I had the opportunity to observe two cardiac catheterization during clinical this week. A cardiac catheterization is a procedure to examine how well a patient heart is working. A thin tube called a catheter is inserted into a large blood vessel that leads to the patient heart. This procedure is done through angiography, a contrast dye visible X-rays is injected through the catheter. These X-ray images show the dye as it flows through the heart arteries, and shows where arteries are blocked (A H A, 2016).
Before the procedure, the nurse assisted the physician with patient assessment. She prepared the patient by taking his vital signs, oxygen level and heart rhythm, before the physician examined the patient. The nurse ensured that the patient
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She administered medication according to the physician instructions, before during and after the procedures.
After the procedure, the nurse monitored the patient vital signs, administered medications and updating the patient chart. During this period I have been told that the nurse watches for signs of infection or side effects from the procedure.
During one procedure, for some reason one of the monitors shut down. It was a stressful moment but the nurse and the catch technician kept calm and find right the way a back up monitor to replace the broken one. I felt like the nurse and the technician were prepare for any situation. I was a learning experience, that I always have to calm down and think even in a stressful situation.
The communication between the team was excellent, they were helping each other to have a successful day beside their stress. I realized that working as team reduced the level of their stress. The physician communicates with the nurse, the technician and also the patient using the healing communication. Each of them knew exactly their role in the
and giving medicine and IVs. A RN makes sure the patient has knowledge of their situation and
Breathing is the most important AL (Roper et al, 1998). A detailed assessment of her airway would be performed because protection of the airway throughout anaesthesia is essential (Yates, 2000). This does not just include recording of respiration rate and oxygen saturation (SpO2) but also noting any use of accessory muscles, shortness of breath, auscultation of chest and lungs areas for wheezes/crackles and asking patient about history of any respiratory illness/smoking (McArthur-Rouse, 2007).
In conclusion, Leonard, M et al (2004) point out that The complexities of patient care, coupled with the inherent limitations of human performance, make it critically important that the multi-disciplinary teams have standardised communication tools. looking back over Mrs X’s journey along this pathway. It was unquestionably the exemplary teamwork and communication, that were so fundamental in providing the holistic care that Mrs X needed. The responsibility and roles of the multi-disciplinary team were varied and often overlapped within the theatre suite. The team members had differing and varying levels of experience and expertise, but combined these when working together to care for Mrs X.
rofessionals from different disciplines collaborating to provide care to patients. Effectively coordinated and collaborative inter-professional teams are essential to the care and treatment of patients (Rowlands & Callen, 2013; Doyle, 2008; Ruhstaller, Roe, Thürlimann & Nicoll, 2006; Simpson & Patton, 2012, p. 300). Communication is a process of conferring information between individuals through use of speech, writing or various other means, and is critical to the success of a multidisciplinary team (MDT) (Higgs, McAllister & Sefton, 2012, p. 5; Rowlands & Callen, 2013; Sargeant, Loney & Murphy, 2008). An MDT must use multiple strategies to enhance communication and ensure their success (Doyle, 2008). An effective MDT generates opportunities that benefit healthcare, which is the reason for the recent dominance of inter-professional care in health practice (Simpson & Patton, 2012, p. 300; Rowlands & Callen, 2013). Many barriers prevent effective communication within inter-professional teams. Lack of communication within MDTs presents challenges to their success, leading to numerous consequences, including the failure of the MDT (London Deanery, 2012; Sargeant et al, 2008). Communication between professionals is the key factor underpinning the potential success or failure of inter-professional teams, the outcome of the functioning of MDTs will either benefit or impair care of patients.
As a nurse leader, I think that it would have been helpful to educate my team of nurses to effectively care for the patient. Communication is the key to interaction between individuals. I feel that if nurses in the ICU, OR, PACU were providing good communication between one another and with the patient, the patient would have had a better understanding of the situation. This was the first triple bypass surgery that the patient had, and it is a major event in the patient’s life. After the surgery, they are often placed in the ICU to recover so that their heart, lungs are oxygenating and pumping effectively. I think that it was an essential to communicate everything with the patient before and after the surgery.
“Foley catheter is a thin, sterile tube inserted into the bladder to drain urine. Because it can be left in place in the bladder for a period of time, it is also called an indwelling catheter. It is held in place with a balloon at the end, which is filled with sterile water to prevent the catheter from being removed from the bladder. The urine drains through the catheter tube into a bag and can then be taken from an outlet device to be drained. Laboratory tests can be conducted on the urine to look for infection, blood, muscle breakdown, crystals, electrolytes, and kidney function. The procedure to insert a catheter is called catheterization” (emedicinehealth.com, 2014)
I followed the RN nurse who was to assist and prep the operating room (OR). She first went into the clean utility room, where she picked up essentials for the surgery. When everything was gathered and prepared, we had to sit and wait for the patient who had arrived late. The RN would check the computer constantly to see if the patient was on file. After the clock hit 9, which was the time for the surgery, the RN nurse decided to go help put the patient on file quicker. When we arrived at the patients room, there was a nurse making the patient fill out papers. The RN nurse took over the papers while the other nurse completed the documents on the computer. While watching all the questions being asked, and the time it took to fill out the paper work, I realized that the paper work process is not easy.
The problem of poor communication stems from an environment of high stress levels. After a consulting company scrutinized processes throughout the hospital related to care coordination and patient flow, the evidence was clear. The company identified areas for improvement around communication at many different levels. In order for patients to have a seamless transition from admission to discharge, the lines of communication needed to change. Daily face-to-face meetings were productive for the staff, hospital and overall satisfaction. The consulting firm worked for the hospital for several months, but as they departed, the prior culture of poor communication started to engulf...
Once the patient is called to the back he/she will record the patients’ weight and height. They will escort the patient to the exam room, where they will carry out patient history interviews, and take and record the patient’s temperature, blood pressure, and respiration rate. If the patient has to be disrobed for examination the Medical Assistant will give the patient a paper gown to put on after he/she has left out of the room. With law suits today physicians prefer for the Medical Assistant to be in the room at all times especially when the patient is a child or a women getting a breast, or vaginal examination. They also assist the physicians in the examinations or surgical procedures by handing them the instruments needed and helping with any other request that might be needed in the exam room to help make the procedure go quickly. They relieve doctors and nurses of a great deal of time consuming functions by way of performing procedures such as venipuncture, administering immunizations, collecting, and preparing laboratory specimens, removing sutures, and changing dressings. Further, they can notify patients of laboratory results, give prevention reminders, instruct patients about medications or special diets, perform basic laboratory
Client Profile: Lane Bronson is a 55 year old male with a history of angina, hypertension, Type 2 diabetes, COPD, and sleep apnea. He comes to the physican’s office complaining of worsening shortness of breath. His skin tone is grey, and his angina is worsening. Previously stable, he now does not get relief from rest or nitroglycerin. The physician called 911 and had Mr. Bronson directly admitted to the hospital.
This was a great experience for me in my junior year. I had never been in an OR setting, nor did I have any knowledge of how the collaborative team worked together. I also didn’t know the role of an OR nurse, which was a great addition to my education of nursing student. Being able to observe this task, I can now say that I have watched two surgical procedures being done, which is very critical in my career path as a nurse. Now that I have had the chance to watch these procedures, an OR nurse is a position that I may consider my future, as a nurse.
The role of the nurse in the preoperative area is to determine the patient’s psychological status to help with the use of coping during the surgery process. Determine physiologic factors directly or indirectly related to the surgical procedure that may cause operative risk factors. Establish baseline data for comparison in the intraoperative and postoperative period. Participate in the identification and documentation of the surgical site and or side of body on which the procedure is to be performed. Identify prescription drugs, over the counter, and herbal supplements that are taken by the patient that may interact and affect the surgical outcome. Document the results of all preoperative laboratory and diagnostic tests in the patient’s record
I went to the operating room on March 23, 2016 for the Wilkes Community College Nursing Class of 2017 for observation. Another student and I were assigned to this unit from 7:30am-2:00pm. When we got their we changed into the operating room scrubs, placed a bonnet on our heads and placed booties over our shoes. I got to observe three different surgeries, two laparoscopic shoulder surgeries and one ankle surgery. While cleaning the surgical room for the next surgery, I got to communicate with the nurses and surgical team they explained the flow and equipment that was used in the operating room.
One of the many categories would be that of the circulating nurse. Ensuring that the operating room is set up correctly based on the preference of the surgeon, the circulating nurse makes sure all the necessary equipment’s are in place, functioning appropriately, likewise ready to go. In addition, the circulating nurse also verifies the patient identity, surgical site, and consent with the surgeon upon entering the operating room to make sure that they are all the same page, before proceeding with the schedule procedure. Yet another function of the circulating nurse is to make sure that the patient is positioned correctly on the surgical table, hooking up the basic suctions needed, and assisting the anesthesiologist or anesthetist during intubation. Moreover, monitoring the overall condition of the
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).