End of Life Discussion

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After spending some time thinking about end of life care, I think that there are multiple options for what I would personally like done, depending on the situation.At this age, if I coded, I would like to be a full code status. If I was a diagnosed with a terminal disease, I would like to die in the most humane way and be a DNR/DNI status. If I was involved in an event that left me in a vegetative state with no brain activity then I would like to be taken off life support. If I was in a long-term coma with brain activity, I am not sure what I would want for myself. I think it would depend on what my family would want and how it would affect them. If there was a possibility of  me returning then I am really not sure what I would want and am continuing to think about this. I think that making my parents the executor of my will/health directive would be the most appropriate decision, however I would have to my wishes well defined because I think they would have a hard time making these decisions without my prior explanation.

I think my family would want a similar situation to what I would personally want for myself. I have spoken to my parents and grandma (on my mom’s side) and they have all expressed that they would not like to be kept on mechanical life sustaining support if it came down to that. I think it would be important to have a more in-depth conversation about this topic to see what specifically they would want if faced with this terrible possibility. My family lives about 100 miles south in Orange County and think that this is more of an in-person conversation so I have not facilitated a detailed conversation about this yet.

Culture, family and diversity play a huge role in end-of-life decisions. Different religions do not allow life-support to be taken away while some might favor this action. Family values could also affect whether or not resuscitation efforts are continued or ended. I think regardless of culture, family or diversity, all decisions should be counted as valid for that individual/family and as nurses we have to respect these choices even if we do not agree with them.

Been birding…

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So I’m currently in an ornithology class and I’m discovering how interesting and fun I think birds are to study. The other day we went on a field trip to Point Mugu Naval Base and the diversity out there is amazing!! We saw about fifty different species in just a couple of hours, many of which were birds of prey. Mugu is a diverse and busy ecosystem and I’m glad I had the opportunity to go out there!!

Photos to come soon!

 

Capstone Update – April 6, 2015

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Returned from the final trip to Santa Rosa Island as a CSU student. All data has been collected and image analysis is moving along smoothly. Hoping to be done with all photo-points within the next few weeks. Looking forward to the end of the semester and presenting my final work.

Family Roles

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End of life is something that I have had experience with over the last several years through my volunteer work with Dream Foundation. Dream Foundation is a non-profit organization that grants wishes to adults who are terminally ill.  One aspect of my work is making floral deliveries to terminally ill patients on hospice, at local facilities, and to their home. I’ve watched and listened to these patients and learned a great deal about what it means to live and when it’s time to let go. It was a few months after my work began with DF that I had the conversation with my husband, Scott about what constitutes “living.” We agreed that neither of us would want to prolong life simply because the technology is available to sustain our life. I know wholeheartedly, when the time comes, that we will be able to carry out each other’s wishes.

A few months ago I was faced with this conversation once again as my oldest sister and I began to bring up the topic to our parents. My mom whose been declining cognitively over the last year just isn’t the same woman she once was. Her dementia makes her forget just about everything. Last August, she rescinded her driver’s license after she walked out of a Target and could not remember how she had gotten there and where her car was. The decision was a tough one for her and for us, as we watched her become increasingly more dependent on those around her. Growing up, the conversation about death and dying has always been an approachable topic. My mom, who lost both parents before the age of 2, grew up understanding what death meant because of her maternal grandmother. She raised us kids the same way.

My sister who was apprehensive at first about starting the conversation was having a hard time, so I initiated it. When the time came to asking those difficult questions, my mom who has been dealing with her declining health daily was much more open to talk about the end of life. My dad however was not so ready to discuss it. I realized that for the first time in their marriage my mom is the one that needs to be taken care of, as she had spent a lifetime caring for a husband while also raising 6 children. I don’t think that this new role is one that he is completely comfortable with yet. I assured them that it wouldn’t be just one conversation in time but an open dialogue about what they want when the time comes. I do my best to get home on a regular basis to see my family and continue this conversation. I am always surprised by my parent’s candor and humility. I believe that culture and family plays a great role in the types of decisions made and who is willing to make them. Family and the roles we assume within that unit influence every aspect of life and the end of life.

Come celebrate our students’ work!

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Posted from Cerritos, California, United States.

On April 8th we will be celebrating our 9th Annual Poster/Video/Gumbo session in the Broome Library from 5-6:45pm.

This is a free event, open to all.  We would love to see you there!

 

2015 Poster Session Ad

NOLA Poster Session Ad 2015

Project 2 Design Document

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End of life….

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JHP_5996My husband and I were in the car on our way to visit family for Easter, I looked at him and asked him what he would want for end of life care. I tend to bring up random topics during our car rides, but this particular topic took him by surprised. He asked me what I meant by end of life care. I knew I had to be more specific with the topic. I started by asking him if he would want me to  make health care decisions for him if he was in a state he could no longer do it for himself. His response will be with me forever. He told me that he trusted that my decisions for his care would be out of a place of love and years of knowing how he would want to live his life. I was deeply touched by his response and I knew that I felt the same. We both had to lean on each, when we  have lost loved ones in the past, but it did not prepare us for talking about the death of each other and I knew it was important for us to explore our feelings.

Our wishes and desires were similar. We both had buried loved ones in cemeteries and felt that even though our loved one’s physical bodies were there, we did not feel that their spirits were. We both agreed to have our ashes spread in a location that was filled with happy memories we both shared. Additionally, I brought up the option of donating our organs. I explained to him that the pink sticker on our drivers license that states “organ donor,” will over ride any feelings of opposition he may have to donating my organs. He then expressed how he would honor any wish I had to donate my organs. I told him that I wanted to specifically outline how my body was going to be donated. I wish not be used for research, because I still want a part of me to remain with him. The conversation during our car ride was harder than I originally thought it would be. The car ride showed me that this should be one of many conversations to come and that both my husband and I should set aside dates that we would begin to outline an advanced directive. I feel that this conversation brought us closer. I am starting to realize the importance of an advance directive beyond advocating for my patient’s wishes to be up held, but to make these situations easier for my loved ones.

 

Copyright basics

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We are not always as conscientious about copyright laws as we should be. Do you understand copyright? What about the photos you post? What about the presentations you put together? As you prepare your presentations, and continue to blog, I wanted to be sure you are informed and are aware of creative commons. CI Teaching and Learning Innovations site has put together a great resource about copyright. Check it out!

Design Doc

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designdoc

second project

Over 120 Dives!

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At first we were nervous about such an inexpensive and user created platform such as OpenROV for performing oceanic research. Comparable systems cost 10 times the price, but are unfortunately out of the reach of our funds. The OpenROV 2.6 units had a lot of problems with the motors, and we had concerns with durability. The new 2.7 unit has been so much more robust in just about every arena and has been a great tool. With just a few tweaks we have repeatedly and consistently collected data.

The team is finally getting settled back into repair, design and build mode after spending a combined three weeks deploying ROVs on Santa Rosa Island, where our Research Station is located. The total combined deployments has given us a total of over 120 dives. We are working on two research projects, a Marine Protected Area health study, and a subtidal/intertidal ecology study. The majority of the dives were done with our two transect duty 2.7 OpenROVs: The Remote Underwater Mariner (RUM) and The Black Pearl. We’ve learned quite a bit from using them on such regular intervals.

Lessons learned:

  • The motors need to have a strain relief on the copper windings to prevent breakage of the wire and subsequent shorting.
    • We used hot glue to better attach the windings to the rear of the stator, avoiding getting glue on the rotor and interfering with the motor mounts.
  • The ROV should always be slightly positively buoyant, we use the hold depth function which works great for running transects.
    • On one of the last 60 meter transects, our ROV’s tether became completely and utterly tangled in kelp due to heavy surge. Harsh conditions and attempts to pilot out of the tangled mess resulted in the tether being severed at 30 meters from the launch site, because the ROV was slightly positively buoyant, we were able to retrieve the ROV!
  • The out of the box balancing of our ROVs needed to have some ballast adjustment because of the tendency to pitch forward on straight transects.
    • The video transects we perform require a higher quality video, so we use two GoPro cameras, a forward one and a downward facing one. We mount them on a 3D printed rail system that Paul designed, with PVC skids for protection (the side outrunners are for the intertidal system.) The rail allows for adjustment of position for balance and ballast. Some additional high density closed cell foam floats from fishing nets were used to offset the weight, and provide more buoyancy in the rear.

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  • The topside adapter boards need to be fully sealed off. One of ours died due to corrosion from sea water splashes, and moist conditions.
    • We have a small pelican box with a battery powered wi-fi access point, the wires pass through holes we drilled and then filled with hot glue. This enables us to connect by wi-fi using our toughbooks, with all of the ports sealed.

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Two absolute necessities for repeated deployments are a tether management reel (a commercially available slip ring works well to allow the spinning) and if working in uncovered areas, a laptop shade!

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