Volume 6, Issue 5 April 2019

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

Global Nursing

Photo credits: Lauren Bliss Pictured on cover: Professor Angela Karakachian, Julia Ciotti, and Emily Twy
What will you find in The Scope?
The Scope is a newsletter/magazine produced by the Duquesne University Student Nurses As-
sociation that displays unique perspectives from current students and faculty. You’ll find pho-
tographs of students collaborating, writing pieces on life-changing nursing experiences, and
messages from faculty aiming to inspire.

The Scope is the proud recipient of the 2013, 2014, and 2016 Student Nurses Association of
Pennsylvania Excellent Newsletter Award. President Morgan Gruender and Vice President
Emily Churchill have created such an established piece of work.

As BSN students are incredibly busy with work and with saving lives, please consider writing
and giving your time to keep this newsletter going. Our goal is to make The Scope something
that every Duquesne nursing student can look back on and be proud of.

We would love to hear your thoughts on this year’s newsletter. Please email all suggestions/
comments/inquiries to us at either blissl@duq.edu or muellerh@duq.edu. All letters to the ed-
itors must include your name, contact information, and major.

All views expressed in The Scope are from each individual that contributed their time and
work. Views do not represent the views of Duquesne University or Duquesne University
School of Nursing. We look forward to producing something inspiring, collaborative, and
memorable and sharing stories from all of our peers.

Best,

Hadley Mueller & Lauren Bliss

BSN Class of 2021

2
 Table of Contents
Nursing Abroad: What’s the Difference? 4
Professor Angela Karakachian details her experience in nursing both in her home country and in America.

Growing Up in Japan 5
Sophomore Emily Twyman explains how her unique cultural background impacts her role as a nurse.

Study Abroad: Tanzania 6

Academic Advisor Emily Lottes shares about her experience with students abroad.

Nursing Without Borders 7

Duquesne Alumna Marybeth Wargo details her life-changing experiences serving and nursing abroad.

How to Ace Your Next Nursing Exam 8

Sophomore Julia Ciotti shares her tips and tricks for test success!

DUSON Abroad 9

Cannoli Recipe 10

Maymester Rome 14

Study Abroad Photo Gallery 15

3
 Nursing Abroad: What’s the Difference? Is there Any?
Angela Karakachian MSN, RN PhD (c)

I received my BSN in nursing from Saint Joseph University in Beirut, Lebanon. Located on the

Mediterranean coast, Beirut used to be called the Paris of the Middle East.

As a nursing student, I learned to respect people, work hard, and care for my patients with all my heart. Did

I get all A’s? Of course not. However, I loved what I was doing. I was helping people during the weakest times of

their lives. When I graduated nursing school, I was very proud of myself because I had accomplished my goal. Yet,

I quickly realized that the Lebanese society did not consider nursing a respected profession. Although nurses were

(and still are) paid well, nurses in Lebanon have no voice and no autonomy, and very few of them pursue their

education to receive higher degrees.

I worked in a med-surg unit and cared for 12 patients during a day shift

and 30-31 patients during the night shift. With this heavy workload, time

management was crucial; it was important to stay on track and work hard to

make sure every patient was taken care of. Was I perfect? Of course not. Like

everyone else, I had my good days and my bad days. I learned from my

mistakes and promised myself never to make the same error again. When I

came to the United States, I was scared and intimidated. However, I stayed

motivated, and I was committed to providing quality care to my patients. As a

nurse, I faced new challenges every day, but I stayed strong and cared for my patients as if they were my family. I

learned to fight for people’s lives, and that is what I did as a nurse no matter where I worked.

Nursing is much more than just administering medications. Nursing is caring and listening to patients.

Nursing is being there for patients and advocating for them. As nurses, we have the responsibility of acting

according to our ethical beliefs and values, and helping and supporting each other in providing the best possible

care to patients. Today, I have the honor and the pleasure of teaching nursing students—our future nurses—and I

try to lead them by example by being flexible, credible, and accountable. I hope to influence my students by

helping them recognize their values, learn to work with others, think critically, and respect people. I had the

privilege of working in Lebanon, and I learned a lot from the most difficult circumstances, but what makes me the
4
nurse I am today is that I did and I still do everything with love.
 Growing up in Japan
Emily Twyman, Sophomore

My father was in the Air Force for 23 years, and he met my mother when he was stationed in Japan.

They had to move to Travis Air Force Base because my brother had liver cancer as a baby. He was getting

treatment at Travis Air Force Base while my mother was pregnant with me. His treatment was successful,

and I was born a little after. At two months old, I moved with my family to Yokota Air Base Japan. When I

was in first grade, I was enrolled in Japanese school until 6th grade. At first it was tough because I was the

only half American, and I got picked on a lot.

There were times when I wanted to quit because I felt that I did not belong. However, as school went

on, I started to make a lot of friends, and school became fun. I made many unforgettable memories, and in

the end I was glad that I stayed. Even now, I keep in touch with many of my

friends from Japanese school, and when I visited the summer before senior

year, we all got together and watched fireworks.

While living in Japan, because my father was in the military, I mostly

went to the hospital on base because it was free. However, when I would get

sick, I would go to the Japanese hospital off base because the hospital on base

was by appointment only. In Japan, the healthcare system works in a way that

if you pay for health insurance every month, then people are able to use it at

any hospital and get 70% of the cost covered. For kids up to middle school,

being seen by the doctor and getting medicine is all free. It is also set up so that the less money a person

makes, the cheaper the health insurance is. In Japan, health insurance is slightly cheaper than it is in Ameri-

ca. While living in Japan, my mother paid for health insurance every month so anytime I got sick, I was

able to be seen at the Japanese doctors and get medicine for free. I believe that treatment in America is

more advanced; however, Japan has a better healthcare system so I believe there is a lesson to be learned

from each.

5
 Study Abroad: Tanzania
Emily Lottes, School of Nursing Academic Advisor

I was fortunate to be selected, along with a group of four other advisors, to travel to Tanzania for a Study
Abroad Familiarization trip in May 2018. After nearly 30 hours traveling, we arrived late at night in Dar es Salaam,
the capital of Tanzania. We had an entire day to spend in Dar prior to meeting up with an alumni group and decided
to take a ferry out to Zanzibar, a small archipelago about 20 miles off the coast and into the Indian Ocean. Zanzibar
is famous for its beaches, spices, and being the birthplace of Freddie Mercury of Queen, and it did not disappoint. I
especially enjoyed watching the fishing boats at work, wandering around Stone Town, and darting in and out of
many local shops. On our way back to our hotel, we also stopped at a gem shop and each purchased a piece of Tan-
zanite jewelry or loose stones as a keepsake (Tanzanite found only in Tanzania).

On our second day in Tanzania, we took six short flights up to the Serengeti – spotting elephants, warthogs,
and antelope from the sky along the way. We arrived at our hotel and were immediately whisked out on safari where
we encountered impala, buffalo, giraffes, ostriches, elephants, hippos, a leopard, and 12 lionesses hanging out in a
tree. I have never in my life seen so much natural beauty in such a short period of time! Throughout the rest of our
four day safari, we had a fabulous guide – Robert, who was both a medical doc-
tor in his Maasai village and a safari guide – who pointed out these animals as
well as birds, zebras, cheetahs, flamingos, hyenas, gazelles, monkeys, baboons,
and wildebeests, all of which are native to the Serengeti. Additionally, we
learned an incredible amount about the people native to the area and Africa as a
whole.

The final leg of our trip started with a flight back to Dar es Salaam, on which we spotted both rhinos over the
Ngorongoro Crater and Mt. Kilimanjaro. We then traveled up to Bagamoyo, where our Maymester students were
studying. We attended a children’s mass and toured the Spiritan Mission before meeting up with our students for
dinner. Our last two days in Tanzania were spent with the students – attending their classes, walking the beach on
the Indian Ocean, participating in a beach cleanup, and learning about the lack but importance of recycling in Tanza-
nia.

Our trip home took another full day – from Dar es Salam to Amsterdam to NYC to Pittsburgh. It was long,
but it gave me time to reflect on the experience. I was grateful for the opportunity to be exposed to life so different
from my own. From learning about the main tribes of Africa to seeing wild animals in their natural habitat to learn-
ing about environmental justice to witnessing the opportunities our students have first hand, it was certainly an expe-
rience I will never forget. I always tell students that my biggest regret from my undergraduate education is that I did-
n’t study abroad – and this trip only emphasized that point. Take the opportunity to explore other lands and cultures!
It’s truly life-changing, and you won’t regret it!

6
 Travel Nursing
Marybeth Wargo, APRN

As an international nurse, I danced late into the night under a sky full of stars, had hippos as neighbors, watched
breathtaking sunsets, and woke up every morning to fresh mangos. I also slept in a tent on a wet mattress for weeks,
stepped in huge puddles past my waist, and worked for weeks on end without a break.
I watched severely malnourished children regain their strength, held new healthy babies, and witnessed nurses de-
velop new skills. I also held hands with a woman as she died from tuberculosis, told mothers that their children have died
due to complications of malnutrition, witnessed 5000 people be displaced overnight due to flooding, treated innocent chil-
dren with gunshot wounds, and listened to terrifying and heroic stories of nurses who risked their lives to save their com-
munity members.
My roles with MSF have been different on every assignment. My first assignment was in a refugee camp in Jordan
that was home to 100,000 Syrian people who had fled the war. When I arrived the hospital was not yet build. I drove
through the refugee camp, not fully understanding what I had gotten myself into. Arriving at the hospital compound on the
first day there were two small tents, a slab of concrete, and an empty water tank. I met the nurses, both Syrian and Jordani-
an, and gave a 5 day training on pediatric nursing. Within a week the hospital was open and we started seeing patients. I
supervised nurses, nursing assistants, and cleaning staff.
My second assignment was in South Sudan. I completed my hand-off with the previous nurse in my roll and was
ready to start working when civil unrest broke out in the capital. Our team was reduced to essential personelle only and that
included cutting my position. I quickly found another assignment in a large pediatric hospital in Mali as the nurse educator.
I was gutted by the large number of malnurished children, severe malaria, and meningitis. Because it was a large hospital
and had been there for several years, we had many resources including a small lab with a blood bank.
Ethiopia was my next, and favorite assignment. Every day I walked around a refugee camp. I managed a large
team of community outreach workers who collected epidemiological data. In the evenings I analyzed the date which in-
cluded demographics of age and gender, number of pregnant women, and number of severely and moderately malnurished
children. We also monitored cases of yellow eyes as we had a Hepatitis E outbreak and self-reported incidence of diarrhea,
fever, and rash. I tracked where people moved as the camp flooded and reported on sanitation and access to basic needs. To
this day I have a map depicting number of people per area and numbers of latrines. It shows 1 latrine for 250 people.
My most recent assignment was in Central African Republic, or CAR for short. There was a large international
team. Our opporation included inpatient adult, pediatric, malnutrition, and obstentric care. We had surgical capabilities. We
also had outpatient obstentric consultations and mental health services. Most of my time was spent on outreach to remote
areas where we trained and supported small health posts. In MSF, all of the international colleagues live together. In CAR,
that meant on the weekends we ate Haitian and German food! Working with MSF was the hardest and most rewarding job
I have every had. The low moments were lower than I though possible and the high moments were higher than I ever could
have imagined.
Doctors Without Borders, or better known as Medecins Sans Frontieres (MSF), is a medical humanitarian organi-
zation founded on the principles of impartiality, independence, neutrality, and temoignage (bearing witness). MSF is well
known for rapid and effective response in emergencies. When MSF works in insecure environments, they build rapport
through dialogue, and not armed security. The principles of MSF, particularly independence and neutrality are important
features of MSF that build trust and protect the organization. The members of MSF are primary local to the area in which
they are working. In addition, only 8% of MSF’s staff are international. The remaining 92% of the staff, the foundation, are
from the country in which MSF is opperating. This not only provides sustainability for the project but allows for growth
and education of international staff and culturally competent care for the patients.
MSF is transparent regarding where their money comes from and how they spend it. Less than 2% of the funding
comes from government entities. They also do not accept contributions from pharmaceutical, gas, arms, or other companies
who could potentially limit their ability to work based on their company’s agenda. Sixty-seven percent of the organiza-
tion’s money goes directly towards humanitarian programs, 12% goes towards projects and programs, 3% towards bearing
witness, and the reminding 18% towards management, administration and fundraising. For more information, please check
out www.msf.org. My advice to anyone looking at international nursing opportunities is to do thorough research on the
organization, their principles, how they spend their money, and to reflect on the sustainability of the organization.

7
 How to Ace Your Next Nursing Exam
Julia Ciotti, Sophomore

As we all know, nursing exams are extremely challenging. However, a diligent study
routine can help make these tests more manageable. Setting yourself up for success and feeling
confident is half the battle. If you are someone who is struggling to find a successful study
method, please feel free to adopt any of the suggestions I have listed below.

My test strategy begins before I even attend lecture. Prior to class, I read over the Pow-
erPoint lesson the teacher has posted. This allows me to have a general understanding of what
material will be covered and formulate any questions that I may have. If time permits, I also
briefly read over the respective chapter in my textbook. Regardless of whether or not I read the
book before lecture, I also skim through it again during the week of the exam.

Personally, I enjoy hand-writing my notes during class. Therefore, I print out the PowerPoint slides and jot down the
important details my professor presents. It is important to be present during class. Actively listening and being engaged is the
simplest task that allows you to retain information and can result in a higher letter grade. After lecture, I organize all of my
notes into a typed study guide. This helps me view all of the information in a concise and structured way. I then highlight and
read over this outline to keep the material fresh in my mind.

When the exam is a week away, I begin actively studying. I recommend doing as many practice questions as possible.
Knowing how to tackle a nursing-style question is a battle in itself. There are many helpful question sets on Evolve, in the red
HESI book, and at the end of each chapter in your respective course textbook. Simulating a test environment; for example, go-
ing to the library and taking 50 or so practice questions, can also be extremely beneficial.

In addition to practice questions, I enjoy watching YouTube videos. A few YouTube channels I recommend are Crash
Course, Simple Nursing, Registered Nurse RN, Osmosis, Nucleus Medical Media, and Learn Through Song. These resources
help condense information that can seem overwhelming and present it in an engaging way. If you need a quick break from
studying, check out Nurse Blake on YouTube and other social media for comedic nursing humor. I find using a combination of
visual, aural, verbal, and physical learning style to be most helpful. Being exposed to the material in various ways helps me to
remember the key points long-term and not simply memorize them for the test.

Finally, one of the biggest keys to learning an abundance of nursing knowledge is making it meaningful to you. You
need to find some way to relate to whatever you are being taught. This can be through the form of a pneumonic device, short
story, patient experience, etc. I find that watching YouTube videos about people and their experiences with their illnesses
helps me to remember the information. It’s hard to take yourself out of exam-mode and realize that these diseases we are learn-
ing about are real. Taking a step back and seeing the illness associated with a human being brings this understanding to life.

Whether you choose to implement my suggestions or use your own established method, go into your next test confi-
dent that you will succeed. You are capable of achieving anything you set your mind to. Nursing is one of the most challenging
things that you will do in life; however, it will also be one of the most rewarding.

8
Nursing Abroad: Unique Opportunities for Travel and Service
Abbey Whitewood, Senior

If you are a sophomore or junior, you can spend four weeks over the summer in Dublin earning six credits.

Three of the credits apply to your Evidence Based Approaches to Professional Nursing Practice class in your sen-

ior year. The other three credits transfer as elective credits. A research project on one of the following three topics

is completed under the guidance of an experienced researcher: Nursing and Midwifery History, Protection of Old-

er Persons, or Professional Nursing Practice. You get to live with other Duquesne Nursing students in St.

Michael's House, which is just a short walk from the University College Dublin. This program is not as well

known, but it should be because it is a great opportunity to study abroad.

Another opportunity to study abroad as a nursing student is to go to Rome, Italy. It is a four week program

in May where students are immersed in the rich culture of the Romans. I was given the opportunity to study in

Rome over the summer of 2017. During my Maymester, I was able to explore Ancient Rome while earning six

credits. Three credits are for Baroque Art in Rome, which is taught by Professor Elizabeth Lev, a world-renowned

art historian. She has written many books and has given talks all around the world. She has a wealth of

knowledge; if you get the chance to learn from her, definitely pay attention because she is amazing!

The other three credits come from the Cultural Applications in Clinical Practice course. In this class , you

learn about cultures around the world and why it is important as a nurse to have some understanding about world

cultures. It fulfills a class in your senior year. It is definitely worth it to take the class in Rome because… well,

why not! And you get to take it in Rome! What a bonus!

When in Rome, you get to wander around the streets and see new things at every turn. You get to see old

Roman art and architecture while learning about the rich culture and centuries of history. It was definitely one of

the most eye opening experiences I have ever had. Plus, you get to go on many excursions with the class all over

Italy including Sicily, Pompeii, Florence, Naples, and the Isle of Capri. I loved getting to be immersed in the cul-

ture and really felt like I was part of Rome. I miss it so much! Well… except the 906 bus.

9
 Sicilian Ricotta Cannoli Recipe
Sara Andrews, Junior

Shells:

I usually like to buy premade cannoli shells from the store just because they are a process to make, but one can easily research a
recipe for cannoli shells.

For the ricotta filling:

4 cups ricotta

3/4 cup confectioners’ sugar or more if you prefer a sweeter filling

dash of cinnamon

confectioners’ sugar for dusting

semi-sweet chocolate chips roughly chopped (optional)

Directions:

In a bowl mix together the ricotta, confectioners’ sugar and cinnamon until the consistency is smooth. Use a pastry bag or
even a freezer bag, and with the tip cut off, pipe the filling inside the shells. You can also dip the ends of the cannoli into
chocolate chips or pistachios and dust with confectioners’ sugar for a more flavorful pleasing presentation!

10
 News & Announcements

Spring DUSNA Events Upcoming Meetings

Steel Cactus Dinner/Banquet Elections are next meeting for the
April 27 5-8 pm 2019-2020 Board!

Walk for MS Congrats seniors, and welcome new

DUSNA board members!
April 14

NCLEX Practice Question!

The nurse provides care for a client admitted with a diagnosis of sepsis. Which assessment
data does the nurse recognize as the early development of systemic inflammatory re-
sponse syndrome (SIRS) when providing client care?

A.) Blood glucose level rises from 180 mg/dL (9.99 mmol/L) to 220 mg/dL (12.2 mmol/L) in
one hour.

B.) Temperature is 101°F (38.3°C), pulse is 98 beats/minute, and respirations are 26 breaths/
minute.

C.) Bleeding from IV sites and body orifices indicating disseminated intravascular coagulation
(DIC).

D.) Hourly urinary output continues to decrease, and last urinary output assessment indicates 5
mL/hour.

NCLEX PracticeQuestion of the Day. (n.d.). Retrieved from http://kaplanquizzes.com/nclex 11

 The Horoscope
It’s formal szn and time to buy a Libra All news seems like bad news lately.
Aries new outfit for the occasion. Keep Sorry to tip the scale even more but
the wallet closed until the 3rd when keep preparing to take a couple more
Mars gets out of retrograde. Trust hits. Nursing school may be killing you,
me, you AND your bank will thank but with Aquarius by your side, you’ll
me later! get through it.

March 21-April September 23-

19 October 22
Taurus Gotta love seeing snow at the end Scorpio The dreaded four-letter word: H-E-S-I.
of March – NOT. Super lame and a This year will be your year – if you
total downer. Bring the horns choose the right path. Mercury will pre-
down, Taurus. Take this time to sent two choices that will give you fail-
reflect on your future. ure or success. Choose wisely.

April 20-May 20
October 23-
November 21
Gemini, as the twins, you are also Sagittarius Last day of clinicals you say!? Treat your
Gemini gonna get in some double trouble. clinical group and instructor to a late
Juniper is blocking you making it lunch after you get out. Jupiter’s moon,
hard to communicate. So watch Europa, is in good orbit and will bring
what you’re saying to people! you $$$$$

November 22-
May 21-June 20
December 21
All you want is some fun on the Summer days and your summer daze
Cancer sun, Cancer. Feels like the weather Capricorn are so close. Don’t spend too much time
is going around and around with day dreaming and start focusing on day
cold to colder to cold. No worries. studying! The new moon will bring you
Watch for some airplane ticket some sweet chances to score the perfect
specials once Orion’s belt is in your summer experience.
zenith!
June 21-July 22
December 22-
January 19
It may be only a quarter of the year You and Libra go hand in hand this lu-
Leo in, but it’s never too late to start Aquarius nar month. Once the moon is full, it’s
anew. And by new, we mean new time to start questioning what lies
memes! That’s right, it’s time to ahead: HESIs, the NCLEX, getting a job,
harvest some new meme crops. Go etc. Don’t be overwhelmed! Take it step
tend to your humble farmer roots. by step. The 15th will bring you some
January 20- guidance.
February 18
July 23-August
22
Virgo Despite the cold, spring is still here! Pisces Don’t worry, you’re not the only one
Time to start fresh with some freaking out about finals. With Mars
spring cleaning. Use the Marie moving out of retrograde, you’ll finally
Kondo method to throw away find some peace and a routine that will
things that don’t bring you joy! help you get A’s on those HESIs.

August 23-
February 19-
September 22
March 20
12
 Interested in writing for The Scope?

We are always looking for new writers.

Contact Lauren Bliss or Hadley Mueller for more details!

blissl @duq.edu
muellerh@duq.edu

NCLEX ANSWER:
DUSNA BOARD OF
DIRECTORS (2018-2019) B
President– Morgan Gruender The criteria for sepsis with SIRS can include a
Vice President– Emily Churchill temperature of more than 101°F (38.3°C) or
Secretary– Shannon Lawler less than 96.8°F (36°C). Other indicators of
Treasurer– Brie Gavin SIRS
: is a pulse greater than 90 beats/minute,
Social– Shannon Lawler and a respiratory rate greater than 20 breaths/
Service– Abigail Whitewood minute.
Fundraising– Ally Dongarra and Nina Sarcone
Legislative Coordinator:- Deanna Webb
Recruitment– Jessica Chan
Publicity– Lauren Bliss and Hadley Mueller

13
 Maymester Rome
Deanna Webb, Junior

The decision to study abroad? One of the best I’ve ever made. Doing a whole semester while in nursing
school? Pretty difficult. Duquesne’s Maymester program? An amazing opportunity that I was fortunate enough to ex-
perience.

Duquesne has its own campus in Rome, approximately an hour (on public transportation) outside of the city.
The campus is a beautiful, gated area shared with the Sisters of the Holy Family of Nazareth. There are two floors of
dorm rooms (each with their own full bathroom), two classrooms, a library, a dining area, and a full kitchen; all acces-
sible to students. Located a short walk down via Nazareth, there are a few stores comparable to Big Lots, Aldi, and
Ross Dress for Less.

While there, you will take 6 credits toward your BSN. One of the three credit courses is Baroque Art in Rome.
This class is on site, so you get to explore the more tourist-y parts of Rome, but also some hidden gems that you can
stay at after class or come back to when you have some free time. Not only are you seeing the sights, but you’re also
learning so much about Rome’s history through art. We also had class during our excursions to Florence and Naples,
which was interesting to learn how the history of those areas influenced their art.

The other three credit course is Cultural Applications in Clinical Practice. This course explores the models of
transcultural healthcare and the healthcare professional’s role in the delivery of culturally competent based care. We
explored our own family’s culture and traditions as well as a research project on an American nurse during World War
II that is buried in the Sicily-Rome American Cemetery. There was a mini-conference in which Italian nurses came to
speak to us about their healthcare process. We also had the opportunity to visit ISMETT, the UPMC transplant hospi-
tal in Palermo.

The month that we were there went by so fast; it was full of exploring and making memories. I’m glad I took
so many pictures because I’d probably have forgotten half of the stuff we did. I made wonderful new friends in the
nursing program; the Italian campus staff were so lovely and welcoming. I think I ate my weight in pasta, pizza, and
gelato. However, if I had the chance, I would do it again in a heartbeat.

14
Photo Gallery

15
16