This final project has been very interesting. Going into it, I did not think I would learn so much about the process and my topic. My groupmate and I worked really hard on this project and put everything we had into it. Many challenges presented but through communication and reasoning we were able to resolve it. This project has taught me how to collaborate with others in a way that is not usual. I have never written a paper with another person before but I really enjoyed it. I feel it requires a different set of skills from other collaboration activities. You have to work through every little detail and both agree on it before continuing. This will help me through my career when dealing with similar situations. For a future employer, I would want them to know that I stayed driven and positive during this project. I worked through each assignment diligently and completed it efficiently. From this project, I can contribute to critically appraising articles and help with examining them. I can identify good articles from bad articles by looking over the credentials and reading the article. I can positively contribute to the medical profession by participating in these articles and giving adequate input. Through this team process I was able to identify some of my strengths and weaknesses. I feel like I am strong in designing and articulating words in a way that makes sense and is meaningful. I feel like I need to work on my grammar capabilities as sometimes this was lacking. Over all the team process was very beneficial and provided great cooperation experience.
Ethical Considerations For EBP
Reviewing the provided resources about nursing and ethics, my opinion has not changed. I understand further that the role of a nurse will entail ethics. This is because patients have a wide view on the practices that they want to participate in. Educating the patient and informing them of recommendations should be a priority of the nurse. With this, it comes down to what the patient feels comfortable doing based on their past experiences or practices. There is a common saying by George Santayana that goes, “Those who do not learn history are doomed to repeat it.” This is the case for ethics in nursing. Understanding what practices have been preformed before will help further the knowledge of the nurse. Taking a deeper dive into these practices can help further progress studies that examine the same variable. A nurse should have a good understanding of the events that have occurred in the past and what lead up to those events. This can help prevent possible complications that could arise. This course specifically has enhanced my knowledge of the relationship between nursing and ethics. This course looks at evidence based practices and how to read, interpret, and explain these articles. It starts with understanding what you are reading. Once you have the ability to interpret results and hold the ability to explain them, the nurse will be able to communicate the results and consider them in their practices. Evidence based practice looks at problem solving in the medical profession while incorporating the patient and family. This should be done with every evidence based article that revolves around care. A nurse should have the capability to participate in these studies once they understand the key concepts of EBP. Contributing can ultimately result in a better experience for the patient by looking at what works and what does not work. This class, along with my ethics class, have delivered home the importance of ethics in nursing. I have the knowledge to examine articles and understand how they can play a role in the care I am providing. In short, the job of the nurse is to provide the most exceptional care keeping in mind the beliefs, values, and morals of the patient.
Appraisal and Synthesis
Our topic of discussion has been very interesting to use. We have found articles that follow on both sides of for and against the use of cannabis for symptoms related for Parkinson’s disease. This disease has no cure so it is the job of the health care team to explore and find new treatment options that best suites the patient. Our research and analysis of our articles made us really think about ethics and how they can play a role in what treatments work some patients. Some cultures and religions may be against the use of cannabis, but the nurse should always educate patients on the variety of options that they have. Without education, the patient could be left guessing what to do rather than making an informed decision.
This critical appraisal did not change my mind, rather, enforce what I had expected. I knew cannabis could play a role in sleep and muscle tenacity in patient’s who have Parkinson’s disease. I am family with Michael J Fox who is currently sufferings from mild Parkinson’s. We watched videos on him to get a better understanding of how the disease works and affects patients. Our findings still lead us to resort to further research before providing a strong recommendation for or against. This does lead me to follow up on the topic as more research is found out about the efficacy. My teammate and I both agreed with the articles that are pro cannabis as they can be affective. The process of articulating the paper has been a challenge. We both have very expansive minds that can counteract each others views. We debated and both came down to the same consensus. Our writing styles are both different as well but I feel like this can compliment our paper by providing different views intertwined with each other. I feel like our hard work through this process of figuring out our challenges will ultimately benefit us.
Simulation Alternative Assignment 1
Watching these interviews, I could gain insight into the feeling in the room and got to observe and listen to questions and how the patient responds. This is key to observing as different patients can react differently to certain questions. The videos feel very real, as if they were not a simulation, which gave more insight into the role of therapeutic communication during the mental health assessment process. In one of the scenarios, my classmates started to talk about the patient’s job and what they liked most about it. This invoked a positive reaction where the patient who was more reserved, opened-up a little more and started describing their work life. This type of communication is beneficial as it can get the patient to talk more about what is going on, in turn, will allow the staff to get to the bottom of the patient’s issue.
In another video, my classmates effectively used various therapeutic communication techniques to build a trustful and caring patient-nurse relationship. Some of the techniques that were observed was silence, active listening, reflection, summarizing, and acknowledgement. These techniques worked well in having the patient express what is going on, as well as, build on the relationship. This intervention as such is extremely beneficial to the patient. Communication is key in almost all situations. Speaking with the patient and observing and listening to what they have to say is vital to understanding and treating the issues at hand. It can help the patient identify themselves what is going on which can lead to a solution. Therapeutic communication should be used in all scenarios regardless of what the patient is going through. These simulation videos demonstrate the efficacy of therapeutic communication and that it is immensely beneficial.
From Inquiry Through Discovery
After thorough development or our PICOT question and retrieving peer edited articles, we found that some revision was needed. We decided to look at a broader age group in which we included anyone receiving the medical marijuana with any age. This helped in finding more article as needed for our paper. In continuation of developing our paper, we looked in depth at each article chosen to compare results and see if they would fit in the scheme of our paper. We want to create a connection between the articles that include the major nursing theory. This was not as easy as it seemed and developed challenges. First was in choosing a theme that correlates with he articles and the scheme of the paper that we want to deliver. This in itself presented a challenge as there was not many theories that we could intertwine into the paper. This made us question some of our sources and we decided to take a look for other sources that could present new information. In doing so, did not completely resolve our issue, rather, gave us more knowledge of our topic and how to discuss it in our paper. With these challenges came success. We were successful in defining what our articles mean and how they relate to each other. With the class activities, we were able to understand what the articles meant and how the information is presented relates to what we need to know. This was not an easy task and required work but we now have a better understanding of what each article is trying to portray. This project has been a challenging one but with determination to succeed, these challenges have been over come so far.
Planning The Journey
Eric and I plan to be very successful in drafting and writing our team project. We cooperate and listen to each other very well and this will set us up for success. We will be on top of each other throughout this whole project as we live together and can keep each other accountable. If one of us is lacking in our part, we will communicate that and find the most effective compromise to the issue. A benefit we have is that we live together and can do each part together. A down fall is that we both can procrastinate at times but I believe this will not be an issue for this project. This project will benefit my communication with others and increase my ability to problem solve. I look forward to getting after it during this project to show case my abilities.
Mental Health Stigma
- There is a substantial amount of stigma that revolves around mental health. This negativity can be sourced from the lack of knowledge of the reoccurring issue. A lot of people are unaware of how prevalent mental issues are in society. It is hard for people to conceptualize that one is suffering from a mental illness when society is so focused on observations and physical appearance. Just because one cannot see the disability, does not mean that the disability does not exist. It is important for people to educate themselves on issues that are frequent in a lot of people. Self-stigmas can also be derived from societies outlook on people with mental illnesses. People are so focused on there public appearance they forget to be themselves. Society looks down upon people with these disabilities, which in turn causes self-stigma. It is important to understand your condition and work to better yourself without the negativity.
- Culture plays an important role in everyone’s conception of wellness and illness. It works with values and beliefs to form the basis of what you believe in. With this, it could deter people from getting screenings done or taking medications that can help a person improve their condition. If a person grows up without the knowledge or awareness about mental illnesses, then they are less likely to seek out help. Religion can also play a similar role in the influence of a person’s response to mental illness. It can give a person direction and influence decisions in their daily life. It is important to establish what values and beliefs you believe in and incorporate them into your own wellbeing.
How I Made a Difference
The first clinical rotation of my nursing career was more than exceptional. I reinforced procedures learned in class, learned new hands on techniques, and built communication strategies with patients. This experience will be the foundation of my nursing career and I will look to build off it. Not only did I reinforce my techniques, I also managed to help and make a difference in a patient.
I was performing my bedside assessment on this little old lady. She was the sweetest and kindest patient I had. We talked about the Portland campus and how my nursing education was going. In doing so, I cracked a couple of funny comments about nursing school, and she chuckled. I explained to her that it was my first ever clinical experience and to just bear with me through this process. I was a little nervous but also excited to take what I have learned in the lab and practice it in person. I started with the neurological exam and moved down to the rest of the
body. I auscultated her heart and lungs, palpated her abdomen, and examined her skin. Through the exam I gained confidence. I provided descriptions, education, and reasoning with each movement and analysis. I was as thorough and informative as I could be. With this, the patient gained the greatest outcome of it all. Once I finished, the patient was grateful. She said that I was the first person to tell her why they were doing these tests. She was amazed as to how complex
the human body was. She did not know about capillary refill, skin turgor, or even pedal pulses. I was the most informative person to who her as she gained knowledge and understanding of how these things work. I thanked her as I finished the exam for being supportive through my first assessment. She thanked me back for teaching her these new topics. I left the room and never saw her again.
The situation could be small or large but no matter what, it is important to make a
difference. The small conversation I had with this patient will go with her through the rest of her life. As little as it can seem to many people, it is as great as anything to the patient. Things aren’t going to be easy at times in the nursing profession, but it is important to take a step back and observe the greatness that nurses do and to reflect on the influence you have on people.
Medication Reconciliation Reflection
Doing the medication reconciliation was very interesting to me. I learned a lot about my family history as well as some of the medications they use. It is interesting to see why a doctor decided to prescribe these and see how they work together with other prescribed medications. A lot of the safety concerns with my patient were the same. It made me think they would have a greater possibility to see these adverse effects. Yet, this was not the case. The main safety concerns seen was headache, dizziness, and nausea. These symptoms are typical for a lot of medications and are seen in a lot of patients. An important aspect that was noted is that the patient required reading glasses to read. I mentioned to the patient that they want to always have their glasses when they are going to take their medications. This will limit the risk of double dosing or missing a dose by taking the wrong medication. The patient had a full understanding of what each medication was for, how to take the medication, adverse effects of the medication, and surrounding teachings of the medication and condition. The patient was on four different medications in which the goal was to lower blood pressure. Upon review, the patient stated that it was the only combination of medications that would stabilize and keep the blood pressure in normal range. It is important that the patient knows what medications they are on and what they are used for so that they are trying to diminish the underlying condition. With all of this, there was no serious drug to drug interaction that the patient had. The medications all fell under a moderate consideration but no serious interactions. Then patient was very responsive and receptive to teachings that included a nutritional reboot, increased exercise, as well as reducing stress. I hope to follow up soon with the patient to see how they are handling the goals set to help the patient live a healthy and happy life.
Response to Theresa Brown’s Critical Care
Life is an ever changing thing. It is fast paced, difficult, and challenging yet, we all get through it. Nursing embodies this essence of what it means to be alive. They deal with death, they deal with new life, and they deal with everything in between. Nurses hold this strong power and courage to deal with these things with compassion and care. Theresa Brown’s book, Critical Care, tells the compelling story of her life as a nurse. She goes through the ups and downs as you would expect, but captures the pureness that the job entails. We learn about the love hate relationship, death, power hierarchies, and the true meaning of being a nurse.
The love hate relationship in the nursing field can be seen in everyone. Brown uses the poem Catullus: Odi et Amo by Frank Bidart as a way to show a comparison between her livelihood in nursing to a poem. I can clearly see and understand how one can love yet hate their career in nursing. The job entails ups and downs from helping a father get back on his feet allowing him to play with his children, to watching a cancer patient lose their battle. Nursing calls for this duality within the job. You care for your patients as if they were one of their own, yet that alone will not cure them of their disease. The loving aspect comes when you are creating a connection with your patient. You work with them and watch them grow as they succeed their goals. The hatred part of nursing comes when your patient passes away or when you can see them deteriorating. This part is hard as your own heart aches because you treated them like your own. Nursing is not an easy job. It requires a lot of skill to be an excellent nurse.
The first death would be the hardest for me. It officially opens your eyes to the realness that being a nurse entails. Brown Shares her experience of when she was still in orientation when Mary died. I was not completely surprised when reading this, rather in awe of the realization of what happens. You sympathize with the family while setting up the patient’s “death appointment”. It is a hard part of being a nurse. You have to stay calm and look the family in the eye while a loved one dies. This is not something you want to do, rather you have to do. I am not looking forward to this part, but believe that being caring and efficient does not go unnoticed. This part will not be easy but comes with the job.
Hierarchies are also essential when it comes to the job. Everyone needs an overseer in which they report to and learn from. Yet, this power role is not only between nurses and doctors, but includes patients as well. The relationship between Brown and her patients was seen to be manifested and egalitarian. When Brown was with the patient Mary during her final hours, she had to treat her patients equally. Even though Mary was her “first death” that she was helping, Brown had to tend to her patient looking to be discharged. She said, “From the flurry of preparing discharge paperwork I walked back into Mary’s quiet room” (p. 39). The treatment between those patients was egalitarian as both we considered and treated equally. In a different circumstance, Brown had to look at the needs of all of her patients and decide which one was more important. She says, “In my mind I rank my patients in terms of least potentially work-intensive to most” (p. 63). The planning involved in proper care of the patients is important. Brown had to prioritize one over another due to the timing and severity of her patients. The hierarchy within the relationship between the nurse and her patients can and will fluctuate.
This book is full of meaningful content that can touch the hearts of anyone. One quote that specifically stood out to me was, “perhaps if our bodies vanished when we died, death would be easier; part of the puzzlement of death is that the body stays, but the person we knew and loved will never come back” (p.86). When you really dissect and think about this quote, you realize the truthfulness behind it. I have always asked myself this same question as to why their body is there, yet the individual we love is not. There are many religious beliefs as to what happens, yet no one has a direct answer. It really makes you think how our lives are so special. No individual is the same and you should always appreciate the gift of life.
Nursing will forever be a challenging field to work in. As hard as it can be, the reward of what you are doing pays off more than anything else. You connect, share, and form relationships with patients as you help them to recovery. I could not be more glad that I decided to become a nurse. I get a special opportunity to grow into someone special who gets to help the world, one patient at a time.
Brown, Theresa. Critical Care: a New Nurse Faces Death, Life, and Everything in Between. HarperOne, 2011.
