Editor’s Letter
Hello everyone,
Finally its the end of February, and that means spring is right around the corner. I know a good part of the country, as well as those of us in the northeast have experienced chillier than normal temperatures over the course of the winter and we are gratefully awaiting the first signs of spring.
Of course, there is another change in the air recently, as Americans have witnesses the recent signing of the President's stimulus plan. Among the various provisions in the package is approximately $59 billion allocated to health care issues such as subsidies of health care insurance premiums for the unemployed under the COBRA program, state assistance with Medicaid, as well as funds for prevention and wellness programs and to modernize health information technology systems.
Lastly, we recently heard from Nurse Susan Hancz who contributed a story for our Nurse On The Go feature.:
Dear Nurse-Recruiter Staff,
I wanted to say "Thanks!" for the opportunity to share my story as a school nurse. My transition from pediatric emergency nursing to school nursing has truly been a wonderful experience and a blessing for myself and my family. I hope the article enlightens other nurses to the challenges, autonomy, and rewards that school nurses face each day. I appreciate the $50.00 award that I received for the article! I didn't have any trouble spending the money. I used the money and had a very nice day with my best friend, Carol (who is also a school nurse). We had a very nice lunch, shopped for new scrubs, then topped off our evening with a "chick-flick" at the movies, and Gelato ice cream afterwards. What a wonderful day!
Thanks so much!
Susan Hancz, RN
If you would like to have the chance to get published in our monthly newsletter and be eligible to win a $50 VISA gift card, we would welcome your submission. All submittals should be between 500 and 800 words. To submit a story, send an email with the subject line Nurses On The Go story submission to info@nurse-recruiter.com.
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Nurse On The Go
I have been a nurse and a certified diabetes educator for the past 11 years. I would like to share a experience I had with one of my patients.
We know that we can prevent or at least delay complications related to diabetes by keeping the blood sugar as close to normal as possible without risking low blood sugar. I provide diabetes education to individuals in individual or group classes. Many patients are very frightened when they come to see me as they don't know what to expect. Mr. Thomas came to see me with his wife last year. The first thing he said to me was, "I don't want you to take away all the foods I like. My wife has told me I can't eat ice cream and drink soda anymore. Please help me!"
Mrs. Thomas immediately stated, "I have to watch him all the time. He eats too much".
After doing a quick assessment, I explained what happens in the body when diabetes develops. I explained that we approach eating differently now. There is no "Diabetic Diet" anymore. Many myths and misconceptions still continue to exist about how people with diabetes should eat. Most foods are not forbidden to people with diabetes. The emphasis should be on portion control. I explained that Mr. Thomas could still eat ice cream and I talked about reading food labels and the importance at looking at the serving size, carbohydrate content, calorie content, and fat content. I also explained that Mr. Thomas should be the one making decisions about the foods he wants to eat. If his wife is constantly watching his food intake, he will sneak food when she is not looking. Patients need to know they can still have small portions of the food they really enjoy. I did explain that regular soda has a large amount of calories and carbohydrates. Mr. Thomas agreed to try seltzer mixed with lemon instead of regular soda. When he left our session, he seemed relieved. He knew he had to lower the portions of food he ate, but he was so happy to know that he could still eat his favorite foods. Can you imagine someone telling you to never eat your favorite foods again?
I don't believe patients suffer diabetes related complications because they eat cookies or ice cream. I believe they are at greater risk for complications, if their blood sugars remain above recommended levels. There are several ways to keep blood sugars as close to normal as possible. Healthy eating is just one way. Exercise, monitoring blood sugars, taking medications, healthy coping, problem solving, and risk reduction are also just as important to review with patients. These behaviors are also called the American Association of Diabetes Educator's 7 self-care behaviors. They summarize the information we share with patients. I am happy to report that Mr. Thomas's blood sugars are within recommended levels. His fasting blood sugars are between 90 and 110. His 2 hour post meal blood sugars are less than 180. He is exercising regularly by walking with his wife at the mall at least 4 days per week. He tests his blood sugars once to twice daily. He takes Glucophage XR 2ooo mg with his dinner meal. He now drinks seltzer instead of regular soda. He lost 10 pounds. And most of all, he is happy.
Sincerely,
Lori OKeefe RN, BSN, CDE
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Patient Simulators Gaining Popularity Among Teachers & Students
Today's complex health care environment demands that nurses are able to make quick assessments and clinical decisions. More and more nursing schools are using high tech mannequins which offer an extraordinary tool for nursing education. The Human Patient Simulator is capable of realistically exhibiting the symptoms of medical crises such as: respiratory arrest, heart attacks, tachycardia, anaphylactic reactions, asthma, chronic heat failure, gastrointestinal bleeding and many more. Often referred to as "SimMan", this patient simulator is so advanced, it’s actually easy to operate. Other simulators include "SimBaby" and "PediaSim", and SimMan can also be turned into a woman and be pregnant. Sim-Man can have multiple computerized symptoms and diagnoses, and will respond to treatment. Different protocols will yield different outcomes and help nursing students learn proper techniques.
The pediatric human patient simulator, PediaSim is approximately the size of a 7-year-old child weighing 20 kilograms. PediaSim is especially helpful since only about 10 percent of calls to EMS providers involve a child. Nurses and physicians also have limited exposure to certain pediatric emergency situations. Infrequently used skills can be practiced and reinforced in HPS education to achieve a higher level of proficiency. As a result, students can learn and practice without risk of harming a real child. They can practice a procedure over and over until it's perfect.
The simulator affords residents an incredibly realistic training experience. But experts said that what really makes the patient simulator ideal for training is that it instantly reacts physiologically to the treatment it's given even if it's the wrong one. The simulator system registers the dosage and drug type, and the patient simulator reacts as a human patient would. Key features include pupils that automatically dilate and constrict, a drug-recognition system with bar code reader, realistic respiratory gas exchange and anesthesia delivery capabilities, and variable lung compliance and airways resistance. Another advantage of the patient simulator is that students can run through a situation repeatedly and that patient simulators allow students the opportunity to practice things they might not encounter except in rare circumstances, such as emergency situations.
A computer system allows the instructor to operate the HPS while working up close with students. Instructors can easily increase or decrease event severity and duration, overlay scenarios or interrupt the event. The scenarios allow students to respond as they would in the course of daily care. For instance, they can request a chest film or CT, or draw lab for blood gases, and will receive realistic values.
Caregivers can assess vital functions such as blood pressure, temperature, differential pulses, heart sounds, including murmurs and gallops, breath sounds including wheezing, and respiratory efforts. Caregivers can also perform procedures in a realistic fashion such as intubation with difficult airway and laryngospasm, IV lines, central line monitoring, EKG interpretation and defibrillation. The simulator can recognize appropriate CPR technique and what drugs are being administered at what amount and will react accordingly. The simulator will start to breathe once his airway receives adequate oxygenation and ventilation.
Since patients do not have as extended stays in they did years ago, its not as easy to observe patient progress over a period of time. In addition, simulation helps new nursing students get over their initial fear of encountering their first real patient. While many students claim they feel funny talking to a mannequin at first, they also recognize the benefits in using the patient simulator. Instructors also appreciate the fact that they standardize scenarios for the students and observe what each student does in a given situation and then follow up with comments and advice.
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