Tech Disconnect

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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!

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“We all had a great time encouraging young students to pursue an education in STEM! “

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End-of-Life

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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

Oct. 25 Chapter 7

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Because my week is so busy, and the readings are long and complex, I don’t get the chance to read them slowly enough, or with the best circumstances, to absorb and make all the connections. However, there are always statements that stand-out for some reason and make me think a little more deeply, or resonate with my own experiences. I had a thought come up tonight that I had a couple of weeks ago in class when we were talking about pulling ourselves up by our bootstraps. I have gained awareness as we’ve discussed all the many sub-groups of people, their disadvantages and challenges. Much of it has been eye-opening. Some of the statistics have been more stark than I realized (although statistics themselves can be biased and I think the real issues are often missed when our eyes are too closely on the statistics). Hearing from the heart of each of our classmates has been enlightening. We (all the sub-groups, advantaged, or disadvantaged) are more alike than we are different. We have all, in very different ways, suffered challenges that require us to pull ourselves up by our bootstraps in order to succeed. I read Angie’s comment and the effect of one person who created a break through for her. We (black, latino, asian, male, female, young, old, white, from wealth or poverty, LGBTQ…) are ALL in this Master’s Program…and why…because we have all been able to pull ourselves up by our bootstraps. I guarantee that we have each faced challenges that have made us doubt, made us falter, made us feel disadvantaged. However, unlike the person who is not here…we have found the courage, the perseverance, the ability to do hard things, even when odds were stacked against us. I think that is what we need to teach, that’s what got each of us here. Page 213 in Smith struck me and made me think of this again–“If I were to describe a pattern that emerges in special-purpose institutions concerning student success, it is that the faculty, staff, and the institutional ethos convey a belief in students’ ability to succeed and excel, regardless of their background….The strategy involves a strong commitment to support, excellence, and belief in students, even when they might not believe in themselves.” On page 214 the text continues, “…they convey a common message to graduates that education is for a purpose beyond themselves…Thus, students who may not come with all the educational preparation needed to succeed are encouraged to persist and work because their success or failure has implications beyond themselves as individuals.” One other study of successful  programs noted on page 214 said, “…initiatives that incorporate characteristics of high expectations, belief, support, an institutional ethos that suggests that effort and hard work matter.”  I know it’s oversimplified to say, we are more alike as humans than we are different…you can do it…keep working…believe in yourself…it’s hard, but you can do it…it’s about more than just you…we’re all in this together…your success will make a difference…but, sometimes I wonder. The story of hope is powerful. And when one is committed and in motion towards a goal, the miracle happens.

I feel like tonight’s post for me is not as ‘intellectually’ reflective, but this is the thought that keeps coming to mind after reading both chapters along with the book And Still We Rise. I’ve spent a lot of time in my life trying to pick apart why, how some people make it regardless of their circumstances and others don’t.  There’s a lot of ‘outside’ work can be done to fix things…ultimately I feel we need to help all of our students do the ‘inside’ work so they can overcome the obstacles that may never be fully understood, and/or removed. (Please feel free to straighten me out, I’m not trying to just wear rose-colored glasses)

On a humorous, but not so humorous, note about the need for “advising…aggressive advising” on college campuses. I was attending a highly respected 4 year university for 2 1/2 years before I had the courage to ask what people were talking about when they talked about a “bachelor’s “. More than half-way through my classes , paying for my own education and living, 13 hours away from home, making all of my grades, and I didn’t even know what I was in college to get!!! I was too embarrassed to ask, because it seemed like common knowledge to everyone else, and I thought I should know.

 

 

Protected: Me and my loved ones wishes // End of Life Care

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Week 9 Readings

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Yay! We’re about half-way through the semester! Congrats! 

Celebration post-midterms aside, I’m obviously posting about the Sternheimer reading we had this week as well as the Fight the New Drug website we had to look at.

First, Sternheimer. This has probably been my favorite chapter so far because it was on a topic I find really interesting. I’m really into music and a big part of our pop culture now is the performing of music. However, it seems like those performances are constantly pushing some sort of sexual envelope (I’m looking at you Miley at the 2013 VMA’s). I was happy that Sternheimer pointed out that the sexualization of our culture reinforces a narrow version of feminity (p.162) which, I think, leads to a power struggle between the media and women. Men, I also think are sexualized, especially on television. Shows like “Teen Wolf” and “The Vampire Diaries” come to mind, where every guy has a ridiculously toned and fit body. Moving on, I really agreed with Sternheimer’s statement that we should find out what children think about sex rather than focusing on what we don’t want them to know (p. 157). We should focus on enriching rather than restricting youth knowledge about sex. It was interesting to see that trend of adults being fearful, once again, of something they don’t understand. Similarly, the trend of poverty as a risk factor has followed from violence and on to sexuality. Overall, I really enjoyed this chapter and found myself agreeing with a lot of what Sternheimer had to say (for once!).

However, I cannot say the same about the website we had to look at. At first, I thought it was a good and informative website, but the more time I spent reading, the more uncomfortable I got. First off, they make people pay for their “helpful” services. I feel as though this is profiting off of people’s insecurities about using porn and their possible serious addictions (I am not sure if whoever developed these programs has a medical license or degree). Secondly, their arguments were extremely one-sided. They did have interviews with people who had left porn, but even then, their examples of what porn actors experience (gun to the head? really?) I felt were a little extreme. I think instead of talking about the why porn is bad, maybe we need to ask why do people feel the need to look at/use porn and why do people go into the industry? There are women who have found much success not only acting but independently producing porn. This, to me, is an example of porn being more of a business than a “drug”.

I am going to link to a couple videos I found that I felt were kind of anti-Fight the New Drug ( and they are written by/explained by an actual doctor!). This is a channel that I really like and I feel is relevant to this discussion. Very informative.

Effects of Porn: Effects of porn are due to the people watching, not the porn itself

Removing the shame from pornography

I’m not saying there are not issues with porn, I do think it can be addictive and perhaps the ethics are not always the best. However, I don’t think the Fight the New Drug website shared the whole story, so this is me playing devil’s advocate.

Also, one more video! Relating to last week’s topic of media and violence, I foud a great video by The New York Times that revisited Columbine and had interviews with people who were students at the time. There is an argument about whether or not the shooters really were out for revenge or if they had an extreme god-complex and were suicidal. Once again, taking in multiple factors that may have contributed to the shooting. This video also compares our modern views on shootings compared to our past views. I spent about an hour watching the videos from this Retro Report series because it’s a lot of news that affects us today but that happened right before some of us were born. Hope you guys find it as interesting as I did!

“The entire country was confident that these two killers were loner outcasts from the trench coat mafia that were targeting who were targeting jocks in a revenge fantasy. None of that was true.”

Sorry for the long post this week but I couldn’t help but go a little further into the discussion. I’m interested to see what you have you to say about the readings and videos that I’ve shared.

Open Reduction Internal Fixation

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Open Reduction Internal Fixation (ORIF) is a correction and alignment of fracture after surgical dissection and exposure of the fracture. It does so by usage of metal screws, plates, wires, nails and pins to stabilize the fracture. Diagnosis of a fracture usually occurs in the ER. Diagnostics include X-rays, CT scans, and MRIs.

Here is a good short informative video that explains what an ORIF is.

Baylor Health Patient Information on ORIF

Disconnecting

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In my attempt to disconnect, I did not achieve the full 24 hours. I made it about 9 hours, then found myself succumbing to the comfort of wandering various social media on my phone while on break at work. I remembered my goal, looked up, and saw two of my colleagues also starting into their phones. I smiled because it is interesting how so many interactions silently occur between two people on different ends of a screen. The need to make plans in person has been replaced by the convenience of social media. Most people in America rely heavily on technology for daily tasks and interactions. Office communication occurs almost solely through e-mail, assignments are submitted electronically, and information is shared through media in countless forms.

During the time that I was disconnected, I had longer conversations than usual and smiled at more people. Conversations were longer because I was focused on the conversation and not awkwardly looking at my phone every few minutes. Looking around different locations at times it was hard to find someone without a phone or laptop in hand. If someone is alone in a shop, restaurant, the library, etc., it is socially acceptable to hide behind a phone or laptop to avoid social interaction. Most people would almost find it odd if someone he/she didn’t know tried to strike up a conversation while waiting in line.

I think that if the entirety of one’s interactions occur through e-mail, texting, or social media, it is perhaps a social issue. However, when technology is used as an adjunct to IRL communication, it enhances communication. As a side-note, being available 24/7 to everyone you know via texting or social media can be exhausting. I think it is important to have a set time everyday when communication is solely in-person, and the phone is put away for a few hours. Along with this, there should be certain places where being on a cell-phone is prohibited or at least frowned upon, including any dinner table, restaurants, social gatherings, and walking on the sidewalk (which I am guilty of). This way people would be more mentally present, because I noticed that 50-75% of people are on their phones in these places, including me. It is something that I am trying to get better at, because at the moment I’m not sure I would survive without my phone.

Disconnecting from Technology

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I am the first to admit that I use my phone and social media more than I should. I was excited about this assignment to take a day (or as much of the day as possible) to disconnect from technology and social media. I unfortunately could not go an entire day without technology, because I have things to check for school and work that require the use of a computer.  However, I was able to disconnect while spending time with others throughout the day, like at meal times. It was really nice to just enjoy the presence of the people around me that I love and have meaningful conversations instead of checking Facebook and Instagram all day. It really showed me how much time is wasted on social media and how much time I have that I could be spending more wisely.

Marissa Cuomo

Protected: Disconnected

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