Reflective ISTAN Journal

1.      Complete head to toe assessment. Documenting all of my findings

Wound care and culture on right foot puncture wound.

Deep breathing exercises to help increase patients O2 sat levels

Replacing pediatric non-re breather to an adult non-re breather mask and monitoring the patients O2 sat levels as they continued to drop.

2.      I realized even more now,  that team work is very important, I had an amazing team with Shane and Tabitha and I feel we worked well together, communicated well and pull on each other’s strengths.  We remained calm in the chaos and really worked together. 

3.      I will change my gloves more often. I changed them at least a dozen times and maybe the instructors did not see me but they commented that I pushed my glasses up with gloves on, although I use the back of my hand to push them up, I will be more aware of doing so in the future. And also that it’s OK to ask questions with you do not understand something.

4.      I learned that you must always check your medications several times before administering it- and to double check the infusion time on IV push medications. I also learned that communication is very important between team members and to communicate clearly with each other.

5.      I feel it is frustrating that Stan has many technical difficulties, when we are told that he had respiration's of 38 and it goes unnoticed when I put my hand on his chest for the entire minute I was assessing his apical pulse and had a hard time get 16 counted and this right after he malfunctioned. I just feel if we are going to get dinged on something like that maybe making sure he is working properly is best.  I am not entirely sure what the purpose is if we only hear of the things that we do incorrectly. Positive feedback is just as important as negative and I feel this is greatly lacking in the IStan component. I also feel that if you want it to be a learning experience then the students should not be working hard to do the best they can and they hear the instructors conversations inside the booth that have nothing to do with ISTAN.  We are giving it our all and they should be as well. I am not being critical I am just trying to be honest and give accurate feedback.  

Reflective Journal

1. Discuss 4 tasks you completed or tried to complete in simulation lab.

Mr. Garcia was found to be missing from his bed. He was found to be outside with Chick-fil-a and a cigarette. We as a group moved him from the chair to a stretcher and transported him back to his room. We then moved him from the stretcher to his bed. An assessment was performed and VS were taken. He was running a fever of 100.5 F. I called his HCP to report his fever and a cough. I spoke with the RN at the office, who gave a phone order for APAP 650mg PO Q4-6H prn fever > 100.4F. I read back the order and entered it into the computer. Another student pulled the APAP and dispensed it to Mr. Garcia. I connected and started his IV fluids. I also spoke with Mr. Garcia about his concerns for his ostomy. He said he would like to speak to someone who has also lived with an ostomy. A call was placed to locate someone to talk with him.

2. What did you learn most about the situation(s) you encountered in simulation lab? Patients will find a way to eat what they want even if their body may not be quite ready to digest it.

3. What will you do differently during your next simulation experience?

  I will make sure I have all of the supplies that I need to perform a specific task, so that I do not have to leave the room multiple times to retrieve items. I will make sure my team mates know to contact the unit secretary for patient labels for specimens.

4. While watching your peers’ simulation experience, what are 3 things you learned? I learned that a nurse can get verbal consent from the patient to give out information to anyone the patient states can receive the information. I learned that when there is more than one nurse and a messy patient that needs VS and an assessment, then two should start cleaning while the other starts VS and assessment.

5. What 3 things did you learn in the classroom (didactic) that you put into practice during your simulation experience? Listen and address the patient's feelings, operation of an iv pump, and labeling specimens.

The Need for Advanced Research Regarding Medical Use of Marijuana

The Need for Advanced Research Regarding Medical Use of Marijuana

            Marijuana has been used for centuries as a medical compound by many different Indian tribes and cultures and recently; in the last twenty years some research has been done on the compounds of marijuana and the effects when used for cancer, HIV/AIDS and MS.

According to Cancer.org; “scientists have identified many biologically active components in marijuana. These are called cannabinoids. The two best studied components are the chemicals delta-9-tetrahydrocannabinol (often referred to as THC), and cannabidiol (CBD)” Unfortunately, with marijuana being listed as a Schedule I controlled substance by the US Drug Enforcement Administration, federally granted research is quite limited and nearly unheard of. The American Cancer Society has issued the following statement in regards to research and marijuana “The American Cancer Society supports the need for more scientific research on cannabinoids for cancer patients, and recognizes the need for better and more effective therapies that can overcome the often debilitating side effects of cancer and its treatment. The Society also believes that the classification of marijuana as a Schedule I controlled substance by the US Drug Enforcement Administration imposes numerous conditions on researchers and deters scientific study of cannabinoids. Federal officials should examine options consistent with federal law for enabling more scientific study on marijuana”.

The medical benefits could be remarkable and one has to wonder why the medical community and the government have not tapped the possibilities of what medical conditions this drug can potentially treat;  why does this continue to be overlooked? Although, the use of marijuana to treat some medical conditions is legal under state laws in many states, it remains illegal by Federal Law. 

The article I have attached explains some of the benefits marijuana has had for cancer, HIV/AIDS and MS patients, how it alleviates nausea and vomiting, helps control chronic pain and promotes some appetite. This article also brings to light the vast need for more research, federal research for medical use.  The possibilities of using marijuana medically could be astronomical if the medical community had the resources and backing of the federal government.  The fact that no cure has been found, for any disease since the 1950’s make one wonder if we as a society are more complacent to push prescription drugs and line the pockets of the pharmaceutical companies that  are creating customers not cures. 

Interestingly;  dronabinol, a pharmaceutical form of THC, and a man-made cannabinoid drug called nabilone are approved by the FDA to treat some conditions and side effects from chemotherapy in cancer patients, so the research was conducted to approve these man made pharmaceutical drugs, why not get the funding and research approved for the real drug, the organic drug, the cost effective drug of marijuana and see where it leads us in finding more organic forms of medical treatment.

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900958/?report=classic

Ok- let's see if I have this right!!  Sad to say this former blogger is lost!! HA!!