Personal Reflection : Effective Management Of Multiple Patients

I always feel slightly off when returning to clinical practice after a break, whether that is one week due to SIM or a whole month for Christmas break. I felt like my sense of direction was disheveled this week. My first morning with a client I found myself lost on were to even start with her care. I forgot to introduce myself during my first morning and I found myself relying on the outline sheet for a head to toe. Even finding my way around the unit made things take slightly longer than I would have liked. As the day progressed I began to get back into the groove of things. Going into the second shift my morning was much smoother and I didn’t have to look at my head to toe guide as I preformed my assessments. I felt more comfortable with my charting and was able

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 B. Additionally, the staff on duty could have lacked training regarding protocols or their training could have been out of date.

As a scholar and leader in the area of medicine, it is imperative to understand how to work as a team to provide the best possible care to patients. “Educators are responding to complexities of today’s medical knowledge by developing educational programs based on current learning theories, such as enactivism, where learning takes place within teams that are actively engaged in clinical environments” (Davidson, Morgan, & Simons, 2012, p. 291). This results in more patients that can place their trust in physicians and nurses who know how to work together as a team.

It is critical to have an understanding of nursing-sensitive indicators in order to provide safe, quality, compassionate and satisfactory patient care. In this scenario, applying restraints to Mr. J, a demented patient with hip fracture seems appropriate. However, it is standard practice that restraints are to be removed as soon as possible, and the patient in restraints may need assistance to change position every two hours. In Mr. J’s scenario, there should have been a bedside commode, and a urinal for him to use at the bedside so he does not have to walk very far to the restroom. As for the CNA, if she was well trained, she would have been able to recognize the marks on his spine

Analyzing case study 16, multiple patients with peripheral vascular disease need to be delegated to staff on a vascular surgery unit depending on the care and responsibilities that each patient requires. The RN team leader has the authority to delegate tasks and will distribute the workload according to each staff member’s position, scope of practice, education and experience. Another factor to consider before delegating is that the RN team leader should consider the following: risk for harm, complexity of task involved, and level of patient interaction involved.

During my clinical competency placement, I was working on a surgical ward when a registered nurse on duty asked me to assist Mr. A with his shower. This incident happened on the fifth day of my clinical practice. He was a dementia patient and had undergone right knee total joint replacement. She also informed me that the patient did not like too many people in his room because of his dementia. When I went into his room, his wife was there with him. I talked to the patient about having a shower and getting dressed to look smart and he agreed to have a shower. The patient got out of the bed and walked to the bathroom and sat on the shower chair to have his shower. Then I asked his wife if I needs to stay with him to assist with shower, she said she can help him as she was taking care for him at home since he has been diagnosed with dementia. Therefore, I left the patient with his wife to help with his shower and told her to ring the bell if she needs any help. After some time I left the room, the wife rang the bell. As soon as I entered the room, I heard him shouting at his wife and she started crying and left the hospital. So I had to stay with him. He was very capable of washing himself and I just had to help him wash his back as he requested. After he had washed, I asked him if he was ready to get out of the bath, he started shouting at me.

Multidisciplinary rounds approach calls for various members of the medical profession to synchronize individual skills, knowledge, and expertise in order to provide quality care for patients (IHI, 2015). The team members consist of nurses, physicians, “ancillary clinicians, and staff” (IHI, 2015, p.4). Each member contributes to the care of the patient individually, but in a cohesive manner (IHI, 2015). The multidisciplinary rounds care model strongly encourages and utilizes parental involvement during rounds (IHI, 2015). Multidisciplinary rounds also solicit parents and family members to communicate with the care team care as well as care team communications concerning the patient to the family (IHI, p.4). For each patient, the rounds are conducted daily (IHI, 2015). For each patient, goals are set daily (IHI, 2015). This ensures daily communication among care team and with patient and the families of the patient (IHI, 2015). The idea is to establish good coordination of care; thus, making safe and efficient care more consistent (IHI, 2015). As the protocols or the guidelines are clearly communicated among care teams, risks are identified, and staff are educated, the quality of health care improves (IHI, 2015).

Two patient verifier completed. Per PA Wu , the patient was informed that she has added an additional bp med to his current regimen. Asked the patient that he has any swelling in legs. The pt says no. Informed the patient that only a 30 day supply was ordered on his Lisinipril. Please record bp readings for the next seven days at the same time then email reading via Micare. If bp in not controlled then a f/u with his provider is needed. The patient agrees and verbalized

After choosing to help my co-worker, to ensure that the client was kept clean and comfortable, I felt that this was my main priority in this situation. As an accountable Healthcare worker it sates within my code of conduct. That I have to make sure that I give care to all clients and treat every person as an individual, with dignity and respect at all times. However, I could still see, and understand why that staff nurse had to explain to me why I had to listen and take instruction.

Many individuals come together to organized a care plan for a patient. The patient plays a role in the process, sharing his or her preferences and needs as they related to information sharing and health services. Family members and caregivers need to have a say in the care of the patient, as coordination failures frequently occur when care is transitioning from one party to another. Healthcare providers must be a part of the care coordination team, and this shouldn't be limited to only doctors.

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

During the home health observation day, there were several opportunities to observe a variety of patients with varying levels of functioning ability, different illnesses, and different needs and levels of interaction with the nurse. The first patient seen was a seventy-three year old Caucasian female with an ulcer on her right heel. Several weeks prior, she had scratched her left leg and she also had several small wounds on her left leg. The orders were to clean and redress the ulcer. She has a history of end stage renal disease, pneumonia, weakness, diabetes, dialysis, and right hip fracture. Upon entering the home, the patient was found to be sitting in a wheel chair in the living room watching television with her husband close by her side. She greeted the nurse with a smile and began to update her on her current condition. Her heel was “hurting” and she rated her pain an 8 on a scale of 1 to 10. She also had some “swelling” that she could not “get to go away; because, she could not get up and walk. They need to fix my foot so that I can get up and get around.” She told the nurse that she had been to see the doctor “yesterday” and the doctor had given her a written order that she wanted her to see. The order was written for an evaluation for a soft pressure shoe fitting. The nurse read the order to

Approximately 12: 30, RN received patient 's blood sugar report that was 232 from Julao-co, Antonina, Nursing Assistant (NA). Patient had lunch approximately 1245. Due to lab system down and unable to receive the result on sunrise, RN called Antonina, Nursing Assistant (NA) again to confirm patient's blood sugar 232 before administering Humalog medication.

Teams working in a hospital or other healthcare setting may consist of several physicians, nurses, medical assistants, referral coordinators, pharmacists, therapists, and students among others. Such large teams can provide comprehensive care for complex and chronic illnesses, but when they fail to work well together, they

Today I had a great day at the clinic. For the morning section, I had Omar Lora as my patient. Last time when he came, I collected all my assessment data. Today I updated his medical history, dental history, vitals, and EIOE, then I completed filling out the gingival assessment, the treatment plan, and the SAOP. Finally, I was ready to have my assessment data checked. It went really well, and I learned ways to helped me be more efficient with my time management, for example, I did not know how to have my radiographs up in the other monitor while I was doing my assessments. It was a little time consuming having to open and minimized the window every time I needed to look at the radiographs. Also, I discovered that having a piece of paper out and taking