class or at clinical, then I can pretty much guarantee that I am still thinking about school or what assignment is due next or mapping out my time so that I can fit is all in. I am so excited to have accomplished this Everest-sized goal. Going through school has taught me that I can be successful at whatever I put my mind to. There were so many times that I felt I would never be able to complete all of the assignments or learn all of the material, but time after time, I did! So many nights I just wanted to give up, but by the grace of God, He kept me going and would remind me over and over again why I wanted to be a nurse.

Going through school I now have a much deeper appreciation for nursing as a profession. I am so proud to be entering the nursing profession on Friday and see it as a great honor! It is something I take very seriously as I have seen throughout these past 3 years the power and responsibility that nurses carry. Power, not in the sense of strength or authority (though they also have these), but in influence over the experience and outcomes of their patients. Nurses have the power to make a patient’s experience the best it can be or the worst. They have the power to make a difference in someone’s life everyday by being present with the person in their greatest time of need. They also carry great responsibility in providing safe and effective care for their patients. Patients and families entrust the care of themselves and their loved ones to nurses. The care nurses provide can mean the difference between life and death for many patients.

When I began this journey 3 years ago, I had some ideas of what type of nursing I wanted to pursue, but tried to stay open-minded each semester except for one area which I was convinced I would never like…Critical Care. I assumed that most of the patients in ICU were intubated and in extremely serious conditions that were too intimidating for me. Since I greatly value patient interaction, I thought I would dislike ICU and would have a very hard time handling the patient situations; however, I was quickly proven wrong. After rotating through the ICU and telemetry, I really enjoyed both areas of care. I loved being able to dive deeper into the situations of each patient I cared for in ICU since I cared for 1 or 2 patients at a time instead of the normal 4/5 to 1 ratio. I was also able to do a lot of nursing interventions and skills that have always intimidated me because I have not had a lot of practice with them and they feel more intense than others. I gained so much confidence in my abilities to coordinate care and assess and intervene appropriately. Overall, this semester has been one of my favorites and I have gained knowledge and experience that have prepared me to enter the nursing profession with a solid foundation that will set me up to succeed no matter what field of nursing I end up in.

Let’s start with a little comic relief…

While Jeff Foxworthy makes a funny joke with some exaggerated side effects caused from medications, sadly, he isn’t far from the truth!  You only have to watch about 15 minutes of tv in order to see a commercial advertising a new medication. The commercials always present the drugs as the quick-fix, miracle pill that will make that specific health problem disappear in a snap. The drug may be effective in treating the specific health concern, but the commercials fail to paint the whole picture of the medication. They  always save the potential side effects for the very end of the commercial and list them off at a barely comprehensible speed, usually ending in “and in rare cases may cause serious injury or death.”  As Jeff Foxworthy so candidly stated, “I’ll just have itchy, watery eyes.”

With the combination of pharmaceutical advertisements and uninformed media coverage of medications, most of the American population approaches prescription medication in one of two ways. They either blindly take whatever their doctor prescribes or their neighbor lets them try because it “worked wonders” for them, or they stay as far away from all medications because they just poison the body. As nurses, we have a great opportunity to step into both camps of thinking and help our patients (and family and friends) have a more accurate understanding of medications so that they can make informed decisions about their health.

For my informal survey, I decided to ask my mom about the medicines that she takes. Thankfully, she does not take any prescription medications and is very healthy. However, she does take some OTC medicines.

-Do you know the names of the medications you take? And why you take each of them?

“Yes, I take ibuprofen for joint pain and headaches. And I recently started taking melatonin at night to help me go to sleep. I very rarely take Tylenol with ibuprofen instead of melatonin. Ibuprofen is the same the as Advil and Tylenol is acetaminophen.”

-Do you know the potential side effects of those medicines?

“Well, ibuprofen can cause stomach bleeding or something like that so I have to take it with food and not on an empty stomach. I took it on an empty stomach when I was also sick and I had bad stomach pain after. Now I always take it with food. I don’t know about any side effects of melatonin; it’s a natural supplement.”

-Do you know if any of those medications interact with each other when you take them together?

“Well, for a long time I thought that ibuprofen and tylenol could not be taken at the same time, but I looked into it a bit and it seems like it is totally fine to take them together. I don’t know about the melatonin.”

I have talked with my mom about some of the medications she takes, so I was encouraged to know that she is understanding and retaining a lot of the information. Talking with her about melatonin reminded me that most people take vitamins and natural supplements without thinking twice about potential side effects or whether or not they even need it  because they do not consider it a medicine. I didn’t know much about melatonin (as a natural supplement) either so we looked it up and made sure it was okay to take with ibuprofen and was appropriate for her to be taking on a regular basis.

I think this was a good reminder for her as well to be more aware of the medications she is taking and gave her some specific key questions to ask before taking new medicines.

AliveCor is a mobile ECG device and app that attaches to a smartphone and interprets the heart’s electrical activity equivalent to a basic 1-lead ECG. While it does not replace the standard 12-lead ECG, it does allow patients to monitor their basic heart rhythms as they go about their daily lives. AliveCor is FDA-approved to detect Atrial Fibrillation and a study published in JAMA has shown it to be able to detect wide complex tachycardia. When used to its full potential, the device and app can track an individual’s heart rhythms as they correspond to daily life. The individual records their ECG tracing then can enter details about their activity, diet, medications, etc. All of this information is stored for later reference and comparison or it can be sent to the patient’s cardiologist by email for immediate review. This device enables cardiologists to gather more comprehensive data about the activity of their patients’ hearts instead of having to rely on office visit ECG monitoring that may not be an accurate reflection of the patients’ varying conditions. As we truly live in a mobile world with increasing use and dependence on smartphones, it is exciting to see healthcare providers begin embracing the use of  smartphones in their practice to improve the health of their patients.

References:

http://www.alivecor.com/home

http://www.alivecor.com/research

Waks, J. W., Fein, A. S., & Das, S. (2015). Wide complex tachycardia recorded with a smartphone cardiac rhythm monitor. JAMA Internal Medicine.

doi:10.1001/jamainternmed.2014.7586.

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