I feel like I slowly got better at ATI. Sometime I feel like the questions didn’t make sense or had multiple answers that were correct. I know it’s about the “most” correct answer but sometimes I thought ATI was incorrect. Honestly, as the semester progressed, I wanted to get through ATI faster and I feel like I didn’t pay as much attention to the questions as I should have.
So far, I haven’t yet adopted any self-care strategies to prepare for the NCLEX, I know I will need to but as summer approaches I find myself wanting to be outside more and garden and I think being outside more will be a part of some of my self-care strategies as the NCLEX comes near.
I think I will review the ATI text and some of the concepts that I know I have struggled with throughout nursing school such as mother-baby and pediatrics. I’ve also thought about purchasing UWorld as I’ve heard that that is a really great resource for preparing for the NCLEX.
During my Medsurg II rotation, I took care of a patient who had herpes simplex encephalitis and as a result had sustained significant speech and motor impairments. The patient had already been on the unit for a couple weeks prior to my assignment and had undergone treatment with lactulose for the ammonia build-up in the brain. This patient was a white female in her later sixties to seventies, which was by no means old. At this point in her care, she was completely dependent on the staff to care for all of her needs. She was on a Kangaroo pump for her gastrostomy tube and had daily PT/OT to try to encourage muscle movement. This patient was awaiting placement at a high level care facility as there was little chance her family would be able to care for her many needs.
I remember walking into the room and assessing. First, I saw the patient. She was lying in bed motionless, unable to turn her head towards the door to see who was entering. She was placed in a low fowler’s position with pillows off setting pressure on her back end. I walked into the room further and could hear her Kangaroo pump working. On the wall across from her bed there were posters filled with pictures of her and her family. When I had first walked into the room, I was ready to assess a stranger. When I saw her pictures, I saw a mom, a wife and a possible grandmother. The pictures were of family vacations and reunions, it appeared she was from a middle-class household. It was obvious that she had a great support system in place. It made me sad to see her in this condition. This was obviously something that had come on suddenly and no one was prepared for it.
I look back and I now reflect on seeing those pictures and how important it was for me to see them. It allowed me to view this patient in a different light and truly allowed me to see them as a person rather than a patient that I was just going through the motions with. I think the healthcare system needs to do better viewing the patient as a person rather than a job. I think this problem is likely due to the fact that nurses have such a large patient assignment that they truly don’t have the time to get to know their patient on a more personal level. I think in these instances, issues of abuse or life-stressors can get missed by the nurse.
I intend to become licensed in Maine but potentially work in New Hampshire. My understanding is that these are compact states so I’m not concerned about the process of attaining licensure. The process for Maine licensure is done online (web-based) and does not require a school transcript. A background check and fingerprinting must be completed by the Maine Department of Public Safety and the FBI.
The state of Maine has the Medical Professionals Health Program (MPHP) for those of whom who are struggling with addiction. The MPHP assists medical professionals in developing strategies for treatment, helping them return to successful professional careers. Report to the DEA, Attorney General’s Office, and licensing boards. Any health care personnel must report, in writing, within 60 days, to the disciplined practitioner’s board or authority if there is suspected or proven impairment.
I will protect my license by following the Maine Board of Nursing and hospital policies. I also think that with the Radonda Vaught case, there is a lot of speculation about a hospital’s support of its staff and the ability to self-report medical mistakes without the fear of repercussion. With that being said, I think it is critical to obtain liability insurance for my nursing license to not only protect my patients but also myself.
1. I think I need to be more personable with patients. I think right now I’m so concerned with making sure that I don’t miss anything with my assessment that I forget to talk to people and make a good first impression. I think as I begin to feel more comfortable and confident in my skills then I will be able to have a more open and welcoming personality. With confidence comes practice and I just need to keep working on myself and my confidence.
I have not had the opportunity to care for individuals of Indian descent. Specifically, Indians who reside on reservations. As a white individual who grew up in a society where I am not judged by the color of my skin, providing care to these individuals requires trust, and the historical unjust that has been done to this group will not easily be forgotten. As a nurse, I can provide cultural humility by recognizing that trust is earned and not easily received. I can make an effort to learn how medicine is perceived and practiced by these individuals and trade knowledge. Anthropology has always been a fascinating field to study and I can take what I have learned from this subject and apply it to my nursing skills and reflect on what makes us human and focus on the human experience.
2. I prepare for interviews by asking others what their perception of me is and what qualities I bring to the table that I could improve upon and what are my strengths. I will describe my strengths as things that I have learned from and things I have yet to experience. I have learned from my mistakes and I am eager to learn about things that I have yet to experience. Being older, I like to think that I bring more maturity to the table, and working in a different aspect of the medical field has allowed me to have a well-rounded perspective of interprofessional collaboration and how important communication is. My biggest obstacle is forming relationships with others. I am known to be very independent, however, I am not afraid to ask for help. I think a drawback to being independent is that I ultimately suffer from feeling alone.
I am most excited about feeling financially secure and self-sustaining. I am excited to start working after being in school for so long (I jumped straight into this program after graduating from my first undergrad). I don’t think I’m going to celebrate, my sister is graduating high school around the same time so I think we will just celebrate her and I’m good with that. I already know that my mom and siblings are proud of me and that is all that matters. I am most anxious about adapting to a 12-hour work schedule and still being able to function, especially if I work nights.
I stay focused and on track by using a planner. I am a very visual person. I try to study or rewrite my notes at least every day after that specific class. I usually try to have all of my notes rewritten at least 24 hours before the exam so that I can reread and review them.
I had completely forgotten about the “least restrictive” “least invasive” method when it comes to answering multiple-choice questions. At this point, I think it’s just a subconscious method I use.
We had briefly discussed survival potential in our leadership class and I wish we had gone over it in more detail as I don’t think many nurses would be prepared for triaging.
I don’t think there is enough emphasis on external risk factors to patients as typically nurses are more focused on the patient’s internal risk factors.
I forgot that there were 3 different types of learners. I was aware of tactile and visual but not auditory.
The most important immediate response of a nurse during a disaster is to activate the disaster plan in their hospital. This includes triaging patients, coordinating evacuations, and communicating effectively with other healthcare providers. Perhaps one of the most important factors when it comes to any emergency situation is maintaining organization and teamwork, which is seen in The Story of Hurricane Sandy and NYU Medical Center.
Although nurses have a duty to care for their patients, it should not extend to the point where a nurse must feel as though they must negate their own needs for that of others. Situations in which a nurse may be faced with making a decision that prioritizes themselves or their patients include mass casualty events in which triaging becomes necessary, or if a scenario warrants that only one person may survive. It is the decision-making process of the nurse that needs to be refined to deal with emergency situations. All nurses should be trained in emergency preparedness, as it is unknown when these situations may occur and this training may help prevent a nurse from having to struggle between the code of ethics and their duty to self. However, nurses must also recognize the power that they hold from the viewpoint of their patients. A patient has a strong reliance and trust in their nurse to do what they believe is best. If a nurse decides to choose themselves over their patients, how will patients be able to trust not only nurses but the healthcare team? In these situations, we must remember that no single life is more important than another, it simply must come down to the professional opinion of the nurse to decide which life is more viable at that moment.
Al Harthi, M., Al Thobaity, A., Al Ahmari, W., & Almalki, M. (2020). Challenges for Nurses in Disaster Management: A Scoping Review. Risk management and healthcare policy, 13, 2627–2634. https://doi.org/10.2147/RMHP.S279513
Veterans are often victims of silent discrimination because they are perceived as damaged individuals due to their wartime experiences. Many times, their services go unnoticed and unappreciated and can be met with disdain for their roles in controversial conflicts. Nurses can serve as advocates for this population by recognizing these disparities and providing just and quality care.
What is a vulnerable population?
Social groups of people with an increased risk of health problems
Veterans as Damaged and Forgotten Individuals
Veteran sues state corrections alleging discrimination
Health Care Needs
Mental Health Services
Trauma Related Injuries
Resources & Services for Veterans
VA Hospitals
Building Homes for Heroes
Tunnels to Towers
Military Child Care
Woven Women Veteran Network
Important Numbers for Veterans
Readjustment Counseling Service Combat Call Center
Veterans Crisis Line
Ethical Principles
Justice
Autonomy
Legal Rights
Americans With Disabilities Act
Veterans Access, Choice, and Accountability Act of 2014
Everyone is going to die, it’s just a matter of when and how. Every day, people choose whether they want to live. My opinion of death with dignity is that it allows an individual to have autonomy over their life. If someone no longer wants to live, they’ll find a way regardless of the law. My belief has always been quality over quantity because otherwise, what’s the point.
Death with dignity does not challenge my beliefs of the first ethical principle of nursing. I believe that the purpose of a nurse is to promote a healthy lifestyle and to improve health. Despite the great lengths that nurses go to to help avoid a patients’ deterioration in the hospital, it happens, especially in cases in which a patient is immobile or comatose. I feel like a nurse would be doing a great disservice to their patients to believe or promote life when it is no longer feasible. Nurses can not always improve life and when they can’t, they should promote comfort and autonomy. Although I agree with the death with dignity act, it doesn’t come without its complications. At what point can it be determined that someone is within their mental capacity to consent to physician-assisted death.
Smith, M. A., Torres, L., Burton, T. C. (2020). Patient Rights at the End of Life. Wolters Kluwer Health, Inc. 25(2), 77-84.
I accessed a 40 question Emotional Intelligence test through the Global Leadership Foundations’ online website. The specific levels of EI, self-awareness, self-management, social awareness and social management each had 10 questions. From each of those questions, I scored accordingly:
Self-Awareness
Self-Management
Social-Awareness
Social-Management
4/10
8/10
7/10
5/10
From these scores, I interpret that I have fair emotional intelligence. It is neither good nor bad but it certainly has room for improvement. Prior to this test, I had thought myself to have better self-awareness than what I had scored. However, after reflecting on my score, there have been occasions where I’ve been told that my body language doesn’t match my tone and it can come across as rudeness or disinterest. I am aware that my social skills could use improvement and perhaps the best way to improve my self-awareness skills would be to have someone mirror my body language. In this case, I would be able to see how my body language could be off-putting or deceptive. “Seeing is believing”, if I can see how I act, I can accept that it truly occurs and I can reflect from it. Reflecting would allow me to put myself in someone else’s position and witness how self-awareness and body language play a critical role in how we are perceived by others, especially in a professional environment. Self-awareness is not only important for everyday interactions, professional or nonprofessional, but also in being a successful leader. The body language of others impacts the way we respond in social situations. A successful leader can portray confidence despite feeling unease. The ability to have self-awareness is critical in maintaining poise in stressful situations.
In terms of self-management, I have always been an organized and deliberate person. I suppose this is my form of maintaining control and alleviating anxiety from not being able to predict the unknown. Ironically, this could explain my poor score in social management. Being unable to control or predict the actions of others is something that I struggle with and therefore I am not always receptive to what others say or do. Improving my self-management skills would require me to actually contradict my score by decreasing it. If I have less of a focus on controlling myself and the others around me, then perhaps I would be more receptive to unplanned events or actions. I believe this to be most of the reason why I find an interest in emergency medicine, it allows me to step outside my comfort zone.
I have always thought of myself to be patient. I attempt to consider all sides of a story before I begin to judge or take action. I know that I was not always like this and I think the majority of that change has to do with not only personal growth but also entering into the medical field. The medical field has taught me that not everything is as it seems. Interpreting a statement on paper doesn’t allow for a thorough understanding of someone’s circumstances when compared to physically speaking with them. There’s always room for improvement, I know that I still jump to judgment on occasions but I am able to reorganize my judgment when it is not appropriate. There is always room to improve my social awareness, especially in an ever-changing society. I believe someone’s level of social awareness can be contributed to the way in which they were raised (open-minded or close-minded). Improving social awareness can be difficult, especially if it contradicts the ways in which someone was raised, but it is never a bad thing to open up our minds and be privy and respectful of how someone else lives. I also believe judgment cannot and should not interfere with the ability to provide safe and effective care to every patient.
I didn’t believe myself to have poor social management skills. I am courteous of others and their beliefs. I am completely capable of being focused in an emergency situation and not allowing emotions to overwhelm me. I value teamwork and I always appreciate input from others. I think perhaps my poor social management skills are a reflection of how I feel about myself when I’m not in situations where I must care for others. I am very much someone who prefers to bury my emotions until they peak and resurface at my most fragile times. I don’t like to be vulnerable and I associate emotions with being vulnerable. In social situations, such as working with others, I am very flexible and I enjoy brainstorming as a group. My 5/10 score is very much reflective of my personal feelings of myself and not a reflection of my ability to work with others. From this, I recognize the importance of improving my psyche so that it does not interfere with how I care for others. I imagine this is only improved with counseling but acknowledging that it is a problem is a good start.
