November 18

Porter Hospital. Ostomy Support Group meeting. Our speaker was a colorectal surgeon. The members with fecal ostomies asked him questions regarding ileostomy and colostomy. We have young members who came. One member had an ileostomy before but now he has been reconnected. However, his disease is bothering him again. Another young member came in. She has a permanent ileostomy. She was cracking jokes! She wants to be a stand-up comedian. She will be a good one. She uses humor and pokes fun at her medical condition. It is her way of coping. Better than crying and thinking negatively about it. She is putting a positive spin on her condition!

November 11

Review of Regranex. Meeting with other wound nurses at the Brazilian Steakhouse downtown.

Reflection

Review in detail your service learning site. Where are you serving? What do the agencies do? Who are the clients and what needs are served? What is the agency funding support? I have three agencies that I serve. I am a member of Save a Leg, Save a Life. Our organization sponsors RNs who are pursuing their WOCN certification. We gave money to two scholars this year. The checks were given to the scholars in our meeting at Porter’s on 10/14. SALSAL aims to help increase the public’s awareness of diabetic foot ulcers and the consequences of getting foot wounds that result to devastating amputations and loss of life. To help increase this awareness, SALSAL holds several educational seminars that target the clinicians. There was also a service activity done for the public where it invited folks that need their wheelchairs and walkers repaired. This organization is sponsored by its members—clinicians as well as sales representatives of different companies that sell wound care products. The other agency that I serve is the Ostomy Association of Metro Denver. We have ostomy support groups which I attend. The meetings are held monthly. The meetings are now held at Porter’s. I was the guest speaker in one of the meetings. In another recent meeting, I invited representatives from a home health agency and a skilled nursing facility. They talked about what services they provide and who qualifies for their services. In this meeting, I also invited sales representatives from a company that makes skin barrier films that are used in treatment of peristomal denudation. The product the company is selling is called cyanoacrylate. The use of the product was discussed and demonstrated to the ostomy support group members. The third person who spoke was my friend, Jeff who is also a CNA at Lutheran Medical Center. Jeff had an ostomy from Crohn’s. Right now he has a J pouch and he discussed his journey when he was dealing with an ileostomy and his journey when he had the J pouch. He currently has a J pouch so he discussed how it is to live with one. There are ostomy support group members who are considering getting this J pouch surgery so Jeff provided good information. He is young, employed and currently going to school to be an RN. He has a degree in kinesiology. The members were so enlightened to hear about his life experiences. Jeff was enthusiastic. He is very helpful. I introduced him by email to my other fellow CWOCNs and guess what? They are interested to invite him to talk in one of our meetings. One of them got his contact information so she can give it to her patients who are inquiring about the J pouch. He is ok with this and has, in fact, been corresponding with one of the Kaiser CWOCNs! What a good resource. I am glad I am doing this Service Learning—look at all these resources I discovered. The third agency I serve is the CWOCN. I volunteered for the WOCN Regional conference as a room monitor. That also involved me introducing the speakers in a couple of the seminars. I also donated goods for the fundraising. I brought one CNA from Lutheran to attend and she was so pleased to learn from the different speakers. The CWOCN group is supported by the members. The sales representatives of different wound, ostomy and continence products also sponsor the group. As for the support group, we members pay our dues. What roles do DNPs play in promoting health and wellness in undeserved population? How do you perceive your individual role in this? The main focus of my DNP project is helping the ostomates also called ostomists or ostomy patients. I can help in their education. Participating in the ostomy support group, I can help by giving them access to an ostomy nurse. In my project, I plan to do an educational in-service regarding peristomal skin care among the home health nurses. This will also be helpful in increasing awareness regarding the needs of the ostomy patients. Once I am done with my DNP program, I plan to volunteer in the public policy committee to help lobby for the causes of the ostomates as well as the CWOCNs. I also have a knack with marketing and I am good in creating networks. So also plan to belong to that committee as well. The WOCN organizations have several committees. What was the best/worst/most challenging thing that happened to you this semester? The best experience was meeting people like Jeff who are willing to talk about their ostomies with others. I also met another lady who heads the IBD (Inflammatory Bowel Disease) and Colitis Foundation. This is an article about her http://www.reporterherald.com/lifestyles/health/ci_24248487/advocate-has-fire-her-belly-awareness-bowel-syndromes Her name is Lois Fink. It is so inspiring to listen to hear talk about her experiences with IBD. She has been a courageous fighter! The most challenging experience is completing my presentation. I will do a PowerPoint but it must be short, sweet and to the point. I have only one hour to do the in-service and the time includes the answering of the pre-, post-test and the short demographic information. I have to practice the presentation several times to make it concise. I have finished most of the PowerPoint but I still need to edit it some more. What can you do differently as an individual and as a professional to support and advocate for some of the issues you encountered during your service learning experience? I plan to be active in the public policy committee of the WOCN organization. There are so many school requirements right now and with a full time job as the lead of the WOCN program at Lutheran, I have my hands full. But once I am done with my DNP, I know I can do more for the organization. What is exciting now is I invite RNs, CNAs, and nursing students to come to SALSAL, the ostomy support group, and even the CWOCN meetings. Engaging other non-WOCN clinicians will help increase awareness of what the CWOCNs do and also increase awareness regarding ostomy care.

With the young Ostomy support group members

Second day of lectures

Two discussions on digestive diseases 

First day of lectures

At the Regional Conference. CWOCN. 

Attending the regional meeting

We have a dinner tonight. Three ostomates shared their story. How inspiring.  

Me with two nursing students

The two ladies are my nursing students. The other one just got her RN. The gentleman is a sales rep. 

The students attended the lecture on nutrition and wound healing. 

Porter. Meeting with SALSAL

A dietitian talked about nutrition and wound healing. Two RNs won the 500 dollar each scholarship that this group granted. 

The Dolphin bed

Meeting with nurses. Wound and Ostomy people

September 23 Ostomy support group Porter

And at the Army Surplus store. Also in Arvada

Promoting the Events

At downtown Arvada! The wonderful Dolce Vita staff posted our communit event flyer!!! 

For SALSAL community event

I plan to drop these off at doctors' offices today. 

Medihoney

Meeting at Oxford Hotel. CWOCN planning for regional meeting 

Scholarship announced

Two RNs selected for the SALSAL scholarship. Yay. More Cwocns! 

Reflections

Review in detail your service learning site. Where are you serving? What do the agencies do? Who are the clients and what needs are served? What is the agency funding support? I am doing service learning activities for three agencies. I still attend the Ostomy Support Group that meets at Englewood, CO. They will have a potluck in July which I plan to attend. This group meets to help the members who are all ostomies. These ostomies are incontinent ones—either fecal or urinary. They are almost always permanent but those with temporary ostomies are also welcome. There are not many home health nurses nor clinic based nurses who are CWOCN certified. The ostomy support group is sometimes the only forum where the patients get support and education way after their surgery. This group is being funded by its members and the vendors such as the ostomy products and accessories manufacturers also come and talk to the group. The second agency that I helped is Exempla Lutheran’s Cancer Center. The hospital has a fundraising in May and they also invite the cancer survivors to this event. The activity is called Leaves of Hope. They have a short walk/run competition. They also have an information fair where different non-profit groups talk to the cancer survivors, their families, the clinicians, volunteers and other attendees. They set up tents to accommodate all the vendors. There was also a singing group called Chris Daniels and the Kings who performed to entertain the attendees. I was a course marshal and also a proud trash collector. There were food and drinks. The garbage cans fill up so I have to help empty the cans. As a course marshal, I have to make sure the participants are running the 5k or the 10k. Not many ran the 10k marathon. The runners will say, “Just the 5k!” That activity was fun. The volunteers like me helped celebrate the cancer survivors and we also helped raise money for the hospital’s cancer center. The third agency, I belong to is Save a Leg Save a Life. The organization has community activities to help the patients with lower extremity wounds, mostly diabetics. They also have various educational seminars that clinicians attend. The last one was June 10. It was held in St. Josephs’ hospital in Denver. The speaker was Dr Arbuckle. He talked about the atypical lower extremity wounds such as bullous pemphigus, and pyoderma gangrenosum. This organization helps the diabetic patients, mostly. They also help clinicians get more education regarding lower extremity wounds. The members, like me, pay the yearly dues. What roles do DNPs play in promoting health and wellness in undeserved population? How do you perceive your individual role in this? The Ostomy Support group of Denver, the one that meets in Englewood, directly helps the patients. The group takes donations of products that other folks are not using. There are times that ostomies are reversed so the former ostomy patient does not need the products anymore. Other times, the patient just switch brands for whatever reason. There are also cases when the patient passes away and the family or caregivers donate the unused products. The meetings serve as forums where patients meet other patients with ostomies. If they are not aware of how to deal with their ostomies, the other patients are willing to give them information. One patient had questions regarding sexual activities and he said he had no clinicians addressing his issues. He was happy to hear tips from the other members of the group. The most common issue of course is leaking and peristomal skin issues. The other members have many solutions for those issues. Other issues that arise concern clothing. One of the most innovative yet inexpensive ways a young ostomy member suggested was the use of maternity binders that can be purchased from stores like Target. Wow! What a brilliant solution—and so accessible, too. What was the best/worst/most challenging thing that happened to you this semester? The challenge I encounter is time constraint. The SALSAL group and the Ostomy group meet at night. After a long day at work, I get very exhausted attending a meeting. The Leaves of Hope was a Sunday so that was easier because I am off on Sundays. The best experiences are numerous! • I met many cancer survivors in the Leaves of Hope who had survived many years. Some have been cancer-free for 20 years, some just a year out. But how wonderful! The survivors are grateful for their second chance in life. It makes me appreciate my life and my health! While I have good health, I should be active and engage in worthwhile activities such as doing my doctorate, getting good work published such as in poster presentations, and later, I hope, my project for Regis. I plan to publish in the WOCN Journal. • Dr Arbuckle cried when he was talking about how he and his partner have a non-profit that cares for bullous pemphigus pediatric patients. They take them out to ski or do other outdoor activities. It is great to meet folks who are enthusiastic about the work they do. • I never cease to admire the ostomy members. There is a couple who have had it for 30 years. It is a drastic body image change. It takes time and effort to adjust to living with wearing an ostomy pouch. I also admire the two young members in their 30s who have permament ostomies. They are working. They are active—they climb, bike, camp. That should inspire me to be active. How much easier it is for me to hike compared to these young ostomates. They worry about emptying their pouch. They worry about the pouch not leaking. They have to think about where they can change their pouches but still they go and get active. They are both slender and fit, too. • The president of the Ostomy support group in Denver is a psychotherapist. She works. She shared that at times, she has to explain to her clients why she is making “tummy” sounds. What can you do differently as an individual and as a professional to support and advocate for some of the issues you encountered during your service learning experience? From attending the Ostomy group, I also confirmed about the lack of community-based care for these ostomy patients. I used to also work in home health so I am aware of the need to educate home health nurses regarding ostomy care. There are also only a few CWOCNs (Certified wound, ostomy and continence nurses) who work in home health. And of course, the written literature also confirms all these. These are the reasons why the focus of my DNP project is educating home health nurses on peristomal skin care. I would like to reach out to home health agencies and start ostomy education with the home health nurses as learners. I plan to publish my findings after I finish my project. I even want to take this to Nevada once I already have my DNP. I will do a similar project and go through the same process. I may be able to get a grant from the WOCN society. There is paucity in research in ostomy care. This is another area that I can contribute to with my DNP project and beyond. As an individual, I will continue volunteering for the three agencies. I will also be more active in the WOCN Society. This October, I plan to do service learning hours helping the regional, Rocky Mountain group.

Great pictures at Leaves of Hope

http://us2.campaign-archive2.com/?u=b1c8ff1f27ce0fa365980448e&id=c00191f1a4&e=857d9c2f6a

Meeting today with other CWOCNs

Denver Chophouse

Lecture on wounds 

SALSAL meeting

Lecture re lower extremity wounds. Dr H Alan Arbuckle MD is our speaker. St Joseph 

Different sponsors of Leaves of Hope

Me as course marshal

The other volunteers tease us and call us "court martial" . 

The run/walk fundraiser is for the benefit of the Exempla Lutheran Cancer Center. 

There are many cancer survivors in this event. How inspiring! 

Leaves Of Hope

Fundraising at Lutheran

June 1 2014

Support group

We met at the meridian yesterday. How awesome. Some members hike, bike, garden, hunt! There is life after an Ostomy. 

A couple of members are young. They were in their 20s or 30s. There are two wheelchair bound folks, too. They are all adapting to living with an Ostomy. How inspiring 

Leaves of Hope May 27

I am with the cancer navigator. We are here in the lobby to promote "Leaves of Hope", cancer center fundraiser. 

Our upcoming class. Open to clinicians

Save a Leg. Save a Life 

Focus group meeting

Coloplast is sponsoring a focus group meeting. Ostomy nurses will be in this restaurant for a discussion. I am here! Fancy place huh ? 

Leaves of Hope

I will volunteer to be one of the Marshalls directing the walkers and runners. This activity will help raise money for the Exempla cancer center. June 1. Come! 

Cancer survivor celebration

Given to us in our GI diseases site meeting today. Come and join us ! 

Vivage

May 1

We had our Ostomy support group meeting. We have Vivage speak to us. We also have a new urostomy and new loop colostomy member. 

Convatec spoke to us

Convatec launched new Ostomy products. They also have a program for the uninsured and folks who need assistance with Ostomy supplies. 

Coloplast spoke yesterday

The rep talked about the new Ostomy products they have. He came to the support group that meets in Meridian. 

tomorrow--April 22

Looking forward to another Ostomy support group meeting at Meridian in Englewood.

April 10

Keith spoke about SALSAL to the nursing students from Regis who were rotating at Lutheran. Lots of good information about SALSAL provided to the audience.

March 27

Karen the president of the Ostomy Association of Metro Denver talked to the nursing students in Exempla Lutheran. Her talk emphasized the importance of considering the psychological needs of the Ostomy pts. Usually the clinicians focus on tasks such as pouch change and pouch emptying. The emotions of the pts are not addressed. Karen's talk made us all reflect on how we can better address pt's psychological and emotional needs. 

  

Ostomy support group meeting

SALSAL

Today we met at the Corner House. We had a one hour meeting on our educational and community outreach for this year.

We plan to hopefully give 2 scholarships to CWOCN students. More to come as the months roll on! 

Reflections

• How would you describe in detail your service learning site?
• Where are you serving? I serve in two agencies: Save a Leg Save a Life or SALSAL and the Ostomy Association of Metro Denver. 

 

• What does the agency do? SALSAL educates clinicians on the importance of wound healing of diabetic foot wounds. It also educates clinicians regarding other lower extremity conditions such as lymphedema, peripheral arterial diseases, pyoderma gangrenosum and the like. The organization raises funds for projects such as sponsoring a RN who is in a Certified wound, ostomy and continence nursing (CWOCN) program.  

 

The other organization, the Ostomy association is a support group for ostomy patients. The members are urostomy, ileostomy and colostomy patients. They meet once a month and take a short break during the summer months. When the group meets, they talk about ostomy issues and they share tips and tricks on what has worked for them. They talk about how to live with an ostomy.

 

• Who are the clients and what needs are served? SALSAL holds a number of educational seminars. The attendees are clinicians example nurses, nursing students, physicians, pharmacists. It helps educate clinicians on good wound care specifically wound care of lower extremity wounds. 

 

The ostomy support group serves the ostomates or ostomists who attend their meetings. The support group meets the emotional needs of the members. The members also get educational support as they learn about how to live with ostomies from each other. 

 

• What is the agency funding support?

SALSAL collects money from its members. The members are clinicians and sales representatives from various companies such as wound product manufacturers, pharmaceutical companies, and durable medical equipment company stores. 

The ostomy support group also collects money from the attendees. The group invites speakers such as ostomy manufacturer representatives.

 

• What is it about the community partner that calls you to work with them?
• Why are you engaged with this agency?

SALSAL. I had been a member of its Denver chapter for 2 years now. I am engaged in this agency because they have informative educational offerings where I can learn. They also invite nursing students who round with me in the hospital to these educational sessions that they hold. These sessions are free. At times, they serve food, too. 

 

• SALSAL also helped one of my new CWOCNS with her tuition fee. She was attending the WOCN program in Emory University. 

 

• Ostomy support group. I run the ostomy support group in Wheat Ridge. I attend the Metro Denver one because they have ostomy questions and they do not always have a CWOCN present in their meeting. I attended one meeting but plan to come more often.

 

• What is your passion here? I am a CWOCN. The ostomy support group definitely benefit from information I can provide them. 

 

• As for SALSAL, I had suggested topics for their educational sessions. I had also identified and invited speakers to do their educational sessions. I had invited several clinicians and nursing students to come to these sessions. Doing this, I have helped spread the gospel of good lower extremity wound care.

 

 

• What are you currently doing with this organization and how do you see it evolving as you sustain your commitment with them? For SALSAL, I plan to help them invite speakers and attendees to come to their educational sessions. 

On February we have a fundraising dinner. I donated an item to auction. I also invited several clinicians to come. The money raised will help fund the WOCN scholarship that SALSAL sponsors. 

I plan to attend the ostomy support group meetings so I can answer the members' ostomy questions. In the last meeting, they had a new ostomate who also happens to be a RN. She was very upset and scared about getting a permanent colostomy. The ostomate and her family member talked to me for a while and they asked me a lot of ostomy questions. They said that the information I provided them had been helpful. 

I have also introduced the president of the ostomy association of Metro Denver, Karen to other community resources such as Exempla’s cancer navigator and genetic counselor to Karen.

I also emailed home health agencies and the other CWOCNs in town about the ostomy group that meets in Englewood and also the one I lead in Wheat Ridge.

I had also informed some clinicians about the support group. I plan to call on some doctor's offices regarding this support group.

 

• What is your role in this service learning experience? I am a member of SALSAL. I am a new member of the ostomy support group of Metro Denver (the one that meets in Englewood, CO). I plan to help them as I have detailed above. 

 

• What hours did you spend at the site and what activities were performed? I had been blogging about the hours I had been spending in the two groups.

 

Location: Meridian at 3455 S. Corona St., Englewood, Exempla Lutheran, and Breckenridge Brewery in Denver, CO.

January 28, 2014—1.5 hours

February 25, 2012—1.5 hours

March 4, 2014—0.5 hours

March 6, 2014—3 hours

Total 6.5 hours

Still ongoing

Service Learning activities

 

 

Location: several restaurants in Denver, CO where the group members usually meet

Meeting and fundraising at Corner House, February 11, 2014—3hours; meeting February 4, 2014 at Exempla Lutheran—1hour; meetings on January 6,2014 and January 20, 2014—1 hour and 2 hours.  Total of 7 hours.

Still ongoing

Service Learning activities

 

So far to date (3/9)=13.5 hours for both

 

• What are the opportunities here?

 

SALSAL. I plan to invite more registered nurses, clinical instructors, nursing students to the educational sessions. 

 

Ostomy support group. I plan to attend their meetings so I can help answer their clinical questions. 

 

Their president requested if I can invite a surgeon to support their group. I will ask one of our surgeons if he/she would be able to help them.

 

• What can you see yourself doing more long-term? I plan to come regularly to the ostomy support group. Their president asked me to help her distribute their brochure to doctor's offices. I plan to help her with that. I also plan to talk to some home health agencies about the Denver ostomy support group. On Monday Feb 3 I talked to one home health agency about the support group. I also emailed home health agency representatives I know. I also emailed all the local CWOCNs about the support group.

 

 

 

• Are people you came in contact with through this experience having some needs met through the community activities? Are community activities like these necessary and/or sufficient to fulfill these community and individual needs? Do you see other means to do so?

 

I see that people in the community are helped by the ostomy support group. The group provides them emotional support. A psychiatrist or similar clinician who can counsel ostomates regarding their psychological issues such as depression or isolation may also be helpful but insurance may not always cover mental health. Also there may be patients with no insurance.

The group also tries to help those without any means to get supplies by donating ostomy items that these folks with supply issues need.

This support group is necessary, however, it would be beneficial if the uninsured and the undocumented can get assistance in taking care of their ostomy needs—assistance that is systematic and consistent. Of course, this is a larger national problem. As for undocumented immigrants, that is an ever bigger global issue.

 

• What was the best/worst/most challenging thing that happened this semester?

 

One of the issues that I am seeing in the US and around the world is the disparity in health access.  This is not an easy problem to fix. The US has contributed to healthcare globally. For one, the negative pressure wound therapy or wound VAC was developed here. However, how can healthcare be accessible to all? The price of healthcare in the US is skyrocketing. What I found the most challenging is learning more about healthcare through this DNP program and at the same time trying to live as a nurse practicing in this healthcare system that is not very organized and not affordable to all.

 

The best thing this semester, for me, is the blending of all the activities to a unified whole. For example, the Service Learning activities of trying to encourage more RNs to be CWOCNs via the SALSAL scholarship, and the ostomy support group participation are both relevant to my DNP project of trying to educate home health nurses regarding ostomy care. The readings in the class, and the service learning activities as well as other work and community meetings such as the CWOCN Denver meetings are all very helpful in building my PICO.

 

• What have you learned about yourself?

 

I am enjoying my Catholic Jesuit education. I was raised Catholic and now I am appreciating the faith again. Regis is not only providing me knowledge and skills via the classes I attend. Regis also encourages me to reflect on my work not just as a professional but also as a human being. What I learned about myself is that I feel fortunate being an immigrant in the US since only 1999. English is not my first language. But yet here I am getting my doctorate. I also am fortunate to be a lead in my workplace. I have nursing students and other clinicians consulting me for my expertise. With these gifts that I have, I should reach out and volunteer. The Service Learning activities such as SALSAL and the ostomy support group are just two avenues to serve others.

 

I also learned that nursing is not just work, not just a career. It is a gift. Not many men and women who want to be nurses become one. Not many nurses can also have time and means to get their doctorates. With the blessings I have, I should strive every day to be a better nurse!

 

• What are your future service learning plans?

 

   

I plan to continue supporting SALSAL and the ostomy support group. I hope that I can get a grant after I get my DNP so I can do ostomy education among the rural home health nurses.

 

 

My patient had an Ostomy takedown. What a sense if humor

Materials Exempla is handing out on Colorectal cancer awareness day

Karen

Karen spoke to my Ostomy support group today about bereavement vs depression among Ostomy pts. Psychological issues such as depression is common among Ostomy patients. 

Inspiring

I talked to three colorectal cancer survivors tonight. One is still battling it. She is on chemo. Stage 4. Mets to the brain, lungs and bone. She is active in the Ostomy support groups as well as the cancer support group. 

One will have some more testing done because of a suspicious lesion noted in her lung. She has been off treatments for a year. So she is hoping this is something she can overcome. 

One is cancer free. He has a daughter who is 23 and they have talked to a genetic counselor for directions regarding screening. 

Let us all wage war against colorectal cancer. Wear blue March 7. 

Just came from a dinner in downtown Denver

Facebook

Friends and family notified via Facebook or text or email to wear blue for colorectal cancer awareness day March 7. 

Today at our Ostomy support group in Englewood

One of the ostomates is a colorectal cancer fighter. 4 years. She is still undergoing chemotherapy. What a fighter. She is Caucasian but speaks good Spanish. She reaches out to Spanish speaking ostomates. 

Meridian Library

This is where the Ostomy support group meets

Thank you note

From the Ostomy support group in Metro Denver. A thank you note and their newsletter 

Poster

At the SALSAL fundraising

Getting more attendees

Another Service Learning

I discovered another organization that needs my help. The Ostomy Association of Metro Denver. I attended their meeting last night. 

This year's SALSAL educational seminar

The line-up:

April 8^th – Patient Resources.  Byram (Dawn Crain) and Hanger (Scott Taylor)

July 8^th – Nutrition.  BSN Medical (Kellie Clark)

Oct 14^th – Unusual Wounds.  Celleration (Lauren Fisher)

One of SALSAL' s sponsor. Epifix. Wound product from human placenta.

SALSAL meeting

Our scholar recipient 2013

food

SALSAL's 2014 Fundraising