Gawande First Central Line Essay

Waking up in the morning, going to sleep at night, and doing what one loves in between, is what success means. That, to me, encompasses being able to help people and possibly save lives as a career. There is a nobility in succeeding in certain areas one cares deeply about. Having the ability and capability to protect and serve is a strong desire within me. Developing my education, in order to further my success something that I perceive as a crucial aspect of being able to do what I love. Attending Endicott is the first step in this journey of mine.

Section 1: Question 1 – The society of Gattaca works to repress rather than to enhance the potential of human beings. Discuss.

Parvana is a novel written by Deborah Ellis. Parvana and Shauzia are 2 young girls who life in a Taliban ruled country, known as Afghanistan. Both girls are faced with many difficulties throughout the novel. The 2 girls are given the chance to leave the war-torn country and Shauzia immediately takes this chance. By doing so, Shauzia will no longer be living under the Taliban’s rules. Being an 11 year old girl, Shauzia deserves to get an education. Shauzia’s family does not value her in any sort of way and she doesn’t deserve to see such disgusting things everyday.

In 1900, the death rate per 100,000 population for influenza and pneumonia (I & P) was 202.2; it was 22.4 in 2003. How much did the death rate due to I & P decline

After surgery, Mr. Baker is taken to a room on the medical-surgical floor. He has an IV infusing at 125 ml/hr, a PCA pump, and a nasogastric tube connected to low suction. He is receiving oxygen through a nasal cannula.

Lewis et al. explain in Medical-Surgical Nursing, a central line is a catheter placed into a large blood vessel for a patient who requires frequent or long-term access to the vascular system. The authors explain that catheters are used for the administration of high volume fluids, medications that are irritating (such as chemotherapy), long term pain medication, blood products, parenteral nutrition, and hemodialysis. Kaiser policy states four different types of central line used for patients: Centrally inserted catheters, peripherally inserted catheters, injection implanted ports and hemodialysis catheters. Centrally inserted catheters

Article by Clancy (2009) explained central lines were a result of an estimated 250,000 blood stream infections and accounted for 30,000 to 62,000 patient deaths, then adding that each infection cost upwards of $36,000 and cumulatively add up to at least $9 billion in preventable costs annually. The article also explains how the mindset has changed from the cost of having a central line in place and expecting complications to lowering infection rates by an intentional interventional process/s. The article speaks of 5 basic steps to reduce CLABSI, hand washing, insertion techniques, skin cleansing, avoidance of certain sites and earlier removal of the CVC. Studies showed that these guidelines were only followed 62% of the time. The system was changed to ascertain that all the clinicians were in compliance. This prompted 5 interventions, education, a CVC insertion cart with all necessary equipment, physicians having to validate central line necessity, a concise checklist for bedside clinicians and the empower of nurses to stop procedures if guidelines were not followed. These low cost interventions from 11.3/1000 in catheter days in 1998 to zero in the fourth quarter of 2002.

The procedure was done emergently because of the patient’s critical condition. His right IJ area was prepped in the usual fashion. It was very difficult to visualize his right IJ vein, even though his habitus should have allowed us to do so, but the patient was, I believe, severely intravascularly volume depleted, and his vein was collapsing. I have attempted to access the right internal jugular vein multiple times, both under real-time ultrasound guidance and even later on blindly. I was able to get blood return and hit the vein; however, I was not able to advance the guidewire. I was able to advance it one time and put the catheter in, and it was nonfunctioning. I had to take the catheter out and tried multiple other times on the right IJ vein without success. That procedure was terminated. Pressure was applied. There was no cervical hematoma whatsoever. The patient was uncomfortable because of the length of the procedure but did well otherwise. Hemodynamically, he was unchanged, and his oxygen saturations remained stable.I prepped the IJ vein area in the usual fashion. One percent lidocaine was used for local anesthesia. Again, the left IJ vein was collapsing. With deep inspiration, the vein could be well visualized on the real-time and ultrasound guidance, after which I could get access to the left IJ vein. A wire was advanced without difficulty while the

I was about to achieve my objective this week by performing nursing care for two patients, hanging an IV piggyback, flushing and administering an IV med and inserting a straight catheter with the help of the nurse.

For nearly 138 years, Brenau University has continued to uphold its slogan Extraordinary Lives. When I first stepped foot on Brenau’s campus in 2012, I wouldn’t have fathomed that four years later, this institution would shape me into the successful woman I am today. Prior to attending Brenau, I had always struggled with understanding who I was and where I belonged. Once I became a student at Brenau, I began to join organizations such as Student Activities Board and Student Government Association, and consequently, I have reached a social and academic success peak I never believed I would be able to achieve. If you are a first year college student or are transferring to a different institution, I advise you to take Brenau University into consideration.

Gawain, a knight of the famed King Arthur, is depicted as the most noble of knights in the poem Sir Gawain and the Green Knight. Nonetheless, he is not without fault or punishment, and is certainly susceptible to conflict. Gawain, bound to chivalry, is torn between his knightly edicts, his courtly obligations, and his mortal thoughts of self-preservation. This conflict is most evident in his failure of the tests presented to him. With devious tests of temptation and courage, Morgan le Fay is able to create a mockery of Gawain’s courtly and knightly ideals. Through the knight Gawain, the poem is able to reveal that even knights are human too with less than romantic traits.

A percutaneous central line is entered into the patient’s subclavian vein. Because TPN solution is concentrated it is better to have CVC access in the subclavian vein so the solution has less distance to travel to its destination. This reduces the risk of the line clotting or damaging the vein.

The purpose of this journal is to reflect on my experience and skills gained during my clinical placement at Ben Taub Hospital. On my first clinical day, I was excited and nervous at the same time. My first placement was in the PREOP/PACU area. I was assigned to help a patient who had been in the PACU area going on 2 days. Normally, once the patient comes from surgery they are only in the PACU area for a short period of time before they are discharged home or given a bed in another area of the hospital. This particular patient still had not received an assignment for a bed. The physicians would make their rounds to come check on him daily. The patient was a 28-year-old Hispanic male, non-English speaking, he had a hemicolectomy. He had a NG tube, urinary Foley catheter, and a wound vac. My preceptor had just clocked in and she needed to check on the patient’s vitals and notes from the previous nurse. Once she introduced me to the patient and explained while I was there, she then asked me to check his vitals. (Vital signs indicate the body’s ability to regulate body temperature, maintain blood flow, and oxygenate body tissues. Vital signs are important indicators of a client’s overall health status (Hogan, 2014). I froze for a quick second. I have practiced taking vitals numerous of times and I knew I could do it correctly. I started with the temperature first, when I was quickly corrected on a major mistake I had made by my preceptor. I HAD FORGOT TO WASH MY HANDS and PUT

The native accepted him as one of their own, and he was no longer a stranger.

Vincent Freeman was a naturally born child. He was called "invalids" along with others that were born in the same way. The doctors told his parents that he had a 99% chance of dying of a heart disorder when he was about 30 years old.