Stages of Grieving – Based on Elizabeth Kubler-Ross Idea

Hey everyone! I am so sorry that i haven’t posted anything recently. You know how life gets in the way right? And I have finals this week and next so I have been crunching with all my studying.

So anyways for today I thought I would touch on the grieving process. This is based on Elizabeth Kubler-Ross’ theory, To me, it seems to make a lot of sense, I can see though how some of the stages could be switched around. I have included an example following both stage based on the patient being diagnosed with terminal cancer.

1) Denial – this is very commonly seen.  Where the patient doesn’t want to accept what they are being told.

2) Anger – very quickly follows the denial.  This is a good reason why there is a witness in the room, this is one of the reasons. When some individuals get angry enough violence can break out.  As a professional nurse, or doctor you need to allow all of this feeling come out, while it is still safe for them to do so.  This will aid in the entire process of grieving.

3) Bargaining – this is when the patient starts asking the doctor or nurse what other options there are.  Whether there are alternative medicines, new drugs, and methods of medicine that can be used to continue there life.

4) Depression – obviously this will be when the person may become tearful, maybe spilling feelings of sadness and parts of life they fell they haven’t finished.

5) Acceptance – when the person understands and come to terms with what they have heard, and they understand what has happened to them, and are willing and ready to either continue living as they are or are willing to take treatment.

And those are the steps to grieving. Sometimes you will find in yourself or see in others that some steps are switched especially steps four and five, but the person will still successfully be able to grieve.

 

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I am so sorry i haven’t posted anything lately!! I have been so swamped with homework, the last thing i could think of was posting another blog.

I promise though that I will have one up by next wednesday.

 

Developmental Disabilities and Mental Illness

In this weeks communication class I learned the difference between developmental disabilities and mental illness. I knew that sometimes there are things that can go wrong when a baby is in utero and that can cause various issues to the baby – what I thought is mental illness.  But as I found out was it is actually a developmental disability, because of various reasons such as something that happened while the baby was in its developmental stages, or some trauma was caused to mom and baby, genetic disorder, or trauma occurred at time of birth.  Mental illness, however, is different because it is something that has developed more likely because of physiological situations or inheritance, and a mental illness can be treated, or can be attempted to treat with medications/supplements.

A learning disability can be recognized by significant differences between expected and actual performance by an person.  As well as difficulty with reading, writing, spelling and math, poor auditory and/or visual memory, and good abilities when it comes to talking but poor abilities expressing them in the written language.  Also consider on whether the individual can directly follow directions, if they get distracted easily, quite impulsive, they have difficulties organizing and keeping track of time, activities and responsibilities.

There are eight pointers I thought could be really helpful to anyone when it comes to being in the presence of an individual who has a mental illness or a developmental disorder.  One, speak directly to the person. Two, offer to shake the person’s hand, these usually are able to have use, even if limited, and are able to try to shake your hand back. Three, when meeting a person who is affected, be sure to identify yourself, especially to one who may have a visual impairment or blindness. Four, treat any adults as adults, NEVER patronize or use childish language. Five, respect this person’s personal space, never invade the personal bubble.  Six, when they have something to say, listen mind-fully, don’t interrupt or supply words, be patient and let them finish, if you need any clarification, explain what you didn’t understand, and then wait for their response. Seven, keep up direct eye contact, this means if the person that you talking to is in a bed or in a wheelchair, kneel or sit down to their level.  Eight, when you express yourself make sure that you are directly facing the person, and when you speak you speak clearly, slowly, and expressively, make sure that you do not have any gum, candy, or cigarettes in your mouth.  This is especially important when the person has their hard of hearing or are deaf but can lip read.

The last main point of the class was the then pointers for a better communication partner:

1)      Get on the same level – sit, bend, squat so that you can be at eye level

2)      Establish Attention – be more interesting than the environment, get it in the line of vision, get close, and be animated

3)      Prepare the Individual for what you are going to communicate – use verbal signs such as “watch, look, listen, ready”, pair a verbal sign with a gesture when you are unsure if you still have the attention of the person, and use visual props

4)      Use gestures and body language meaningfully – exaggerate movements, use gestures in a slow pronounced way REMEMBER THAT YOUR HANDS, FACE, AND BODY ARE CRITICALLY IMPORTANT COMMUNITCATION TOOLS

5)      Support your communication visually – pictures, gestures, your body

6)      Speak slowly and clearly

7)      Limit verbalization – sometimes talking isn’t the best in the situation

8)      Include a “wait time” in your interactions – always pause, wait your responses when you ask questions, look at the individual as you  wait your response

9)      Guide or prompt the person to respond if needed – guides or prompts can be simple and subtle

10)  Stay in the interaction until you reach a desired response

 

Reflection:

Sometimes people think that someone with a developmental disability or mental illness is not capable of carrying on a conversation or feeling emotions. It is sometimes the case that these people are not able to carry on a conversation but they may be able to understand conversation, or specific words, or hand signs or gestures.  These people, although maybe a one way conversation in a sense, can still be communicated with and they can feel a part of society as well.  Some people also have the same stigma with those who have learning disabilities. I know from personal experiences that this not the case.  Some of my friends have learning disabilities, this doesn’t meant that they are shut off from the world, or that they need to be separated from ‘normal’ society.  They are fully functionally, stable jobs, have their own vehicles, furthering their education, and they are the most fun to hang out with

 

Self-Concepts

Hello World!  Todays class was really good! Our instructor did a fantastic job of discussing the topic of self concepts.  I felt so bad during the first hour and half though, I didn’t have that great of a sleep last night and I was sitting there listening to her and my eyes were fluttering up and down because I was trying to keep them open.  Thankfully!! Break time I was able to run to McD’s for a coffee, and I got paid to do so because some of my fellow students were also in desperate need of caffeine.  There was a Bon Jovi concert this weekend … need I say more? So they all gave me the money and I got to keep the change…THANK YOU FOR TOMORROWS COFFEE! I will definitely need it.

So on to today’s topic… Self-concepts are the individuals evaluations of himself or herself, a person’s self-appraisal, how well you know your self.

There are four ways of how ‘self’ develops. a) appraisals made by significant others about the self.  This is when someone would for instance tell you that you are a thoughtful person.  It is when someone states something about your personality whether good or bad. b) appraisals that are repeated, become a pattern and become incorporated into self.  Like the first appraisal this would be when there are more than one comments of others stating that you are a thoughtful person. c) Behavior emerges to match the appraisals.  This would be when you notice yourself being thoughtful toward others.  Noticing that the comments that others have mad are true about you. d) With each new era of development , the self it open for reappraisal.  This meaning that with new situations, you are ready to hear constructive criticism.

The functions of self-concepts are: a) helping explaining behavior, b) providing a conceptual frame-work for decision-making, c) shaping expectations for the future, (making goals that you are able to meet), and d) provides bridges for meaning (knowing the reasons for why something happened).

Components of Self-Concepts are our body image, how we view ourselves.  Our self-awareness, all of our psychological beliefs and attitudes.  Our personal self-esteem, whether we see the value and significance of ourself or not.  And our role performance, the roles that we play in teams, in your family, and how we function with expected behavior.

Aspects that can make it hard for us to improve our self-concepts, essentially the barriers, are:

1. To be perfect – trying to perform at unrealistically high levels at work, school, and home; thinking that anything short of perfection is unacceptable.
2. Being Strong – weakness and any of the more vulnerable emotions like sadness, compassion, or loneliness are wrong.
3. Pleasing Others – seeking approval from others; assuming that if you gain the approval of others, then you are worthy and deserving person, but if others disapprove of you then you are worthless and undeserving.
4. Hurrying Up – doing thing quickly, doing more than should be reasonably expected in any given amount of time.
5. Trying to Hard – taking on more responsibilities than any person should be expected to handle.  Trying to more than is what expected in your scope of practice.

One section I really like about today’s class is ways to improve our self-esteem and that of our patients.  I am sure that all of us have one thing in our lives that make us feel insecure, maybe we don’t like the way we get all flustered when talking in front on an audience, or we feel we aren’t qualified for certain responsibilities.  These strategies could definitely be helpful for ourselves, and with others around us:

• make and define clear and realistic goals
• make your self think clearly, or your patient
• give positive feedback, give yourself a pat on the back, or indulge yourself in treat because you know you did well
• encourage positive self-affirmations
• stop negative thinking, not negative put downs when performing a task
• visualization exercises, showing how wonderful a place is, or bringing to mind the wonderful benefits for after the fact

In summary, we defined what self-concepts are, and the four steps to how one develops.  The various components of self-concepts and the aspects that make it hard on our selves to improve.  Lastly, I shared some strategies on how we can build up our self-esteem, or that of others, in my case it will be building up the patients self-esteem.

And that was today’s Communication Class!! It flew by, thanks to a great teacher!!

 

Perception in Communication

Yesterday’s class was able to help me think a little more on my communication techniques. Communication is very important between nurse and patient/client, and perceptions have a lot to do with communication. Perception is a personal identity constructed by which a person transforms external sensory data into personalized images of reality. Perceptions are ‘functions of the mind and not sense.’

Sensory stimuli are firstly ‘sorted’, then they are ‘organized’ by the CNS, then all the stimuli are ‘interpreted’. In nursing, a nurse wants to get as close to all the facts as possible, so a nurse wants to make sure that all that is perceived is organized into subjective (non-factual) and objective data (factual).

In our perception there are three different phases.

1. Selection – the process of neglecting some stimuli in the environment to focus on other stimuli
· Selective exposure – is the tendency to expose ourselves to information
· Selective attention – is the tendency to focus on certain cues and ignore others
· Selective perception – is the tendency to see, hear, and believe what we want
· Selective retention – is the tendency to remember better the thing that reinforce our views and beliefs
2. Organization: grouping of stimuli into meaningful units
· Figure – focal point of a person’s attention
· Background – the environment, circumstances
· Closure – the process of getting as much information as possible
· Proximity – being as close to patient so as to get as much factual information as possible
· Similarity – noticing similarities in patient cases with either conditions, treatments and/or recommendations
3. Interpretation: process of assigning meaning to get the perfect evaluation

Through all this, you want to take time after taking in information; we want to avoid making judgements on patients, as this could distort our care depending on personal ethics, values and beliefs. What was suggested regarding this was the 4T’s: think (initial thoughts and evaluation), time (do not come to conclusion after conversation, take time to think over conversation), trust (major requirement for a good nurse-patient rapport), and touch (this only comes after strong trust has been developed). The 4T’s will aid a nurse in their way of gaining true facts about their patient.

Then there are four factors that affect our perceptions so that our view is different to that of another person. These factors are really good to keep in mind when communicating with anyone! They can really help you try and understand a person.

1. Physiological Factors – such as gender, look, size, and needs
2. Past Experiences – life experiences, pearls of wisdom
3. Culture – knowing people and how they see, what they see, what they taste, feel, and like
4. Present Feelings and Circumstances – daily, monthly, and yearly cycles of thinking can affect how you perceive stimuli (e.g. good and wonderful attitude one day, depressed or cranky following day)

Lastly, guidelines that can improve our perception and communication, which I am going to start using these daily. I think that everyone can improve their communication using this. Think of how much better some of us would get along if we all practiced this! We would all get along, or at least respect each other a lot more. Well that’s what I would hope would happenJ.

1. Remember that all perceptions are subjective (in nursing our perceptions need to be sorted into subjective and objective)
2. Avoid mind reading
3. Check perceptions with others (don’t use this as an excuse to gossip about others, this is simply asking another co-worker, or family member or friend if your perception is correct so that you don’t make a false judgement on someone)
4. Be able to distinguish between the facts and the inferences
5. Monitor the self-serving bias
6. Monitor labels (no matter who you are, where you are from, your station in life, never ever label a person based on the color of their skin, accent, religion; and when and if there is a label make sure you do a back ground check to see whether it is a label you want to use for someone)

And that is that. I missed class today cause I wasn’t feeling good, I won’t give the details :p so I even have more homework for the following few days! Hopefully I will be able to complete all of it by Saturday night because I want to go out on Sunday and have some fun with friends!! Which I think I deserve after three weeks and six turned down invites. Lights out, g’night

 

Anatomy and Physiology – Intro

Mr.Ford\’s Anatomy & Physiology: Lesson 01:06 Body Positions

We had the most amazing instructor on Friday! So knowledgeable, interesting stories, intriguing studies, amazing research projects, just can not say enough about her! We had Doctor Mitra Panahi, she has a Ph.D. in biochemistry, I believe.  She is apart of the University of British Columbia and some of the research projects they have going on.  She was telling us that she is involved in their studies of making artificial blood!!! She explained that they have been able to carry out a lot, but still have some more proteins to build.  They are closely following the Japanese who have been able to develop an artificial blood, except for one more protein that they need to completely finish.  I think that is all so amazing and weird at the same time. Seriously, ARTIFICIAL BLOOD!! Feels like a sci-fi dream, right?

The other project she was telling us about that she is involved with is using a genetically modified rice instead of insulin for diabetics.  The reason for researching this, she said, was so that diabetics would no longer have poke themselves with needles to inject insulin.  I think it would be great! I know of ones who have diabetes, friends and family, and for some of them who have their doses automatically injected into their bodies by needles already inserted into their abdomens, I think that the genetically modified rice would be a huge advance! She did explain though that this rice would have to be grown in different areas and separated from other foods, specifically for diabetics, because it is a genetically modified rice, those who started to eat it for something other than its purpose, it would cause issues.  Really interesting and I am really looking forward to her class again on Friday.

Anyways I guess I should move on to what we ACTUALLY learned in class.  It was a simply an intro to Anatomy and Physiology.  Only thing is that Anatomy and Physiology are not simple. For example, a friend and I were talking about cells and some of their parts this weekend.  In one animal cell, there are so many parts making it so complex, the lysosomes, Golgi apparatus, three different parts of RNA, smooth and rough ER, etc. I think that I could discuss all the parts extensively.  But that’s not what my blog is about today, sorry for those of you who were hoping that it was.  I am just stating what anatomy, and physiology is, the different planes we use to talk about the body, and the body cavities.

So… anatomy is the study of structure, physiology is the study of function, what, how and regulation.  Knowing and using the directional terms and planes, helps out so much when making references to certain ares of the body.  I am going to leave a link of a really good YouTube video that is fast and has easy ways of remembering the directional terms, as well, I am going to find diagrams to help with the directional terms. Typing them out would be wayyy too much work I will though tell you what the different body cavities are.

Starting from the head down, first off is the Cranial Cavity, which includes the brain.  Next is the Ventral Cavity, holding the spinal cord and spinal nerves.  Third, the heart and lungs are held in safe keeping by the Thoracic Cavity.  Fourth, Abdominal Pelvic Cavity, holding the stomach, spleen, liver, intestines, bladder, colon, rectum and the reproductive organs.  Technically the abdominal pelvic can be separated into the abdominal and the pelvic cavities.

And that’s all im typing for today… in a lazy mode today. Hopefully I’ll get some more homework done and I will get a homemade cinnamon bun from my sister to help me out.

 

Infection Chain

Here is a summary of our Wednesday and Thursday lesson, and it is as compressed as I can get it!  There is information on 1) The Chain of Infection, 2) what makes a person susceptible, 3) signs of infection, and 4) asepsis, medical and surgical. Enjoy soaking up knowledge J

 

The chain of infection starts with the host, and as you probably already guessed, the host is the person that is already diagnosed with the infection.

Second is the infectious agent, this is the micro-organism that has started the infection.  This agent can be bacteria, viruses, fungi or protozoa (parasite).

Third in the chain is the reservoir or source, and this is the place where the pathogens can survive and supply.  A good reservoir is a place that provides food, oxygen, H2O, temperature around 35 degrees Celsius, proper pH (which is in between 5-8), and minimal light.

Portal of Exit is fourth, and this is where the infection exits the body or reservoir.  Yes that means any openings, such as the mouth and nose, and the urethral, rectal and vaginal openings.  An infection can exit the body also by artificial openings like breaks in the skin and mucus membranes. And don’t forget that infections are carried through blood, bodily fluids, excretions, and secretions.

Fifth, is the Mode of Transmission and there are five different ways that an infection can be transferred to you or others around you.

1)      Contact – this can be direct/physical touch, skin to skin, or indirect contact, like the tubing for medical machines like IV tubing. Examples of infections transferred this way are herpes,  hepatitis B, C

2)      Droplet – large droplets from the respiratory system that are propelled into the air by coughing, sneezing or talking.  The droplets can be breathed in causing contamination. Examples are flu, rubella, SARS

3)      Air Born – small droplets that contain the infection but are in the air for longer periods of time and can be carried by air currents which transfer the particles, and then a person breathes these particles and become infected if susceptible. Examples are tuberculosis, chicken pox, and measles.

4)      Vehicle – single contaminated source like a body of water, food, or blood.  And this transmits to multiple hosts resulting in an outbreak. Infections that can be transmitted this way are Hepatitis B, C, HIV, and e.coli.

5)      Vector – infection transmitted through insects, or pests. Examples are West Nile, Cholera, and Malaria.

The sixth and last part of the chain is the Portal of Entry. This is where the pathogens enter the body and make a new host.  They will use the same openings as the portals of exit, opening of the body.

A susceptible person is one whose body immunities cannot fight off the infectious micro-organisms. A susceptible person is one who has a weak immune system, such as a person who is not vaccinated, the elderly, a baby, or ones who are already trying to fight something with their body such as an HIV/AIDS.

There are many different signs of an infection, some of which are general knowledge such as a fever, pain, and malaise (severe tiredness).  Other signs that could be looked for are diarrhea, vomiting, disorientation, and loss of appetite.

The way that we, student nurses, have been taught to prevent transmission and contamination of infections is through asepsis, medical and surgical.  Medical asepsis is a clean procure, this would involve gloves, and if needed, cap, gown, goggles/face shield, and possibly slippers. A time when you need to use medical asepsis is say when you are going to get the vital signs of your patient/client.  You would need to wear gloves.  If though, one had an isolated client, they would have to completely protect themselves with all of the above supplies.  Surgical asepsis is a lot more than just ‘clean’, everything needs to be sterile.  This means that there can be no micro-organisms. This would be the case in the operating room.

 

So that was as short of a summary that I could get for Wednesday and Thursday’s lessons any questions or terms that you need defined?

 

Start of Week Two

I had the worse load of homework I have ever had last weekend!! I spent all weekend, and I really mean all weekend spending time reading text books, taking notes, completing study guides, answering chapter questions, and trying to figure out what the medical lingo was!!

By the end of the weekend I was already thinking, “Great, this is my life for the next year of my life. buh bye friends, buh bye to fun nights out, buh bye to having a quiet hour or two to sit and read at my leisure.”  It was then I realized I had done homework that was supposed to be ‘assigned’ the week before school.  With 80% of my courses, there is pre-reading (about 1-3 hours per course), and because we were never given our books or our assignment outlines the week before school, we were made to do it this past weekend.  I still have a little catching up to do, and not to forget to start the pre-reading for next week’s classes, and its only Tuesday!!!  So I still have a massive load of homework every week, my social activities are going to be super limited now when I start to get to the burning out stages though I will be going out to have a good time, just to let all y’all know

On top of the homework, we had a quiz today that we had to study for, and we have a medical terms quiz on Friday!  Not happy about the studying part, but I do have to admit I love the feelings after you finish a test and you know you did a good job.

So far what have I learned about? 1) Principles of good communication, 2) There are some personal values that I will need to overcome when it comes to working with certain individuals, 3) Medical Terminology – how to understand them, and how to make them (not so good with making them), 4) nursing math – fractions, per cents, ratios, (I’m flying through this course so far, just saying ), 5) asepsis, 6) introduction to the body.  That is that so far!

I love my teachers so far, but it’s sad that they are just subs, our actual instructor has been in sick leave and although we love our subs and their style, we desperately need our real teacher so we can go full throttle!

So far, that is that, lots of homework, a little time before be for personal things, less sleep, better eating habits, and  getting to learn new things

 

First Real Week

Today was the start of the first official week of school. We had two different courses: Human Relations, which will help improve communications between patients/residents/clients, and Health which is to help us understand how we all can have good well-being.

Already have three assignments, two of which are not due until end of March. My food diary though is due next Monday for Health class. We are to document the foods that we eat for three days, then try to figure out the daily fat, carbohydrate, protein, vitamin and minerals amounts that we actually put into our body. The only other homework from today is to read a chapter from one of my texts about communication for Human Relations. Looking forward to getting that done by tomorrow night. Tomorrow though the real homework starts, so I heard,  I guess I will have to do everything one at a time.

Tomorrow I have two new courses and I’ll see what is waiting for me then