On 5/16/17 I was able to visit Ms. Perez at Select Specialty Hospital. I met with Theresa the internal case manager from Select Hospital. We were able to have a case conference at the bedside with her husband. Throughout the whole meeting Ms. Perez appeared to be sleeping. She remains on a 28% trachea mask, nasal gastric tube, tube feeding for nutrition, non weight bearing to the lower extremities secondary to fractures (non weight bearing is projected at 6 to 8 more weeks), and the right arm has a cast. Occupational therapy said they get her up in a cardiac chairs but she is a full lift by staff. Ms. Perez weighed 312 lbs. Respiratory therapy reported that they will try to wean her trachea size down and work towards capping and then removing at some point. Mr. Perez asked what pain medication she was on because all she does is sleep. I asked the case manager to check and she what her level of alertness is on the second and third shifts. Per the EMS and ER report Ms. Perez was thought to have had a seizure and a full cardiac arrest at the scene with active CPR by a bystander, but once in ER she was alert and oriented. The CT scan of the head was negative. Nursing reported that she is only on one Norco every eight hours for pain and a very low dose of Gabapentin. He also reported that a Neuropsychologist was in on Sunday to see her, and he increased her Cymbalta. We did confirm with Mr. Perez that before the accident Ms. Perez used a walker in the house and that he helped
This essay will discuss a clinical skill in which I have become competent in practicing as a student nurse.
Conducting an interview with someone makes you see things in many different perspectives and in a new light. The person I interviewed saw nursing as a broader term that saw things in a different way even though she has just started. She knows that special people need to take roles in being a nurse. I interviewed my aunt, Ann Juknevicius. She is 30 years old and she has been a nurse for 2 years in Illinois now. Relatively she is a new nurse. One of the main reasons why I started the nursing program is because I look up to Annie a lot and she showed me so many different perspectives on how to look at people, different situations, and the way you handle things. I thought that it would be a great interview session to see if Annie’s expectations were the same as the nursing reality.
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.
This self-reflective paper is focused on what I’ve learned about myself this semester regarding my strengths, and weaknesses. Concentrating on areas of my professional practice that need improvement and discussing two goals I have created for my self, and how I plan on achieving them. This semester I have discovered I have two key strengths those being a dedication to the practical nursing program, and seeking help in the program when I need it. This trait is hopefully carrying through as a strength in my nursing career. However, I have many weaknesses to work on as a student and future nurse. Along with my shortcomings, there are fears I have looking into the future, into CPE 1 and term 2. Those are the fears of not being good enough in
Nursing can be a demanding career, but the benefits far much outweigh the challenges. Most importantly, it’s the rewards it offers by allowing an opportunity to make a difference in another person’s life through the provision of care when they need it. Just as Patricia Benner theorized in her book “Novice to Expert,” nursing encompasses both educational knowledge and extensive clinical experience acquired throughout one’s career. This far, I continue to acquire knowledge and clinical knowhow which will promote proper and efficient care to patients. Since I began practicing one year ago in a long-term healthcare facility, I have interacted with patients, families, physicians and other members of the healthcare team to coordinate patient’s care which has enabled me to gain confidence in myself. While I cannot deny that it was difficult to transition from a student to a licensed nurse, I learnt to overcome these challenges and focus on my strengths. Practicing as an LPN has provided a platform to learn and gain experience even though the duties and responsibilities are limited by the scope of practice.
Hello Students, my name is Teresa Damien MS, APRN-BC. I have been a registered nurse for over a decade and currently practice as a psychiatric mental health nurse practitioner at an academic institution clinically focused in addiction psychiatry. I have worked in multiple areas of nursing over my career prior to mental health that include medical-surgical nursing, respiratory nursing, hospice nursing, home care pedicatric nursing, and nursing education.
As I near the finish with my journey with Aspen, I realize what I have achieved. I have improved my decision-making skills, attained knowledge in leadership and managerial skills. Also, I have improved my communication skills for leadership positions, increased knowledge in the organizations functioning, and increased knowledge in quality. Therefore, we will review some of the areas, which my goals were achieved.
Nursing, as the largest health care profession in the United States, plays a tremendous role in health promotion and delivery of care. From the 2.7 million employed registered nurses to the current Deputy Surgeon General of the United States, nursing infiltrates all aspects of healthcare (Bureau of Statistics, 2015). Therefore, as a profession, nursing must understand the intricacies of the Patient Protection and Affordable Care Act (ACA) and within its framework develop strategies to “advance nursing, health, and healthcare through education, clinical practice and research,” (Young et al, 2017). This paper aims to review portions of the ACA as it pertains to nursing, and offer an example of nurse practitioner innovation in practice.
One the most important issues facing nursing these days is the changing healthcare insurance industry. I saw how these changes affected staff firsthand. I worked at Quincy Medical Center for three years until it closed in December of 2014. The Affordable Care Act led to cuts to Medicaid supplemental payments for the uninsured and has forced many hospitals to reduce staff or close like Quincy Medical Center. This is a concern for nurses because under current federal regulations there are no specific requirements for nurse to patient ratios. Multiple research studies demonstrate that lower nurse-patient ratios save both lives and money long term. For example, hospitals that routinely staff with 1-to-8 nurse-to-patient ratios experience five additional deaths per 1,000 patients than those staffing with 1-to-4 ratios, according to the Journal of the American Medical Association. Higher nurse to patient traditions lead to higher burnout
The national league for nurses defines critical thinking in the nursing process as “a discipline specific, reflective reasoning process that guides a nurse in generating, implementing, and evaluating approaches for dealing with client care and professional concerns” (Kozier, 2008). This definition is imperative to help a nursing student learn how to think in terms of nursing care. Nursing students must achieve a comprehensive understanding of critical thinking in order to understand the nursing process. The purpose for this paper is for nursing students to learn how to use the nursing process, how to properly document their findings and assessments, and correctly implement APA formatting in a formal paper.
Lily was a 65 year old lady with stage 5 CKD, she had recently begun hemodialysis treatment three times a week as an inpatient and had been responding well to treatment. During dialysis treatment on the morning of the first day, Lily’s observations showed that she was: tachycardic, hypotensive, tachypnoeaic, had an oxygen saturation level of 88% and was becoming confused and drowsy. It became apparent that Lily had become hypovolaemic. The hypovolaemic shock seen in this patient was of a particular critical nature due to the fact that her dialysis treatment had moved her rapidly through the first two stages of shock with her compensatory mechanisms failing very quickly (Tait, 2012). It was also much harder to identify the early signs of
This self-reflective paper focuses on what I’ve learned about myself this semester regarding my strengths, and weaknesses. Concentrating on areas of my professional practice that need improvement and discussing two goals I have created for myself, and how I plan on achieving them. This semester I have discovered I have two key strengths those being a dedication to the Practical Nursing Program, and seeking help in the program when I need it. Both being potential strengths in my nursing career. I have some weaknesses to work on as a student and a future nurse.
The following reflection demonstrates my awareness for my own cultural influences. Through the cultural lenses of a student nurse and a tennis member. They have impacted the way I view others and is a guidance to my bicultural professional health care relationship.
The nursing profession has been around for a very long time. Through many changes and reforms, it has drastically evolved into the nursing profession we have today. Nurses have an important role within the healthcare industry in the treatment and medical care of the sick. These trusted healthcare professionals continue to make up the largest majority of the healthcare field, as well as the fastest growing occupation. Nursing is a job that allows people to not only care for the sick but also to experience, learn and further their interest in the human body. This course has definitely provided me an insight to the roots of the profession I would like to pursue. I think it is important to know the history of nursing to understand fully on the problems that are affecting the profession. I believe that we cannot effectively address important issues without a foundation of historical knowledge. In other words, by examining the nursing history, I will be able to appreciate my important role as a nurse in the healthcare system. The topics I will be including in my reflection are the works of Florence Nightingale, the affects of World War II, the challenges of Filipinos aspiring to be nurses, and excerpts in Chapter 10 of “A History of American Nursing.”
Furthering nursing research is essential, as it forms the basis for evidence-based practice in healthcare today. With this in mind, developing the skills to critically appraise research articles is of the utmost importance in order to determine the relevance of research findings for clinical practice. As I pursue a doctorate degree in nursing practice, I am reminded of the necessity of these skills. Thus, in the following paragraphs, I will reflect on the research goals I developed at the beginning of the Critique and Design of Nursing Research course, and will discuss my views on the role of the graduate nurse in regard to