Author: A. Lexgelinas

On October 1, 2017 a single man shot into the Route 91 music festival  killing 59 people and injuring 546. He shot from the 32nd floor of Mandalay Bay hotel on the Las Vegas strip. Barriers for providing care rested in the uncertainty of the shooter being on the ground or up in one of the surrounding buildings, getting adequate medical personnel to assist the hundreds of people injured and transport them to one of the 3 surrounding hospitals. Paramedics, nurses, and doctors both on duty and off duty rushed to help people get to safety and provide medical care until transferred to hospitals. The shooting took place from 1005pm to 1015pm. While people trampled over each other and tore down fences to escape it created some difficulty to get the injured immediate attention. After the shooting, there were hotel cancellations and business’ had some fall in sales the first 3 days after the shooting. Trauma care needed was tourniquets, pressure to bullet wounds to stop bleeding, and CPR for some that lost adequate perfusion. With the amount of people that came into hospitals injured, the healthcare team would have to call in additional employees and even keep some employees significantly overtime in order to manage the influx of trauma patients. I believe real disasters like this give emergency and medical personnel the tools they need to provide faster effective care. They can evaluate the protocols they already have in place and see what works and what needs adjusting.

On October 1, 2017 a single man shot into the Route 91 music festival  killing 59 people and injuring 546. He shot from the 32nd floor of Mandalay Bay hotel on the Las Vegas strip. Barriers for providing care rested in the uncertainty of the shooter being on the ground or up in one of the surrounding buildings, getting adequate medical personnel to assist the hundreds of people injured and transport them to one of the 3 surrounding hospitals. Paramedics, nurses, and doctors both on duty and off duty rushed to help people get to safety and provide medical care until transferred to hospitals. The shooting took place from 1005pm to 1015pm. While people trampled over each other and tore down fences to escape it created some difficulty to get the injured immediate attention. After the shooting, there were hotel cancellations and business’ had some fall in sales the first 3 days after the shooting. Trauma care needed was tourniquets, pressure to bullet wounds to stop bleeding, and CPR for some that lost adequate perfusion. With the amount of people that came into hospitals injured, the healthcare team would have to call in additional employees and even keep some employees significantly overtime in order to manage the influx of trauma patients. I believe real disasters like this give emergency and medical personnel the tools they need to provide faster effective care. They can evaluate the protocols they already have in place and see what works and what needs adjusting.

According to Swearingen, Cox, Lesko, Lucas, and Clark (2018), there is a new stroke neuro check called SNAP (Stoke Neuro Assessment by Providence). It is defined by four assessment components; LOC, pupillary response, extremity movement, and originating symptoms. The purpose of this article was to examine SNAP checks between a comprehensive stroke center (CSC) and a primary stoke center (PSC) for any stroke patients that had IV alteplase and/or thrombectomy (Swearingen, 2018). A primary stroke center primarily cares for ischemic strokes while a comprehensive stroke center cares for all types of strokes. In order to check compliance with the SNAP assessment, the number of documented SNAP assessments were divided by the opportunities for the checks. Of the 37 patients in the study, SNAP check compliance was 68%. In the SNAP checks, the highest compliance fell under LOC and the lowest was originating symptoms, 90% to 45% respectively. Comparing the CSC to the PSC, CSC’s had higher compliance rate, 82% to 62% respectively. In conclusion, there needs to be more emphasis on originating symptoms during assessments and compliance with SNAP checks in PSC’s.

Swearingen, N., Cox, K., Lesko, A., Lucas, L., & Clark, D. (2018, January). Abstract 9: Compliance of a New Standard in Stroke Neuro Checks in a Comprehensive Stroke Center Compared to Primary Stroke Centers for IV Alteplase and Thrombectomy Patients. American Heart Association Journals, 49(1).  Retrieved April 06, 2018, from http://stroke.ahajournals.org/content/49/Suppl_1/A9

According to Swearingen, Cox, Lesko, Lucas, and Clark (2018), there is a new stroke neuro check called SNAP (Stoke Neuro Assessment by Providence). It is defined by four assessment components; LOC, pupillary response, extremity movement, and originating symptoms. The purpose of this article was to examine SNAP checks between a comprehensive stroke center (CSC) and a primary stoke center (PSC) for any stroke patients that had IV alteplase and/or thrombectomy (Swearingen, 2018). A primary stroke center primarily cares for ischemic strokes while a comprehensive stroke center cares for all types of strokes. In order to check compliance with the SNAP assessment, the number of documented SNAP assessments were divided by the opportunities for the checks. Of the 37 patients in the study, SNAP check compliance was 68%. In the SNAP checks, the highest compliance fell under LOC and the lowest was originating symptoms, 90% to 45% respectively. Comparing the CSC to the PSC, CSC’s had higher compliance rate, 82% to 62% respectively. In conclusion, there needs to be more emphasis on originating symptoms during assessments and compliance with SNAP checks in PSC’s.

Swearingen, N., Cox, K., Lesko, A., Lucas, L., & Clark, D. (2018, January). Abstract 9: Compliance of a New Standard in Stroke Neuro Checks in a Comprehensive Stroke Center Compared to Primary Stroke Centers for IV Alteplase and Thrombectomy Patients. American Heart Association Journals, 49(1).  Retrieved April 06, 2018, from http://stroke.ahajournals.org/content/49/Suppl_1/A9

According to Swearingen, Cox, Lesko, Lucas, and Clark (2018), there is a new stroke neuro check called SNAP (Stoke Neuro Assessment by Providence). It is defined by four assessment components; LOC, pupillary response, extremity movement, and originating symptoms. The purpose of this article was to examine SNAP checks between a comprehensive stroke center (CSC) and a primary stoke center (PSC) for any stroke patients that had IV alteplase and/or thrombectomy (Swearingen, 2018). A primary stroke center primarily cares for ischemic strokes while a comprehensive stroke center cares for all types of strokes. In order to check compliance with the SNAP assessment, the number of documented SNAP assessments were divided by the opportunities for the checks. Of the 37 patients in the study, SNAP check compliance was 68%. In the SNAP checks, the highest compliance fell under LOC and the lowest was originating symptoms, 90% to 45% respectively. Comparing the CSC to the PSC, CSC’s had higher compliance rate, 82% to 62% respectively. In conclusion, there needs to be more emphasis on originating symptoms during assessments and compliance with SNAP checks in PSC’s.

Swearingen, N., Cox, K., Lesko, A., Lucas, L., & Clark, D. (2018, January). Abstract 9: Compliance of a New Standard in Stroke Neuro Checks in a Comprehensive Stroke Center Compared to Primary Stroke Centers for IV Alteplase and Thrombectomy Patients. American Heart Association Journals, 49(1).  Retrieved April 06, 2018, from http://stroke.ahajournals.org/content/49/Suppl_1/A9

My very first patient in nursing school was my most memorable patient. She had a song that she loved to sing and perform for herself and others to hear. Her special instructions were that you clap with her. During the shift I had sang the song with her many times, sometimes even in the hall. By the end of my day, some other classmates and I rounded up the clinical group, instructor included, to listen to her song. It put a smile on all of our faces and certainly brightened up the day. We still try to sing her song to this day.

My very first patient in nursing school was my most memorable patient. She had a song that she loved to sing and perform for herself and others to hear. Her special instructions were that you clap with her. During the shift I had sang the song with her many times, sometimes even in the hall. By the end of my day, some other classmates and I rounded up the clinical group, instructor included, to listen to her song. It put a smile on all of our faces and certainly brightened up the day. We still try to sing her song to this day.

My very first patient in nursing school was my most memorable patient. She had a song that she loved to sing and perform for herself and others to hear. Her special instructions were that you clap with her. During the shift I had sang the song with her many times, sometimes even in the hall. By the end of my day, some other classmates and I rounded up the clinical group, instructor included, to listen to her song. It put a smile on all of our faces and certainly brightened up the day. We still try to sing her song to this day.

I engage in self-care via staying hydrated and exercising regularly. In clinical, I notice I don’t take enough time to drink water. However, every time I go to drink my water I usually try to drink the whole bottle or half. This might be 17 or 8 ounces at a time. I need to take more time throughout the day to hydrate. Not even just during the clinical day but the day before also. Friends that I’ve asked also complain of not taking time or having the team to hydrate. Although, one of my friends ensures she gets enough water throughout the day and is very timely with drinking water throughout her shift. Self-care is important for professional development because when you aren’t caring for your own self it’s difficult to be the best asset to the team you can be. When you’re tired, hungry, or dehydrated you can’t make the best decisions for you, your patients, or your team. Keeping yourself fueled, rested, and hydrated ensures you to run as a well-oiled machine and have the proper nutrients to fuel your body and make safe practice decisions. Self-care is important for safety and for the ability to organize the day and to allow yourself some stress relief and regrouping. During spring break I intend to drink 2 gallons of water a day and exercise 5 days a week. I will also take some time to relax my mind and regroup my thoughts and stress.

I engage in self-care via staying hydrated and exercising regularly. In clinical, I notice I don’t take enough time to drink water. However, every time I go to drink my water I usually try to drink the whole bottle or half. This might be 17 or 8 ounces at a time. I need to take more time throughout the day to hydrate. Not even just during the clinical day but the day before also. Friends that I’ve asked also complain of not taking time or having the team to hydrate. Although, one of my friends ensures she gets enough water throughout the day and is very timely with drinking water throughout her shift. Self-care is important for professional development because when you aren’t caring for your own self it’s difficult to be the best asset to the team you can be. When you’re tired, hungry, or dehydrated you can’t make the best decisions for you, your patients, or your team. Keeping yourself fueled, rested, and hydrated ensures you to run as a well-oiled machine and have the proper nutrients to fuel your body and make safe practice decisions. Self-care is important for safety and for the ability to organize the day and to allow yourself some stress relief and regrouping. During spring break I intend to drink 2 gallons of water a day and exercise 5 days a week. I will also take some time to relax my mind and regroup my thoughts and stress.