Clinical Context And Experience At Sharp Memorial Hospital

This was my first shift back from having a few days off and I returned to work on a night shift. Patient A was admitted to the hospice that day. She was admitted for general deterioration and she had tried to maintain her independence up until breaking point. It was handed over she has aphasia.

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

Even though I had been caring for this lady for the duration of my shift I was unprepared to give the next shift a handover. I assumed my mentor would do it since she had been doing it on all my previous shifts. However, on this occasion my mentor said to do it at the end of her last handover. I listened to her giving the handover for her patients then when it was my turn, I panicked and muffled up my information. I started with basic information about the patient such as name, date of birth , age and the reason for her admission. Unfortunately, I became flustered after that and it was clear to both my mentor and the other nurse that I was out of my depth and needed help. My mentor then took over and continued the handover.

During my first day of clinical, I encountered an issue that I believe is very significant. As a student nurse, our duty for this day was to follow our health care aide around the ward and assist in completing resident care. The resident required assistance in many of her daily tasks. The health care aide asked if I would perform one of those and do perineal care for her. I turned down her offer because I did not feel comfortable with my skill level. The resident had a bowel movement during the night. There was a significant odour in the room that overwhelmed me. I really wanted to leave the room because it was so unpleasant, but I stayed in the room so that the resident would not be embarrassed. This feeling of embarrassment, I assume,

During my clinical rotation during my last semester of nursing school, I was able to work one on one with a BSN degree nurse named Judy in the ICU. Judy had three years of experience in the ICU setting. She had been a medical surgical nurse prior to her ICU transfer. The ICU at this hospital consisted of two associate degree level nurses and two BSN level nurses on my shift. I rotated three days in this particular ICU. I worked with Judy all three days of my rotation. I was excited about being placed with her for she seemed knowledgeable and skilled. We were given a male post trauma patient to work with all three days. This patient was a 30 year old male admitted for trauma related injuries and was considered unstable and was to be monitored in ICU. This patient had been involved in a motor vehicle accident and

For this reflection instead of focusing on a specific situation I am going to be reflecting on my feeling throughout the shift. Going into the clinical rotation I was really looking forward to a experiencing the new pace of the surgical floor. Last semester I was on Medicine A. While I doubt I want to work full time on medicine I did fine it as a very easy way to transfer from Long Term Care to the Hospital. I found that it really taught me to prioritize and spend my time wisely while on the floor, because even through it was a slower pace, there was a lot to complete each shift. It also helped me to work on creating therapeutic nurse-client relationships not only with my assign patient but also for the patients I was helping by answering call bells. I found all of this gave me a good background to go into the surgical floor. Even from the moment of report I could tell the more serious feel from how the nurses went through report, it was quick, informative and effective. I was nervous about meeting my co-assign because I did not ever really have a good experience with them on Medicine. However I found my co-assign this week was approachable and answered all of my questions and even helped explain the differences between how she does

During my clinical competency placement, I was working on a surgical ward when a registered nurse on duty asked me to assist Mr. A with his shower. This incident happened on the fifth day of my clinical practice. He was a dementia patient and had undergone right knee total joint replacement. She also informed me that the patient did not like too many people in his room because of his dementia. When I went into his room, his wife was there with him. I talked to the patient about having a shower and getting dressed to look smart and he agreed to have a shower. The patient got out of the bed and walked to the bathroom and sat on the shower chair to have his shower. Then I asked his wife if I needs to stay with him to assist with shower, she said she can help him as she was taking care for him at home since he has been diagnosed with dementia. Therefore, I left the patient with his wife to help with his shower and told her to ring the bell if she needs any help. After some time I left the room, the wife rang the bell. As soon as I entered the room, I heard him shouting at his wife and she started crying and left the hospital. So I had to stay with him. He was very capable of washing himself and I just had to help him wash his back as he requested. After he had washed, I asked him if he was ready to get out of the bath, he started shouting at me.

We arrived at Clearview at 2231 Hrs. and took the patient to room 14. I went back outside and began to put our unit back together when Supervisor Carlock approached me and in a very agitated voice said: “WHY DID YOU PULL OFF?” Surprised, I said “What are you talking about?” He said loudly, “I TOLD YOU TO STOP AND YOU DIDN’T!” I replied, “Jeff was telling me not to stop because we had a pulse back.” He said “I DON’T CARE WHAT JEFF SAID, I’M YOUR SUPERVISOR AND I TOLD YOU TO STOP!” I said “Dennis, I think you’re talking to the wrong person, you need to be talking to Jeff, I was doing what he told me to do.” He replied “WHO’S YOUR SUPERVISOR, WHO’S YOUR SUPERVISOR, I AM, NOT JEFF, YOU DO WHAT I SAY!” I said ”yes, you are the supervisor, but at that moment I was doing what the Paramedic in charge of patient care was telling me to do, and what I felt was best for the Pt., since we had a 41 Y/O patient who had a pulse.” He said “I DON’T CARE, YOU DO WHAT I SAY!

We can treat a patient with a variety of underlying medical conditions, from different cultural backgrounds, and socio-economic classes. However, there are a couple of common characteristics that our patients share. Most of the lymphedema patients are suffering from either diabetes, venous insufficiency, morbid obesity, or any type of cancer, such as breast cancer, ovarian cancer, multiple melanoma, or lymphoma. Our patients are usually 60-year-old or older, Caucasian, and live 10-20 minutes away from the outpatient clinic. Most of them have some sort of family support either from their spouses or children. Also, the majority of our patients are religious and attend church on a regular basis. In addition, 99% of our patients are not familiar with the lymphedema diagnosis and require extensive education regarding this

On November 12th 2016 around 21:00, at the nurse station, I was approached by my Charge nurse Rosario Laino, as known as Rosa. She told me: “What are you doing? I check the medications you need to pass and I will help you because there will be no overtime!” I explains that I started to pass the medications for room 4119 and was on my way to changing the tubes of room 4101 which needed new TPN and Lipids infusions. After 15 minutes attending to the patient needs in room 4101, Rosa came and yield: “What are you still doing in the room, you need to finish to pass your medications and your TPN in room 19 is completed! Huh!” I replied that I will go right away.

My charge nurse informed me that my assignment was to care for an increased intracranial pressure new admission. The gentleman was in his early thirties and he came in thought the hospital emergency department after wrecking his motorcycle. This patient was immediately transferred up to my intensive care unit and had family present. I went into the room to get report and my patient’s father constantly interrupted the dayshift nurse. He frantically asked what was happening, if there was any hope of survival, and if he should have his son’s care transferred to another hospital. This was all the overwhelming information that happened in the first five minutes of the first portion of my simulation. The second portion of my simulation was on advanced cardiac life support. Though completing the critical care simulation, I learned a major strength and weakness I have as a senior nursing student.

It was the end of my second day in a new emergency room where I was starting a midnight shift contract. Approximately 06:45 an EMS came into one of my rooms with a patient stating he was having chest pain. The paramedic was giving me report and telling me that he was unsure about the EKG he had obtained on the way in and that the patient had not been feeling well all night. Upon looking at the EKG I noted ST elevation, was able to get a physician and additional assistance into the room within minutes.

Another day of my clinical placement 420 in orthopaedic unit began on July 4, 2015. I received my patient and started to research a patient history and medications. At 0700 a shift report started, I received information that my patient had fall at night shift without witnesses. By the policy of Providence Healthcare a patient who had fall without witnesses should be automatically monitored for head injury therefore, a Glasgow Coma Scale was initiated by previous nurse: every 15 minutes, then every hour, every two hours, and every 4 hours. This scale is to check and monitor level of consciousness which possibly may decline after head injury. At this day we had a student as a "nurse in charge", she volunteered to come with me to patient room and to supervise my work. For this particular patient close monitoring of vital signs and neurologic assessment required. I explained to the patient the purpose of frequent health assessment and started to work. Close patient monitoring in addition to all daily routine activities was challenging to me because I never had a patient with this diagnosis. Despite my explanation of the purpose of frequent assessments patient stated that "I am fine, do not feel any discomfort, there is no need for that". While assessing patient she keep asking a lot of questions such as why so many time why do I need to drink more than one mouthful of water with my tablets, what these tablets for, why do I need to wait few minutes after

Then I was off for two days at work. When I returned, I found out that this patient is improving and has been transferred to medical surgical floor. I went to see her at the medical surgical floor before the start of my shift. I noticed that patient conditioned has improved and I introduced myself and told her I wanted to make sure that she was alright before starting my shift. I asked if she wanted to talk to me about this visit. She thanked me for providing great care and discussed about her event. I listened attentively. She further said that she has been stressed a lot these days and drinks excessive alcohol to recover her stress because everyone around her are dying. She is not paying attention to her health lately. But with this incident

The preceptor experience today was short, so we didn’t really get to do a whole lot, but it was still a good experience to have. Today in the Matthews office there were only 2 nurses total where as there were 8 in the office last time. This was due to them having meetings and doing house visits. I asked my nurse if she did house visits and she stated she did not because she just physically does not have them time to do them with all the documentation that is required of her. This was interesting to me because sometimes I really do feel like nursing is 70% charting and 30% actually caring for the patient. She then went on and showed me how she has to have a 40 patient workload each month to meet quota. Even though a lot of those patients are