Reflection

This has been a great semester for learning. I have been made aware of the many different social aspects that are integrated in the health constructs of patient care. Public health and the many risks and preventative measures that can manifest, ensure that we as nurses will always have the opportunity to further educate the people we care for. As healthcare professionals, it is our role as a nurse to be an advocate for the people. For those in poverty, who are underserved, who are children, adults, and elderly.  In order to be the voice they need, we need to learn to assess and plan interventions that will effectively improve their quality of life. I have learned that while caring for children, it is important to get on their level and be aware of the age group you are working with. Initiating a trusting relationship with the parent entices the child to be willing to work with you. As nurses work with families, it is important to understand where they come from and be aware of the different challenges each family faces. Assessing these aspects of social experiences engrains a bond of trust between healthcare provider and client. Having that trust not only allows the ability to gain further knowledge on health problems, it also allows for the opportunity of health promotion. Establishing that base spreads beyond individual care and supports community involvement. I have learned a plethora of community agencies that are set in place for the benefit of the public. A big unit of this knowledge came from our discussion of emergency disaster plans. Staying updated and current with community programs that are available is important in allowing nurses to share that information with their patients. I biggest thing I am able to take away from this class is the importance of communication. Healthcare is a system of interrelated programs/agencies that operates at its best based on communication. Keeping communication among healthcare professionals is essential to success.

One particular health issue I learned more about was concussions. The differences between individuals who experience concussions and their recovery rate were rather surprising to think about. I was aware that after each concussion a person has, the next one is typically worse and that concussions are typically followed by some confusion and sensory problems. However, I did not realize how prevalent concussions really were. I did not know that adults 75 years and older were the highest rated for hospitalization and death because of a traumatic brain injury. As I found out many suffer from concussions, I was not surprised then to find out that Wisconsin had their own Concussion Law that requires parental signatures of youth under 19 years old to consent that they have received information on concussions and what signs to look for before signing their child up in a sporting event. Having this law is great way to help prevent concussions from going unnoticed.         

Reflection of a Student Nurse - 05/08/13

As I am starting this post, we have 7 days, 15 hours, 29 minutes, and 15 seconds until the end of the semester courtesy of my countdown app.  :)  How fast has this semester gone!?  Seems like just yesterday that we were taking finals for first semester.  I’m not going to lie that I was looking forward to learning about public health.  Having several years of experience on a busy and exciting post-surgical floor of abdominal, vascular, and ENT patients, the idea of public health had absolutely zero interest to me.  To me, public health sounded like sitting at a desk all day with paperwork and phone calls - boring! 

However, as the semester progressed, the class opened my eyes to the job of a public health nurse.  It’s not just sitting at a desk all day.  Community health nurses play a vital and oftentimes unrecognized role in the community.  Using the public health wheel as a guide, the sky is the limit on what role they can play.  Public health nurses aren't just involved with a certain population like what I'm accustomed to.  They interact with with children, health care professionals, and community agencies.  They hold an important role in the safety, health, and education of the community.  Instead of waiting for the individuals to get an illness, they educate and monitor the community to improve their health and prevent the disease.  Many of these issues, we have touched on through lecture and blogging.

Just as with public health, I wasn't excited about the idea of weekly blogging.  I'm more of a "read the family blog" than "write the family blog" type of person.  I've tried the whole blogging experience and because I'm a perfectionist and spend way too much time analyzing what I've written, I made it much more complicated than it had to be.  Of course, the perfectionist in me is also a procrastinator and as the last person to comment most weeks, I found myself digging deep into Google most weeks to contribute new information to the coversation  :)  However, for once by procrastinating I was able to dig up new information that I would have probably never ever considered Googling on a rainy day outside of lecture.  

I really enjoyed the guest lecturer, Heidi Giese, and her involvement as a child-life specialist.  Her job hits close to home as my now 8-year-old niece Julia was diagnosed with a Wilm’s tumor in late 2010.  Because of her chemotherapy and radiation treatments, she missed quite a bit of school, creating many questions and concerns for her first grade classmates.  One of Julia's child life specialists came to talk to her class about everything that had been going on.  Her child life specialist , like Heidi, was able to explain some of the things that she had gone through using examples and pictures and made sure to emphasize that cancer is not contagious.  The kids even got to play with the gloves and masks :)

In their family blog, Julia's parents wrote “Children are taught from an early age that you can catch a cold or other illnesses from other people, so it's a natural inclination to shy away from someone who is sick. Another point that was made was that the kids in her class now know more about the things Julia has gone through and will be going through and that makes all of them advocates for her to other kids who might not know as much”.

Similarly, our guest lecturer emphasized on how important it is to "provide services that are developmentally appropriate, psychosocially sound and family centered".  The Child Life Program addresses the needs of hospitalized children which includes "security, comfort, acceptance, affection and age-appropriate activities" which are magnified with the stress of illness (Ministry Health Care, 2011).

Closing this reflection with now 7 days, 12 hours, 43 minutes, and 20 seconds left of the semester, I am surprised to say that I look forward to learning more about public health in the future semesters.  Although I love my current job and have a hard time thinking outside of the unit, there is more to nursing than working in the hospital.  There are many more avenues to helping people and providing care. I am proud to be a nursing student and have the option to impact so many lives through so many avenues.  :)

Good Luck with finals and enjoy the summer break!  

Reference

Mayo Clinic. (2011). Wilm's tumor. Retrieved from http://www.mayoclinic.com/health/wilms-tumor/DS00436

Ministry Health Care. (2011). Child life program. Retrieved from http://ministryhealth.org/SJCH/ChildLife.nws

Reflection Post- May 8th, 2013

It’s hard to imagine that it is already almost the end of another semester. We have made it through our first year of nursing school, congratulations everyone!!! I have learned a lot in this course throughout the semester and it has changed my view on the nursing profession. One of the things I really liked about this class was that it opened my eyes to the vast number of opportunities for nurses to be involved in. Sometimes when people think about the career of a nurse they only focus on the typical hospital setting and a nurse caring for sick individuals, but nursing is SO much more than that. Nurses have the opportunity to work with all different types of populations, and in countless settings and scenarios. The amount of possibilities for nurses is amazing. Just think back on all the things we discussed during the semester...community health care, disasters, hazards, injuries, school nurses, communicable diseases, vaccinations, public health, child and family health…nurses play a critical role in all of these fields and others! It is very exciting to me when I think about the abundant possibilities for us as we enter the nursing field. I find it encouraging that if you go into your career as a nurse in one specific field and find that this field doesn’t really suit you, its alright, there are many other fields of nursing to experience. With so many diverse fields of nursing available we are able to tailor our careers to our individual preferences and hopefully love the career we ultimately find ourselves in.

In this course we spent a lot of time working with the public health wheel. I think that this is a great example of how nurses work in collaboration with individuals, families, health care professionals and community agencies. Some of the interventions on the wheel, like case management and health teaching, can be done on an individual level or with families. Interventions such as outreach and screenings are more community based and may involve other health care professionals. Nursing is a multifaceted field that provides different levels of care for various populations while collaborating with others. The care of an individual person is a complex task that takes into account many contributing factors. At the onset of care a nurse may be able to focus solely on the individual and their acute condition, but as care progresses the nurse must focus on other outside forces affecting the patient. For an example let’s take the situation of an overweight child. At first, the nurse may focus on only the individual child and any problems they may be experiencing due to being overweight. Next, the nurse may move to the child’s family situation and identify factors, such as poverty, that may be playing a role. Finally, the nurse could assess the child’s community. The community may be the child’s school, which may not offer healthy mealtime options, or the area where the child lives, which may not have access to fresh fruits and vegetables. If the family had poor access to healthy food options the nurse could offer assistance by connecting them with food bank agencies in their community. Additionally, if the nurse concluded from the assessment that the cause was not poor nutrition he/she could refer the child to another health care professional who may discover an underlying medical condition to explain the obesity. To provide the best care the nurse must take all aspects of the situation into account and collaborate with others to find the best solution.

One issue that I discussed in one of my blogs was the affect of poverty on the health of individuals, families and the community. This is another example of how health care is so multifaceted. We don’t often think of poverty as something that we would need to consider in nursing care, but it does have an effect on health. Individuals and families living in poverty do not have access to healthy food options, medical attention and infection control practices. These habits may have an impact on the community’s health by spreading disease due to lack of cleanliness or limited access to vaccinations. As nurses we must be aware of all the aspects that play into the health of individual patients and the community. By being aware and taking a well-rounded approach we can provide the best care for our patients and also be proactive with health care. 

Reflection 5/8/13

I can't believe how fast this semester has gone! I have learned so much about the different aspects of nursing through lectures and especially the variety topics of the blogs. I also found it beneficial to read the comments on the blogs to get different opinions about the topics; which opens your eyes up to the many different points of view and different approaches to certain issues.

Throughout this semester I learned a lot about the many different aspects of nursing. There are many roles that go unrecognized, but are very vital in the community. I really enjoyed learning about the many roles nurses play in the care of vulnerable populations. They play an extremely important role in the care of vulnerable children especially. By conducting health screenings in school, they can identify at risk children. They also play as an advocate for their patients, especially children. Education is key in promoting good health and well-being. Education is an important part of being a nurse and can play an important role in not only the current patient or community, but also with other health care professionals and in other communities. I really enjoyed listening to the guest speaker that talked about communicating with children. Even if they aren’t the patients directly, it can positively influence the family involved.

One of the more interesting topics to learn about for me was childhood fear. I thought it was interesting to read about the different stages children go through and how they perceive fear at that time. One age group in particular is the preschool years. This age group experiences the greatest number and variety of real and imagined fears. I found it interesting that they couldn’t yet differentiate between what is an animation and what is actually real. 

Reflection Post 5/8/13

Overall, this semester has completely re-shaped my view on nursing and the role that nurses play in many different areas of health care. Community health and public nursing has been a very interesting area and an eye-opening learning experience for me during the lectures and blogging. I will admit my view of the nursing role thus far was narrower and stereotypical. I now have distanced my views of nurses only having the role of one-on-one patient care within a hospital. I knew that other careers were possible as a nurse; I just did not know the degree and variety of areas that nurses can control and impact. This semester, we learned about how to care for an overall population and how to intervene appropriately during a crisis or disaster using the public health intervention wheel. Learning about the public health intervention wheel taught me how to outreach to a community or mediate to a population via social media.  Epidemiology is the study of distribution of disease and physiologic conditions in human population and the identification of factors which influence this distribution. This area of nursing was fascinating to me. Public health nurses can identify issues/trends within the community and act appropriately on it. Additionally, nurses promote and implement upstream thinking when responding to an issue in order to improve a community from its core versus just the “curing” the surface. This semester I was able to synthesis not only the skill of giving an influenza shot (NRSG 345), but connect it to the importance of educating a community about getting this annual shot. There is a direct correlation of a population’s health and compliance to a vaccination regimen or lack thereof.  Finally, when our groups worked on our community papers, I learned about the steps within a disaster plan. Although each community may implement a slightly different plan, mitigation, preparedness, response, and recovery are essential components of a successful disaster plan.

I really enjoyed when our guest lecturer, Heidi Giese, came in to speak about working in Pediatrics and communicating with children and families. Her lecture allowed us as a class to experience a hospital visit/stay from a child’s point of view. We as nurses need to be able to understand a child’s developmental stage physically and mentally and treat them appropriately. We need to be able to use the correct terms so that a child can understand and not be scared. An example of this would be instead of saying urine say “pee.”  The different developmental stages determine how to speak to the patient as well as how involved a parent or guardian needs to be. An example is during a physical assessment of a toddler (1-3 years old). The patient will be more fearful and need to have a parent present for reassurance. It is common, also, for parents to have their children sit on their laps during an assessment. This helps with cooperation and contains the child from moving too much.

Asthma is the leading chronic condition of children in the United States and is the primary cause of school absences.  Asthma is the chronic inflammation of the bronchial tubes caused by inflammatory cell infiltration. Symptoms include coughing (especially at night time), wheezing, and shortness of breath, chest tightness pain, or pressure. A nurse’s role includes monitoring and assessing airway clearance, education about care and management, and medication teaching and administration. Nurses should demonstrate correct administration and have patients (especially children) periodically show how they use their inhaler. The correct technique is essential especially when a patient needs quick-relief during attacks and outbursts. Finally nurses can play a role in educating about keeping track of environmental factors and how trends within seasons and certain states can help someone with asthma plan for their care. Visiting the AIRnow.gov website may help those who suffer from asthma understand the air content for the day. Outdoor activities and carrying enough medication can be planned out ahead of time.

Reflection 5/8

In nursing so far the focus has been on treating a single patient or client, this semester I was able to view the nursing profession through the public health lens and learned that an entire population is their client. The main goal of public health is to provide the greatest good to the greatest amount of people and by doing so many lives are positively impac

ted, spread of disease is slowed, and the community overall becomes healthier. I learned how to analyze a communities resources, find their weaknesses, and make suggestions for improvement which challenged my critical thinking skills. The public health nurse collaborates with many agencies in the community in order to make these improvements. These include emergency management, the police and fire departments, schools, environmental safety agencies, local health care providers, and many more.

The public health nurse also collaborates with families to improve the health of children and other vulnerable populations in the community. They participate in health screenings such as hearing and vision screenings, immunization clinics, they study the rates of certain diseases and work to increase awareness in schools and the community to halt the spread, and also teach healthy lifestyle practices. I really enjoyed the fact that public health has an “upstream” approach to improving health, the focus is more on prevention and teaching healthy habits in order to prevent illness or if illness already exists, to help prevent further complications to the client.

One of the many diseases we learned about is Asthma. I learned how common of a disease it is, but also how treatable and manageable it is. Being the third leading cause of hospitalization in children under 15 years of age, this is a perfect example of a way public health can intervened to help those with this disease live long, healthy lives. The specific cause of Asthma varies from individual to individual but is usually some type of irritant in the environment along with some genetic factors that cause the bronchioles to spasm and narrow the airway. Manifestations include coughing, wheezing, shortness of breath, and tightness in the chest. During an exasperation, it becomes very difficult to breath and it is necessary to have an emergency inhaler. Long term therapy is also available. If Asthma goes untreated it can lead to the child being absent from school, health complications, and even hospitalization. The public health nurse can intervene by teaching the child and the family how to manage the Asthma and also work to eliminate environmental irritants such as pollution. Eliminating environmental causes may not always be feasible so they could also educate the client on tools such as the air quality index so they can monitor the safety of the air and avoid exposing themselves to dangerous irritants.  

Blog Reflection 5/8/2013

We made it!!! I can't believe how fast this semester has gone. It was great to share this first blogging experience with you;before this year I had never imagined that I would be fascinated by reading blogs, let alone write one! It was interesting to see each week all the different perspectives and
thoughts people would bring to the academic discussion. I think that was the most valuable concept I got out of blogging. That each of us brings different experience and research together have a chance to share it with everyone else! In nursing this research and life experiences will be a great tool to keep in mind when working with the many broad spectrum of people out there!

I have learned a lot about the different roles of public health nursing within this course material.  However, what stands out the most is being aware of different diseases and conditions out there and the need for upstream thinking in any population of people. Most problems can be prevented or managed early with the use of screening, education, and outreach. Whether it is working in schools, with children, in a hospital, small town clinics, or in disadvantaged communities,  these tools and thought processes will be essential in a public health nurse's  job. Our speaker Tom Hurley's emergency management lecture really had a great impact on me. One of the most moving comments he made during his lecture was how much they need public health nurses to deal with patient care, support and managing stress in these difficult times. To me it just is amazing how much we can do in and outside of a hospital setting that makes this profession worth while. And if we are able to prevent these occurences we should do so at all costs; we are the communities advocates!

Finally,  the most interesting topic to me was about video gaming. I really had a great time researching this topic and I believe it is going to be one of the main reason for health concerns among younger generations physically, mentally, and socially. As popularity of these games grows in younger children, it is altering the way children used to play and interact with others their age. It was additionally interesting to read responses to this topic because many people in the blog are within the age group that video games started becoming more advanced, and remember using games in elementary school. Unfortunately, obesity rates are climbing at staggering heights, and the amount of outside activity is decreasing. Also the nature of these games has become increasingly violent and and as a result, there has been correlation with children mimicking these behaviors. To make things worse there is lack of parental control and supervision. As we discussed, nurses can advocate for children and parents to offer education and guidance.

I'm glad to have had this chance for a different type of learning experience and appreciate every ones contributions and hard work!

Hope everyone has a safe and happy summer!!!  :)

Blog Reflection 5-7-13

I can’t believe this semester is almost over!   We’ve had so many interesting conversations and ideas that we’ve bounced off one another.  I really enjoyed reading everybody’s feedback on my posts and ideas regarding the wide array of topics. 

This course has taught me a lot about the many different roles nurses play in society, and it has really opened my eyes to all of the work done that goes unrecognized.  Nurses serve as advocates for children in so many ways because they are so important to the future of each community.  For example, community nurses do health screening for school age children to detect problems earlier, give referrals, and prevent larger problems later on in life.  It is the nurses of a community that work to educate, support, and assist all of its community members.  Nurses are advocates for so many people because they have the tools and knowledge to avoid preventable problems and increase the quality of life for each member of a community.

One of the main topics discussed that stands out to me is that of vulnerable populations.  I believe that nurses need to focus on helping everyone in a community, and it is those vulnerable populations that often are neglected.  Although often forgotten, these vulnerable populations affect many people and influence many factors within a community.  I really enjoyed learning more about vulnerable populations and reading everyone’s ideas regarding upstream thinking.  I firmly believe that there needs to be many changes in our healthcare system to get everyone on the same page of prevention instead of dealing with issues once they occur.        

Honors Credit: Addiction

My honors project focuses on the physiological and psychological effects of alcohol and opioid addiction on the human body and how addiction affects nursing care.Alcohol, for many years, has been a means of addiction for countless people. 61% of Americans report being current drinkers, 5% considering themselves heavy drinkers (Nies & McEwen, 2011). Alcohol abuse has led to many preventable deaths, ruined careers, and torn families apart and still does today. In more recent history a new type of drug addiction has been growing at an alarming rate and what is more disturbing is the fact that this addiction is common among school aged children, especially those in high school.  I am referring to the abuse of prescription opioids such as Vicodin and OxyContin.

A recent study states, “The non-medical use of prescription and over-the-counter (OTC) drugs has increased at least eighty percent since 2000… over fifteen million Americans age 12 and older have taken a prescription pain reliever, tranquilizer, stimulant, or sedative for non-medical purposes at least once… deaths resulting from drug overdose increased nearly fivefold since 1990, making drug overdose a leading cause of unintentional death in the United States…” (2011). Clearly this is a big issue in our country but specifically with our nations high school students. According to the National Institute of Health, 1 in 12 high school seniors have reported using Vicodin for non-medical purposes (2011). It has also been shown that those students participating in recreational use of prescription medications are more likely to abuse alcohol as well. As public health nurses, if we are to battle addiction in communities we need to start in our schools by promoting healthy lifestyles and educating the students about the consequences of drug and alcohol abuse.  

Figure 1: Retrieved from http://www.musahlotallah.com

I chose this photo to represent the abuse of drugs in schools. As aforementioned, it is a prevalent issue in our country right now so as nurses, we need to work towards creating a healthier environment for students. I have chosen the Transtheoretical Model to help me understand some of the barriers to creating healthier choices. I chose this theory because it emphasizes that change occurs in various stages and take place over time. It also states that behavior changes can be very difficult for a variety of reasons therefore leading to resistance of change. (Nies & McEwen, 2011).

The stages include precontemplation, contemplation, preparation, action, and maintenance. These stages describe the varying degrees of commitment to change from having no intention to maintaining a change for over six months. Students who abuse drugs in high school may initially resist making healthier choices for many reasons. For example, they may feel it will hinder their social relationships, perhaps all of their friends abuse drugs and in order to remain a part of the group they will continue the unhealthy practice. Giving up something they consider to be pleasurable or will require a change in their self-image are other factors that decrease willingness for change. 

Knowledge of these barriers to making healthy lifestyle decisions along with the concept that teenagers generally feel they are invincible shines light on the reason these choices are being made so frequently.  As we better understand this subject we can work towards halting harmful habits that begin in youth and eventually transform into addictive behaviors as adults.

References

National Institute of Health (2011). Prescription drug abuse: A fast-growing problem. Medline Plus, 6(3),       21. Retrieved from http://www.nlm.nih.gov/medlineplus/magazine /issues/fall11/articles/fall11pg21.html

Nies, M.A., McEwen, M. (2011). Community/public health nursing. N. O’Brien, C. Irwin (Eds.). Health                      promotion and risk reduction (pp 54-57). St. Louis, MO: Elsevier Saunders.

Sham, M.K (2011). Down on the pharm: The juvenile prescription drug abuse epidemic and the necessity             of holding parents criminally liable for making drugs accessible in their homes. Journal of Contemporary Health Law & Policy. Retrieved from: http://www.lexisnexis.com.proxy.uwec.edu      

Honors Credit: Family Nursing

My honors topic is family focused nursing. I feel that promoting and managing health at a family level is extremely important and beneficial. By providing care and educational opportunities to the family we hope that we are able to help all its members. Families work as a team, and when the entire team is focused on making healthy lifestyle choices it promotes adherence. Additionally, many families need each other for support when it comes to health issues. Children rely on their parents to keep them in good health, sick individuals may lean on family members for help and emotional support, and the elderly may rely on their children when their own health begins to fail. Family is incredibly important, especially when it comes to health and well-being.

The health of a family and the health of a community go hand in hand achieving a close relationship where one plays off the other. One example of this relationship that came to mind was immunizations. Communities must provide access to immunization services and families must take advantage of them, one does not work without the other.  I chose this image because it reminds us that it is important that everyone takes on the responsibility of getting vaccinated. Herd immunity, “a state in which those not immune to an infectious agent will be protected if a certain proportion of the population has been vaccinated of is otherwise immune”, is an example of how individual families affect the overall health of a community (Nies & McEwen, 2011, p. 497).

The family systems theory, which states that “the family is viewed as a system that continually interacts with its members and the environment”, further promotes the idea that family and community health are linked (Hockenberry & Wilson, 2011, p. 47). In order for a family to thrive it must have access to necessary resources which the community, or environment, provides. The community can be viewed as one large family made up of many, smaller families that work together to achieve optimum health status. The community is responsible for providing resources to families in order to keep them healthy. Immunizations, as I mentioned earlier, are not the only example of this. Others include food programs such as Women, Infants and Children (WIC), health care facilities such as doctor’s offices and hospitals, health promotion facilities such as the YMCA, and countless others. These programs are all beneficial to promoting health, but they are useless if families do not take advantage of them. Families must take responsibility for their own health and use these facilities for their intended benefits. It is the job of families to keep up to date on immunizations, seek out medical attention when they are ill and promote good health by eating well and exercising. A community that provides resources to maintain optimal health will foster healthy families, which in turn will create a healthy community. Families and communities are separate entities that must work together as one system to achieve the most ideal outcomes, especially when it comes to health.

References

Hockenberry, M.J., & Wilson, D. (Eds.).  (2011). Wong’s nursing care of infants and

 children (9th ed.) St. Louis, MO: Saunders/Elsevier.

Nies, M.A. & McEwen, M. (2011). Community/public health nursing: Promotion the

 health of populations (5th ed.) St. Louis, MO: Saunders/Elsevier.