Katie Garagnon 6th Period

Journal #1: Week of 9/10/18

My mentor's name is Mrs.Featherston and she is an ER nurse at UTMB. I discovered her
with the help of Mrs. Click after struggling to find an RN to agree to be my mentor during the
duration of the summer. She has mentored students in ISM in the past and as soon as I met her,
she displayed nothing but kindness and enthusiasm about mentoring me. I am tremendously
excited to learn about ER nursing, as I aspire to become an RN in the future; I'm hoping this
mentorship will convince me that the ER will be my future specialty/nursing field I decide to
pursue. I was unable to begin my actual mentorship hours in the hospital because my UTMB
clearance is still being processed, but my mentor and I have been communicating consistently.
She will be unable to begin mentoring me until October 8 anyway, due to trauma training and
personal time off, but Mrs.Click has offered to allow me to make up the three hours of
mentorship per week with various research topics my mentor assigns to me, followed by a
paragraph synopsis of the research/what I learned. Since I did not need my clearance in order to
do my alternative assignment, I went ahead and began my three hours of mentorship credit for
this week so that my make-up work will not accumulate later on. For this week's research topic,
my mentor asked me to research sepsis because this week was World Sepsis Awareness Week
and she herself had to give a presentation about it at work. After researching sepsis, I learned that
it's a pretty common occurrence in the ER and can be life-threatening! I thoroughly enjoyed
writing my synopsis about it, because it taught me something that I will need to know about for
the future, as I will most likely see many cases of sepsis in patients, and now I know what it is,
the treatments, signs/symptoms, and more! I am extraordinarily grateful for the opportunity to
learn and grow from my mentor, and I can't wait to see what's in store the rest of the year!

Journal #2: Week of 9/17/18

For my fall project topic, I chose resuscitation and a tri-fold board encompassing crash
carts for my product. I chose this topic because my mentor is an ER nurse and she deals with
resuscitation every single day when patients code. While creating a brainstorming web, it came
to my attention that resuscitation is one of the most important and relevant parts of an ER nurse’s
daily routine; I also find it tremendously intriguing. My mentor helped me come up with this
topic in the sense that she inspired me to dig deep into what I know about the emergency room
and what I could research that piques my interest. This week, for my mentorship hours my
mentor informed me that many patients in the ER present with shortness of breath (SOB) and
chronic obstructive pulmonary disease (COPD). While researching, I found out that both are
exceedingly common (there are over 3 million U.S. cases of COPD every year). Additionally,
COPD is the third leading cause of death in Americans. I have loved learning more about what
my mentor sees in the ER on a day-to-day basis!
 Journal #3: Week of 9/24/18
For my project topic of resuscitation, I decided that my five key points will be the general
background information and/or history, influential factors that lead to high success/failure rates,
crash carts, DNR patients, and the aftermath of resuscitation on a patient. My first research topic
is about the background information on resuscitation and possibly its history if there are any
interesting facts about when/how its incorporation into medicine came to be; this will provide a
background for the audience to learn about what the different methods are, what they provide for
the patient, and what exactly takes place during the process. My second research topic is the
specific factors that possibly lead to higher success and higher failure rates among resuscitating
patients; this will reveal if there are any medications that should be given to optimize results,
how time factors in, and whether or not certain medical conditions make resuscitation
increasingly difficult/impossible. My third research topic involves what happens in the aftermath
of resuscitation once a patient is successfully revived; this will reveal if there are detrimental
effects, changes to the brain/person, and the downsides of resuscitation. An additional research
topic that applies mostly to my tri-fold product is about crash carts; this will encompass what
exactly is found in crash carts and their common uses, which is useful to know in a high-stress,
fast-paced situation. Finally, this week my mentor informed me that many patients come into the
ER presenting with signs/symptoms of weakness, numbness, and altered mental status. She told
me that these are some of the signs/symptoms of cerebrovascular accidents and/or transient
ischemic attacks. CVAs are more commonly known as strokes, and TIAs are known as “mini
strokes” that warn of a future stroke. After researching my mentor-given topic for my mentorship
hours credits, I learned that these two conditions occur very frequently and are one of the most
common reasons for visits to the ER. I was surprised to find out that strokes are the 5th leading
cause of death in the U.S. and approximately 800,000 people have one each year, equivalent to
about one person every 40 seconds.

Journal Entry #4: Week of 10/1/18

During this first nine weeks mentorship period, I have learned a lot about the some of the
most common reasons that patients visit the ER. My mentor informed me that some of them
include sepsis, COPD, CVAs/TIAs, and TBIs. After extensive research, I learned all about their
signs and symptoms, treatments, and shocking statistics that apply to the American population.
Learning about some of the most common reasons for visits in the ER and what the patients
typically present with has helped me get background knowledge/a foundation for ER nursing. I
feel like now I am better prepared for what to expect on a daily basis in the ER, though an ER
nurse’s day can be very unpredictable and different from the previous. Next nine weeks, I hope
to learn as much as possible about emergency medicine and be exposed more to resuscitation and
the use of crash carts in the ER setting because that’s my project topic and I would benefit from
being exposed to it more. Essentially, I hope that the next nine weeks mentorship period will
have a large focus on my project topic and allow me to grow and apply my experience to my
project.
 Journal Entry #5: Week of 10/15/18
Upon reviewing my nine weeks evaluation form, my strengths are flexibility,
determination, and interest in the field of study, according to my mentor. She did not list any
areas that I need improvement in, but I received a four instead of a five in a few categories.
These include extension, technique, knowledge, and depth/level. To improve and become a five
in these categories the second nine weeks, I plan on showing improvement by applying every
single little thing that I learn in the ER into every possible activity I participate in. Knowledge
was given a four because though I learned a lot in the first nine weeks, of course it wasn’t
possible to know everything there was to know about ER nursing or the conditions they treat thus
far, which is understandable as it is still early. I plan to improve this by learning more and more
about what happens with patients in the ER and growing my knowledge through more time,
experience, and exposure. Lastly, for technique and depth/level I plan on incorporating my
mentor even more into the development of my final project presentation and product; she would
be one of the best resources since she is a professional in my topic of study and I would benefit
greatly from receiving her advice.

Journal Entry #6: Week of 10/22/18

Unfortunately, I was unable to meet with my mentor this week due to Joint Commissions
at all UTMB facilities. I plan to make up these missed hours next Friday, November 2 by staying
for additional hours, since it will be a weekend night rather than a school night. My mentor has
informed me that biker rally weekend is taking place at that time and there are usually several
traumas that come into the Galveston UTMB ER. I am excited for mentorship that day because
though it will be undoubtedly chaotic, I will get great exposure to the fast-paced chaos of an ER
with multiple traumas pouring in. I am sure I will learn a lot about my mentor and the ER
nursing career as a whole. My favorite thing about my mentorship facility is its colossal size,
which makes it easy to accommodate for many patients with smooth transitioning. I enjoy not
knowing what to expect to come through the ER doors, and the fact that every day is different
from the last.

Journal Entry #7: Week of 10/29/18

From the perspective of the visitors and patients, I’d say that the most frustrating thing
about my mentorship site for them is the large size. Many patients and family members ask me
and other employees where certain things are and how to navigate from one area to the next
pretty frequently. From the perspective of the patients, the best thing is the attentiveness of all
the nurses and doctors in the ER at UTMB Galveston because their top priority is the patients
and you can tell right off the bat that they care about them on a deeper level than just typical
patient-doctor/nurse relationships. My mentor is always spreading positivity in every room she
enters and makes sure to always smile, speak gently and politely, and make the patient as
comfortable as possible, informing them of every step she takes. This week during my
mentorship I observed a spinal tap, which was very captivating and interesting to watch and learn
from. Also, I monitored and helped patients with my mentor, such as patients with UTIs,
cellulitis under the eye, broken scapulas, dizziness associated with pregnancy, and fevers/colds.
Lastly, we heard a few psychiatric patients screaming and having hysterical breakdowns from
across the other side of the ER even though none of them were my nurse’s patients, but it was
nonetheless an eye-opening experience.

Journal #8: Week of 11/5/18

This week at mentorship, I observed and followed various patients with diabetic
ketoacidosis, intoxication, assault, and abdominal pain. The most interesting case from this week
were two ladies that came in, both traumas. One had been smashed in the face with a hammer by
the other woman (who was her boyfriend’s ex-girlfriend) and the hammer victim stabbed the
other lady in the neck. I didn’t get to see the woman with the stab wound to the neck, but I did
get to see the woman who got violently hit in the face with a hammer. She was in very serious
condition and I observed as a doctor on her case pried open her left eyelids with tools and used
two cotton swabs to lift her eyeball upwards, since it had sunken into her head. This particular
case was the best part of this mentorship day and the worst was probably a male patient who
came in with fake complaints of flank pain just so he could get drugs; he was very creepy and
made all of the nurses and myself uncomfortable. Regarding my final product, I am planning an
informative tri-fold board encompassing crash carts and so far I have had discussions with my
mentor who said she will get me a list of items the facility personally stocks in their crash carts
to help with my research. I plan to utilize the time during Thanksgiving break to get as far as I
can on my product and hopefully finish it with the exception of some small, final finishing
touches.

Journal #9: Week of 11/12/18

At mentorship this week I shadowed patients including COPD/emphysema, shortness of
breath as a complication of lung cancer, abdominal pain/vomiting, and a major trauma from a
laceration due to a machete. The laceration was wide and deep, with muscle protruding outwards
on the patient’s lateral left calf and a severed saphenous vein and it was gushing blood so much
so that the entire leg was blue/cyanotic. Regarding my final presentation I’d say the thing I’m
most nervous about is merely the process of giving an oral presentation because I tend to get
very nervous and anxious when presenting. Also, my topic is something that my mentor is an
expert in, so I am uneasy about whether or not I will be up to her level of experience since I have
significantly less experience and knowledge. This mostly applies to my product which will
encompass crash carts and there are just so many details about what specifically is in each
drawer and what each are used for, so it will be difficult to adequately portray the sufficient,
complete information since it goes so far into depth within the limited amount of time given for
presenting.

Journal #10: Week of 11/26/18

At this week’s mentorship, I observed an assortment of different patients under the
direction of my mentor, including headache and dizziness due to previous natural gas exposure, a
head laceration from a motorcycle crash, back pain, vomiting, fever, diarrhea, and flu-like
symptoms. My final product this semester is a tri-fold board encompassing crash carts and their
function in the ER, photographic comparisons, common drugs and equipment found, and the
purposes/usage of the drugs and equipment. I plan to incorporate it into my presentation after
talking about my key points, since crash carts is one of my key points my tri-fold goes together
with it and elaborates upon the introductory background information. I chose to create a tri-fold
board as my product because I thought it would be a professional way to organize my
information while incorporating some visuals that appeal to and keep the audience’s attention.