The wound that I observed at clinical was a diabetic ulcer. It was located on the patient’s left hallux. The main factors that placed the patient at risk for developing this ulcer was diabetes mellitus and having a history for smoking for 30 consecutive years. The patient stated that his history of diabetes and smoking has led to him having poor circulation in his legs and feet. Another factor that could have influenced the development of his ulcer is immobility due to an amputation. His right leg was amputated due to complications from diabetes. This patient was not the one I was assigned to for the day, so I was unable to get his full background and lifestyle information. If he had poor nutrition, that would be a contributing factor as well. …show more content…
This article describes ostomy care for patients in palliative and hospital settings provided by wound ostomy continence nurses (WOCN). It discusses challenges of ostomy care, which includes progressive changes that affect the capability of patients with a stoma to provide self-care, due to vision, motor, sensory, cognitive, and sensory deficits. The article also addresses possible peristomal complications of ostomies and how to assess them such as caput medusa, mucocutaneous separation, and abdominal plane. The WOCN must also take into consideration that the absorption of medication may affect electrolyte balances in the body. Based on this article, I would consider becoming a WOCN. This seems like it is a challenging area of nursing to go into, yet it would be rewarding. Patients with ostomies need a lot of education in regards how to care for it, and I do enjoy teaching patients. I do not have a sensitive stomach when it comes to wounds and ostomies. I did care for a patient that had a relatively new ostomy last semester in clinical and the gratitude that the patient showed for being so patient and understanding made it worthwhile. The URL for this article
Today’s clinical experience truly affected me in multiple ways. I went into this day with an open mind, and was pleased with the patients and the way I was able to conduct myself. This clinical affected me because throughout the day I felt that I experienced many emotions. A few times during my day I did have to fight back tears. I felt I had this emotion because some of the individuals expressed how they wanted to get better in order to get home to their families.
On admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings. J.P. was positive for dyspnea and a productive cough. She also was positive for dysuria and hematuria, but negative for flank pain. After close examination of her integumentary and musculoskeletal system, the examiner discovered a shiny firm shin on the right lower extremity with +2 edema complemented by severe pain. A set of baseline vitals were also performed revealing a blood pressure of 124/80, pulse of 87 beats per minute, oxygen saturation of 99%, temperature of 97.3 degrees Fahrenheit, and respiration of 12 breaths per minute. The blood and metabolic panel exposed several abnormal labs. A red blood cell count of 3.99, white blood cell count of 22.5, hemoglobin of 10.9, hematocrit of 33.7%, sodium level of 13, potassium level of 3.1, carbon dioxide level of 10, creatinine level of 3.24, glucose level of 200, and a BUN level of 33 were the abnormal labs.
Maintenance of an appropriate healing environment is also essential throughout the management of diabetic foot ulcers. The choice of dressing is dependent on many factors including presence of infection, amount of exudate and the required frequency of wound bed inspection.
Working in a wound care setting and seeing the stress that it brings to an individual’s life is can be a challenging situation. Many people do not have a good understanding of how the human body works and how one disease process affects another. Highly educated people often have no idea how a little sore on a foot ultimately can causes loss of toes,feet and unfortunately limbs.
Overall, I retain three goals for this clinical day: Safely and efficently administer medication, enhance my nursing/CNA skills, and determine how to implement infection control into a health care setting. This week reflects my assigned time to administer medication in a health care setting for the first time, with a resident who retains nearly twenty medications. I except this experience will be a great learning experience, but it will also subsist slightly stressful. With the assistance of my FOR, my goal is to administer all of my resident 's medications without complications. To ensure that medication safety, I will perform the six medication rights and three checks prior to administration. Along with medication administration, a goal
My clinical week was emotional and physically draining this week. I enjoyed being the lead on Thursday because it gave me the opportunity to stop and observe. The nurses and the CNAs were very stressed out, and I clearly saw the effect on the patients. For instance, one of the CNAs asked me to help her with an occupied bed change. I was excited. However, she kept passing a bunch of comments of how hard nursing is and how she did not want to be old. I did not acknowledge any of her comments. Perhaps she thought she could express herself (as a result of her stress) in front the patient since the patient was non verbal and could not understand. I felt very bad. I was very uncomfortable and sad. For me, it doesn’t matter whether the patient
Medical surgical nursing is the framework for all nursing practice. Prior to modern day nursing, almost all nurses were medical or surgical; that is where all nurses started. Medical surgical nursing, once an entry-level position, has evolved to a specific specialty. Rather than a stepping-stone, medical surgical nurses are the backbone to most all institutions. These nurses specialize in the care of patients with surgical or non-surgical conditions. This group of healthcare providers accounts for one of the largest and in most demand. As a medical nurse, you will have a very complex job. You work as an advocate and health educator for your patient. That could mean managing as many as five to seven patients at a time. Medical surgical nursing is not the easiest but many find it very rewarding and find satisfaction, that no two days are ever alike.
Throughout my final ten weeks at my placement, I have grown and overcome so many obstacles. I have accomplished a wide range of skills since the beginning and have been improving on them as I gained experience. At my placement as a student nurse, I have gained a lot of confidence, skills, knowledge and experiences that have helped me act and work in a professional way. All the experiences I have had during the ten weeks of my student years have helped me in shaping me into a professional.
I believe placing student nurses in the clinical setting is vital in becoming competent nurses. Every experience the student experiences during their placement has an educative nature therefore, it is important for the students to take some time to reflect on these experiences. A specific situation that stood out to me from my clinical experience was that; I didn’t realize I had ignored the patient’s pain until I was later asked by the nurse if the patient was in any pain.
This reflective essay will discuss three skills that I have leant and developed during my placement. The three skills that I will be discussing in this essay are bed-bath, observing a corpse being prepared for mortuary and putting canulla and taking it out. These skills will be discussed in this essay using (Gibb’s, 1988) model. I have chosen to use Gibb’s model because I find this model easier to use and understand to guide me through my reflection process. Moreover, this model will be useful in breaking the new skills that I have developed into a way that I can understand. This model will also enable me to turn my experiences into knowledge that I can refer to in the future when facing same or similar situations. Gibbs model seems to be straightforward compared to the other model which is why I have also chosen it. To abide by the code of conduct of Nursing and Midwifery Council (NMC) names of the real patients in this essay have been changed to respect the confidentiality.
When a wound is determined as non-healable, as described by Sibbald et al (1), it should not be treated with a moist treatment and should be kept dry in order to reduce the risk of infection that would compromise the limb. It is also important to consider the patient 's preferences and try to control his pain, his discomfort in activities of daily living and the odour that their wound may produce. In this case, special attention must be given to infection prevention and control. Some charcoal dressing would be interesting in the care of our non-healable wounds at St. Mary 's Hospital.
The interdisciplinary course is a core requirement in the after-degree nursing program as it incorporates the principles of self-directed learning and promotes critical thinking, which is an essential element in nursing practice. As a final year nursing student, I believe that knowledge from this course will enhance my ability to provide patient-centered care.
Working with children can be very different than working with adults. When working with children it is important to gain an understanding of the child, their family or care provider as well as the environment in which they are in. The purpose of this paper is to discuss what excites us as well as concerns us about pediatrics as well as discuss a nursing theory to guide our practice in pediatrics as well as provide a timeline of our activities.
I was very excited to have healthcare as the topic for my groups presentation, I’ve personally never had to deal with the logistics of healthcare or even needed to know how it worked. If I was sick I would go to the hospital or see a doctor and as long as they took my insurance, we were good to go. When we first started thinking about our topic as a group and the elements we wanted to add, we asked ourselves this: “What have we heard about healthcare but know nothing about?” the result was three main categories Medicare, Medicaid, and Obamacare. We assumed that as a group if we knew little about these topics, then there was a good chance no one in the class did either. Some of the things I found most interesting during the process of creating
The course Psychology 361: Introduction to Clinical Psychology served as an introduction to the profession and personal life of clinical psychologists. We discussed the ethical and legal issues, the importance of the client-therapist relationship, the rights and responsibilities of the client and the therapist and the different types of therapy within this field of practice. However, after evaluating these concepts in depth, I have come to find some of the material surprising, interesting and difficult to understand. After recognizing my interests and conflicts within clinical psychology, I was able to evaluate myself and determine this profession would not suit me as an individual.