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.