Have to Pee in the Pool?

January 15, 2012 by Amy Sellers - Leave a Comment

I can’t believe that it’s been 2.5 months since I’ve posted on Nursing Influence. Although, since I have grad school (my FNP program) to blame, I don’t quite feel as bad. :-P

I’ve been spending this gorgeous 70-degree January weekend inside studying fluid, electrolyte, & pH balance. I can definitely say that I’m getting quite a bit done. But, as I was reading I came across the most interesting fact of the week and wanted to share it here!

 

BNP (brain naturetic peptide) is one of the reasons why people feel the need to urinate after getting in the pool. The increased pressure on the body drives more fluid into systemic circulation which leads to a slight increase in preload. In response to the increased preload, the ventricle secretes BNP, which has a natriuretic effect and leads to an increase in urine production.

Who knew?!?! :)

Nursing and Health Policy

October 30, 2011 by Amy Sellers - Leave a Comment

I just started a new class in my NP program – Ethics, Policy, & Finance. So far, I’m totally loving it. I’ve always loved aspects of business (which is why I took extra classes in undergrad to get a minor in business), but it’s even more interesting hearing about aspects of business that specifically relate to the field of nursing. Our first section is focused on health policy and changes in healthcare through the last 100 years.

Excited :) I’m sure there will be more posts to come on these topics

(my last course was nursing research which was very uninteresting as far as blog posts go)

California Prevents San Fran Circumcision Ban

October 3, 2011 by Amy Sellers - Leave a Comment

I heard about the proposed ban earlier this summer and while I can’t say I was shocked (it is San Fran, after all), I was annoyed. I can see their side of the issue… babies unwillingly having a piece of their skin cut off. But where do we draw the line? There are a lot of things that occur within medicine that aren’t pleasant… immunizations, IVs. If I were a boy, I would hope that my parents would have gotten me circumcised when I was an infant. I know that my grandpa was circumcised when he was 19 years old due to an infection… I bet he wished he had it done when he was too young to remember it.

Circumcision is not just a cosmetic procedure. Boys/men who have been circumcised have a lower incidence of bladder infections, reduced incidence of balanitis (inflammation of foreskin/head of penis), reduction in spread of HPV to women during intercourse, as well as improved body image and ease of male hygiene.

 

California Governer Signs Law Preventing Male Circumcision Ban

By the CNN Wire Staff
Sun October 2, 2011

(CNN) — California Gov. Jerry Brown signed into law Sunday a bill that prevents local governments from banning the practice of male circumcision.

The legislation comes in response to an effort this summer by a San Francisco Bay Area advocacy group opposed to the practice to get a measure proposing a citywide ban added to the November 8 city ballot.

In July, a Superior Court judge ordered the proposed measure removed from the ballot, saying that male circumcision is “a widely practiced medical procedure” and that medical services are left to the regulation of the state, not individual cities.

The legislation signed Sunday, which takes effect immediately, prohibits governments at the local or county level from “restricting the practice of male circumcision” and “declares that the laws affecting male circumcision must have uniform application throughout the state.”

Cath Lab University

September 28, 2011 by Amy Sellers - Leave a Comment

Our cath lab shared leadership (shared governance) team decided that we’d like to help our hospital staff better understand what goes on in the cardiac catheterization lab which will lead to better patient education and care. So, we have broken the cath lab procedures into 3 basic categories: diagnostic, interventional, and EP studies/device implants. We will be putting on 3 different presentations to cover these topics.

Last week, we started with our first of the presentations (on diagnostic caths). We used one of our cath labs and set up a “sterile” tray, brought in a mannequin, and turned on our equipment. We presented 30-minute mock caths, where we talked about topics like pre-procedural prep, sterile fields, coronary anatomy, and closure devices. We had about 60 staff members come through the lab in just a few hours and received positive feedback from the staff who attended.

I’m honestly really proud of what our team put together – I think programs like these do nothing but help the staff to care for our patients.

Lacking Education

September 24, 2011 by Amy Sellers - Leave a Comment

One thing that’s been hard for me while working in the cath lab is the lack of education I’m able to give to my patients. I love educating. I really think that patient education is a highlight of what nurses can do to make a difference in the lives of their patients.

Working in a procedural area, it’s not breaking news that we don’t get to spend much time with our patients (while they’re awake anyways). When we roll patients into the cath lab, they are usually nervous, so I focus on small talk to take their mind off of the procedure or do some pre-procedural education about what to expect at the start of the procedure (deciding between the two is based on a quick judgement about how the patient is feeling as I first meet them in their room before the cath). Then, they’re sedated for the procedure…

After the cath, they are usually groggy which leads to short term memory issues (they can barely remember that we told them the procedure was over, let alone information about which artery has blockage). If the patient’s post-sedation state of mind isn’t the issue, the patient has often gotten news they might not have been expecting, such as needed open heart surgery or receiving stents, which cause the patient to focus on those facts and limits their ability to take in other information.

So, that’s been one of my issues. I would love to educate patients on the importance of taking their Aspirin and Plavix, or the importance of risk factor modification based on the results of the cath. I miss having that opportunity.

During a recent on-call shift, we were called in to cath a 38 year old female who was having a heart attack. She has a significant medical history of high blood pressure, smoking, diabetes, and obesity as well as noncompliance of medication. Her cath showed a stumped off LAD (completely blocked coronary artery) and partial blockage in her other two arteries. When asked, she admitted that she often had trouble paying for her medications. There is an obscene amount of education that this patient needs: importance of taking her plavix, financial resources for medications, smoking cessation, importance of diabetes control (her glucose was 360), and the effect that smoking, obesity, and noncompliance with blood pressure/diabetic medications have on the arteries in the body.

But, after opening up her LAD with a stent, we took her to the ICU for recovery. Chances are that I’ll never see her again or know what happens in her life.

This is my motivation for becoming a nurse practitioner… continuity of care.

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