Personal Narrative: Follow Up Mike's Oxygen

However my concern for the patient’s health and the feeling that it was the right thing to do prevailed for me to tell the nurse in charge the correct oxygen saturation of the patient.

The nurse found Mrs Smith to be tachypnoeic, her respirations were recorded as 24 breaths per minute it was observed as being fast and it appeared that her accessory muscles were being used. Mrs Smith’s pallor also appeared flushed and her saturations were documented as 93%. The nurse used the stethoscope to check for wheeze the patient’s lungs were clear and chest rise was symmetrical. Mrs Smith was commenced on 100% oxygen through a non-rebreathe mask, oxygen as an intervention is necessary as Creed & Spiers (2010) highlight ‘metabolic demand for oxygen throughout the body is hugely increased by sepsis and is essential to ensure the supply of oxygen is maximized’ .The nurse monitored the patient closely because in her confused state the patient may try to remove the oxygen mask.

Growing up with a father in the military, you move around a lot more than you would like to. I was born just east of St. Louis in a city called Shiloh in Illinois. When I was two years old my dad got the assignment to move to Hawaii. We spent seven great years in Hawaii, we had one of the greatest churches I have ever been to name New Hope. New Hope was a lot like Olivet's atmosphere, the people were always friendly and there always something to keep someone busy. I used to dance at church, I did hip-hop and interpretive dance, but you could never tell that from the way I look now.

I returned to the recovery ward, my patient was still hypertensive and tachycardic and I felt by assessing her non-verbal signals of communication that she was still in great discomfort. After 15 minutes of no improvement I returned to theatre to see the anaesthetist, I explained that I was not happy with the patient’s level of pain and requested that he come to the recovery ward to assess the patient. He reluctantly came to the recovery ward and after spending a few minutes assessing the patient agreed that she was in an unacceptable level of pain and prescribed a further 5mg of morphine which I duly gave to the patient in 2.5mg increments. After this the patients heart rate and blood pressure decreased to pre operative levels, she seemed to be more relaxed and eventually fell asleep. After a further period of time spent continually reassessing the patient and when I was satisfied she was comfortable and haemodynamically stable I discharged the patient back to the ward.

Additionally, the care environment developed a hazard when the patient population increased both in number and acuity with the admission of the acute respiratory distress patient and increasing patient load in the lobby without note of available back up staff being called in. Examples of errors from the flow chart comparison might include failure to assess and monitor when Nurse J initiates blood pressure and SpO2 measurements, fails to initiate ECG with respiration monitoring, fails to administer supplemental O2, and leaves the room without apparently noting the baseline of the patient2. Furthermore, there appears to be an error in the lack of communication collaboration between the RN and LPN regarding Mr. B’s post procedure status and monitoring needs, and there is a failure to rescue when the LPN notes the low SpO2 value, fails to respond, and instead re-initiates another blood pressure reading without noting the results. As Mr. B’s condition deteriorates and a code is called, an ACLS error is observed in the timeline when the patient is noted first to have absent pulse and respirations and that a monitor is next applied and the patient and displays ventricular fibrillation. Chest compressions appear to not have been the first action in this scenario, nor is end tidal CO2 monitoring noted as initiated to monitor the quality of compressions. These are examples of hazards and errors in the care of Mr. B and in an actual RCA the level of detail would likely turn up

On the early morning of August 17, 2002, James C., a patient in one of the wards under the supervision of Ellen Hughes Finnerty, RN, went into respiratory depression. Between 3:00 and 4:00 a.m., Ann Mugi, the patient’s primary nurse, sought the assistance of a respiratory therapist, Hiran Obeyesekere, to help her care for the patient. As Obeyesekere suctioned the patient airway, Mugi called the service of the patient’s primary care physician, Dr. Jackson, to report the changes in the patient’s respiratory status, e.g., respiratory rate of 40 breaths per minute and low urine output.

As the primary nurse for the patient, I felt it was my responsibility to inform

A.W., a 52-year-old woman disabled from severe emphysema, was walking at a mall when she suddenly grabbed her right side and gasped, “Oh, something just popped.” A.W. whispered to her walking companion, “I can’t get any air.” Her companion yelled for someone to call 911 and helped her to the nearest bench. By the time the rescue unit arrived, A.W. was stuporous and in severe respiratory distress. She was intubated, an IV of lactated Ringer’s (LR) to KVO (keep vein open) was started, and she was transported to the nearest emergency department (ED).

One day I was in class and a tornado erupted 17 miles away. Alex Ogle and William Burnett went outside with me and somebody came by and picked us up and dropped us off on an island. We were stranded on an island. We were safe until the tornado was over.

The only goal of this meeting is to disclose the event and answer any questions the patient and/or family may have. The physician will describe what actions the hospital has taken in response to this event, any future actions that will take place, and what policies were reviewed while investigating this error. The physician and designated hospital staff member will also disclose contact information for future communications with the patient and/or family members. It is the physician’s discretion to initiate future communications and face to face meetings with the patient and/or family

The ER physician said he would need some treatment (oral charcoal) for the amount of medication he had on board and he would need to be on observation for up to 12 hours. I advised my supervisor and Juvenile Services of that update.

I think that my family realized that I had crossed the threshold between childhoods when I began to form my own opinions. This first took hold when I took part in poverty stimulation at my local shelter. I was giving a character and a story behind the card I was given; the story made me become emotionally attached to this name I had been assigned and the family in which I came from. The experience made me question the prejudice of the society I was living in. How many times had I avoided eye contact with the people on the side of the road begging for money? I began a long journey of soul searching and questioning the beliefs my parents had raised me on. My thoughts were continually brought back to a book by C.S Lewis, it was called Out of the Silent Planet; a character named Weston believed that individual human lives don’t matter, they must be sacrificed to save mankind.

The incident happened on Nov 21st, 2017. The patient has sleep apnea and a health history of chronic bronchitis (no episode in recent 2 years). Her respiration rate was 16 and all lung fields were clear upon auscultation. After I took the patient’s vital signs, I noticed that her oxygen saturation was low (83%). Then, I notified the nurse and asked the patient to do take some deep breath. After that, we put her on 2L of oxygen and her oxygen saturation went up to above 90s. However, the patient had a bladder control problem (was incontinent), so I took the oxygen off because she went to the toilet for around 4-5 times in an hour. However, I forgot to monitor her O2 saturation right away. Instead, I checked her oxygen saturation after she finished her dinner, and it dropped to 86%. The instructor showed me how deep breathing exercise can help the patient increase her oxygen level quickly. I notified the nurse and we put the patient on 2L of oxygen, but again I forgot to check her oxygen saturation right away. Instead, I checked her oxygen around 7pm later.

I was born on September 20th, 1997 on the coast of Virginia Beach. Now living in South Carolina I am 19 years old and living a very healthy and eloquent lifestyle. As I filled out the Real Age questionnaire I encountered many questions that made me think if my diet and health were flawed, while other times it seemed as if I was the pinnacle of health. I found at the end it had me down as a 16-year-old teenager. This three-year difference in what my age and what Real Age had put me down for really opens my eyes about how well of a healthy lifestyle I am living, and motivates me to continue living it to the best of my ability.

When I was in 6th grade I tried out for O.V.A. (volleyball) for the first time. From doing it I learned that when you put your heart into something you will accomplish it.