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Taylors fundementals of nursing physical assessment
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Description
Clinical rotation for spring 2018 started off at the recovery unit at the General Hospital, it was quite a slow start to my day. The task began with 66-year-old G.L, male who entered the recovery room at 10:35 am from his haemorrhoidectomy. After, Mr. G. L we had several other patients who came to the recovery room from operating theatre, which all the patient underwent different procedures, from D&C to Laparotomy just to name a few. Although the nurses and ward manager stated that we choose a slow day to do our clinical rotations, we made the best of our days. The patient was G.L. 66-year-old male who was diagnosed with Prolapse Hemorrhoid. He was an outpatient, who arrived at 8 am to get ready for his surgery.
Feeling
I was ecstatic and enthusiastic to get back into the field of work to do my clinical rotations. Although I was ready to have a new experience at the recovery unit, I was also extremely scared, because this unit was a specialized unit, where the patient needs vital care while recovering from anesthesia. In addition, the experience was great because been assigned to a specialized area, one is expected to know all the basic for caring a patient, that just undergo a procedure. For instance, vital sign,
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Furthermore, the amount of time a patient spent in the recovery room depends on the patient's advancement and the type of anesthesia they may receive. During the first hour after surgery, patients will need to lie flat on their backs to reduce the risk of headache induced ant anesthesia, which can be painful. Before a patient is discharged, full sensation must be regained in the lower part of the body. After the two outpatients is recover, from the anesthesia they were sent home and were required to do follow-ups at the clinics close to them; however, the inpatients were returned to their respective
My studies through the IU School of Medicine have allowed me to become qualified for this position. I rotated for a month in the gross room, autopsy, and frozen section. They all taught me how to work with the residents and attendings and the different skills involved in each rotation.
The hospital promised early ambulation following hernia surgery. The hospital facility was designed to encourage movement without unnecessarily causing discomfort. Postoperative regimen designed and communicated by the medical team to patients
When I started my first job as a nurse in the Surgical Care Unit I was a novice nurse, I did not have experience, I lacked of the confidence to demonstrate safe practice and I required continual verbal and physical cues in from my preceptor. I was developing my nursing judgement and the graduated nurse residency program offered lectures and clinical experience that helped me to
Although the comorbidities and type of surgery dictate certain decisions in managing patient care, anesthesiologists maintain various modalities for the perioperative period. These consist of anything from local to regional anesthesia, including neuraxial techniques and peripheral nerve blocks, as well as monitored anesthesia care with sedation to general anesthesia. Overlapping of different anesthetic types and combinations of regional analgesics to supplement general anesthesia occur frequently.
Anesthesia is used in almost every single surgery. It is a numbing medicine that numbs the nerves and makes the body go unconscious. You can’t feel anything or move while under the sedative and are often delusional after being taken off of the anesthetic. Believe it or not, about roughly two hundred years ago doctors didn’t use anesthesia during surgery. It was rarely ever practiced. Patients could feel everything and were physically held down while being operated on. 2It wasn’t until 1846 that a dentist first used an anesthetic on a patient going into surgery and the practice spread and became popular (Anesthesia). To this day, advancements are still being made in anesthesiology. 7The more scientists learn about molecules and anesthetic side effects, the better ability to design agents that are more targeted, more effective and safer, with fewer side effects for the patients (Anesthesia). Technological advancements will make it easier to read vital life signs in a person and help better decide the specific dosages a person needs.
With two weeks of clinical experience, my plan for this clinical day draws directly off my pervious experiences. I will start my clinical day by getting with my FOR and administering medication to my assigned resident. This activity will probably take around an hour, as my assigned resident takes numerous medications, and I must perform the skill safely - six rights and three checks. After my medication administration skill, I will take vital signs, perfrom CNA skills, feed the residents, and monitor glucose with any additional time I have in the morning. Around 11 o 'clock, our group normally gathers together and takes a lunch break for half hour. After the group lunch break, I would like to get with my partner and begin to fill out our concept worksheet - Infection - for this week. My partner and I will walk around the long term care faiclity and observe what infection control precautions are taken to prevent infections when caring for residents, and consider what further interventions we could implement into our care. When we complete our concept map, I would like to gather this week 's required information from our assigned partner and her medical record - Fall risk/mobility, systems assessment, basic nursing care choices, and vital signs. While gathering information from our assigned resident, we will assist with her care, if needed. With the information we gather from our assigned resident, and her medical record, we can further complete our concept map, drawing additional links, if observed. With my medication administration complete, and my required information gathered, I will spend the rest of the clinical day answering any call
Brunner, L.S. & Suddarth, D. S Textbook of Medical- Surgical Nursing, 1988 6th ed. J. B. Lippincott Company, Philadelphia
What surprised me the most was that I was in surgery that I found the most enjoyment, the most satisfaction. During every day of my rotation I went home exhausted, but happy. Sure there were long days observing and helping in the operating room and changing dressings on the floor, but I was happy doing it. I went home feeling like I accomplished something, that what I did mattered, that I had help improve my patient’s quality of
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
Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).
This week’s clinical experience has been unlike any other. I went onto the unit knowing that I needed to be more independent and found myself to be both scared and intimidated. However, having the patients I did made my first mother baby clinical an exciting experience. I was able to create connections between what I saw on the unit and the theory we learned in lectures. In addition, I was able to see tricks other nurses on the unit have when providing care, and where others went wrong. Being aware of this enabled me to see the areas of mother baby nursing I understood and areas I need to further research to become a better nurse.
Clinical Orientation was the concept of the week. Knowing what’s the importance of Hand washing or hang hygiene and knowing how to execute it well was the topic during the simulation day. It is about preventing to chain of infection from nurses to patients, family, friends and to the public. So nurses having a knowledge on how to execute hand washing properly makes the nurse to be aware of their own hygiene and the nurse would be able to provide individualised hygiene care. (Crisp et all, 2013) Knowing your way around to the hospital and knowing hand hygiene was the main focus of the clinical orientation.
My clinical rotation in the acute care hospital has definitely been a great learning experience, it was a big transition for me having been working in a long-term care facilities for six years. There were three positive aspects about my performance that I will take away from this learning experience.
Certainly, I began with the goal getting of his vital sign and giving him a bed bath. Fortunately I had practice how to take a vital sign and giving a bed bath before my first clinical at the university skill lab and I had developed this confidence before my clinical tour. That day will be mastering the skill which I had just learned in manikins, and applying in real human with huge safety precaution. In between morning my instructor was giving me a brief before I getting to the patients room. From her experience she knew what kind of challenges and a patient behavior can be I face. As I proceeded to my own patient, I hit a roadblock that would give me a flat tire for the rest of the shift.
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.