Nursing Observation

On 01/27/2016, I observed about 22 patients in Postanesthesia Care Unit. Some of the patients were observed after surgeries while others were observed after endoscopy. During my shift, I observed patients awaiting recovery for removal of kidney stones, malignant melanoma (removal of moles), Endometrial Biopsy (EBX), superficial femoral artery (SFA), Hernia repair, Oophorectomy (ovary removal surgery), Cardiorrhaphy (Ventricular repair), Cystolithalopaxy (bladder stone removal), gall stone removal, Ectopic pregnancy surgery, and leg surgery.

There was additional backup staff present (including a respiratory therapist) that could have been called upon for help, yet they never were. The charge nurse or nurse supervisor could have stepped in at this point to provide additional help. A lack of present nursing staff and support can lead to unfavorable patient outcomes, as is the case with Mr. B. Additionally, the staff on duty could have lacked training regarding protocols or their training could have been out of date.

On Saturday 10/26/2016 at approximately 2328 hours, Security Officers Christopher Paz, Ariel Weiland, Omar Alonso along with Supervisor Steven Evans were dispatched to the EMS Off load Ramp for an incoming (51S) Patient Standby In E.D. Upon arrival at 2328 hours Security met with E.D. Charge Nurse Johnathan Bacal who stated that there was a combative male patient being transported by the Orange County Fire Department. At 2330 hours, the patient, Alan Castillo (DOB: 08/03/84; Fin #86501337) was brought by Orange County EMS (Engine #83) with an escort from Orange County Sheriff's Deputy. He had been combative on the way in and kept stating that he wanted to leave. He was rapidly taken to the Special Care Unit, E.D. room #38 but once inside the

There are errors and hazards in care that occurred in the Mr. B scenario. One error was the emergency room physician’s failure to recognize the signs and symptoms of deep vein thrombosis (DVT) that Mr. B was presenting. If not treated early, a DVT can become a pulmonary embolism, a fatal condition that Mr. B unfortunately developed. Another error in care that happened in the Mr. B scenario is the nurses’ failure to monitor Mr. B’s ECG and respirations. Early detection of critical ECG and respiratory changes could have initiated medical interventions that would have saved Mr. B’s life. One hazard is the emergency room nurses’ heavy patient load at the time of Mr. B’s sentinel event. Another hazard is having a licensed

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

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.

On august 13, 2016 I was assigned to follow one of the ICU Nurse. It was a very calm day. She had two patient one was more critical than the other. Both patients were on the ventilator because they had to be intubated the night before. The lady is obese and had gastric bypass surgery two years ago and suffering from severe sleep apnea, but the patient is non-compliance to the CPAP treatment. That was her second time being intubated. She was admitted for seizure monitoring because she was constantly having seizures the day before while she was at home. Due to the fact that she did not want to wear her CPAP machine while in the hospital, after pain medication was administered she was found unresponsive, that was the reason for her intubation the night before. Patient was on intermittent suctioning, she has sinus tachycardia . I had the opportunity to observe some of her daily care. The patient was on fentanyl but when the Dr. try to wean her out of the ventilator she stop breathing, therefore, the DR. discontinue the fentanyl temporarily in other to retest her later.

My colleague and I received an emergency call to reports of a female on the ground. Once on scene an intoxicated male stated that his wife is under investigation for “passing out episodes”. She was lying supine on the kitchen floor and did not respond to A.V.P.U. I measured and inserted a nasopharyngeal airway which was initially accepted by my patient. She then regained consciousness and stated, “Oh it’s happened again has it?” I removed the airway and asked my colleague to complete base line observations and ECG which were all within the normal range. During history taking my patient stated that she did not wish to travel to hospital. However each time my patient stood up she collapsed and we would have to intervene to

The objective of this reflection is to explore and reflect upon a situation from a clinical placement on an orthopedic unit. The incident showed that I did not provide safe, timely and competent care for my patient when the oxygen saturation was low. Furthermore, this reflection will include a description of the incident, and I will conclude with explaining what I have learned from the experience and how it will change my future actions.

During many years the role of school nurse was traditionally viewed as one where the nurse cared for students that were injured, applied bandages and gave out ice bags. Throughout the years the role of the school nurse has evolved into one of leadership and management along with many other duties including traditional roles as mentioned above. The services provided by a school nurse range from assessment and screening to coordinating care for regular students as well as students with special needs. School nursing requires experience and knowledge in school, public, community and emergency health to meet the many needs of school aged children and youth. The school nurse provides many services but the basic services provided include

I have scheduled an interview and time to observe a nurse leader with the Director of Nursing (DON) for the Virginian Nursing and Rehab facility in Fairfax, Virginia for Thursday October 2, 2014 at 7:30am. I plan on spending a full eight-hour shift with the nurse leader observing the following three leadership activities: 1) Observing her making rounds on the units 2) Observing and or participating in a nursing leadership meeting and 3) Observing the facility’s interdisciplinary team meeting.

My supervisor, one of the head nurses, hurriedly pulled me to the corner of the bleach white hospital room and directed me to put on gloves, an eye mask, and a face mask. I felt as if I was preparing for war as I put on all of the required gear. The sound of expensive shoes click-clacked down the hallway indicating the arrival of two doctors who rushed into the room and shouted out orders to the staff while pulling the doors to the room shut along with the curtains. Two doctors, eight nurses, an intern, and a dying patient squeezed into the already claustrophobic ten by fifteen-foot room. The machine monitoring the patient’s vital signs continued to beep incessantly as my heart rate accelerated. Throughout my internship, I had never seen a patient in critical condition until that moment. I remembered my teacher’s advice if we were ever in a situation such as this: take a few deep breaths and sit down if you feel like you’re going to pass out. In that

Before she could even take a step in the ambulance, my mom fell to the ground. The paramedics picked up the orange stretcher and placed it beside her shoulders. As they slid her over to the stretcher, they picked her up and placed her on the wheeled bunk support. They settled her in the ambulance and took my mom in The next week or so, the police called they wanted me to come to the police station and talk about something. When I arrived at station , everyone looked at me as if something had happened.

I agree. Nursing intuition is a vital part of what we do. Most of us nurses feel that our profession is more than a job, it’s a calling. I have often wondered if some of my “gut feelings” are from God. Years ago, my crew and I were on the ambulance and we were called to a residence to assist a toddler that had a witnessed seizure and was not breathing. On the way to the house, I lifted my hands up and said, “God, here are these hands, do with them as you please”. I did that because I was not comfortable in caring for children, and I knew that if a miracle were going to occur God would need to assist. When we arrived, the paramedics on scene were frantically doing everything per protocol, and I began to assist. In the end, the child survived

Learning goals I have set for myself during the course of this class are to gain an understanding and foundation of nursing theories, gain and understand the impacts of nursing practice as it relates the theories, and how to apply nursing theories to practices as appropriate and necessary. These goals were chosen because they will help set a foundation in nursing theories. Looking at the different topics to be discussed the two most interesting are (1) Theory of Cultural Care Diversity and Universality and (2) Nightingale’s Environmental Model (George, 2011). The two topics that are the least interesting are (1) Child Health Assessment Interaction Model and (2) Maternal Role Attainment/Becoming a Mother (George, 2011).