My Clinical Experience Essay

My first encounter with a Certified Registered Nurse Anesthesia (CRNA) was during my undergraduate nursing OB/GYN rotation. I was impressed with the CRNA when she placed the epidural to the patient in labor. I remembered patient had difficulty staying still due to the contraction, but the CRNA took her time to explain the procedure while comforting the distressed patient. Once the epidural was in placed and the medication started working, I could tell the relief the patient experienced. I realized then that a CRNA goes beyond the delivery of anesthesia, pain management and monitoring of patients. Thus, obtaining this degree will prepare me to ease the patient’s mind through education, pain management, monitoring, experience and compassion.

Hospice exists in the hope and belief that, through proper care and the encouragement of a caring and sensitive team, patients and their families may be free to achieve some level of mental and spiritual preparation for death that is comfortable to them. The goal is to help

Death is inevitable. It is one of the only certainties in life. Regardless, people are often uncomfortable discussing death. Nyatanga (2016) posits that the idea of no longer existing increases anxiety and emotional distress in relation to one’s mortality. Because of the difficulty in level of care for end-of-life patients, the patient and the family often need professional assistance for physical and emotional care. Many family caregivers are not professionally trained in medicine, and this is where hospice comes into play. Hospice aims to meet the holistic needs of both the patient and the patient’s family through treatment plans, education, and advocacy. There is a duality of care to the treatment provided by hospice staff in that they do not attempt to separate the patient’s care from the family’s care. Leming and Dickinson (2011) support that hospice, unlike other clinical fields, focuses on the patient and the family together instead of seeing the patient independent of the family. Many times in hospitals, the medical team focuses solely on the goal of returning the patient back to health in order for them to return to their normal lives. They do not take into account the psychological and spiritual components of the patient’s journey and the journey that the family must take as well. For treatment of the patient, Leming and Dickinson agree that hospice does not attempt to cure patients, and instead concentrates solely

The first half of this clinical placement, I was on a palliative ward. While others might find it difficult caring for patients at the end stage of life or in great deal of pain, I find that it gives me a great deal of satisfaction that I was able to provide care for these client in my own unexperienced way of palliative care. Being a patient myself of a very serious illness in the past, the goal of a palliative care team which is to provide quality of life during these difficult stages of the client, hits close to my heart. I might consider working in the palliative care unit in the future.

Caring for patients at the end of life is a challenging task that requires not only the consideration of the individual as a whole but also an understanding of the

Caring for patients at the end of life is a challenging task that requires not only the consideration of the patient as a whole but also an understanding of the family, social, legal, economic, and institutional circumstances that surround patient care.

According to Allen et al. (2012), “millions of people with chronic illnesses endure unrelieved pain, uncontrolled physical symptoms and unresolved psychosocial or spiritual problems.” This issue occurs because palliative care is often considered a form of end-of-life care. Palliative care is a treatment that can be used for patients who suffer from chronic illnesses and diseases while receiving curative treatment. (Horowitz, Grambling & Quill, 2014) purposely states the misconceptions of palliative care and advocated for seriously ill patients that education must bring under control the misconceptions. Some patients do not receive appropriate symptom management because the palliative care treatment needed is often confused with end-of-life care. However, end-of-life care attempts to relieve pain and suffering when a disease is no longer responsive to curative treatment. Pain and suffering could ultimately be controlled or even eliminated through the proper utilization of palliative care. Patients who are not referred to palliative care in a timely manner is more likely to have poor quality of life, uncontrolled symptom management and increased amounts of visits to the emergency room during the disease process. Patients with life limiting illnesses bear the burden of increased discomfort and increased suffering. Nurses experience clinical practice issues and difficulties in the clinical setting during the delivery of comfort and symptom management. These issues

You are working in the internal medicine clinic of a large teaching hospital. Today your first patient is 70-year-old J.M, a man who has been coming to the clinic for several years for management of CAD and HTN. A cardiac catheterization done a year ago showed 50% stenosis of the circumflex coronary artery. He has had episodes of dizziness for the past 6 months and orthostatic hypotension, shoulder discomfort, and decreased exercise tolerance for the past 2 months. On his last clinic visit 3 weeks ago, a CXR showed cardiomegaly and a 12-lead ECG showed sinus tachycardia with left bundle branch block. You review his morning blood work and initial assessment.

Public health nursing is an important aspect of nursing field, which contributes tremendously to the safety and health of our society. Public health nurses work hard to assure our communities are healthy and are able to attain needed support to be self-sufficient. However, it seems their hard work goes unnoticed by vast majority of our society. This of course, is my opinion, but I would say that if I were to survey various communities, most people would say that “Nurses just work in the hospital”. I could be very wrong.

A couple of years ago, my mom got a bellybutton pain in her lower-right side of the abdomen. It was an intense pain which moved all around her belly. She decided to ignore the pain, thinking it could be something temporary. Days went through and nothing could relieve the discomfort she felt. My dad decided to take her to a private doctor right away. The doctor had her do some blood tests accompanied by some others. When the results were ready the doctor asked us to take mom immediately to the hospital. He said something related to surgery and I lose control on myself. We had never been as scared of surgery as this day. We knew this kind of surgery was not as risky as others. The problem was hospitals in Honduras. Doctors back then did not care about the patient. Patients in the hospitals would get their wounds infected and they would die. I lacked trust in the abilities of the doctors. Not because they missed the knowledge required in doing this, but their interest in the patient was none. They knew the government was going to pay them either way. Therefore, they mistreated some patients. My mom received a

Before beginning, I would like to preface my remarks with one disclaimer. I am currently an Assistant Professor of Medicine, on the faculty at the University of Virginia School of Medicine. Additionally, I serve as Medical Director of our in-patient hospice and palliative care unit. Moreover, I serve on the board of our local hospice organization, Hospice of the Piedmont, where I also serve as Associate Medical Director. Though my work with these organizations has greatly enhanced nd deepened my commitment to the care of the terminally ill, I in no way claim to speak for or on behalf of any of the institutions for which I serve. The opinions expressed below and in my written testimony are entirely my own.

Dr. Ira Byock’s latest book, The Best Care Possible: A Physician’s Quest to transform Care Through the End of Life, is a remarkable book written from a personal perspective as one of the foremost palliative-care physicians in the country. Dr. Byock shares stories of his experience with patients in his clinical experience to illustrate how end-of-life care affects each person. He explains what palliative care really is and how to make humane choices in a world obsessed with conquering death. Byock presents an agenda for end-of-life care that stresses compassion, dignity, and each patient being viewed as a unique case with the opportunity to partake in shared decisions amongst a team of professionals and family members. Dr. Byock is an advocate of dying well in a society marked by a fear of death; his highly personal account provides thought-provoking vignettes of how people struggle to make the right decisions in the winter of their lives. Byock urges society to embrace the reality of death and transform the medical community into an environment that will allow patients to live the last of their days in comfort with dignity and peace. This book is a vitally important piece of literature for everyone to devour with fervor. Everyone needs to understand the inevitability of death and the environment end-of-life care can present in what will be the final moments of life.

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

A twist on the "patient's perspective" approach is to describe a time when medicine failed to save or heal someone close to you. The purpose of this tactic would not of course be to rail against the medical profession, but rather to show how a disappointing loss inspired you to join the struggle against disease and sickness.

As a student of nursing program I am doing 220 clinical placements at True Davidson long term care. On the first day of my clinical, I was so excited and quite nervous too. On that day, I picked one patient and it was my first experience to handle the client individually. I am going to write about that I eventually learn something from my first clinical experience. My buddy nurse told me to go to client’s room and ready her for breakfast. Then, I went her room and said her to be ready for breakfast. She looks at me and seems angry. At that time my mind was wandering that what I did mistake to her. It was the fifth week of my 220 placement, however, that event has left a permanent effect on my mind and it comes to my mind on every