A Disoriented Patient, Aged 25 Years

1. The physician in this video went against the patient's wishes. The nurses in the clip followed the physician's orders and participated in the resuscitation. What professional roles and/or attributes that we discussed in class did they ignore and how should they have responded in this situation? Describe specific examples of professional communication techniques they could have used.

The journey to embrace the speciality of anesthesiology has been ecstatic and full of fond memories. It was not until the end of my internship that I finally developed a passion in anesthesiology and the field of critical care. I soon realized that with my zeal for clinical anatomy, command over concepts of physiology, dexterity in medical procedures and empathetic connection to my patients, this speciality would be an ideal match. In my opinion, anesthesiology demands a physicians ability to consolidate the core principles of clinical medicine with the knowledge of basic science principles delicately balanced with high standards of ethical code and conduct. I am confident that with my depth of knowledge, passion for clinical research as well

When faced with a tough, and timed emergency situation, there are many directions a heath care provider can go in from there. They can freeze, act improperly, or not quick enough, but some will also act professionally and correctly perhaps saving a patient's life. What determines the direction a health care provider will take is their experience. From knowledge to observation, a medical professional can learn the most efficient ways to work. But one way in particular, past medical experiences and the patient, provider relationship, can influence the decisions a health care provider will make. This can be demonstrated by both Atul Gawande, author of Complications: A Surgeon’s Note on an Imperfect Science, and within Courtney Davis’s The

My educational fear in the past was during my first week off ICU orientation, I was assigned an admission from the ER of a post cardiac arrest middle aged patient who was placed on a therapeutic hypothermia. I verbalized to the Charge Nurse of being hesitant to accept the admission since I’m fresh off orientation. She told me “this would be a good experience for you”. I want to keep good positive impression to my colleague being a new nurse of my new unit and took on the mission to accept the assignment. After receiving a report, the unconscious patient arrived on our unit on a ventilator with hypothermic jacket and with multiple drips. My heart started to pound and said to myself “what am I getting into, transferring here in ICU is a mistake, and I just want to cry”. While being shaky, I took good long deep breaths. After the patient was situated the on the bed, I carried on the task according to the doctors’ orders and the protocols. I stayed in communication with my charge nurse for assistance, questions and moral support. I succeeded the patient care uneventfully on a 12 gruesome hours by working and collaborating with the charge nurse, the senior RNs as a

I participated in numerous and varied electives to gain a wide appreciation for the scope and practice of medicine. I learned countless lessons from physicians, nurses, midlevel providers and ancillary staff, while caring for hundreds of patients gaining a level of autonomy. The importance of a focused history and physical – to not be afraid of the myriad of details and at the same time to not loose sight of the bigger picture – how to present cases, and how to formulate a high-quality differential diagnosis with appropriate testing measures were all emphasized. These experiences showed me that being an effective Internist involves not only the treatment of those severely ill, but also the need for comprehensive treatment of the patient and their families. I was genuinely inspired to be a part of the IM team and my goal of becoming an Internist was

As I began my medical education my interests had piqued; however, my true passion was ignited when I discovered the stimulating environment of internal medicine. Foremost, with the aid of an exceptional physician preceptor, I discovered that managing a wide variety of pathologies within a varied population is the ideal way to develop a broad clinical knowledge. Additionally, I found that I enjoyed the ‘hands-on’ component that comes with the privilege of performing procedures and resuscitation. Finally, I discovered that managing patients holistically, through collaboration and coordination, is the best way to facilitate excellent patient outcomes. It was after these discoveries that I decided to further my pursuit of a career in internal medicine.

Since I was young I saw society often looked up to doctors, how history, revered them as great leaders men and women to be admired. That’s who I wanted to be. I wanted to be better myself in every aspect so that one day I could become the doctor I myself admired. Through the International Student Association (ISA) KSU Chapter under Mr. Martavius Thompson, I was able to build upon my leadership skills from high school. I learned that despite personal feelings, disagreements, and administrative hurds if you have goals there is always a way. That’s medicine, right? Doing whatever is morally and ethically necessary to help save a life. You may be working with someone who does not do their job correctly or is completely arrogant and uncooperative, however, at the end of the day, none of that will matter if there is a lapse in someone’s care. That is what ISA taught me, doing my job despite the

As a member of the staff I am able to see the impact that medicine can have on an individual during a crucial moment in life. A patient post-resuscitation arrived in the emergency department. My top priority was to get the EKG for the physician. When a critical patient comes in, the room gets loud and crowded fast. I have learned how to handle the adrenaline, stay focused, and get my job done. The EKG I performed showed the patient had suffered a massive STEMI. Our main goal was to get the patient stabilized and transported to a bigger facility. The patient’s heart rate and blood pressure were both steady for transport but his SpO2 was 72% while intubated. The patient’s tube had proper placement and no pneumothorax was detected. The acting physician was going through trying to rule out the cause for the low oxygen saturation level. The patient was a stubborn, according to his family and never went to his primary care. With previous information and a chest X-ray, the patient was diagnosed with not only a STEMI but also a severe case of pneumonia, presenting with large amounts of fluid in his lungs. I could see the stress in the physician’s eyes while working that case, but what he couldn’t see the envy in mine. I want to be the person who is able to make critical decisions and lead a team through difficult

Critical Thinking: During the first scenario, the patient was a 39-year-old female admitted to a med-surg unit following an abdominal hysterectomy. She had no known allergies and had a Foley catheter in place. Also the physician’s orders included, sequential compression devices and pain medication. While receiving report about my patient, I was beginning to think, as a nurse what my priority would be when first entering the patient’s room, which would be performing an assessment, monitoring vitals, assessing pain and inspecting the surgical site and dressing for signs and symptoms of infection, and assessing for potential post-op complications such as respiratory and cardiac problems; however, that didn’t go as planned. I was too focused on being reactive and thinking about what I was going to do next instead of being proactive, that I forgot simple steps such as introducing myself to the patient. Moreover, in the second scenario, my colleagues and I were placed in the emergency department to care for a 34-year-old patient with complaints of difficulty breathing due to asthma. In this scenario, the physician’s order consisted of administering oxygen via nasal cannula as needed in addition to administering albuterol via the nebulizer. Once again, before entering the patient’s room, I knew my first priority was going to be to assess the patient’s respiratory status by auscultating breath sounds, examining the quality and rate of respirations, the shape and configuration of the

From that moment during the internship, I was never the same person again. A Disoriented patient, aged 25 years, suspected with cerebral malaria was admitted to the emergency department of my medical college, 4 Years back. Upon administration of a loading dose of quinine with dextrose, The general practitioner in charge of the emergency department shifted him to the intensive care unit. On the 2nd day of ICU, a catastrophic event occurred; the patient suffered from fatal ventricular tachycardia with hemodynamic instability. Following this, The Resident Doctors urgently proceeded with the Synchronized cardioversion, while assigning me to deliver Cardiopulmonary Resuscitation in between the events. Fortunately, by God’s grace, our efforts to

In the health care system, a multitude of errors occurs on a daily basis. Doctors, nurses, orderly’s, etc., everyone in health care settings has responsibilities that warrant careful attention. This was exhibited in the case study titled ‘An Extended Stay’. In this case study, we are introduced to a middle-aged man in his 60s named Mr. Stanley Londborg. He presented with several health conditions, including a seizure disorder, hypertension (also known as high blood pressure), and Chronic Obstructive Pulmonary Disease (COPD). Londborg was no stranger to the hospital and was known fairly well by faculty members. Londborg paid a visit to the Emergency Room at the hospital complaining of wheezing and breathing complications. The physician that examined Mr. Londborg yielded his symptoms as an acute worsening of

As a member of the healthcare team, I solemnly promise that I will to the best of my ability: honor the Profession of medicine, be generous to its members, and help them provide care for the sick. I will give my teachers the respect and gratitude that they deserve and share my knowledge with others. I recognize that this practice is a privilege that comes with a great deal of responsibility and I will not abuse it. I pledge my life to the service of helping others and place my patients’ interest before my own. I will practice with honesty, integrity, and compassion working with physicians and my colleagues to meet the needs of my patients. When someone comes to me for help I will not ask if the patient is rich or poor, old or young. I will

Patient reports dizziness and light headedness for the past 2 weeks. Current medication: Wellbutrin 150 mg XL QD. Patiet states she is not taking her medication regular bases, especially for the past one week.

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.

I believed that I deserved punishment. It was a really bad internal feeling. My instructor and staff nurses blamed me andgot angry about my ignorance. It was obvious to me that I lost their trust about my competence. I was wondered why I made such a harmful mistake? What was wrong with me during taking blood sample?What would happen to patient due to my mistake? What should I do to avoid hurting patients since now?My mind was preoccupied with different feelings and questions that I think stem from my values and beliefs.I strongly believe in respect, honesty, kindness, compassion, responsibility and a client- centered care. I always put the patients in the first priority in my profession. I think these values mainly originate from my family, culture and myholly profession. In relation to that event, although I was encompassed with lots of feelings, thoughts and words, the most important thing to me was the patient’s sense of comfort which was impaired due to my mistake. So, I respected my instructor and staff nurses’ words and acceptedthe responsibility of my action.I promised myself to be more careful about my actions and patient’s safety.