Weekly Self S.O.A.P - A. S- Discuss your SUBJECTIVE feelings for this week:
This week I finished my rotation in the emergency room. I felt very comfortable in this unit. I was able to put to practice what I have been learning during lecture by triaging and assessing patients. I was able to work in the trauma area and in area 4, where they hold “non urgent” patients. It was interesting to see the difference between the areas. Although I enjoyed both, I was busier in the trauma area.
O - Discuss an OBJECTIVE summary of interventions and skills you performed this week:
In the emergency department I was able to do initial assessments of the patients as they initially arrive and every 2 hours there after. I was able to hang IV solutions as boluses. I was able to administer po medications of HTN. I also administered IV pushes for pain and gastric acid prophylaxis. I was able to start 3 IVs. I was able to observe and help during a Trauma code, stab wound. The trauma code was not what I expected, but I at least was able to see the different roles that each individual plays during a code.
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Unfortunately, one of the IVs infiltrated when we started a NS bolus. I was very upset about this because the patient was in pain due to the infiltration. My nurse explained that this does not make me a “bad” nurse. It happens to everyone, even the most experienced nurse. Fortunately, the patient was also very understanding, and was not upset. On the other hand, I felt more comfortable being on my own during my assessments and asking the right questions. I was also able to document more accurately and
So now that he was unable to get IV access, he had to obtain an intraosseous infusion (IO). Upon insertion of the IO, you could hear the drill perforate through the tibia. Through the access, Narcan was administered. The advance support provider then took over to establish an advanced airway. He was asking for certain equipment and I can remember feeling my adrenaline pump through my veins, it was really a mix of
Surgical Tech: As a seasoned surgical technician, I provided training to 7 enlisted personnel on all aspects of the department. I work hand on hand with the general surgeon, nurses, and technicians to ensure quality of care is present at all times. I have scrubbed and circulated over 46 demanding surgical cases with zero discrepancies and zero post-operative infections, resulting in 100% customer satisfaction and promoting mission readiness. Supply PO: As the Supply PO for my department, I have been crucial for the sustainment of the hospital’s mission and delivery of quality care. I efficiently and effectively managed an OPTAR of $156,129 in support of day to day operations of the MOR.
I had known about the Mercy Flight Explorer post from way back when I was a Cub Scout, I remember them being at our events and I may have taken a few trips to their tent back then too. When I was a Cub Scout I didn't fully understand what the explorer post was, when I joined Boy Scouts however I realized the boys and girls in the post were not all that much older than me and I thought it was the coolest thing that they got to work in EMS at their age. Through my time at Boy Scouts the post was in the back of my mind and when I was ranked as a star I felt that I had gotten all that I needed from Boy Scouts and decided it was time to check out the explorer post. My first meeting was when we were training for competencies I honestly did not expect to get thrown in and get to do hands on stuff on my first day
I was highly impressed by the overall teamwork in the emergency department. It has a sense of organized chaos that would have taken me some time to adjust to. My nurse and I ended up going through a large group of patient during the time I was there. The nurse has this uniformity to how she would get her tasks done. The thing that through me off was the amount of stuff got done with our patients by other people.
My first activity was sitting in the bed board meeting. This takes place every morning with the Chief Nursing Officer (CNO), departments nurse managers, departments charge nurses, house supervisor, wound care nurse, Infectious Disease (ID) and social services. The purpose for this meetings is to address important information to plan the day. Some of the information that was mention was: How many patients are admitted at this time, open beds, pending discharges, foley telemetry, central lines, sitters, and inmates.
During one of my clinical experiences on an extremely busy unit I was watching nurses communicating with each other during a morning report. It looked like it was going to be a busy shift as they were working short. I was on that team and they asked me if I could straight catheterize a patient who has not voided for six hours as soon as possible. I was excited to help them out and to perform my first catheterization. Prior to that shift I had read over that procedure and felt ready to do it.
During the second week, I was feeling more comfortable and confident working closely with the other health care providers and residents in the facility. The most interesting and enjoyable part of my time at the facility was caring and assisting
The thing I did best today, was, communicating with my patient, and doing his physical assessment. My clinical rotation this quarter for Galen College of Nursing ,is at the VA medical center, in Louisville Ky. The VA medical center is a govt hospital for the veterans.
Description During my clinical group orientation trauma units on the second week, I was collecting more information from the patient when I noticed that one of the doctors are trying to convince the patient to removes one of the drainage tubes that was connected to the patient abdominal. The patient refused the procedure, and the doctor left the room. So I step-up to convince
Since graduating, however, I have been fortunate enough to establish a multi-year shadowing opportunity with an ER physician. This experience has easily been one of my most meaningful exposures to the medical field. Unlike other specialists I've observed, whose practices focus on a narrow branch of medicine, shadowing in the ER has allowed me to familiarize myself with pathologies affecting all body systems. Furthermore, having frequent shifts in the ER, I've been able to transition from a passive observer to an active contributor; I now recognize how certain ailments present, and can intelligently discuss possible diagnoses with my mentoring physician. This experience has enabled me to learn about the human body instead of just the specialty itself.
Upon arriving to the unit this morning, I quickly realized today was going to be a chaotic day with the current patient census, and all of the new admissions. I was able to assist the night charge nurse with today’s assignments, while she helped with the code, and the day began. I informed my team that today was going to be a long day, and encouraged them to use each other and myself for help. I recommended they taking a few minutes to coordinate their work after receiving report. At 0745, when Jane informs me that the patient in 408 has fallen, I am quick to get into the room and do an assessment again.
I have been able to practice skills several times that I have not been previously able to perform such as the insertion of intravenous catheters, wound care, and end of life care. I have gained much insight into what a day in the life of an ICU nurse is like. I was able to take the full patient load by the end of my preceptorship, whereas in the beginning I was like a deer in the headlights, standing back afraid to touch anything. I am able to care for more complex patients, without becoming extremely overwhelmed. I have been able to successfully chart on my full patient assignment successfully, remembering all of the specific additional charting for special machines and specific time parameters.
During these past weeks at the Archbold ER, I had the opportunity to put into practice many of the content learned in class. This included but was not limited to the proper placement of a Foley catheter using sterile techniques, insertion of an NG tube, and assessment of patients. Even though I attempted to complete some of my initial goals for this internship, I noticed that I couldn’t complete a few of them due to lack of time and lack of experience in the field. Therefore, some of my goals that I’ll need to address during the following three weeks include improve my assessment skills, have better communication with my patients, and improve my questioning to get a better understanding of the cause that brought them in. One the most beneficial
Today, I am glad I choose nursing because I have overcome my social fears, learn to be a team player, learn how to prioritize and most importantly learned to manage stress. Lastly, I grew as a nurse with each semester because I learned how to respect and treat each patient as a unique individual. I have also learned to put my patient safety as my priority and provide presence because I realized through my clinical experience that, sometimes that all the patients need. Below is the breakdown of how I have developed each semester in nursing school. FALL 2013 • Foundations of Nursing: NUR 2310
I have always hated writing about myself, and I always dreaded assignments in school where I had to describe myself. I always wanted to avoid doing these assignments because I did not want to sound narcissistic, or self-absorbed. I dislike people like that now, because I used to be one of those people. It took many lessons learned before I humbled myself; I am still learning to humble myself today with recent experiences I have had. Although I hate to write about myself, I have always liked to reflect on myself.