Category: Reflection

Reflect on what you learned from the John’s Hopkins University COVID-19 Contact Tracing Course. In a thoughtful, one- to two-paragraph post, describe ethical considerations around contact tracing, isolation, and quarantine. Describe some of the common barriers to contact tracing efforts as well as strategies to overcome them. How will you apply what you learned to your future nursing practice?

Completing the John’s Hopkins Contact Tracing course has allowed me to have a deeper understanding of new vocabulary and practices that are used in public health emergencies. To some the words of ‘isolation’ and ‘quarantine’ may mean the same, but this course has laid out the foundation to understand the concepts more. There can be many barriers when an individual is notified that they may be a close contact of an individual with an illness such as COVID-19. The different examples of contact tracer phone calls and zoom sessions showed a marked difference in how the individual felt after the call and if they felt like they were educated and supported in the phone call. Having more contact tracers in the community can allow for more people to keep safe and be notified in a timely fashion. When approaching each conversation with a potential contact or positive case, the top things I noted to remember are: tell them this is a private and confidential space, that you are there to support them and help them find resources and to have a calm and warm presence over the phone to make them feel valued. If an individual is receiving a phone call there is a high chance they are already under a great deal of stress so attempting to lessen the burden and help them in any way that you can is essential. I will apply these concepts of approaching patients in a caring manner and make each person feel valued during each interaction. I also now have a better understanding of the terms that are used and can help differentiate and provide up-to-date information for my patients.

To achieve a goal takes careful consideration planning and motivation. For at least the past year I have told myself that I would like to better my physical wellness, however, I stayed in the contemplation phase and neglected to start on the journey up until June. Something as simple as writing down goals for the previous assignment helped to manifest the start of progressing toward my goals. My two goals focused on improving my food choices and integrating more fruits and vegetables into my daily diet and also to incorporate exercise into my daily routine. One major factor that played a role in starting to work toward the goals I made was living on my own for the first time, in this setting, I am the one accountable for how I structure my day and also what food I bring into my apartment and limit on going out for unhealthy snacks or fast food. Another factor that helped was including my friends in on my plan and make connections with those that already exercise and have gym memberships to have a buddy to motivate me to go. I have never had a gym membership so at the beginning of this goal I was attempting to incorporate aerobic exercises that required limited equipment, but this wasn’t the best fit for me after experimenting. Finding out what strategies work for me was an important learning curve and I believe now I am on the right track and plan to continue on my path of working on completing these goals and then setting new ones that align with my abilities at that time. 

My first goal was to improve my overall wellness by integrating more fruits and vegetables daily and to eat more mindfully. By the end of the summer semester, I will have integrated 3 or more servings of fruits and vegetables into my daily food intake. Starting this program directly after finishing undergrad into a new apartment by myself just transferred my eating patterns. Not knowing how to cook many things, therefore eating the same things for several meals throughout the week that would often include high amounts of simple carbohydrates, sodium, and excess sugars. Being at home more often because of COVID-19 has made me curious about using my kitchen more and learning how to cook things that interest me that I typically would only order at a restaurant. This spark has allowed me to make a plan before going into a supermarket and include foods that I know I will eat and that fit my goal of including 3 servings of fruits and vegetables each day. When I have access to a kitchen, my breakfast plan has stayed the same over the past couple of years but with this goal, I made some tweaks. Each morning I eat one egg over easy on a whole wheat light English muffin with seasoning and a full peach. Keeping this meal in my routine makes it easy to plan to shop and always tastes good and keeps me happy. For lunch, I found was the place where I often used to not eat the healthiest, so this was the area to improve the most and still somewhat challenges me. Some options that I have come up with are chicken salad sandwiches, baked chicken with steamed vegetables, steak fajita salad, and a couple of others. Planning out my meals in the morning also helps me to visualize and plan out that I need to eat a certain meal and don’t grab snacks instead. For snacks, throughout the day I include strawberries, light popcorn, and wholegrain pretzels, and guacamole. Dinners weren’t the problem area for me, so I stay consistent with having a serving of vegetables with protein. One way I found was fun to incorporate vegetables into my meals was a vegetable version of pasta, like cauliflower gnocchi or zucchini noodles. To stay on track with my plan I try to incorporate at least one meal a week that I tell myself not to be upset about like getting pizza or a burger and fries at a restaurant. Being able to balance out the rest of my meals is doable when you can look forward to something. 

My second goal was to improve physical wellness by planning out aerobic exercises more regularly. By the end of the summer semester, I will have integrated at least 3 aerobic exercises into my weekly schedule to help towards maintaining a more ideal body weight. I am very proud of myself for the progress I have made on this goal. At the beginning of making this goal, I was doing outdoor walks on trails like Back Cove and Scarborough marsh, however, I was inconsistent maybe doing them once or twice a week. Two weeks ago, I made the decision to get a gym membership to Planet Fitness and have been going every day except one day and completing some cardio, core, and strength exercises each time. I was quite intimidated since I had never had a gym membership before, never utilized the free gyms on the Biddeford campus as an undergrad there but pushed myself to try this. I started going initially with a previous classmate and she showed me around and a general workout flow to try to follow and now I have been going alone for well over the past week. I look at my class schedule and homework schedule for the day and decide on a time to go wherever it fits in and both me and others have noticed a start of a difference in my appearance and I can’t wait to continue. If there’s ever a day in the gym that I feel myself getting more tired and can’t finish what I planned to accomplish then I pick a middle ground in the distance goal and achieve that instead. Paying for membership also plays a role in motivating me to go and also, I know that if I try to do a workout at home, I won’t get the same satisfaction in myself as if I went to the gym.         

Prochaska’s transtheoretical model is a way for individuals to recognize what stage of making a change they are currently in. The stages each outline the likelihood that the person is going to make the change starting with precontemplation up to termination when the change has occurred and relapse will not occur (Prochaska, Redding, 2015, p.125). This model is useful to determine where in the cycle of change a person may fall recognizing that it is possible to go back and forth between the stages before completing a goal. With the two goals that I had made for this course, when I made the goals, I was in the preparation stage since I had wanted to make a change for some time but never took the leap and committed to it. Currently, I am in the action stage and will be for a while, at least 6 months, before reaching the maintenance stage before they become habits. I never thought that I would be successful in starting these goals based on previous health tendencies I had in the past, but I couldn’t be happier that this assignment has started me on my journey to improving my physical and mental wellness.

Module 3

Priority setting- this module went through each step of the nursing process and how it differs from a RN to an LPN with the step of assessment not being present for the LPN. The next process discussed was the ABC’s of airway, breathing and circulation explaining the ranking and what support the nurse can provide to fix that stage or help the client reach their maximum potential in that area. Safety and risk reduction methods include keeping the focus of safety of the patient and all parties involved, doing least restrictive methods first of preventing harm to client or caregivers by reducing injury. Some interventions to ensure safety include utilizing supervision and sitters in the facility, using alarms on the bed to make sure patients don’t ambulate without supervision. In addition, when treating a patient do least invasive interventions first prior to becoming more invasive such as inserting catheters or other devices which can bring on the increased risk of infection since a foreign object was inserted into the body as a part of the care. The next framework is the patient survival potential that can be used in trauma and emergency situations that helps rank a patient in their likelihood to survive and assigns priority for treatment. Relating all patient care back to these set frameworks can help nurses and other health professionals set priority when treating patients and help in hard decision making about seeing one patient first over another, deciding with acute vs chronic, urgent vs nonurgent and unstable vs stable. Lots of factors go into setting priority, but this is all important in deciding what patient to see first and knowing how to interpret the information to do so. 

Module 4

Testing and remediation – this module identified strategies and ways to be successful in nursing examinations developed by professors and the NCLEX exam. Setting realistic expectations and realizing good habits to do leading up to the exam is important so that you can have the best possible outcome. One area of information that was new to me was analyzing the component of a test question into the stem and options. Taking apart a test item piece by piece can be a successful test strategy if done correctly as it will point to the correct answer once it is determined what is being asked. Different ways can be utilized to mark up the answer choices based on the student’s confidence level with thinking that it is the correct choice. Finding what works for you is critical for success and to stick with the same code so that no accidental mistakes are made. Remembering that a nursing student typically never gets all questions correct is important and allows the person to recognize what areas improvement must be made so that learning can continue. In the areas that need to be worked on, it might be useful to go back to the strategies identified early in this module to take notes more efficiently, read prior to lecture and study ahead of the day before the exam. The alternate format styles on the NCLEX section was interesting to learn about since I assumed all questions were multiple choice, instead of the multiple response, fill in the blank, drag and drop, hot spot, exhibit, graphic and audio format styles. Learning more about the NCLEX was good to hear about since I didn’t know too much about the format of the exam and to learn tips to start practicing with on practice problems and tests. 

Module 1

This module covered the aspects of nursing knowledge including knowledge, skills and attitudes that are necessary to provide safe and effective care for patients. These skills and knowledge will be increased throughout the time as a nursing student and increased through classes, labs and clinical application. One important part of the module was going over learning styles which is applicable to both us as nursing students but also for our future patients to think about as we begin to incorporate patient education into our care plans. If someone is a more tactile learner then we could ask them to demonstrate a skill back to us which may be different from someone who is a auditory learner who would rather listen to us provide instructions as they performed the skill. Providing multiple formats of information will allow for optimal knowledge being learned. All of these skills and basis of the helix of success will be built on throughout the next 15 months as a nursing student and then even more so throughout the time spent working as a new grad nurse. The information provided in this module is a good baseline to be aware of as I am starting my nursing education and know what aspects of the profession are to be expected of me both as a clinical student and by the time I graduate.

Module 2

This module focused on the different roles and attitudes that the role of the nurse follows. The main and most important role of a nurse is to be an advocate, the nurse is the person that spends the most time with the patient out of the whole interdisciplinary health care team and can work as an informal leader relaying the most up-to-date information about the patient to the team. Gaining competency and skills are built right from the start of being a beginning nursing student and done through different experiences like in clinical settings. One key point to be aware of is to maintain professionalism and accountability for safety that is consistent with professional nursing practice, we, as student nurses, are expected to act at the same level as professional nurses. I found the leadership roles of nurse’s section very interesting because I have been in leadership roles throughout my undergrad and even was awarded the Student Leader Award from UNE this past year, so I can see myself pursuing some of these positions in the future. This module took a deeper dive into who the nurse is and what attributes they have and what kind of interpersonal skills to look forward to gaining and expanding upon.

When asked what words come to mind when you hear the word nurse some of my non-nursing student peers responded: “sweet caring and smart”, “under appreciated” , “caring compassionate and helpful” , “very tolerant” , “really caring people, people who take care of patients of all kinds” , “nurturing, friendly, protecting” and “selfless, dedicated, resilient and strong interpersonal skills”.

Each of those responses alludes to the aspect of nursing that isn’t the countless hours of studying, exam prep, time at clinical, preparing for labs or studying for NCLEX exam that is often what nursing students do with their time. The art of nursing can be taught to an extent, being lectured on how to compassionately care for patients, learning what interventions can be done to establish rapport and role-playing to practice giving assessments, but there needs to be a drive within the student nurse to want to pursue this field. What is known as the most trusted profession, nursing and nurses are who they are because of their work-ethic, ability to genuinely want the best for their patients and advocate for them to successfully create a care plan that respects their wants, abilities and beliefs. As seen in the painting above, the nurses behind the focal point are the individuals actively with the patients, ensuring their safety, promoting health, continuously assessing their care plan and being a support system. Nurses leave their home life at the door and quite often forget to care for themselves because their full focus is on the patient. Art of nursing is compassionate, genuine, individualized and focused care to promote health and wellness.