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Event 4: Non-Fatal Strangulation Reflection

Event 4: Non-Fatal Strangulation Reflection

Core Competencies: Communication as well as roles and responsibilities

On October 19th, I had the opportunity to observe a lecture, called “Non-Fatal Strangulation”, presented by Shaun Johnson, University of New England’s Regional Sexual Assault Nurse Examiner (SANE) Coordinator. Although I was aware of strangulation, I did not have a detailed understanding about it or what to look for in a patient; therefore, as a result of Johnson’s lecture, I enhanced my awareness about the different types of strangulation, the effects it has on the human body, signs and symptoms of an individual who experienced strangulation, how to provide patient care for this vulnerable population, and how strangulation impacts different age groups. As a result, I will be better prepared, as a nurse to provide better care for these individuals. Specifically, throughout this reflection, I will discuss how I have gained knowledge to strengthen two core competencies including ‘communication’ and ‘roles and responsibilities’. Overall, Non-fatal strangulation (NFS) is more common than we assume especially with domestic abuse victims, so this education was important for me in my future in nursing.

Johnson went into great detail explaining NFS, and in short, it occurs when one person places excessive pressure around another person’s neck, which compresses the blood vessels as well as the airway, all of which impairs oxygenation. Strangulation can occur via several methods, including the use of hands, body weight, and other appliances to cut off an individual’s ability to breathe. Prior to this lecture, I did have previous conceptions that strangulation referred to an individual using their hands, or another object placed around in individual’s neck. But it could also be a person using their knee, for instance, to block someone’s airway. I knew if a person’s airway is blocked, it can endanger their life. However, prior to this lecture, I was not aware how the term strangulation differs from the term choking which is important. For example, a reference, “he is choking him”, thought to strangulation is not medically considered actual choking. It was my preconception that acts of choking and strangulation could be one in the same, however, I appreciated learning from this lecture that the two terms are medically different. Both mechanisms block the airway, but they are significantly different otherwise. Today, in society, because these words are often used interchangeable, it is important, as a future nurse, to learn to use the proper terminology when referencing the exact mechanism of injury. Although both choking and strangulation impede blood flow and airflow which prevents oxygen from reaching the brain, the term “choking” is caused by a blockage inside an individual’s throat blocking the airway while “strangulation” is caused by an external pressure applied to someone’s neck causing a blockage to the airway.  Thus, after hearing the difference in this important lecture, I recognized how terminology can be used interchangeably these days and how critical it is as a future nurse to increase my awareness about differences when referencing mechanisms of injury because it is critical for proper diagnosis and treatment. Although this may seem minor in general use, using proper and accurate terminology in the medical field is of utmost importance, so there is no miscommunication when providing and planning patient care as well as during discussions about strangulation or choking with other members of the medical field. As a result, I have strengthened my communication skills, which is a core competency.

In addition, during this lecture about non-fatal strangulation, I learned how to identify victims by assessing signs and symptoms of strangulation. This is an example of strengthening the core competency of roles and responsibilities of a nurse, specifically associated with assessing for manifestations of strangulation. These include a raspy and/or hoarse voice, coughing, the inability to speak, the total loss of voice, swallowing impairments, neck edema, drooling, and nausea/vomiting. It can also lead to strained breathing, hyperventilation, and life-threatening inability to breathe. In addition, there can be brain trauma including subsequent confusion and memory loss. Lastly, strangulation can also lead to seizure which was new information to me.

Accordingly, because I was able to participate in this lecture, I have enhanced my skills and knowledge on how to provide optimum care to strangulation patients which is important in my future practice as a nurse. I understand now that a strangulation patient’s traumatic situation is difficult, so as part of their support system, I will be graceful, empathetic, and provide any form of support they may need. I will lend a helping hand and be a good listener which I understand can provide comfort in violent cases such as NFS.

In addition to being compassionate and gentle with NFS patients, Johnson expressed the importance of proper questioning during assessment. By learning about proper questioning, I have strengthened both core competencies, roles and responsibilities as well as communication. I learned that getting critical information will not only help with an optimum care plan, but it can help with the prevention of future events. I will tailor my questions so that they are gentle but effective including, who was inflicted their injury; where did the event occur?; how were they strangled? (object or hands/which direction/how often/duration); what positions were both of them in?; where specifically did they feel pressure on their neck?; was this the first time or occur prior times?; any preexisting neck surgeries/injuries?; was the person wearing a ring?; how long did they hold your neck/throat?; was there shaking involved; how did the attack stop? what are their current symptoms?. The goal is to be as thorough as possible, so all these questions are imperative to ask to comprehend the patient’s situation/condition so as a nurse, I am better able to provide the appropriate care and to allow information to be documented for legal purposes in the event the matter is pursued.

And, lastly, because NFS is so traumatizing, I learned from Johnson’s pertinent lecture that it is important to assess and offer any applicable resources according to the patient’s needs including consultation with a social worker, law enforcement, counseling, support groups as well as resources for the patient’s family as well. Because strangulation is usually the result of a violent crime, I understand now how vulnerable these patients can be following an event. Therefore, my role as nurse is not important not only in a strangulation victim’s physical care but their emotional as well.

Event 3: Needle Exchange Program Reflection

Event 3: Needle Exchange Program Reflection

Core Competencies: values and ethics as well as roles and responsibilities

The presentation, Needle Exchange Program, delivered by Kerri Barton, was a wonderful opportunity to learn about the harm reduction and substance use prevention services in Portland, Maine. Substance use disorder (SUD) is a chronic disease involving the inability to control one’s use of legal and illegal substances such as street drugs, alcohol, or medications. SUD is a challenging disease to overcome, and it often takes various treatment interventions and numerous attempts to achieve long-term recovery with many individuals relapsing multiple times and some never fully recovering. Typically, individuals suffering from SUD are in and out of treatment programs throughout their lives. Therefore, harm reduction is critical for these individuals to alleviate the negative social and physical consequences of substance use. Harm reduction incorporates strategies that promote safer drug use, abstinence, and it is about bringing people together who use drugs for support in their continuum of recovery and ensuring that they are safe throughout the process. Harm reduction has been shown to reduce drug-related deaths, life-threatening infections due to unsterile needles, and chronic diseases such as hepatitis and HIV. 

For this section, I am going to focus on how this lecture is associated with the core competency of ‘values and ethics’. Prior to this lecture, I was aware that harm reduction concentrates on a set of practical strategies that are directed at lessening the negative consequences associated with substance use disorders with particularly focus on six generalized principles utilized in health care, including humanism, pragmatism, individualism, autonomy, incrementalism, and accountability without termination. However, my preconceived thoughts about harm reduction and the Needle Exchange Program focused primarily on ways to educate the public on the harms of illicit and licit drug use and to prevent harm from happening to individuals suffering from SUD, but truly, this program focuses on the fact that society needs to accept, for better or for worse, that drug use is a phenomena, whether illicit or licit, that needs to be managed. It is a public health crisis that cannot be ignored. Thus, in this lecture, I learned that these programs focus on working to reduce SUD’s harmful effects instead of overlooking or condemning them. Although this program does supply aid to help those with treatment and recovery, it is not simply preventing drug use from occurring and forcing people into treatment but educating individuals on safer ways to use drugs and allow them access to resources to keep them as safe as possible to reduce harm from happening. The programs also promote wellness and recovery. Harm reduction is a strategy involving approaches that engage directly with those suffering from SUD’s to prevent overdoses and infectious diseases while improving the physical, mental, and social well-being of those suffering and to offer substance use disorder treatments and health care services. As a nurse, I intend to educate those suffering from SUD about various proactive and preventive programs. I will work diligently to assist people to find harm reduction services such as the needle exchange program to help them reduce risks such as overdoses and transmissible diseases.

Regarding values and ethics, one important takeaway I learned from today’s lecture is that health and health inequalities play a huge role in substance abuse, which I believe is not readily acknowledged by the public and it should be part of the discussion. For example, poverty, trauma history, gender discrimination, class, race discrimination, and several other social inequalities play a crucial role in affecting an individual’s vulnerability to substance abuse and can also affect how successful or unsuccessful they may be in accessing/continuing treatment and achieving recovery. Lack of education, and support mechanisms as well as socioeconomic disadvantages often influence SUD outcomes. As a nurse, I will therefore, ensure that I assess all these factors for a patient suffering from substance abuse and will take efforts to assist them to access treatment throughout their potential recovery. 

Furthermore, as a nurse, I will ensure to implement many techniques I have learned today and include them in my patient care for those suffering from SUD. I will ensure to uphold the roles and responsibilties associated with a nurse working with those suffering from SUD. For example, I consider including harm reduction by promoting access to safer use supplies and use of drugs counseling on how to be aware of and respond to an overdose- blue lips and nails, slow, shallow breath, slurred speech, and pinpoint pupils. Also, I will discuss antidotes such as naloxone to reverse the effects of an overdose. Finally, I would educate the individual to seek assistance immediately in such a situation if needed. I would also help with access to community-based groups, counseling, etc., to help them with recovery and treatment. I would also teach them prevention strategies, such as never using drugs alone, reducing the frequency and intensity of drug use, going slow when using a substance, and testing it first because strengths can vary. Overall, because of this excellent presentation, I have learned to do all I can to assist my patients in achieving the best outcomes possible for each individual. Therefore, this lecture reflects the roles and responsibilities of a nurse working with patients who have SUD as well as the ethics and values associated with these situations.

Event 2: Aging and Wellness Reflection

Event 2: Aging and Wellness Reflection

Core Competency: roles and responsibilities

Throughout the presentation, “Aging and Wellness”, I learned about the eight dimensions of wellness as well as the concept of resilience in the context of aging and wellness. With aging, it often comes with the assumption that aging is a disease that should be treated with medicine. However, the eight dimensions of wellness for aging adults offers a holistic approach by focusing on the whole human being including mind, body, and spirit. Specifically, the eight dimensions of wellness are interconnected, which include the areas of developmental, physical, emotional, relational, contextual, vocational, spiritual, and cognitive. As individuals age, they often experience challenges and adversities, which may negatively impact one of the dimensions of wellness; and in turn, this can have the potential to impact all areas of wellness and well-being. Thus, it is of utmost importance for a nurse to identify an aging client’s challenges to counsel them to find strength and resilience as well resources needed to overcome any struggles they are facing. As I have learned in the lecture, resilience is a construct in geriatrics that contributes to an older adult’s ability to identify and overcome adversities that may affect their eight dimensions of wellness and to positively adapt to these challenges in order to strive for harmony and balance as they age. Notably, resilience of an older adult is not that they are not experiencing challenges and suffering within these dimensions, but it encompasses the ability to identify the areas of weaknesses and pain to work through such adversities they are facing to achieve their greatest potential to achieve harmony within themselves. Geriatric patient care involves awareness, empathy, and action in order to assist aging clients to experience healthy and fulfilled lives. Throughout this lecture, I will be discussing the roles and responsibilities of a nurse working with the geriatric population, which is a core competency associated with the honors distinction diploma.

For example, as a nurse I will be certain to assess all dimensions of wellness, but for the purpose of the reflection today, I will be focusing on two dimensions: emotional and relational. Thus, this lecture has allowed me to reflect on the roles and responsibilities of a nurse working with the geriatric population. In this lecture, I learned that the facet of emotional wellness focuses on the ability of an older adult to adapt and manage the many stressors life bring while at the same time being hopeful about what the future holds as well as being resilient in the face of adversities. Hopefulness is important to well-being because goals and dreams instill a desire thrive. This is extremely important to patient care because having poor emotional wellness has the potential to impact all areas of wellness. A person’s inspirations and drive come from their ability to see themselves as contributors to society. Without continued goals and aspirations, an aging adult can become hopeless and their ability to strive for wellness and longevity can decline. Thus, the information regarding emotional wellness that I have learned today will be applied in my future nursing profession. For instance, I will assess the client’s thoughts, feelings, behaviors, self-esteem, and coping mechanisms. While, at the same time I will provide ways for the client to manage these qualities in healthy ways when they are experiencing the stress or emotional pitfalls that life can present in order to help promote positive emotional wellness which can lead to physical well-being. Lastly, I will encourage my aging patients to ask others for help whenever necessary and not to feel ashamed about weaknesses experienced during the process of aging. Overall, individuals advancing in age should focus on their strengths while simultaneously recognizing any weaknesses, so they can reach out for help and support as needed.

In addition, achieving relational wellness is also extremely important to assess in an aging client. Relational wellness focuses on the client’s support network including family, friends, peers and even their medical providers. It also involves their connection with their community. Sometimes older adults feel isolated and not connected with those around them on a social, physical, and emotional level. Thus, the risk of isolation is strongly associated with a decline in emotional well-being which can result in mental health conditions like depression and anxiety. Emotional and mental health is as important as physical, and together, they need to be considered when providing geriatric patient care. Relational wellness is important to ensure positive emotional health, so aging patients should be encouraged to stay involved with family, friends, and community, but at the same time health care providers should also be aware if their aging patients are feeling alone and isolated. Both emotional and physical health are intertwined and critical to how well people age, so healthcare providers need to monitor their aging patients carefully. Thus, the information regarding relational wellness, I have learned today, I will apply in my future nursing profession. As a nurse, I will ensure to assess a client’s support network, whether they feel connected to others in their family and community, and whether they have a sense of belonging. I will encourage them to reach out to others for support when in need, participate in family gatherings, social groups e.g., book clubs, and even volunteer groups. I will provide resources for support if a patient’s emotional and relational wellness is concerning, and I will be empathetic and a good listener. Sometimes lending an ear and offering a gentle hand can be the best medicine, so I will be sure I pay my patients close attention, talking to them about their concerns and provide helpful encouragement and advice as needed, so they can lead the best lives possible well into their old age.

Event 1: Exploring Childhood Obesity

Event 1: Exploring Childhood Obesity

Core Competency: Roles and Responsibility

Before this lecture, my pre-existing beliefs surrounding childhood obesity were that obese and deconditioned children suffer primarily physical effects, such as cardiovascular disease, diabetes, and respiratory conditions (e.g., asthma). However, this lecture brought my attention to the impact obesity has on a young child’s mental and emotional well-being, which can begin at very young ages. In the lecture, we learned negative weight stereotypes often begin as early as pre-school age and can be stigmatizing throughout a child’s lifetime. Childhood obesity can cause isolation because obese children often withdraw from making friends and joining social and sports activities. Consequently, these children are more susceptible to depression, anxiety, lower self-esteem, poor body image, and weight-related victimization from bullying can make matters worse. Thus, as nurses, it is crucial that we address childhood obesity when providing treatment to children and their parents to help implement preventative interventions so that obese children can live healthier and happier lives that will continue to adulthood. Thus, I will be addressing the roles and responsibilities of the nurse in regards to childhood obesity.

Overall, many factors contribute to childhood obesity, some of which I was unaware of before attending this presentation and some I have learned throughout the lecture. For instance, stigmas and biases surrounding childhood obesity include the assumption that childhood obesity stems from poor diet and low levels of physical activity. It is easy to assume that lack of exercise, and poor diet is the primary roles in obesity; however, those two factors are not always the leading contributors to childhood obesity. Several other factors are associated with the increased risk of childhood obesity, such as genetics, race, socioeconomic factors, and family influences. Thus, multiple disparities play a huge role in contributing to and preventing childhood obesity.

Regarding socioeconomic factors, good health is often unattainable. Medications and healthy foods, such as fruits, vegetables, and lean proteins, are expensive. The lack of access to these healthy foods can majorly contribute to childhood obesity. Processed and fast foods are more affordable and easier to attain, but they are loaded with saturated fat, sugar, and carbohydrates. Diets high in processed foods are known to lead to obesity. Also, the cost of health insurance can be high, making it difficult for some families to purchase it, and if they do have it, some insurances do not cover certain medications. So if parents cannot afford the necessary medications, children suffering from health issues may go untreated. Wellness is essential to good health, so a lack of good healthcare too can contribute to childhood obesity. In addition, low-income families often live in disadvantaged neighborhoods where healthy foods are hard to find. Instead of full-service supermarkets in some communities, fast-food chains and convenience stores often provide cheap, high-fat foods. This is detrimental to good health, and those providing such foods gear their marketing to such communities and help contribute to children’s weight issues. Families often cannot afford healthy food, and food insecurity concerns many communities. Schools and governments try to assist, but the lack of access to healthy foods is a massive problem for lower socioeconomic communities. Stress and emotional issues are also vital factors associated with increased weight gain and metabolic issues. Children in insecure neighborhoods or unstable homes often deal with increased stress, fear, and anxiety, leading to emotional eating and obesity. Furthermore, some forms of childhood obesity may be inherited due to changes in a single gene, such as a commonly implicated gene known as the MC4R.

Additionally, the lecture focused on many barriers to treating childhood obesity, which deepened my awareness and understanding of childhood obesity, and how I can apply this in my future nursing practice. Thus, as a nurse, I will ensure that I consider and address the barriers discussed in the lecture. In addition, I will work to raise awareness and implement interventions to help lessen childhood obesity and related stigmas. Some strategies for managing/resolving health and healthcare disparities that may affect affected populations that I will implement will include recommending healthy food choices. I will also help find resources that can be accessed to attain healthy foods for a well-rounded, balanced diet. Also, I will promote physical activity and make suggestions for exercise routines and how to make simple lifestyle changes to increase activity. I will facilitate family involvement, which can help promote wellness, benefit the entire household, and promote changing behaviors associated with positive eating habits and increased physical activity. I will make every effort to try to recognize if lower-income families are struggling to assist them better in combatting food insecurities and to help them access pertinent medication when in need. Finally, I will be committed to helping overcome healthcare disparities. My goal as a nurse is to be understanding, aware, and committed to wellness so that all children have the best advantage for healthy, stable, and thriving lives.

Mental Health Simulation Reflection

Mental Health Simulation Reflection

Being involved in the mental health simulation, on August 4th, 2022, was an incredible experience. Throughout my experience working with individuals with mental illness this semester, at Spring Harbor in Westbrook Maine, I have not yet encountered patients with severe suicidal ideation, schizophrenia, borderline personality disorder, or a significant pattern of alcohol use as I did in the simulation. Although the four patients were actors in the simulation, they were incredible and truly appeared to be real patients whom I was able to access and interact. Their appearances, mannerisms, behaviors, and communication styles accurately depicted patients suffering with mental illness. With each patient, I faced anticipated challenges as all of it was unfamiliar territory for me but in the end the process was a success. The simulations were an insightful and knowledge gaining experience for which I am incredibly grateful.

One of the major challenges I experienced was that every patient is so different, so the nursing approach for gathering information is varied and individualized for each. In this way, I have learned that the nursing process for every patient is incredibly unique, even for those patients who share similar conditions. For instance, the patient with schizophrenia was uncommunicative and extremely distracted by auditory hallucinations, so receiving information was exceedingly difficult. Prior to the simulation, using the case study we received a week earlier; I formulated multiple questions to ask the patient in the domains of psychological, biological, and social. Prior to interacting with the patient, I had assumed I would be able to ask these questions and receive information easily from the patient, however, I soon realized it was the furthest from the truth. From then on, I learned how difficult it can be to obtain information from some patients. As a means of overcoming this challenge, my group and I strived to establish an early rapport with the patient, so they could feel engaged in the conversation and feel more comfortable opening up about their current situation. Also, we would reorient the patient to keep them engaged, and we would repeat the questions in a different format if the patient had difficulty answering some of them. The simulation raised my awareness that reorienting is important with some patients, and this will help prepare me for future experiences in the nursing field. I recognize that I need adapt unique styles according to the patient’s needs to reach the best possible outcome.

Additionally, by participating in this simulation, I have learned the importance of regulating my internal feelings when working with patients as our own personal judgements and bias can be a barrier. I did not feel as though I was being judgmental, and I try to be empathetic but sometimes, I feel frustrated and anxious working with some patients, such as the borderline personality disorder as well as the alcoholic. Both patients were lucid, yet they were in denial they have medical conditions. For the sake of the case study, they were sent to see us by their family members and did not willingly want to receive help. It was challenging because it was frustrating that we were trying to help patients that do not want to receive help. They were reluctant to talk about their current situations and felt as though there was nothing that could help them, primarily because they did not believe they needed help. However, after a period talking and counseling them about support groups, medication, and therapy, both patients in the end agreed to begin treatment. Because of this simulation, I realize that I need to be patient with some patients because their perceptions are not always reality. It is important to adapt and consider various presenting options to establish trust and instill hope with the patient while at the same time establishing a rapport that builds a relationship which is one of the keys to helping guide the patient towards appropriate care and treatment.

Overall, through this rewarding simulation, I have learned that the nursing process is individualized for every patient. Being understanding, flexible and adaptable is key to developing a needed rapport with a patient to achieve the desired outcome. After completing this simulation, I feel more confident how to address mental health issues that I may face in a clinical setting. I am better prepared to manage complex situations with patients suffering from mental illnesses and that adjusting my nursing style is important to provide comfort and to assist patients.

Medication Reconciliation Reflection

Medication Reconciliation Reflection

  Through the process of completing this medication reconciliation, my client gained a greater understanding about their medications and the potential for adverse reactions as well as about the importance of safe medication administration. In the same regard, I gained a greater understanding of the purpose of the various medications and the risks associated with their potential side effects. I learned how to counsel a patient regarding their medication use as well as how to best educate a client regarding safe and timely medication administration which is so beneficial in preparing me to be a nurse in the field. This was not only critical to my education, but it raised important awareness about the combinations of medications and how they can impact patients uniquely based on their individual needs and circumstances. Subsequently, in this reflection I will highlight on the key concerns that were discussed with the patient and provide a brief overview of my medication reconciliation paper.

   Overall, the client was aware of the purpose of each medication and counseled how to take their medication as well as the potential for adverse reactions. The client was familiar with Allegra as well as Adderall. However, the patient was a bit unfamiliar with safe medication administration regarding Synthroid. The client was unfamiliar with the adverse reactions of some medications that could potentially cause them harm. For instance, the client was not aware that Lexapro causes weight gain as well as potential sedation with the consumption of alcohol. As a result, the client stated that he will be cautious of their alcohol consumption to avoid potential harm. Furthermore, they are committed to eating a healthier diet as well as exercise more frequently. 

  In addition, the client was unaware of the importance of safe medication administration regarding Synthroid, their thyroid replacement medication. The client admitted that they do often forget to take this medication, and as a result they will take 2-3 pills sometimes within a day to make up for their missed days. The client was not aware that they could experience adverse reactions because of this, and I counseled the client that the need to post reminders to ensure they take this medication each morning with only water and 30-60 minutes before other food, drinks, and medications to ensure safe medication delivery. Likewise, the patient also shared that he often takes a higher dosage of Adderall than prescribed somedays, and I informed him about the cardiac complications that can arise as well as all the other adverse effects associated with all his medications. We discussed at length the importance of lifestyle modifications in adherence to the recommendations and warnings associated with all their prescribed medications.

 Overall, this was an insightful experience for both me and my client. Understanding the purpose of medications, their risks for potential adverse effects, the importance of a healthy lifestyle and safe medication administration was a vital lesson for not only the client but for me as well. It was rewarding for both of us to gain this new awareness that will help ensure the patient’s health and safety going forward.

Experiential Nursing Summer 2022

Experiential Nursing Summer 2022

Service-learning Project. “Run Across America“. The priority focus was to advocate for and help those facing hunger across America.

Over the course of this semester and continuing through September, I have had the privilege of participating in a collaborative service-learning project, Run Across America, which is a social enterprise that began in May 2020 because of the pandemic. Run Across America was formed to support causes, such as feeding vulnerable families across America, those who are food insecure because of COVID-19. Since its inception, there has been as many as 68,000 participants who have raised money and resources to supply more than four billion meals annually for individuals and families facing food insecurity in our communities and across the country. Because countrywide lockdowns resulted in unemployment and businesses closures, the pandemic has created widespread food insecurity especially in families with young children. For the last two years, the everchanging COVID-19 virus has progressively changed our society and taken a toll on our economy. Consequently, two social determinates that I have advocated for during my involvement with Run for America includes economic stability as well as increased health and healthcare. Many citizens cannot afford food or healthcare, so my efforts with Run Across America has been rewarding, and I am grateful for this positive opportunity because it has allowed me to help not only my community but those in need across the country.

Joining Run Across America, I signed up for the event early this past July with members of my family, friends, and peers with the goal of completing a total of 50 km (about 31.07 mi) or more of running, walking, or bike-riding by Labor Day and ultimately raising money for individuals who are food insecure. As a group, we have run in neighborhoods all over Falmouth and Portland as well as Mackworth Island, Back Cove and Eastern Promenade Trails all located in Maine. We have already made great strides by exceeding the hours of 8-10 required for this course, and I am excited to continue my efforts for this wonderful cause. Overall, this service-learning opportunity aims to immerse us in the community to provide valuable support while promoting emotional, physical, and mental health for those facing hunger today. By helping those in need, as an Interpersonal Practice (IPP), our coordinated effort is also consistent with the values and ethics inherent in nursing. It has been our goal to help reverse the challenges of hunger by providing food to those in need while at the same time promoting a healthier lifestyle as well. In doing so, I have had the opportunity to deepen my understanding of IPP and I have strengthened my skills involved with the roles and responsibilities in collaborative practices including values and ethics for interprofessional practice, interprofessional communication, interprofessional teamwork and team-based care.

Throughout my experience with Run Across America, I have worked closely with family members, friends, and peers to learn about and assist individuals facing food shortages, poverty, and hunger within my community and across America. This effort has simulated my future in the interprofessional world of nursing. As a group, we delegated roles and responsibilities to ensure our efforts were successful. They pertained to deciding about the running/walking trails, maintaining suitable time management, supplying snacks and water, as well as the assignment of a leader who focused on the overall coordination of the event. At the same time, effective interprofessional communication was utilized which increased efficiency and fostered us working better as a team. For instance, we created a telephone group-chat in which we could designate times and locations, and every Sunday, we developed a weekly plan of action. In addition, we communicated online each night to ensure everyone was aware of developing details. This ensured there were no miscommunications, everyone showed up on time and was prepared which made for a smooth implementation of our plan.

Our effort with Run Across America is an example of how an IPP collaboration with effective communication can facilitate a positive outcome for those in need within our communities and across the country, such as those facing food insecurity. Although the communication was within our small group to raise awareness of the issue of hunger, additionally we can further communicate with others within our community to advocate for marginalized populations. To further facilitate positive outcomes for individuals in need, we could utilize social media platforms, such as Instagram and Facebook to raise awareness about the benefits of Run Across America, so others may join this wonderful cause and raise additional money and resources for those in need.

Consequently, this rewarding experience, Run Across America, has further educated me on the benefits of IPP and I now recognize that IPP is highly focused on working together cohesively to explore and improve values and ethics while striving to make a positive impact on the lives of individuals in need in our communities and across our country.

NSG  315 Skills Lab

NSG  315 Skills Lab

Bowel Diversion/Ostomy Reflection Assignment

The purpose of an ostomy diversion is to allow a person to pass stool safely from the body when experiencing a diseased part of the bowel, or a segment of the bowel is removed due to injury or disease, to allow the bowel to heal adequately. If the diagnosis is severe, it can be permanent in some cases. An individual living with an ostomy diversion faces many physical, emotional, and psychological challenges that many people are unaware of because most have not experienced this life-changing event. Therefore, the purpose of our assignment was to wear an ostomy pouch filled with materials that mimic fecal matter so that we, as students, can better understand and experience what it would be like to be an individual living with an ostomy appliance.

 Prior to wearing the ostomy appliance, I was aware of its importance for an individual’s physical well-being. However, I was unaware of the multiple challenges an individual encounters with an ostomy for bowel diversion. For instance, my previous personal perception of the challenges one would encounter primarily pertained to managing the ostomy appliance itself, including the physical discomfort of the appliance, preventing a breakdown of the skin surrounding the stoma, and the need to empty or change the ostomy pouch frequently. But, of course, as a nursing student, I was aware of the psychological impact an ostomy may have on an individual. Still, I was not consciously aware of how impactful it could be on their daily living experience. Therefore, wearing the pouch for only a day was an insightful experience for me and one I am grateful for because this simulation raised my awareness of a person’s challenges physically and emotionally. When an individual undergoes an ostomy, they have to function in a new way, which can be an uncomfortable adjustment. As a result, it raises serious concerns, including maintaining good hygiene, managing daily routines, and dealing with the stigmas involved. Thus, as a nurse, I will ensure that I not only care for the physical needs of a patient with an ostomy appliance, but I will also pay great attention to their psychological and emotional needs. This critical experience gave me an understanding of how difficult the transition is for a new patient with an ostomy device. Each person is unique in their experience; as a result, this insight will help me provide the best care possible for my future patients.

The minute I put on the ostomy appliance, I had so many questions. Will anyone see the pouch under my clothes? Will there be a smell? Can I resume normal activities? The questions were endless, and I understood how a patient undergoing an ostomy could feel awkward and uncomfortable due to the overwhelming changes in their life. I can only imagine how challenging it must be for a patient to have to learn to look at the stoma, apply and empty a pouch, maintain proper skin care and hygiene, and manage any complications related to the device. The new responsibilities for caring for themselves are daunting and scary. I felt a little sad initially for anyone facing this experience. Although I was part of a simulation, I realized this could realistically happen to me, a family member, or any of my future patients, and I needed to completely grasp the whole experience.

Admittedly, I was very self-conscious on the first day I wore the ostomy appliance. I thought everyone was looking at me and could see my ostomy appliance and realized this is how my patients will feel. I wore a loose-fitting shirt over my yoga pants and rested my arm over the pouch so no one could see it. It was not only that I was self-conscious, but the bag itself was uncomfortable under my tightly fitted stretch pants. I realized clothing is key to comfort both physically and emotionally.

Regarding the physical experience, the first day wearing the bag caused my skin to feel itchy and irritated, especially when it got wet after my shower. Thus, this observation will allow me to adjust my nursing care priorities, interventions, and client education based on this knowledge. In addition, I will encourage my patients to keep the stoma clean and the skin around the stoma dry to prevent skin breakdown and irritation. Also, I will educate my patients to empty the drainage bag when it is one-third full to prevent it from leaking, which can further prevent skin irritation. Aside from the physical discomfort, I did not feel like myself for the first few hours and wanted to avoid my regular activities, such as seeing my boyfriend, going to the gym, and grocery shopping, because I was embarrassed by the ostomy appliance. I felt like it was so obvious I was wearing it. Like many new patients with an ostomy appliance, I was experiencing facets of a disturbed body image. I felt anxious, and I was frustrated with the way in which it was impacting my life, and I wanted to withdraw from my daily activities. Because of this experience, I have gained a greater understanding of the emotional impact the ostomy appliance will have on my patients, which will allow me to provide improved client care and education in the future. I now recognize that one of the most critical care considerations I must employ as a nurse is to identify how drastically an individual’s perception of their body image is impacted. I will ensure to emphasize that coming to terms with a new stoma and ostomy appliance is a vital part of the healing process, but too, I will be sure to validate their feelings of concern and empathize with their fears. From my experience of only a day, I was extremely discouraged initially. My world was completely different and if I had an ostomy appliance attached for months while I healed, I know I would need support to adjust to my new situation. Thus, I will reassure my patients that adapting may not happen quickly and I will reiterate that learning to accept their new body is a gradual and sensitive process. As needed, I will encourage patients to seek support from loved ones and join support groups with others who are experiencing the same journey.

After wearing the ostomy appliance for several hours and adapting to it a little more, I realized that I could do many of the same activities before wearing it. For example, although hesitant to go to the gym at first, later that evening on the first day, I attended a local gym near me, Planet Fitness. I felt confident in my skin with the proper clothing, and it was physically more comfortable. Nevertheless, it was a difficult adjustment. Due to the weight of the ostomy appliance on my stomach, I chose to walk for a few miles on the treadmill instead of running. I also chose pants with a band to support the ostomy bag on my stomach as I feared it would fall off as I walked on the treadmill. After a mile or so, it did start to feel more comfortable. I was also fearful that individuals around me could smell an odor from the ostomy appliance. However, I learned the fear of going to the gym was far worse than my experience.

Furthermore, this experience at the gym gave me further insight into client care and education. In the future, as a nurse, I can share with my patients how to make accommodations to raise their confidence, as did the clothing that helped me to adjust to wearing the ostomy appliance. If they are able, I would recommend non-tightly fit clothing, such as stretch pants, yoga pants, or athletic shorts for the first few days if the patient feels uncomfortable with their new ostomy appliance. I would also address foods available that help prevents gas and odor of the ostomy appliance to ease their concerns. Eating a lot of leafy greens and avoiding gassy foods, such as broccoli, Brussel sprouts, cabbage, and gum, can be highly beneficial. I wondered what I could eat and learned that I could eat anything, but as with any food, they digest differently, and a patient should treat food like they would typically to lead an active life. For example, suppose spicy food, for example, bothered them digestively before the ostomy it will bother them afterward. So, if they have special activities planned, I can suggest they may want to avoid such foods to avoid a negative digestive experience just like they would have in the past. This would be something I would gently teach my patients as I would with recommending other adjustments.

Additionally, when I was wearing the ostomy pouch, I started thinking about how my future days would be affected if I continued to have the ostomy appliance. Since it is summer now, I immediately became concerned about going to the beach and swimming, something I love doing in the warmer months. It was a bit heartbreaking knowing, at least for me, that this was an activity I would avoid doing while wearing the bag because there would be no way to hide it. Then it dawned on me that I could wear one-piece bathing suits rather than a two-piece. At this moment, I immediately tried on my one-piece bathing suit to see how it would feel and look. Truthfully, it hid my ostomy pouch very well, and I would suggest this helpful tip when educating my patients.

In conclusion, this valuable simulation raised my awareness that there is a level of self-consciousness that comes with wearing the ostomy pouch, and I know as a nurse, I will have to be incredibly supportive and empathetic with my patients who undergo ostomy procedures and that helping them with planning will be critical and beneficial to them. This experience will help me become a better nurse because I have been able to gain perceptions regarding nursing care priorities, nursing assessment, nursing interventions, and client education. Although it was only a simulation, this event gave me insight that will transfer to my nursing protocol, including assisting patients with their body image and how to manage their situation best while validating their concerns about their bodies and the reactions of others. As mentioned earlier, I was extremely uncomfortable with the new adjustment at first. My advice to future students and patients, who may have an ostomy appliance, is that it takes time, and everyone adjusts differently. To adjust emotionally, a person needs to do what is best for them. I realize that everyone is unique. Every procedure and the experience of wearing the ostomy appliance will be different for each patient, and I understand that everyone will go through various trials and tribulations. I can use this experience in other areas of nursing as well because any changes a patient may experience that alter their lives are challenging. Therefore, I will not only be there to assist them with their physical adjustments, but I will be there for their emotional challenges as well. 

How I Made A Difference

How I Made A Difference

During this semester, my clinical rotation has been a fantastic experience. It has been a privilege to meet various patients and take care of them in the best possible way. As a student nurse, I am not yet able to conduct many nursing procedures, but I have had many opportunities to be the support system for my patients. I have used genuine empathy, kindness, and compassion to help each of my patients through their difficult times. I have been eager to lend a listening ear or a helping hand, which has brought both joy to my patients and myself. In particular, because of the pandemic, visiting hours for patients have been unavailable or limited as a precaution to protect them from COVID-19, so patients are often craving human contact and communication. Realizing this, I take extra time attending to each patient’s emotional needs and spend time talking to them about their conditions and how it affects their daily lives, which they are often eager to talk about. With each friendly smile and gentle touch, I believe I have made a difference in my patients’ lives because I have been a source of comfort and support for them. I have learned that giving them a shoulder to lean on is a special part of being a nurse. 

In one situation, a patient I connected with during my clinical rotation had been at the facility for an extended period due to suffering an injury from a fall and appeared to be emotionally struggling. When I entered the patient’s room to assess her vital signs, I noticed she was quiet and seemed upset. Instead of immediately collecting her vitals, I took a moment to sit down and talk to the patient. I started the conversation by asking the patient about her life, why she was there, and how she felt. Immediately, as our conversation began, there was a spark in my patient’s eye, and she seemed thrilled to share her story with me. It was evident it was a relief to have someone to talk to about her current situation. As our conversation continued, I realized her mood began to change. It became clear that my patient was yearning for personal interaction, and it directly affected her emotions as she went from sad to happy in a brief time. It was as rewarding for me as my patient because I knew I had made a positive difference. All semester, experiences like this one have made me realize that being a positive support system for our patients is one of the greatest virtues of being a nurse. Not only is physical well-being essential, but so is the emotional as well. Positive support is beneficial to physical healing and expedites a patient’s recovery time. 

NURSE LOGIC MODULE 3 & 4: REFLECTION

NURSE LOGIC MODULE 3 & 4: REFLECTION

The third module, called “knowledge and clinical judgment,” focuses on the knowledge required for patient care, as well as clinical judgment, to ensure safe, high-quality client-centered care. Concerning the knowledge of patient care, I have learned that a nurse needs a fundamental understanding of many aspects that influence excellent patient care. These aspects include physiology and pathophysiology, pharmacology, nutrition, effective communication, comprehensive knowledge of nursing procedures, mathematic calculations, technology, ethics, and laws. Before this module, my knowledge of ethical and legal issues associated with the nursing world was limited. Although the module briefly summarized these issues, it expressed the importance of legal and ethical issues with the nursing profession. Legal issues are of the utmost importance to protect the public by providing a safe and secure environment by maintaining best practices implemented in certain institutions, continuing education, and promoting the most elite skills in a rapidly evolving discipline. At the same time, ethical issues are significant to consider because some situations could or could not be supported by legal requirements. Often, personal views and feelings could potentially impact ethical issues in the nursing environment, so it is essential to consider these issues before encountering them in practice.

Additionally, this module was beneficial because it corresponds well with the curriculum in my classes this semester. In this first semester of my program, I have learned about effective communication, nutrition, mathematical calculations and have had some experience with actual nursing procedures within the field of nursing. Overall, my new understanding of the importance of nursing practices, including critical judgment, will influence my integration into the nursing culture because now I am aware of the significance of the many facets involved, which will help me become a better nurse.

The fourth module, “Priority Setting Framework,” outlined the significance of priority setting and decision-making in the nursing field. It provided a good understanding of aids to good decision-making on prioritizing matters that cold face us daily, which is greatly important in preparing us for the integration into the nursing culture. This module discusses various vital techniques and schools of thought; however, the significant two included “Maslow’s Hierarchy of Needs” and “Airway, Breathing, and Circulation.”

Maslow’s Hierarchy of Needs” describes that as a nurse, we should prioritize the physiological concerns and needs of the patient, such as oxygenation, circulation, nutrition, elimination, fluid balance, activity and exercise, rest, and sleep. Then to follow in order includes the patient’s safety and security (e.g., safe environment, stable income, shelter), love and belonging (e.g., love, affection, relationships with others and the community), self-esteem (e.g., self-respect and personal worth), and self-actualization (e.g., personal growth). This theory correlates well with the material I am learning in my courses because we can apply this to various nursing situations. Also, it will be a valuable tool to utilize on exams when questions are asked about “which patient is a priority?” or “which patient should the nurse see first?”. In the same regard, the technique “Airway, Breathing, and Circulation” relates well to current class material and current testing methods in my courses this semester. “Airway, Breathing, and Circulation” discusses how a patient who is having an “airway” complication such as obstruction is the top priority, then as follows; a patient who is in respiratory distress and having inadequate ventilatory effort; and lastly, circulation, which pertains to an individual’s cardiovascular system.  Overall, this module will influence me as a nurse because now I have gained a greater understanding of how to integrate decision making and priority setting in patient care, so each patient will receive the best outcome physically, emotionally, and mentally.

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