Sarah's Site

For my community health partnership I ended changing partnerships to Fresnuis in Biddeford. I ended up spending the day shadowing a nurse on the floor and interacting with patients who were there for their dialysis. Going in, the only knowledge I had was from our renal unit and the guest speaker who came in. I had yet to consider the population and any social determinants that might affect the outpatient care this population needs to receive multiple times a week. While being there I learned more about their transportation needs as well as the cost and what maine care covers. As they go to dialysis 3 times a week for 3-4 hours (not including transportation) many of the population are unable to work. 

I talked with the nursing staff, asking questions to try and better understand the different aspects of care, and needs these dialysis patients need. One of the most meaningful things I learned in how personalized the care is that these patients receive. That dialysis treatment center is able to accommodate about 75 patients Monday-Saturday, so the staff can easily begin to create therapeutic relationships with their patients. As they will see them multiple times a week for months to years. Seeing how the nursing staff and PCT all knew the patients easily by name, asking about weekend activities and making very personal connections was more than I’ve seen happen in the med surg hospital setting. 

One interaction that stood out to me was one patient who was a retired nurse. When I asked how long she’d been getting dialysis she told me it was the 11th year. That took a second to sink in and consider the commitment and patience this patient had to their health and how even after showing up 3x a week for 11 years, you wouldn’t have even been able to guess. It makes you think about how each of these patients still have a whole life outside of this care they receive. Truly a different side of nursing that I have not seen yet. I am very happy that this partnership was able to be accomplished.

I found it interesting how much their experiences differed. It was interesting to hear the bsn vs absn how in the end the process for job application and graduation is very similar. Something that stood out to me was how more often new grads are placed on night shift. It also stood out the time frame for the testing times for the nclex. I still don’t fully understand the process but it was interesting to get started with just some basic information. In addition, it was good to know that we will have a whole class next semester that will set us up for the nclex and for a job post graduation.

For my first nursing job I am really still trying to figure that out. I’m thinking of just a general med surg to get my foot in the door and get some experience under my belt. In addition I need to figure out what state I’ll be practicing in. At this moment in time I’m not very sure where I will be living once my lease is up in May. This has been a fair amount of stress since I need to figure out where I’m living to be able to apply to jobs. 

Listening to the two new grad talks helped in some way to hear how their experiences differed and how they have confidence we will be able to do it. Something I learned from them is the fact that even when I graduate I still won’t know everything and that is okay. It’s reassuring knowing that it’s okay to not know everything and that I will have an onboarding experience that will enhance my clinical skills.

Initially the location of the care needs to be accessible to the client to get their care needs treated. The building and services provided must be able to accommodate anyone with any sort of disability. The client may also need transportation to said health care location. Medical equipment must be able to accommodate the clients disabilities as well. The care team must be able to communicate as well which may be a challenge if the client can’t hear or see.  

We should prioritize education on disability awareness which allows for care team members to get more familiar with how to care for these individuals as people. It is important to actively engage with each patient to understand their needs and avoid making assumptions. Health care providers should utilize assistive communication tools to accommodate these patients. It is crucial to create a supportive environment that respects each and every person who comes through their door and listens and respects each individual’s abilities and preferences.

Providers may lack the knowledge, experience, and skills to care for people with disabilities. There are common attitudinal barriers which affect the delivery of care to clients with disabilities. These barriers include viewing the disability as an illness, having a lack of knowledge, fear of harming the patient, and misconceptions.Some providers may view a disability as an abnormality that needs to be fixed, rather than a natural part of a person’s life.

Something I never really considered before about patients with disabilities is all the extra thought and planning which goes into receiving the care they need. It’s about having to call the day before to ensure you can get an accessible room. It never even crossed my mind about how online pre screening forms can easily be inaccessible to so many.

 For this project I will utilize my group members for a total collaboration from topic proposal to dissemination. Communication is key for this to be successful, and for each member of the group to do their part as we can collaborate together to get to our final project. Holding myself accountable will entail me keeping a close eye on due dates for this project as well as scheduling time together as a group to discuss and work on the different portions.

This will be useful in my further nursing career because this project will utilize evidence based practice as well as group collaboration. Communicating with my group members allows for me to practice working as a team and helping out where I can which is often used in nursing.  Another concept this project utilizes is prioritization and delegation both are important nursing skills for time management and safe patient care.

Having a general knowledge on ESRD helps to provide better care to my patients. I may not be specializing in renal however it doesn’t mean that I won’t come across a patient presenting with this disease. Understanding the pathophysiology and how this is affecting the patient allows for me to create a care plan specific to meet their needs and to provide safe and competent care. I want to understand expected and unexpected findings and be able to perform focused assessment and monitoring for these patients. As a nurse a way I can help reduce the risk of ESRD is by educating my patients on causes of this disease as well as lifestyle and diet modifications. Educating patients to manage blood pressure, blood sugar, exercising, keeping a healthy weight, limiting alcohol, and eating a healthy diet. 

Some people believe that they must travel to receive dialysis. However this is incorrect as there are options to be able to complete dialysis, both a facility and at home. There is another thought that dialysis is painful which in reality, there may be some discomfort with the needles but the treatment itself is painless. I have never specifically cared for a patient in end stage renal disease. My only interaction has been with one patient who has a fistula which I was allowed to listen to and palpate. That allowed me to begin to acknowledge how ESRD may affect the patient as well as what is done to the vein to be able to have frequent dialysis.

Listening in on this recorded presentation I was able to learn more about the importance of affirming care for LGBTQ patients. It is always important to remember that assuming a person’s preferred gender is not appropriate. One way to start any conversation is by asking the patient how they would like to be addressed along with asking what their preferred pronouns are. By learning and being mindful of gender affirming care the nurse can work towards building safer and more inclusive practices. 

Understanding the significance of affirming care provides a more positive impact on the care I will be providing. Working my patients my goal is to be a resource and advocate for them Maine is open to many different online and in person resources for the LGBTQ+ community. There are programs from youths, parents, educators, allies, and training for professionals all of which are easily accessible through outmaine.org. This website also has a quick exit feature which allows for privacy when accessing their site. Other resources include Equity Maine, Hallowell pride alliance, HEAL and MaineTransNet all of which can be accessed through namimaine.org/lgbtq. There are even more campaigns, schools, projects and more all dedicated to this community and helping them with any need imaginable.

Correctional nursing is a specific type of nursing that provides care for those incarcerated in the criminal justice system. Correctional nurses are often the first health care professional which the inmate will see for medical care. They often screen inmates when they enter the facility and will provide care for a wide range of different medical concerns. I have never had any interaction with anyone who is in a prison. So, I am not completely sure what to expect when it comes to what I might see. During my volunteering experience I have created two learning goals. My first  goal is to be able to better understand and explain what correctional nursing does. Another goal of mine is to identify common health problems of the individuals that the nurses see in the prison. I am not specifically nervous about anything in particular but more interested in what I will be able to see or potentially do. I am definitely looking forward to learning more about what this experience entails since I truly do not know anything about what I will be going to do. 

Community programs in Maine consist of self-help groups, support groups for loved ones, and programs for reentry. More specifically there is a Maine prisoner community reintegration project which focuses on increasing public safety for those reentering the community. There is a reentry network, and center which offers community newsletter and there is a residential center which provides skills and experience to live successfully. Additionally there is Rose’s room which is a monthly support group for loved ones and family who have someone incarcerated which allows for community support and faith based organizations.