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Preparation for Licensure and Transition to Professional Practice Reflection

Preparation for Licensure and Transition to Professional Practice Reflection

Over the course of this semester, this class has significantly prepared me for my licensure and future professional practices through the multiple practice exams we have taken as well as helpful lectures guiding us through job application and interview processes. I am extremely grateful for all the wonderful and helpful information that this class has provided me with as well as for the excellent education and experience I received while at the University of New England (UNE). It is with great pride that I am graduating with a degree in nursing and this class has given me worthwhile tools and skills to assist me as I look forward to starting my career.

For instance, I learned early this semester to develop SMART goals which entails creating specific, measurable, achievable, relevant, and time-bound goals. In doing so, throughout the course of the semester, I have aimed to achieve these goals throughout my completion of each ATI assignment to improve my individual outcomes. In order to continue improvement with each individual assignment, I created a calendar to plan my weekly goals for completing assignments and other needs each week. Then, I outlined them daily with specific times applicable to complete required tasks while making them achievable and relevant to class material. Then, I included other obligations on my daily schedule to ensure that I met my other responsibilities, personally and educationally. Keeping my priorities and responsibilities organized helped me avoid feeling overwhelmed, which was important for my mental, emotional, and physical health. Planning my weekly schedule allowed me enough time for each assignment, and I noticed that as I improved my time management skills, I took each test slower, which allowed me to concentrate more and prevent silly errors from occurring. I read through each question slower, which minimized misreading the questions and allowed me more time to think through my answers. My exam scores continuously improved, and I realized that effective time management is so important because it helps increase efficiency and goals are achieved with greater ease. Time management can also reduce stress because it helps ensure that important tasks are completed in a timely manner which results in improved performance.

Not only did mastering time management help to improve my proficiency with nursing content, but so did practicing several ATI quizzes, taking the assigned ATI exams, and completing ATI remediations. I identified several content gaps, which I needed to improve on by taking additional practice assessments and quizzes, and I took the time to realize why I chose the incorrect answer and to understand why the correct answer is correct. In addition, I spent several hours outside of completing the assignments reviewing nursing concepts, previous power points from lectures in other semesters, and meeting with faculty to discuss areas of weaknesses and ways to strengthen any nursing knowledge I am lacking. Overall, I noticed that as I continued to take practice questions, it helped strengthen my knowledge that I was not overly strong with which helped me improve on all the exams I was taking.  

At the same time, although this semester was extremely demanding and stressful, I took time outside of school to focus on self-care, exercise, and spend time with family and friends. In this way, I utilized several self-care strategies that better prepared myself for studying for licensure and practice because I am not as burned out as I once was and I feel better prepared to be the best nurse possible. Improved time management, mindfulness practices and improved work/life balance has resulted in me being a better person. I have noticed changes in myself over the course of the semester, and I feel more organized, better prepared, and I am in an excellent state of mind because my life is more balanced, and I am achieving my goals with greater ease due to skills I have acquired that help me better manage my work and personal life.

Overall, I will utilize what I have learned. and demonstrate the skills I have gained this semester, to continue my preparation for licensure and transition to professional practice following graduation by continuously completing practice questions, studying with peers, taking the time to recognize content areas that are weaker than others, and continuously strengthening nursing knowledge by watching videos, reading the textbook, and reviewing PowerPoints from previous semesters.  

Preparation for Licensure and Transition to Professional Practice

Preparation for Licensure and Transition to Professional Practice

After I complete the NCLEX-RN exam, I plan to become licensed as a registered nurse in the state of Maine with a compact nursing license. The Maine State Board of Nursing declares that Maine is a compact state, which means once I am licensed in Maine, I would have the ability to practice nursing in a total of 39 states throughout the United States without having to be licensed separately for those states.  Therefore, if I decide to leave Maine at some point later in life, I will have the opportunity to practice nursing in any of those applicable states.  The application for licensure I plan on attaining is a web-based application. This application I am filing does not require official transcripts because I have received my education through The University of New England (UNE) in the state of Maine. However, the application will require a verification sign off by the director of the UNE nursing program, which will be done May 14, 2023, when grades are finalized for the semester.

In addition, as part of the licensing process, the State of Maine Board of Nursing requires a criminal background check, which is done through The Maine Department of Public Safety. Licensure also requires finger printing, which is done through the Federal Bureau of Investigation, which costs approximately fifty dollars. For this process in order to become licensed, I will have my fingerprinting conducted through “IdentoGo” which is an electronic digital scan of my finger using “Livescan”.

Also, the State of Maine Board of Nursing requires mandatory reporting for suspected impairments, disciplinary measures, and resources for recovery. As a nurse in Maine, failure to do so can result in serious consequences for our licensure, such as suspension or termination. Therefore, I must ensure to document all suspected harm as well as harm I have witnessed. As a nurse, I am aware that legal issues commonly associated with licensure involve patient safety, informed consent, patient refusal of treatment, patient personal belongings, malpractice, negligence, mandatory reporting, abuse, and overall unsafe nursing practices. Therefore, as a nurse, it is of utmost importance to protect myself and licensure from a vast array of legal issues. Consequently, to protect myself, I will ensure to prioritize patient safety at all times by using restraints properly as needed; turning my patient every two hours to avoid skin damage; ensure proper disposal of needles; ensuring to use patient transport equipment properly (e.g., wheelchair); ensuring side rails are down on the bed and that the bed is locked. I will ensure consent is fully explained and granted by the patient. I will ensure to use the five rights of medication administration to ensure patient safety as well as proper disposal of patient medication. In addition, I will ensure to monitor the patient before and after treatment is administered. I will ensure to document anything and everything. In addition, if I were to witness improper treatment of a patient or suspect improper treatment, I would report it.

Overall, it is my ultimate intention to provide the best patient care possible as a nurse in my future career, and therefore, I will practice safe protocols at all times while caring for my patients and report any questionable issues should I encounter any.

NURSES If Florence Could See Us Now Reflection

NURSES If Florence Could See Us Now Reflection

The movie, “Nurses: If Florence Could See Us Now”, was a wonderful way to see the incredible roles nurses play in the lives of their patients and their families. Throughout time, nurses have laid the foundations that has led to today’s clinical practices. Nurses are innovative and transformative leaders who not only treat patients physically, but they consider all aspects of patient care, including emotional and spiritual, while at the same time considering the patient’s family and environment in which they live. The movie highlighted the ways in which nurses exemplify skills of nursing leadership as I have learned in my nursing courses. Nursing leaders inspire, influence, and encourage other nurses and other associated professionals while working as a collaborative team to ensure optimal patient care. The primary goal of a nurse leader is to maximize the potential of the team and achieve the intended goal. Nurse leaders are motivators, mentors, and advocators for themselves, their patients, and their associative medical team all-encompassing. As a future nurse, I will strive to develop these leadership qualities to provide the best possible healthcare. I can build on my previous learning by seeking out continuous education and working with inspirational mentors. Leadership requires the highest knowledge and competency, so lifelong learning will be important in order to stay up to date on the current advancements in medicine and patient care. To acquire this level of experience, nurse leaders continue their education and coursework throughout their careers as well as attending training sessions, nursing conferences and working on special projects which continuously helps advance their clinical and leadership expertise.

            Throughout nursing school, I have participated in several clinical rotations, however I have not had the chance yet to work with the vulnerable patient population suffering from cancer. At the beginning of the movie, I had the opportunity to witness a nurse caring for a young child with cancer. In the movie, the nurses stresses how wonderful an opportunity and a privilege it is to help these children through their difficult times, but how there are some barriers that exist when working with this critically ill population. For instance, the nurse in the video voiced that when treating pediatric cancer populations in critical condition, you are not only treating the patient and their painful disease, but you are treating the whole family as well. Pediatric oncology nurses are invited into the patient’s family at their most difficult and vulnerable time, and it can be challenging for the nurses because not only is the child patient scared and emotional, but so is the child’s family, so a nurse can be comforting the family as often as they are comforting the child. Another challenge for a pediatric oncology nurse is that they also are often experiencing a host of emotions especially during times when a child is critically ill and in severe pain or if a young patient dies. It is hard for nurses to witness these difficult moments and it can take its toll on them overtime. Witnessing the vulnerable children, who are so ill, afraid and in continuous pain, can be emotionally exhausting and heartbreaking. At the same time, it is a rewarding time for the nurses as well because they know they helping sick children by providing a gentle hand, a reassuring voice, providing comfort and reducing anxiety.  The pediatric oncology nurses are a support system for the whole family which is so important to the well-being of all. Also, it is so rewarding to witness a child recover and there is always a renewed hope when a once critically ill young patient is ultimately discharged from care and goes home.  Nurses are such a big part of the recovery process and because they are so special, they often leave a lasting impression on the child and their entire family long into their lives.    

Other barriers noted in the movie was about how critically ill children do not understand about their disease or the treatment they receive at the same level adults do which makes it challenging for the nurses because the small patients are often upset due to their fear, stress and confusion. It is often hard for nurses to overcome these issues to bring ease to their young patients which can be overwhelming and stressful for the nurses because their goal is to provide support and comfort. For instance, drawing blood or administering medications using a needle are often scary for young patients as are treatments which are critical to recovery, such as chemotherapy, that are frightening and painful. It is the role of the pediatric oncology nurse to help these children through these challenging moments by comforting them and trying to alleviate their fears and to reduce their pain if possible but it is not always easy for the nurse so being patient and creative is important. For instance, in the movie, one of the nurse’s wears a Disney costume which appears to help make the children feel safe and brightens their moods as they experience an interaction with a ‘need-stick’.  It is the little gestures such as this one that can make all the difference to a suffering child and their family when they are experiencing difficult treatments.

            Furthermore, the movie emphasized the importance of the practice of cultural humility, which readies nurses to care for patients of vulnerable populations. Cultural humility allows nurses to form a therapeutic relationship with a patient by honoring their beliefs and values. This requires empathy, self-reflection, and respect for others. By practicing cultural humility, care givers are able to understand what it might be like to walk in someone else’s shoes by understanding the other person’s perspective and their world view. The practice of cultural humility is especially important when working with diverse populations because it gives healthcare providers a greater understanding about cultures and beliefs that are different from their own. Patient populations are becoming increasingly diverse, so it is important that healthcare providers are increasingly empathetic and understanding as well.  Being aware of and sensitive to a patient’s viewpoints, beliefs and culture can help create deeper connections between caregivers and a patient which can help to optimize care outcomes.

            My goal, once I graduate, is to work in the Neonatal Intensive Care Unit at Maine Medical Center or in pediatrics, so this movie was special for me because it involved caring for vulnerable, critically ill young patients.  As a future nurse wishing to work with the young, I want to learn as much as I can about this patient population and how to improve my communication with them and also to learn how to help bring the most comfort and positive support. A hospital setting can be scary, especially for the very young, so as a future nurse, I want to be sure I have all the skills possible to reduce the stress and anxiety of a sick child and their family and to provide the best care giving to those young patients who are seriously injured or  enduring a life-threatening illness. 

For the latter part of this reflection, I will be discussing how I will be preparing for completing future job applications and interviews after having the wonderful opportunity to listen to the guest speakers based on career preparation as well as listening to the recorded career services presentation. During the application/interview process, I will research an organization’s mission statement and priorities in order to demonstrate that my own skills and values align with theirs and to present myself as someone who would be  a valuable addition to their team.  

Effective communication skills are critical during the interview process as well as when I will be working as a nurse. During my interviews, I will be sure to actively listen and clearly articulate my responses. I will be aware of my body language and be sure my tone of voice is friendly and confident yet respectful. My goal is to build a rapport during the process just as I will do with my future patients.

 In addition, I will be prepared to fully convey effective responses with the ability to outline my strengths including my clinical skills and how I am a team player who is adaptable and willing to go up and above to provide the best healthcare care possible.  I will be prepared to advise the interviewer that it is my desire to make a difference in the world and improve the lives of others which is why I am pursuing a career in nursing and be able to outline the multiple skills I have learned during my rewarding experience at the University of New England including how I have excelled while developing a solid foundation in nursing concepts including evidence-based practice, holistic and client-centered care as well as critical thinking, clinical judgment, and nursing leadership.  

Furthermore, if asked, I will be able to discuss any potential challenges I anticipate, such as adapting to a new culture and learning the healthcare provider’s policies and procedures, as well as, how I will manage conflicts and stressful situations which I am aware I will face especially as a new nurse. I will describe the importance of self-care and working to avoid burnt out as well as outline how I stay organized and manage my time well. In addition, I will be ready to answer how I will stay up to date on the latest advances in healthcare and newest treatments as well as how I see my career progressing over time if asked.  My goal is to confidently convey that I have the overall skills to be a significant contributor to their organization and that I am excited and ready to work hard in partnership with their colleagues to help make their organization a successful one.

I will be prepared to describe my strengths which are my strong work ethic, effective organizational and time management skills and the ability to adapt and thrive in even the most stressful environments. I will be ready to discuss that I have successfully completed rotations at Maine Medical Center, New England Rehab Hospital and Spring Harbor Hospital and that I am a Helene Fund Scholar being inducted to the Sigma Theta Tau International Honor Society, Kappa Zeta-at-Large Chapter in October 2022 and that my dedication and hard work has rewarded me by making the Dean’s List. I have worked as an emergency medical technician for the Gray/New Gloucester Fire Department which exhibits my ability to effectively work as part of a team and it has given me experience in the field dealing with acutely sick and injured patients.

Being a new nurse, I realize that there will be a number of challenges that will I face. The first is that I have never been a full time employee of in a hospital setting so I do have clinical skills but understand there will be a learning curve adapting to a new environment. I will need to learn everything from policies and procedures to the hospital layout and personnel. During my training, I plan to listen attentively, ask questions whenever necessary and take detailed notes as I job shadow during my onboarding process. I will not hide challenges I face and look for direction and consultation to insure I proceed effectively.  Furthermore, I will look for a mentor that I can use as a resource and routinely ask for feedback from my supervisor so that I can improve myself.  My goal is to seek out any resources that are available to overcome any challenges so that I can quickly meet and ultimately exceed expectations.

Pre- Community Partnership Assignment: ‘HELP’

Pre- Community Partnership Assignment: ‘HELP’

Prior to participating in my first community partnership with the “Hospital Elder Life Program” (HELP), I was aware that this program was created to prevent delirium among acutely ill elderly hospitalized patients. The aim is to maintain the cognitive and physical function of the patient so that he or she is as independent as possible when discharged. In doing so, this program includes several protocols, including therapeutic exercise, good nutrition, stress reduction, and sleep improvement, to name a few. Hence, this program utilizes interactive techniques involving patient conversations, which keeps them engaged. Thus, this wellness program is designed to support both mind and body healthy for optimal results, which has been proven to be very successful. Notably, with this program, I recognize that safety is of utmost importance. However, I am aware that patients who fall have a higher chance of suffering delirium, so it is critical to avoid falls as part of prevention.  
Although I have limited experience caring for patients who are part of the elderly population, I completed clinical rotations at New England Rehab, where I assisted in the care of the elderly and witnessed first-hand the effects of delirium. In one example, an elderly patient endured a long-term recovery after a broken hip, leading to an episode of confusion and agitation. In another case, a male patient was recovering from a stroke, and he, too, was confused and frightened. The staff worked diligently to give the patients as much normalcy as possible in a healthcare setting. In addition, the entire team provided care for the patient with kindness and focused on therapies to reduce the symptoms experienced by the patient. The aim was to help the patient not only recover physically but also to be released with cognitive independence as well.
Due to my limited involvement in working with elderly patients suffering from delirium, it is essential for me to gain an understanding of the aging and elderly population. From a health perspective, the elderly have a higher risk of illness and injury due to aging. Hence, as a nurse, it is highly likely I will be significantly involved with the treatment of this population due to the higher percentage of elderly patients treated each year. The experience with HELP will be rewarding for my future in care for the elderly. Furthermore, being involved in the program will give me insights into the complex condition of delirium and how to prevent it. Delirium can significantly impede recovery in the elderly and even lead to long-term consequences and death. Therefore, having a good understanding of this condition is crucial for my future success as a nurse working with this population. HELP is a wonderful opportunity. After all, I am incredibly excited to help the elderly because I often know their conditions can go untreated or they receive inferior care for one reason or another. My goal is to be highly conscientious and compassionate so that the elderly patients I care for acquire the highest level of care so that they have the best chance for a successful recovery.
 As an individual who works hard and is committed to achieving optimum results, I am prepared to be involved in this program, HELP.  I am anxious that I have never volunteered in a program such as this one in the past, so I have some fear of the unknown, but I am highly motivated to participate and help in this worthwhile and rewarding program.  I am confident that my nerves will be put to rest once I receive my training and have some time to acclimate to the process and protocols I will be practicing.  
Moreover, I am excited to help those in need and will do all I can to prevent delirium in my elderly patients and to provide the best care possible. I am ready to meet this population of patients and to help increase their mobility, maintain and improve their cognitive ability, and make their patient experience a positive one.  I realize many of these patients are nearing the end of life, and I am prepared to be a kind voice with a gentle hand and provide as much support as possible so that they can recover and be discharged from care with a high degree of independence.     
In Maine, I have not been involved with community programs caring for this population, but I have heard of the positive effects of pet therapy within nursing homes. Interaction between an elderly patient and an animal, whether it’s theirs or a support animal, can help physically and mentally. It can improve personal interaction, communication, movement, and willingness to exercise. The elderly may be more motivated to practice their therapy, and there may be increased optimism when they work with a pet.  In addition, spiritual care is a therapy for the elderly community. Staying involved in their religion and receiving spiritual counseling can be very important to an elderly patient. The use of spirituality enables an elderly patient to maintain meaningful faith-based relationships, which can help improve physical and emotional health.  
I am genuinely inspired to make a difference in my community and assist with Hospital Elder Life Program. I intend to positively impact each patient and work diligently to prevent delirium so that the elders I am involved with successfully recover and are released from care as independently as possible.

Prepare for Transition Eportfolio Post

Prepare for Transition Eportfolio Post

As I move towards graduation, licensure, and my first job, I am brimming with several emotions. For instance, I am incredibly excited to utilize all the knowledge and skills I have gained through lectures and clinical rotations to help those around me. I am grateful for the excellent education and experience I have had at UNE, as well as the pride that I am graduating with a degree in nursing. I also am feeling a level of anticipation for what will come with my new job but looking forward to starting this next chapter in my life.
With all that being said, I have some anxiety at the same time about all the upcoming changes and many adjustments in my life. As a new graduate, I will be encountering a new work environment and new colleagues, learning new skills, and applying skills I have learned throughout this program for the first time as a new nurse treating patients.
In addition, I am tentative about how long it will take me to adapt to the culture of my new workplace and whether my colleagues will be supportive. I worry about making mistakes, but I know I have the tenacity and committed to becoming an effective caregiver. Additional anxiety involves adjusting to the physical requirements with the long hours, shift changes, and sometimes a lack of staff. Still, I will care for myself by getting rest, eating well, and exercising whenever possible.
Although I have some anxiety about my future role as a nurse, I am incredibly grateful I am embarking on a journey to help others around me, which is my goal in life. That said, I need to focus on planning and preparing my weekly studies throughout this semester to stay on track to graduate and attain my licensure. In doing so, I will utilize the SMART goal method, which entails specific, measurable, achievable, relevant, and time-bound goals. Then, I will create a calendar to plan my weekly goals for completing assignments and other needs each week. Then, I will outline them daily with specific times applicable to complete required tasks while making them achievable and relevant to class material. Then, I will also include other obligations on the daily schedule to ensure that I meet my other responsibilities, personally and educationally, without getting overwhelmed, so it will be meaningful for me to leave time for mental, emotional, and physical health.
Regarding Nurse Logic 2.0, I will reflect on three new things I have learned from each module. Module one, “NurseLogic Knowledge and Clinical Judgement Advanced,” focused on the knowledge required for patient care and 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. I learned that considerations should be made when administering care to provide the most optimum care possible, which will help me excel in my future career in nursing. For example, one question focused on the proper application of benzocaine ear drops for pain relief in a child with acute otitis media. For this question, I was previously unaware that these drops were refrigerated; therefore, they need to be warmed to room temperature before installation. In this case, the ear drops are warmed to prevent the risk of further pain and trauma for the toddler. This is imperative information that a nurse should know, and with this new information, I will administer ear drops properly as a nurse. In addition, in this module, a question focused on the proper teaching a nurse should give to a client for dumping syndrome. Although I have previously learned about dumping syndrome, I was unaware of the appropriate education a nurse should give regarding diet. Thus, this module has taught me that a client should be encouraged to eat foods high in soluble fiber, such as peanut butter and toast, because it reduces the frequency and severity of dumping syndrome. Lastly, this module allowed me to review previous content surrounding active pulmonary tuberculosis. In this review, I learned that tuberculin is an effective screening tool for detecting a client exposed to tuberculosis who has developed antibodies. However, it is ineffective in distinguishing an active case of tuberculosis in someone previously exposed.
Likewise, for module two, “NurseLogic Nursing Concepts Advanced,” I have reviewed and learned valuable content that will significantly prepare me to become a nurse. For instance, I learned that when a client is having an allergic reaction by demonstrating urticaria and angioedema, the correct answer may only sometimes be to administer epinephrine based on what the question is asking. This question allowed me to reflect on my test-taking strategies. I need to read what the question is asking thoroughly. In this case, the question asked what the nurse should do first, with the correct answer being to determine the client’s respiratory rate. Although this question did not necessarily teach me new content, it taught me to reflect on and strengthen my test-taking strategies to excel in future exams. In addition, this module strengthened my understanding of the side effects of Betamethasone. For instance, I have learned that this medication does not affect neonatal vital signs, although it is used to prevent respiratory distress syndrome in premature infants. Instead, a complication the nurse should assess for is hypoglycemia in the neonate because this medication can lead to hyperglycemia in the mother, which thereby can predispose to hypoglycemia in the neonate within the first few hours following delivery. Lastly, this module strengthened my previous understanding of interdisciplinary collaboration among health professionals. For instance, if a client has undergone an amputation, I was previously aware that a social worker and physical therapist should be involved in coordinating care. However, I have now also learned that a dietician should also be involved in coordinating client care because they have the knowledge to help provide dietary contributions for wound and muscle repair and healing. Once again, this module allowed me the opportunity to better prepare for my future as a nurse.
Similarly, module three, known as “NurseLogic Priority setting Frameworks Advanced,” outlined the significance of priority setting and decision-making. It provided a good understanding of aids to good decision-making on prioritizing matters that could face us daily. For instance, this module enforced my education about triaging clients during a mass causality. It taught me that the highest priority of treatment is assigned to those with a life-threatening condition who also have a high probability of survival following treatment. Then, the second priority patients treated include those who have not life-threatening injuries but still have endured significant injuries. They can wait 30 minutes to 2 hours until a medical team is available to treat them. Lastly, unfortunately in a mass casualty situation, the lowest priority patients are those who do not have a high chance of survival.
Furthermore, this module taught me to utilize the “unstable versus stable priority setting framework.” This application technique gives unstable clients priority treatment because it threatens their survival. In addition, this module taught me nursing content, which is of utmost importance for nurses to know in their future careers. For instance, this module enhanced my understanding of the early manifestations of a fat embolism in a client, including a change in the client’s level of consciousness.
The final module, module four, “Testing and Remediation,” allowed me to deepen my knowledge of nursing content and skills. It also emphasized the significance of priority setting and decision-making in nursing. In addition, this module provided an opportunity to review content I have learned in past semesters that needed strengthening or provided me with new nursing knowledge I have not yet encountered. For instance, this module touched based on antihypertensive medications I learned in previous semesters, which was a helpful overview. Also, I learned that aspirin could potentially reduce the antihypertensive effects of Captopril. Therefore the patient must be educated to avoid taking aspirin if taking Captopril. Also, this module reinforced my understanding of mental health disorders that I have the potential to encounter with patients in my future career in nursing. For example, this module reviewed the manifestations of borderline personality disorder, and I learned that these include unstable relationships, impulsivity, unstable mood, and a distorted self-image. Lastly, one of the questions I was given focused on a client experiencing an anastomotic leak postoperatively following a gastric bypass, which is content material I had not encountered yet. Thus, this was an excellent learning opportunity that taught me that a gastric bypass is when the stomach, part of the jejunum, and duodenum, are bypassed by connecting the small intestine to a surgically created stomach, and an anastomotic leak occurs when gastric/ intestinal fluid leaks at the connection. Another piece of information that I have learned from this is that oliguria is a typical manifestation indicating that the client might be experiencing an anastomotic leak. Overall, this review allowed me the opportunity to better prepare for my future as a nurse.

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