The Surgeries I Witnessed

A nurse attending stated “during the morning’s second surgery, he actually dozed off. The nurse took him aside and recommended that he take a break, but he refused and returned to the operation.” The nurse here was in fault in more ways than one. This nurse should never allowed the doctor return back to operate on the patient, he should have been removed from the operating room immediately. The nurse should have

A patient arrives at the hospital for their knee replacement surgery that has been scheduled for today. The patient is checked in at admitting and is called back to the pre-operative area by the nurse. The patient changes and the nursing staff begin to take the patient’s vital signs, review the patient’s history, draw blood for lab work and they let the patient know what to expect before, during and after surgery. The surgeon arrives and checks in with the patient, asks if they have any final questions before surgery and then leaves for the operating room to prepare. The patient is taken to the operating room, anesthesia is given, and the operation begins. The procedure goes smoothly and the patient is taken to the post-op area. When the patient comes out of the anesthesia, the surgeon

* Personnel Issues: One of the key barriers to effective interaction for the pre-op nurses is that they are not getting any information from the registrar or the surgeon related to the patients unique circumstances. There is not a communication process in place for the pre-op nurse to actively communicate with the surgeon or his office regarding a patient’s care during their day of surgery. An additional factor in this situation was the pre-op nurse documented the mother’s contact information in her notepad, but not on the

A junior staff nurse was employed to take care of the patient who after one week of the surgery had developed a very close relationship of understanding and care with each other through the proper usage of ethical values related to physical care and pleasing attitude towards the patient. After three days, the nurse was shifted to day duty and was very hospitably and lovingly greeted by the patient

During the pre-briefing, the group collectively discussed the patient’s history, presenting issues and other influences to the patient's care. As well, during this time, the group worked to identify role expectations, protocols, timelines and other presenting issues that would require consideration, including impaired circulation/post-op bleeding, mental status or hypoxemia. Decision-making in this aspect was based on the determined role and intended learning outcomes.

On my second day of clinical experience this week I focused a lot on time management and documentation for a full patient load, and also on the admission and discharge process. After taking report on all three of our patients, I began my initial morning assessments. It was clear that our 8-year-old post-operative appendectomy was ready to be discharged. My priorities were assessing her incision sites and ensuring the presence of bowel sounds, as well as making sure she did not have a fever and was tolerating a general diet. After completing my assessment and documenting in the computer, we

I am a second year nursing student in my third week of the practicum placement on a surgical ward with my co-student and the morning shift registered nurses. We had just finished analysing the patients handover report (Levett-Jones & Bourgeois, 2015) and I had been assigned to work with the registered nurse. I was looking after Mrs. Brown (pseudonym) is 82 years old New Zealander was admitted to surgical ward on the 08/06/16 for multiple SCC removals from L) hand and L) foot with skin grafts.

The key aspects of this skill are consent, preparation and prevention. The nurse must obtain consent from the patient and explain the procedure. The patient must be made comfortable and placed in a suitable position

(Mayo Clinic, 2013) Some surgical procedures used to treat CAD are angioplasty and coronary artery bypass surgery. (Mayo Clinic, 2013) The angioplasty surgery is when your doctor inserts a catheter to the blockage in the artery and threads the wire through the narrowed arteries. (Opening blocked coronary arteries: New questions about the old answer, nd., p.2) Once the balloon is in place, at the sight of the blockage, the balloon inflates which causes the plaque to crack and the artery to become free from blockage. (Opening blocked coronary arteries: New questions about the old answer, nd., p.2) The other surgical opinion for CAD is coronary artery bypass surgery is a procedure done by a doctor using a graft. (Mayo Clinic, 2013) The doctor will construct a graft to direct the blood flow around the blockage using existing blood vessels in the body. (Mayo Clinic, 2013) Due to the fact that this procedure requires open heart surgery, it is usually used for patients with several partial or full blockages. (Mayo Clinic, 2013)

Evaluation is the third stage of Gibbs model of reflection and requires me to state what was good and bad about the event. While reflecting back on the incident I felt that there was one thing which I could have dealt with differently and also some aspects which demonstrated good practice. On the first hand, this incident made me realised that I was part of the team and that I was also involved in positioning and preparing the patient prior to surgery, therefore I had a responsibility to find out from the patient if he had any concerns. On the other hand, I should have communicated to the patient, explaining what I was about to do maybe he would have had the opportunity to raise his problem with the shoulder before lifting his arm. The Health Professions Council (HPC 2008) clearly states that it is the responsibility of an operating department practitioner to ensure that effective communication occurs when delivering patient care. In addition, Psychologist Helmreich, R. (2000) said, `better communication’ is being the most useful way of reducing errors.

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

1. Angioplasty: Kereiakes and Wetherill write that “angioplasty is a procedure in which a heart doctor inserts a balloon catheter over a thin wire across an artery. The balloon is inflated and compresses the plaque to clear the arteries of any blockage.”(p. 106-107).

A surgical nurse is responsible for monitoring and ensuring quality healthcare for a patient following surgery. Assessment, diagnosis, planning, intervention, and outcome evaluation are inherent in the post operative nurse’s role with the aim of a successful recovery for the patient. The appropriate provision of care is integral for prevention of complications that can arise from the anaesthesia or the surgical procedure. Whilst complications are common at least half of all complications are preventable (Haynes et al., 2009). The foundations of Mrs Hilton’s nursing plan are to ensure that any post surgery complications are circumvented. My role as Mrs Hilton’s surgical nurse will involve coupling my knowledge and the professional

246). Twenty-two participants spoke of the provision of information giving as comprehensive and helpful in surgical preparation, in contrast eight participants felt the information giving was deficient in its content. One individual went on to say “I personally felt that I was not given any information once the preassessemnt nurse discovered I worked as a staff nurse on a day surgery unit in another hospital” (Gilmartin, 2003, p. 247). Negative case studies do not weaken research findings but make the study more credible as the researcher has considered alternative views in the analysis of data (Tappen, 2011).

First everyone had to put on a mask, wear surgical head covers, proper scrubs, and shoe covers. Inside the operation room, the surgeon and scrub tech had to put on a sterile attire, which included sterile scrubs,gloves, and equipment because they were the first people to have contact with patient. The circulator or documenting nurse and anesthesiologist were around the sterile field (aseptic technique) without any contact with the patient whatsoever. As you would have guessed, the surgeon was the one who performed the surgery with the help of the scrub tech and monitored by the circulator nurse and anesthesiologist. The main duties of the circulator nurse was to document everything during the surgery from what medications used to how many sterile dressings were used, proving supplies to the surgeon and the scrub tech as needed,and making sure the room was prepare for the assigned surgery. This nurse also provides conform measurements for the patient while in the operation room. For instance, there was a patient who was too big for the operation bed, so the circulator nurse had to find additional supplies that would prevent the patient from sliding down the bed. Nurses always provide the finest education towards their line of duty but also take the time to teach those people who starting the nursing