Archive for date: October 25th, 2015
F.T.N.D.
Fight The New Drug’s website was very interesting to me. Additionally, i had no idea this site existed and pornography was such a problem. In addition, after browsing the website, the site does a great job on explaining the harmful effects of pornography. Moreover, the site explains that pornography can be harmful in three ways. These ways affect the brain, heart, and the world around you. Additionally, they elaborate on how pornography can be addictive, changes your way of thinking, affects your behavior, ruins relationships, and may lead to violence.
Furthermore, in chapter six, Sternhiemer explains how we all “live in a time where nothing is off limits in pop-culture, and the most private information about celebrities love lives becomes tabloid fodder.” I can definitely see how young teens may be influenced due to the content displayed of a celebrities life. The young individual may think it’s acceptable to act or mirror a celebrity, which may lead to negative outcomes. Additionally, Sternhiemer elaborates on how many adults fear that sex is no longer a big deal to kids, and how young teens are hooking up and growing up fast. This might have to do with the sexual content they read, view, or hear that may trigger certain actions.
Disconnected
Disconnect yourself from everything was the challenge. Was it possible ? Somewhat, but overall no. I can’t believe how much of my life revolves around my phone, computer, or even listening to the radio when I’m driving. I stopped by some grocery stores and noticed many people on their phones. Even when having lunch with my classmates most of us were having a conversation, but our phone was always by our side and constantly in use. Its very surprising how much I need my devices whether it is to socialize or to complete my daily duties with school and work. Its definitely necessary that we take some time away and look at our surroundings and engage in conversations with people. Its something good to try once in awhile and see the difference .
Surviving Sepsis Campaign Bundles
In order to contribute to our understanding of sepsis management, I searched sepsis protocols and found the “Surviving Sepsis Campaign Bundles” through the Centers for Disease Control and Prevention website.
The Surviving Sepsis Campaign Bundles include:
- To be completed within 3 hours:
- Measure lactate level
- Obtain blood cultures prior to administration of antibiotics
- Administer broad spectrum antibiotics
- Administer 30 mL/kg crystalloid for hypotension or lactate greater or equal to 4 mmol/L
- To be completed within 6 hours:
- Apply vasopressors (for hypotension that does not respond to initial fluid resuscitation) to maintain a MAP greater or equal to 65 mm Hg
- In the event of persistent hypotension after initial fluid administration (MAP < 65 mm Hg) or if initial lactate was greater or equal to 4 mmol/L, re-assess volume status and tissue perfusion and document findings
- Re-measure lactate if initial lactate was elevated
Please review video at:
http://www.medscape.com/viewarticle/831158
References
Levy, M. (2014). Surviving sepsis campaign: The takeaways. Retrieved from www.medscape.com/viewarticle/831158
Disconnecting
Disconnecting from electronics has always been hard for me but once it happens, I find it calming. Over the weekend I was able to disconnect for about 4 hours. I couldn’t do the 24 hours. I spent those four hours eating with a friend and just walking around talking. While eating, I noticed a lot of people would have their phones out–something I would do. My friend has his phone out too and he would check it from time to time.
In the past for my birthday I rented a cabin in Topanga Canyon for myself. I wanted to get away from everything and just relax. There was no service up in the mountains but there was wifi. I spent the two days up there reading the newspaper sitting outside. I used to read the newspaper a lot but now I rarely have time. I drank wine looking at how beautiful the sky was. I showered outdoors. I did a lot that I wouldn’t have normally done surrounded by people and electronics. It did get creepy at night though being alone in the mountains. I probably wouldn’t do it again because of that.
End Of Life Care
End of Life Care
Ever since the death of my sister I found it very hard to talk about death of even think about it. Because talking about something makes it real and gives it power. For the longest time I spoke only of life with death not a topic for conversations. Then the most amazing thing in my life happened. My beautiful amazing son was born. The epitome of life, love and compassion. Then when he turned 4 he asked. “Pappa does everything die”. This forced me to confront the issue, talk about it and think about it. So I decided I will face death but on my terms. So our family had a conversation about, end of life wishes, DNR, what procedures can be done. We even spoke about who may be in the room when procedures like CPR and intubation is done. Even when life support could be turned of. This again really hammered home for me how I wanted to spare my family the sadness of seeing all these procedures done to me, and that only the medical staff may be in the room. I have seen CPR done and have done it myself with family in the room and I could see how seeing this brought them anguish and pain. It was a relief to be able to voice my wishes and hear my loved ones wishes. And it turns out we feel the same way. It was a cathartic moment to realize a loved one will make sure my wishes are adhered to
Tech Disconnect
Personally, not having a home phone line, i couldn’t disconnect via my cell phone due to work responsibilities. My technology disconnect was via my work shift which was approx. 8 and a half hours. On countless occasions, customers had phones out in their hands or laying on their table. As i brought food, it seemed like they were so attached to being connected to social media that they would only acknowledge my presence if I spoke up that their food was here. Television wise, many people in the bar area were very into their football games. At a home setting, I have a very hard time disconnecting from technology. The interweb and social media is a big distraction in which i find myself attached too. Personally, I dont have a hard time disconnecting when i’m outside of the house because I enjoy and thrive for memorable experiences. Your cellphone can capture moments, but it is forever ingrained in your mind.
CI Computer Girls inspiring youth at annual Science Carnival at Thurgood-Marshall Elementary in Oxnard on October 24th!
“We all had a great time encouraging young students to pursue an education in STEM! “
End-of-Life
End of life care is a very complicated topic. When I get older or become very sick, I will make sure to get a DNR status. I would like to die peacefully and naturally without any attempts to prolong my life for a short time. It seems that multiple resuscitation attempts can make the end of life a much more traumatic experience for me as well as for my family members. I know it is important to take care of this issue ahead of time, but in case I am not capable of making my own decisions, I would like one of my children or my husband to do it for me. My family feels the same way. They expressed a desire not to continue life support, if there is no hope for recovery and/or they are in a vegetative state. I did not include my younger son into this conversation. I don’t think he is ready to discuss this topic and he gets very emotional.
I think it is very important to provide comprehensive information to the patients and talk about their end-of-life care. According to a study conducted in 2015, patients who have end-of-life conversations with their physicians are “less likely to experience physical distress at life’s end, less likely to undergo high-intensity interventions, less likely to die in the Intensive Care Unit, more likely to receive outpatient hospice care and be referred to hospice earlier” (Periyakoil, Neri, & Kraemer). The authors identified six barriers (reported by health care providers) to the effective end-of-life conversations with diverse patients.
Barrier 1: Language and medical interpretation issues
- “Language barrier, inability to communicate with patient/family and ensure they understand the discussion.”
- “Inherent language barrier – medical terms are difficult enough for fluent speakers.”
- “It is hard to talk about sensitive topics through an interpreter.”
Barrier 2: Patient/ family religious and spiritual beliefs about death and dying
- “Religious cultural values may lead people to prefer life-sustaining treatments that we may see as futile.”
- “Reconciling religious ‘obstructions’ to a DNR status.”
- “Discussions of God and afterlife beliefs.”
Barrier 3: Doctors’ ignorance of patients’ cultural beliefs, values and practices
- “Doctors not understanding the cultural values surrounding end-of-life care for a patient with different ethnic/religious background.”
- “Cultural norms that differ from my own causing me to inadvertently offend the patient or his/her family.”
- “Not knowing how to discuss goals in a way that makes sense to someone with different views about death based on different beliefs about spirituality and afterlife.”
Barrier 4: Cultural differences in truth handling and decision making
- “In some cultures, patients may not want their diagnoses/prognoses discussed with them directly and will instead appoint a family member as surrogate decision maker. It can become difficult however, to be sure that that family member is acting in the best interest of the patient and acting with the patient’s preferences in mind vs. their own.”
- “Eliciting the personal wishes of a female from a culture in which men make all the decisions can be difficult.”
- “I think it’s fair to say that some cultures conversations about death as something to be avoided at all costs, which is not necessarily how I, as a health care provider, feel about it.”
Barrier 5: Patient/family’s limited health literacy
- “Certain medical terms may be difficult to explain in a way the patient can understand.”
- “They may not be used to the health system they find themselves in and it may be overlooked that they lack what we would consider common knowledge.”
- “Incomplete understanding of what resources/therapies that can be versus should be provided for a patient.”
- “Misunderstanding what is described by resuscitation, thinking it means we are giving up completely on treatment.”
Barrier 6: Patient/family’s mistrust of doctors and the health care system
- “Mistrust/misunderstanding of the motivations of the medical community”
- “Patients may believe that care is being “withdrawn” from their loved one because of racism.”
- “Certain cultures lack trust in the medical profession, do not believe physicians have their best interests at heart.”
It is important for the nurses to be aware of these barriers and facilitate the end-of-life conversations. Having comprehensive information can help the patients as well as their family members make reasonable decisions and avoid traumatic experiences.
References
Periyakoil, V., Neri, E., & Kraemer, H. (2015). No easy talk: A mixed methods study of doctor reported barriers to conducting effective end-of-life conversations with diverse patients. PLoS ONE, 10(4), 1-13. DOI:10.1371/journal.pone.012232
