In theory, I am a great advocate of technology; however in my own life I am barely proficient with computers. Going into Evergreen Hospital I was intimidated by the idea of computer charting, however I found that it was very organized and efficient. Multiple people could enter information into the computer, and the team of healthcare workers could view it immediately and be “on the same page.” It was very organized, and removed the issue of messy charting and unintelligible handwriting. The nurses could access the computer database from inside or outside of the patients’ rooms, and they did not need to lug the massive charts in and out of patients rooms. Additionally, even I could navigate the computer chart – the ultimate test of whether or not a program is “user-friendly.” I think it is appropriate for hospitals to take advantages of advances in technology. While the transition to computer charting may have been difficult – the nurses now have the ability to scan medications, view patient information in a clear and organized manner, and cooperate with other healthcare workers online. Improvements in technology may contribute to patient safety, and improved efficiency and clarity in charting, and should be embraced.
In regards to education, I believe that there are many benefits to technology. For example, this blogging exercise has permitted us students to communicate our ideas from home. There is not enough time to communicate all of our ideas in class, so these forums allow students to view the ideas of the peers in a concise manner. I can certainly sympathize with those individuals who struggle accessing information on a flash-drive or are bewildered when printers won’t work, however I think technological improvement are useful and valuable enough to struggle through all the inconveniences. Technology is an integral part of the future, and in this case, I think we just need to get on board.
Monday, December 7, 2009
Wednesday, December 2, 2009
Blog #7: Acute Care Patient
Several weeks ago I met a very unique patient while shadowing a nurse in the Medical/Surgical unit. During the change of shift report, the nurses talked about a woman who had been in the hospital for weeks, and suffered from a long list of diagnoses. I was taken back by their abrasive attitudes regarding this particular patient whom they described as “lazy,” “needy” and “difficult.” After the report, the nurse and I entered the patient’s room to begin the morning assessment. I was surprised to find that the patient was very pleasant and conversational, and was very cooperative with both myself and the nurse. Throughout the day, I was in and out of the room doing vitals and assisting the nurse. Each time, the patient would become very talkative and eagerly engage us in conversation about the television shows, the meal, etc. I had many conversations with her, and I never saw the negative characteristics that the nurses attributed to her. After a month in the hospital with minimal visitors, I believe she was beginning to feel very socially isolated. It was very clear that she would benefit from some more one-on-one care, so the following week I chose her to be my patient in order to enable more contact and care time.
Throughout the two days in which she was my patient, I was in her room quite a bit, and she began to talk with me about her anxiety about her hospitalization and her strained relationship with her husband. I was able to assist her with her first shower in a month, and while I was situating her back in bed she expressed to me how poorly she felt about herself. I listened, and asked questions, but did not feel able to give her any counsel.
On the second day of working with her, I completed the second section of the Gordon’s Assessment. When I came to the content on role-relationship, coping-stress, sexuality and spirituality, the conversation took a difficult turn. She began to cry and was unable to answer some of the questions and merely shook her head. She seemed very relieved to be able to express some of her difficulties; she explained to me that she had no family or friends to rely on or talk to. Throughout our conversation, she disclosed her difficult circumstances and shared some personal struggles. I asked if she had communicated these things to anyone, and if she had spoken to a social worker about her living situation. She expressed that she had, and that her living situation was going to be different when she left acute care. She was very discouraged, but this potential change in living situations gave her a small degree of hope.
Throughout the two days in which she was my patient, I was in her room quite a bit, and she began to talk with me about her anxiety about her hospitalization and her strained relationship with her husband. I was able to assist her with her first shower in a month, and while I was situating her back in bed she expressed to me how poorly she felt about herself. I listened, and asked questions, but did not feel able to give her any counsel.
On the second day of working with her, I completed the second section of the Gordon’s Assessment. When I came to the content on role-relationship, coping-stress, sexuality and spirituality, the conversation took a difficult turn. She began to cry and was unable to answer some of the questions and merely shook her head. She seemed very relieved to be able to express some of her difficulties; she explained to me that she had no family or friends to rely on or talk to. Throughout our conversation, she disclosed her difficult circumstances and shared some personal struggles. I asked if she had communicated these things to anyone, and if she had spoken to a social worker about her living situation. She expressed that she had, and that her living situation was going to be different when she left acute care. She was very discouraged, but this potential change in living situations gave her a small degree of hope.
Sunday, November 15, 2009
Blog #6: Acute Care Clinical
I am finally beginning to feel like an asset rather than a nuisance at our acute care clinical at Evergreen Hospital. The first week at Evergreen I felt very out of place and in the way. My first patient was very ill and I was not able to really participate in her care, other than vitals and assessments. I observed as the nurse attempted to place a nasogastric tube, but it was very difficult and painful for the patient. Even the charge nurse was unable to place the NG tube and both the patient and the nurses were very frustrated. The patient was so miserable that I did not want to interrupt her more than necessary, so I kept my visits to a minimum and did not start the Gordon's until the second day. At the end of the first day I went home feeling very discouraged. The second day however, was a great improvment. My patient recovered from her nausea and vomiting and was in very high spirits. I was able to giver her meds, ambulate with her, and use a number of therapeutic techniues such as opening the blinds and finding her book and making her warm tea. She was very conversational and alert when I completed the Gordon's Assessment and was very encouraging to me and my vocation as a nursing student.
This past week I was with a very complex patient who had been in the unit for 30 days. After a 30 day hospital stay, with full-contact precautions, she was sufffering repocussions of social isolation as well as her extensive list of medical diagnosis. I was happy to have so much time to dedicate to her, because she was very eager to have someone to talk with - it was sometimes difficult to leave her room in order to do charting and paperwork. Throughout the two days that I worked with her she talked about a number of things, from her television shows, her past, her family and her medical care. I was very involved in her care and was required to be in her room a great deal and I could see a trust-relationship beginning to develop.
Near the end of the second day of our working relationship I completed the final questions on the Gordon's Assessment. When I asked about her role-relationships and her spouse, she shook her head and began to cry. She described her very difficult situation with her husband to me and shared quite a bit of her story. As I finished completing her Gordon's I found out that she had a very impaired sense of self-esteem, little-to-no coping mechanisms or support systems, and was in an abusive relationship. I was somewhat overwhelmed by her sense of hopelessness and depression, and yet I was glad that she trusted me enough to share her struggles and fears with me. I did not have a profound answer to give her, yet I do believe that it was helpful for her to express these unmentioned fears and struggles and to receive compassion and interest.
After our conversation I looked through her chart and saw that a social-worker had been working with her and making arrangements regarding where she would live when she was discharged. The details she had told me were in accordance with the chart, and had been addressed by a social worker. I am very glad that nurses and social workers cooperate with patient's care, because I could not stomach the prospect of my patient returning to an abusive living situation, with no support system or family to help with her care or coping. I am glad that social workers are also invested in the health of patients and are trained to deal with situations.
This past week I was with a very complex patient who had been in the unit for 30 days. After a 30 day hospital stay, with full-contact precautions, she was sufffering repocussions of social isolation as well as her extensive list of medical diagnosis. I was happy to have so much time to dedicate to her, because she was very eager to have someone to talk with - it was sometimes difficult to leave her room in order to do charting and paperwork. Throughout the two days that I worked with her she talked about a number of things, from her television shows, her past, her family and her medical care. I was very involved in her care and was required to be in her room a great deal and I could see a trust-relationship beginning to develop.
Near the end of the second day of our working relationship I completed the final questions on the Gordon's Assessment. When I asked about her role-relationships and her spouse, she shook her head and began to cry. She described her very difficult situation with her husband to me and shared quite a bit of her story. As I finished completing her Gordon's I found out that she had a very impaired sense of self-esteem, little-to-no coping mechanisms or support systems, and was in an abusive relationship. I was somewhat overwhelmed by her sense of hopelessness and depression, and yet I was glad that she trusted me enough to share her struggles and fears with me. I did not have a profound answer to give her, yet I do believe that it was helpful for her to express these unmentioned fears and struggles and to receive compassion and interest.
After our conversation I looked through her chart and saw that a social-worker had been working with her and making arrangements regarding where she would live when she was discharged. The details she had told me were in accordance with the chart, and had been addressed by a social worker. I am very glad that nurses and social workers cooperate with patient's care, because I could not stomach the prospect of my patient returning to an abusive living situation, with no support system or family to help with her care or coping. I am glad that social workers are also invested in the health of patients and are trained to deal with situations.
Tuesday, October 13, 2009
Blog #5: I want to be a nurse, but can I be a human too?
Oh dear, I am about to vocalize a real concern. My hope is that as soon as I express this fear I will realize how ridiculous it is: I am afraid that in order to become a good nurse, I have to transform into a humorless super hero that needs no food, no sleep, no friends, and of course – no other interests besides nursing. I hear about 12 hours shifts with no food, and lonely night shifts with cranky doctors, and I begin to fear the worst for my future. Sometimes when I make a joke in clinicals I get a sad nostalgic feeling that my time for joking is drawing to a close. Of course I want to be professional and competent nurse – but I also would like to retain my personality. I rather like my personality, and I am worried about exchanging it in for a pair of baby blue scrubs.
And yes, as I vocalize this I realize that it is exaggerated and childish, but somewhere underneath my jokes is real concern. I do not possess an incredibly “scientific mind.” I can learn science and it does interest me, but I also love to read and write – and when will I have the time for that? How will I have the time or motivation to go on runs or invest in friendships? Am I destined to become a tired, heavy, lonely nurse? How will I be able to give to my patients if my well is dry? My only hope is that real life is not as dramatic as I imagine it. Or, that the Lord will to provide me with the resilience and energy to do my job with passion.
And not to mention my fear of making mistakes… somehow nurses have to go around on empty stomachs making decisions , passing meds and performing tasks without making mistakes. The real, primary fear that I have about nursing is making mistakes. I know it might happen – but how serious will it be? Will I catch it? What will happen? Am I intelligent and detailed enough to avoid mistakes? Prior experience says “no,” which leads me to believe that I still have to undergo a great deal of change before I will be a good nurse.
And yes, as I vocalize this I realize that it is exaggerated and childish, but somewhere underneath my jokes is real concern. I do not possess an incredibly “scientific mind.” I can learn science and it does interest me, but I also love to read and write – and when will I have the time for that? How will I have the time or motivation to go on runs or invest in friendships? Am I destined to become a tired, heavy, lonely nurse? How will I be able to give to my patients if my well is dry? My only hope is that real life is not as dramatic as I imagine it. Or, that the Lord will to provide me with the resilience and energy to do my job with passion.
And not to mention my fear of making mistakes… somehow nurses have to go around on empty stomachs making decisions , passing meds and performing tasks without making mistakes. The real, primary fear that I have about nursing is making mistakes. I know it might happen – but how serious will it be? Will I catch it? What will happen? Am I intelligent and detailed enough to avoid mistakes? Prior experience says “no,” which leads me to believe that I still have to undergo a great deal of change before I will be a good nurse.
Blog #4: Visionaries
Today in our Social Issues course, a panel of 8 nurses came to discuss their careers and experiences with the Northwest U nursing students. All of the nurses on the panel had been nurses for over 20 years, and some far exceeded that mark. What struck me about these exceptional nurses is the amount of change they have seen the profession under-go and how much they have been pioneers of change themselves. A number of the nurses had begun their nursing careers in the 1960’s, a time when race and gender were very prevalent issues. To loosely paraphrase one of the nurses: “When I started nursing school in a small Christian program, there were no people of color; according to the university ‘if they admitted one person of minority ethnicity that person would feel even more awkward in a class of Caucasians.” The nurse went on to say, “It wasn’t good, but we wanted to be nurses and we did what we could. And we have really changed things since that time.” These women were true pioneers, even if they did it quietly and gradually. Many of them are highly educated, receiving the Doctorate’s degree in the 1960’s. Many have been involved in building new health care projects from the ground up. I get very excited about being involved in progress and change. Being a nurse is a very privileged position. We have privy into our patients’ minds and fears, and we can use our knowledge to promote improvements in patient care and systems. We can see the effects of protocols and systems on real people, and we can work to improve these systems so that they are more effective and efficient.
I think the nursing profession draws many visionaries and real "do-ers". Because nurses care so much for people, they are not easily deterred when it comes to advocating for that patient. The nursing profession is very worthwhile and significant, and worthwhile causes are always worth the effort. I am sure the being a visionary is often hard and lonely, yet I look at women like those on the nursing panel, and I cannot help but think that they are proud about how they lived their lives. I want to live a life that I am proud of and be a person that I respect, and that includes devoting myself to valuable endeavors. I am glad for women like the nurses of the 1960’s who pursued higher education with fervor and worked for racial equality and better patient care. I can only hope that I will have an equal impact on the nursing profession.
I think the nursing profession draws many visionaries and real "do-ers". Because nurses care so much for people, they are not easily deterred when it comes to advocating for that patient. The nursing profession is very worthwhile and significant, and worthwhile causes are always worth the effort. I am sure the being a visionary is often hard and lonely, yet I look at women like those on the nursing panel, and I cannot help but think that they are proud about how they lived their lives. I want to live a life that I am proud of and be a person that I respect, and that includes devoting myself to valuable endeavors. I am glad for women like the nurses of the 1960’s who pursued higher education with fervor and worked for racial equality and better patient care. I can only hope that I will have an equal impact on the nursing profession.
Monday, October 12, 2009
Clinicals: Thoughts on the Artifical Extension of Life
I must admit I have mixed emotions regarding the beginning of clinical. Firstly, I must say that I love being in the long term care center, and finally providing care for patients, however clinical have raised many questions in my mind.
The primary question that I have been dealing with through the first two weeks of clinical has been the matter of artificially extending life with the use of modern medical science and medications. Of course, as a nurse I whole-heartedly agree with keeping our patients alive, in fact I believe that is a rather central goal in nursing. I simply cannot reconcile myself to the fact that so many people in the long-term care facility are no longer themselves. I believe that every individual consists of spiritual and physical aspects, specifically mind, soul and body. If the mind irreversibly begins to die, is it ethical to preserve the body?
One of the first questions of philosophy is the following: what makes us human, or rather what set us apart from the animals? This is certainly a very complex question that cannot be answered casually in a blog entry, but I think it is worth contemplating as it deeply affects the way we view the world and other people. I am including this quick philosophy side-note because I think some of what makes us human is our ability to communicate, our consciousness, our capacity to empathize with others, feel emotions, and learn. And as I look at my patient with severe dementia I cannot help but think that part of what makes her uniquely her is being robbed by disease. Our intensive medication regimes keep people’s bodies alive far past the time when their personality or mind begins to fade. I am always encouraged when my patient recalls memories of her up-bringing, or shares a laugh, because I feel that the cloud of dementia is lifted and I can briefly see the real person I am caring for. Her mental status does not determine the quality of care I give her, yet it is deeply rewarding for me to see who the real person is beneath all the diagnosis.
My patient goes through cycles in which one thought dominates her mind and conversation. Last Friday, predominant thought was appreciation for me. Every few minutes she repeated her appreciation for my work and how glad she was that I had come. I knew that a great deal of her repetitiveness and conversation was a product of dementia, yet I was also sure that somewhere in her mind those statements were sincere. I do not care if I cannot reverse dementia - but I do care that I can make simple moments and days better for another human being - even if that person does not remember.
One thing that I can say with confidence is this: I do not want to be sustained by medicine long after everything that makes me uniquely “Chanda” has gone. On the rest of this subject, however, I am relatively undecided.
The primary question that I have been dealing with through the first two weeks of clinical has been the matter of artificially extending life with the use of modern medical science and medications. Of course, as a nurse I whole-heartedly agree with keeping our patients alive, in fact I believe that is a rather central goal in nursing. I simply cannot reconcile myself to the fact that so many people in the long-term care facility are no longer themselves. I believe that every individual consists of spiritual and physical aspects, specifically mind, soul and body. If the mind irreversibly begins to die, is it ethical to preserve the body?
One of the first questions of philosophy is the following: what makes us human, or rather what set us apart from the animals? This is certainly a very complex question that cannot be answered casually in a blog entry, but I think it is worth contemplating as it deeply affects the way we view the world and other people. I am including this quick philosophy side-note because I think some of what makes us human is our ability to communicate, our consciousness, our capacity to empathize with others, feel emotions, and learn. And as I look at my patient with severe dementia I cannot help but think that part of what makes her uniquely her is being robbed by disease. Our intensive medication regimes keep people’s bodies alive far past the time when their personality or mind begins to fade. I am always encouraged when my patient recalls memories of her up-bringing, or shares a laugh, because I feel that the cloud of dementia is lifted and I can briefly see the real person I am caring for. Her mental status does not determine the quality of care I give her, yet it is deeply rewarding for me to see who the real person is beneath all the diagnosis.
My patient goes through cycles in which one thought dominates her mind and conversation. Last Friday, predominant thought was appreciation for me. Every few minutes she repeated her appreciation for my work and how glad she was that I had come. I knew that a great deal of her repetitiveness and conversation was a product of dementia, yet I was also sure that somewhere in her mind those statements were sincere. I do not care if I cannot reverse dementia - but I do care that I can make simple moments and days better for another human being - even if that person does not remember.
One thing that I can say with confidence is this: I do not want to be sustained by medicine long after everything that makes me uniquely “Chanda” has gone. On the rest of this subject, however, I am relatively undecided.
Christians on the Forefront of Progress
As I was reading the text “Called to Care” I noticed that the author had a skeptical attitude regarding scientific advances or changes in nursing practice. Culturally, I think there is a stereotype regarding Christians as “anti-science” or “slow to accept change.” I have even noticed a tendency among some believers to be prejudiced against people of different religions and lifestyles. Even at Northwest University I have heard derogatory comments made about homosexuals and people of different religions – and it surprised and saddened me. While I certainly think there are things that are important to maintain, it makes me sad to think that many people associate Christianity with ideas like “skepticism to science” rather than love or justice. In a class discussion the question was raised about whether or not secular nurses can be good caregivers. I think this idea reveals a subtle reluctance to cooperate with people who do not share our belief system. Of course secular nurses can be good caregivers - even atheists have the ability to love. If we doubt our co-workers ability to care for their patients than we cannot truly cooperate with them. As a Christian nurse I want to inspire and encourage my fellow nurses, rather than alienating them with the misuse of my religious beliefs.
We are in the fortunate position to be entering the health care feel where we will have countless opportunities to engage in dialogue to co-workers regarding changes in the nursing practice or research findings. I believe it is important to prepare ourselves for these discourses so that we may accurately portray what is important to the Lord, not simply our own opinions. Christian nurses should be on the forefront of research and progress, so that we may be involved in advances that improve patient care and the quality of nursing care. Certainly we should practice the techniques that work, but we should also be actively pursuing ways to improve as nurses and caregivers. As I prepare to graduate and eventually enter the work force, I want to do my part to re-invent society’s conception of Christians. I want to be known for my excellent care and determination, not for any prejudice or bitterness. We will accomplish nothing for the Kingdom of God by parading our opinions, rather than the message of love. I am tired for being known for all the wrong things: I want to be involved in progress and improvement.
We are in the fortunate position to be entering the health care feel where we will have countless opportunities to engage in dialogue to co-workers regarding changes in the nursing practice or research findings. I believe it is important to prepare ourselves for these discourses so that we may accurately portray what is important to the Lord, not simply our own opinions. Christian nurses should be on the forefront of research and progress, so that we may be involved in advances that improve patient care and the quality of nursing care. Certainly we should practice the techniques that work, but we should also be actively pursuing ways to improve as nurses and caregivers. As I prepare to graduate and eventually enter the work force, I want to do my part to re-invent society’s conception of Christians. I want to be known for my excellent care and determination, not for any prejudice or bitterness. We will accomplish nothing for the Kingdom of God by parading our opinions, rather than the message of love. I am tired for being known for all the wrong things: I want to be involved in progress and improvement.
Calling
Blog #1
The question was raised a few weeks ago in class about whether we as students consider nursing a “calling.” The phrase “calling” certainly carries a number of connotations. In my mind, it implies a significant supernatural experience or a specific moment in time in which a person feels confirmation regarding a certain vocation. I am hesitant to use the term “calling” in reference to my desire to enter nursing, in fact I do not think the emphasis should be on whether or not one has experienced a supernatural experience, but rather if one has enough diligence to carry out his or her desire to become a nurse. In my understanding of Christianity, the moments of true growth do not happen in isolated experiences, but rather in the daily commitment to live a life of perseverance towards a worthwhile end. My desire to enter nursing was cultivated over a number of years as I began to learn more about the functions of the church and the responsibility to believers. I connected what I believe about the Christian responsibility to be dutiful ambassadors; working to promote justice, health, and peace, with my idea of the nursing vocation and decided that the two were very compatible. I do not feel called to a certain region of the world, I simply feel called to whatever community could benefit most from my skills and training. Certainly the question of utmost importance is not whether I have experienced a supernatural calling experience, but rather, how will I be able to complete the work that God desires me to do?
The question was raised a few weeks ago in class about whether we as students consider nursing a “calling.” The phrase “calling” certainly carries a number of connotations. In my mind, it implies a significant supernatural experience or a specific moment in time in which a person feels confirmation regarding a certain vocation. I am hesitant to use the term “calling” in reference to my desire to enter nursing, in fact I do not think the emphasis should be on whether or not one has experienced a supernatural experience, but rather if one has enough diligence to carry out his or her desire to become a nurse. In my understanding of Christianity, the moments of true growth do not happen in isolated experiences, but rather in the daily commitment to live a life of perseverance towards a worthwhile end. My desire to enter nursing was cultivated over a number of years as I began to learn more about the functions of the church and the responsibility to believers. I connected what I believe about the Christian responsibility to be dutiful ambassadors; working to promote justice, health, and peace, with my idea of the nursing vocation and decided that the two were very compatible. I do not feel called to a certain region of the world, I simply feel called to whatever community could benefit most from my skills and training. Certainly the question of utmost importance is not whether I have experienced a supernatural calling experience, but rather, how will I be able to complete the work that God desires me to do?
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