Month: October 2021

When I first heard about the Electric Health Record, I immediately thought of a great way to send and find information from one facility to another. I think of programs like EPIC that allow health systems, such as MaineHealth, to share patient information across the state. From the perspective of a college student, I think of EHR as a useful tool for someone who moves away from their primary care provider. Health information exchange is a great tool that can both benefit the patient and provider. For providers, especially nurses, it allows us to better provide for our patients. We can do this by being up to date with any appointments, medications given, or interventions. For example, if a patient goes to one facility and receives a prescription and then goes to another, the nurse can see this on their EHR. HER can help enhance communication while decreasing the number of unnecessary tests and procedures. 

 I found the presentation to be really helpful getting across the information regarding EHR. I didn’t know the large scale that it works on. I always thought of it as a local thing for health systems but not cross-country. My future in nursing will be shaped by the EHR. If my future facility uses the EHR, I will be able to get a bigger picture regarding my patients. Benefits of EHR include coordination between providers, reduction of unnecessary tests and procedures, and allows providers to have direct access to health records (Benefits of health IT). I’m excited to see how the medical field will continue to change with the use of EHR. I hope to see a reduction in mistakes (medications, procedures) and an increase in positive patient outcomes.

Benefits of Health it. HealthIT.gov. (2017, September 15). Retrieved October 21, 2021, from https://www.healthit.gov/topic/health-it-and-health-information-exchange-basics/benefits-health-it. 

Prior to jumping into her nursing career, Smity was a leader I looked up to. I still look up to her even though she’s hundreds of miles away. As I went through my interview, I realized that the leader I knew wasn’t the same leader who now works as a nurse. I asked her about her job, and she said, “I’m overworked and tired”. She began to explain to me a typical day for her job. She gets into work and before she clocks in there are signs everywhere asking for nurses to pick up extra shifts on her unit. Once she clocks in, she immediately goes onto the floor and gets her assignment. She explained to me that the “hallway patients” are the worst because they just keep getting added to her assignment. After her shift she rushes home to go to sleep. I asked her if she would ever consider a leadership position on her unit, and she quickly responded back with “hell no”. 

 Smitty not wanting to seek a leadership position sounded like a foreign language to me. She’s someone who naturally falls into leadership positions, so I was surprised to hear her response. When analyzing Smitty’s EI she has social awareness, self-awareness, motivation, and empathy. I know this because of years of friendship with her but also, I found more about her in the interview. I asked her why she didn’t want to pursue a leadership position. She went onto explaining the difficulty it has been being a new-grad ER nurse in Pittsburg. She explained to me that the mess that is happening in hospitals is something that she can’t even fix. She’s acknowledged her needs both mentally and physically and knows that taking on an additional role would not be best for her or her patients. “I’ll be stretched too thin”, she told me, “And I don’t want to break”. I found her answer to be respectable. She knows her potential, but she knows that she wouldn’t thrive in this setting. 

Knowing the mental toughness that Smitty and her coworkers must have I asked what Smitty does for herself and what does the hospital do for them. She said how she’s found a schedule that really has been working for her. She works out before going into her night shift, works, then comes home and sleep. On her days off she said she tries to do at least one thing for herself. This could be hanging with friends, watching a movie she’s been waiting for, or cleaning her apartment. She said to me, “it wasn’t an easy transition, but I’ve found a system that is working for me”. She then went on to talk about the support she has at work. Smitty told me that her hospital has a wellness team that anyone can meet with anytime about anything. She’s found this helping as she’s witnessed a lot of death and didn’t have the easiest time coping with it. Once a month on each unit they will have someone come down and perform an activity with the staff such as yoga or meditation. In the hospital there is a room with comfy massage chairs, low lighting, and just a room to relax in. “No one ever has time to go to it though”, she said. She acknowledges the hospitals efforts to help the staff but “it’s just not enough”. Smitty explained to me that a lot of people feel guilty for using these services. Everyone is so short on time, so no one wants to take time out of their shift and focus on themselves. This is what has motivated Smitty to keep a journal. Since she does come home with a lot of baggage, she likes to leave it all on the pages of her journal. She finds it to be a great tool to go back and reflect. 

            I think it’s great having friends who are already in the nursing field who I can ask for advice or their routines. I think Smitty stepping back and not taking any leadership roles show signs of how developed her EI is. It takes courage to take a step back and to identify what your own personal needs are. “Put on your own oxygen first before others. If you’re dead, then who will you help?”. Smitty said she hopes to move back home to MA and “it’ll probably happen” she said regarding a leadership position. Taking to someone who is so aware of themself, and their surroundings has taught me a lot for what I will need to do in the future as a nurse. 

In every class and clinical setting, they always say “mental health nursing is everywhere”. Understanding emotional responses, especially that to trauma, can help define you as a nurse. When someone has experienced trauma, it can control their life. An individual can become paranoid, anxious, or socially isolate themselves. Psychological stress also can be seen in physical symptoms. Physical symptoms could look like fatigue, insomnia, weight loss/gain, or even low immunity (getting sick). As health care providers we typically are focused on treating the physical symptom. By betting understanding trauma and its physiological effects, we can better treat our patients. Trauma can also affect someone spiritually. They could find themselves questioning their faith, wondering why them. Others might find comfort in religion and find themselves being more spiritual. Trauma can also hinder friendships and relationships. Someone might feel like they aren’t being understood and further isolate themselves. Family and friends can also feel overwhelmed and not know how to deal with the situation. Trauma affects all aspects of our lives and can occur at any time. 

Trauma that occurs during one’s childhood can be categorized as adverse childhood experiences (ACEs). Similarly, to other trauma, people who have ACEs have psychological, phycological, spiritual, and social difficulties. The stress of trauma during the developmental period can have negative neurological effects. Those with ACEs more frequently participate in risky behaviors such as heavy drinking. It can also increase one’s chance of developing depression, diabetes, asthma, and cancer (Adverse Childhood Experiences). By learning how to use trauma informed care in my practice I can better provide for my patients. How I behave and what I say can determine how much a patient feels comfortable sharing things with me. There won’t be a special device that can tell me who and who hasn’t experienced trauma in their life. I will have to learn how to convey trauma informed care to build between relationship with patients and create positive healthcare outcomes. 

Adverse Childhood Experiences (ACEs). (2019, November 05). Retrieved from https://www.cdc.gov/vitalsigns/aces/index.html