This Past Week Was My First Full Week In My Outpatient

* 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

The second week of my preceptorship brought many new experiences for me, and I can honestly say that each day I spend with my preceptor is better than the last. This week I focused on time management of a full patient load with continued documentation practice as well as admission and discharge procedures. I’ve had brief experiences in my past rotations assisting with discharge teaching and admission assessments however I have never been able to fully take charge and complete the process from start to finish, so this was a great learning opportunity for me.

Since I will have so much previous experience with all types of play on the med/surg unit, I will be observed 1-3 times providing EACH of these types of play by my new preceptor and once she verbally tells me that I am at a “professional entry level” I will begin to be independent with play at this new facility. My third goal was successfully achieved, however only my first two objectives were

My patient was a pleasant eleven year old male who didn’t display any major health disorders besides being slightly overweight. His mother was present during the process and the patient was able to provide reliable information. I did a good job communicating with them both keeping in mind the developmental level of the patient. We discussed several things ranging from his eating habits to his playing

During my time on 3000 pediatrics I was a part of an IV insertion in a young seven year old patient which was quite traumatic. The nurse was assisted by the patient’s father and three other nurses to hold down the patient so the IV could be properly inserted. As I observed the procedure and watched the patient be incredibly resistant, it occurred to me this would never happen in the adult world; once a patient says no as an

Interventional Radiology was running slow today during clinical. It first started off by the nurses explaining what the day was going to consist of. After that they explained, how to get everything ready to start the day. We did not start procedures until around 0845. First patient was in for a cat scan, an I.V. was placed. The first nurse was not the best person to explain a procedure, therefore I just watched as she did the I.V. The second procedure was another cat scan, and I.V. placed too. This nurse was more willing to explain as she did the procedure. However she did have a harder time doing the I.V. because she was not having blood return. Another nurse helped her but she also had trouble getting the I.V. placed. Later after that patient, another patient was in, but he was going to be taken to catheterization lab. I did not get a chance to go with him because another patient was going to have permanent catheter insertion. I got ready to see the permanent catheter insertion, and the nurse explain what they were going to do. However I did not get to see the whole procedure because in the middle of the procedure I felt dizzy, and dizzy. Finally I got to see a nephrostomy exchange tube. The patient it’s a regular patient that

It was five minutes to 11:00PM on Friday the 13th, and Dr. Jordan Alexander stood at the unit secretary’s desk in the emergency room of San Antonio Memorial Hospital. She sipped her iced coffee and casually glanced at her watch, waiting for her shift to begin. So far, it was quiet, but like most overnight shifts, that was bound to change in a heartbeat.

Firstly, a health questionnaire will be performed, where James’s mother will be asked a range of questions outlining James’s past medical history, current medications, previous issues with anaesthetics and infections. James’s weight, blood pressure, pulse rate, respiratory rate, temperature, oxygen saturations and blood sugar level will also be recorded, in order to assess the current health status of the child. It is important that these assessment findings are correctly documented, scanned and uploaded to the patient’s files, so information can be reviewed and revisited on the day of surgery (Chand, 2014).

Critical Thinking: During the first scenario, the patient was a 39-year-old female admitted to a med-surg unit following an abdominal hysterectomy. She had no known allergies and had a Foley catheter in place. Also the physician’s orders included, sequential compression devices and pain medication. While receiving report about my patient, I was beginning to think, as a nurse what my priority would be when first entering the patient’s room, which would be performing an assessment, monitoring vitals, assessing pain and inspecting the surgical site and dressing for signs and symptoms of infection, and assessing for potential post-op complications such as respiratory and cardiac problems; however, that didn’t go as planned. I was too focused on being reactive and thinking about what I was going to do next instead of being proactive, that I forgot simple steps such as introducing myself to the patient. Moreover, in the second scenario, my colleagues and I were placed in the emergency department to care for a 34-year-old patient with complaints of difficulty breathing due to asthma. In this scenario, the physician’s order consisted of administering oxygen via nasal cannula as needed in addition to administering albuterol via the nebulizer. Once again, before entering the patient’s room, I knew my first priority was going to be to assess the patient’s respiratory status by auscultating breath sounds, examining the quality and rate of respirations, the shape and configuration of the

1. I think that the patient misunderstood the nurse’s intentions when he was moved from the ICU to the other places in the hospital because there was limited communication letting the know what will be happening. It seems that the patient was not familiar with the hospital, procedures and the people and because of that, the patient felt that all the interventions were to harm him. Even before the surgery, the surgeon visited the patient very quickly and told the patient this was a routine surgery. Although it may be routine, I think that it would be good to educate the patient about what will be occurring in each of the processes. In addition, when the patient was going for exams, the patient had to wonder what exam

This Friday, September 15th, I had my clinical observation experience in the ED. I was there from 7:00 am till noon, viewing the flow and duties of the nursing staff on the unit, as well as practicing the skills I have thus learned in school. Throughout most of the morning, I followed Jessica, who had been a nurse in the ER for ten years. It was an insightful experience that broadened my previously limited knowledge of the roles and experience of an emergency nurse.

In the room was a nurse who spends ten hours a day with the boy and his mother. There was also a social worker, the practioner, Dr. Donovan and myself. Overall I had a great experience. I did not just sit down and observe, I was a part of the appointment since I played a role in interpreting since I spoke Arabic. Before we went in, the doctor said that she will not give the mother Baclofen because of the side affects her son has been getting. She does not trust the right amount of dosage is being provided. The objective of the meeting was to convince mom to put a device in the boy’s body that helps give him the right amount of Baclofen. The mother has refused this before and the doctor said this is the best for her child. As I interpreted back in forth, the mother was complaining how the child has been suffering without this medication and it is giving her and everyone who cares for him a really hard time. She went on to explain how well Baclofen works for him and she really wants him to be taking it. It took a good half hour of back and forth explanation and questionnaire for the mom to say she wants the surgery. Her biggest concern was this device being a health problem for her son. The doctor told her it will only help him and her. I explained to her that she does not have to worry about giving him medicine anymore, the machine will automatically give it to him. All she has to do is

This quarter is most important and intense quarter for me. Thinking about the last quarter and excitement of graduation is one part but the workload is unbelievable. Five upper division classes and 100 hours of internship (10hours for HSC 4700) are definitely keeping me busy. I am doing internship at Kaiser. They provided two days mandatory training for students on March 28 and 29. Program Supervisor Mary Joy Rojo, Andy and Ivy, gave training on what intern should learn and expect while working by themselves. It was wonderful as I was able to learn and even practice. This two-day session helped me to make friends. I also participated on 3 hours event on San Leandro on April 2nd. It was an event for employee; in presence of Ivy, I helped many

On Tuesday, I completed eight hours of my internship from 8:00 am – 4:00 pm. From 8:00 am – 1:00 pm, I assisted in making patient charts for surgery on Wednesday. There were a lot of patient charts to make because patients are trying to get surgeries in before the end of the year. I learned that patients try to get the surgery in before the end of the year because when the New Year starts they have

At this point, her foster dad engaged her with me and was right by her side encouraging her and providing emotional support. She continued to say that she, “just wanted to have the IV pump back on and not the water through her straw.” After a while, the RN had called in multiple staff to help (she became aggressive and attempted to kick anyone who came near her other than her foster father and myself) and then decided to not continue attempting to flush her IV, because the patient was going to be discharged and the foster father adamantly asked if the nurses could leave the room and give her some time to calm down. I also left and then came back about 5 minutes later and brought some more art supplies to try to have some post-procedural play and she readily engaged in the activities but I was called to the ED for a procedure and could not stay. I debriefed with Kristi and although I felt incredibly defeated, I was reassured that I did everything that I could have done in the moment and that this was not a typical response from a patient this age. I wanted to do a medical play art activity with her, such as syringe painting or creating love bugs with syringes, but she was discharged. In all, I was excited to continue learning about what the child life department at NWCH