Volunteering Reflection

During my volunteer hours I learned a lot about my own community I that I have not been able to experience. For example I have never been able to participate in so many writing programs and workshops in my local high school, this is because I also did not attend my own local high school because my mother did not allow me to instead, she asked me to attend a charter school. By partnering with LA826, I was able to attend different writing workshops where I would help different high school student write essay, cover letters, and personal statements. Furthermore I believed that most of my activities consisted of just being able to listen to some of the students.

There were even times when the nurse asked us some of the medications and what they do, which we gladly answered. The nurse was very open-minded, and contributed to the conversation really well, without overshadowing the pharmacists. After discussing, we briefly split the questions that we wanted to ask among the three of us. Up until this point, I believed that our team would do well since we prepared ourselves. However, to our surprise, we were not prepared when the patient continuously complained about feeling dizzy, and not being able to breathe. All three of us were not knowledgeable enough to help the patient with his symptoms that he kept complaining about. At first, we attempted to adjust the bed, however, that did not help and made it worse. Not knowing what to do, we tried to persuade the patient to try to focus on the questions that we were about to ask in order to help with his symptoms. When the patient complied, the nurse started asking very general questions about his health and lifestyle. It was a great start until the nurse started asking questions that we were going to ask the patient. In the end, she asked all the questions that we planned to

As part of my clinical experience at St. Joseph unit, I had an opportunity to work with my classmate, Kingly and Dat. Dat was a very kind and efficient nursing assistant and I felt fortunate to have had the chance to work with and learn from him. Our day together seemed as though it was typical for the residence. The first resident was Ms. Nancy; she is in room no. 220A. My duty gave her breakfast and feed her in morning. Upon waking Ms. Nancy I respected her privacy by always knocking before I entered the room and asking permission to enter. I have introduced myself and followed standard precaution by washing my hands before start any procedures. I tried to talk to her while I was feeding her. I tried to wake her up before the breakfast is over. She only ate 35% of her meal. Then, Dat showed me how to use a full sling mechanical lift to move Ms. Nancy to shower chair and show me how to use shower chair while showering Ms. Nancy. After finishing

When I arrive to the facility this morning I was informed that one of the patients had passed away during the night, which was quite sad. Today I was in the acute ward all day and was able to watch the RN perform an ECG on a man that was bought in via ambulance who was complaining of chest pain. I watched as she placed the ECG leads on different positions of the chest. The RN showed me what a normal heart rate should look like. I also went around the ward taking OBS and notice that one of the patient's O2 levels were very low at 73%, the RN then gave the patient some ventolin through a mask to increase oxygen levels and they rose to 95%. The RN also showed me the medication charts and how they are to be read. I went around with her watching

* 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

Second, the nurse commences assessment with an evaluation of patient’s airway, breathing, and circulation for any signs of inadequate oxygenation and ventilation. One of the patients’ temperature was 102 F and the physician recommended pain medication (dilaudid) and it was administered instantly. The nurse gets vital signs and compare the result with intraoperative care. The nurse chart vital signs every 5 mins for the next 15mins, every 15mins for the next hour depending on the recovery state of the patient. I also noticed that for diabetic patients, the nurse checks for blood glucose and also compare result with intraoperative care unit result. Third, the nurse assess pain although the patients receive pain medication before surgery. Fourth, the nurse assess surgical site (dressings and drainage). Fifth, the nurse assess neurologic (level of consciousness, orientation, sensory & motor status, pupil size and reaction. Finally, the nurse assess gastrointestinal (nausea, vomiting, intake of

I shared this information with the night staff, left contact numbers and names and the Nurse was called the following morning.

During my clinical rotation during my last semester of nursing school, I was able to work one on one with a BSN degree nurse named Judy in the ICU. Judy had three years of experience in the ICU setting. She had been a medical surgical nurse prior to her ICU transfer. The ICU at this hospital consisted of two associate degree level nurses and two BSN level nurses on my shift. I rotated three days in this particular ICU. I worked with Judy all three days of my rotation. I was excited about being placed with her for she seemed knowledgeable and skilled. We were given a male post trauma patient to work with all three days. This patient was a 30 year old male admitted for trauma related injuries and was considered unstable and was to be monitored in ICU. This patient had been involved in a motor vehicle accident and

The patient was located on the fifth floor and as I was bringing them down the elevator, there was a family member of a patient in the elevator. Under HIPAA regulations, I cannot allow others to view the patient confidential information that I had in my hand. As we got to our stop I told the patient to follow me through the mechanical doors. I told the patient to wait in cubical 2 and that the nurse will be with then in a few moments. In addition, I will be getting them a warm blanket once I come back. I headed to leave the binder at the receptionist desk in the OR where they had another patient pick-up waiting for me. Before I left, I went to get the patient a warm blanket from the storage area that had temperature control. I gave it to the patient and left. Ronnie saw me and asked me if I did the patient pick-up alone, I said yes and he was surprised. Usually he needed to teach others in order to know what exactly they had to do. The only reason why I knew that I had to do everything that I did was because Ronnie told me everything verbally. He did not have to show me what to

Throughout the class, many aspects of the curriculum were seen as useful in future social work practice. Before this course, in other course work, treatment planning and goal setting was often something that was reviewed briefly, yet within the coursework of the capstone seminar this matter had been gone over in more detail. Within this course, it was possible to gain more insight into a more balanced way of setting treatment goals that included conversations with the client concerning what they desired out of treatment in addition to what was needed. This aspect of the course was particularly useful when it came to working towards the development of the treatment plan with the client who was presented during the case presentation, Sarah.

It was a very busy night on M10, call bells ringing non-stop for pain medication, or toileting needs, IV pumps alarming, concerned family members coming to the nursing station, numerous patient admissions from urgent care and PACU. I received nursing handoff on all my patients from the day shift, gave handoff to my patient care technicians, and we had our nightly nursing huddle in the station. After hearing everyones concerns about their high risk patients, I wanted to get out on the floor as early as possible to complete my assessments, and administer my medications to leave time for the many uncertainties that my gut instinct warned me would occur. I was able to finish all my patient assessments, and pass my medications earlier than usual, and when this occurs, I always do my best to help my co-workers if they have fallen behind. I went around asking everyone if they needed assistance, and indeed one of my fellow RN’s needed help moving one of my former patients closer to the station, because she had been hypotensive. I greeted Ms. T and her face lit up like a Christmas tree, I asked her how she was feeling and the smile she had on her face immediately turned into a grimace. I assured her, that we would do our best to make her more comfortable once we settled into the new room.

Upon arriving at Hays Medical Center, my classmates and I met on the third floor for preconference. I grabbed a computer and logged into my client’s chart to see if there were any new orders. I had no new orders. In conference, we were to give report on our patient. My client was a young male in for a bowel resection due to an obstruction. After giving report, I met up with my senior two, Brendell. We proceeded down to the acute floor. I found my client’s room and waited for report from my nurse. I went ahead and introduced myself to my patient and explained to him that I would be helping today, that if he needed anything he should hesitate to ask. I went forward with my bedside assessment, making sure to do everything

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

making Practice-Based Learning work Reflection on PRACTICE A resource commissioned by the Making Practice Based Learning Work project, an educational development project funded through FDTL Phase 4 Project Number 174/02 and produced by staff from the University of Ulster. www.practicebasedlearning.org Author Patricia McClure School of Health Sciences, University of Ulster www.practicebasedlearning.org contents Reflection on Practice 02

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