Junior Year of Nursing School is Complete

WOW! Time sure does fly when you are having fun or when you are in…nursing school. This has been one hectic ride but worth every minute. In one year I’m going to become a RN and I am very excited about it. Finals are over and the stresses of junior year are behind us…senior year…here we COME! :)

We have been told that our junior year of nursing school will be the most difficult time in nursing school. And… I sure hope so because the best is yet to come.

Many people have received externships for the summer and I have received one also at St. Joseph’s hospital. This job entails working under a RN where you learn and work at the same time. I am very excited about beginning to work there over the summer. I look forward to keeping you posted and cant wait to update you all about my Senior Year!

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Fast

One word can characterize the accelerated-BSN experience. Fast. The scope of information we need to learn to effectively and safely function as RN’s is vast. But even more overwhelming is social responsibility and trust which accompanies the title of “Nurse.” A little less than a year ago I was simply a young woman, working my way through life and this world. But now, I am looked on differently. Parents automatically trust me with their children; clients in the hospital open their hearts to me and trust me with their bodies. I am still the same young woman. But now – I am a nurse. (Well – almost.)

I under estimated the emotional impact of embarking on this journey of a career. I knew it would be intellectually and academically challenging. But almost more demanding than the sheer number of papers and tests and projects I have completed in the last 10 months, has been building the confidence to measure up to the new responsibility of this title. Prior to May 2011, I did not even know there was such an object as a nasogastric tube, let alone imagine I could insert it into the nose of a little 5-week old boy. Walking into that room, armed with all necessary supplies and a wavering confidence, I gave myself a pep-talk. “You can do this, do not back down now!” Knowing that any fear would only increase the apprehension and worry of the family, and also knowing that efficiency was my ally, increased my courage. Still, there was a little part of me that balked at the very idea of what I was about to do. I knew the steps, I knew the evidence, in that I was confident. With the guidance and support of my clinical professor, we inserted the tube and heard the satisfying puff of air, ensuring correct placement. I exited the room amazed. Last year, my world did not contain tubes that feed acutely ill babies, tubes that enable proper flow of urine, tubes that bring medicine. And now –I am the one being trusted to insert them.

In my classes we discuss the art and the science of the nursing profession. I have performed various procedures, learned the multiple ways the physiological functions of the body can go awry, and discovered the plurality of methods scientists have found to restore health. Out side of the classroom my colleagues and I have rejoiced in our excitement, cried our frustrations, and supported each other through times of discouragement, anger, hopelessness, and exhaustion. I have been blessed with wisdom and insight from each of my classmates, as we have been sharing this experience of nursing school. Collectively, we have experienced a more complete picture. With our class, the whole is definitely more than just the sum of its parts. Because they have shared their insights and experiences with me, I will be a better health care provider. I gain confidence because I know I am not alone. Yes – fast is the best word to describe the last year I have spent as an ABSN –because of how much I have learned and done and grown – which has been amplified both in richness and depth by my colleagues and friends.  Fast. 10 months down, only 5 more to go. Wahoo. (And yikes!)

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Senior Year – Community Health Interventions

This past week, multiple groups of students finishing their Community Health Clinical rotations gave presentations to fellow students, faculty, and staff on the experience of working as student nurses in a Community Health setting. For many of the students, this was the first time we had worked in a larger, population-based community setting. Some of the areas represented included: The Gateway Center for homeless men and women in downtown Atlanta, Moultrie migrant farm-worker populations, the Clarkston Community Center (home to a variety of ethnicities and refugee populations), and Café 458 Restaurant for the homeless. Overall, the majority of students expressed that they had an incredibly informative, moving, and successful experience working in the community.

Student activities ranged from education with the populations, to interventions to address specific issues – such as high rates of teen pregnancy or increased rates of hypertension. Many of the main health topics and interventions focused on exercise promotion, healthy diet promotion, and prevention activities. The levels of prevention included primary, where clients were provided education; secondary, where clients were screened for different ailments; and tertiary, where clients already suffering from diseases were taught ways to decrease morbidity and mortality from their illnesses. Many of the groups were able to evaluate the effectiveness of their interventions through the use of surveys and data collection of community members’ thoughts. The prevention activities were based on the goals and objectives of Healthy People 2020, a US Department of Health and Human Services nationwide program dedicated to disease prevention and treatment. As a part of these Healthy People goals, it is especially important to reduce the disease burden in vulnerable populations – such as the homeless, minority groups, and immigrants.

One of the most common themes described by the students when reflecting on their experiences included the importance of cultural sensitivity, such as respecting cultural differences and different beliefs. Many students expressed that they learned a variety of new information about different cultures and communities that they had not previously come into contact with. Another similarity discussed among the students was the importance of recognizing the heterogeneity inside of the groups. We learned that community groups often have more intra-group variation among their individual members, as compared to inter-group variation. It quickly became apparent that members of the same community cannot necessarily be easily categorized or stereotyped into one or two broad descriptors.  In this sense, we learned the importance of breaking down barriers, such as stereotypes and assumptions about group needs and desires, in order to deliver the most culturally-relevant and appropriate care.

The feedback that students received from the Community Health Interventions was overwhelmingly positive. The majority of community participants were incredibly appreciative of our work with them in multiple areas. In addition, all of the students were mutually grateful that we were so readily accepted into these different communities. The people we worked with embraced not only our education and teaching, but also our cooperative spirit and developing sense of unity with them.

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Junior Year- Time Flies

Time Flies

 

It is hard to believe that there is only 6 weeks left in this semester. Which means that our first year of nursing school will be completed. It has been an amazing experience full of emotions. I never dreamed I would learn so much in such a short time!  I have completed clinical rotations at Emory and Northside. I am currently at CHOA and it is a wonderful hospital and my instructor is great.

I had a great spring break, however, getting back in the swing of things is a little hard. Luckily, there are no exams scheduled this week or, spring break would not have been so relaxing. You honestly never get a real break from nursing school until you graduate from the program…. Wait…. Then you have the stress of your nursing career, however, it will be well worth it. 

            This week I began my pediatric rotation and really enjoyed it. The day mainly consisted of orientation of the hospital and the protocols of what you as a nursing student can and cannot do. Having been around healthy children most of my life, it was difficult seeing these sick children and I hope they all recover. I remember sitting in the cafeteria and seeing a family bring in their child who had cancer. The sadness just broke my heart. However, pediatric oncology patients have a higher survival rate than most cancers. The patient that I took care of for the day was full of life (6 months old) but unfortunately was ordered palliative care. Knowing that she is going to die so young is a sad realization. Nevertheless, nursing involves both life and death. You have to embrace each moment and make every moment worth it. It also makes you appreciate your health and the health of your loved ones.

            Florence Nightingale, an amazing woman and also a nurse, once said:

“Nursing is an art;

and if it is to be made an art,

it requires as exclusive a devotion,

as hard a preparation,

as any painter’s or sculptor’s work;

 

for what is the having to do with

dead canvas or cold marble,

compared with having to do with the

living body – the temple of God’s spirit?

 

It is one of the Fine Arts;

I had almost said

the finest of the Fine Arts.”

 

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Southern Nursing Research Society Conference, New Orleans

While in Nursing School, there are a variety of different conferences that students are able to attend, both in the state and nationally. They cover a variety of different topics – for example, the Georgia Association of Nursing Students Convention. Recently, I attended the Southern Nursing Research Society (SNRS) Conference in New Orleans, LA. The theme for the conference was: Nurse Scientists as Crucial Partners to Health Delivery. I was selected to present one of the Top Student Posters at the convention, “Perceived Benefits of the HPV Vaccine by Parents who Reside in Rural Areas.” I had an absolutely great time at the conference, where I experienced and learned so much about the field of nursing research.

My initial experience of becoming interested in Nursing Research began over a year ago. One of the courses I took during the Spring semester of my Junior Year (2011) was an Honors Research course. I began working with faculty member Dr. Tami L. Thomas on her research centering on Parental Perceptions of the HPV vaccine. I chose to work with her for a variety of reasons, one of the most important being that my Grandmother passed away due to complications from cervical cancer before I was born.

Throughout the course of the past year, I worked with Dr. Thomas to conduct my own research on the Perceived Benefits of the HPV Vaccine, specifically focusing on parents in rural Georgia. Dr. Thomas not only guided me, but also genuinely supported me in all of my endeavors throughout the research program. With her help, I learned how to make scholarly posters, presentations, and conduct and analyze quantitative and qualitative research. I had never realized that Nursing Research could involve physically going out into a community in need of help, and actually finding a way to make a difference in the population.

Part of my project involved submitting my research abstract to a conference. I chose to apply to SNRS because they offer a variety of opportunities for student researchers. While the majority of the presenters were in their Doctoral Programs, I was selected as one of the few Undergraduate BSN students. I was able to present my work alongside different PhD students in a Top Student Poster section. In addition, I also participated in a panel discussion focusing on different aspects of conducting student research. Some of the other student presentation topics included: Sleep quality & stress in parents whose children have Bronchopulmonary Dysplasia, Managing the healthcare needs of adolescents with Autism, and Children’s perceptions of themselves living with Cystic Fibrosis.

In addition to presenting at the conference, I attended many different sessions and events as well. During the three days of the conference, with over 700 Nurse Researchers/Scientists attending, there were a variety of posters and presentations to view. Some of the presentations that I attended had topics such as: Asthma self-management, Children’s coping behaviors with Autism, the Effects of caffeine & technology on children, Parent’s perceptions of child ICU death, and Predictors of depression in hospital nurses. I found these presentations especially interesting because of their pediatric focus. I also found the session on Clinician Health especially crucial because nurses often forsake their own health when caring for others.

Throughout the conference program, I also attended larger, group-wide events, such as the Opening Keynote with the Dean and Distinguished Professor Dr. Marion Broom from Indiana University School of Nursing. There was also a Plenary Session – SNRS Board Panel: Reference Hearing, a Student Networking Session, and the SNRS Annual Business Meeting. There were a large variety of Nursing Schools present, including Emory School of Nursing, in an Exhibition Hall where they recruited students to MSN, DNP, and PhD programs. Finally, there was a special reception for the prestigious Robert Wood Johnson Foundation, Nurse Faculty Scholars Program – which includes my mentor, Dr. Thomas, in the current 2009 cohort.

Finally, after the Conference concluded, I had some free time to go out and explore the city of New Orleans. I spent some time walking down the *famous/infamous* Bourbon Street, in addition to checking out the well-known Café du Monde and Acme Oyster House. This was the first time that I had ever been to New Orleans, and I thought the city was wonderful. I found the people to be exceptionally friendly and festive, and the building architecture absolutely beautiful.

Overall, I had an amazing time at the conference. I was incredibly impressed by all of the work that my fellow nurses and student nurses are accomplishing. In addition, attending the conference helped to solidify my interest in nursing research and desire to continue conducting research throughout my nursing career.

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V.L. Franklin Conference on Psychiatric Manifestations of Physical Illnesses

One of my many great experiences throughout nursing school, and consequently one of my passions and interests, was my mental health/psychiatric clinical rotation. While working at the Behavioral Health Hospital, Peachford, I found that I truly enjoyed working with the populations there, especially the adolescent group. Because of this, I chose to attend the 2012 Virginia Lee Franklin Memorial Conference, hosted by the Emory University School of Nursing. This year’s topic was “Psychiatric Manifestations of Physical Illnesses.” Mental health and well-being assessment and treatment should be emphasized in every aspect of nursing, even if a nurse is not specifically working in a behavioral health facility.

The Virginia Lee Franklin Memorial Conference has been held by Emory’s School of Nursing every year for the past few years in honor of former Emory Nursing Student Virginia Lee Franklin. Ms. Franklin graduated from Emory in 1957 with a Master’s Degree in Nursing, with her expertise in neurology. The program brochure stated that she was well-known for being “an excellent teacher, an advocate for the nursing profession, and a compassionate nurse.” Originally, her parents started a fund in her honor, which has since grown into the present day Conference.

The “Psychiatric Manifestations of Physical Illnesses” topic covered the objectives of discussing psychiatric symptoms commonly seen with physical disorders, describing “red flag” physical symptoms that can be associated with psychiatric disorders, and examining specific physical illnesses commonly associated with psychiatric symptoms. The program faculty included the Dean of the School of Nursing, Dr. Linda McCauley, and the main speaker, Dr. Nzinga Harrison, Clinical Adjunct Faculty at Emory’s Department of Behavioral Health and Sciences. In addition, a variety of other well-known School of Nursing Professors and Clinical Faculty Members also participated on the planning committee. The majority of the attendees were nursing students or nurses in the community, with a wide variety of backgrounds. Some of the nursing specialty areas that were represented included: psychiatric, med/surg, neurology, rehabilitation, emergency room, social health, and advanced practice.

Dr. Nzinga Harrison provided an informative, engaging lecture on a variety of different symptoms, both physiological and psychological, in mental health and non-mental health patients. We learned about a variety of different factors that are associated between psychological and physical disorders. For example, we spent time discussing symptoms of Anxiety Disorders (such as Post-Traumatic Stress Disorder), including: increased heart rate, insomnia, nightmares, decreased concentration, irrational thoughts, irritability, and hyper-vigilance, among others. One of the most important things that I learned was to document symptoms of any patient in terms of the following areas: physical, cognitive, emotional, and behavioral. The vast majority of illnesses present with symptoms in a variety of these areas. Therefore, taking an assessment with this framework in mind will help to include as much information as possible in the diagnosis and treatment.

One of the greatest benefits of Emory is having such a strong, interdisciplinary group of schools and departments. In this instance, the School of Nursing and Dr. Harrison, from the Department of Behavioral Health and Sciences, worked together to share their strengths and knowledge with a variety of students and professionals. This Conference is one of many wonderful educational opportunities that nursing students are able to participate in throughout the year.

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Senior Year – Topics in Class

The last semester of Senior year is somewhat hectic for most of the students. Not only are we busy keeping up with schoolwork, we’re also applying to jobs, applying to graduate programs, culminating research projects, and practicing for our NCLEX Licensure Exam. In addition, we all have two 12-hour clinical shifts per week. Needless to say, there isn’t a lot of free time! Our courses this year are geared towards bringing together all of the fundamental information we’ve learned in the previous three semesters. Senior Year courses include: Synthesis, Core Concepts: Acute Care Nursing, Community Health, Role Transition, and Professional Development: Politics and Public Policy.

Synthesis is a course that focuses on preparing Nursing Students to take the NCLEX Licensure Exam. We take practice quizzes every week on a variety of different topics, such as general Medical/Surgical care, Psychiatrics, Pediatrics, Maternal/Infant Care, and many others. Overall, we’re reviewing what areas we need to review prior to taking the NCLEX exam.

Core Concepts: Acute Care Nursing focuses on the “sickest of the sick.” Many of the patients that nurses come into contact with, especially in the hospital setting, have some type of illness. However, this course instructs students on how to care for the “acute” patients – such as those patients experiencing Hypovolemic Shock and Cardiac Instability. Thus far in the course, we’ve learned a variety of different monitoring devices for patients with Cardiac Output issues (i.e., patients whose hearts aren’t functioning/pumping effectively). In addition, we’ve also learned techniques never before discussed in Nursing School – Emergency/Disaster Nursing. We’ve covered many different subtopics under this umbrella, from care during an environmental emergency (e.g., flood or tornado), to care during biological terrorism events (e.g., Anthrax and Viral Hemorrhagic Fever).

The Community Health Nursing course addresses nursing care on a larger, population-based level. Students participate in a Community Health Clinical two days a week at a variety of different locations, working with vulnerable community groups, such as immigrants and the homeless. As mentioned in some of my previous posts, my clinical is at the Gateway Center in downtown Atlanta. This facility caters to homeless men and women in the area, and provides them with shelter, healthcare, educational opportunities, and assistance finding work.

The additional Clinical course this semester is Role Transition. This course focuses on the students’ involvement and experiences in their Role Transition/Practicum site, where they are placed based on their particular interest. Students participate in either the Community Clinical or the Role Transition Clinical for half of the semester, and then switch mid-way through. I will be finishing up my Community Health Clinical in a few more weeks, after which I will begin my Role Transition Clinical. I’m placed at the Mother-Baby/Postpartum Unit at Emory University Hospital, Midtown. During this clinical, I’ll have two 12-hour shifts to complete each week. It sounds a little hectic, but the students in Role Transition now are somehow managing to meet the requirements, so I know it’s possible!

Our last course is Professional Development: Politics and Public Policy, specifically relating to Healthcare. Because of the rising costs of healthcare, and new policies being enacted regarding healthcare, it is imperative that students become informed and aware of these changes. This course provides invaluable information to us about a variety of different topics, such as the economics of healthcare, healthcare reform, and quality improvement. In addition, we also attend some type of legislative day for this course. I attended the Georgia Nurses Association Legislative Day this past January, where I was able to speak with a variety of senators and representatives about Healthcare delivery.

This is a busy semester for virtually all of the students, but I think we’re gaining information that will be highly useful for our future careers as BSN nurses. I think one of our biggest motivators to keep working through this semester is the countdown to our graduation on May 14th!!

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Have you ever heard that nursing school is difficult, well I have come to know that this is true. I feel that the hardest part of the program is time management. It is common to have two tests and many papers due in the same week. You have to prioritize the tasks and this is where time management comes into play. With exams and papers comes stress, however, there is joy and excitement through clinicals. You are able to put what you have learned in the classroom to work. Being able to see the care that you are providing to sick patients is a remarkable feeling. In life, I have always been taught to look at things that make you happy. Happiness to me is comforting someone and helping them feel better so they are able to fulfill their life to the fullest. Not all of the patients that you will encounter are sick, some are bringing a life into this world. The past two weeks I have been in my labor and delivery rotation and it is by far my FAVORITE. I absolutely love it and it clicked, this is the type of nursing that is meant for it. Things happen in your life for a reason and these past couple of weeks have been wonderful. Within two days I experienced approximately ten births. It was wonderful! The nurses on the floor were wonderful and taught me the roles in becoming a labor and delivery nurse. To see the face of the mothers when that baby is laid into their arms is wonderful and to see the fathers cry with joy is moving.

Besides the joy of clinicals…. (school) the following week is hectic but manageable. There are two tests but thankfully is not on the same day. Spring break is within the next couple weeks and within the next couple of months the first year of nursing school is over. What a wonderful feeling!

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Senior Year – Community Health Clinical

Checking Blood Pressures

Throughout the last semester of Nursing School, the seniors have either one of two clinicals – Community Health or Role Transition (i.e., practicum/preceptorship). After half of the semester is completed, the students switch from one to the other. For the first half of this year, I’ve been in my Community Health Clinical at the Gateway Center in downtown Atlanta. This facility serves homeless men, women, and children that have come to the Atlanta area for a variety of different reasons.

The Gateway facility is able to provide temporary shelter to these clients, but it places a special emphasis on gaining work and education. Many of the clients are enrolled in a variety of educational or treatment programs in an attempt to restore their lives and regain their independence. The initial intake area is a large, open room with a variety of clientele – all different ages, races, genders, and ethnicities. One of the first things I learned very quickly in this clinical rotation is that there is no stereotypical “face of homelessness.” Many people have preconceived notions about what a homeless man or woman looks like. However, just from working in this Center for only a few weeks, it is quite clear to me that this is not the case at all. Many of the clients we work with were once in very stable positions, but due to some unforeseen event, they have come to find themselves homeless. In fact, one of the staff members of Gateway was even a former client of the facility. Working with this population makes it quite obvious that all of us, no matter what our situation or background, are susceptible to homelessness.

During our clinical shifts at Gateway, we participate in a variety of different activities, such as educational sessions, art therapy, and health fairs. Some of the topics that the clients are most interested in include hypertension, diabetes, stress management, and heart health. We usually get a pretty good turn-out at each event, with a record set for our group of 39 participants in last week’s health fair on Heart Health (conducted by students Chelsea Pharr and Marcus Whitlow). The patients are always especially interested in finding out what their blood pressure is, ways to reduce these numbers, and information on healthy diets. I’ve been so impressed by how interactive and receptive the majority of them are with all of the students; they’re genuinely interested in hearing what health advice we can provide, and ways to improve their situations.

The nursing students at Gateway act in many different roles during the clinicals – student nurse (of course!), educator, counselor, and listener. I’ve found that the latter role, listener, is often one that the clients appreciate most. As our clinical instructors, Prof. Monica Donohue and Jordan Simcox, have informed us – many of these men and women are never even routinely called by their own name when living on the streets. So many of us get caught up in all of the busy work we have to do each day with school, friends, and family, and while this work is difficult and time-consuming, it’s important to think of populations that are quite worse off than us. Imagine living on the street and having most people avert their eyes whenever they walk past you, as if to ward off any type of conversation or pretend you aren’t even there. When a student, or anyone, sits down with any of these men or women and takes the time to talk to them, and especially listen, it truly seems to improve their outlook. Once again, the “art of listening,” that is often highlighted as a gift of nurses, serves to provide a connection with these clients that may have been missing in their lives for quite some time.

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Junior BSN 2013

Another blog…. another day!

These past couple of weeks have been great. Clinicals have been great. Last week I was in the Special Care Nursery (NICCU) at Northside and those poor little babies are so small but have a heart that will help them survive. The one that touched my heart was a baby that was just admitted and she was not even 1 pound. It was a happy day but there were some sad times also- a poor little one quit breathing and had to be resistated, and lived. This week (tomorrow), I’ll be in the labor and delivery department and I’m  very excited because I would love to work in that field. On average- my fellow classmates that are with me on the my maternity rotation has gotten to see close to 4 births in their one day rotation there. So that is very exciting. Northside is the #1 hospital in the United States for delivery, so that is an amazing place to be learning.

The upcoming weeks in our classes are extremely busy with tests, but before you know it, it will be spring break. The main thing about nursing school is to prioritize you tasks and to look ahead and upcoming things to be done so when it gets crazy busy with tests and papers that you have been prepared and ready.

 

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