The Really Useful Page + The Last Patient

I run a website to help out my clinical level at NSU.

Basically, I scan all the paperwork forms into the computer so that they can be printed from the website. The copy machine is 10 cents a page, but computer lab printouts are free. My clinical level has found it invaluable, so I plan to expand the project next year. I'm thinking of requesting some official school webspace to set this up permanently. It would be a student-run thing that would fill in the gaps left by teachers who can't figure out how to use Blackboard.

Those of you at other colleges... you should look into doing this for your own school. Its a great community-support thing. (I'd link my page as an example so you could see it for yourself, but there are copyright issues involved.)

It is important for nurses to help eachother.

~~~

Today was my last day in the hospital as a first level clinical student. I can hardly believe the semester has flown by so quickly! I had an exciting ending to the semester. My patient had wildly fluctuating glucose levels and uncontrolled diabetes. Thankfully they'd gotten her down from 400 to about 200, and holding steady. Then, when we were talking about brushing her teeth, she told me she wasn't feeling right. A quick glucose check showed her level to be down in the 40's. Freak out! I was running around with orange juice and sugar packets and sticking her finger every fifteen minutes. She started to get drowsy before I got the juice in her. Thankfully she didn't pass out on me! As I left I watched her grimace as they kept re-sticking her for some blood to take down to the lab. The longer I work in the hospital, the more thankful I am that I am an "easy stick".

She was an interesting patient in more ways than one. She told me about her move into the nursing home after her daughter could no longer care for her. It was disheartening to hear; she was obviously intelligent and fully cognizant. She didn't want to bother her daughter with her depression. I found myself unable to speak. What words could I offer in the face of such suffering?

I feel this society needs a major paradigm shift when it comes to nursing homes. People think these homes are where people go to die, but that isn't the case at all. Nursing homes are places where people keep on living.

True, quality of life is often diminished from what a person once knew. Especially for a woman such as this; she is only there so health professionals can monitor her blood sugar and her tendency for falls. When I listened to her speaking in such soft, deliberate tones, she conveyed to me such profound sadness. Yet even with the sadness, her voice also held a resolve to live in spite of it. To live.

When I am old, I hope to bear myself with such dignity. When I am depressed, I hope I can find such strength of will.

Report Card

*does a dance* Who made A's on their last two tests? That's right, it was me. And it's something to be proud of; the third Pathophysiology test had a class average of 71%. (As you know, 80% is the lowest passing grade.)

Patho is going to keep a lot of people from going on to second level. One guy in my group has already calculated that he can't raise his average to 80 even with the final grade, so he's out before the semester's even over. Poor guy. Some say Patho was easier over the summer last year. I don't regret waiting to take it, and I'll be more than happy to pass with the B this year.

We're in the midst of registering for second level classes. Everyone is telling horror stories to their underclassmen. "Walker knows her stuff. If you get Landry, she'll only put you on the spot about drug cards and send you home with an F if you don't know what all your meds are". Others say "Downy is really easy, but Landry is better because she doesn't assign much paperwork". Conflicting rumors. I wonder which are true? Its so hard to judge, with everything being so subjective.

Honestly, I could care less who I end up with. If it's someone really hard... well... I know I'll be that much better a nurse for it. I may be a grade-obsessor, but I'd rather make a hard-earned C than an easy A, since I'll know for sure that I passed by sheer force of will rather than from people handing me things. Easy teachers don't make for high NCLEX scores.

What We Are Asking For

Create an Office of the National Nurse to Advocate for, Educate and Empower American Health Care Consumers

Request: Create an Office of the National Nurse to focus on providing all Americans with preventive health care resources.
The office is necessary to acknowledge the critical role nurses play in hands-on patient care and education. The Office of the National Nurse would provide Americans with the tools to prevent disease and effectively manage chronic illness thereby reducing utilization of health care resources. The National Nurse will oversee state coordinators who will assemble nurse teams to provide screening, education and referral services in their communities.

Nurses treat people in their response to wellness, disease or injury and do this through collaboration with physicians and other health care service providers. The Office of the National Nurse will function similarly in a complementary role with the Office of the Surgeon General and other current agencies providing health care services.

Background: There are 44 million uninsured Americans and millions more are underinsured, leaving large gaps in people's access to primary and preventive care services. Americans who are insured may have limited understanding of the importance of primary or preventive health care services. Nurses know the importance of outreach and integrating patient and family education into their care for every patient. Studies demonstrate that when nurses provide early intervention, educate and work closely with patients, patients require fewer hospital and emergency care visits. (Palmer, Appleton, Rodrigues, 2003; Cherry, Moffatt, Rodriguez & Dryden, 2002) Nurses overseeing and promoting preventative care will decrease the need for hospitalizations, thereby reducing utilization of Medicare and Medicaid dollars. (Collins & Wadhwa, 2005) Ultimately, fewer nurses would be needed to provide "sick care" at the hospital or nursing home bedside, thus lessening the impact of the current nursing shortage.

Community based nurse led health services focusing on identification and early intervention have been shown to prevent unnecessary admissions to hospitals, reduce length of stay of necessary hospital admissions, and improve patients' ability to function while enjoying a higher quality of life. (Young, 2005)

There are 2.7 million nurses who work on the front lines in the United States health care system. Even though they are one of the largest groups of health care service providers in the nation, nurses hold too few positions of influence to have a national large-scale impact on the nation's health. The Office of the National Nurse integrates Nursing's Agenda for the Future (2002) as proposed by nineteen national nursing associations and organizations that call for an improvement of the image and value of the nursing profession. The activities of the Office, as well as the National Nurse, will fulfill this objective by portraying nursing as a nationally respected and valued career.

Also in Nursing's Agenda for the Future (2002)one of the objectives calls for achieving nursing's desired future state by creating "a process that provides for ongoing communication, collaboration, support and monitoring of the overall plan activities within the nursing community and among other health professions, the health care industry, and health care consumers."(p.9)

Plan: Create an Office of the National Nurse to promote and coordinate opportunities for the nation's registered nurses and licensed practical nurses to collaborate in community-based Nurse Teams. Nurse Teams will utilize the traditional nursing approach that focuses on assessing the individual's overall physical and mental state of health and working with the patient to achieve a positive outcome in accessing health services.

The Nurse Teams will be responsible for the implementation of four educational programs per year which have been identified by the National Nurse through collaboration with the Surgeon General's office and other members of the health professions, including but not limited to members of the nursing and medical professions, pharmacists, nutritionists, health educators, the Center for Medicare and Medicaid Services, pharmaceutical companies and hospital associations.

These programs will occur nationwide simultaneously to raise awareness and increase participation. For instance, if obesity/diabetes screening is the top national health priority, then the National Nurse would direct the State Coordinators who would direct their Nursing Teams in presenting the educational program in churches, supermarkets, schools, senior centers, libraries and other accessible locations in their communities. Any licensed nurse in the country would be allowed to receive training to participate and these educational programs will be designed to reach every American instead of a targeted population.

State Nurse Teams will include nurses prepared at all educational levels and will represent diverse populations. Programs will foremost focus on keeping Americans healthy by providing education about how identify their individual wellness needs, understand how to access available health services, and how to navigate the myriad of choices to better care for themselves.

Programs will improve quality of care by helping identify the special needs of communities including but not limited to geriatric and culturally diverse populations. As members of their community, nurses are better able to identify and target the diverse needs of the patients they serve.

The Office of the National Nurse, as a center, will share and disseminate information and collect data from the Nursing Teams to assist government agencies such as the CDC with their ongoing research. The Nurse Teams will focus on educating Americans using "best practices" to improve their health while reducing costs.

Nurses identified as "experts" from the National Nurse Teams will present one health education topic to the American people each week. The expert is defined as a nurse who has the educational background and practice experience to represent the health topic information to be delivered. These weekly educational pieces will be available for broadcast and on the Internet in different languages to reach America's diverse population. The goal is to create the most massive community outreach ever conducted by nurses.

Role:

The National Nurse will serve as spokesperson, publicizing the distinct role of nursing, and encouraging nurses to become involved in grassroots activities and educating the American public about the services provided by the Office. Educating the public about nursing's pivotal role in health care will be basic to involving nurses in health care policy formulation and in key business decisions that affect nursing's future." (Nursing's Agenda for the Future, 2002, p 10)

The National Nurse will be responsible for collaborating with members of the nursing community and other health care providers to determine priorities for the National Nurse Teams' community-based programs.

The National Nurse will identify state coordinators for each of the states that will be responsible for ensuring the volunteer activity is disseminated to the grassroots level.

Through the Office of the National Nurse, nurses from around the country will sign up indicating the state they are licensed from and their willingness to serve on a Nurse Team in their community.

The National Nurse will choose an expert nurse to address the nation via a public service announcement on pertinent health care topics.

The National Nurse will actively recruit qualified individuals into the profession and encourage nurses to become nurse educators through media campaigns and public appearances.

The National Nurse will work with other interested persons and departments to promote policy that would improve the nation's health.

The Office of the National Nurse will collect data to demonstrate the success of the National Nurse Team activities.

A Paper and a Picture

I am writing the most inane paper.

My "Nursing as a Profession" course is exactly what it sounds: a class that studies why the career is a profession rather than simply a job. We read long chapters about the history and legalities of nursing, and compose over-researched essays on pretentious topics. Right now I have to write a two page, APA-perfect paper about a professional organization. I've chosen to do mine on the National Student Nurses' Association (NSNA) because I'm already a member. Usually when writing people complain about having to spread a little information out over several pages, right? Oh no; this one is a burden because I don't know how I'll ever fit all the criteria into so little space. I loathe this assignment far more than my "Definition of Nursing" paper from a few weeks ago. Despite having many resources, I feel like I haven't made any progress all day.

Hence this blog entry. I love to take a break.

I find my mind drifting to other things NSNA related. For example: I've finally finished my shirt designs for the school's SNA chapter. I think these designs are much more interesting than the huge school seal they've had on their backs for the last couple years. Apparently our SNA has gotten itself in trouble in the past for having questionable phrases on previous shirts. Things like "Not Tonight, I Have Clinicals". I think its hilarious personally, and not nearly so bad as some of the things we've seen at the national conventions (One group had shirts saying "Palpate THIS". If only someone walked by our Dean in one of those, hoooo boy.)

I think they turned out quite well, don't you? Sorry about the watermarks.


After I'm done with the paper, I have to study for a test on Monday. It's in Health Assessment, one of my B classes. Being the grade-obsessor I am, I'm certain I'll end up barricading myself in the room with my books until midnight. (Emerging perhaps only for Starbucks?) I can't wait until Monday as over, since after that I'll have nothing major left to do before Thanksgiving break. There IS a Thursday test in Foundations, but that class is always a breeze. Then, I can't wait to climb in the car and head up to Memphis for family, food, and fun. Thanksgiving is wonderful.

I love to take a break.

Foley Catheterization, Genitals, and Social Rules

Before we can dress, administer, or insert anything in the hospital, we must pass a clinical checkoff. Today I had a practical examination in Foley catheterization. (For those of you who don't know what that is, it's where you insert a tube into the bladder. Through the urethra. Yowza.)

The labs are filled with these pathetic looking dummies students can use to practice everything on. I say pathetic because they look worse than many of the vegetative patients I've seen in the hospitals; their plastic bodies have interchangeable parts for just about every ailment possible. You can even swap out genitals, which amuses me to no end, so today I inserted a Foley tube into a somewhat disturbing labia mold. Disturbing because the urethra was very exaggerated for easy learning, which is NOT the case in the real world. (Where the hell is the hole?)

I'm not someone who balks at nudity. (As a 96 year old woman once said to me, "If you have something I've never seen before I WANNA SEE IT.")
But I'm also not someone who thinks you can totally objectify something like this. For example: sometimes when inserting Foleys in males you can first inject this numbing gel inside the urethra. Only problem is this: you have to hold it there for five minutes. My instructor said "I've never done the gel thing, probably because I'm not one for small talk". Honestly, what do you say to someone while you hold on and wait for the stuff to kick in?

It always amazes me how willing people are to get naked for you once you wear a hospital uniform. I've had a good number of patients sofar this semester, and not a one objected to me lifting their shirts to listen to their chest, or helping them put on clean undies and a gown. Of course, they have no reason to worry about me seeing them naked; I am a professional. I'm going to see a million before I'm done. But what is it that makes them trust me with their body more than they would any other stranger? Surely it isn't the purple uniform... though I'm certain they'd be more uneasy if I was there wearing jeans and a tee-shirt.

We build up the most interesting environmental associations. Being in a certain setting, playing a certain role, and wearing a certain costume makes all the social rules change. Sometimes the roles can be de-humanizing (people expect super-human responses to their problems, especially from doctors). When someone fails while playing their role, we are disillusioned and disappointed with the role (profession!) as a whole, and not just the offending individual.

This is why I try very hard not to laugh at the plastic genitals of the practice dummies when I'm in the lab, less I undermine my professionalism. But another part of me sees that professionalism is a function of context. Objective detachment is a function of one's role. And though nursing is arguably something that becomes ingrained in one's very identity... I AM still a student.

So. Between you and me, I am seriously considering turning all the "parts" upside down one day. Just to see if anyone notices. I have the serious suspicion the instructors would find it hilarious. For all the roleplay, nurses aren't as stuffy as people think. So long as no one is watching. ^_~

I thought this was going to be a documentary

..but it is far too sparse to provide any accurate picture of what it is to be a nursing student.

Or perhaps, maybe this is the perfect example of what nursing school is... I am so busy, I am unable to find time for even the smallest tasks like blogging.

Today is a Tuesday, which means I must prepare my preclinical paperwork before going to the hospital at 0630 tomorrow. If I want to give a medicine, I must construct a "drug card" detailing the drug's action, effects, side effects, safe dosage level, half-life, nursing implications, etc. Today I (somewhat masochistically) picked a patient with no less than 17 different medications I am able to give. Quite a cocktail, that bunch. Needless to say, I'm going to be really really busy for the next seven hours.

I was set back in time a little bit by a random drug screen today. Once a semester we have to pay $30 to pee in a cup. Failure means dismissal from the program, but I'm beginning to think that it is more for money than to assure quality service. $30! Yeesh! Life is expensive.

Time to study. Good luck with your own studies, everyone.

Please Sign Up For Our Newsletter

The National Nurse Team would like to encourage all website visitors to sign up to receive our newsletter. This is a way you can find out the very latest news about pending legislation, new supporters, and published articles.

For those of you new to the website, here is a short list of what the Office of the National Nurse will accomplish:

* Collaborate with members of the health care team to determine the health care agenda for America.
* Participate each week with an expert nurse to address the entire nation, not just a targeted population, on ways to prevent disease and promote health (for instance, how to have a healthy heart or strategies to prevent diabetes).
* Utilize the Internet to make the above information available in multiple languages to reach our diverse population.
* Encourage every nurse licensed in the U.S. (there are presently 2.7 million nurses) to volunteer to be a member of a National Nurse Team in their own community.
* Organize and promote four nationwide health education days per year that will be coordinated and delivered by the National Nurse Teams in every city and town across America.
* Build an infrastructure of ready available nursing teams that could assist during the time of a national disaster/epidemic.
* Give public recognition to the work nurses do every day and help stem the nursing shortage by attracting others to the profession.

Be Aware and Prepared

Last Wednesday, Portland Community College nursing faculty and students participated in the Washington County Public Health preparedness exercise. The objective was to practice dispensing medications/vaccinations to community members as efficiently and quickly as possible. Should there ever be any type of communicable disease event where this action would be warranted, the public would then be notified (TV, radio, internet) with instructions of where to go to receive treatment. The county health department along with first responders ran this event. M n Ms were dispensed, either plain or peanut. Again, one wonders if real vaccinations were needed, would there be enough nurses ready in a very short period of time to help? This is another reason why we need an Office of the National Nurse, with National Nurse Team members in every community who could immediately respond to provide the best possible care to all Americans

Special Announcement

The National Nurse Team supports the extraordinary efforts of the Center for Nursing Advocacy in their plight to have released from prison five Bulgarian nurses and one Palestinian physician. These healthcare providers have been wrongfully accused and imprisoned. If they are not released by November 15, they face execution by firing squad. Please learn the details of this travesty and join Center for Nursing Advocacy's letter writing campaign to free these innocent victims of political pandemonium. Visit www.nursingadvocacy.org/news/news.html for more details.