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Archive for month: April, 2015
Welcome!
Thank you for visiting my portfolio for Business and Economics in Literature. I am majoring in Economics at CSUCI.
ATI Review Tips Post Test Overload!
Information for ATI remediation or if you want to review weakest areas!!
Log in to ATI – My Results tab
Review the Assessment Report for the exam, which provides a list of Topics to Review.
Obtain a focused review by selecting on the Focused Review next to the Assessment Report and click Create. On the next page, click % of your final score (eg 50-70%) in the ‘sections where percent is below __’ to obtain areas of focus review; then Create Focused Review.
Choose at least 2 content areas in which the results fell below Level 1; it is highly recommended to choose the 2 lowest scored areas, reflecting the need for further focused review relating to the specific content in the course. Identify the ATI study plan by choosing two or more activities identified by ATI and/or resources from the course (textbook, etc).
La Conchita landslide 1995 & 2005
The hillsides of Southern California are notoriously prone to landslides. On January 10, 2005 the steep cliffs behind the unincorporated town of La Conchita, in Northern Ventura County crumbled into the community killing 10, injuring 15, and destroying 31 homes http://www.latimes.com/local/california/la-me-la-conchita-20150104-story.html#page=1. The same hillside had failed, in the same area ten years before in 1995 destroying 9 homes, but the community had gotten lucky the first time being spared any loss of life. Now 10 years later, the community of La Conchita is looking back at what has changed since 2005, and members of the emergency response system would be well advised to do the same.
Though the two previous events occurred after significant rainfall, the US Geological Survey has authored a study of the La Conchita area, siting geological evidence of frequent landsliding in the past several milenia that suggests this area is at significant risk for landslide activity even in the absence of rainfall (http://pubs.usgs.gov/of/2005/1067/508of05-1067.html#conchita07). And yet the community of La Conchita continues to grow, with approximately 300 residents including about 30 children. And though the community has made efforts toward increasing preparedness for future events with emergency supplies and a tractor stored in a safer location within the community, a proposed modification of the hillside itself that would significantly reduce the risk of failure, remains stymied at the state government level.
The types of disaster most likely to affect Ventura County are fire, landslide and earthquake and as we have seen time and again, and though landslides are fairly predictable they still manage to incur incredible cost to both property and human life. The website http://readyventuracounty.org/ is a great resource for learning how to be prepared for a variety of disasters. Nurses would do well to keep themselves up to date with resources such as this, and with the disaster response plans in place at the facility with which they are affiliated… Because it seems that the people most at risk of harm due to landslides are not planning on getting out of the way any time soon.
Disaster
Choose a disaster that has occurred in the last 10 years (in the United States or internationally). Research the event online. Blog your report about the event specifically addressing the healthcare perspective. What were the barriers for providing and/or accessing healthcare? Who responded? How long did it go on? How did socioeconomics and environment impact the event and environment? Imagine being a healthcare provider during that event. Are we better prepared for the next disaster?
In 2011, a magnitude-9 earthquake caused a huge tsunami and tremendous damage to northeastern Japan. In addition, the tsunami caused a cooling failure at the Fukushima Daiichi Nuclear Power Plant which resulted in a nuclear meltdown and leak causing release of radioactive materials into the Pacific Ocean.
Although Japan was prepared for earthquakes, they were not prepared for the tsunami – which caused most of the damage and deaths. More than 18,000 people were killed in the disaster, mostly to drowning (Oskin, 2013).
The damage impacted the country’s utilities, transportation, and healthcare facilities. Electricity, water, and gas were cut off during the disaster and were not restored for coastal areas for up to one-four months after the disaster (inland areas were restored within 3 days) (Nohara, 2011). The rural coastal areas did not have public transport, and many of the roads were damaged or blocked making access to the disaster areas difficult. In addition, initial lack of gasoline made health and medical support activities difficult (Nohara, 2011). Three hospitals in the coastal areas had been completely destroyed and half of the other clinics/health facilities were damaged, adding to the difficulty of providing medical services. Fortunately, other hospitals designated for disaster base medical care were able to provide emergency care (triage, emergency response, and transport of patients to inland areas/hospitals). A total of 28 Disaster Medical Assistance Teams (DMATs) were able to provide care from the day of the disaster (March 11, 2011) until July 2011.
References:
Nohara, M. (2011). Impact of the Great East Japan Earthquake and tsunami on health, medical care and public health systems in Iwate Prefecture, Japan, 2011. Western Pacific Surveillance and Response Journal, 2011, 2(4). doi: 10.5365/wpsar.2011.2.4.002.
Oskin, B. (2013). Japan earthquake & tusnami of 2011: facts and information. Retrieved from: http://www.livescience.com/39110-japan-2011-earthquake-tsunami-facts.html
Haiti Natural Disaster
In 2008 Hurricane Gustav affected Haiti. It is important to understand that Haiti is one of the poorest countries in the Western Hemisphere and have original problems in respect to health (AmeriCares, 2009). Moreover, Haiti has high infant and maternal mortality rates, high malnutrition, and the inhabitants have a high rate of having HIV/AIDS too (AmeriCares, 2009). To make matters worse, Hurricane Gustav struck the area and destroyed about 10,000 homes and up to 90% of crops were lost as a result (AmeriCares, 2009). This original incident of malnutrition could have been aggravated by this natural disaster. One of the organizations that managed to send medical and disaster supplies within a few days was AmeriCares (AmeriCares, 2009). This organization supplied about 80,000 people with medical supplies and brought food to this country as well (AmeriCares, 2009). The only barrier to access healthcare was through the hopes that other countries would send over food and medical supplies to the area because they had lost everything by the disaster. Money was raised through different organizations and that also helped buy food and supplies that these individuals needed. Before the disaster struck, it was known that three out of four Haitians were living in poverty (AmeriCares, 2009). Lack of money can affect their health because of the lack of money to pay for health care costs. The disaster helped everyone regardless of their socioeconomic status, which helped these individuals get some type of care health wise. The health services lasted for many months because these individuals living in Haiti were under environmentally unhealthy conditions.
If I were to have been a healthcare provider for this event, I feel that adequate help arrived for this natural disaster. Other countries cooperated by sending food and medical supplies as well, which was great. The first organization to respond was AmeriCares and its warehouses are located in Miami and New York City in order to rapidly respond to Haiti and nearby regions (AmeriCares, 2009). I feel that Haiti is best prepared for another natural disaster if it were to occur because their experience with hurricanes and earthquakes allows them to estimate the amount of supplies they need to have for an emergency situation.
Reference: AmeriCares. (2009). Health and hope in Haiti. Retrieved from http://www.americares.org/who-we-are/newsroom/news/health-hope-in- haiti.html
Earthquake!
The disaster I chose to discuss is the earthquake that occurred in 2010 in Port Au Prince, Haiti. It was a 7.0 magnitude earthquake that affected the southern part of Haiti. Haiti is considered a third world country where poverty and limited resources are very common. Although it occurred over a great distance, the impact was felt internationally. On the date of January 12, 2010, and the following weeks and months, the death toll estimate ranged from 230,000-316,000, 300,000 were injured, 85,432 individuals were displaced, and help from all around the world was centered on this country. A review on the event by CNN five years after the earthquake determined that billions of dollars have been utilized in efforts to restore their country. Many organizations including The Red Cross, the Peace Corps, the U.N., Habitat for Humanity, and more played a role in the restoration of Haiti either by traveling there and providing support or by raising funds. Personally, the reason I chose this disaster is because I was fortunate enough to travel to Haiti in 2012, two years after the incident as part of a medical group with International Service Learning (ISL). Although we did not travel into the city for safety purposes, it was evident how much of an impact the earthquake had on the rest of the country. Our group traveled to little villages on the border between Haiti and the Dominican Republic, and everyone we spoke to was affected by the earthquake, just about every family knew someone that lived at the capitol since many family members migrate there with hopes of finding jobs and more opportunities that the little villages do not provide. While we talked to the villagers on occasion, it was evident that they were distressed about not knowing where their family members that had moved to the city were or whether they were still alive. It was interesting to observe how different their life style was compared to ours in the U.S. we might have the luxury of contacting hospitals, police stations, or even fire stations to look for our loved ones in case of an emergency, these individuals did not even have a phone or any form of communication or transportation to go and look for their loved ones that possibly were affected by the earthquake. Through our work with this country, we observed the great impact of cholera post the earthquake incident. Individuals were banned from using water from local streams and rivers due to the great possibility of obtaining cholera, a deadly bacterial disease that may cause dehydration and diarrhea. In the U.S, we may think how hard could it be to treat cholera? Well, in a third world country such as Haiti, sometimes their only source of fresh water is from these cholera-infested streams. Then, when its times to get treatment, there is no access to health care (such as in these small villages), or when there is access there is no money to pay for treatment, so as a result many people ended up dying as a result of cholera after the earthquake.
An impactful story I heard from one patient we were treating in Haiti was that her child had become infected so she attempted to travel to the nearest medical center, which was across the border in the Dominican Republic (3 hours away). She traveled on foot to the border, which is identified by a large river, a bridge, and a chain blocking the entrance into Haiti at the end of the bridge, guarded by a heavily armed military man. She begged and pleaded to the guard to let her cross as her child was sick and she had been traveling on foot for many hours. The guard was not compelled. She contemplated crossing the river, but knew it would make it worse since it was probably infested as well and the guards would probably catch her anyways. She returned every day, but ultimately her child ended up passing, probably from dehydration. It is sad to think that no matter how many billions of dollars were donated from many countries, it was not enough to help the residents of Haiti.
Some barriers identified that prevented Haiti from obtaining help were lack of resources, lack of proper money handling from the superiors of this country, and no proper infection control. Although I would like to say that we would be better prepared for the next international disaster, it is a difficult situation when we are 100% prepared but the resources from the country that needs relief are minimal. I believe the United States is very prepared for most situations, but when the number of people needing help surpasses the amount of supplies and providers, it is evident that many individuals will die or suffer terrible consequences resulting from inadequate resources.
Final Reflection
I cannot believe that pinning is just around the corner. It feels so unreal. I cannot believe I will be walking down the line for graduation, my goals are slowly being accomplished. Such an amazing feeling. When I came back to the program after taking a break due certain reasons, I was nervous because there was no time to fool around since I would not be getting a second chance. I knew I had to do well. To be very honest, I was also nervous about going into a new cohort and I knew I would miss my old cohort very much; but, everyone in 2015 are very friendly and I felt like I was part of their cohort. I want to state how lucky I am to have been part of two amazing nursing cohorts (2014 and 2015). I enjoyed the supportive and friendly nature of both cohorts. My motivation to finish this semester strong is my son because I want to be able to provide a future for him.
Since I haven’t done patient care for over a year, I knew I had to slowly merge into what it meant to be a nurse again. The first day, I made sure I could handle the care of a patient, documentation, and looking at the patient as a whole. I gained some very valuable experiences during the critical care rotation and when I got into the swing of things again, I knew that nursing is what I am meant to do. Not only was I able to practice my nursing skills such as Foley insertion and IV insertion, but I also wanted to assess other aspects of my patients by providing holistic care even just for a day. One of my patient’s thanked me for listening to his story and for not assuming that he was a chronic smoker. This patient had a permanent tracheostomy and people would always asked if he smoked; which was not the case. This clinical rotation enforced therapeutic communication and the importance of just listening even for 10 or 15 minutes. Also, I always told my patients when I would be back to check on them and I stuck by my word. I think it’s very important to assess the patient’s other needs when their physical needs are being met, or assess the physical needs that are not being met outside the home. Our reaction to our patient’s slight physical chance in vital signs, mental status, or other body system changes really do pave the road of recovery for our patient.
The assignments provided for critical care were valuable because it allowed you to dive into how you think and how you process the information. We also got to see how our peers would handle the situation. I want to be the type of nurse that provides safe, effective patient-centered care by focusing on my patient as a whole, looking at aspects on them and being mindful of 
changes in the patient’s status.
Overall, this semester has been a great experience. I am really happy about the path I chose to take and the obstacles I had to overcome; I have no regrets. I will truly miss cohort 2015, but I know we will all flourish and become great nurses. Not only were my peers supportive, but all the instructors who helped us grow as nurses and taught us to follow our own path. I want to take all the instructors because they helped us spread our wings and fly; they did all that they could to help us keep our wings from being damaged along the way. The nursing program has become another family for me that I will truly miss.
Earthquake in Nepal
This past Saturday, a 7.8 magnitude earthquake hit Nepal, India. To date, more than 4,800 people have been found dead and more than 9,200 people are injured. Nepal’s weak healthcare system, terrain, and whether are some identified barriers for providing and accessing healthcare. According to the 2011 World Health Organization report, Nepal has a population of 28 million people, only has 2.1 million physicians, and 50 hospital beds for every 10,000 people. One trauma center, Bir Hospital’s Trauma Centre has 200 beds. However, doctors need more than 1,000 more beds to treat patients. Families and children are sitting on hospital floors and tents posted outside the hospital. Patients are being discharged prematurely to make room for more injured survivors that come into the hospital. Outside major cities have limited access to healthcare facilities and only have basic medical centers that aren’t equipped to handle the injuries sustained by survivors. Additionally, the rugged terrain and poor whether have made it difficult for relief parties to reach these hospitals via helicopters. The Kathmandu International Airport has one runway and space for a limited number of aircraft to part, which has hampered the delivery of relief materials.
Aside from the response from Nepal’s local hospitals, the United Nations (UN), various aid groups and at least 16 nations have rushed aid and workers to Nepal. This catastrophic event happened less than a week ago and residents of Nepal continue to feel aftershocks from the initial earthquake. The day after the earthquake (Sunday), a 6.7 magnitude aftershock, struck east of Kathmandu; which further destroyed homes, buildings and surrounding areas. As far as socioeconomics and environment, the few medical centers present and the few number of physicians and healthcare providers has impacted how patients are seen and treated. As mentioned above, farther regions from the major cities don’t have the proper medical services to treat these severely injured patients.
As a future nurse, it is important to remember that a catastrophe can happen anytime. I believe that no amount of preparation can really truly prepare us for major traumatic events such as this one. However, we can learn from events such as the one in Nepal and prepare supplies and beds in case we were to encounter a similar situation.
References:
“Nepal earthquake: Death toll rises above 3,000.” (2015). BBC News. Retrieved from http://www.bbc.com/news/world-asia-32475030
Reuters. (2015). Earthquake overwhelms Nepal’s weak healthcare system. IBN Live. Retrieved from http://ibnlive.in.com/news/earthquake-overwhelms-nepals-weak-healthcare-system/542403-2.html
Watson, I., Mullen, J., & Smith-Spark, L. (2015). Nepal earthquake: Death toll passes 4,800 as rescuers face challenges. CNN. Retrieved from http://www.cnn.com/2015/04/28/asia/nepal-earthquake/
Picture: http://whatstrending.com/news/18953-earthquake-devastates-nepal
