Medical Surgical Floor

Last Monday at clinical gain a lot of experience. My nurse I had was very knowledgeable and exited that she had a student. I was very proud of myself that I pass all her meds and could do the injection while she standing there guiding me though the whole process. I also experience flushing a med-port with the instructor guidance also witness one of my classmate suction out a trach. Overall Monday was a success for me learn how thing flow in the nursing

The goal of my nurse preceptor and I was to prepare client M.E. for surgery and ensure she was in the healthiest position possible prior to entering surgery in order to prevent both intra-op and post-op complications. This includes performing a physical examination, managing pain, ensuring the patient is being compliant to being on NPO status, obtaining the patient’s health history, identifying all medications and/or dietary supplements currently taking, monitoring for signs and symptoms of infection or other complications, and ensuring the patient signs the informed consent for surgery (Hinkle & Cheever, 2014). The first task my nurse preceptor and I was to evaluate patient M.E.’s condition and level of pain. The patient had reported that

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

Ambulatory Surgical Center provides same-day surgical care that includes diagnostic and preventive procedures. Ambulatory Surgical Center treats only patients who have already seen a health care provider and selected surgery as the appropriate treatment for their condition. Ambulatory Surgical Center must be certified and approved to enter into a written agreement with CMS. Ambulatory Surgical Center has a unique set of regulation and standards under the Medicare and Medicaid program or other third party payers. The outpatient payment provides a set payment for each surgical procedure. They must be licensed and inspected by the State and Federal government to see if they meet standards Certified facility standers.

My clinical week was very interesting because I removed a Foley catheter. I was helping the nurse give medications, and he asked me if I would like to remove the catheter with him. I felt an adrenaline rush. I was excited but also worried I was not going to do it right. Nevertheless, I still took the opportunity. The patient was complaining that she would love the catheter removed as soon as possible because she had a bowel movement the night before, and the CNAs did not do a good job at cleaning her. The nurse and I reassured her that we would remove the catheter and help her clean up. At that point, I started regaining confidence, probably due the patient’s lack of comfort. In my mind, I was thinking “oh I will exactly as they taught us in

My clinical two observation began at 2:30 PM in the catheterization lab. Upon my arrival they were just finishing a radial heart catheterization with stenting. As they transported the patient to ICU the staff was preparing for an emergency catheterization. It was hectic in the operating room; there were two nurses suiting up in led suits, and a surgical technician was organizing instruments and equipment on the table. In addition, there was nurse Erin controlling the X-ray imaging from behind the glass wall.

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

Central Sterilization Department had to be my best experience on clinical overall. I felt as if I was on the show Grey’s Anatomy when Mrs. Burton helped me put on my extra scrubs and cap so that I was protected and clean from causing any contamination. When I first got there, I was introduced to a central sterile nurse named Anibal who was being shadow by a new employee as well. He was running around and getting things in order so I was alone majority of the time. However, he left me to observe a robotic procedure in which we call…. Only upsetting thing is that I could of been inside the room during the procedure if the doctor didn't start already. He explained to me how the patients muscle had broke through and ruptured their abdominal wall.

The Vacuum Assisted Closure (V.A.C) Therapy of controlled levels of negative pressure has been shown to promote wound healing by applying negative pressure to remove fluid and infectious materials from the wound area or operation site and accelerate debridement from a wound. The V.A.C has been used for acute and long-term care facilities and even at home if those are a candidate. The use of or placement of this vacuum is very simple. This vacuum comes with a piece of foam and transparent adhesive membrane which also called a drape. First of all, we want to make assure to clean the surface of the skin very well before applying the transparent adhesive membrane. Once this skin cleaned; firmly secured the drape to the healthy skin around the wound margin and remember

As soon as the patient is positioned on the table, a thorough skin prep is completed. With new, clean scrub, we clean the skin with chlorhexidine scrub from the prep tray, then rinse scrub with alcohol squares. This is repeated a total of 3 times, since the all gross debris has been removed from our first scrub. I begin each scrub in the center of the scrubbed area, over the planned incision site, and scrub in a ‘bulls eye’ pattern toward the periphery, never going back to the center with the same gauze sponge. The skin preparation should be thorough but gentle to avoid unnecessary skin trauma. The final application of chlorhexidine solution is allowed to remain on the skin. It is important that the skin preparation is started as soon as the animal is on the surgery table to allow for maximum scrub and contact time between antimicrobial and the skin. After skin prep is complete, finish securing legs and make final adjustments in lighting. Limbs are tied to help stabilize the patient. Soft ropes are double looped over each leg. One loop above the carpus and one below on the front legs, and one loop above and below the tarsus on the hind legs are sufficient to hold the animal’s legs. The legs are tied to the surgical table without slack in the rope using a quick release knot if possible. (This is also known as the halter tie knot used in livestock and can be quickly released in case the patient needs to be repositioned in an emergency) In large, deep-chested

When operation and surgery come up in conversation the main person that is highlighted is the surgeon but there is a large team of people behind the surgeon assisting him at every step. The operating room is a very different experience then being on a general hospital floor. The operating room gives the perspective on what happens, in some cases, before the get to the hospital floor. The purpose of this paper is to identify the clients risk for complications during and after the procedure, identify teaching opportunities and appropriate topics, identify different tasks done preoperatively, intraoperatively and postoperatively

During my second week of clinical I had three different clinical days. It was really nice to be able to go on a Monday since that is when my nurse primarily does her wound cares. On Monday we saw 6 people and with a variety of different types of wounds. I learned the process of how to perform wound care on a patient who had a wound vacuum. This patient had a C-section which had opened twice. She also had a 4-year-old and a 17th month old in addition to her new baby. It was interesting to see much a difference the wound vacuum had made in the four days that she had it. I could see all the new tissue growth that both at the edges of the wound and its depth. I had never seen a wound vacuum dressing before so it was nice to see what the steps to

The first experience I had as a nurse tech, and my first night working, I had a patient that had a cardiac catheterization procedure. The patient had a femoral approach and was confused, therefore, she was not following instructions.

In 2009, a close family member became extremely ill, underwent various surgeries, and was hospital bed bound for 6 months. Following her surgeries, she developed a very large wound that ran across an area of her body. I watched nurses come into our home day after day to treat the wound and assist her with the wound cleaning and healing process. It was through my daily observations that I became fascinated by wound care and the wound healing process. Towards the end of my family member’s recovery process, I was able to identify all of her dressings and change/treat the wound myself. It was then that I realized that I highly enjoyed wound care and that I wanted to enter in a health care fields that heavily involved wound

In the beginning of my training I had been assigned with a small group. The group had a consultant, junior resident, nurse and medical student. We all were working under the supervision of the consultant. At the first two weeks we were meeting the patients at the out patient clinics. However, due to the time I had my training on Ramadhan and the fact that the training was in summer, we didn’t meet a lot of new cases. We met a lot of follow up patients and patients who were referred from ER.