Interviewed a school nurse to understand her role and identify how school nursing relates to public health nursing.

Analyze: Analyzed the information the school nurse gave me about the tasks she completes for her job during the year.
9/24/2017 21:51:39
Christina Collins ccolli27@dtcc.edu 9/18/2017 2100-2200 1 hour Mollie Graham 1.3 Use skills of inquiry,
Reflect:analysis,
I reflected
andabout
information
how theliteracy
schoolto
nurse
address
incorporates
practice issues.,
measures 1.5toEngage
see thatinoverall
ethicalwellness
reasoningis and
met actions
for the children
to provide
as leadership
well as theinadult
promoting
in the community
advocacy, 6.1
collaboration,
at her
Compare/contrast
school. and
School
Discussed
social
the
nursing
justice
roles
thehas
and
as
role
a7.2
multiple
perspectives
of
socially
Conduct
the school
levels
responsible
a of
health
nurse
ofthe
School
disciplines
nursing
versus
history,
citizen.,
nurse
profession
working
making
including
1.6
monitors
Integrate
8.9
decisions,
in Recognize
environmental
the
with
forhospital
the
fifth
otherstate,
knowledge
disease
care
theThe
federal
exposure
impact
professionals
in
school
and
children
to
ofmethods
ensure
and
attitudes,
nurse
to
aon
family
prevent
as
overall
the
ofvalues,
aamajor
healthcare
history
variety
and
health
and
impact
child
that
offor
expectations
diciplines
team
bearing
recognizes
the
on community.
the
(i.e.,children.
woman
toscope
inform
on
genetic
the
from
of
The
She
decision
care
discipline,
risks,
contracting
school
isofathe
tocomfort
making.,
identify
nurse
very
education
fifth
young,
zone
must
current
1.8
disease
Value
and
for
continue
frail
and
them
licens
olde
the
fut
w
ti
Describe: My clinical was at Ashley Addiction Treatment. I shadowed the preceptor engaging with patients in the medically managed detoxification program. Patients range in age from 18 - 70's. Male and female. The patients come from all walks of life, IE. homeless to millionaires. Depending on the patients drug of choice, they a
Describe: Part of the program is theDescribe:
patients are
As part
not allowed
of treatment
to have
thefood
patients
Describe:
or drinks
go During
toin
multiple
their
clinical
room,
lectures
aparticularly
member
a day.ofIcaffeine
the
wasnursing
ableortosugar.
team
attend was
They
a lecture.
listening
are notTheto
good
inappropriate
lectures
for anprov
ind
Analyze: In order to understand what and why patients were taking certain medications I had to do research about the different medications. Addiction does not discriminate and with that one must be culturally competent when dealing with many different types of people, with beliefs ranging from Agnostic, Christian, Jewish, Muslim
Analyze: In this instance I felt as though
Analyze:
I wasByanattending
advocatethe forlecturer
every patient.
IAnalyze:
was ableI advocated
When
to seecaring
how forthe
for
theeducation
patients,
nurse to we
be
fromthe
must
the
role
always
lecturer
modelpresent
would
the patients
provide
ourselvesneed
theinpatients
atathis
positive,
momen
withprc
Reflect: A few of the detoxification medications that I learned about are valium, librium, clonidine, and phenobarbital. One of the patients was a female who identified as a male. Cultural competence played a huge role in this persons life. Nursing must care for this individual, respect the individual, an accommodate the needs of the
1/13/2018 22:47:39
Christina Collins ccolli27@dtcc.edu 11/8/2017 9a-4p 7 Aaron Owens 1.3 Use skills of inquiry, analysis, and information literacy to address practice issues., 1.4 Apply knowledge of social and cultural factors to the care of diverse populations., 1.6 Integrate
6.6 Advocate
the knowledge
for high
Reflect:
quality
and
Themethods
and
nurse
safe
7.4went
ofpatient
Use
a variety
back
behavioral
care
toofthe
as
diciplines
Reflect:
aroom
change
member
and
Attending
totechniques
inform
removed
of the8.2
interprofessional
decision
thethe
Assume
tolecture
promote
skittles.
making.,
accountability
nothealth
He
only
Reflect:
team.
1.7
set
provided
and
Demonstrate
asideThinking
manage
forthe
personal
education
fact
illness.,
about
tolerance
that
and
and
he
how7.11
professional
really
coping
for
the
Participate
the
nurse
want
mechanisms
ambiguity
to
behaviors.,
spoke
leave
in clinical
in
and
the
front
forunpredictability
8.3
skittles,
patients,
prevention
ofPromote
the but
patients
buthe
and
the
I left
of
knew
image
population-focuse
made
the
rejuvenated.
the
world
of
meright
nursing
very
andthing
its
un
Nob
Describe: During pain rounds observed a male patient about 65 years old who has been addicted to pain medications for 15 years. His addiction started following an accident on the job where he hurt his back. Surgeries followed. Addiction ensued. He has been on workman's compensation since
Describe: During clinical, I observed many patients whom were suffering from addiction, as well as, other mental health issues.
Analyze: There are many people involved Describe:
in managing
Observedthis a CIWA
patients
(Clinical
care,
Describe:
Institute
not onlyDuring
Withdrawal
in the assessment,
treatment
Assessment
program
vitals
Describe:
for
are
butAlcohol)
taken
a caseObserved
using
assessment
manager a vitals
a male
from
machine.
performed
apatient
workersDescribe:
at
Aoncomputer
Ashley
comp
a patient
standpoint
Observed
forsystem
treatment
going through
for
e-mar
a meeting
financial
mandatory
assessment
withdrawal.
called
reasons.
by Grand
his
isThe
workers
used
The Rounds.
patient
patient
and comp
can
wasThe
hasbe
claim
ask
many
meeting
accessed
ainstandard
order
psychological
is by
afor
multi-disciplinary
all
set
him
healthcare
oftoquestions
issues.
continue
team
He of
and
tostruggles
medical
still
members
scored
receive
professionals
with
based
caring
benefits.
recovery.
on
forthe
the
who
questions.
He
patients.
meet
wantstogether
to
Depending
feel better,
onceon abut
week
theforday
to
15ofdiscus
years
with
Analyze: It was important to understand the patients from a mental health perspective. In order to understand the patients the an assessment is completed. During the assessment, the patient is asked questions. Using the answers the health care team can formulate a plan of care.
Reflect: Working this patient it is very Analyze:
important
Thethat
CIWAevery
is based
one fromon evidenced-based
the
Analyze:
healthcare During
teamresearch
allcommunicate
communications
regarding effectively
Analyze:
the
of transition
the patients
and
Dueinduring
toa mandatory
contact
timely
detoxification
manner
withtreatment
their
in order
healthcare
from
Analyze:
byalcohol
toworker
provide
Part
teamwith
comp,
ofcompetent,
itthe
regards
is documented
often
meetingto
times
beneficial,
withdrawal
areservices
Psychiatrist,
throughand
symptoms,
are
ansafe
integrated
limited
Psychologist,
care.medication
to Itwhat
computer
is important
Counselor,
workers
titration,
system.
that
compdelirium
Nurse,
theFrom
believes
healthcare
Financial
tremens,
theto
time
beteam
Manager,
the
seizures,
beneficial
patient
continues
Program
etc
toenters
the
to patient.
treat
the
Director,
program
theWorkers
team
anduntil
holistically
a Medical
comp
they isleave.
and
Doctor.
basingdoestheir
One
notbeliefs
have
by one his
from
eac
ca
Reflect: I did research and read about mental health issues that often occur with addiction so that I could educate myself about the experiences someone may go through when suffering an addiction. It is interesting because different cultural backgrounds will often respond differently to certain situations.
2/3/2018 23:39:33Christina M. Collins
ccolli27@dtcc.edu 11/16/2017 8A-5P 9 Aaron Owens 1.1 Integrate theories and concepts2.1
from
Apply
liberal
leadership
education
Essentially
concepts,
into nursing
thisskills,
patient
3.1
practice.,
and
Explain
was
decisionmaking
seen
1.2
theSynthesize
interrelationships
at Reflection:
a hospital,
in the
theories
will
provision
It isbe
among
interesting
and
4.1
managed
concepts
of
Demonstrate
theory,
hightoby
quality
read
from
practice,
the about
skills
Reflection:
treatment
nursing
liberal
and
inthe
education
using
care,
research.,
CIWA
facility
The
patient
healthcare
and
integrated
and
5.7
to 3.2
build
then
care
Examine
hisDemonstrate
care
team
actually
an
technologies,
computer
understanding
managed
the
coordination,
watch
roles
Reflection:
MAR
an and
information
by
understanding
theallows
his
of
assessment
responsibilities
and
the
workers
During
the
all
human
systems,
healthcare
6.1
oversight
my
compensation
ofCompare/contrast
take
experience.,
the
clinical
ofand
basic
place
the
and
team
Icommunication
regulatory
observed
accountability
elements
and
members
team.
Reflection:
1.3
to Use
see
the
aAll
agencies
offew
roles
skills
the
to
the
three
for
devices
have
Grand
patients
actual
research
and
of
care
healthcare
and
inquiry,
aperspectives
rounds
continuity
symptoms
delivery
that
their
who
process
support
analysis,
were
effect
are
teams
inofoccur
one
athere
and
of
on
care
variety
safe
must
and
the
of
patient
models
in
for
nursing
my
nursing
information
the
care
of
each
treatment
favorite
settings.,
care
patients.
for
for
practice.,
patient.
profession
applying
the
quality,
parts
literacy
as
patient
2.2
Some
aAtof
4.2
workplace
requirement
Demonstrate
evidence
clinical
any
with
to
following
of
Use
address
the
time
other
telecommunication
because
symptoms
to
safety,
allcare
their
due
clinical
leadership
healthcare
practice
to
professionals
organizations
and
I love
their
practice.,
youthe
issues.
to
worker
and
do
team
scope
watch
technologies
not
communication
3.6
member
on
mission
even
comp
of
the
Integrate
the
nursing
different
have
claim.
healthcare
can
while
to to
evidence,
and
assist
pull
skills
During
ask
not
individuals
other
upteam
deterring
the
into
medical
effective
the
effectively
patients,
professionals'
clinical
(i.e.,
care
bounce
the
records
scope
judgement,
communication
plan
you
goal
implement
idea
meeting
of
can
of
to
practice.,
discipline,
off
each
ensure
visually
interprofessional
ofpatient
when
each
toin5.8
proper
enhance
see,
aeducation
discussing
other.
variety
Discuss
safety
the
procedures,
the
nurse
Iof
and
love
the
perspectiv
and
healthcar
quality
the
quality
implica
can
to
licens
patie
wat
me
us
of
Describe: Observed a male patient who is about 30 years old. His addiction is to pain medication. He has an individual who oversees his financial affairs. The patient asked if he could see the doctor because he had pain in his
Describe: Observed a male patientDescribe:
who is aboutObserved
30 yearstheold.
Infection
His addiction
Quality
Describe:
Control
is toObserved
painnurse
medication.
review
a patient
nursing
Hehaving
hasprocedures
an
severe
individual
headache.
and who
policies.
oversees
He recently
his financial
quit smoking.
affairs.HeThe
waspatient
givenasked
a Nicoderm
if he could
patch.seeHewthe was
doctor toldbecause
not to chewhe had Nicoderm
pain in his
gum, knees.
but heHe didrequested
on top using
to get
thean patch.
MRI of his knee. The financial advisor sent an email to Ashley Addiction
Analyze: The patient is mentally sound to make all decisions for himself. Ashley informed the financial advisor that they would be violating the rights of the patient without his consent if they were to speak with the financial advis
Analyze: The patient is mentally sound Analyze:
to make
Theall
company
decisionspolicy
for himself.
and procedures
Analyze:
AshleyNurse
informed
are reviewed
assessed
the financial
and
patient
updated
advisor
to seeyearly
what
that to
they
may
ensure
would
havethey
been
be violating
arecausing
aligned
the
the
with
rights
headaches.
theofcurrent
the patient
Once
evidenced-based
without
the patient
his consent
revealed
Describe:
procedures.
if that
they
During
he
were
Fluwasprocedures
pain
tochewing
speak
roundwithmeetings,
evaluated
gum thein financial
addition
the
usingpatients
advisor
to
current
the patch,
discuss
and
hospital
deny
she
how
protocols.
advised
the
they
patients
are
Describe:
him doing,
to
request
discontinue
how
Ashley
based
their
Addiction
use
medications
on theof the
financial
Treatment
gum.
are advisors
working,
(AAT) advice.
upholds
their stress
a professional
level, cravings,
workandethic
what
at all
thet
Reflection: In order to speak with the financial advisor and/or allow him to make decisions for the patient, the patient would have to consent. If the patient has not consented then this would violate HIPAA. It is the responsibility
2/21/2018 17:59:13
Christina M. Collins
ccolli27@dtcc.edu 12/7/2017 8A-5P 9 Aaron Owens 1.3 Use skills of inquiry,
Reflection:
analysis,
In order
and
2.6to
information
Apply
speak
concepts
withliteracy
the
Reflection:
of
financial
quality
to address
advisor
and
Onesafety
practice
important
3.5and/or
Participate
using
issues.,
allow
policy
structure,
him
in
1.5
and
the
Reflect:
to
Engage
procedure
process
process,
makeNurse
in
decisions
of
ethical
and
isretrieval,
used
the
outcome
4.3Flu
reasoning
for
resources
Apply
Protocol.
the
appraisal,
measures
patient,
safeguards
and
toAshley
determine
and
actions
the
tosynthesis
patient
and
identify
Addiction
todecision
medications
provide
would
clinical
ofTreatment
evidence
5.1
making
leadership
have
questions
Demonstrate
the
to support
in
consent.
patient
follows
collaboration
inand
promoting
is
tools
the
describe
basic
If
taken.
the
guidelines
embedded
knowledge
patient
with
advocacy,
Nurse
theother
process
that
has
went
inmembers
of
6.4
collaboration,
patient
the
not
healthcare
through
of
Contribute
hospitals
consented
changing
care
ofthe
the
technologies
policy,
in
and
list.
the
then
current
healthcare
theAnalyze/Reflection:
social
unique
Asked
area
this
finance,
practice.,
would
are
justice
and
nursing
the
team
following
and
patient
information
violate
as
to
2.10
regulatory
perspective
aimprove
socially
ifHIPAA.
Use
in
During
anything
order
systems
improvement
patient
environments,
responsible
this
to
It else
is
interprofessional
limit
meeting
the
to
outcomes.,
changed
support
exposure
responsibility
methods,
citizen.,
aincluding
nurse
ain
3.9
safe
tohis
1.6
teams
the
based
sits
Describe
local,
life?
of
practice
Integrate
flu
8.1
in
the
to
virus
on
on
Nurse
Demonstrate
state,
treatment
optimize
the
mechanisms
data
environment
and
the
meeting
national,
discussed
from
knowledge
make
patient
facility
the
the
Analyze/Reflection:
so
sure
and
to
for
outcomes
with
professional
that
to
outcomes.
resolve
both
the
global
and
make
the
if community
there
methods
patients
doctor
identified
decisions
healthcare
of care
are
standards
the
and
any
of
processes,
Individuals
remains
practice
a
patients
for
healthcare
concerns
trends.,
variety
the
of moral,
patient
as
discrepancies
symptoms.
of
to
with
5.2
healthy
regarding
diciplines
design
workers.,
Describe
ethical,
addiction
that as
respect
and
Ifthe
to
possible.
and
4.7
between
the
how
test
are
inform
patients
Recognize
legal
nurse
his
very
health
changes
privacy,
decision
conduct.,
identified
did
fragile
medications
care
not
the
toautonomy,
when
is
continuously
making.,
verify
role
standards
8.4
organized
Demonstrate
of
entering
the
the
information
1.7
patient's
nurse
and
and
and
Demonstra
improve
the
dignity.
practice
can
finance
facilit
profe
med
tech
an
th
During intake each individual has a thorough intake

During the assessment a family history is taken an

The assessment also addresses any cultural or sp

Describe: At Ashley patient either are scholarship, self-pay, or commercial
During
insurance.
intake each
I was
individual
able to has
sit ina athorough
meeting intake
whereassessment.
several patients
During
had this
different
assessment
methodsa of medical
payment.history and physical
All assessment are recorded in the eMAR and is a
Analyze/Reflection: It is interesting to see the inner workings of how a During
patient's
themedical
assessment
care isa dictated
family history
byDuring
insurance
is taken
any assessment
and/or
and socio-economic
money.
withDepending
the patient
historyon
the
isthe
completed.
nurses
type of always
insurance
These
made assessments
determines
sure to askthe
give
thelength
patie
insig
During assessment a treatment plan is implemente
I also observed patients questioning each medication they were takingThe because
assessment
they were
also
self-pay
addressesand any
they
Atcultural
all
didtimes
not or
want
the
spiritual
medical
to be practices
onstaff
any additional
only
thecommunicate
patient
medication
may have.
firstunless
names
Understanding
it and
it was
last
absolutely
name
beliefs
initials
can
necessar
help
to he

A few patients were in the program Describe:

through workers
Throughout
comp.the
I felt
dayaspatients
though
All assessment
come
some to
of the
theare
nursing
workers
recorded
desk
comp
intothe
patients
receive
The
eMARpatients
experience
medications,
and isattend
available
with
report
classes,
treatment
forailments,
each
which
can
person
etc.
The
discuss
often
facility
from
The
bedifferent
patients
the
hindered
has
health
aissues
church
sign
because
care
inthat
on
team
site
aarise
workers
kiosk.
ofso
the
during
that
comp
Three
individual
patients
addiction
expects
nurses
tocau

2/21/2018 22:06:02
Christina M. Collins
ccolli27@dtcc.edu 1/18/2018 8A-7P 11 Aaron Owens 5.1 Demonstrate basic
The few
knowledge
patients of
who
6.2healthcare
Use
are lucky
inter-policy,
to
andget
Analyze/Reflection:
intraprofesional
finance,
a scholarship,
and regulatory
communication
may
7.1The
Assess
also
nurse
environments,
beprotective
limited
completes
andThe
collaborative
to facility
and
services
including
anpredictive
assessment
has
because
skills
local,
a 8.10
church
factors,
to
state,
Protect
there
on
deliver
on
the
including
national,
site
ispatient
patient
evidence-based,
only
so Anytime
that
so
and
genetics,
based
privacy
much
patients
global
aon
money
and
patient
which
the
healthcare
patient-centered
can
confidentiality
type
available,
attend
9.1
influence
askof
Conduct
someone
addiction
trends.,
on so
a
the
of
daily
care.,
generally
comprehensive
health
patient
5.2
athey
questions
basis
In
Describe
6.5
order
are
ofrecords
Demonstrate
they
ifindividuals,
suffering
they
for
regarding
are
how
and
awould
and
patient
given
health
focused
from.
other
families,
appropriate
like.
their
ato
30-day
care
privilidged
The
succeed
physical,
care
groups,
is
nurse
organized
stay
the
teambuilding
they
communications.,
inputs
health
behavioral,
but
communities,
must
one
and
the
care
funds
have
results
and
finance
profes
psyco
an
co
ar
in

During clinical I researched the medications that the patients were taken
Observe
for different
a teammedically
of healthcare
managed
member
withdrawals.
discuss dis
On

Librium is used for alcohol withdrawal, but it is excreted through the liver.
TheSerax
medication
is used
assisted
for alcohol
detoxification
withdrawal,program
but it isisusa

Every day patients in the detoxification program ar

Determining the best course of treatment for each patient is crucial because if a patient is not detoxed using the proper m
During clinical I researched the medications that the patients were taken for different medically managed withdrawals. One I had not heard of, serax. I was also interested in why they would choose one drug overAshley another.Addiction
The medications
treatment facility
I researched
uses alternative
where Se
In any given day a patient will see aEvery nurse,Thursday
a doctor,there
a psychiatrist,
is a ground a clinical
rounds counselor,
meeting. I alove yogadoing
instructor,
my clinicals
nutritionist,
on thisspiritual
day because
director,
I get
swimto observe
coach, athletic
a meetin t
2/25/2018 19:28:34
Christina M. Collins
ccolli27@dtcc.edu 2/1/2018 8A-7P 11 Aaron Owens 3.3 Advocate for the
Librium
protection
is usedof for
human
4.4
alcohol
Understand
subjects
withdrawal,
inthe
During
theuse
but
conduct
of
assessments
it CIS
is excreted
ofsystems
research.,
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