02/08: Palliative Care, 8Am-6Pm (Due To Seeing A Lot Of

During this day, I was assigned to care to one of our sick residents and based on my assessment, her condition shows no sign of improvement from her chest infection so I checked her vital signs specifically her respirations. After assessing her, we rang in the GP to inform him about the condition of his patient and asked him to schedule a visit. Also, in the afternoon, we had a new admission from Eversley. Firstly, we greeted the patient, introduced ourselves and oriented the resident to the unit. Secondly, the nurse from Eversley informed us about the relevant information about the patient’s

When I arrive to the facility this morning I was informed that one of the patients had passed away during the night, which was quite sad. Today I was in the acute ward all day and was able to watch the RN perform an ECG on a man that was bought in via ambulance who was complaining of chest pain. I watched as she placed the ECG leads on different positions of the chest. The RN showed me what a normal heart rate should look like. I also went around the ward taking OBS and notice that one of the patient's O2 levels were very low at 73%, the RN then gave the patient some ventolin through a mask to increase oxygen levels and they rose to 95%. The RN also showed me the medication charts and how they are to be read. I went around with her watching

My work day began the night before my shift started, as I received an email from my supervisor and was pleased to see my favorite patients on my list. Anna was scheduled first on my itinerary. She had become a quadriplegic after a serious fall down a flight of steps. Next was Mr. William, who was dying of a brain tumor. This man had the best attitude towards life, and always kept me laughing. My last patient of the day was Mrs. Patsy. She was very dear to my heart, and I had grown very close to the family, because I had been seeing her for over six months. Every time I walked into Mrs. Patsy house, she wanted an update and recent pictures of my children. It is unusual to have everyone agree on the scheduled time, but this warm summer evening was the exception. Tomorrow’s schedule was looking great and I was ready to get some rest.

So when my mentor Mary and I were preparing the trays we made sure that everything he wanted was on the trolley. As I was working under supervision of Mary and the Circulating nurse Mark, they were explaining to me about the importance of preparing the theatre according to each surgeon’s preferences. After all the necessary checking’s and preparations in the anaesthetic room done, Mr Dillon was brought into the theatre after he was given general anaesthesia and Mr Mann started the surgery. Everything was going well until Mr Mann started to fix the tibial implant. As per surgeon’s instructions we had it ready but unfortunately the ‘71’ size he had requested was a bit smaller and he asked for a ‘73’ size. But Mary told him that it is not available in the tray so she asked me to get it from the tray room. Mark left me to go on my own to the tray room and I could not find it. I was afraid to go back into theatre to tell the surgeon. When I finally went back and told, the surgeon that I could not find it, he started shouting. Mary stepped in and told me to go with Mark so I could see where it was kept. That made the surgeon to calm down. We ran back again and got it. Mary, Mark and I were so relieved. The time taken for such a small incident was almost 10 -15 minutes which was really stressful to the whole team and very dangerous to the patient. Luckily everything went

Week eight was the same as always. I began the day at eight in the morning to receive patients, print out superbills and doing the usual. I will soon be I find my clinic a bit repetitive, but I like it because I learn by repetition. As I was taking in patients a woman told me her son had the Flu. Her son is believed to have type b, or category B

The second week of my preceptorship brought many new experiences for me, and I can honestly say that each day I spend with my preceptor is better than the last. This week I focused on time management of a full patient load with continued documentation practice as well as admission and discharge procedures. I’ve had brief experiences in my past rotations assisting with discharge teaching and admission assessments however I have never been able to fully take charge and complete the process from start to finish, so this was a great learning opportunity for me.

I arrived to work well rested and ready to start the day. I had just returned after a two week long vacation. Because of the time off, I arrived to 7 East to find that the assortment of patients was not familiar at all. As I began getting reports on my patients, one in particular I started to feel a little anxious and stressed. At first glance I could tell I would be busy for the next twelve hours. Lynda was a 45 year old woman that was admitted almost a week ago after having an emergent tracheostomy placed. Lynda was newly diagnosed with laryngeal cancer with already having several other diagnoses including: seizure disorders, mild mental retardation, behavioral issues, and was legally

My clinical day of week 3 started pretty much with the same routine. I had to shadow a CNA preceptor and helped her throughout her assignment. By late morning, I have encountered a patient that at first refused to have a conversation with me despite my efforts of searching the right therapeutic questions that will make her open up to me. I founded the situation to be a little bit frustrated and made me feel unsuccessful that I was not be able to form a relationship with the patient. I did not know what to do or what to say. She just kept staring outside the window without saying anything. At lunch time, she surprised me when she approached me and expressed her apology for her earlier behavior.

When he came into the examination room he was different, I had his medication record and a record of his vital signs and blood glucose checks but had not looked at them. He started to talk before I had a chance, he told me that when he left from the previous visit that he went back to his room and prayed the entire night. He said that God told him that he needed to start following his treatment plan. I than looked at his records and saw that he had been taking all of his medications and that blood pressure and blood glucose numbers were decreasing. I could not believe it, I just looked at him dumbfounded. The patient told me he felt great and that I needed to keep continue what I was doing because I really did make a difference and had changed his life. I must have looked so silly because I was crying and smiling at the same time. He said that he just could not believe that someone cared that much about what happened to him. I continued to see that patient for several more months, and he would tell me how he had started to repair all of the relationships in his life through understanding, forgiveness and god.

I arrived at clinical 0630 and picked up patient information the morning of. I reviewed all assigned diagnoses, medications, labs, and orders with my assigned students, and we discussed our plan for the day. We both took report from the patient's nurse and then Elizabeth presented at preconference. Kala shadowed the Nurse Lead and I helped Elizabeth with brief changes, pericare, and vital signs. I continued to check on both Elizabeth and Kala throughout the day. Last, lunch and then post-conferance.

I was able to be more confident and assertive with all of the tasks that I performed in clinical this week, which is a huge improvement for me.

Throughout the second half of the semester, I have not made any significant changes to my pre-clinical routine. I still prepare and gather my supplies the evening beforehand, and I try to avoid during schoolwork in order to facilitate restful sleep. However, upon arriving to the unit, I have developed a familiarity with the staff and environment that has reduced my stress and anxiety levels, allowing me to focus more attention on my patient assignment for the day. Although we do not have assigned preceptors, I have developed a mentoring relationship with two of the nurses on the unit and will work with those staff members if available. As we have gotten to know and trust one another, we do not have to spend the first part of our shift familiarizing ourselves,

While sadness plays a big role in hospice…it is also true that there is happiness, positive reflection as well as wisdom. This month we want to recognize our two volunteers Connie and Paul Steber who have been volunteers for Hospice since June and considered it a true blessing to share the stories and experiences of patients who are living through a very emotional and difficult time. They are honored to be making a difference and to be able to share the stories of the patients like James Ellis best known as the Coach, who enjoys their company but most of all watching a football game, especially if his favorite team is on the winning end. The Stabers enjoy conversing with James and listening to his stories. There are also times when James and

This past Friday at the Cardiac Catheterization Lab my mentor was not there but I still got to do everything that I enjoy doing, like watching procedures and talking to the doctors, nurses, and staff. When I arrived I knew my mentor would not be there so I had asked another one of the ladies in the office if there were any surgeries that were going on for me to watch. After I was given scrubs to change into I was able to go into where the surgeries are happening. I went into the control room that I was told to go and the nurses and other staff were preparing the patient and setting up the computers and everything they needed before the doctor arrived. The surgery overall was one I have seen before and not as exciting as some of the more unique and different ones that I have seen previously.

On Thursday the 9th, I worked with a patient who is a 74 years old male, with general weakness. His admitting diagnosis was caused by the metastasis of prostate cancer to the bone. Talking to the patient was an amazing experience for me because we liked the same thing such as the NBA. He told me that he was a lawyer and that all of his children are grown up and successful. He does a wife, who I did not see during my rotation. But, it was easy to talk to communicate with him. I have always had social anxiety growing up. Talking to people had always been my weakness because I was always worried about how people would perceive me when I talked. However, now that I have grown up, I learned to look past my social anxiety. I learned that from shutting my brain off that caused me overthink, facilitated me to