ICU Nurse Observation

When I arrive to the Trauma ICU 4800 unit, all of the nurses were already being followed by other students. The nurse in charge had me follow several different nurses, so I was able to observed several different patient cases. The first patient had received a triple bypass open-heart surgery. The patient had received a creatinine blood test. The patient had a dialysis machine next to them, which was used to function as the kidneys since the patient’s kidneys were not functioning correctly. Also, the patient’s body temperature was lowered from having a taken cool liquids so the nurses were keeping him warm with a bair hugger, which was a machine that helped regulate the patient's’ body temperatures.

The American Association of Critical Care Nurses (AACN) is the largest non-profit specialty nursing organization in the world. There are over 500,000 nurses involved in the AACN and its mission is to provide its members with the latest knowledge and resources for providing the best care possible to acutely and critically ill patients. They do this through education of products, seminars and even national conferences where critical care nurses can learn about the latest in technology and treatment techniques.

As a new graduate nurse, I was hired as a floor nurse on the medical surgical unit. I had two months of orientation before I was on my own on the unit. It was a fighting experience for me because I had a full assignment with eight to ten patients during night shifts. My nursing director and colleagues were very supportive during my transition. I had a patient who was abusive to staff with past medical history of IVDU, GERD, Bipolar (untreated), and chronic pain. I felt outside my comfort zone because I was worried about my safety. The patient was labeled as a “difficult patient” on the unit and most nurses refused to have her. One evening, she was complaining of back cramping after a session of physical therapy and received morphine IVP with little effect.. Patient was impulsive, and abusive toward the staff that morning. When I was getting a report from the previous nurse, the patient was getting agitated and left the unit to smoke. The nurse felt that would calm her down and make her less belligerent toward the nursing staff. During my assessment, she reports being extremely nauseous which was not resolved with antiemetic. The patient continues to seem to be in distress, obtain normal vitals and 12-lead EKG. She appears less comfortable, agitated, and her EKG remain normal sinus rhythm. The doctor was at the bedside to evaluate but not concerned. He ordered for another dose of morphine IV with Zofran IV left the unit. He reported he would be back later to check on the patient with the primary team. In addition, he consulted pain services to better manage her chronic pain. The pain was not managed, she remains nauseous and sweating. I needed to approach her with an open mindset and look for an underlying cause of her discomfort. I notify the charge nurse on the

I have been a CNA since 2007. I started working in a nursing home when I was 18 years old and by the time I was 21 I was given the opportunity to work on the Med-Surg floor at KGH. When the hospital moved to its new location in 2014, I chose to work on the Medical floor since the unit was splitting into two separate units. Though I was content on the unit, there were occasions in which I was floated to the ICU. The acuity of the patients, the use of equipment I had no experience with (i.e. vents, central lines), and the overall flow and air of the unit intrigued me to the point that I had no doubt in my mind that this is where I wanted to work. In August 2016 there was an opening in the ICU that was going to accommodate my school schedule. Without hesitation I applied and was given the position. Since that time the things that I have seen on the unit have both fascinated me and completely blown my mind (in a good way). Though the patients may not be as stable as on some of the other units and the risk of things going awry is so much higher, I

An understanding in nursing sensitive indicators in this case could have solved a couple problems that arrived during this patient’s stay. One of the issues was that the patient’s back was reddened due to restraints being placed and the patient not being turned properly to prevent pressure ulcers. If this would have been recognized when the restraints were applied, the patient would have been turned every two hours by placing a pillow under the sides of the patient so that he would not be on his back constantly. Due to him being confused, he may have been moving around a lot and pushed the pillows out, but there is also the case he should be getting rounded on hourly at the minimum. If this understanding would have been understood and the nurse knew what could have happened, she would have been turning the patient to ultimately decrease the hospital stay.

Stacy has been a nurse for ten years, she holds a bachelor’s degree in nursing and currently she is working on obtaining a master’s degree in nursing. Stacy is part of tripe “R” (rewards, recognition, and retention) committee, quality control committee, education committee, and creative awards committee. She is part of the Emergency Nurses Association, and she is a certified emergency nurse too. Stacy shows excellent transformational leadership style, and great communication skills, for example, when I just started as a nurse in the emergency department; I did not have any interest on become a certified emergency nurse, but then in one opportunity Stacy started talking with me about the benefits of getting the certification and the great impact that will have to me and to the facility where I work, and then to my patients. I will be more prepare to care for the critical patients and ready to respond to an emergency. I am currently studying some books that Stacy gave it to me and when I am ready I will take the text to be a certified emergency nurse.

After returning to the unit after a few days off, I cared for the same patient on post-operative day 8. Upon assessing, the patient findings included; patient needed oxygen to ambulate to the bathroom and appeared very short of breath, low urine output, lungs with crackles throughout, low-grade temperature, brown drainage from abdominal incision

The population on the day of the walk through was 230 (140 females, 90 males). This includes a young adult male population as well as inmate workers in the kitchen area. All meals for both facilities are prepared at the north facility. Services provided are similar to those provided at the Jail central; however, there is no infirmary area in the north facility. Any inmate in need of infirmary or detox services is transferred to the main jail facility. The ACA team made the following observations and recommendations.

Nurses role is a call, a call to dedicate yourself to your patient at any time: during favorable or severe weather condition, nurses still must deliver their care to the patients. They are at the bedside when physician and families are gone. Evacuating critically ill patient is a huge challenge to any health care facilities and healthcare workers especially the nurses.

The aim of the Intensive and Critical Care Nursing is to better promote excellence of care in critically ill patients. Specialized nurses and their professional teams improve care. The articles provide an exchange of research, experiences of professionals, knowledge, and different skill sets, that are aiming to improve critical care nursing.

My patient was a 29-year-old female who was 34 weeks pregnant and brought in by EMS for a drug overdose. She had been found down outside of an apartment building with various needles, legal and illegal drugs. There was not much report from the EMS, just that she had a high heart rate in the 110s and noncompliant with questioning. After hearing that I would be receiving this patient, I honestly was angry. Frist, because of that innocent baby that she was surly about to have. Second, was fear because I had no clue where to go with this situation. There was much discussion with the other staff as to the safety of this patient coming to the ED because of how far long she was. However, she was stable from the labor and delivery aspect and was bound to our unit.

Upon receiving the patient into care, the patient was difficult to wake. When awake the patient was “grumpy” and would start to cry. The mother said that he did not sleep well last night because there were multiple disturbances last night by the other patient’s and the nurse. The mother did request to hold off on any assessments that would involve us walking him up. It was important for her that he sleep because he can be difficult to handle when tired. The mother also expressed that it was hard for her to be in the hospital. Being in the hospital has increased her anxiety level. Therefore if we can keep the environment calm for her she would appreciate it, as she feels she is going to “loose it.”

My day in the intensive care unit, ICU started out very challenging. Upon arrival I entered into my patient’s room to find him covered in blood. He had taken out his IV, stripped from his gown, and was attempting to pull out his Foley catheter. He had arrived to the ER the previous night after being found at his hotel in only his underwear. He was admitted to the ICU to be closely monitored due to the fact that he has diabetes type 2 and his blood sugar level were critically high. His blood sugar levels were ranging from the 800’s and had even gotten as high as 1,098. To regulate his blood sugar level his physician ordered hourly finger sticks as well as a drip of 100 units of regular insulin via IV every 12 hours. His blood sugar level dropped

The night nurse had restrained her because of her awful behavior towards the health care personal. My nurse removed her restraints once she was extubated that morning and the patient hit her and tried to bite her. She was very confused and violent until her family came to visit. Once her nephew had left she seemed even more confused, the nurse practitioner thought that narcotics may be altering her state and decided to prescribe a different form of pain medication. The Nurse practitioner also wanted to move the patient to the telemetry floor since they needed the bed, however the patient went into Atrial Fibrillation after one of her chest tubes was removed. Therefore her time at HVCC was

Furthermore, she showed incapability in one of the emergency situations that took place in the ward. She was able to press the emergency button during that time but failed to take any independent nursing actions that could help the patient save his life. As a competent nurse, you should be able to act promptly and think fast during an emergency situation. It is