Disciplinary Expert Tour

Within the article it states, "many people, the most worrying thing about technolo-gies is that they have the capacity to change the way we experience and think about reality". I can see this occurance happening when using sites within the internet because not all information is credible or bias free. These systems, however, are credible and bias free. In terms of "being", all nurse anesthesits need these types of devices to make their job run smoothly and safely. If they did not have these devices, it would make their job extremely difficult and challenging. Nurse anesthesists are professionals who are trained at using these types of devices with patients. They are very skilled at what they do on a daily routine to keep patients safe when put to sleep for surgery.

I observed a nurse anesthetist in the disciplinary of science. They use a computer system called Epic to chart everything during a surgery. The nurses also chart on it and the doctors so that everything can be seen from one platform by all medical professionals who work with the patient. They can even access the patient's medical records from other hospitals and doctor's offices. All the information from the ventilator and the vitals gets automatically populated into the electronic record on Epic. In terms of "do", this machine keeps all records in an organized, systematic fashion. If we did not have this machine, they would most likely use a paper/pencil procedure. This machine pulls up information needed in seconds by identifying the patient's first and last name. Everything is available 'at hand' and readily available. It stores all previous medical history of the patients so that they do not need to make a phone call or ask someone else about their medical history. In terms of "meaning", this machine can do many different things for nurse anesthesists. They can check medical records from every location that the patient has visited. Whether its a doctor's office, hospital or prompt care, all data is stored within one system. Along with their medical data, nurse anesthesists can locate a patient's vitals and ventilator information. This system does a variety of records for the nurse anesthesists so that s/he does not need to use more than one system to locate a patient's information. In terms of "relating", this machine gives nurse anesthesists a system of data, but let's them decide how they want/need to read the data given. Some want to find out specific information, whereas others need to use the machine to find out other informaiton from the same patient. They can interpret and analyze the data how they choose.

Nurse anesthesiologist use this machine with patients when they are putting them to sleep before surgery. Medication is given to put the patient to sleep and paralyze them. The patient is then put on a breathing tube and hooked up to this ventilator to breathe and kept asleep during the surgery. In terms of "do", this machine helps patients breathe when they are put to sleep for surgery. If we did not have this machine, the procedure would/could be very dangerous in terms of their ability to breath and stay alive for the procedure. The ventilator on the machine breaths for them when they do not have that ability themselves. In terms of "meaning", this machine has changed the safety of the procedure. Without this machine, patients would not have a breathing support system. They would have to rely on breathing on their own, which would result in more dangerous situations than doing the procedure with this device. In terms of "relating", this machine adjusts to the needs of the patient in terms of their ability to breathe while the surgery is in place. Some patients might need more oxygen support than others. The machine situates itself so that the patient can safety complete the procedure.

This machine tells medical professionals a patient's heart rate (green), pulse (blue) and breathing (CO2) (yellow).

This is their Pyxis machine that medical professionals get the patient's drugs from. When they get the drugs out of this machine, they are automatically populated into Epic. Nurse anesthesiologists and other medical professionals just have to chart the dose and time. In terms of "do", this machine stores all medicines for nurse anesthesists so that they do not have to go search for the drugs before surgery. If we did not have this machine, nurse anesthesists would have to spend more time locating the drug, which would take time and effort before the surgery. This keeps the medicine organized and 'at hand' when they need it. In terms of "meaning", this machine makes medicine readily assessible for nurse anesthesits so that they do not need to order medication or go find it elsewhere. They can locate and identify drugs needed for the patient. In terms of "relating", this machine holds a variety of different medications for patients. Nurse anesthesists can each use the machine to locate and access the drug they need during each surgery. They can document what drug they need and access it within seconds. The machine will keep all medications that are not needed by nurse anethesists during a given procedure.

This machine tells medical professionals a patient's heart rate (green), pulse (blue) and breathing (CO2) (yellow). This is the same picture as above, just shows what the machine looks like when a patient is connected and the machine is working. In terms of "do", this machine gives nurse anesthesists the ability to detect one's heart rate, pulse and breathing. Without this machine, it would be difficult for nurse anesthesits to complete these necessary steps before surgery. This step in the process ensures that the patient's heart rate, pluse and breathing is at an acceptable rate for surgery. In terms of "meaning", this machine let's a nurse anesthesist document different types of data needed for the procedure to go smoothly. If levels (breathing, heart rate and pulse) are not at a good rate, the procedure could results in many different (high risk) situations. This machine helps nurse anesthesists make sure that the patient's levels are in the ranges needed for the procedure. In terms of "relating", some nurse anesthesists pay close attention to heart rate, whereas others pay close attention to one's pulse. Depending the rate needing most attention, the nurse anesthesists can determine which component displayed they focus on to keep the patient safe during the procedure.

Possible implications for teaching:

**Most schools experience a teacher shortage in the field of science.

** Students cannot find relevance in connecting science concepts to their lives.

** Schools have an insufficient number of resources available for teachers to successfully plan and implement science experiments and activities.

**Schools have an insufficient number of in-service trainings and professional development opportunities for science teachers.

**Students generally lack motivation and have low self confidence in learning science.

Life as an anesthetist:

They interview the patient before surgery about their medical and surgical history. They formulate an anesthesia plan based on the patient's history and the type of surgery/sedation verse general anesthesia (with LMA or endotracheal tube). Then, they set up for their surgery (get all the supplies ready and draw up all the drugs). Then, they do the surgery (put them to sleep, monitor vitals throughout the whole case, give meds, treat pain/high or low blood pressure and wake them up/extubate them at the end). When they are awake and breathing on their own adequately, they transport them to PACU (recovery room) with OR nurses and give a report to the recovery room nurse. Then they go.... and do it all over again.

She works with surgeons, other anesthesiologists, nurses (in OR - they are called circulating nurses and nurses in PACU) and scrub techs.

How can I help students develop the skills and mindset they would need should they want to follow a path like a nurse anesthesist? Students must be able to work with technology. Nurse anesthesists use many different types of computer systems throughout their day. Students must also know how to read and understand each system. Students must be good at communicating wtih others. They will need to communicate with other workers and also with their patients. Students can become familiar with all the medical equiptment that they will be using as a nurse anesthesist. All these skills can be practiced and improved.

How can I implement practices in my class that would prepare them for some of the things nurse anesthetists do in their work?

I can have students do a 'career choice' activity on the computer where they need to create a presentation describing a day in the life of their dream job. This will get students familiar with the job and what it entails. It will get them familiar with what they would experience working within their career choice.

I can have a nurse anesthesist come into my classroom and 'talk with students' about their every day life at work. The anesthesist can bring in supplies he/she uses on a daily basis so that students can see 'first hand' what they use and how they use them.

I can have them do a book study where they read about their 'career choice' and make a poster outlining what they've learned from their research.

The technologies mediate what people could "do, mean, relate, think, and be" in the career field.