Monthly Archives: December 2017

The Miracle of Birth

The Miracle of Birth

Ashley Dyer

The most spiritual experience I had this semester was the day I was able to see my first birth while completing OB and Pediatric nursing clinical rotations at the University of Utah and Primary Children’s Hospital .

That whole morning, I sat in front of a computer screen monitoring an unborn baby’s heart rate.  Every 15 minutes I would have to chart how he was doing – what his baseline heart rate was, if there were any abnormal decelerations, etc.

The time finally came for baby to be born. I was so excited. I had gotten to know baby’s family that morning. There were quite a few family members there who would be present during the birth and they were all so anxious and excited. Rather than just watching the birth, I stood at mom’s side, with my arm on her shoulder, helping her breathe and monitoring baby’s heart rate. It was intense, despite the fact that she had an epidural.

As I watched her concentrated face as she struggled to bear down and saw her exhaustion and relief each time she was allowed to rest, my heart went out to her. And then, after minutes of contractions that involved pushing and resting, the baby finally entered the world.  His first cry was emotional and precious. The second the mother heard it, she broke down crying. In turn I was suddenly overcome with so much emotion that I surprised myself when I started crying as well. I quickly reminded myself that I needed to be more professional and  hold back the tears that kept wanting to come out. The grandmother later came over and, with a smile on her face, told me she had seen the tears.  So much for trying to be professional.  But she seemed to think it was cute.

Ashley

As I have pondered on my experience with birth this Christmas season, my thoughts have naturally turned to the experience of Mary, who gave birth to the Savior of the world in a grotto filled with animals. After taking OB and seeing an actual birth, I have come to understand how miraculous the delivery of a baby really is. There are so many things that can go wrong, especially in a natural birth. Without pain medications to ease the experience, I can’t imagine how hard it must have been for Mary that special night.

I can, on the other hand, imagine how hard the Adversary was working to prevent this birth from happening. Yet Mary was faithful and willing to keep the commandments of God. Her response to the angel Gabriel’s announcement that she would bear the Son of God was, “Behold the handmaid of the Lord; be it unto me according to thy word” (Luke 1:38). How similar these words are to the words Mary’s son would later speak as He was about to do the most difficult thing He had ever done on earth: “Not as I will, but as thou wilt” (Matt. 26:39).

So when the time came for Mary to deliver her baby, her faith allowed her to follow the Lord’s command, despite the obstacles that were placed in her way. This handmaiden of the Lord was able to discover God’s will, develop faith in God’s will, submit to God’s will, and praise God for allowing her be a part of His will (Luke 1:46-55). And I can imagine that Mary’s unexpected sacrifice to give birth in an animal-filled cave and the suffering she went through during her birth experience must have been so worth it for her.

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Have you ever held a newborn baby? And watched it look up at you, somewhat confused as its eyes accustom to the bright lights? Have you seen the purity that seems to naturally radiate from its countenance?  And the innocence that can be so easily found in its beautiful newborn eyes? After this semester, I can finally say that I have. As I cared for the newborn baby boy I had watched enter the world that special day, I could not help but think about where he had come from and what he had been called to do here on earth. I could not help but conclude that he was truly a child of God who had divine potential. And I could not help but confirm to myself that the Plan of Salvation was true thanks to the birth and lifelong ministry of the Only Begotten Son of God. And with the apostles, this Christmas season, I too would like to rejoice and declare, “God be thanked for the matchless gift of His divine Son.”

Ashley Dyer is a fourth semester BYU nursing student. She was born in Ann Arbor, Michigan and grew up in Shanghai, China.

 

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Caring for Those Who Need It Most

By Jonathan Schroeder

BYU Nursing student Emily Graham took a deep breath as she entered the surgical unit. As she inhaled, she looked at the operating table… and the blood. The patient in front of her had cut himself pretty badly. Wasting no time, Graham and the physician went to work, checking the wound for any foreign objects that might have gotten inside and placing sutures to close the wound. Once the sutures were finally placed and the wound had stopped seeping, Graham began gingerly wiping the blood off the patient. Every so often, her eyes strayed to the shackles that bound her orange jumpsuit-clad patient to the surgical table. This man had been through a lot, she thought to herself. She didn’t know anything about his past, and she didn’t need to, she reminded herself. At that moment, she was just glad to give him the care he needed.

Last spring, Graham was one of several students who participated in the At-Risk Populations clinicum for the Public and Global Health Nursing course, an experience that she and many of her fellow classmates say changed the way they view “The Healer’s Art.”

“The purpose of the course is to help students prepare to take care of patients that are vulnerable and are at more risk,” associate teaching professor Peggy Anderson explains. “The group that I teach gets to work with and serve populations that are at-risk here in the local area.”

Students enrolled in the course have the opportunity to work with patients from a wide range of backgrounds – from diabetes and disability clinic patients to inmates at adult and juvenile detention centers. Anderson says that nearly all of her students have an opportunity to volunteer for 8-10 hour shifts at either the Utah County Jail or the Utah State Prison.

“For most students, this is a cultural type experience, where they learn cultural humility,” Anderson explains. “The students learn how to care for someone without making judgments. Even though the inmate’s lifestyles may be different than the students’ lifestyles or their choices are different than what the students’ choices might be in life, the students learn to care for all of God’s children without judgment.”

“I think a lot of us are raised to think of prisoners and inmates as ‘bad people’ and that we shouldn’t associate with these individuals because they are ‘dangerous’,” Graham says. “However, I learned that many of these people are simply products of their environments, and that many of them lacked the love and opportunities I enjoyed as a child. Through learning about inmates and prison culture, I was able to see the good, the courage, and the strength many of these men possess, and also able to shake off my own prejudices and fears. I learned that everyone wants to feel loved, and everyone deserves love.”

“The inmates were really nice,” fellow student Annemarie Sudweeks adds. “I was a little scared at first because I didn’t know how they would interact. My first day was kind of weird for me, but the more I went, the more I felt comfortable interacting with them. You want to keep your distance, and keep those professional boundaries, but they’re human beings and they have feelings and you can tell that they have needs.”

During their time at the prison, students have the chance to serve inmates in a wide variety of circumstances. On any given day, students will perform physical assessments, administer and distribute medication, or change bandages for inmates.

For many students, the highlight of the course was a special musical fireside held at the women’s prison just before the end of the semester. Students shared their testimonies with many of the women they had served during their time at the prison.

“I really got to interact with the inmates in that setting more than in the clinical setting,” Sudweeks recalls. “It was cool just to see how much they want to do better and improve; you can see that they’re trying. It was reminder to me that they’re someone’s mom or daughter or grandmother and that they have a lot of potential.”

While reflecting on the impact of this course, one student wrote, “Throughout my experience I’ve been thinking about Jesus Christ and wondering about His culture. The more I look around in the world, the more I see that He does not subscribe to a single culture. When He was resurrected, He appeared to people of different cultures and He perfectly connected with people in each and every one. I could feel His love and influence as I worked with children with special healthcare needs and with inmates. I now know that Jesus’ art of healing can come to me as I attempt to understand where people are coming from. I can never perfectly understand anyone’s situation, but I know that as I try to love someone as the Savior would, the barriers of culture will crumble and I can truly connect and help people.”

 

 

 

An Act of Love

As a part of the 50th anniversary of the BYU College of Nursing, a book was compiled called “The Healer’s Art: 50 stories for 50 years.” It has been 15 years since this book was first published and these stories were shared. We plan to regularly post selections from this book to help each of us remember and cherish the experiences of nursing and learning the Healer’s art. 

An Act of Love

Laura Linton

In my last semester in nursing school, my rotation was in labor and delivery. I was assigned to a hospital that worked with an adoption agency for girls from another state. I went to clinical on Monday and during report, the night nurse told us about one of the girls in labor. At the age of seventeen, Michelle conceived through an assault from her father, who was divorced from her mother.

Michelle did not communicate much with the nurses or her family. The night nurse suggested we care for her one-on-one so she could receive better attention and care. During the day we found out a little bit more about the family. Michelle discovered she was pregnant when she started to feel the baby move (about four months). She tried to find out if she could have an abortion but it was too late. Michelle finally told her mother at eight months. They found out about the adoption agency that sends girls to Utah, because the adoptive parents live throughout Utah. Michelle and her mother decided that was the best thing to do, so they came to Utah for the delivery, even though the mother lost her job.

Throughout the day, the mother would talk with us, yet Michelle would only say a few words. One time I went in to check on her alone, without my nurse or the girl’s mother. I started joking around and tried to see how she was really doing. After a couple of minutes Michelle started to smile and glanced at me for a second. Then a little while later she kind of laughed, made eye contact, and actually had a pleasant facial expression. Throughout the day she grew to be more comfortable with me and told me how she was feeling. She was very scared. She was in a lot of pain, not only physical, but emotional. She said that she did not want to hold the baby after the birth, but did want to see the baby. She did not want to remember this as her first child. She wanted to have a family right; not the way this baby had been conceived. She had a stack of letters from possible parents sitting on her bed table. We all looked through them to see if we could pick out the perfect parents for the baby. She decided on one family if it was a girl and another one if it was a boy.

That afternoon Michelle delivered a very healthy, beautiful baby boy. He was perfect in every way. It was hard to believe what his mother had gone through to have him. We showed her the baby, asked again if she wanted to hold him. “No,” she said, so we took him to the nursery.

The next day I came back for clinical and was assigned to the post partum side. In report, we found out Michelle wanted to have the baby in her room during the night and then decided to keep him. She was sobbing all night and not verbally communicating with the nurses. Everyone was worried because the family did not have a place to live. (They had been staying in shelters for the last month.) Neither Michelle or her mother had a job or any money, and they had no place to go. They would have to reimburse the adoption agency for all the services the agency had already provided and try and find a place to go after leaving the hospital. Also, Michelle was not emotionally prepared for such a huge responsibility, especially knowing how she conceived the child. She asked to talk to a counselor to try and work things out.

Because of the time I spent with Michelle the day before and the rapport we had developed, the other nurses wanted me to care for her. I went in to find out how she was doing. Her mother was excited to see me, but Michelle wouldn’t look at me and didn’t really answer my questions. Her mother said she had never been the type to talk to anyone, and was quiet about her feelings and the issues she was dealing with.

I went back in a little bit later, sat on Michelle’s bed, put my hand on hers, and said, “I heard that you had a rough night. What happened?” The tears started pouring down her face. I held her hand more tightly, waiting a moment, until I said softly, “Do you want to keep your baby?” The tears came harder and she nodded and looked up at me and said, “Yes.” “That must be so hard to carry a baby for nine months, see such a beautiful boy and then give him up,” I replied. She nodded. “So what are you going to do?” I asked. She sat there for a moment, looked up at me again, and said, “I don’t know.”

“You must love him so much.” “Yes,” she said. I then talked with Michelle about what would happen if she kept the baby, where they would go, and what she would do. She knew the baby wouldn’t have a good life, because she didn’t even know where she was going. I shared an experience about a friend, Karen, who gave her baby up for adoption. Karen said it was the hardest thing that she had ever done. She held the baby for a couple hours, but in the end she gave the baby up.  Karen said that she loved the baby so much that she did the best thing for the baby, which was the hardest for her. She gave the baby a wonderful family that promised to take care of her and love her for eternity.

Michelle looked up at me and said, “She did that?” “Yes, she did, and she did it out of love.” I said, “If you give up this baby I know that you are doing it out of how much you love him. I do know it will be the most painful thing you have had to do so far in your life.” As she looked up at me, still with tears streaming down her face, I said, “And it is okay to cry: you need to grieve.” She held my hand tightly and sighed. It was like she needed that permission to hurt.

We talked for a while longer, looked at the adoptive families again, and talked about what the baby needed. Throughout the next couple of hours, I spent as much time as I could with her. The hospital counselor and the adoption agency representative came and spoke to her.

That afternoon Michelle decided she would give the baby up for adoption. I was there as she signed the papers with tears dripping down her cheeks. I know it was difficult to come to that decision, and I know she will grieve. I know she will physically heal from giving birth to her baby, but I also know she will forever carry the memory of her first child. I hope the memory will not always be painful. Even though I didn’t do much for her, she had someone to talk with. I gave her permission to hurt, which gave her a little bit of reassurance and strength. That day I had a taste of the art of healing by using the simple act of caring.

 

Strong Character and Values Are Just as Important as Knowledge

Piano

Whether nursing students are learning about safe patient handling, isolation precautions, or bowel elimination, there is always something that I have learned that applies to building my character as I continue in my career of becoming a nurse. This has taught that no matter what we learn, the true point is to shape our character to provide the best care possible.

The idea of strengthening values and building character also influenced my actions in my clinical experience [last] semester. I had the opportunity to work at a nursing home and dealt with many patients who had a variety of health problems.

One week, I was working with a patient. (I’ll call her Katie.) I was nervous to work with this patient as a new student nurse. Not only did she suffer from hemiplegia and paraplegia, which severely limited her movement, she also could not speak.

She had suffered a stroke a few years back and had lost her ability to talk. Her only speech was three nonsensical syllables that she would say over and over again. She communicated by the tone of her voice saying those syllables and by moving the one arm that she still had control over.

Nothing in nursing school had prepared me for this. How was I supposed to help someone that could not even express to me what she needed? I spent over an hour looking for her glasses that first day. She became upset with me, and I left at the end of the day feeling extremely frustrated.

That weekend I completed my mid-semester evaluation where one of the categories was evaluating my caring ability. I rated myself on how I met my client’s biopsychosocial needs in a caring and compassionate manner. I knew this was something I needed to improve and I remembered back to my N295 Fundamentals class, where the professor would explain that the important lesson was not just the knowledge that we learned but how it contributed to our character and values.

I went to the care center the following week with a renewed resolve on how to care for my patient.

Since this was the second week caring for Katie, I knew more of her daily routine. I was able to get her ready for breakfast, but we arrived 20 minutes early, and preparation for breakfast was underway.

I saw a piano in the room and asked if she had ever played the piano. She nodded that she had, and then motioned to ask me if I knew how to play. I responded in the affirmative and she pointed at me again to go to the piano as if she wanted me to play.

I knew accompaniment was not in the scope of my duties as a student nurse. However I had promised myself to do all that I could to care for her, so I sat down at the piano. The only book on the piano was an LDS hymnal; I knew she was LDS, so I started playing for her.

The amazing thing was that even though she could not speak, the stroke did not affect the area of her brain that dealt with singing. She sang the notes of the melody to every song I played. I have never seen someone happier than Katie at that moment. For a brief time, I even had the whole room singing a hymn with me.

When finished, even though she could not fully express it, I knew she was thankful that I played the piano. I appreciate the opportunity to go out of my comfort zone and do my best to be sensitive to Katie’s needs, even though what I did was not a normal nursing duty.

The next week at the care center I found out that Katie had passed away. I am thankful that I took the advice of my professor and worked attentively to meet Katie’s needs and lift her spirits. I am blessed to know that in her final days, I was able to provide the best care possible.

Winner of the college’s annual essay contest, Claire Hunsaker is a third-semester nursing student from El Dorado Hills, California.

Sabbath Around the World

The Lord has frequently declared that we are to keep the Sabbath Day holy. Earlier this month we explored BYU nursing professors balance work responsibilities with this commandment while working on Sundays. Now we highlight some of the various ways that students in the clinical practicum for the Public and Global Health Nursing courses sanctify the Lord’s Day while serving others in their diverse locales.

Veterans

After church services, the Veteran group visits Arlington Cemetery where many of the United States’ war veterans are interred. The group participates in the Changing of the Guard and a wreath ceremony while touring the grounds. Students present on veterans that they have researched.

“It’s a spiritual feast every year to be in such a sacred place, where all who are there have given the ultimate sacrifice,” says teaching professor Dr. Kent Blad, who heads the group. “’Greater love hath no man than this, that a man lay down his life for his friends’ (John 15:13). It’s my favorite day of every year.”

Vets

Samoa

In Samoa, students tend to volunteer with the local wards.

“We divided the students up and some helped in the nursery, some substituted primary and taught about the love of God for all his children, and some worked with the young women-all in an English speaking ward,” writes assistant teaching professor Gaye Ray of one of her trips to Samoa. “Another Sunday we attended a Samoan-speaking ward and participated in the fast and testimony meeting.” Students also met a 92-year-old convert and visited the Samoan temple.

“In all sites we use the day for personal study, reflection on lessons learned about humility and what it means to be culturally humble, gospel truths, along with discussions surrounding our observations on ‘locally appropriate’ cultural adaptations of church programs and how they bless the lives of the saints in the country,” Ray says.

Neil

Finland and the Czech Republic

Associate teaching professor Dr. Leslie Miles explains that students visit the small Savonlinna branch in Finland, give talks, and present musical numbers. She describes it as the “highlight of the year for the members.” Afterwards, the students take flowers to the local cemetery, tour houses, walk in the forests, and talk with the missionaries.

In the Czech Republic, students visit other churches and learn about various religions.

Ecuador

Ghana

The Lord’s work doesn’t stop on the Lord’s day. Students who travel to Ghana will do blood pressure and blood glucose checks for local ward members on Sunday.

“A favorite activity is to have a fireside with the Abu family and hear first-hand about the conversion story of African pioneer members,” says associate teaching professor Karen de la Cruz, who heads the Ghana trip. “We have also had the sweet opportunity to have a dinner and testimony activity with the missionary couple that serve in the Abomosu sub-district.”

Eat

College Begins Recognition of DAISY Honorees

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Sage Williams (left), Dean Patty Ravert, and Julie Valentine.

The BYU College of Nursing has partnered with the DAISY Foundation to begin a new tradition and recognize an extraordinary nursing faculty and student each semester. Last October we were pleased to recognize assistant professor Dr. Julie Valentine with the first DAISY Faculty Award and Sage Williams as the DAISY In Training Award recipient.

The DAISY Foundation (an acronym for Diseases Attacking the Immune System) was established in 1999 by the family of Patrick Barnes, as a way to honor him after he died of complications of the auto-immune disease ITP. Pat’s family created the DAISY Award for Extraordinary Nurses to honor registered nurses who make a difference in the lives of patients and families experiences in healthcare (some of our alumni have received this distinction).

The DAISY Faculty Award provides national recognition and appreciation to nursing faculty for their commitment and inspirational influence on their students. The DAISY Student In Training Award is designed to remind students, even on their toughest days in nursing school, why they want to be a nurse.

Each January and September, the College of Nursing will accept nominations at nursing.byu.edu of a nursing professor or student that reflects compassion and exemplifies the Healer’s art. Recognition occurs at the college’s professionalism conference in February and the scholarly works and contribution to the discipline conference in October.

DAISY Faculty Award

CMH01731-1Julie Valentine is an assistant professor and also a certified adult/adolescent sexual assault nurse. Dr. Valentine focuses on multidisciplinary, collaborative research studies uniting disciplines in sexual assault case reform to benefit victims and case processing. In 2015 she was the primary author of two grants totaling $3.2 million for the testing of previously untested sexual assault kits and the resulting investigation and prosecution of these rape cases in Utah.

She is engaged in a collaborative research project with the Utah state crime laboratory exploring the impact of new DNA testing methods in sexual assault cases, and a collaborative law enforcement study on trauma-informed victim interviewing in sexual assault cases. From 2014 to 2017, she served on the Sexual Assault Forensic Evidence Reporting committee with the National Institute of Justice developing national best practice policies in sexual assault cases.

In 2016 Dr. Valentine served on the BYU Advisory Council on Campus Response to Sexual Misconduct which investigated Title IX implementation and recommended substantial policy and structural changes. As a mother of eight children and two grandchildren, Julie is an influential teacher wherever she goes. Whether at the lectern, hospital, courtroom, legislative floor, church or home, she shows love, compassion, and a kind listening ear with everyone.

Of interest, her favorite holiday is Valentine’s day, when her family sends our Valentine cards and enjoys making dozens of yummy treats to share with neighbors, friends, and co-workers.

DAISY In Training Award

CMH01733-2Sage Williams (BS ’17) became a research assistant at the end of nursing semester one, working with faculty members Dr. Julie Valentine, Dr. Linda Mabey, and Dr. Leslie Miles on multiple research studies on sexual assault victims throughout Utah. Her passion for caring for underserved and vulnerable individuals expands beyond the research arena to immersing herself in volunteer work.

She takes a monthly 48-hour call as a victim’s advocate in Utah County for sexual assault victims with Center for Women and Children in Crisis, volunteers at the University of Utah Health Burn Camp program for children, and worked this past summer in a family refugee camp in Greece for children and families fleeing Syria. Of note, she left the camp to join faculty members in Dublin, Ireland to present at the International Sigma Theta Tau conference. While there, Sage only had sandals to wear because she had given her shoes to those more in need at the refugee camp.

Her plans include obtaining a DNP as a psychiatric mental health nurse. She is truly an exceptional nursing student who emulates the Healer’s art and will make a difference in the world, especially with those who have been traumatized.

Who Comforts Nurses?

Note: See our Facebook page (https://www.facebook.com/BYUNursing/) for this article’s accompanying video

Who comforts nurses?

It’s a question that may feel odd to ask, given that nurses care for and comfort others. People sometimes forget that nurses are human too.

So who is the designated person for nurses to turn to when their workload seems to be overwhelming them?

“Unfortunately sometimes nobody,” explains assistant teaching professor Stacie Hunsaker. Hunsaker studies two phenomenon that occur frequently in the nursing profession—burnout and empathy fatigue.

Burnout, she explains, is “exhaustion from the demands of work” and can happen in any job. Empathy fatigue is a condition that is a bit more specific to healthcare and has reaching consequences.

“That is when a healthcare provider feels too tired to care,” Hunsaker explains. “Maybe they’ve had a lot of emotional patients, a lot of emotional cases, a lot of things that cause almost PTSD. They didn’t experience the event that caused the stress, but by caring for others and having that empathy for them, it hurts them. People often build up a hard shell to prevent more hurt, so they stop caring.”

When a nurse experiences empathy fatigue, it can deeply affect the way he or she treats patients.

“Most of us decide to enter nursing because we love people and we care for people, and if you build up a wall, you can’t make that connection with a patient,” Hunsaker says. “It really can negatively impact the patient’s care. A lot of research has shown that it can negatively impact even a patient’s recovery.”

How common is empathy fatigue? According to Hunsaker, it’s fairly prevalent.

“There are a lot of studies and a lot of research that it’s most often recognized and probably the biggest problem in those areas that have more exposure to death or dying or psychologically exhausting patients,” she says. These areas include intensive care units, emergency departments, and oncology.

Luckily, research has also shown ways to combat empathy fatigue. Some are basic, such as getting enough sleep, exercising, and eating well. Hunsaker recommends that new nurses avoid picking up too many overtime shifts and take sufficient time to focus on themselves and their relationships with others outside of work. Positivity is also an important tool.

“The number one thing that’s easy to do that I would suggest for nurses is every night before you go to bed write down three good things that happened to you,” she says.

Additionally, nurses need to find someone who they can turn to for help. Research has shown that those who comfort in turn need someone to comfort them.

“I teach and try to tell my students and new nurses to talk to somebody that you know gets it or understands,” Hunsaker says.

One of these sources can be Heavenly Father.

“I can’t imagine practicing nursing without prayer and without praying before a shift, without praying before a difficult case or after,” Hunsaker says.