Volume 3, Issue 4 October 2015

A P U B L I C A T I O N O F
T H E D U Q U E S N E
U N I V E R S I T Y
S T U D E N T N U R S E S ’
A S S O C I A T I O N

1
 Who We Are

We are members of the Duquesne University Student Nurses Associa-

tion. All views expressed are our own and do not represent the views
of Duquesne University or Duquesne University School of Nursing.

We are members of the BSN Programs at Duquesne University. We

love health! We love patients! We love to write!

The Scope is the proud recipient of the 2013 and 2014 Student Nurses
Association of Pennsylvania Excellent Newsletter Award.

We would love to hear your thoughts on our newsletter! Please email

all letters to the editor to Bridget Seelinger, at dusnapublici-
ty@hotmail.com. All letters to the editor must include name, contact
info, and major.

Like us on Facebook and check out our blog at

DuquesneScope.wordpress.com

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Image from clk-
er.com
Table of Contents
DUSON Welcomes Examsoft Page 4
Ashley unveils the new testing program

Telemedicine: The way of the Future? Page 5

Briana discusses the pros and cons of the new technology

A Summer in Spain with a Little Bit of Leininger Page 6

Heather recalls her summer abroad

In Our Last Moments, Hospice Nursing Page 7

Chelsea captures the essence of this noble profession

Importance of Down Syndrome Awareness Page 8

Brooke tells us that October is about more than breast cancer

Save the Ta-Tas? Save the Women! Page 9

Elizabeth discusses the struggle of the cancer patient

McGinley Symposium Highlights Page 10

Sarah and Holly have all you need to know about this year’s symposium

Interprofessional Insight—OT Page 12

News Page 13
Healthy Recipe– Apple Crisp Page 13
Nursing Horoscopes Page 14
NCLEX Nook Page 14
Want to get more involved? Page 15

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 DUSON Welcomes Examsoft
Ashley Altieri, senior
The initial switch from paper exams to a computer program
known as Examsoft, was an adjustment for students and
teachers alike. Now that the program is up and running, ad-
ministration, professors, and students are singing the prais-
es of this new program.

Director of Technology, Joe Seidel, says that the School of

Nursing chose Examsoft over other programs because of built in security and compatibility with com-
puters and Ipads.

“This complete end-to-end solution of software for student devices, question banks, test creation and
powerful reporting and analytic tools for faculty made ExamSoft stand out from other products,” he
says.

Seidel also discusses how ExamSoft ensures security by closing off access to Wi-Fi during an exam.
Once the student is finished with their exam, the program connects to Wi-Fi and uploads to the Exam-
Soft server. Then, ExamSoft generates analytical reports that are available for faculty to see and adjust
the test as needed.

“ExamSoft is always making updates and adding

features to make a better test taking experience”,
Seidel says.

Professor Debra Lewis enjoys using ExamSoft in her

classroom, despite the initial unfamiliarity of the
program.

“It helps students become comfortable with taking

tests on the computer, which helps prepare stu-
dents for Hesi and NCLEX,” she says.

Lewis says that since she gets the results of the ex-
ams back so quickly, she is able to review what
questions need thrown out, and thus get the results
back to students in a short period of time.

Ilena Godleski, a senior nursing student agrees with

Lewis about the convenience of Examsoft.

“I like that I can read the rationales for questions and get my results as soon as I’m done with my test.”

ExamSoft is helping lift the burden from teachers of sending scantrons to the testing center and wait-
ing for the exam to come back. It offers students a way to alleviate the anxiety of waiting to know the
grade of a test. Technology has already made enormous impacts in the daily activities of hospitals,
such as the incorporation of telemedicine and electronic medical records. It creates quicker ways for
patients to receive treatment and results. Anyone that has worked in a hospital knows that time is
precious and in a short supply. How we respond to the changes in technology now as students will
help to prepare us for the numerous and wonderful changes we will face as nurses.

4
Photo from Arizona College
Telemedicine: The way of the Future?
Briana Gavin, Freshman
Telemedicine has been around since the creation of the telephone but has continued to go along with our
technology. Officially, telemedicine is the remote delivery of health care services and clinical information
using telecommunications technology1. Under telemedicine, also referred to as telehealth, patients are able
to meet with a health care provider at the office or in the comfort of their own home. In this system patients
who previously would have had to wait days for an appointment at Photo from Dartmouth-Hitchcock Center for Telehealth
their local doctor’s office and then sit in a waiting room,
would be able to use this service and arrange a vide-
oconference or phone call with a certified doctor and re-
ceive quality health care conveniently.

Telemedicine is a growing component of the American

health care system having around 200 networks with
3500 service sites in the United States1. While Telemedi-
cine is the name given to the entire concept, multiple
service provider companies run different centers located
all over the United States

Services under telemedicine are videoconferences,

phone calls and emails with a health care provider or
any service that involves using technology to provide
health care such as using a cardiac monitoring system.
Yet there are other advances through telemedicine, many remote hospitals such as in Mexico or other coun-
tries are able to communicate through these services and receive consults from world leading specialists to
provide health care to some who may not receive it otherwise3.

Telemedicine can be offered through applications on people’s phones and through monthly subscriptions. It
offers efficient health care at an affordable price with each consultation being around 40 dollars it will not
only reduce the overuse of emergency services but also low-
er the medical burden on American citizens3. However
though it may be cost effective some health care plans will
not cover these co-pays and patients will have to pay out of
pocket3. Another obstacle is that in some cases the patient
could be diagnosed wrong due to missing information not
mention or symptoms not noticed. In many states, the use of
telemedicine is being limited if not banned completely 2.

Despite draw backs telemedicine continues to evolve and

advance and is now being used to educate health providers
at remote hospitals through tele-simulations where they can receive direct instructions and information
from a specialist in fields of medicine they do not commonly encounter3.

Dr. Ravenna Rihal who works for Doctor on Demand, a telemedicine company, says “the technology sur-
passed my expectations and I think the future holds more because of all the wearable devices and all the
information we will be able to transmit soon”4.
1, http://www.americantelemed.org/about-telemedicine/what-
Telemedicine is becoming more and more popular and as our is-telemedicine#.VilPMfmrTtQ
technology advances we can only expect to see more come out 2, http://www.forbes.com/sites/billfrist/2015/03/12/
telemedicine-is-a-game-changer-for-patients-the-system/
of this system to benefit our health care and to expand towards 3, http://www.post-gazette.com/news/health/2014/08/12/
other locations. Telemedicine-gives-patients-an-alternative/
stories/201408120011 5

4, https://www.youtube.com/watch?v=u1-MFo7_n-Y
Photo from Interglobal Health above
A Summer in Spain with a Little Bit of Leininger
Heather Konstanzer, senior
As you’ve probably learned in your Freshman Seminar, Contemporary or Fundamentals nursing courses,
NCLEX loves to ask about cultural considerations. Sure, studying from
books can teach you which ethnicities eat what, the days that certain reli-
gions observe holidays, etc. What these books don’t teach is how you,
however, is how you, as a nurse, will react when you’re taken out of your
comfort zone and you’re implanted into a society bearing social, cultural
and professional norms that differ from your own.

This Summer, I traveled to Cuenca, Spain—a small city located Southeast

of Madrid. There, I spent three weeks shadowing healthcare professionals
of various specialties, teaching English to Doctors and gaining invaluable
experience in practicing cultural competence. During these three weeks, I
embraced the Spanish culture and was exposed to their version of
healthcare. Despite the common goal of delivering quality care to patients,
I noticed several significant differences between care in Cuenca, versus
care in the United States. While perhaps had I interned in a larger city, I
would have drawn more parallels be-
tween the two systems of care, I felt that
in Cuenca, the patients generally acted
less sick, the hospital setting was much more casual and deliverance of
care was far less complicated.

Part of the Spanish culture is to be very direct. While, warned of this by

one of my fellow Atlantis Project peers, the doctors I worked with never
sugar coated anything, did not worry about political correctness and
were surprisingly blunt in their manner of speech. This aspect was, in
many ways, extremely refreshing. If the doctor I was working with was
doing paperwork and I was uninterested, they took no offense in my stat-
ing, “I’m bored and would like to go work in the Emergency Department
for the rest of the day.” In the States, I probably would have panned my
way around saying that I was uninterested. I now try to adopt this habi-
tude in my daily practice. While there is more backlash associated with
saying what you feel in our culture, it is truly empowering and much
more efficient to be assertive with what you want.

As part of my rotations, I was able to see intensive and emergent care. These patients were critically ill,
however in some way they seemed less debilitated than
American patients. My completely subjective analysis of the
patients was that they simply seemed to take less pity on
themselves than the typical American patient. For example,
a patient could come in with a broken ankle, directly state
what facilitated the broken ankle and then listen to and
abide by what the doctor said. In my experience in the
States, the patients, more often than not, have circuitous
stories about what happened to them and then proceed to
question the doctor about his or her choice of treatment,
how their insurance will factor into the care and how abid-
ing to treatment will impact their normal routine. Not once
in Spain did I hear the phrase, “WebMD says. . .” The sub- 6
missiveness to the doctor makes care appear ...
Continued on page 15...
 In Our Last Moments, Hospice Nursing
Chelsea Kwong, senior
At some point in everyone’s lives, one will have to face the death of a loved one, and eventually, their own death.
During this time, it is critical to have adequate support and guidance in the various phases of the end-of-life stage.
Some nurses voluntarily put themselves in this position, caring for those with a terminal diagnosis and their griev-
ing loved ones. These nurses, known as hospice nurses, aim to provide maximum comfort for those whose treat-
ments have ended, and provide support and education for the loved
ones that the patient will leave behind.

Hospice care, by definition, is a type of care that “focuses on

providing compassionate care while maximizing a person’s quality
of life”1. Nurses in this field work to manage pain and assess the
patient’s condition, rather than performing aggressive measures to
keep them alive. Major duties of the hospice nurse lie within the
“Gold Standards Framework”, which is a tool to guide healthcare
professionals in the care of the terminally ill. The concepts within
this framework (also known as “the 7 C’s”) include: communication, coordination of care, control of symptoms,
continuity of care, continued learning for nurses and other professionals, caregiver support, and care of the dying2.

Hospice nurses not only provide care for their clients, but also for their clients’ families. As a terminal illness diag-
nosis also takes a toll on loved ones, nurses must prepare to educate the families on expectations during the end-of-
life phase, and support them during the grieving process. One way that the nurse may do this is by educating the
family on performing comfort measures (such as oral care) and
encouraging the family to tell stories or perform family rituals2.

The concept of hospice nursing is relatively new, having been de-

veloped within the past 25 years. Care is primarily provided in the
client’s home, but can also be provided in an in-patient hospice
unit, a nursing home/long term care facility, etc3. Those who wish
to become hospice nurses need not have additional certification
beyond an RN degree, however, organizations such as the Hos-
pice and Palliative Nurses Association offer various certifications
(including providing care for pediatric patients)4. Master’s degrees
in hospice and palliative care nursing exist at New York University and Ursaline College (in California)3.

Hospice nursing can require a great deal of vulnerability when providing care. One nurse provided a statement
about grieving a patient’s death to Linda Norlander, author of To Comfort A lways: A Nurse’s Guide to End-of-Life
Care, saying, “ I cry with the family. I also try to take some quiet time-sometimes I just sit in my car. But I need the
time to remember that patient”2. After providing care to a client and their family for a great deal of time, it can be
easy to form a bond, and hard to let the patient go.

During the end-of-life stage, many uncertainties can arise. It is a very emotional and confusing time for the patient
and their loved ones. With a hospice nurse, these people will not have to go through this journey alone.
1
Crusse, E.P. (2014). Hospice care is comfort care. Nursing Made Incredibly Easy!, 12(3), p. 40-49. DOI-10.1097/01.NME.0000445322.70273.8c
2
Norlander, L. (2014). To comfort always: A nurse’s guide to end-of-life care. Indianapolis: Sigma Theta Tau International. 7
3
Nurses for a Healthier Tomorrow. (2015). Hospice/palliative care nurses. Retrieved from http://www.nursesource.org/hospice.html.
4
Hospice and Palliative Nurses Association. (2015). Certifications offered. Retrieved from http://hpcc.advancingexpertcare.org/competence/certifications-
offered/ Photo from Georgia Mountains Hospice
 Importance of Down Syndrome Awareness
Brooke Calta, junior
Melissa Reilly works as an inspirational speaker and a teacher and is a gold medal skier, cycler, and swim-
mer. Sujeet Desai graduated from Bershire Hills Music academy, plays seven instruments and was featured
in Time Magazine and the Wall Street journal. Michael John works as an artist who has sold more than five
hundred portraits and had a solo gallery at Vanderbilt University. His paintings were
featured on the cover of the American Journal of Public Health.

What do these three individuals have in common besides seemingly successful careers?

All were born with Down syndrome.

Students who are enrolled in basic high school science courses usually get some basic
genetics concepts drilled into their mind:
“Chromosomes are rod-like structures that are made of genes.”

“Genes carry codes for inherited traits.”

“A mutation of a chromosome can cause a physical or mental change in an indi-

vidual.”

“Down syndrome is called Trisomy 21 because of an extra copy of a chromosome on the

21st pair.”
Melissa Reilly, photo from USA Today
Sure, many Americans know what causes Down syndrome, but are
we as a population aware of what it truly entails?

Roughly 1 in every 700 infants are born with Down syndrome.

The birth defect alters how the child’s body and brain grow, and
causes both physical and intellectual challenges. If diagnosed at
birth, health care workers look for a single deep crease in the
palm of the infant’s hand, a slightly flattened facial profile, an up-
ward slant to the eyes, and low muscle tone in addition to blood
tests for genetic testing.

Despite somewhat similar appearances and tendencies, people

with Down’s have varying abilities, unique to each individual. Ac-
cording to The Arc.org, children with Down syndrome can show few to several signs. In essence, an affected
individual is typically more similar to the average person in a society than different. Contrary to several
common myths, most people with Down’s can develop athletic abilities, learn to read and write, attend
public school, and live independently.

Why should we care about Down syndrome? Fortunately, people with Down syndrome are living much
longer lives because of advances in medicine and technology. With the increased life expectancy comes an
increase in the number of affected individuals in the work force, health care settings, and schools. There-
fore, it is imperative that Americans be not only educated, but accepting.
Like Melissa, Sujeet, and Michael, many people with Down syndrome are living successful, fulfilling lives. Un-
like the common belief, people with Down syndrome can receive therapy that, depending on the severity, allows
them to be more independent and partake in activities http://www.ndss.org/Down-Syndrome/What-Is-Down-Syndrome/
http://www.cdc.gov/ncbddd/birthdefects/downsyndrome/data.html
that they otherwise may not have been able to. Ad- http://www.globaldownsyndrome.org/about-down-syndrome/misconceptions-vs-reality/
vances in healthcare are allowing people with Down
8
syndrome to live longer, and now more and more http://liveactionnews.org/9-successful-people-with-down-syndrome-who-prove-life-is-worth-living/

progress is being made towards national awareness. http://www.thearc.org/learn-about/down-syndrome

Save the Ta-Tas? Save the Women!
Elizabeth Kovacs, junior
As the month of October nears its end, I think all of us can agree
that it was not lacking in enthusiasm as the month dedicated to
raising awareness for breast cancer. While I adore the outpour-
ing of support that breast cancer awareness has generated,
there is one thing I believe we could all do without. The phrase
“save the ta-tas” is one that most have heard countless times,
especially during the month of October. While the expression
may seem cute and harmless, it is really just as frivolous and
uncultivated as it sounds.
Not only does the phrase focus on a hyper-sexualized attribute
of a woman, it implies that saving these body parts is more im-
portant than saving the life of the person afflicted with a life-
altering, potentially fatal illness. Even worse, it implies that
women who have undergone life-saving mastectomies to either
prevent or treat their cancer are in some way wrong or less
feminine than those who have not. Having breasts is not an indicator of femininity or beauty, and cancer
patients should not be made to feel so. It’s also discriminatory against the men who suffer from breast can-
cer.
There is no other cancer that has gen-
erated a phrase of the same nature.
Saying “save the colon!” or “save the
prostate!” sounds pretty ridiculous,
and for good reason. Unfortunately,
because of the culture we live in
where women’s breasts are hyper-
sexualized, the focus is taken off of the
individual and placed on the body
part afflicted. Doing so diminishes the
struggle of the cancer patient; of going
through chemotherapy and radiation,
of making life-changing medical deci-
sions, and the prospect of succumbing Photo from spyrliving.com
to a horrendous disease that has been made into a cutesy slogan.
As soon-to-be nurses, I encourage everyone, especially during the month of October, to remember that our
goal is to save the lives of the women (and men) afflicted with breast cancer. Our job as nurses is to sup-
port and assist our patients, whether this means “saving their ta-tas” or not. Nurses should know better
than anyone else that a disease as serious as cancer should never be reduced to a mere sexist slogan, and
that our goal is always to save our patients before anything or anyone else.

9
 Miss out on McGinley? Here are the Highlights!
Sarah Dudley and Holly Storm, freshman
The Charleston Church Shootings. The televised murder of two journalists.
The various college shootings. This is how Dean Glasgow introduced The
Sixth Annual Rita M. McGinley Symposium, “The Face of the Person who
has Experienced Violence” which was held on Thursday, October 22-23,
sponsored by Duquesne University’s School of Nursing.
Dean, Mary Ellen Glasgow opened the symposium saying that this year’s
symposium is a way to stop the violence that our nation has experienced.
The morning began with Dr. Jackie Campbell’s speech on holistic approach-
es in treating those who have experienced violence. She was an incredibly
informative and persuasive speaker. It was an incredibly informative
speech and really was really insightful into the needs of these unique pa-
tients.
Next, the Plenary Panel was a group of three community members discuss-
ing how to deal with the violence in the communities in Pittsburgh and dif-
ferent aspects of the impact the violence has on the community. The speak-
ers included Malik G. Bankston, the
We took a minute in between sessions to snap
McGinley Symposium also featured research by executive director of The Kingsley
prominent members of the Pittsburgh community a McGinley selfie!
Association which deals
with communities of Pittsburgh and tries to help them get
back on their feet, Paul Abernathy, the director of Focus Pitts-
burgh which is a Christian organization that tries give sustain-
able and action-oriented options to communities in the United
States, and Walter Howard Smith who is the Clinical Director
and Deputy Director Office of Children, Youth, and Families.
This panel was informative as to what was happening to the
community and how the people are suffering while also hav-
ing the panelists give their own opinions on ways to heal the
community, which stems from their individual backgrounds
such as sustainability, not letting people suffer alone, and em-
powering people.
Fawn Robinson, an academic advisor in the School of Nursing,
also gave a speech titled “Black America: Facing the Realities
of Violence Impacting the Black Community”. It was a favorite
of the symposium because of her passion for this important
topic. She spoke about the incredible violence that the black community has faced and even mentioned taking
part in the “Black Lives Matter” movement.
“The reality is that being African American is not
an easy road,” she said in her speech, “It is not.
Not with my fancy suit and not with a PhD.”
Robinson’s speech evoked many emotions from
the audience, prompting some black members to
give personal experiences with racism and bigot-
ry. It was very moving and really very eye open- 10
ing.
 Carol Powell, who was a nurse and trains other nurses to handle sexual as-
sault, was next up in line for speeches. She spoke about sexual violence and
her experiences caring for this patient population. The overall theme of the
presentation was the role of the nurse in these situations. Powell discussed
the importance of documentation and advocacy. This presentation was
very powerful and moving as she spoke from experience and the heart
while also being educational for nurses on how to delicately care these pa-
tients.
There were many breakout sessions, but the two that stood out the most
were presented by Samantha Caravino and Kathleen Sekula.
The breakout session “Emergence of Gender Inequitable Practice in Adoles-
cence: Innovative Models”, was an incredible presentation by Samantha
Caravino, a Clinical Research Coordinator from University of Pittsburgh.
The Power Center was absolutely She reported on a study she has been conducting that found 81% of high
packed with people school seniors have reported being a wit-
ness to an abusive relationship. She also re-
ported that a group of middle schoolers felt it necessary to share the sen-
tence: “Belts are for discipline, but extension cords are for abuse”. This was
a very moving session and really got one thinking about children and vio-
lence.
Kathleen Sekula, one of the leading developers of the Masters of Science in
Forensic Nursing program at Duquesne, explained a study conducted by
one of her students, Julie Valentine, in Utah. Valentine found that in Salt
Lake City, on 6% of Sexual Assault Kits have been pushed through from the
police station to the crime analysis lab, and many police officers had re-
ported that the victim was “stuttering, forgetful, and out-of-it”, which are
all symptoms of being traumatized. The study has resulted in increased
funding in educating police on violence victims, and increasing the percent
of kits that are being analyzed.
This year’s symposium was held on the 5th
The Face of the Person who has Experienced Violence Symposium was a floor of the Power Center
huge success with many interesting sessions. It was successful because it
covered so many topics from domestic violence to violence in the LGBTQ community to vulnerable popula-
tions in violence. It focused overall on the topic of violence while also having panels talking about how this
relates specifically to the city of Pittsburgh. They did not leave any stone unturned and they will do the
same next year which make it a hit again. We are so glad that we attended, and highly encourage everyone
to attend next year!

All photos by Sarah Dudley

11
 Occupational Therapy: Recovering ADLs
Sarah Cousino , OT major
Occupational therapy is a field in the healthcare in-
dustry that is unfamiliar to many. A typical reaction
when I tell someone I major in OT is, “What is
that?” To this day, it is still challenging at times to
give a concrete answer to that question, because
the role of an occupational therapist can be so
many different things. OT includes a vast realm of
job settings and fields in which one can practice.
The essence of occupational therapy is to help indi-
viduals lead a life that is meaningful to them. Occu-
pational therapists use holistic methods to assist
Photo from cerebalpalsy.weebly.com
clients in regaining the ability to complete tasks that they once
could and reach goals they set for themselves.

The recovery process after an injury or traumatic event is long and arduous, and often times,
simple tasks, such as brushing your teeth, are no long-
OT helps patients master fine motor skills/ Photo from dyc.edu
er simple. People may need to entirely re-
learn how to complete these tasks. This is
where OT comes in. Occupational thera-
pists work side by side with clients to sup-
port and assist their involvement and mas-
tery of daily occupations. This promotes
and supports the overall health and well-
being of the client. They identify what is
valuable to someone, whether it be taking
a walk, or cooking a meal, and strive to de-
velop ways to make these things achievable. Put simply, occupational therapists help people
live the life they want to live, and experience it the fullest, without letting a disability or injury
hold them back.

Occupational therapists work in many of the same settings as nurses, such as hospitals,
schools, and mental health facilities, to name just a few. It is important for occupational thera-
pists and nurses to work together and understand each other’s respective fields so that an ef-
fective and successful work environment is created, in which a patient can flourish. For exam-
ple, the information, instructions, and precautions a nurse provides a patient regarding their
condition or disease are crucial to a successful recovery. On the other hand, the development of
individual adaptations to aid independent living is something that would fall under an occupa-
tional therapist’s job description. By communicating with each other, both professionals can
decide what is best for the patient, and what techniques will make the recovery process as
smooth as possible. It is important to inform each other about patient’s progress, and provide
updates about any recent changes. In the same regard, it is necessary to maintain a level of re-
spect and cooperation between all members of the healthcare team. By understanding each
profession, the strengths and weaknesses of each member can be incorporated appropriately 12

to maximize efficiency and achievement.

 News & Announcements
DUSNA School of Nursing
 DUSNA ‘s next membership meeting is on  Sophomore and Junior forums
November 5th at 7pm in Mary Pappert
with the dean are scheduled for
 NSNA’s Midyear Convention in Atlanta, Georgia is
the last week of October.
November 5th-8th and DUSNA is sending 3
representatives! Wish them the best of luck!
 Nursing Alumni had a fantastic
 SNAP Convention is November 18th-21st. If you
weekend during Homecoming
are interested in running for office, email NEC
West at NECWestSNAP@gmail.com. weekend
 Duquesne Nursing clothing sale will be taking
 Ribbon cutting for the new simula-
place until November 6th. Check your email for the
tion lab is scheduled for Novem-
link to the online store!
 Keep your eyes peeled for a mentor/mentee social ber 4th from 11:30am- 1:30pm
coming up before Thanksgiving!
 Watch your email for a PIYO class in the Power
Center in early November
 You’ve heard of Thanksgiving but have you heard
of “Friends”-giving? Come to the DUSNA meeting
for more info.
Own a business and want to get the
 The university counseling center will be coming to
the December membership meeting to help us out word out? Place your advertisement

with test stress here! Contact Bridget Seelinger at

 The resolution "In support of educating parents of dusnapublicity@hotmail.com for details
intersex infants on all available surgical and
nonsurgical options.,” will be presented at SNAP

Apple crisp Try this warm treat on a cool fall evening!

From: BettyCrocker.com
1 Heat oven to 375ºF. Grease bottom and sides of 8-inch
What You Will Need: square pan with short-
4 medium tart cooking apples, sliced (4 cups) ening.

3/4 cup packed brown sugar 2 Spread apples in pan.

1/2 cup all-purpose flour In medium bowl, stir
remaining ingredients
1/2 cup quick-cooking or old-fashioned oats
except cream until well
1/3 cup butter or margarine, softened mixed; sprinkle over apples.
3/4 teaspoon ground cinnamon 3 Bake about 30 minutes or until topping is golden
3/4 teaspoon ground nutmeg brown and apples are tender when pierced with a fork.
13
Serve warm with cream.
Cream or Ice cream, if desired
 Libra and Scorpio

My Libras out there, your future I read through the planet Venus and your sign is the air. You are a caring friend
and have an overall graceful way about you. In the life of a Libra, balance is important—you need all your food
groups to be represented, if you will. Your time cannot be occupied too much by the same
thing, but you need your alone time, your academic time, and your social time in equal dos-
es in order to function. The fact that you like to please those around you may not exactly
help you keep this balance. As the academic year is beginning to pick up its pace, the HESI
questions are demanding your attention while you are still juggling a social life, do not be
afraid to take a moment for yourself. Go for a run, read a book at the point, take a kickbox-
ing class, or go dancing! You may be surprised how much some time to yourself clears your
mind and enables you to maintain balance in your schedule.

Hello, all my fellow Scorpios! Your destiny determined by the position of planet Mars, your sign may be water, but
you are definitely not known for being peaceful and calm. You are of a mature and passionate personality type—
feeling emotions to their extremes and not afraid to voice your opinion. If you see an opportunity help out Sim
man in the nursing lab, you are the first to volunteer. Likewise, if you see a patient on the floor whose needs aren’t
being attended to, you do not hesitate to advocate for them (way to attack those nursing competencies!). You are
wonderfully insightful into the needs of others as well as in touch with yourself—all excellent qualities that suit
you well as a student and future nurse. However, your good characteristics of being emotionally intelligent and
dynamic and confidant in your voice can often lead you to let your emotions take charge. Unfortunately, Scorpios,
we have to fight the urge to hold grudges and to take this so personally. After all, our patients are definitely deal-
ing with a lot and our co-workers and peers are human and often overworked by the craziness that is life too.
Keep lovin’ and keep speaking up for the underdog! You’re often times one of the few people who will…

P.S….Stressed out with nursing school? Overwhelmed by life? Need nursing school ad-
vice, life advice, or just an anonymous person to talk to who may be able to relate? Feel
free to contact me, Lady HCTZ at LadyHCTZduq@gmail.com!

Futures divined by: Lady Hydrochlorothiazide, filtering through your fu-

ture with a daily dose of dire etiquette.

Check back next month for what the future holds!

A woman in labor is diagnosed with abruption placenta. The nurse

NCLEX Nook would expect which findings in the client’s history that may contribute
to the occurrence of the complication?
Question is from NLEXReviewers.com
a. Age of 24 years old
Answer is on page 15 b. Cigarette smoking
c. Sleeping 8 hours per night 14
d. Sitting for long period
Spain...cont from page 6
...more concise. In the States, it’s our drive to be knowledgeable consumers DUSNA BOARD OF
and participate in our care that sometimes interferes with expediting and
simplifying care.
DIRECTORS
Another compounding factor in the
 President– Emily Kinley
United State’s complex healthcare sys-
tem is our idea of a market-based sys-  Vice-President–Caroline Miller
tem in which private companies dic-
tate cost and provisions of medical  Secretary– Allison Erceg
coverage. Each year, the US shells out  Treasurer– Joelle Augustine
more money per capita than any other
nation in the world, and yet we rank  Social Co-Chairs– Tara Shipe and
near the bottom of all developed na- Mikayla Dongell
tions in terms of quality of care. The  Service– Rachel Keto
act of controlling costs not only bur-
dens these companies, but it burdens  Legislative Coordinator– Amanda
the consumers. Constantly worrying Matkovic
about what is covered versus not cov-  Fundraising– Monika Spangenberg
ered impedes quality and equitable access to care. Along with individuals not
having insurance, some Americans will actually  Recruitment– Julie Herr
experience adverse outcomes due to delay in  Publicity– Bridget Seelinger
seeking care, simply because it’s not covered.
Spain’s healthcare system is government funded,
which takes out the middleman of private mar-
kets. Costs come from one party—the govern-
ment and access to care is relatively standard
across the population. The idea is that everyone
pays into the system and everyone benefits.

From my experience abroad, I’ve gained confi-

dence in my practice and abilities. I am better
equipped to empathize with patients of foreign
cultures, because I’ve experienced what it’s like
to be an outsider in another country’s healthcare
system. After witnessing the lack of autonomy
nurses in Spain appeared to have, I have an immense appreciation for the lat-
itude that continuing education provides for nurses in the United States.
Most importantly, I discovered that truly exceptional care is up to the indi-
vidual practitioner, not the system itself. Each healthcare provider has the
responsibility to improve the circumstance of each patient they encounter,
and to the best of their ability, strengthen quality of care.

Photos by Heather Konstanzer

NLCEX Nook Answer: B

Predisposing factors for abruptio placenta include:

advanced maternal age , short-umbilical cord ,
chronic hypertensive disease , PIH , direct trauma , 15
and vasoconstriction from cocaine or cigarette use
 What is SNAP?
SNAP stands Student Nurses Association of Pennsylva-
nia. SNAP is the state level version of DUSNA. It is an ex-
cellent way to network as well as get to know nursing
students from all over the state of PA. The annual confer-
ence is in mid to late November. If interested in running
for office, email the NEC West at
NECWestSNAP@gmail.com!

What is NSNA?

NSNA stands for National Student Nurses Association and is the na-
tional version of DUSNA. NSNA is active in federal and state health pol-
icy and has close ties to the American Nurses Association, the national
association for all nurses. The annual conference takes place in late
March early April and is a great way to network and get to know nurs-
ing students from all over the country. Contact the NEC East at
NECEast@NSNA.org if interested in running for office!

Photo from Student Nurses of Rhode Island

How can I be involved in DUSNA?

If you’re looking for ways to be more involved, join a committee! The board of directors is always
looking for help. Legislative committee is an excellent way to get involved if you have an interest in
health policy. Social and Service are regularly needing help with organizing activities. The Scope is
always looking for writers and bloggers. DUSNA is an excellent way to get to know other nursing
students and have FUN. The more involved you are the more fun you will have! Contact anyone
from the board!

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