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I can still remember the first day of nursing school, thinking what a long journey laid ahead of me, three years of endless emotions and experiences. Now I am in my last week and it is unbelievable. The sensation seems unreal, time passed in the blink of an eye and just like that nursing school is over. It is an exciting feeling, yet overwhelming.  It is also unbelievable to think we will be transitioning from student nurse to a “real” nurse once we pass the NCLEX. We have learned many skills and it is time to put them to use.

I really enjoyed NRS 420 because it reviewed the majority of med surg content, it was concise and short. The book was very helpful and it had all the “need to know” information, which was pretty much the whole book :). Clinicals helped tie the material together and overall it was a great semester. An ending with a new beginning.

Image Retrieved from: http://www.theguardian.com/world/2014/feb/07/hurricane-katrina-after-the-flood

Hurricane Katrina was the most destructive “natural” disaster in US History. It impacted about 90,000 square miles and displaced over two million people.  The healthcare infrastructure in New Orleans ranked among poorest in the nation and the hurricane greatly impacted the healthcare infrastructure. Hospital basements were flooded and medications, food, equipment and supplies were lost. Electrical systems were destroyed and hospitals eventually ran out of fuel to power their generators. For many hospitals running water was not available and sewage systems did not function and communication was not possible. Food had to be rationed among individuals in the hospital and more problems occurred by additional patients seeking care and other members looking for temporary shelter. There were 16 hospitals in the New Orleans area and 8 were closed permanently. Of the practicing doctors 2,000 of the 3,500 were displaced. The available resources were insufficient to care for the community and affected individuals after the hurricane (Rodriguez and Aguirre, 2006).

The hurricane affected the quality of care of many patients. Not having running water inhibited hand hygiene putting patients at risk of HAI’s. Not having a running sewage system also did not work in their favor. Medications were not available, beds, and chaos occurred. The hospitals were filled to their maximum capacity and they were probably short staffed. The Hurricane depleted all the hospitals stores and not being able to communicate and know when assistance was on their way must have been a frustrating situation. Eventually other states, government, the Red Cross, volunteers, etc… were able to help and it has been a long journey in making New Orleans what it was before the disaster.

I cannot imagine being a nurse in this situation. It must be very frustrating knowing that your patient needs care and you are not able to provide it because you do not have the necessary supplies. Also it would be important to prioritize care and provide comfort measures. Also non-pharmacological interventions would be necessary due to lack of medications. It would be very difficult to be a nurse in this situation, but very rewarding. In order to be able to function properly you need to be organized, calm, and think out of the box. We all need to be prepared for any kind of disaster. After Hurricane Katrina, a few more hurricanes have occurred and the response has been better. I believe that we are now more prepared for any disaster, but we will never fully be prepared.

References:

Rodriguez, H. and Aguirre, B.E. (2006). The impact of hurricane Katrina on the medical and healthcare infrastructure: A focus on disaster preparedness, response, and resiliency. Disaster Research Center (DRC) University of Delaware. Retrieved from: http://udspace.udel.edu/bitstream/handle/19716/2380/Australia%20PP%20-%20Havid%C3%A1n%20DSPACE%20READY.pdf?sequence=1

Death is evident, it can occur to any one at any time. It is important to have a clear understanding of end of life care and what your desires are for when that day approaches. Would you like to be intubated? In a vegetative state? Would you like to be resuscitated or would you prefer to pass away without any resuscitation measures? It is important to have an end of life talk with your family members and the important people in your life. Who will be able to make these decisions for you? Will you write a living will? These are important questions that we should consider and discuss with our family, I did so and the following describes my family’s end of life thoughts.

The topic of death is something I have always avoided. I cannot imagine losing my parents, it brings me to tears. My mom has always expressed her desires to me if something tragic or her death was to occur. She wants to be cremated and not have a memorial service. She does not want me to cry, and she wants me to believe that she has passed away to a better life. She will not be suffering and she would be able to look down upon our family. This may be easy for her to say, but hard for me to believe. The thought of losing my mother is something I cannot imagine. My confident, my best friend, the woman who gave birth to me. I just love her so much that the thought of death is unreal, a reason I believe I would never be able to be her power of attorney nor implement her end of life wishes. My father is the same way. He would like to be cremated, and he would like his ashes scattered in the ocean. My father has never been one to talk about death nor show much emotion. I think it would be easier for me to implement his end of life wishes than my mothers. Why, I don’t know.

In regards to myself, if something tragic was to occur and I was still young I would like to be kept alive. If I have children I would like to be kept alive at all costs because my children deserve to grow up with their mother and father. If I was to have a very low chance of survival it would be ideal to let me go. There would be no point in prolonging my families suffering. I know that my mother would do anything in her power to keep me alive; therefore I would not appoint her as my power of attorney. At this moment I am still unsure of my end of life wishes. It is something that I have to put more thought into and I believe once I have a family of my own I will be able to make a better decision.

It is very hard to have a conversation where end of life decisions are discussed. It is not pleasant and sometimes we are in denial. I am guilty because I cannot imagine my parents passing away. I cannot get over the idea of never seeing my parents or sister; my loved ones being taken away without even saying goodbye or letting them know how much I love them. This topic is difficult for everyone but it is an important conversation that we all must have.