iStan Reflective Journal

Reflective Journal: To be completed individually and turned into Mrs. Dukes the Thursday after your simulation rotation.

1. Discuss 4 tasks you completed or tried to complete in simulation lab.

·         Followed through with arranging the urology consult.

·         Coordinated our health care team’s treatments, etc. (Role of “charge nurse”)

·         Ensured the right equipment was easily accessible for team.

·         Dosage calculation for IV ABX; reconstitution of medication.

2. What did you learn most about the situation(s) you encountered in simulation lab?

·         We were able to work really well as a team when we had a set plan and worked together as a unit instead of four separate nurses.

3. What will you do differently during your next simulation experience?

·         Be more conscious about putting my gloved hands in my pocket

·         Write down SBAR before calling doc.

4. While watching your peers’ simulation experience, what are 3 things you learned?

·         Asses allergies every time before giving meds even if you already did it.

·         Be ultra cautious when labeling lab samples; it’s a “fire-able offense” at hospitals if you mislabel a sample.

·         Be more cautious about proper body mechanics.

5. What 3 things did you learn in the classroom (didactic) that you put into practice during your simulation experience?

·         Be cautious of drug interactions, especially in elderly patients.

·         Giving a medication to help one problem can often cause another problem to arise.

·         AMS in an elderly person is a big clue to diagnose dehydration/UTI.

Crispr-CAS9 say whaaaatt?!

This article, though hard to understand because of the prolixity and complexity of the subject matter, is still very fascinating! The main focus of the article was to discuss the bright future, and existing challenges of clustered regularly interspaced short palindromic repeat (CRISPR) technology and the importance of developing customizable specificities, such as CAS9, to improve its capabilities.  This technology, when mastered, will enable scientist to target specific gene mutations in DNA, cut out the faulty sequence and insert the correct sequence, thus curing the genetic disease.  Even more exciting, scientists are currently creating large Guided-RNA (gRNA) libraries which will not only be able to target one specific gene mutation, but THOUSANDS all at once! These libraries currently contain about 67,000 to 84,000 separate distinct gRNA’s and have shown to be effective phenotype screens in both human and mouse cells!  This biggest obstacle that the CRISPR-CAS9 developers are facing right now is the effects of “off-target” effects.  “Off-target” effects are defined as nucleotide cleaving at an unintended site of the DNA.  So far, they have found that these effects are much more detrimental if they occur at the 5’-end rather than the 3’-end. So far, the best strategy for preventing these negative effects is to lower the concentration of the gRNA and/or CRISPR-CAS9 being expressed in the human cells.  I, for one, am very excited to see where this technology leads us! https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4022601/

Hi Lauryn!!!!!!