Author: elangland (Page 1 of 4)

     It was the 5^th night of my preceptorship.  My nursing instructor and I were finishing up our charting and last bit of rounds as we prepared for change of shift report.  We were tired from a busy night and were ready to get some sleep as we wound be working the following night.  While checking in on our last patient who was complaining of pain, (recently undergone a surgery for an abscess on their amputated leg), we noticed their dressing had soaked through entirely with bright red blood and there was a small pool of blood underneath them.  This was where the patient had been complaining of pain.  After cleaning up some of the bloody drainage, running a set of vitals, and giving them pain meds, we paged the trauma surgeon to come take a look.  Upon arrival, the surgeon took down the dressing and then blood shot in the air like a fountain.  The surgeon quickly applied pressure to blood source, and then everyone acted.   While the patient was screaming in pain, everyone scrambled for supplies, meds, making phone calls, and running units of blood.  I was right in the middle of all of this.  I was grabbing supplies for the team, giving meds, holding a light source for them, and providing comfort for the patient while they performed an emergency surgery in the room.  This was the first rapid response I had ever been a part of and contributed to and it all felt surreal.  A patient who an hour ago was totally fine is now bleeding out and getting lifesaving surgery in front of my eyes.  Thankfully, within 10 minutes the team got the bleeding under control, but the patient still needed to return to the OR.  By the end of it all, my nursing preceptor and I with some blood stained on our gowns just looked at each other like what just happened.  Not many students can say they got to experience something like this, and I think that I was very fortunate to be able to learn from this and such a great healthcare team. 

       Reflecting on this experience now, there was so much I was able to learn from each member of the response team.  Each member understood their roles and carried out their tasks promptly.  They also supported each other in doing so was great to hear especially as a student.  What stood out to me the most however, was how quickly the patient’s condition deteriorated.  It really happened in the blink of an eye.  It made me realize how important it is to prioritize and do excellent assessments.  If we had not looked at the dressing because it looked fine 30 minutes ago, this patient could have bled out without even realizing.  Also, If the patient had started bleeding out before the surgeon was there, how different would the outcome have been.  There were so many different scenarios that ran through my mind on this patient.  I am happy that I was able to have this experience as it will serve as a reminder to take great pride in my assessments and working as a team.  It was also an honor to have been able to care for this patient and comfort them in their times of distress.  This is the rewarding part of nursing in bringing someone from a low point in their life back to themselves again. 

During the pandemic I would stay in touch with my grandparents regularly.  This was done through phone calls and zoom.  We would talk about what was happening in the news, what we did each day, and how we were adjusting to this new way of life.  My grandparents talked about how they would attend virtual mass, play with their cat, listen to music, and spend time watching TV to keep busy.  And despite the fear of COVID-19, my grandparents said it was nice to have the extra time to talk and connect with each other.  This was one of the few positives to come out of the pandemic.  However, I found my grandparents to be mostly stressed during the pandemic.  With my grandfather being a diabetic, this made them even more nervous about the virus.  They were always on high alert and followed protocols strictly when traveling anywhere.  Additionally, with no family visiting for holidays anymore, you could tell that it took a toll on them mentally.

I was surprised to learn more about older adults and their resilience with age.  However, this made sense the more I learned about it.  With a lifetime of experiences and hardships, it is no surprise that most of these older adults have found ways to cope with their stresses.  Also, during these times, they were given the opportunity to learn how to use new technologies such as zoom.  With this new sense of accomplishment, it had a positive impact on their mental wellbeing.  This changed my perspective on the older population, and it reminded me to reserve my judgement when working with this population.  They are more resilient that you may think. 

Previously, I was not familiar with Telehealth or Telemedicine. I remember first hearing about this during the pandemic seeing advertisements and posters mention them however, I never really looked further than this. I just knew it was a resource that could help to reduce patient contact and the spread of the virus.

After learning about the eICU and the new technological advances that have been made, I think that this is a great addition to healthcare. Not only can patients receive care and supervision from physicians who are in a different location, but this helps to reduce the transmission and spread of disease. I can think of this being particularly useful during the COVID-19 pandemic. With the virus being as contagious as it was, having the ability to remotely provide care is a huge benefit. This resource is definitely a step in the right direction for the healthcare industry and it is exciting to see what more advances will bring.

In my future, I see myself working in some sort of critical care environment whether it be the ICU or the ER. Seeings these improvements being made in healthcare will benefit both the patients and the providers . Any hospital that utilized resources such as eICU would definitely be a place I would want to work. It would make providing care less stressful and help to give my patients the best possible outcomes.

    Prior to learning about the needle exchange program, I had never thought there could be a benefit to increasing access to substance use.  However, after learning more about what this program had to offer, I learned that it decreased infection rates and costs associated with infection.  I also learned about an app that users could utilize to let people know when they are using to prevent potential overdose.  I thought this was a good resource to have with how significant the opioid epidemic has been.  With usage so being so high and almost unpreventable, having access to these resources will at least reduce some of the negative effects of it.

     There are plenty of downsides to this program as well.  First, with the increase in usage, there will be an increase in overdoses and use of resources.  This can impact emergency response times and who may get the care they need.  Additionally, with the increase of needles in circulation, there will be an increase in needle stick injuries and litter.  For example, I can recall over the summer almost stepping on multiple needles while walking through Portland.  There were hundreds littered throughout the streets and on the sidewalks.  This could impact anyone who may not be paying attention to where they step.  If I had accidentally stepped on one of these needles, it would have cost me significant amounts of time and money with testing, medications, and resources. 

     The opioid epidemic is a very complex issue and there are a variety of ways it can be approached.  I think it starts with educating our younger populations on the dangers of use and then increasing the awareness/availability of rehabilitation resources.  There are many people who lack the proper education and know no better than to turn to these drugs.   Addressing these health disparities and continuing the fight these drugs on the streets is what we must continue to do to reduce its impact.  As nurses we must carry out this education and advocate for improved resources. 

The discussion we had in class with our guest speaker delivered a powerful message and further opened my eyes to the massive problem of human trafficking.  This was not the first time that I have been a part of a discussion or heard news about this issue, so I felt I had a solid grasp on it.  One thing that always comes to mind when I hear about human trafficking is Epstein case as we discussed in class.  I feel that this case and many others do not get the media attention they deserve.  With the prevalence of this issue, it is a shame that more people are not informed or aware of how to identify and handle these situations. 

     One thing that stuck out to me during our discussion was to learn that health care workers can be labor trafficked.  Knowing that healthcare workers frequently are ones to identify trafficked people, this was surprising to hear that they can also be victims of it.  Having discussed this in the past, I thought the lecture would be more of a review however, this lecture challenged my thinking and made me realize how much more there is to be aware of.  Now, having this increased awareness, knowledge, and access to resources.  I feel more confident in my ability to fight this problem in my future practice.  There are so many people to save from this issue than we may understand.  Therefore, it’s important be aware of the little things and to assess and question to your best ability  

In the event of a man made or natural disaster, nurses play a key role in the management of these situations. Nurses are responsible for evaluating/treating injured patients and are also responsible for transporting these patients to safety or other medical facilities. Decisions must be made quickly as often disasters result in a loss of power, equipment and other necessary tools to provide proper care. These choices nurses must make can be life or death which makes it important to have a plan in place and to be trained for these situations.

The ANA Code of Ethics states that a nurse’s primary responsibility is to the patient. The Code also states that a nurse owes the same duty to themselves. As this relates to disaster nursing, we must still be placing the patient as our top priority. As the first provision in the ANA code of ethics states, the nurse must practice with compassion and respect for the inherent dignity, worth, and unique attributes of every person. A nurse should never put themselves above a patient unless they themselves have been injured severely from the disaster or are in extreme danger. Nurses must have respect for patients dignity and worth. Disasters can be extremely unique situations and nurses must be prepared to do anything to protect patient lives.