2/13 Journal for PACU

Questions

What were your responsibilities or duties this week?
-Observe the tasks of RNs


What new knowledge or skill did you  learn this week?
-One can have very different vital signs when they are awake compared to asleep


What was the best thing that happened at the site this week?
-The patient I spoke with was quite interesting


What was the worst thing that happened at the site this week?
-Things were very quiet the whole time


This week was FAIR.

Experience Record

Technology observed:
The main technology that I observed were the computers that had the patient's vital signs and the charting computer.


Diagnostic procedures observed:
I was informed that the patient got an endoscopy which was why they were unconscious. It was to check on possible cancers which the person had a history for.


Therapeutic procedures observed:
The patient was given anti-hypertensive medication which was for their high blood pressure. It was abnormally high after they woke up.


Diseases/disorders observed:
The patient had hypertension which was usually controlled with a diuretic but they avoided taking it due to the procedure.


Medical terminology encountered:
Endoscopy is a nonsurgical procedure used to examine a person's digestive tract.

Journal

The PACU is a rather small and quiet area. The nurse's station faces directly where the patients are, which makes sense given that people who have just woken up are very disoriented. All the equipment is pushed to a wall or next to the patient it is for. There is not a lot of space there so room needs to be conserved. The patients were all against one wall and were separated by curtains. There were a few individual rooms but they were empty. Most patients were out patient thus making the rooms a bit unnecessary. They were also harder to keep an eye on by the nurses.

The nurse I followed was very nice. They only had one patient at the moment which is typical due to the ratio being 1:1 or 1:2, nurse to patient. They informed me that even though the ratio was so low, they had 20-30 plus patients a day,which were mostly outpatients. It all depended on the doctor's or surgeon's schedule for the day. There was not much talking that I could hear on the floor but when the nurses did interact they were rather friendly to each other and the patients.

I learned that it takes a while for a person to wake up from anesthesia. Even if they are being shaken and spoken too they can sleep through it. I also learned that in certain endoscopy procedures, the patient is 'pumped' with air to help the navigation of the endoscope through their intestines.

I had a relatively alright visit. There were no glaringly bad moments or anything that was too exciting. There were few patients on the floor that were all asleep which did not make anything very extravagant. It was not bad but still was not anything special. That day felt very relax, which was something a rather needed.

1/6 Journal for MSU Floor 6

Questions

What were your responsibilities or duties this week?
-Observe the tasks of RNs


What new knowledge or skill did you  learn this week?
-PPE is important


What was the best thing that happened at the site this week?
-There was a meeting near the end about infection control


What was the worst thing that happened at the site this week?
-I stood outside a room for 15 minutes waiting for the nurse that I was assigned to
-I did not see any patients

This week was BAD.

Experience Record

Technology observed:
I saw the different vials which are used to draw blood into. The different colored tops are signals for the lab to tell them which kind of test to do, or what to look for in that sample.


Diagnostic procedures observed:
I did not see any patients nor did I see my nurse interact with patients. I did not even see any charting.


Therapeutic procedures observed:
I did not see any patients nor did I see my nurse interact with patients. I did not even see any charting.


Diseases/disorders observed:
I did not see any patients nor did I see my nurse interact with patients. I did not even see any charting.


Medical terminology encountered:
Personal Protective Equipment- Equipment that ranges from gowns, gloves, and masks, that must be worn for protection from infections when entering an isolation room.

Journal

The floor looks exactly like MSU Floor 5 down to a T. There were 30 rooms, numbered 601-630. All the doors were closed or near that which I thought was odd. The floor was really quiet too compared to all the other places I've been to. There was not a lot of beeping or lights flashing at all. One or two family member of the patients walked through the hall but that was it. The nurses that I saw minded their own business and did not talk to me until I spoke to them.

The nurse I followed was newer than the others I saw. She was nice enough for the most part. Every time were were about to start something one of the other nurses called her on the hospital issued phones. I know that they have to work together well enough because when a patient needs to be moved some way, they have to do it as a pair. I did not get to see that for fact but it was obvious enough. However, I'm not sure how well they interact outside of working with a patient.

Since I did not see any patients or watch my nurse interact with them I did not really gain any kind of opportunity to learn anything new. I tried asking my nurse things but there was little I could draw questions from. At the least I observed my nurse put on PPE to go into a isolation room. The door was closed and got to stand outside again.

My experience was not good. Not that it was really bad or terrible but it was truly boring. I tried to talk with my nurse which worked for a bit until she was called to talk with the head nurse, I think. She became quieter after that which lead me to believe she was being told off for something. Also, right as I left, I believe that the head nurse was about to 'lecture' the whole floor of nurses. I was glad I left when I did.

1/30 Journal for Day Surgery

Questions

What were your responsibilities or duties this week?
-Observe the tasks of RNs


What new knowledge or skill did you  learn this week?
-Learned about wound care
-Learned about port maintenance

What was the best thing that happened at the site this week?
-Met the one of the most interesting patient with sickle cell anemia


What was the worst thing that happened at the site this week?
-There was no definite person to follow so I just jumped to people
-I wanted to be there longer

This week was GOOD.

Experience Record

Technology observed:
Some interesting technology I saw, which I didn't really see, was a port. A patient had a port on the left side of their chest due to how many times they had their blood taken. It is a faster and easier approach for taking or giving blood without having to go find veins.


Diagnostic procedures observed:
I did not see anything be diagnosed. The patients I saw were already diagnosed and they were just going through regular therapeutic procedures.


Therapeutic procedures observed:
I saw the cleaning of a surgical wound. It was not really pretty. It was a long procedure that involved lots of tape, some sponge, and a strong disinfectant. The nurse had to be very through due to the fact that it was a foot and it was not allowed to get wet so foot infections are a high possibility.


Diseases/disorders observed:
There was a patient who had part of their foot removed due to an infection of some kind, I believe. There was also a patient with sickle cell anemia, who came in for a port cleaning and check up.


Medical terminology encountered:
Sickle Cell Anemia is a disorder in where the red blood cells become curved shape like a sickle. It is due to abnormal strands of hemoglobin. It causes 'traffic jams' in the blood stream which does not allow the blood to oxygenate the extremities easily.

Journal

The unit was rather quiet when I was there. All the equipment was to the sides of the wall and the nurse's station was clean of any paperwork. Which in a way was proof that it was an easy day but then again it meant little for me to do. In one of the patient's rooms I was in there was not much equipment at all. The room itself was rather small too. There was only the small cleaning station which included a sink, counters and some cabinets which held medical equipment, I would assume. There was the patient's bed right in the center of the room; there was a chair right next to the bed. Other than that it was a rather uninteresting room, I believe it is for outpatients due to the fact that they would not need lots of big, expensive equipment if they will only be there for a short time.

The whole time I was there, I did not get to see the nurses interact much. I spoke to only four nurses the whole time. Each of them was very nice, and tried to find something interesting for me to do or observe. They seemed genuinely sorry that there was nothing 'cool' or 'interesting' for me to see while I was there. That, however, is all just depends on whose point of view it is. I believed the port cleansing and wound care to be fascinating to see, no matter what.

I learned that one' veins can gain 'scar tissue' if they are 'poked at' a lot. A port is helpful if this becomes the case for some patients. The port is under the skin, which is one of the weirdest things ever. It spans about six or so inches of the chest and is made of a hard material. It is so odd feeling it under skin. It's funny how feeling a port under skin un-nerved me more than seeing a foot being held by some stitches and having a 'chunk' of it missing. I also learned that a port has to be maintained by cleanings at least every month, if not, it will clog up and become useless. The patient admitted to trying to have their port cleaned every two months. After the fourth month, it clogged and they had to have it moved to the other side of their chest. They say they learned their lesson from that.

All in all, I had a fantastic time. The nurses I did interact with were horribly nice, and the patients I met were even kinder. They both were willing to talk about themselves and help educate me in either who they were or what happened to them. Some patients are not that receptive but the two I met were, which I am glad for. I learned that on has to have the right mindset to be a RN in anything, including Day Surgery. They see a wide spectrum of patients and illnesses, which they have to meet with the same calm composure without freaking out. That, I am not so sure I can do.