WE FINALLY MADE IT!! Cohort 2016

First and fore most I would like to thank Dr. Jensen, Jaime, and all of our nursing faculty that has taught us all that we know and have created a group of amazing patient advocates.  Because of them we are going into the healthcare field and making a great difference and impact in many patients lives.  Below is a link to a blog post from John Hopkins that perfectly describes the importance of the work we do after graduation.  It sums up all that we hope to be and desire to be, and I am so excited to fulfill that goal.

https://international.blogs.hopkinsmedicine.org/2012/10/15/why-i-cant-say-enough-about-the-importance-of-nursing/

I have learned so much throughout this amazingly crazy journey.  I have found a passion that I am lucky to call my career.  Looking back at all the struggles we have all went through during the program, I cant help but see them as the stepping stones that have pushed us to become the well prepared nurses we will become after graduation.  Nursing school also solidified my love for caring for children which I am very excited to move forward with.  I plan to work my way up into the neonatal intensive care unit and eventually go back to school to receive my NP with an emphasis in neonatology.

End of life care is an essential part of our roles as health care professionals especially when working in any acute care setting where the patient population is of high acuity.  I have learned a lot about my own beliefs in end of life situations throughout my clinical experience.  The hospital is a very intimidating and scary place to be in for both the patient and the family members.  Personally, I have come to realize I would not want to be in a situation where I spend the end of my life in a hospital bed hooked up to tubes and confined to four walls. My family and I have discussed topics such as end of life before and for the most part agree with wanting to live a happy life rather than the length in which it is lived.  Both my grandparents and my parents have a will and legal documents in case of medical emergencies.  I have yet to fill out any paperwork for myself but I plan to in the near future.  I believe it is never to early to discuss the topic and work on those legal documents regardless of what they may be individually and with family members.

Palliative care is such a powerful aspect of healthcare that I feel gets neglected at times due to the stigma individuals correlate it with.  I love that palliative care takes a holistic approach to patient care that is so vital in being a patient advocate.  Patient advocate is the key word in that last sentence.  whether it is for medication regimens, dressing changes, dietary, or end of life care; it is our job as nurses to advocate for exactly what the patients wishes are even if we disagree. It is also our jobs to educate our patients and our family members about any questions they may have about end of life care and connecting them with proper resources.

So the assignment is to discuss medications with our family and friends, to see exactly how well they know their medications.  My mom is very aware of her medications and supplements that she takes. She takes a number of daily vitamins such as vitamin D, vitamin C, ferrous sulfate and vitamin B12 in addition to cranberry supplements for her urinary tract. She educates herself on how it’s affecting and benefiting her body, when to take it during the day, and the safe amount she should be taking. She is a person who always takes the consult from the pharmacologists every time she has a prescription and will call me to discuss it with me.  She was recently on Nitrofurantoin or macrobid.  She was very on top of the reportable symptoms and really paid attention to the side effects.  She is anemic, so she was aware that she may feel more fatigued than the normal person due to her anemia and a drug that induces fatigue itself as well as worsening anemia.  She asked her physician and I about what SJS was.  My mom is a patient that wants to understand what is happening to her body and the medications she takes which in return causes better outcomes.

Assignment:

Interview friends, family members, or coworkers. Ask them to tell you what does “Cardiopulmonary Arrest” mean to them. Ask them if they know what “MI” means? Ask them what they perceive happens during “CPR”. Reflect on your findings and post your thoughts about this to your blog. Feel free to add additional questions if you would like, or educate those you interview if they have any misconceptions.

So I interviewed my mom about what she thought cardiopulmonary arrest meant as well as MI.  Her response was “doesn’t that mean your heart stops and you can’t breath”.  When I used the terminology “heart attack” instead of MI or myocardial infarction, my mom knew what I was talking about.  Furthermore, I asked her what she thought treatment was for cardiopulmonary arrest was.  Her response was CPR and a shock.  My mom has taken a CPR class before so she was knowledgable about that; however, it was interesting when I asked what the defibrillator does for the heart.  She stated, it restarts the heart, kind of like jumper cables.  I feel like that is definitely a major misconception; I educated her on what the defibrillation of the heart really does and how CPR is what brings the heart back into a normal rhythm.

Thursday: February 4, 2016

• (1) apple and peanut butter (w/chia seeds and flax seeds)
• (1) banana
• (1) Brown rice cake
• 16oz. soy chai with a shot of espresso
• Brown rice, broccoli, and grilled chicken – lightly salted
• (1) cup of olive oil popcorn – lightly salted
• Salami, triscitts, and Havarti cheese
• Protein shake with PB2 powder
• Arugula salad with balsamic vinaigrette, parmesan, grilled chicken – lightly salted with a 1/2 cup of red quinoa mixed into the salad
• Chocolate fudge Greek yogurt bar
• ALOT of H2O!

I find that I eat fairly healthy on a regular basis, I do add salt to most meals but in very little portions.  The hardest part for me is to stay away from the sweets and the complex carbohydrates.  However, when I have the time to make a meal I make it as healthy as I can and prep for a couple days so I stay consistent.

It’s hard to believe that in just a few days, we will officially have our BSN degrees! It’s always a happy moment when you finish a semester and realize that you are that much closer to finishing nursing school. Officially completing nursing school this semester, is a mix of emotions as we are closing the book on this chapter in our lives and starting a whole new one. This is our last semester of nursing and after 3 long years of hard work and dedication, it is hard to believe that it is coming to an end. We have all worked so hard to get where we are and now, all of our hard work is paying off. We will soon be working as nurses and beginning our careers as BSN’s.

This critical care course has truly transformed and prepared me for the real world. Before this class, in previous classes, we focused on specific aspects of the nursing profession and worked to perfect it. We have had classes dedicated to fundamentals, pharmacology, medical-surgical nursing, pediatric nursing, mother baby nursing, psychiatric nurse, and the list goes on. Each course has provided invaluable learning opportunities. It is this critical care course that has allowed me to put all of the pieces together and incorporate each aspect into my nursing practice. Rather than focusing on individual aspects of nursing care, I can see patients and their situations in a holistic way. I can effectively incorporate the nursing process into my nursing practice to competently provide the best care possible to my patients. More specifically, this course has provided us the opportunity to care for the sickest people in the hospital. This gave us the opportunity to fine tune our assessment skills and properly prioritize our care to promote well-being and prevent complications thereby improving patient overall outcomes. I have learned so much in this course and throughout nursing school. I am looking forward to beginning my career as a nurse and utilizing my knowledge and skills to improve the lives of patients.

Just this past Saturday (April 25, 2015), the country of Nepal has experienced what has been deemed the worst natural disaster in Nepal’s history for more than 80 years. The Nepal earthquake was a 7.8 magnitude quake that has, so far, resulted in 5,000 deaths and over 9,000 injuries. Eight million have been affected by this disaster, so its effects are dramatic and far reaching. The earthquake has resulted in several offshoot disasters, including aftershocks, landslides and the well-publicized Mt. Everest avalanche. As tragedy strikes, 16 nations have hurried in to come to Nepal’s aid, including India, China, and Israel. The United States has sent several disaster relief teams as well as provided $10 million in assistance.

Despite these international efforts, barriers remain to providing relief to Nepal and surrounding areas devastated by the earthquake. Barriers include unreliable means of communication, the terrain, badly damaged roads, weather (heavy rains), lack of supplies (food, drinking water, electricity, gas, etc.), unsanitary conditions and a continually rising number of injured. Hospitals in Nepal are overflowing with patients and healthcare professionals are running low on medications and surgical supplies. The relief efforts are ongoing for the country of Nepal at this time. They continue to require international assistance as they continue searching for survivors and cleaning up the rubble. The country of Nepal is dependent on income from tourism so this disaster will greatly affect their economic status.

I can’t even begin to fathom what it would be like to be a healthcare provider during this crisis. The overwhelming number of those affected and the destruction of homes and buildings is difficult to imagine. I have yet to participate in a disaster effort, let alone one of this magnitude, but it is essential that we learn from this disaster to better prepare for future disasters. Previous earthquakes and other international disasters have better equipped the world for more efficient and effective response to save lives and minimize devastation. With each new disaster, new obstacles are encountered and hopefully overcame and/or provided a learning experience that will improve the world’s preparedness for the next disaster.

References

Watson, I., Mullen, J., and Smith-Spark, L. (2015). Nepal earthquake: Death toll passes 4,800 as rescuers face challenges. Cable News Network. Retrieved from http://www.cnn.com/2015/04/28/asia/nepal-earthquake/

Shapiro, E. (2015). Nepal earthquake resucue teams en route in wake of devastation. Good Morning America. Retrieved from http://abcnews.go.com/International/nepal-earthquake-rescue-teams-en-route-wake-devastation/story?id=30609810

Mai-Duc C. (2015). Nepal earthquake: 8 million affected, 4 Americans dead; how to help. Los Angeles Times. Retrieved from http://www.latimes.com/world/asia/la-fg-asia-nepal-earthquake-what-you-need-to-know-20150427-htmlstory.html

Pesta, J. and Bhattacharya, S (2015). Rescuers struggle to reach outlying villages hit by Nepal earthquake. The Wall Street Journal. Retrieved from http://www.wsj.com/articles/nepal-rescuers-struggle-to-reach-quake-victims-1430113791

For a class assignment, I took an informal survey of my family members and friends to assess their knowledge about the medications they take. To assess their knowledge, I asked a series of five questions about each medication they take.

1. What is the name of the medication?
2. Why are you taking that medication?
3. How much of the medication do you take?
4. When do you take the medication?
5. What effects do you look for regarding this medication?

In asking these questions, I was hoping to discover whether or not they know the Trade name of their medication or the generic name; if they knew why they were prescribed each medication; if they know the dose they are supposed to take; if they know what time of day they are supposed to take their medication; and both the desired effects and the adverse effects of the medication.

I also asked them about some common over-the-counter (OTC) medications like ibuprofen (Advil, Motrin, Midol), acetaminophen (Tylenol), aspirin (Bayer, Excedrin), and naproxen (Aleve). About half of those I surveyed were very knowledgeable about the medications they take and could correctly answer most of the questions. The other half of the people I surveyed were not as knowledgably and didn’t know that ibuprofen is the same as Advil which is the same as Motrin and that acetaminophen is the same as Tylenol.

When it comes to prescription drugs, whether they knew the trade or generic name of their medication depended on whether or not their prescription medication was generic or brand name. Everyone I surveyed was able to tell me at least one (generic or trade) of the names of their medications and they could tell me what they take it for. The next few questions became increasingly difficult for them to answer. Everyone could tell me how many pills they take and when they are supposed to take it but only a few could tell me the exact dose in milligrams they were prescribed. For those that knew the milligrams prescribed, I further asked them if they knew the safe dose of that medication and nobody was able to answer that. Lastly, I asked my friends and family what effects they look for when taking their medication. I asked them what the desired effect is and what some adverse effects are. Everyone could tell me the desired effect, the reason the medication was prescribed. When it came to adverse effects, most knew the typical nausea and stomach upset but most people struggled with this question.

Overall, I learned that there is a need to improve the knowledge of the community regarding prescription and OTC medications they take. As a nurse, I am going to play a key role in patient education and my goal is to make sure that all of my patients are adequately informed on the medications they are taking as well as the resources available to them if they have any follow-up questions or concerns.