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September 2022 CNSA - SACRAMENTO STATE CHAPTER VOLUME 41, ISSUE 1

One Day at a Time

By Rebecca Acoba
CNSA Historian
2nd Semester

I have been in nursing school

for a full semester now and am
Considering Culture
starting my second. One thing
During End-of-Life Care
I can say is that it goes by
quickly! One of the principles I
Page 2
try to always keep in mind is
Community Health
to take it one day at a time.
Nursing vs Acute Care
Each day has its own troubles,
Nursing
so focus on today. One of the
Page 3
things I have strived to work
Importance of Listening
on throughout this journey of
Page 4
nursing school is self-care. For
Pressures as a Second-
me, self-care during nursing
Language Speaker in
school has meant learning to
the Healthcare Setting
take breaks. Spending time with my loved ones both friends and family has been a good
Page 5 mental reprieve and has been a means to greater enjoy this journey over the next two
My Time at Camp Krem years. I have learned that self-care is about actively choosing to take these pauses. I
Page 6 have heard so often that we need to take care of ourselves before we can take care of
HHS Fall Kick-Off others (our patients). And I thoroughly agree with this statement. Our patients deserve
Event! this care, a care that is focused, achieved, and cultivated once we have taken care of
Page 7 ourselves. This career of nursing is an opportunity to serve others and be there for
Covid-19 and Monkey- people when they are going through one of the hardest times of their life. To do that,
pox Updates we also must remember ourselves. The passion for the care we pursue for our patients
Page 8 should also be pursued for ourselves. Self-care can look different for each of us, it could
Mental Health Re- be going for a walk after class, watching an episode of our favorite show, making our
sources favorite meal for ourselves, a quick boba stop, or a Facetime call with loved ones. We
Page 9 all should make it a priority in our lives, to also find these outlets to take a break.
Campus Resources
Page 10
Nursing Meme Corner
Page 11
Updates & Such
Photos from CA Coalition for Youth
Page 12
 THE MONTHLY SHOT PAGE 2

Considering Culture During End-of-Life Care

By Mariely Guevara Lopez

Death and dying are perceived differently according to cultural back-

ground, ethnicity, or religious orientation. In Hinduism, people consider
death to simply be another step within the trajectory of life, whereas, in
Christianity, it is viewed as the day of the final judgment. For nurses to
understand how a group of people manage the End-of-Life (EoL) process,
they must explore cultural backgrounds along with religious values, be-
liefs, traditions, communication styles, and familial relations. The Filipino
culture is one that values collectivism; Filipinos are exceptionally hospita-
ble and family oriented as they care for their elders during times of illness
(Dela Cruz & Periyakoil, 2015). They are also known to be extremely hard-
working and caring in nature, especially when it comes to supporting their
families. This explains why so many from the Filipino culture pursue nurs-
ing.
Communicating with Filipino patients and their families during the EoL process requires nurses and other members
of the inter-professional team to utilize a culturally competent and sensitive approach. While caring for Filipino patients,
nurses should refrain from addressing the elderly by their first names as familiarity might be perceived as disrespectful
or rude (Dela Cruz & Periyakoil, 2015). Most Filipino patients speak perfect English indoctrinated within their educa-
tional system; however, clinicians must keep in mind that not all Filipinos had adequate access to education to learn
English while growing up in the Philippines. In the face of such, clinicians can facilitate language using medical interpret-
ers with the goal of engaging patients, family members, and caregivers during high-stress, EoL situations (Lowey, 2015).
Clinicians need to ask for permission to access interpreters and explain that interpretive services are beneficial tools to
ensure the clarity of complex, medical conversations.
As the time of death approaches, nurses should also consider the cascade of events that will occur during and even
after death often referred to as bereavement. Nurses advocate and facilitate patients’ wishes regarding care preferences
during the dying process (Lowey, 2015). Simple interventions go a long way and mean so much for the patient and fami-
ly. Nurses can provide constant oral care, comfort repositioning, and monitor changes in respiratory patterns to alleviate
unnecessary pain for the patient at the time of death. They are also responsible to monitor for patient changes often
seen hours prior to death including a decrease in bodily fluid output (e.g., urine), skin changes in color (mottling) or
temperature, decrease in their level of consciousness, and altered behaviors (Heart House Hospice, 2017). Patient and
family education on the passive and active dying phases is just as important as clinical skills. The care clinicians provide
to patients and families during EoL will be remembered even after the death of a loved one, so it is highly important that
interventions occur in a timely manner with the highest level of compassion, dignity, and respect.
In the Filipino culture, EoL care is often connected with religion as most Filipinos identify as Catholic. It is appropri-
ate for nurses to refer them to a Catholic priest, if they wish, for regular prayer visits and the reception of sacraments
(e.g., receiving communion, confession, last rites) may be beneficial to both patients’ and families’ well-being. Moreover,
a Catholic custom is to attach religious icons to the patients’ bodies such as a rosary, crucifix, or an image of Jesus Christ,
the Virgin Mary, and other Saints (Pattison, 2008). A way Filipinos pay respect to the diseased following their deaths is
by reciting the rosary for nine consecutive days often referred to as a nove-
na. Catholicism accepts the practice of autopsies and believers may give con-
sent depending on individual preference. Organ donation is also acceptable
in which a family member, often the family patriarch, can choose for the de-
ceased relative to become an organ donor (SUSM, 2021).
The contribution of a nurse is especially valued during EoL care. The Filipino
culture is just one of the groups we, as nurses, aim to care for. Cultural com-
petency continues to be a priority skill that nurses need to develop to con-
nect with patients from different cultural backgrounds, religions, ethnicities,
or races to ensure patient-centered care during difficult situations.
References on the final page Photos provided by author
THE MONTHLY SHOT PAGE 3

Community Health Nursing vs Acute Care Nursing

By Tigran Movsisyan
Vice President
4th Semester

While the notion of nursing

stays the same in acute
nursing and community
health nursing, the patients,
and the methods of how the
nursing does change. In
both types of nursing, the
aim is for the betterment of
the patients. Nurses try to
do everything to make sure
that the patient is safe dur-
ing their stay and has
enough education to get
better after their stay and prevent future visits. However, community health nursing focuses on
the patient and the community influences around them. Parent education is vital in both types
of nursing, but in community health nursing, a nurse must realize that other factors in the
community. For example, if a parent does not have a nearby clinic to visit for their child’s medi-
cations, they cannot get the proper prescriptions and signatures needed for their child to have
the medication at school. Many students today might have their rescue inhalers but have no
preventative inhalers from their physicians. Parent education should be done on this issue, but
a nurse must factor in that the parent may be unable to afford the medication or does not have
access to a physician that can refill their prescription after it runs out, so they tend to only have
the rescue inhaler for emergencies. The community health nurse should work to connect the
family to resources so they can get their health needs met and avoid hospitalization or worsen-
ing of symptoms. Nurses should consider the background and community of all their patients.
Just because a child is not receiving the best care does not mean that the parents do not care
about the child; it could mean that they just do not have access to the necessary resources in
their community. It is also important to consider the family dynamics when taking care of a pa-
tient. The nurse should work to identify family strengths that can support the various health
conditions of each member.

Photo from Sac City School District

THE MONTHLY SHOT PAGE 4

Importance of Listening
By Samantha Jang
Class Representative 2
2nd Semester

During clinical, I had the opportunity of providing wound care to a patient recently diagnosed
with cancer. Having to both process her cancer diagnosis and take care of an enterocutaneous
fistula, my patient was both in physical and mental pain. When I walked into her room with the
Wound Care RN my patient was somber and slouching on her bed. When we greeted her, she
gave a weak smile and grimaced as we announced that we would be providing wound care to
her enterocutaneous fistula. However, as we set up the equipment and began to clean her
wound, she started to open up about herself. She talked about not only her life on the acreage
she owned but also her worries about her recent cancer diagnosis. As she expressed her con-
cerns, I actively listened, encouraged her to share more, and, most importantly, became a per-
son who can listen to her worries. Slowly, she began to lift her head, straighten her back, and
have a spark in her eyes. She explained how her family has not been able to visit her and simp-
ly having someone who would listen and acknowledge her concerns cheered her up. This expe-
rience taught me that the little things in nursing, such as listening to a patient’s worries, can
have a significant impact on a patient’s experience at the hospital. My patient explained that
more than the wound care or other medical treatments she was receiving, having a person to
talk to and express her concerns with helped her the most in healing her pain. As student nurs-
es move into their professional careers, I hope that the importance of listening to their patients
remains a vital aspect of their nursing care and a priority in their future nursing practice.

Photo from author

 THE MONTHLY SHOT PAGE 5

Pressures as a Second-Language Speaker in the Healthcare Setting

By Angel Nguyen
Activity Director
4th Semester

I have always had a powerful sense of pride in being

able to speak a second language. Even though I would not con-
sider myself fluent, I could communicate with my family, espe-
cially my grandmother who only spoke Vietnamese. Knowing I
did not lose the language was enough for me. Being bilingual has
even benefitted me, helping me get into Sac state’s nursing pro-
gram and in the clinical setting. Throughout my clinical experi-
ence, I was able to use my bilingual skills and help patients with
simple tasks such as calling a family member or getting a cup of
water. Although any nurse could have helped and done this for
the patient, they communicated with me easier because they
were only Vietnamese-speaking, and I understood the language. It is a great feeling to know I can use a skill I hold dear
to my heart to help those around me even if it is just small, simple tasks.
However, there are incidences where I feel being a second-language speaker, especially in the healthcare setting
can bring an abundance of pressure. I work as a student nursing assistant and there was an incident when I felt pres-
sured and obligated to interpret. For that shift, I was assigned to be a sitter for a Vietnamese-speaking patient. The nurs-
es were elated even though I was hesitant and explained I only knew conversational stuff and nothing medical. Most said
that was fine, knowing something is better than nothing. I was delighted to be able to communicate with the patient and
that I could build a rapport, he had a sense of trust in me. However, this shift felt like one of the longest I have ever had.
The patient was confused and tried to disconnect his IV line to walk around the unit. On the one hand, being a bilingual
speaker helped me communicate with him; however, when communicating he could not do certain things it was frus-
trating when he would not understand or listen, and no one around could help me. The hardest part for me was when
various members of the interprofessional team would come in to check on him and ask me to interpret. It would start
with simple things such as asking about common symptoms or asking him to follow commands. However, I stated since
the beginning I do not know most of the medical jargon in the language so felt pressured when asked to interpret things
with more complex symptoms or to explain the medical procedures they would perform on him later. I interpreted for
nurses, doctors, case management, dietician, and physical and occupational therapists that day, and out of all of them,
only the physical therapist said to me “I want you to know that you should not have to feel obligated to interpret. It is not
a part of your job. I can manage and do my job even without an interpreter.” At that moment, I felt a sense of relief, clari-
ty, and appreciation. It did not occur to me that I was not obligated to interpret. I felt obligated because no one else
would or could. I wanted to help in any way I could, but there are times when doing less is more.
I realize getting a hold of certified medical interpreters is difficult and a nuisance, but it is vital. They are a re-
source for a reason. As nurses and the number one advocates for our patients, we need to ensure they are involved and
understand the care they will receive. This experience reminded me of the importance of interpreters and how to better
my care for future patients. I still believe being a second-language speaker is amazing especially in the healthcare setting
due to the diversity of our community, but to have safe, competent care it is crucial to get those certified medical inter-
preters to communicate the important conversations related to care when needed. Nursing is a team sport, and we are
part of an even bigger interprofessional team. It is important to work and communicate as one unit and utilize each oth-
er and the abundance of resources at our fingertips.

Photo from author

THE MONTHLY SHOT PAGE 6

My Time at Camp Krem

By Hugh Darwent
Monthly Shot Editor
3rd Semester

This last summer I had an amazing op-

portunity to work at Camp Krem’s new Yosem-
ite location. Located in Ahwahnee in the rem-
nants of an old Camp Pacifica, three nursing
students from my cohort and I journeyed out
to be nursing assistants. Jessica Ornelas, Julie
Ryoo, Mariya Tkachenko, and I were able to get
the ground running with the help of our lead
RN Debbie Daley. We oversaw setting up the
health center, preparing for oncoming camp-
ers, providing first aid, dispensing medications,
and ensuring the safety of all our campers and
staff.
Camp Krem is an amazing summer camp
that provides the opportunity for kids and
adults with disabilities to experience freedom
and a change from their routine. Disabilities at
Camp Krem range from mental to physical. Au-
tism, ID, Down’s Syndrome, and epilepsy are
just a few of the disabilities this camp catered
to. It provides campers with cabins, arts & crafts, swimming, sports & games, and music for a
10-day stay. Every day was an adventure for the campers and staff. I saw so much growth in
everyone around me. I learned a lot about myself and how I can be a better communicator,
nurse, and human being.
This summer camp counted towards service learning for N139. I had to complete three
journals and write about a health presentation I participated in. I would highly recommend
working at a camp to count for this experience. I gained so much more than I thought I would
and made friends along the way!

Photo from orientation week at camp

 THE MONTHLY SHOT PAGE 7

HHS Fall Kick-Off Event!

By Julie Ryoo
Undergrad Representative 3
3rd Semester

Pictured above from left to right are Andrey Arreola, Clarice Ferrolino, and Oscar Hernandez, representing
Sac State’s School of Nursing at the HHS Fall Kick-off Event! This took place on September 29 and was in the Un-
ion. This is an annual event hosted by Associated Students, Inc., and the HHS Joint Council to promote the clubs and
organizations under the College of Health and Human Services. The clubs featured were: the American Association
of Men in Nursing (AAMN), American Society of Safety Professionals (ASSP), California Nursing Students' Associ-
ation (CNSA), Multicultural Association for Health Professional (MAHP), National Student Speech Language Hear-
ing Association (NSSLHA), Planned Parenthood Generation Action (PPGA), Pre-Dental Association (PDA), Pre-
Physical Therapy Organization, R.A.I.N.B.O.W Organization, Social Work Student Association (SWSA), Student
Academy of Audiology (SAA), Student Interprofessional Education (SIPE), and the Coalition of Concerned Medical
Professionals (CCMP). It was an amazing opportunity and privilege to be able to represent CNSA and MIN and gain
attention for the school of nursing!

Photo from event

THE MONTHLY SHOT
Covid-19 and Monkeypox Updates
Sac County has had 4,373 new cases this
month and 58 deaths.
Regardless of vaccination if you have
Covid-19 you should isolate from others.
Isolate for at least 5 days from others after
you test positive. If you develop symptoms
after you must start isolation over and do
an additional 5 days.
The CDC recommends getting the new bi-
valent booster if it has been at least 2
months since your last Covid-19 vaccine.
You can get boosted at any local pharmacy
by making an appointment online or walk-
ing in!
PAGE 8
Monkeypox Update
Sac County has had 8 cases in the last
month and 138 total cases.
Monkeypox is spread 3 ways: close or inti-
mate contact, infected animals, or through
the placenta.
Monkeypox can be spread from the time
symptoms start until the rash has fully
healed and a new layer of skin forms.
The illness typically lasts 2-4 weeks.
Vaccine Info for Sac County can be found
here
https://dhs.saccounty.gov/PUB/Documents/
Communicable-Disease-Control/FL-
MonkeypoxVaccineFlyer.pdf
Photo Credit: CDC, NHS England
 THE MONTHLY SHOT
Resources
COUNSELING:
Student Health & Counseling Services
https://www.csus.edu/student-life/
health-counseling/counseling/
We offer confidential individual and
group counseling. If you would like to ex-
plore whether counseling is right for you,
the first step is to call us during business
hours at 916-278-6461.
If you are experiencing an urgent matter,
you can drop in during our business
hours. (Mon-Fri: 8:30 a.m. - 4:00 p.m. )
Please reach out, support is out there you do not have to be alone!
PAGE 9
CRISIS ASSISTANCE & RESOURCE
EDUCATION SUPPORT (CARES):
https://www.csus.edu/student-affairs/
crisis-assistance-resource-education-
support/
The Sacramento State CARES office provides
support to students who are in crisis or experi-
encing unique challenges to their education.
They address a variety of issues including, but
not limited to: Transportation Barriers, Mental
Health and Wellness, and Physical Health and
Wellness.
THE MONTHLY SHOT PAGE 10

Campus Resources—Food Pantry and Pop Up Pantry

ASI Food Pantry ASI Pop Up Pantry

Registration once every semester:

Fresh produce at no cost to Sac State
https://asi.csus.edu/asi-food-pantry
students in need!
MONDAYS: 12 pm—3 pm 10:30-1:30pm or until supplies last
TUESDAYS: 10 am—2 pm October 10th and 24th
WEDNESDAYS: 1 pm—5 pm November 7th and 21st
THURSDAYS: 12 pm—3 pm December 5th
FRIDAYS: 10 am—2 pm
Location: University Union, Room 1246

Students are able to select foods using a

points system every week!

For more information, visit ASI’s website https://asi.csus.edu/asi-food-pantry or Instagram @sacstateasi

Photo Credit: Andrea Price (Instagram @andrea.price.sac)

THE MONTHLY SHOT PAGE 11

Nursing Meme Corner

Do you have a nursing meme you want posted?

csus.cnsa.monthlyshot@gmail.com
Photo Credits: CNSA Board
 THE MONTHLY SHOT PAGE 12

Learn more about

Men in Nursing at IMPORTANT
aamncsus.weebly.com UPCOMING DATES
& aamn.org
Events:

Men In Nursing Meeting

Fall 2022 Apparel Order October 28th @4:30pm
Folsom Hall 1049

C.N.S.A. Meeting
October 7th @4:30pm
Folsom Hall 1050
Q&A with a New Grad Panel

Contact Info
California State University, Sacramento,
Orders due by October 16 School of Nursing:
7667 Folsom Blvd.
Sacramento, CA 95819-6096
https://www.csus.edu/college/health-
View Past Monthly Shots human-services/nursing/
Phone: (916) 278-4106

sacstatecnsa.weebly.com/past-entries Monthly Shot Editor: Hugh Darwent

Email: csus.cnsa.monthlyshot@gmail.com

Faculty Co-Advisors:
Dr. Denise Wall Parilo
& Dr. Bridget Parsh
Write for the Monthly Shot!
Join CNSA: CSUS CNSA chapter:
Each article is one CNSA event and is great for your
nsnamember- resume! Articles should be at least 250 words, and can
sacstatecnsa.weebly.com
be about anything nursing or school-related.
ship.org
We want to hear from all semesters!

SUBMIT YOUR PHOTOS TO “The best preparation

THE MONTHLY SHOT! for tomorrow is doing
For each issue, it is nice to see pictures
of you and/or your nursing school
friends doing awesome nursing-related
activities! Become a celebrity and submit
pictures for the next issue!
your best today.”
“Like” Sac State Nursing on Facebook!
www.facebook.com/SacStateNursing
-H. Jackson Brown Jr.
Follow Sac State Nursing on Instagram!
@sacstatenursing

Send pictures today to:

csus.cnsa.monthlyshot@gmail.com
THE MONTHLY SHOT PAGE 13

References

Considering Culture During End-of-Life Care

Dela Cruz, M.T. & Periyakoil, V.J. (2015). Health and health care of filipino american older adults. Stanford Univer-
sity School of Medicine. http://geriatrics.stanford.edu/wp-content/uploads/downloads/ethnomed/filipino/
downloads/filipino_american.pdf
Heart House Hospice. (2017). What dying looks like during final days of life [Video]. YouTube. https://m.youtube.com/
watch?v=3oTxX5g0MpU
Lowey, S. E. (2015). Nursing Care at the End of Life: What Every Clinician Should Know. Open SUNY Textbooks.
Stanford University School of Medicine (SUSM). (2021). Ethnogeriatrics: End-of-life preferences. https://
geriatrics.stanford.edu/ethnomed/filipino/delivery.html