• Identify your preconceived thoughts about the Needle Exchange Program prior to this class discussion and presentation. 
• Discuss how this presentation may have changed your pre-existing beliefs or bias about this program (if any). 
• Discuss strategies for resolving health and healthcare disparities and improving the health of those affected within this population. 
• How will you apply what you have learned in today’s presentation to your nursing Center To Advance Interprofessional Education And Practice? 

Prior to the presentation today, I had not had many preconceived notions about the Needle Exchange Program. I believe this is a program where you can discard used needles and replace them with new ones. This program can be utilized by anyone who needs fresh needles. I understand that this can be used for individuals who are struggling with substance use disorders and this is a way to provide safe injection practices. I have a different idea about this program as my brother has to inject himself with growth hormone daily because he has a tumor on his pituitary gland that has hindered his growth. My mother will drop off his filled sharps disposal container to the nice people at this program. They have the ability to dispose of them at no or little cost. I believe that this program is controversial but overall beneficial to my family. 

After this presentation they made me think differently about people who are a victim of substance abuse. These people deserve the same level of care as any other person. This program protects these victims and provides the care they need without judgment. They emphasize the reduction of harm with people’s substance abuse issues. They understand the complexity of addiction and provide varying levels of care to help everyone individually. They use an interdisciplinary approach to care for people with substance use disorders in Maine. They provide as little or as much help and interaction as warranted by the individual. They offer connection and comfort for people who would like extra help with further resources. I thought it was interesting that they have sharps containers located throughout the community to allow for the disposal of dirty needles. They also provide Narcan training to anyone who is willing to listen. They will also provide naloxone nasal spray just in case. This program will provide free services along with testing for HIV to diminish the healthcare disparities. If the individual tests positive they will then follow through and provide more resources to care for the new HIV diagnosis. 

I have learned a lot during today’s presentation. I will ultimately take away the amount of judge-free care that they provide. They will help people who are only there to get new needles and those who are there to quit their addiction. They were extremely accepting and understanding about this disorder. They understand that there is usually a deeper issue that leads them to this lifestyle. It takes courage for the patient to ask for help and they value and recognize this. I hope to never judge any of my patients based on their choices because there is always a deeper story. I hope to make the world a better place by doing this within the community as well.

• Discuss your pre-existing thoughts on Human Trafficking prior to this Discussion. 
• After hearing this discussion, have your thoughts changed or been challenged? What would you love to know more about?
• How will or what can you apply in today’s lecture to your future practice as a registered nurse?

After hearing the discussion, I have learned a lot about how this is a nationwide issue that can affect anyone of any race, gender, income, age, or sexual orientation. Originally I was worried about strangers and primarily men being the attackers but that is not necessarily the case. The attacker could be someone I know such as neighbors, friends, or even family members. I was extremely surprised by the amount of control the traffickers have over the victims. For example, the victims could have tattoos that mimic brandings as a form of control. It can also be important to focus on how the victim communicates such as their mannerisms or vocabulary. I was very surprised to hear that statistically the victim will only open up about their situation after the 5th-8th intervention. There was so much more that I have learned during this short 3 hours. All in all,  I really enjoyed this presentation and learned a lot from Shaun. 

In my future as a nurse, I hope to always remain vigilant when caring for any patient. I hope to be able to recognize the signs and provide proper care for them. I will always report to my supervisor if I suspect anything unusual with my patient. I also hope to take advantage of the certification to become a forensic nurse a year after I graduate from UNE. I have the understanding that the school will provide free training for graduates. I believe that this will help me become a better nurse to my patients. 

• Which event did you select to attend? Why?
• How did this event build on your knowledge from prior courses and experiences? 
• What most surprised or impressed you about the event? Why?
• How will you incorporate this new knowledge into your care of patients?

I have chosen to attend the interprofessional Knowledge Exchange event presented by UNE’s Planetary Health Council (PHC) team. This presentation called, Exposing Forever Chemicals: PFAS Contamination in Maine, seemed interesting to me because I am from Falmouth, Maine and I always love to learn new ways to help improve our lovely state. I chose this event because the environment is always changing and plays a role in our overall well-being, so knowing how to help the earth will ultimately benefit our health. I have always been aware of the many different crops that are grown in Aroostic Country because that is where my parents are from. My grandfather grew up on his family’s dairy farm in Frenchville, Maine. I also know some of the dangers of pollution and its risks to human health. 

After watching this event I have learned so much about Maine’s environmental health. A few things that surprised me the most are that PFAS, a harmful chemical within the farms, was mostly from farmers in the 1980s and 90s. This chemical can contaminate water, soil, livestock, and crops therefore affecting food safety and work environments for the farmers. This was surprising to me because things we are doing now within the environment can have detrimental effects 40+ years down the line. Maine is the first state that is providing testing, emergency relief, and risk reduction for PFAS. I hope to use this knowledge when caring for patients from the county or Maine in general. Occupation can affect a person’s health and knowing about this harmful chemical can alter our plan of care. I will keep nutrition and diet in mind along with where they get their food when obtaining a health history of my patient.

• What are your thoughts about the value of telemedicine (either via teleICU or telepresence) for care of the critically ill patients?
• Examine the history of telehealth & telemedicine and the influence it has on the profession of Nursing… think about it since the pandemic!
• How will you apply what you learn about Telemedicine to enhance the care provided in acute care?
• How has this knowledge built on your prior knowledge or experience with telemedicine?

I believe telemedicine is a blessing in disguise. This is a new realm of healthcare that can be controversial. In my opinion, telemedicine is extremely valuable for critically ill patients. It can allow these patients to stay in the comfort of their own homes while receiving medical advice from professionals. This can give the provider a brief overview of how the patient is doing within their own home. It can also provide remote teaching to patients who may be completing their home care (dressing changes, IV medication administration, etc.). In my experience with telehealth, I have been allowed to reach out to my pulmonologist during my exacerbations to get advice as to how to continue. During the pandemic, this was one of the main ways of connecting with a healthcare team. I was able to have my ENT, Pulmonologist, Home Nurse, and PCP on the same Zoom call to talk about my healthcare regime during this scary time. I hope to use this knowledge of telemedicine to encourage patients to learn how to use electronics to set up appointments. Video call appointments can benefit many patients who live far away and may have an acute illness. This presentation has enhanced my prior opinions about telemedicine. I believe that this can be life-changing for anyone and everyone willing to take this next step into the unknown. 

• How did the documentary influence your thinking about the ‘final days’?
• Do you or your loved ones have an advance directive?  Why or why not?
• Have you ever discussed your thoughts about your own mortality with those you love?  Why or why not?

This documentary was extraordinarily well-directed and produced. It made me start to think about how life is short and unexpected. I may be healthy right now but there is no telling what the future may hold for me. I have a rare chronic lung disease called Primary Ciliary Dyskinesia and because of this, I have thought about what may happen. My parents both have an advance directive. They have one because they believe it is important for our family to be on the same page if something were to happen. I am a part of a family of 6, so opinions and points of view vary between all of us. I can see how making medical decisions may become a problem.

I have discussed my own mortality with my parents. I was especially curious when I was younger and trying to grasp the concept of my disease. I remember my parents explaining to me that even though this is a rare disease they have trust in the medical professionals. My disease is similar to Cystic Fibrosis but has a better life expectancy. This information helped me feel safe. I have not recently talked about death with them because everything is going right with my health right now. After watching this documentary, I am going to ask them their thoughts about this topic.