The writer currently works in an emergency room that has a cardiac catherization lab. Therefore, the emergency room sees patients that are suffering from a myocardial infarction that go up to the cardiac cath lab. This author finds it interesting to see what common nursing interventions are performed after a cardiac catherization because this author does not get to see what happens after the procedure. This author found it interesting that getting a patient up and changing position in bed can make a difference in comfort without increasing risk of bleeding. In nursing school, student nurses are taught not to move the patient after a cardiac catherization and to keep the sandbags on to prevent bleeding, it is interesting to see how often and quick nursing interventions can change based on evidence based
Also the next practical nurse needs to know what the previous practical nurse has already completed in the chart that she left. For example, if anything different has happened and what she needs to accomplish on her shift. She will need to know everything about her patient’s diagnoses, and what medication she need to administer to their patients, what concern she will need to look for, what urgent needs the patients may have.
Usually, patients donate their brain to be examined after death. Therefore, patients are normally diagnosed clinically, which involves a physician compiling facts and assessing them to make a decision. There are several steps to clinical diagnosis. The patients go to the physician if concerns are expressed by the patients or their family members. First the physician will evaluate the patient in an office.
This essay explains a critical incident that occurred on the pediatric emergency room, on my first week on the unit as a nurse technician, the incident relates to pediatric patients that range from three days old to fifteen years of age. The patient that fell during the fall was six- year old patient that had a increase of drowsy from pharmological treatment, which caused an increased risk for falls. In the Emergency department falls happen due to stretcher side rails up not being up while transporting or leaving patients unattended. As a nurse technician in the pediatric emergency department, I feel it is imperative to ensure patient safety. The age groups that are being seen pose an increase for falls.
Critical Care refers specifically to those patients receiving care for life-threatening conditions. ED doctors and nurses triage and take care of minor emergencies like broken bones, dog bites, etc. to those with major problems like MI 's, knife or gunshot wounds. In the ED patients are stabilized and then sent to ICU, CCU for further in-depth multi-professional team care as an in-patient in the hospital. The unit team includes physicians, nurses, respiratory therapists, pharmacists all with additional training to work in "the units."
They will be on each shift to help with answers, the use of the SBAR tool and guide practice. The leader will collect feedback from the nursing staff and patients. The feedback will help to revise and review the new change. The last stage of Lewin’s is the refreezing stage. In this stage, the change is integrated and stabilized.
Commander and Board Certified Clinical Nurse Specialist of an Inpatient Operations Squadron that included: Intensive Care Unit, Multi-Surgical Unit, Labor & Delivery, Post-Partum, Anti-partum and Behavioral Health Unit. The squadron was a combination of military, civilian and VA employees. I incorporated the use of evidence-based research and treatment plans/protocols in all departments to improve the efficiency of nursing practice. I directly advised the Group Commander, Chief of Medical Services, Chief Nurse Executive, Patient Safety, and Quality Services daily. I daily enforced Unit Effectiveness Inspection standards and The Joint Commission Standards.
I got to see several ways that nurses provide care for their patients. I observed ICU nurses care for their ill, elderly patients. I witnessed physical therapy nurses assist their patients to ambulate immediately post-surgery. I noticed how fast ER nurses work to triage their patients. I learned a lot from those nurses but could not decide which unit was meant for me.
The nurses in the observatory room helped with communication as well by properly documenting everything that was done during the procedure. Describe a clinical situation in this setting that posed a communication challenge. This can be between client/nurse, nurse/nurse, nurse/physician, nurse/nurse anesthetist, nurse/ respiratory therapist, nurse/nursing assistant, etc. What was difficult? How was it handled?
After 3 hours of taking the second dose his symptom worsened and he asked for more medication. When I spoked to my primary nurse regarding the patients’ ordered, he said we can not change the doctor’s order. I asked my primary nurse if I could speak to the doctor and he said yes. I presented the patient’s situation to the doctor who adjusted the prescription so that the patient could get a dose of the medication immediately. 3) In my 2402 placement, one of my female patient shared a bedroom with 2 older gentlemen.
Recently on the post-surgical unit at Children’s Medical Center of Dallas (CMCD), the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPHS) scores have declined. It was noted that scores for nurse attentiveness to patient requests and responsiveness to call lights dropped, with an overall decrease in patient satisfaction scores. After careful review of the literature, CMCD plans to implement hourly rounding on the post-surgical unit. Current practice on the post-surgical unit at CMCD is for nurses to check on their patients every two hours. Ethical Dilemma Nurses make a moral commitment to care for all patients and take responsibility for the healthcare environment they work in.
Later, a nurse or a medical assistant calls the patient for the examination. Usually the patient is weighed by the nurse or the assistant, and might be requested for a urine sample (if required), blood pressure check, and temperature. The scale is often located at the nurse section but vital signs are taken in the examiner room and this is where the patient is inquired about the reason of the visit. The patient might be asked also about any changes in his / her chronic condition or about any new taken medications.
Most healthcare facilities integrate hourly rounding to help reduce falls. A quasi- experimental study was conducted by (Olrich, Kalman, & Nigolian, 2012) to determine the efficiency of hourly rounding in hospitalized patients on a medical-surgical unit. The researchers compromised of nurse managers and a clinical nurse specialist educated the nurses and nursing assistants on the importance of hourly rounding and questions to ask when performing hourly round. Some of the questions asked during the rounds included toileting assistance, pain, position and making sure personal items were within reach. At the completion of the study, there was a 23% decrease in falls and an increase in patient satisfaction on the
They plan their day according to their patient on a piece of paper or in their brain. Throughout they day they are constantly charting and observing a machine of each patients heart rate and blood pressure. They do this every hour. They are in constant contact with doctors unlike the nursing home when its only if a patients is seriously injured. Also another big difference is if something is wrong with a patient at a nursing home they have to call the doctor at the hospital they have to use your brain and figure what the thing to do.