Reflecting on just three months shy of three years brings tears to my eyes. Tears of joy, laughter, sadness, and hope. We entered this program as strangers and we are leaving as family. Through the program, it seemed to go by slow; now, the remaining ten days are flying by. Each day, I try to slow it down a bit and take in the moment because nursing school is the greatest experience thus far in my life. I will forever treasure each moment we all created together. I have made lifelong friends and through it all have made substantial personal growth.
I underestimated the nursing profession prior to the start of the program. However, I know now that nurses are truly superheroes, irrespective of the specialty we enter. We have the pleasure of delivering babies, sitting next to those who take their last breath, and everything in between. We change lives every single day. We keep patients alive medically and emotionally. We care for families and have learned to better care for our own loved ones and ourselves. We are advocates. We are the most dedicated group of individuals that I have ever met. Nursing is a profession that I am proud to be part of. If I could afford to do it for free, I would.
I remember how terrified I was to learn my head-to-toe assessment and perform it in front of the lab instructors. Next was the foley catheter insertion. Today, I can perform these skills with my eyes closed. I will forever cherish all the care I have been honored to perform with members of my cohort. I have learned to trust my intuition and my knowledge. I remember learning that there may be a chance we could insert catheters in this semester and I was terrified. However, I have learned that the unknown is what I fear the most. Knowing this, I am ready to move forward and experience what life will bring to my next chapter.
Critical care has been such a wonderful gift as our last semester. I truly believe it is the perfect way to end this program. I have learned more in this semester than ever before; I know now that I am ready for the transition to call myself a RN. I have learned what to do and what not to do. I have gained a myriad of insight into the type of nurse I want to be. I vow not to get “lazy” with my interventions or assessments. I want to change the world one day at a time; as nurses, I believe we can. For me, critical care has transformed me into a butterfly; throughout nursing school, I have been a caterpillar. I am ready to fly.
We have worked so hard to get to this moment. Pinning and commencement is around the corner, and we deserve to celebrate us. All our hard work and accomplishments will pay off with beautiful, fulfilling careers. Amazing job to everyone and a special thank you to each and every instructor we have had as they are such a huge inspiration. They have truly changed my life. I couldn’t have or wouldn’t want to endure this journey without our cohort. Congratulations and thank you for impacting my life. I am forever grateful and I love you all <3
The Chatsworth train collision occurred at 4:22pm on Friday, September 12, 2008, when a Union pacific freight train and a Metrolink commuter train collided head-on in the Chatsworth district of Los Angeles, California. A northbound commuter train, holding mostly Moorpark and Simi Valley residents, collided with a Union Pacific freight train, killing 25 and injuring 135 others; 46 of them were critical. The scene of the accident was a curved section of single track on the Metrolink Ventura County Line just east of Stoney Point. The Simi Valley Acorn writes that according to the National Transportation Safety Board (NTSB), which investigated the cause of the collision, the Metrolink train ran through a red signal before entering a section of single track where the opposing freight train had been given the right of way by the train dispatcher. The NTSB faulted the Metrolink train’s engineer for the collision, concluding that he was distracted by text messages he was sending while on duty.
The crash left 25 dead, including the engineer, Robert Sanchez, who had reportedly sent or received 43 text messages while on duty that day. His last message – to a teenage boy who he had told could operate the train later that day -was made just 22 seconds before the crash. Following the 16-month investigation, the board recommended to the Federal Railroad Administration that trains be installed with audio and video recorders to be assured that railroad employees are following safety rules. This event became the deadliest railway accident in Metrolink’s history. There was more than $7,100,500 in damage.
Responders: this “mass casualty event” brought massive emergency response by both the city and county of Los Angeles, but the nature and the extent of physical trauma taxed the available resources. The captain of the LAFD called for every heavy search and rescue unit in the city. Responders included CEMP (California Emergency Mobile Patrol Search and Rescue) as first responders, requested by LAPD. Firefighters, EMTs, air ambulances, public health officials, sheriffs, police officers, and healthcare providers responded to this event in order to triage those involved. Hundreds of emergency workers were involved.
This disaster is incredibly significant to me because I watched it unfold for hours on my television screen. My education was scheduled to begin the following month, but I knew that I wanted to be there. I contemplated driving to the scene but knew I was not qualified to help even though it occurred less than 15 miles from my home. This is when I knew I wanted to enter the healthcare industry, somehow, someway. Seven years later (today), I would drive to the scene without hesitation. I hope that we are better prepared for a similar event. There was no discussion about Ventura County responders, but I would assume that they could help in any way they could. All I know is that I will be there as a responder who is now qualified to help next time something of this nature occurs!
When thinking about end of life (EOL) care for myself, I find the considerations very different than those for my clients and even for my family/loved ones. At face value, it seems impractical to state my wishes as I am so “young,” but after further reflection, it seems extremely suitable given our knowledge and experience through the nursing program. I know that I would not want extreme measures taken to keep me alive if something were to happen. Although we can state specifics in an advanced directive, such as interventions that are time-specific, I have discussed this topic in great detail with my family members and vice versa. I started asking the tough questions and really taking the time to understand the wishes of my family members and various loved ones beginning in MedSurg II. They understand and respect my wishes as I do theirs, so I feel comfortable leaving the decisions up to them. I feel most comfortable designating my father as my power of attorney. He has medical experience as a firefighter and EMT, which is why my passion for the medical field began at such a young age as I was exposed to graphic pictures, stories, and medical terminology. Although the decision(s) would be incredibly difficult and painful for him, I know that he would be able to speak and listen to a multitude of doctors and other health care professionals in order to make the most rational decision possible about my fate, irrespective of his bias.
Due to my experiences in the clinical setting, I believe culture plays an enormous role in the matter. In speaking to many about EOL care over the last year, I realize that the latest “fad” seems to be that Caucasian parents do not wish to be a “burden on their children.” Most people would choose not to live with their children regardless of their physical or psychological ailments. However, my parents and I had a heavy-hearted conversation about the genuine meaning of those statements and I shared my thoughts on the situation. I stated that I feel opposite from them and if they had a condition of some sort that they needed assistance and did not have to be in a medical facility or hospital, I would want them to live with me despite their feelings. This has been a recurring conversation with both of my parents, but I feel as if we have finally understood each other. They no longer state that they “don’t want to be a burden” on me. I know that each family feels differently and I do not believe there is a “right” or “wrong” way to feel. In fact, I am aware that many families believe the children should always care for their parents. Irrespective of the decisions, EOL care and personal wishes need to be discussed so they can be respected. It should no longer be kept silent, because it may just be too late…
Eight out of ten people did not know what acetaminophen is and similarly, only two people could tell me the generic name of Tylenol. Nobody knew the difference between Ibuprofen, Motrin, and Advil. Only three people claimed they have only heard of the word “NSAID;” nobody knew the meaning and that it was an acronym. With cold remedies, some claimed they have briefly read the side effects but admitted to only focusing on the front of the box, which lists the indications for using the drug; they then follow the directions for how frequently they can consume the drug. Four moms knew that the maximum dose for tylenol was 4 grams/day! Likewise, about half of the people I interviewed said they prefer to use homeopathic remedies mostly for stress, sleep aids, ADHD, and energy. The people that consume daily medications knew the basic reason for taking it such as “for my high blood pressure,” “for my heart,” and “for my anxiety and/or pain.” They were not aware of particular side effects but instead claimed they “feel fine” consuming these medications, but if something changed, would contact their medical provider. Only half of those who consume medications daily were aware of the actual dose. Many people admitted that they stop taking their antibiotics once they feel better so they can “save them for the next time they do not feel well and experience the same symptoms.”
I found that people were more aware of the names of illicit drugs rather than OTC drugs. When I originally asked them about “drugs” they immediately said, “do you mean heroin, Adderall, marijuana, speed and Vicodin?” But instead of just asking them questions, I printed out the questions for each person, folded the paper in half, and answered the questions for them to reference. Education is a priority in the nursing profession. If I was not at their house for the interview, I encouraged each of them to go home and look at the medication(s) they consume or the ones sitting in their medicine cabinet. I asked them to look at the daily dose, maximum dose, indication for use, side effects, expiration date, and generic versus trade name. Additionally I asked them to share the information I provided for them with at least one other person. Education is the key to awareness and as nurses, we need to expand the knowledge of others! 
Due to the advancements of technology, Allie and I thought it would be beneficial to research current cardiac applications available on our smart phones from the patient’s perspective; HeartDecide was quickly discovered. This free application, available for all Apple products, introduced an all-encompassing cardiovascular easy-to-use tool for patients to understand their respective cardiac anatomy, conditions, and procedures. Although this application was released in 2012 by Orca Health, Inc. at Harvard University, it is continuously updating its information with a copyright date until 2015. Once downloaded, the user has the option of entering the application as a doctor, nurse, or patient. We reviewed the information as if we were a patient, browsing to find a specific medical condition. For instance, we searched “heart attack” via the “conditions” tab and found a simple video lasting 1 minute and 32 seconds. In addition, there are written materials provided after the video by swiping the screen to the left. Here we found a frequently asked question and answer section detailing “what is a heart attack,” “what causes a heart attack,” “what are the symptoms,” and “how is a heart attack treated.” Furthermore, there are numerous conditions available to search such as angina, atherosclerosis, atrial fibrillation, sudden cardiac death, heart failure, and many more. We both believe this to be a great informational tool for patients in order to understand more about their clinical condition.