The medical industry is in a period of rapid transition. The technological advances that have occurred in the last ten years is astounding. One can only imagine what is to come. The rapid advances in technology along with health care reform and the millions of aging “Baby Boomers” is a heavy cocktail for not only the amount of change forthcoming in nursing. As the “Baby Boomer” generation ages and the patient population continues to rise, physicians are unable to meet the demands. Therefore, healthcare is relying heavily on nurses and the scope of practice for nursing is increasing. This emphasizes the reasons that the healthcare industry is pushing to produce better educated, and well rounded nurses that will have the ability to take on more responsibility in their care. This will be crucial with the shortage of primary care physicians as nurses will need to step in. The National Center for Health Workforce Analysis estimates that by 2020, the U.S. will experience a shortfall of 20,400 primary care physicians. Furthermore, only 12% of American medical students focus on primary care, while 85% of nurse practitioner students prepare to offer primary care of family medicine. Lawmakers are discussing the expansion of the role of nurse practitioners to make them more autonomous and care for the inundating patient population. However, in order to fill the primary gap, nurses need more education. As the healthcare industry will increasingly rely on advanced practice nurses with MSN degrees to provide primary care for patients, hospitals are also increasing their standards and requiring nurses to have a BSN.

      This only solidifies my desire to continue my education in nursing and achieve my MSN. Through my nursing school career, I have learned the importance and the value of knowledge, research, and evidenced based practice to improve and advance the nursing profession as a whole. I hope that I can some day contribute to our expanding profession as we work to deliver exceptional patient care. As of now, I have not decided what direction to take or where my true passion lies in nursing. However, I do know that whatever I do, I want to make an impact on the lives of my patients and an impact on the nursing profession.  

http://blog.pharmadiversityjobboard.com/prepare-for-the-future-of-nursing-earn-an-msn-today/

    Just over two years ago, on April 15, 2013, two pressure cooker bombs exploded near the finish line of the Boston Marathon, killing 3 people and injuring an estimated 264 others. Although unexpected, the time and location of the event was favorable in regards to healthcare response. For one, hospitals were already on standby for marathon runners and numerous medical professionals (doctors, nurses and emergency medical staff) were onsite at the marathon to address the needs of the marathon runners. Secondly, the 1449 EST explosion happened to also be the time of mid-shift change at surrounding hospitals, nearly doubling the number of medical staff on site.  However, the chaos surrounding the disaster made challenges inevitable.
    One of the major barriers that the trauma hospitals faced receiving the victims was the identification of the victims. Within minutes of the April 15th bombing, nearby hospitals were inundated with unconscious victims without purses, wallets or family members to identify them. At Brigham Hospital, staff assigned unidentified victims six-digit numbers. However, this system  created confusion for the doctors and nurses who continuously had to double and triple check that the test results and medications were going to the right patient. The chaos surrounding the unidentified victims was only exacerbated when frantic and upset family members swarmed hospitals searching for their loved ones. As a result of the attacks on Boston, Brigham Hospital
now identifies anonymous patients using states, colors or the military alphabet.
    One of the most interesting facts that emerged from this disaster in regards to healthcare was the influence that social media had. According to a report by The Boston Globe (2013), the
hospital staff was alerted to the bombings when a physician at the scene sent a tweet. A fellow colleague and anesthesiologist was alerted of the tweet and notified the chief of emergency medicine and the chief of surgery who responded immediately by canceling elective surgeries, clearing ER rooms and calling in staff members. Thus, social media is now understood to possibly be the most effective early warning system, especially in trauma as every minute counts in preparing trauma teams and operating rooms.
    Social media has not only become a means to communicate and relate information, but it has evolved to be an essential multi-purpose tool for various industries. However, in medicine, social media could make the difference between life and death.

      End of life…I find it interesting that our culture does not welcome death as others do. In fact, we seem to be in a state of denial about it. But, it is understandable. Why would we want to think about our wonderful life ending and leaving our loved ones behind? But in reality,  it is going to happen someday, and there is no time frame on it, which is why we need to prepare as though it may be tomorrow.

      Unlike most young people, I unfortunately experienced death early in life. At the age of 13, I lost my best friend in a tragic car accident. I had previously lost my grandparents, however, losing someone so close to me that was my same age was a huge eye opener for me. Mainly, it made me realize the reality of death at a young age. Ever since Annie’s death, my family and I have been very open about discussing death with one another. Over the years, we have talked about different aspects of death. However, I have never actually thought of myself in the situation of actively dying and what I would want.
My overall thoughts about “what I would want,” are really not about me at all. I feel that at that point, it’s about what my family wants and needs in that situation. At the end of the day, I am passing on and my family has to go on living. In any event, I would want the process of losing me to be as easy as possible. My family and I have had small discussions about this topic, however, we have never gone into too much detail. I honestly have never thought it was all too important to discuss because I feel as though they know my overall feelings about the situation (as I have just discussed). However, this semester has opened my eyes to the importance of these conversations. I have witnessed first hand the vulnerability and desperation that families go through when their loved on is ill and the disharmony that it creates within the family. The last thing I would want is for that to occur in my family. So, I have realized that I need to plan and share with my family in further detail what my wishes are- in writing.

When it comes to my family, my step-dad is the only one that takes prescription medications. He has hypertension and hyperlipidemia. Prior to this assignment, I was even unsure what he was taking so it was interesting for me to ask him. Here is a recap of what was said:

Me: “Do you know what medication/s you are taking?”

Ray: “Yeeeea, ummm- let me walk into the bathroom and look at it.”

Me: “Would you recognize it if I said it, or have you never looked at the label?”

Ray: “No, I would recognize it, it’s fairly new becuase the last one I was on didn’t have a generic version so it was super expensive. Ok, its Benicar HCT.

Me: “Do you know what that is or what that means?”

Ray: “Yea, I did ask my doctor and from what I understand, it’s a heart medication with a diruetic to get rid of some of the fluids in my body.”

Me: “Wow, I am impressed. That is right.”

Ray: “Well honey, I only am on one medication. If I was on more than one, I would most likely mix them all up and have no idea what is what!”

Me: “See, that’s the problem that most people face….”

So, my stepdad passed my test! I was actually impressed becasuse he isn’t really the kind of guy that would care too much about the medication he is on. He is more of a “do what the doctor says and don’t ask questions” sort of guy. I thought his comment on him only knowing the medication because it is only on one was interesting. As I told him, that is a major issue with non-compliance today. People have so many prescriptions, they can’t keep them all straight and because of that, the desire to maintain their treatment because they “know” why they need the medication falls to the wayside. Then, they are back in the hospital- a trend that is happening far to often in America. This emphasis once again, the importance of patient education.

      Technology in medicine is evolving faster than ever before. Smaller devices, more effective medications and less invasive procedures are exploding on to the market. One technology on the rise is the use of bioresorbable stents. Up until this point, stents have been made of metal. The drawbacks associated with metal stents is that they are associated with acute and late thromobis, require the use of long-term dual anti-platelet therapy, prevent adequate CT or MRI tests, and interfere with vascular remodeling due to the metal scaffold in the artery. Metal stents also make future coronary artery bypass graft (CABG) procedures difficult, if not impossible (Fornell, 2014). 

      Most bioresorbable stents are made of polylactic acid, a naturally dissolvable material. Bioresorbable stents, as the name implies, break down and are absorbed by the body after a few years (Fornell, 2014). Since the stent is absorbed, it eliminates the risk of inflammation (which occurs with metal stents) that can lead to late-stent thrombosis and restenosis. Furthermore, once the stent disappears, the vessel returns to a natural state of physiologic functioning and does not interfere with any future procedures. Disadvantages to the using polymer include recoil after expansion, stent thickness causing maneuverability, and difficulty visualizing a non-metallic stent on fluoroscopy (Fornell, 2014). 

      There are nearly 15 bioresorbable stent programs in progress, with five in the advanced development stages. Samin Sharma, M.D., director of clinical and interventional cardiology at Mount Sinai Medical Center in New York stated, “Dissolvable stents may be a future game-changer for the way we treat coronary artery disease and heart attack in the United States if proven to show clinical benefit in this nationwide clinical trial” (Fornell, 2014).
Although clinical outcomes and recent data is promising, experts believe that more development and experience is needed before polymer stents become the primary device. Stay tuned…

Reference

Fornell, D. (2014, September). Bioresorbable stents are the way   of the future. Retrieved February 5, 2015, from http://dicardiology.com/article/bioresorbable-stents-are-way-future

      Going into this semester, I was really excited to be back in the hospital working with patients. I have prepared myself for a tough semester and so far, I can guarantee that it will be. However, I feel that I am prepared for the work load and the content this semester and as long as I stay on top of things, I should be okay. My biggest challenge, as with every semester, is balancing school, work and other commitments. Nursing school is not only teaching me nursing skills but also the life skills of “balance”.

   I am really looking forward to bringing technology into our learning experience. I think that it is super important for us to be proficient with technology as our profession is becoming more and more driven by it. I have to admit, I am not so savvy when it comes to technology, so I am grateful that I am being pushed. So, here it goes…

My final semester of nursing school… It is hard to believe that I have come this far. I remember starting this journey towards becoming a nurse and being overwhelmed with what seemed to be a never-ending road ahead of me. But, here I am and in a few months, I will be graduating with my BSN. I am experiencing a mix of emotions from excitement to anxiety to even sadness. As hard as it has been, nursing school has been an amazing experience that I will never forget and always cherish.

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