Prior to this course I’ve never heard of emotional intelligence. I never thought that our emotions and ability to be both self-aware and socially aware could be scaled on something like this. The test I took was a forty-question quiz that would provide two options to every question. After finishing the test, I had to then understand my score. I’d have to say I was consistent in that I scored a 5s and one 6. For self-awareness, self-management, and relationship management I received a 5. For social-awareness I received a 6. At first, I really didn’t know what this meant because I wasn’t sure what I was being scored out of. I soon realized that my score for each section was out of 10, or 40 total (EI Quadrant Descriptors). 

            Once I got a better understanding of my score, I then was able to reflect on it. I was surprised by some of the results. I always have felt that I am a very self-aware person. With this test though I only scored a 5 out of 10. This signifies that I do have some self-awareness but still have plenty of room for improvement. Self-awareness is broken up into three categories: emotional self-awareness, accurate self-assessment, and self-confidence. With this section being broken down further I can now identify where I most likely made my score go up and down. I would say once I am emotionally aware I do have an accurate self-assessment. I don’t always have that emotional awareness though to get me to that next step. Lastly, I believe I most likely lost points with my self-confidence. Doubting myself is something I’ve always struggled with. To help my self-awareness I need to be more confident in myself as well as getting better with being always aware of my emotions. As a nurse I need to be confident, and I need to be self-aware of my own emotions that way I can help others with theirs. 

            With self-awareness comes self-management. In this section I scored a 5 again. Self-management is further broken into five sections: self-control, transparency, managing oneself, adaptability and achievement orientation. When it comes to “keeping my cool” in front of others I will say I do a good job with that. Even though I may be panicked inside I can “fake it until I make it” is most situations. Transparency is something I do struggle with at times. Depending on the situation I do get very stuck on an idea and have trouble seeing the other side. This is something I’ve been working on for the past 6 years and feel like I’ve improved but still have much more improvement to go. There’s much I need to improve with this section. I will give myself credit thought in my adaptability and my goal-orientated mindset. This is part of the reason why I wanted to go into nursing. I love being able to set a goal and reaching it. I need to continue to be adaptable, managing myself well, and setting goals. 

            The section in which I thought I’d score the lowest in ended up being my highest score. Social awareness is something I’ve struggled with since I could remember. I’ve lost multiple friendships due to lack of social awareness. I’ve always struggled with picking up social cues and reading body language. Social awareness is broken into three sections: empathy, organizational awareness, and service orientation. All three of these things are something I’ve always struggled with. I honestly think that being in nursing school has helped this section of my EI drastically and is the reason why I was able to score a 6. I believe the nursing skills I’ve gained in the past 10 months have been reflected in the score I received. I will need to continue to work on my social awareness since I will be dealing with so many different people in my future. 

            The last section of the EI test is relationship management and I received another score of 5. This section is broken into seven sections: visionary leadership, developing others, influence, convincing, conflict management, building bonds, and teamwork. I thought that I would have scored higher in this section because I’ve been in multiple leadership positions in the past. When reflecting on the leadership roles I’ve held, I’ve realized they’ve all been in situations that I have lots of confidence in. This makes me go back to think about working on my confidence to become a better leader. I’ve always loved working in a team, and I have the flexibility to be both a leader and a follower depending on the situation. Relationship management is so important to the nursing field. To have a successful unit teamwork needs to be present. As well as conflict management, leadership, the ability to develop others, and building bonds. 

            All sections of the emotional intelligence test have given me an insight to who I am and how I deal with emotions. I was both surprised and not surprised by my results. I’ve realized I still have so much more to learn and work on. I was pleasantly surprised that my social awareness is much higher than I had anticipated. It just shows me that I need to be more confident in my ability to be social and communicate with others. I found it very helpful that the EI test further broke down their four sections into more specific questions. It helped me to identify what exactly are my strengths and weaknesses. If I’ve learned anything from this though it’s those things aren’t always how I see them and that’s something I need to continue working on. These skills will help better develop my role as a nurse and my role in an interprofessional team. 

EI Quadrant Descriptors. (n.d.). Retrieved from http://www.globalleadershipfoundation.com/cgi-bin/eiscore.pl

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

My freshman year of college I joined the women’s rugby team. They were lacking numbers in the freshman class and only had one freshman prior to recruiting myself and a few others. This one freshman’s name was Smitty. When I first met Smitty I thought to myself, “how can this girl who’s barely over 5’ play rugby?”. Once I saw her play though I understood. Right from the beginning she’s been the leader of 2020 rugby girls and a force to be reckoned with. She went on with another teammate and myself to be captains our senior year. Prior to selecting captains our coach asked us to vote for who I wanted to see as captain. I immediately said Smitty and then she asked me why. 

When telling someone about this individual, leadership is the first quality that comes to mind. I’ve never seen someone be able to move a group of people and motivate them with just their words. She also was always leading by example by always giving it her all on the field. She’s that teammate who will finish her conditioning drill then go back and run more with those who are struggling to finish. Off the field she was the first one that anyone would call. No matter the hours of the night she would answer, and she would listen. 

I think what made her such a great leader is her ability to adapt and come to an even ground that everyone will listen to her on. She makes people want to be a better player on the field and a better person off. Now after college she’s working in an emergency department down in Pittsburg. I have full confidence that she will succeed in emergency medicine. She’s someone who’s willing to put in the long hard hours in order to reach an outcome she’s working for. Although being captain of the rugby team was a former position, she is still a leader in her ER department. Now I don’t work with her but from year of friendship and watching her work ethic, I know she will be an informal leader in her department. Even though she doesn’t have a designated role, like nurse manager, she still has an opportunity to lead others. During my interview I’m excited to dive into her time working in the ER for the past 14 months. I’m curious as to what leadership qualities she’s brought over to her job and which ones she’s decided to hold back on. 

We often think we have no control of our life. Now that being true in many ways, we do have the power of autonomy. No one can choose where they are born, what genitalia they have, how rich their parents are or if they even have present parents. Someone might look at a homeless person and blame them for their choice. They may have decided to do things that put them in a bad situation but there are also things that may have no control over. If an individual was born into a home that was in a neighborhood with lots of crime, poor education system, no good access to healthy foods or medical care, they might live a life poorer health than someone with the opposite. The things and people around us influence one’s likelihood to live a long healthy life. Environmental factors such as air quality, access to fresh foods, and transportation can negatively affect vulnerable populations. If someone is working a job with no health insurance and just got diagnosed with diabetes, that will greatly influence their life and health. Societal factors like growing up around drug users and crime can influence someone to also grow up to live a life like that. The environment and community we grow up molds and shapes our values and outlook at a very young age. This then moves on to affect us for the rest of our lives. 

Over the years we’ve seen a push to help these populations. More and more people are recognizing that certain populations are facing problems in which they have no control over. Unfortunately, a lot of people lack the education regarding social determinates of health. A lot of politicians use this misunderstanding that people have and turn it into hate to drive elections. Lack of momentum within our government has continued to put these populations on the back burner. Programs such as MaineCare, WIC, English language learners (ELL), and public transportation are just some examples of ways the government is helping the public. There still is much more to be done though. To help these populations we need to further educate others and continue to voice to government officials the needs of one’s community. In Maine we have high rates of heroin use. This is just one example of a public health crisis occurring here in Maine. It’s a public health issue as it causes addiction, transmission of blood born diseases, and death. Safe and clean needle use is a public health intervention that would better the health of many. Education regarding safe needle use and knowledge of where to get access won’t stop their addiction, but it can save their life. 

In my first undergraduate degree I took some sociology classes that talked about the social determinants of health. I never looked at the world the same after that. After that I learned about nursing and determined that was what I wanted to peruse. Not only did what I’ve learn help drive me to further my education, but it will help me be a better provider to my patients. It will help me to start the conversation of how I can help them. It’ll make me want to peel back a few layers to really determine what is driving their issue. I think it’s also taught me to be a much more understanding human being. 

Prior to sim I wasn’t sure as to how it would go. This was the first time we’ve had sim with real actors and not a human made of plastic. I was nervous because I knew I would have to be quicker with my responses since it was a real human. I was also unaware as to how good the actors would be. As sim went on, I thought it went much better than I had anticipated. The hardest case for me was the first one, borderline personality disorder. The actors were so good at portraying the mental illnesses. When talking to the actor with BPD, I got to learn how quickly things can change with them. I went from starting to form rapport then I looked down at my paper for too long and she freaked. I wasn’t ready nor knew what to say when she began yelling. It most certainly caught me off guard. I also was not anticipating for our manic patient to be this high energy. I’ve meet with patients who are experiencing manic and they exhibit those traits but they were all older so they didn’t have the same spunk. It was hard for myself and my group to separate him from his alcohol. I kept feeling like I didn’t want to step over boundaries but knew I had to for the session to be successful. 

            Once the day ended I felt like I had learned a lot. It helped me realize that I my communication needs some work but I know that it will come with experience and confidence. I tried to do my best and stay ahead with some responses but the patients did well with saying answers that I wasn’t expecting. This taught me that I can’t prepare in mental health nursing because everyone is different. Today’s experience taught me that my mental health nursing process is better than I thought but it still needs much work. 

Throughout the semester, I’ve been excited to finally be in a psychiatric setting. Much of our hours in clinical throughout nursing school are in a med-surge-like floors. When I found out I was going to BHU Sanford I was quite excited. As this class has gone on though, I’ve realized that mental health isn’t just for the behavioral health units, it’s everywhere. During my 6^th week on the medical-surgical unit I met a young man who was going to change my perspective on mental health in all health care settings. 

During my clinical shift, I was assigned a man in his late twenties who came in with stroke-like symptoms. Upon reading his chart I found out he had recently been hospitalized out of state for an alcohol withdrawal seizure while on a plane. His flight was diverted and he had hyponatremia upon arrival. The hospital staff had increased his sodium levels too fast causing his pons to demyelinate. His symptoms of slurred speech, left-side weakness, and unsteady gait got worse over the week after his discharge. Because of his worsening symptoms, his parents decided to bring him in. Prior to coming into any hospitals, this patient worked down in the Florida coasts as a merchant marine. Both him and his wife lived down in Florida as merchant marines but they worked on separate boats and didn’t live together. Around the new year, the patient began drinking out of boredom. He stated that “it started as a few drinks once a week or twice a week then turned into a 750mL of whiskey or vodka a night”. It didn’t appear that the patient had any close support system down for him in Florida. When he became bored he turned to the bottle. He never reached out to his parents or wife about this drinking issue. His parents noticed a change in his behavior and became very worried so they decided to fly him back to Maine. 

The patient’s psychological problems of isolation and maladaptive behaviors have now turned into a physical disability he will have for the rest of his life. When talking to the patient, he appears very depressed. He doesn’t talk much and gives short answers to questions. He understands that it is drinking that got him here but I don’t see that he’s making the connection between the deeper issue and his drinking. I would have liked to gain rapport with him and possibly find out if there are any other reasons besides boredom that caused the alcohol binging. I would also like to see if the wife has been contacted and her knowledge about her husband’s current condition; both mental and physical. If the patient didn’t appear so tired and express that he wanted to rest, I would have tried to talk to him more to try and find out more information regarding support systems. I would also like to sit down with him and gain insight as to how much he knows about his current diagnosis of osmotic demyelination syndrome.

This is a condition that will stay with him forever. It could have been potentially corrected if he went to the hospital within 24-48 hours after raising his sodium. I wish I would have had more time with the patient but I unfortunately didn’t. If I could have more information on him I would have wanted to gather a family history of any mental illnesses and substance use. I would also like to assess the substance use of his wife, is this something they do together too? The patient has ineffective role performance so I would want to assess what his daily activities entail and if he’s performing his basic ADLs (brushing teeth, bathing, etc). I would also want a mental health examination to take place because drinking 750mL of liquor a day usually has a reason. This could uncover if the patient is dealing with any stressors and is ineffectively coping. With the binge drinking, I would also be very concerned for his nutrition. Drinking heavily puts you at risk for malnutrition and is most likely what caused his hyponatremia. I would want to assess his diet, where he gets his food from, and if he is able to afford it. 

Some examinations I would want to perform would include the mini mental status exam, and CAGE. I would want to assess for any mental illness as well as his own perception on his drinking. The CAGE will give me insight as to what he perceives other thoughts to be about his drinking. Once the reason behind his drinking is uncovered, more support can be directed as needed. I would see what the patient’s thoughts on rehab or programs such as AA are.  I feel that the hospital that we were at did a good job in addressing his physical problems, but didn’t pay so much attention to the psychological issues. I didn’t find anything in his chart regarding psychological examinations. The only thing regarding substance use that I could see was a CIWA. I think since the reason for his physical issues is his psychological issue, the medical staff should take a deeper dive into what the major issue is.