It is hard to believe we have moved through so much of our program. One of the goals of our service learning project was to develop a long term, strong relationship as a volunteer. My work with the American Heart Association certainly meets any of those goals! I must have triple the needed hours dedicated during this semester and foresee a very long future relationship with AHA and its volunteer teams.
We have designed the order sets for rural facilities sending patients having heart attacks to the tertiary care facility. It is all evidenced based. except for the (funny, odd) situation:
The use of oxygen with acute myocardial infarction can not be "proven". When studied, it did not change oxygen saturation or outcomes. Can you even imagine if we sent out our policies without oxygen application? Those who have Advanced Cardiac Life Support know MONA (Morphine-Oxygen-Nitroglycerin-Aspirin). It is so traditional!! We vote next week to decide whether or not to keep this non-EBP intervention. What do you think we should do???
My work with the AHA has been a bit of a roller-coaster ride this term. There are some national policies which if activated would eliminate most facilities from participation. I was a strong voice against these very high membership fees. The national office of AHA met by phone with me and several of my team members. That result is not known. I was very proud of the cardiologists who joined me in confronting the AHA. I believe they temporarily lost their mission/vision and will drop the fees ($21,000) for inclusion in the heart attack network. we will see.
All said and done, I am dedicated to this volunteer relationship. I've had to drop other volunteer relationships while in school (flying veteran to Washington DC and horse rescue) and enjoy knowing I'll be back into those situations in just one year.
Thanks for reading my blog! Best wishes to all my fellow students as we come down the home stretch.
Julie Benz
Sunday, August 14, 2011
Sunday, June 26, 2011
NR715B Midterm Blog for Julie Benz
Midterm Service Learning Blog, June 26, 2011
I believe I could have the best service learning project –ever! I am volunteering hours to evidence base the rural health care delivery to acute coronary syndrome patients. This matches my Capstone project perfectly. I have a team of three cardiologists, one Emergency Room physician, one MPH, two cath lab leaders and two other nurses. My co-champion is one of the cardiologist and from a totally different system (Banner) and perspective.
We have made enormous progress. We developed orders sets. The docs tend to put the orders in the priority of medical driven orders first. I suggested the group place the orders in the order of care delivery. They honestly had not thought of that! I was glad I was on phone conference call, so I could mute my end as I giggled! Well, that did not take a clinical nurse expert to fix, but it will make a difference when the critically ill cardiac patients come through the rural ED doors.
I attended the national conference for STEMI care in Chicago in mid-May. It was STEMI heaven. All of the major contributors to cardiac research journal writings were present. I talked with everyone. I did not miss a class (I did miss a trip to the aquarium to write one of our NR 707 papers!) and learned many things. South Dakotas has a grant from the Helmsley Family for 11 million. They have set up a perfect system. It is true, money talks. The have set up unbelievable resources. The Chicago Fire Department does not have 12 lead EKG machine in every rig. Honestly- the action plan is to ask OPRAH for the money. They were serious……
I learned that rural health care is best served if the geography is flat, not challenged with rivers or mountains. Everyone is working on defining their service area, mostly with circles around the tertiary care facilities. The international leaders from Duke University asked for my map!! I will take all of this back to our team. We have been careful to not become prescriptive as cases = business=money. It is interesting how little of the topics were about advances (one new medication: anti-platelet substitution for Plavix®) and now it is all about access.
If I had to change anything, I would like to see other states and their rural access programs. We hear about things, but filtered throught American Heart Association. I would like to talk with the nurse leaders in teh states with success (not jus the docs). My role is so active, I can not imagine changing anything else at this time.
I am in the right place at the right time. I have 37.5 services learning hours thus far with 42.5 hours for the two semesters. Hope everyone is enjoying this as much as I do……. I am making a difference.
Monday, April 18, 2011
Final Service Learning Blog for Spring 2011
The volunteers for Mission LifeLine at the American Heart Association (AHA) are present every meeting, contribute to email threads and take charge of the issues at hand. This group includes professors of medicine, politicians, Public Health Department staff, MPHs, Nurses, cardiologists and the cath lab staff. We have added EMTs and Fire Fighters from rural settings. It is not the group you’d expect to donate hours per month to a cause! The binding factor is belief in the service we will provide when finished. This process could not be launched from any single facility and must be politically neutral so the AHA is the perfect setting.
The other steps which will happen in 2011-2012 will be work in the community setting, with the Critical Access Hospitals and Emergency Medical Services. This will be a challenge and I hope we all can continue in our politically neutral stance.
• What was the best/worst/most challenging thing that happened this semester?
The best thing that happened was the team nominating me and selecting me to co-chair the evidenced based practice arm of the MLL work. This is a huge honor and I am the only non-physician leader in the state. There really have not been “worst” experiences. It has been smooth sailing thus far.
• What have you learned about yourself?
I learned to build these hours into my expectations of myself. All of volunteering in the past had been lectures, trips for veterans to Washington etc. Those are timed, come and pass through your life. This volunteering is rigorous, somewhat always present and time consuming. I tracked my hours for SL and I have >30 hours this semester. Had I not tracked that I would have guessed at 10 hours!
• What are your future service learning plans?
I will see this project to its completion or extinction. We want a statewide network of cardiology services for the very critically. I hope this finishes and has a product by the end of 2012. That may be ambitious. I want to take another group of veterans to Washington DC before the WWII veterans are only a memory. While in school I’m thrilled to get to the grocery every two weeks, so I have nothing new planned for the next 13 months!
Sunday, February 20, 2011
Midterm Service Learning Blog Entry
As hesitant as I am about the use of this blog, I am not hesitant to share my Service Learning project with anyone willing to listen (or read)! Welcome to my SL project!!!!
How would you describe your SL site?
Where are you Serving? I am doing volunteer work with the American Heart Association. I have worked with this team for two years and I was pondering how to proceed with my SL project when they sent me an email and asked if I would co-chair the Evidence Base Practice portion of the project I had been so attached to for the last several years. The project is called Mission Life Line. I meet with team of professional cardiac care providers from the entire state of Colorado. The meetings are at the AHA on Parker and Leetsdale Roads, Denver.
What does the agency do?
Almost everyone is familiar with the AHA. They sponsor programs to increase the public awareness of heart diseases: heart attack and stroke. The AHA is involved with many professional level activities including funding, research, education, sponsorship, publication and conferences. This project is sponsored by the American Heart Association and the American College of Cardiology (ACC). It is a national level project, with the Rocky Mountain region involved in the current work.
Who are the clients and what needs are served?
Our team is working on the state of Colorado and specifically we are reviewing the assets in rural setting for care of the ST Elevation Myocardial Infarction (STEMI) such as Critical Access Hospitals, pre-hospital service providers and incidence of transport for STEMI. We are working to identify the needs for access to major hospital providers for percutaneous coronary interventions for STEMIs.
What is the agency funding support?
The AHA is funded by donations from the public and major contributors of industry such as Southwest Airlines, Qwest, Direct TV, Kellogg Foundation etc.
What is it about the community partner that calls you to work with them?
Why are you engaged with this agency?
I became interested in the AHA when I heard they were looking for a manner to develop a network of hospitals which would cover acute cardiac illnesses. I had been envisioning a Level I Cardiovascular Center program, much like the Trauma Service levels of care. I admire the Trauma program, sponsored by the American College of Surgeons and knew I need a huge sponsor, with political neutrality (not the ACC) to take on a project destined to last a decade. When I approached the AHA they enveloped me. It was a match made in heaven. I had a successful STEMI program, was willing to travel around the country and lecture for the AHA. The AHA offered the network of peers, all determined to make this system happen.
What is your passion here?
I remember the trauma services banding together to build the levels of trauma providers. Political barriers, funding barriers, temperament barriers and facility barriers prevailed.. The teams persisted and it has grown into one of the best system of health care delivery in the world. I want the same for the cardiac patients. It should not be based upon pride or rumors which Emergency Departments have the back up to provide 24/7 care toe STEMI patients. It should be pre-planned, well know, well defined and designed to save lives, not reputations.
As a new nurse, I watched as the STEMI population- uniformly died. We had no interventions. We had no treatments to offer, other than morphine for comfort. I now see people every day who left untreated would have died, but walk out of the hospital in 36 hours- comfortable, pink, warm skin, cognitive and pain free. I think it is incredible and I want this for all people. The AHA can help us provide this care.
What is your current role in this SL experience?
I am the co-chair of the evidenced Based Practice Committee of the Mission Life Line project for the Rocky Mountain region, sponsored by the AHA and ACC. I just assembled about three dozen recent publications for the team to review (mostly the same as as our literature review!). We will have a meeting on Weds Feb 23, another in April which I will co-chair with a cardiologist from Banner in Greeley.
What hours did you spend at the site and what activities were performed?
So far, I have attended the meeting in which they nominated and elected me co-chair (January). I have communicated with Dr Jim Beckmann (cardiology co-chair) to design and set up the meeting for Wednesday. I have reviewed the applications for the team and made recommendations to the AHA. The AHA will contact the members as they need paper work (conflict of interest documents). I believe I have about 8 hours in the project at this time and will have at least four more this week. the anticipated workload will be 4 hours of prep for 3 hours of meetings per month. Independent review of the literature and work with Dr Beckmann will add another 6 hours/month.
What are the opportunities there?
The opportunities are limitless. I have turned down a position at the AHA as I wanted to be on the resource side of Mission Life Line. We will publish our work, present around the country and set a benchmark for other regions. The team is so impressive, I stand in awe: Governor's office, MPHs from Rural programs, EMS, and University of Colorado, cardiologists, nurse program managers, researchers and pre-hospital service providers.
What can you see yourself doing more long-term?
The work group is so impressive, I decided I needed a doctorate to continue on with the team. This project is the reason I'm seeking my DNP. I hope to work on this issue until my retirement in 11 years. I hope to successful start Level I, II, III CV Centers and then assist other regions in the same work. I want to study and document the impact of this type of program. I want to push the margin and assure the highest level of clinical standards are set, avoid the politics of the facility competition and save lives. I am in this for the long run and my DNP is a very nice launching pad. The team is very supportive of my SL project and Capstone.
Thank you for the opportunity to present this story to you all. I am very passionate about this work and enjoy every minutes of every time it consumes!
Julie Benz
How would you describe your SL site?
Where are you Serving? I am doing volunteer work with the American Heart Association. I have worked with this team for two years and I was pondering how to proceed with my SL project when they sent me an email and asked if I would co-chair the Evidence Base Practice portion of the project I had been so attached to for the last several years. The project is called Mission Life Line. I meet with team of professional cardiac care providers from the entire state of Colorado. The meetings are at the AHA on Parker and Leetsdale Roads, Denver.
What does the agency do?
Almost everyone is familiar with the AHA. They sponsor programs to increase the public awareness of heart diseases: heart attack and stroke. The AHA is involved with many professional level activities including funding, research, education, sponsorship, publication and conferences. This project is sponsored by the American Heart Association and the American College of Cardiology (ACC). It is a national level project, with the Rocky Mountain region involved in the current work.
Who are the clients and what needs are served?
Our team is working on the state of Colorado and specifically we are reviewing the assets in rural setting for care of the ST Elevation Myocardial Infarction (STEMI) such as Critical Access Hospitals, pre-hospital service providers and incidence of transport for STEMI. We are working to identify the needs for access to major hospital providers for percutaneous coronary interventions for STEMIs.
What is the agency funding support?
The AHA is funded by donations from the public and major contributors of industry such as Southwest Airlines, Qwest, Direct TV, Kellogg Foundation etc.
What is it about the community partner that calls you to work with them?
Why are you engaged with this agency?
I became interested in the AHA when I heard they were looking for a manner to develop a network of hospitals which would cover acute cardiac illnesses. I had been envisioning a Level I Cardiovascular Center program, much like the Trauma Service levels of care. I admire the Trauma program, sponsored by the American College of Surgeons and knew I need a huge sponsor, with political neutrality (not the ACC) to take on a project destined to last a decade. When I approached the AHA they enveloped me. It was a match made in heaven. I had a successful STEMI program, was willing to travel around the country and lecture for the AHA. The AHA offered the network of peers, all determined to make this system happen.
What is your passion here?
I remember the trauma services banding together to build the levels of trauma providers. Political barriers, funding barriers, temperament barriers and facility barriers prevailed.. The teams persisted and it has grown into one of the best system of health care delivery in the world. I want the same for the cardiac patients. It should not be based upon pride or rumors which Emergency Departments have the back up to provide 24/7 care toe STEMI patients. It should be pre-planned, well know, well defined and designed to save lives, not reputations.
As a new nurse, I watched as the STEMI population- uniformly died. We had no interventions. We had no treatments to offer, other than morphine for comfort. I now see people every day who left untreated would have died, but walk out of the hospital in 36 hours- comfortable, pink, warm skin, cognitive and pain free. I think it is incredible and I want this for all people. The AHA can help us provide this care.
What is your current role in this SL experience?
I am the co-chair of the evidenced Based Practice Committee of the Mission Life Line project for the Rocky Mountain region, sponsored by the AHA and ACC. I just assembled about three dozen recent publications for the team to review (mostly the same as as our literature review!). We will have a meeting on Weds Feb 23, another in April which I will co-chair with a cardiologist from Banner in Greeley.
What hours did you spend at the site and what activities were performed?
So far, I have attended the meeting in which they nominated and elected me co-chair (January). I have communicated with Dr Jim Beckmann (cardiology co-chair) to design and set up the meeting for Wednesday. I have reviewed the applications for the team and made recommendations to the AHA. The AHA will contact the members as they need paper work (conflict of interest documents). I believe I have about 8 hours in the project at this time and will have at least four more this week. the anticipated workload will be 4 hours of prep for 3 hours of meetings per month. Independent review of the literature and work with Dr Beckmann will add another 6 hours/month.
What are the opportunities there?
The opportunities are limitless. I have turned down a position at the AHA as I wanted to be on the resource side of Mission Life Line. We will publish our work, present around the country and set a benchmark for other regions. The team is so impressive, I stand in awe: Governor's office, MPHs from Rural programs, EMS, and University of Colorado, cardiologists, nurse program managers, researchers and pre-hospital service providers.
What can you see yourself doing more long-term?
The work group is so impressive, I decided I needed a doctorate to continue on with the team. This project is the reason I'm seeking my DNP. I hope to work on this issue until my retirement in 11 years. I hope to successful start Level I, II, III CV Centers and then assist other regions in the same work. I want to study and document the impact of this type of program. I want to push the margin and assure the highest level of clinical standards are set, avoid the politics of the facility competition and save lives. I am in this for the long run and my DNP is a very nice launching pad. The team is very supportive of my SL project and Capstone.
Thank you for the opportunity to present this story to you all. I am very passionate about this work and enjoy every minutes of every time it consumes!
Julie Benz
Everything has a first time.....
February 20th
This will be my first post and I feel like a total novice at this! I once had my own web site for my horse breeding operation and was very good at programing it and linking to others.... It has been too long. This is a foreign assignment for me and I hope with my peer group input, I'll get it right! See you all again soon.
Julie Benz
This will be my first post and I feel like a total novice at this! I once had my own web site for my horse breeding operation and was very good at programing it and linking to others.... It has been too long. This is a foreign assignment for me and I hope with my peer group input, I'll get it right! See you all again soon.
Julie Benz
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