Personal Narrative: The Health Care System

By this document I, DANIELLE M. MOORE, of 13317 Wyngate Point, San Diego, California 92130, intend to create an advance health care directive under California Probate Code Section 4600 and following. This advance directive shall not be affected by my subsequent incapacity. All references herein to “my agent” refer to the agent acting at the pertinent time.

I was denied access to health care after my Nurse Practitioner wrote up an order for my x-ray. I had stopped by the front office for patient registration, inquiring why I kept seeing the amount of my bill go up to the tunes of hundreds of dollars, even though I was clearly punctual in making my co-payments after each visit.

Imagine a connected healthcare interface where your medications are linked to your smartphone, smart pill bottles remind you of when it’s time to take your medications, and prescription medications or surgeries are customized towards your individual genetic and physical needs. This is the future of healthcare - we just have a long way to go before we get there. As you look at startups in the healthtech space - many of them are well on their way to having one piece of the puzzle - AdhereTech with smart wireless pill bottle to TalkSpace with customized online mental health counseling. To create that integrated network I believe the buy-in will need to come from some of the largest healthcare companies currently, such as Johnson & Johnson, Cardinal

I was born on September 20th, 1997 on the coast of Virginia Beach. Now living in South Carolina I am 19 years old and living a very healthy and eloquent lifestyle. As I filled out the Real Age questionnaire I encountered many questions that made me think if my diet and health were flawed, while other times it seemed as if I was the pinnacle of health. I found at the end it had me down as a 16-year-old teenager. This three-year difference in what my age and what Real Age had put me down for really opens my eyes about how well of a healthy lifestyle I am living, and motivates me to continue living it to the best of my ability.

I have been in the Marine Corps for roughly three and a half years and throughout that time I have done many things. Most of the things that I have done were with Combat Logistics Battalion 26. For three years, I worked with that unit through work ups and a deployment and I have seen and done many unique things. However, nothing I did with CLB 26 felt fulfilling, but that all changed when I changed units to CLB 8.

I have worked for The Advocate, a Baton Rouge award winning newspaper, for more than 23 years. When I first hired on in May of 1992, it was only to be a temporary job until I finished college. Before computers and electronic layout programs simplified this process with the click of a button, people had to cut out and paste the stories, pictures, and advertisements that appeared in the daily newspaper. This was my job: I was a Compositor. I worked evenings so this allowed me the availability to go to school during the day. I have always been a hard worker and taken pride in whatever assignment I was given. This character trait was recognized by others and I was quickly promoted to other jobs. As the computer age and world wide web came to life,

My wrists burned terribly and the stinging pain seemed to rivet through my entire body. I didn't mind it though,it gave me a sense of being alive, a sense of that somewhere in the midst of this all, I'm still human and even thought I feel dead, I know I'm not.

Throughout my clinical experiences I have encountered a large variety of school cultures and environments. I've been lucky enough to work with both public and charter schools and have first-hand experience with grades one through four. While I have taught and observed all of the typical subjects including math science, reading, and social studies, I have also worked in the schools to educate students in theater as well as health and physical education. From all of these experiences I learned that my greatest passion is in working with young students, grades K-2, in underprivileged schools.

The nurse gestured for me to come closer. I took a few steps forward and she leaned towards me and whispered, “Try holding her hand. You’ll help her feel more at ease.” I was a little hesitant but I did as I was told and took the patient’s hand. I felt her hand mold into a strong grip around mine without hesitation. While the patient’s grip never lessened on my hand, sometimes it would clench up for a moment before slowly relaxing again. The rest of the staff was busy following the surgeon’s directions, moving quickly around the room. I felt uncomfortable being the only one standing still, doing nothing. So I glanced at the patient. She was breathing hard with her eyes closed, her hand still securely around mine. My hand was starting to hurt, so I tried to ease it out of her grip. But as the patient winced in pain, she grabbed my hand even more strongly.

The first thing that comes to my mind about this clinical experience would be exhausting. I had only three hours of sleep because I had forgotten I had a prior obligation later in the evening, so was unable to leave Alamosa until 2100, so I did not get home till 2330. I had to get up at 0400 to then go to SCCF. Four hours asleep, while sick was not a good idea. It was an extremely tiring day that I feel like I am probably missing something in this journal.

When I woke up I had no idea where I was. I was dazed and really confused. The nurse came in and said, “Jaclyn you're in the Toledo Flower Hospital and you passed out.” My parents were sitting there with worried faces. I just wanted to know what was going on. She was giving me a medicine through my IV, looking as if she was frantic and dripping with sweat. As soon as I got my medicine a stretcher burst through the door. There was a bloody unconscious man lying on it. My nurse immediately ran to them and she was rushing around and looked like she was on an adrenaline rush. She was yelling for a Doctor, but there wasn't one around. She had to make the decision to intubate the patient without the doctor and that was a risky decision.

My goal for clinical experiences is to apply what I have learned throughout my semesters to a clinical setting. I want to become more competent in my skills. I want to be able to look at a patient and identify clues that help me create a focus assessment. I also want to be able to use the patient medication to identify some adverse effects to create a preventative plan of care. My goals are to become more structured with my care plans. I want to make them more patient centered and more focused on initial issues that the patient might have then move it towards preventive methods instead of having my preventative methods first . I also want to become more confident in preparing and starting IV. I know that perfecting starting an IV will come

Allied Health was my first real exposure to the medical process, and allowed me to gain a clear picture of why I believe I would excel in this profession. The first semester of Allied Health was spent in the classroom, pouring over basic medical practices, medical terminology, and anatomy. Before this, I had known subjectively that being a doctor meant knowing a lot of stuff, but I was unprepared for the overwhelming amount of objective information Dr. Lynott taught us for two hours each day. Going into her office one day to inquire about a poor grade, I remember asking "Is it really this much studying to be a doctor?" Her immediate response has shaped my idea of what it means to be a medical doctor to this day. "When a patient is on the table, that much studying could mean the

I stumble out my one-night-stand’s apartment grasping on to the nearest railing for support. Sloppily, I buckle my belt and take a swig from my vodka bottle, stinging my throat with every drop. The bottle slips out of my hand crashing at my feet, almost in slow motion. I giggle hysterically and hobble down the steps. My brain is numb and filled with psychotic thoughts. I grab the car door handle and slump into the cushioned seat, nearly passing out, from a night of careless sex and non-stop alcohol can really put a load on a 5’6, skinny guy. Without thinking a grab my keys and start the car pulling out to the abandoned, dimly lit freeway. Everything was better at night.

To describe a time that a leader I know “Challenged the Process”, I am going to look back at the example that I used for our last reflection. One-day last summer while working for the Boulder County trail crew, my crew, as well as one more, were tasked with moving a 1-ton bridge using grip-hoists (manually-operated winches), and it proved to be a much more daunting task than we had anticipated. After many failed attempts to move the bridge, frustration among crew members was at an all-time high. We were working near a high-use mountain bike trail, and many riders had been watching our progress, so the pressure to accomplish our goal was higher than usual.