Author: ewalsh11 (Page 3 of 6)

Presenting Change

Working on this project with my peers was a good experience. I was pleasantly surprised in how this project went compared to the project that we had to do for EBP 1. Our audience was the special care nurses at SMHC and some of the MS4 unit nurses. The feedback that we got was it was a good refresher for them. They have been dealing with COVID patients since the beginning, so this was nothing new for them. My feeling on this is that if we had presented this to nurses at a long-term care facility the feedback that we could receive might have been different as they are not dealing with acute COVID patients every day. The nurses thought that the quiz was a good way to assess their knowledge to see what they already know or need to brush up on. 

What I learned from this team project was that I can work with people on a project who might see things differently than I do and actually learn something from them. I also learned more about the topic itself and the facts behind proning. Working on this project helped me gain skills to work with people even when we all don’t have the same schedules. We also meshed well together and created a good system for getting work done. This was partly because Dr. Kramlich was so helpful in providing feedback and ideas when we needed them. I also learned that I do not always have to be the leader.

Often times in all the groups I am a part of I am the leader, this time I took a step back and let someone else take on this role. This was a good learning experience for me because it gave me the freedom to take a more supportive role instead of being the one who spear heads everything. I hope that I can take this experience with me throughout my nursing career as well and realize that I do not always have to be in the lead role. 

Disaster Nursing

Nurses play a large role in disaster response/management. Depending on the position of the nurse, you can be triaging, activating the response team, providing care to those who are injured, helping evacuate patients, coordinating with other healthcare officials/facilities are just a few. It goes without saying that no matter what the disaster or crisis maybe it is important for the nurse to be prepared and trained. This is why disaster trainings are so important because you never know when something may occur. Being prepared for the worst at all times is important because if you’re prepared hopefully, it won’t actually happen but in the event that it does you have the tools and knowledge to get through it. 

When determining between provisions 2 and 5 that is the constant internal battle of being a nurse. How I personally distinguish is when I am off duty or not working, I put myself first so that when I am working, I can be the best that I can be to put the patients first. When you sign up to be a nurse you know that you will never truly get a lunch break and might not pee for 10 hours and that is just the commitment that we make. You can argue that that is not right, but it is the reality, when at work the patients are the priority. I think if take care of yourself and train your body when you’re not at work that will pay off for when you are, the stronger and healthier you are the better off you will be. Nursing is almost like a sport; you must be ready for the game each shift. 

Death with Dignity

Prior to watching the videos and reviewing the readings I have had some experience with death both as a family member and as a healthcare provider. I have been an LNA for 5 years and have had numerous patients pass on. I have seen a wide range from “happy” deaths to sad or more tragic ones. I think there is something very special about a family surrounding their loved one at the end of life. Not only does it provide them with closure that they need but it also allows them to be physically present with their family member and sort of experience it with them. I personally am very afraid of death when it comes to me and my family but as a healthcare provider when I am in more of that support role, I handle it a lot better. I think it is very important to maintain the patient’s modesty throughout the entire process, including end of life care or postmortem care. To me that patient that once was, is still my patient even when they have passed on, to the time that they go to the morgue or funeral home. Realizing that the patient can still hear you up until the final moments is of upmost importance because it gives you the opportunity to provide comfort in more than one way. 

Death with dignity challenges my beliefs to a certain extent however I do realize that administering morphine and keeping the patient comfortable is helping practice the “do no harm” mentality because it is putting their body through less suffering, in the sense that I helps make the process more comfortable for them. It also helps regulate their oxygen saturation and respirations make it more comfortable, so they are not literally gasping for breath. I think as nurses it’s hard to sometimes see that we are not “killing” the patient by pushing that dose of morphine. I have not been in this position as a nurse yet but I would hope that my feelings remain the same in that I know that this is what is truly best for the patient to keep them comfortable and with hopes to make it less of a traumatic experience for the family. 

Reflective Writing

A patient encounter that I will always remember from my time at UNE was with an elderly lady who had a stroke history and was considered a “feed assist.” I went into the situation like any other, I will probably just give her a few bites of food and then she will be done with it. Well this lady and I spent 2.5 hours together, it took me that long to feed her and monitor her while she ate. At first there really wasn’t much conversation beyond how are you feeling, surface level stuff. Then she began to tell me about how one of her daughters has been a nurse for over 30 years and we got to talking about school and how times have changed especially in the time of COVID. What I learned most from this situation was that just because she had a stroke doesn’t mean that she herself was not there, she might have some difficulty swallowing and things like that but she was still there and is still a real person. We ended up having a really good conversation and she gave me some really good advice, as most elderly people do but she told me to enjoy this time of my life and that yes it might seem like youre always climbing a mountain but once you get to the “top” its hard to mentally shift to the other way of thinking. She also told me that these are the good days, I replied with that I realize how lucky I am to have this opportunity to get an education and to be in the position that I am today. Looking back 4 or 5 years ago I would be looking up to who I am today and proud of who I have become. So yes it is easy to get lost in all the surface level stuff that life throws at you but that stuff really doesn’t matter in the end. 

Proposing Change

What I learned about my topic through literature reviews and collaborating with my peers is that this is an effective way to promote/increase gas exchange in patients with COVID-19. We found that educating the staff on the given floor that is providing the care to these patients is of highest importance when seeing increasing results of this being implemented. When the staff new exactly why and how important it was it translated into how much more this technique was used.

The literature review did not change my view on this topic. Over the last year and some change I have worked on a COVID floor and in an Emergency Department seeing lots of COVID patients. I understood how important this was early on because we as staff were being educated throughout the process of COVID in learning new ways to help our patients in a relatively simple way. 

Our team did not revise our topic at all. I will carry this knowledge going forward in my nursing career because this can also be beneficial to patients with other types of respiratory issues. Some successes of our team were that we communicated well, we designated one person to always submit the assignments which I think worked out well in the end so there was less confusion on what/who was doing various tasks. We also worked together as team very nicely we just meshed, and it even showed when we were out on the floor at clinical. The only minor challenge we faced was feeling enough time to get this done as we are in other demanding classes right now but I feel this was an invaluable experience and I would not have done anything differently. We solved this issue with google docs, zoom meetings, and everyone bending their schedules a little bit. 

Electronic Health Records

My initial thoughts about the use of electronic health records in nursing were that it is used to document vitals, assessment findings, and medical history. I was pretty blind to the fact they can be used for so much more than just nurses and providers. With the presentation from last Wednesday, I was able to see that there are so many more people involved in the process of documenting in electronic health records and without all those various aspects involved that would not allow all the types of healthcare providers to provide the most holistic care possible. To me modern medicine seems more holistic and in my opinion, this is just another step in that direction. 

I will apply what I learned about electronic health records to enhance the care that I provide in two ways. One I will take a deeper dive into the charts of the patients that I am working with to see if there is information in there that would be beneficial for me to know in hopes to provide quality holistic care. Two I will take my documentation process more seriously knowing that this can be used to help other healthcare providers down the line, not only will this help healthcare providers but in turn make the patients care and experience better. I always knew that accurate timely documentation is important but not to the level that I do after the presentation from HIN. 

Trauma Informed Care

Trauma exposure impacts the whole person, as healthcare providers we are not only treating the patient as well as the family. The patient might have obvious physical issues, but they need to be looked at wholistically because in my opinion the psychological and spiritual welling being is almost more important. There can be long term physical ailments but if we ignore the mind and only treat the physical, we are only looking at half of the person. I will apply the trauma informed care principles in all my patient interactions. I think it is important to treat everyone the same and treat them like family. Part of this is addressing their past whether it’s good or bad. I will go into it always assuming that the patient has some form of trauma, personally I believe that everyone has some form whether small or big it doesn’t matter to that person it is a “traumatic” experience and we need to support them in a way that speaks to them the loudest. Long-term impacts of adverse childhood experiences can range from physical to emotional/mental and beyond. A few that come to mind right away are PTSD, anxiety, depression, cardiac issues, diabetes (from unhealthy eating and physical activity habits), as well as skeletal abnormalities. I think as healthcare providers this is one of the most important aspects of our care because it helps us develop trust and rapport with our patients, without trust and rapport there is a significant lack in the healing relationship. 

Public Health and Vulnerable Populations

There are many factors that influence the health of the vulnerable and marginalized populations. So many that I cannot possibly name all of them in this post. The ones that come to the front of my mind are the elderly, children who are in the “system”, and access to health insurance. People who cannot find jobs that provide them with the opportunity to have access to health insurance or the elderly/early elderly people who are on the cusp of Medicare and Medicaid. There are many factors that go into this but just in the way that we are all raised and brought up in this world sets you up for the person you will become and the opportunities you have. I feel that it also has to do a lot with your personality, there are people who are born into very privileged homes and come into adulthood with inadequate drive and skills to be a successful adult and then there are those who are thought to have no chance at surviving this world and have the most beautiful success stories. Because of this wide range I feel that it is hard to pinpoint very specific ideas as there are so many. Job opportunities, money, support systems, and upbringing are the ones that come to my mind first. 

I do not feel that we will ever be able to solve healthcare disparities as this is what makes the world go around. However, I do think that there are always ways to improve. It can be as simple as recruiting and helping people find jobs that provide health insurance. Education is huge and starts young, creating a health conscience vision that our younger population will understand and buy into will make a huge difference. Also providing support groups and systems, the first one that comes to my mind is for new first-time parents, both for moms and dads, it is a team sport. There are also ways that as healthcare providers we can help connect with our patients more by meeting them at their level and learning about where they come from and why they made the decisions they made to put them in the predicament that they are in today. There are so many ways to improve, and it is a revolving door but starting small and working our way up is the only way we can start. We can sit here and think about it and keep coming up with ideas but until people take initiative nothing will change. By taking initiative I don’t just mean the healthcare system workforce, I mean as a country as a whole, everyone needs to do their part in order to live a healthier lifestyle not just those who are providing the care. 

Planning Change

I anticipate that this dissemination project will get done in a timely fashion. There will absolutely be bumps in the road, disagreements, and group members that don’t do their part but that is nothing new. Individually I will be organized and timely to get my contributions and portions in on time and do the best quality work that I can. I can control me, I can’t control others so I can’t worry about what they’re doing or if they aren’t doing their part, they’re only hurting themselves. I plan to communicate with my group in person, over text, and over email. When conflict does arise I will be clear and direct with my group members while still being respectful, my goal is to not shy away from conflict this year and actually address it and not feel bad about it. I think this will be a beneficial project because we should obviously learn something from it and it should work in our favor to work together as a group. Barriers will be addressed head on in a respectful way this will help for future nursing practice because when it comes to life and death situations there’s no time to be indirect and indecisive. This will be useful in many ways but my personal goal for this semester is to do better at communicating more directly and to the point.

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