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April 2024 CNSA - SACRAMENTO STATE CHAPTER VOLUME 44, ISSUE 3

Rekindling Motivation in Nursing School

By Joshua Lejano, he/him/his
Class Representative 1
1st Semester

As I’m reaching the end of my first semester in nursing school, I can’t help but
be grateful for all the experiences. Each day I would come into class, lab, or clinical with
On Nursing: A Legacy of Care a burning motivation to learn as much as possible. I still have that motivation to learn,
Page 2 but for the past few weeks it has felt difficult to maintain that same level of enthusiasm.
Quality Improvement Poster Be it the weekends working on assignments and studying, the hangouts declined, or
for Increasing Appetite of even the warmer weather it has been hard to stay motivated.
Patients Undergoing Chemo-
therapy
Thankfully, I was given an opportunity by a friend that would help me remem-
Page 3
Thinking Creatively! Stories of
ber how important each day in nursing school is. I was invited to talk about my experi-
Accessibility ences as a nursing student with the nursing club at a local community college. It was
Page 4 refreshing to see how motivated and passionate the students were to get into nursing
The Benefit of Making Mis- school. I was able to help give the students an idea of what to expect when entering
takes in Simulation Lab
nursing school. The time management skills, schedule, flow of classes, and clinical ex-
Page 5
periences were all topics that we discussed. It was exciting to see how motivated the
Lessons from the Emergency
Department students that were applying this cycle were, we were able to show them how to calcu-
Page 6 late their points to apply to the college.
My Time in the Pediatric Sur-
gical Unit Although a bit cliche, the opportunity to talk about my experiences in nursing
Page 7 school with the pre-nursing students allowed me to reminisce on my past four months.
Nursing Artwork I have met so many amazing people and become a much more capable nursing student.
Page 8 In the grand scheme of things I have yet to breach the surface of nursing, but that
Nursing Students in Action means that there are millions more things to learn. I was reminded of how amazing it is
Page 9 to learn and grow. If I have learned this much in only four months, I can’t imagine how
Mental Health much more I’ll learn by the end of nursing school.
Page 10
Campus Resources
Page 11
Updates & Other Info
Page 12

Photo from Recruiter.com website

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On Nursing: A Legacy of Care

By Stacey Escano, she/her/hers
Undergraduate Representative 1
1st Semester

It’s been almost a year since I got into Sacramento State’s Nursing program and just shy of three since I
expressly decided to pivot to a degree in Nursing, and yet I am still endlessly surprised at the direction my life
has taken! Perhaps I shouldn’t be. I mean, in retrospect, it really does seem like I came by it quite honestly.
My mother has been a nurse for about 30 years–much longer than I have been alive. Her twin sister–my
aunt–works as a nurse manager at a hospital in Washington state and my great-aunt was a cardiac nurse. Four
cousins also became nurses. Yet another aunt used her education as a nurse to run away from home and work
for causes special to her heart in Kuwait.
As for myself, I was also born and raised in the Philippines–a country widely known to be the greatest
exporter of foreign-born nurses in the world. It was, and still is, common practice to emigrate to the United
States to find work so that we may take care of those back home who, for whatever reason, cannot afford or
get lucky enough to bypass the USA’s stringent immigration process. Just yesterday, my parents sent money to
my mother’s aunt, who is currently bedridden from a long illness.
So, in these ways and others, pursuing nursing has always felt like an inevitability for me–especially
given that I have so many good memories associated with it. I remember when my mom and I were still living
in Manila, while my dad was halfway around the world, working hard in food service at a hospital so that he
may finance our passage to move to California. During that period of time, my mother was working as a pro-
fessor of nursing at St. Paul University, her alma mater. She used to take me with her to class, where she would
give me the answer key to a test that she distributed to her students and I would be tasked with grading them
by hand while she taught. From the corner of my eye, I would watch the black-veiled heads of the Sisters of St.
Paul as they flitted about the campus hallways. Though it has long been considered an old-fashioned tradition
of antiquity here in the United States, religious nursing orders commonly comprised the faculty of many Phil-
ippine nursing programs as late as the early 2000’s. They, along with my mother’s nursing students, used to
play with me during downtime, as well as give me gifts. I still have the computer games that a student installed
for me on my mom’s laptop and a copy of The Wizard of Oz that a sister nurse gave me that first animated my
love for literature.
After finally arriving in the US, I quickly became too preoccupied with fitting into a culture that was so
different to my own that I did not give thought to nursing for a very long time. This was fostered by the fact
that the sense of community I had back home with my mom’s coworkers and nursing students had firmly been
lost by the time I got to California, as well as my mom’s new stint as a psych nurse–details of which my mom
felt was too delicate to be explained in detail to a 9 year old. So, I never gave this career path much thought
again until I was 19, where I found myself working towards a degree in English. One summer, my mom sug-
gested, out of the blue, that I work as a Nursing Assistant at the rehab facility near our town. I was bored and
hurting for cash, so I gave it a try. My first months employed as a CNA were at the height of the pandemic; it
was a grueling education in the importance of prioritization and efficacy. I was acutely disturbed by the differ-
ence in scope and proportion of care that I expected I would be able to do for a patient versus what I encoun-
tered in reality, where care is imperfect and often substandard due to the time constraints that are inherent to
working during an ongoing crisis. (I learned that patient to HCW ratios were always at their worst at convales-
cent homes)! Within that experience, however, I felt myself come into a sense of power. I have never felt so ca-
pable as after I was able to help someone achieve a modicum of relief. Sometimes, that could be enough, if only
for a little while. And as a person who feels bumbling and embarrassed and pathetic a lot of the time, a genuine
expression of trust, a hug, a “thank you,” a smile directed my way…In many ways, it’s a relief for me, too.
So, yes, I came by it so, so honestly. However, it was ultimately my choice–and mine alone–to access
that beautiful legacy of care.
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Quality Improvement Poster for Increasing Appetite of Patients Undergoing Chemotherapy

By Esther Shackelford
MIN Undergraduate Representative 2
4th Semester

When tasked with the assignment of finding a quality improvement project for patients, I had so many different ideas. I was assigned to
find a topic that fell under basic care & comfort, so I focused on the basic needs of patients such as food, water, socialization, and comfortable place
to rest. Struggling to decide on one topic, I consulted with my preceptor about the needs for patients on the floor, specifically the oncology unit.
Personally, I have an interest in working in pediatrics, but I also know there is a growing population of oncology patients. In my experience work-
ing on the pediatric floor, specifically with pediatric oncology patients, in addition to my preceptorship on the adult oncology floor, I chose to de-
sign a quality improvement project on improving the appetite of patients undergoing chemotherapy.
This issue requires improvement, in that patients undergoing chemotherapy are at risk for poor nutritional intake and if their electrolyte
levels are not maintained they are at risk for more complications in addition to a longer hospital stay. Chemotherapy drugs are designed to kill rap-
idly dividing cells, which means it does not just attack cancer cells but also cells in the intestine. In addition, a side effect of most chemotherapy
drugs includes nausea and vomiting, which further contributes to the decrease in appetite. The population I would address this issue to includes
the clinical nurses, oncology patients, family members of oncology patients, nurse leaders or nurse managers, and oncology dieticians.
There are several studies that support good nutritional intake which helps improve quality of life. Good nutrition will help to prevent sig-
nificant changes to body weight or composition, in addition to decreasing length of hospital stay (Parsons et al, 2023). Electrolytes and blood levels
must be monitored in patients undergoing chemotherapy, and to maintain normal electrolyte levels and normal blood levels, oral or intravenous
supplementation can be given (Ukovic & Porter, 2020). There are other studies that discuss total parenteral nutrition or oral nutritional supple-
ments such as ensure or custom smoothies.
To propose a solution to this issue, I would first need to gather data, which I suggest doing through a survey of clinical nurses and pa-
tients’ undergoing chemotherapy. In the survey I would ask about: how much is eaten during chemotherapy? How often does nausea/vomiting
hinder appetite during chemotherapy? What foods are tolerable by the patient during chemotherapy? Also, when finding a solution I would also
include observations from the floor. A factor that I noticed increases appetite is the presence of family and home cooked meals. Some patients will
attempt to eat more when surrounded by loved ones. Furthermore, home cooked meals provide a sense of comfort and familiarity for the patients.
Possible solutions to the issue could be education and finding patient preferences based on their responses to the surveys. I propose mak-
ing a pamphlet or brochure to provide to patients and family members of patients admitted for chemotherapy treatment. The pamphlet could in-
clude information about on the importance of maintaining an appetite during chemotherapy and education on hospital policy of food brought from
outside the hospital and sharing a meal with the patient, encouraging patient to maintain appetite.
While this proposal has only been an assignment for school, I hope to pursue it further in my nursing career. I know that I will participate
in many quality improvement projects for patient care, and I am excited to have started during my time as a nursing student.

References:
Ukovic, B., & Porter, J. (2020). Nutrition interventions to improve the appetite of adults
undergoing cancer treatment: a systematic review. Supportive Care in Cancer, 28(10), 4575–4583. https://doi.org/10.1007/s00520-020-05475-0
Parsons, H. M., Forte, M. L., Abdi, H. I., Brandt, S., Claussen, A. M., Wilt, T., Klein, M., Ester,
E., Landsteiner, A., Shaukut, A., Sibley, S. S., Slavin, J., Sowerby, C., Ng, W., & Butler, M. (2023). Nutrition as prevention for improved cancer health
outcomes: a systematic literature review. JNCI Cancer Spectrum, 7(3). https://doi.org/10.1093/jncics/pkad035

Photo from Author

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Thinking Creatively! Stories of Accessibility

By Elise Pacifico, she/her/hers

MIN Community Outreach Director
2nd Semester

Accessibility is defined as “the practice of making information, activities, and/or environments sensible, meaningful, and usable for as many people as possi-
ble” (SeeWrite Hear, 2024). The Americans with Disabilities Act of 1990 helped to make great strides in improving accessibility in the United States, such as through
equal opportunity employment laws and putting sidewalk bumps before crosswalks. There is so much progress to be made to make the world a more accessible
place, and we have the power to contribute to the change as future nurses. This article highlights some positive experiences to hopefully spark some inspiration on
how we can help aid in the accessibility movement!

Jill Van Zanten is a ceramic artist residing in Davis, California. She makes “Adaptive Pottery”: this includes works such as double-handle mugs and squared cups to
make eating and drinking easier for people with movement disorders. She worked with a few people, including Paul Knott, her neighbor with quadriplegia, to test out
and workshop her ideas in order to perfect each piece. By slightly changing the characteristics of dishware, people with Parkinson’s disease, essential tremors, and
other neuromuscular conditions are able to eat much easier, and without spilling. A great example of this is her plate, with an extra high backstop, or side. This allows
someone with a tremor to use the sides of the plate as a way to easily scoop food into their spoon. Photos of her amazing work are below.

Bowls with handles to increase stability

Plates with high backstops

Photos from Jill Van Zanten’s Online Gallery

TechOWL is an organization based in Pennsylvania that is working on the development of assistive technology, and increasing accessibility of technology to disabled
communities. One of their exciting projects involves using 3D printing to make assistive devices to help people hold pens, button their clothes, and unlock doors with
ease. Some examples of these devices are below. They also have a REEP Closet full of wheelchairs, closets, canes, and more. They provide free mobility aids trials so
that people can test what devices work best for them. Through innovation and providing free resources, TechOWL is improving accessibility for their local communi-
ty and making daily acts easier for many.

Two 3D printed creations by TechOWL APA! Easier ways to cut your nails
and write with a pen.

Photos from TechOWL APA Instagram @techowlapa

The topic of accessibility is starting to carve its place into pop culture as well! Justina Miles is a deaf performer and ASL interpreter, best known for her recent perfor-
mance at Rihanna’s Super Bowl XLVII performance. She is the first Deaf woman to perform ASL in a Superbowl halftime show. Her stylistic use of sign language went
viral this past year – her energy and hype was quickly noticed by Superbowl fans nationally. By doing this, she brought the concept of ASL as an artistic expression to
popular culture. She stated that it was important to her to provide “‘empowerment to millions and millions of Black deaf people all over the country who’ve never
really seen that before. I feel that is truly lifting every voice, even my voice’” (Liu, 2023). Justina’s story proves the importance of allowing unique perspectives into
the spotlight of pop culture, providing representation for all kinds of people and making modern media both accessible and fun. Performances like hers help to break
the barrier and reduce the stigma of discussing disability: by providing people like Justina with a platform, we can encourage viewers all throughout the US to be
mindful of accessibility in their daily lives.

By learning about improvements in accessibility in other communities, we can start to consider how to make our own community more accessible as well! By making
a consistent effort to notice areas in need of improvement, we can think creatively and make great strides in the equal opportunity movement.

References:
Get Assistive Technology – TechOWL. (n.d.). TechOWL. Retrieved April 2, 2024, from https://techowlpa.org/get-assistive-technology/
Liu, J. (2023, February 12). Meet Justina Miles, Rihanna's Super Bowl halftime show ASL performer. CNBC. Retrieved April 2, 2024, from https://
www.cnbc.com/2023/02/12/meet-justina-miles-rihannas-super-bowl-halftime-show-asl-performer.html
Technology for Our Whole Lives (@techowlpa) • Instagram photos and videos. (n.d.). Instagram. Retrieved April 2, 2024, from https://www.instagram.com/
techowlpa/
Van Zanten, J. (n.d.). Adaptive Pottery – jillvanzanten. jillvanzanten. Retrieved April 2, 2024, from https://jillvanzanten.com/adaptive-pottery/
What is Accessibility: An Introduction. (n.d.). SeeWriteHear. Retrieved April 2, 2024, from https://www.seewritehear.com/learn/what-is-accessibility/
THE MONTHLY SHOT PAGE 5

The Benefit of Making Mistakes in Simulation Lab

By Ngoc Xuan Hoang Ho, she/her/hers
Fundraising Chair
4th Semester

Mistakes are often considered to be avoided at all costs, especially in the healthcare field. However, in
the controlled environment of a simulation lab, making mistakes can be a valuable learning experience for
nursing students. Simulation labs provide a safe and realistic setting where students can practice clinical sce-
narios and develop essential skills without putting actual patients at risk.
For some students, the idea of making mistakes in front of instructors and peers can be daunting. It's
natural to feel scared or pressured when being watched by many people and judged for doing things incor-
rectly. However, it's crucial to remember that simulation labs are designed as a learning environment where
mistakes are not only accepted but encouraged.
One of the primary benefits of making mistakes in a simulation lab is the opportunity to learn from
those mistakes. When a student makes an error during a simulated scenario, instructors can provide feedback,
and discuss the appropriate course of action in the debrief room. This immediate feedback loop is invaluable,
as it reinforces correct procedures and allows students to understand the potential consequences of their ac-
tions in a low-risk setting. From personal experience, I learned and retained knowledge and skills better from
the simulation labs where I made mistakes compared to those where I performed everything correctly. Mak-
ing errors and working through them with guidance allows for deeper understanding and helps ingrain the
proper procedures more effectively.
Furthermore, making mistakes in a simulation lab can help students develop critical thinking and prob-
lem-solving skills. When faced with unexpected situations or complications during a simulated scenario, stu-
dents must think on their feet and apply their knowledge to resolve the issues. This process of actively work-
ing through challenges and learning from mistakes can better prepare students for the unpredictable nature of
real-world clinical practice.
While it may feel uncomfortable initially, I strongly recommend that all nursing students embrace the
opportunity to participate in simulation labs, even if it means making mistakes. These controlled environ-
ments provide a safe space to learn from errors, develop critical thinking skills, and ultimately become better
prepared for real-world clinical practice. Seek out these experiences, and don't be afraid to make mistakes –
that's how true learning happens.

Photo from Academy to Innovate HR website

THE MONTHLY SHOT PAGE 6

Lessons From the Emergency Department

By Heather Conway
CNSA Secretary
4th Semester

During my 4th semester, I was lucky enough to be placed in the ED at a local hospital for my senior pre-
ceptorship. This was my number one choice for preceptorship placement because I felt that the large teaching
hospital and Level 1 Trauma Center designation would make this ED the best place to learn and develop my
nursing skills. Now, having completed 15 of my 18 shifts, I see that I couldn’t have been more correct.
Throughout these 15 shifts, I have met some of the most skilled and kind nurses who have taught me
innumerable clinical and communication skills. I believe that ED nurses display some of the best assessment
skills I have seen and working with them has helped me to sharpen my own assessment skills. Patients in the
ED are often acutely ill and can have changes in condition at a moment's notice, so understanding how to eval-
uate them and notice small changes is very important.
I have had the opportunity to care for com-
plex ED patients that require extensive work-ups,
ICU-level patients, pediatric patients, and much
more! The diversity of the patient population in eve-
rything from age to ethnicity to diagnosis has been
absolutely amazing to experience as a student.
Beyond assessment and clinical nursing skills,
I have learned so much about communication and
how to support patients that are in crisis. More often
than not, patients in the ED are having one of the
worst days of their lives. To the nurses on the unit, it
is just another day at work, but to the patients it can
be a life-changing, overwhelming, anxiety-inducing
experience. Therefore, learning how to connect with
these patients is one of our most important skills.
I have grown so much during these past cou-
ple months and I know I still have so much left to
learn. I look forward to getting my first new grad job
and getting to further grow and develop all of these
skills!

Photo from Author

THE MONTHLY SHOT PAGE 7

My Time in the Pediatrics Surgical Unit

By Katrina Orizonte, she/her/hers
Monthly Shot Editor
3rd Semester

This semester I signed up for an optional shift to shadow nurses caring for pediatric pa-
tients undergoing surgery. During the preoperative process, I observed the PACU nurse per-
forming vital signs, HTT assessments, and ensuring consent was done and documented on the
EMR. I also saw how the nurse introduced and communicated patient/family concerns to the
surgical staff (e.g. CRNAs, surgeons, scrub RN, etc.). A few hours later, I followed my patient to
the OR room where she was being prepped for a craniotomy for an epidural hematoma (EDH)
evacuation. She developed an EDH due to a car acci-
dent which resulted in mental status changes and fre-
quent headaches that gave great discomfort to the pa-
tient. The surgery lasted for 3 hours and it was inter-
esting to see an actual surgery being performed while
also observing how the nursing team collaborated
amongst one another and with the rest of the surgical
staff. During my time in the OR, I was taught by the
scrub nurse that there are 5 main things they are re-
sponsible for. Counting/keeping track of equipment
and tools used to make sure nothing stays in the pt,
charting/documenting what is done, communicating
with the team to make sure things are addressed, col-
lect specimens properly and make sure it doesn't get
lost, and always make sure consent has been record
and accounted for as part of the universal protocol.
After the surgery was completed I went back to the
PACU with my patient and observed the nurse per-
forming assessments to make sure the patient was
recovering well. Overall it was an interesting experi-
ence and I would highly recommend it to other nurs-
ing students, especially those who may be interested
in working in the OR or PACU units.

Photo from Author

THE MONTHLY SHOT PAGE 8

Nursing Artwork

“You got this, pookie”

Meme by Esther Shackelford
By Panyia Thao, she/her/hers
MIN Undergraduate Representative 2
2nd semester
4th Semester

Twinkle Twinkle nursing student

How I wonder where you are?

Studying deep into the night

-Poem by Esther Shackelford
MIN Undergraduate Representative 2
A new assignment, every waking light 4th Semester

Twinkle Twinkle nursing student

How I know you will be a nurse!

Do you have a nursing meme you want posted?

Email csus.cnsa.monthlyshot@gmail.com
THE MONTHLY SHOT PAGE 9

Nursing Students in Action

Photos Courtesy of CNSA Board and @sacstatecnsa

 THE MONTHLY SHOT PAGE 10

Resources

COUNSELING: CRISIS ASSISTANCE & RESOURCE

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 explore
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)
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 experiencing 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.
Office Hours: Mon-Thurs 8:00 a.m. - 5:00 p.m
Fri 9:30 a.m. - 4:30 p.m.

Please reach out, support is out there you do not have to be alone!
THE MONTHLY SHOT PAGE 11

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: 11:30 am—2 pm Spring Semester 2024 dates:

TUESDAYS: 11:30 am—3:30 pm
WEDNESDAYS: 10:30 am—6 pm February: 5,12
THURSDAYS: 11:30 am—3:30 pm March: 4, 11
FRIDAYS: 11:30 am—2 pm April: 8, 22
Location: University Union, Room 1246 Location: Library Quad, 10:30am- 12pm

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 12

Learn more about

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

CNSA Meeting
May 3 @4:30 pm
Folsom Hall 1050
View Past Monthly Shots
Men In Nursing Meeting
sacstatecnsa.weebly.com/past-entries May 10 @4:30pm
Folsom Hall 1048

Contact Info
California State University, Sacramento,
School of Nursing:
7667 Folsom Blvd.
Sacramento, CA 95819-6096
https://www.csus.edu/college/health-
human-services/nursing/
Phone: (916) 278-4106

Monthly Shot Editor:

Katrina Orizonte
Email: csus.cnsa.monthlyshot@gmail.com

Faculty Co-Advisors:
Write for the Monthly Shot! Dr. Rachel Hill
Join CNSA: Each article is one CNSA event and is great for your
& Prof. Maria Wheeler

nsnamember- resume! Articles should be at least 250 words, and can CSUS CNSA chapter:
be about anything nursing or school-related. sacstatecnsa.weebly.com
ship.org
We want to hear from all semesters!

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