Day two: on arrival to 3N at 530 am our clinical instructor handed as the RN patient report to see if anything had changed from yesterday. My second day was less stressful than my first because I had an idea of what is required. I was assigned to stay the same patient. I was more comfortable providing patient care and medication administration without feeling much pressure because I got to review my patient’s medication over the night before my second day. On my second I was also a little bit more settled than my first day, I was able to spend more time caring for my patient. I had completed safety check on my patient and witnessed the dose of insulin and heparin with another RN nurse before administering, double checking medication and …show more content…
Something that comes to my mind in today’s clinical experience was the importance of maintaining a sterile technique and patient safety. I had a lot of experience in today’s clinical experience; I had a three-way Foley catheter insertion on a 91 years-old male patient who had colon surgery with a history of Arterial fibrillation. The three-way Foley catheter was designed for the patient who develops blood clots or infection in the bladder, to provide continues bladder irrigation. Of course, the patient was not able to void urine for longer hours that’s why he had this order. Since the patient was combative/agitated and has an enlarged prostate the insertion processes was very difficult, plus it was uncircumcised patient and it was a phimosis (ability to retract the foreskin) urinary meatus. I had to use a blind insertion, while two RN nurses and one nurse tech were holding the patient for me because the patient was very agitated and trying to fight and get out of the bed. But, I had a successful insertion and the patient was able to void significant amount of urine following the insertion and able to calm down and sleep. I thought a Foley catheter insertion in a male patient is easier than female, however, I found out if the patient is old and has an enlarged prostate Foley insertion on a male patient is way more difficult than a female patient. Something I had noticed different than regular Foley catheter
2013). Inappropriate use of urinary catheter in patients as stated by the CDC includes patients with incontinence, obtaining urine for culture, or other diagnostic tests when the patient can voluntarily void, and prolonged use after surgery without proper indications. Strategies used focused on initiating restrictions on catheter placement. Development of protocols that restrict catheter placement can serve as a constant reminder for providers about the correct use of catheters and provide alternatives to indwelling catheter use (Meddings et al. 2013). Alternatives to indwelling catheter includes condom catheter, or intermittent straight catheterization. One of the protocols used in this study are urinary retention protocols. This protocol integrates the use of a portable bladder ultrasound to verify urinary retention prior to catheterization. In addition, it recommends using intermittent catheterization to solve temporary issues rather than using indwelling catheters. Indwelling catheters are usually in for a longer period. As a result of that, patients are more at risk of developing infections. Use of portable bladder ultrasound will help to prevent unnecessary use of indwelling catheters; therefore, preventing
5), many hospitals in conjunction with the Joint Commission's 2012 National Patient Safety Goals has been rallying for hospitals to use evidenced-based practices (EBP) to the prevention of CAUTIs because evidence is growing showing that many are avoidable. Such practices such as utilizing a nurse-driven protocol to assess and evaluate the appropriateness and use of urethral catheter to determine how long a patient should have an indwelling catheter and when to discontinue it. Several factors have been identified that pose as risk factors to CAUTI which include but not limited to drainage bag not being below the level of the bladder, healthcare personnel not practicing standard precautions and utilizing aseptic techniques during insertion of catheters, unsterile equipment, and unnecessary placement of urinary
Overall, I retain three goals for this clinical day: Safely and efficently administer medication, enhance my nursing/CNA skills, and determine how to implement infection control into a health care setting. This week reflects my assigned time to administer medication in a health care setting for the first time, with a resident who retains nearly twenty medications. I except this experience will be a great learning experience, but it will also subsist slightly stressful. With the assistance of my FOR, my goal is to administer all of my resident 's medications without complications. To ensure that medication safety, I will perform the six medication rights and three checks prior to administration. Along with medication administration, a goal
This systems limits patient involvement creates a delay in patient and nurse visualization. Prior to implementation of bedside shift reporting an evidenced based practice educational sessions will be provided and mandatory for nursing staff to attend (Trossman, 2009, p. 7). Utilizing unit managers and facility educators education stations will be set up in each participating unit. A standardized script for each nurse to utilize during the bedside shift report will be implemented to aid in prioritization, organization and timeliness of report decreasing the amount of information the nurse needs to scribe and allowing the nurse more time to visualize the patient, environment and equipment (Evans 2012, p. 283-284). Verbal and written bedside shift reporting is crucial for patient safety. “Ineffective communication is the most frequently cited cause for sentinel events in the United States and in Australian hospitals 50% of adverse events occur as a result of communication failures between health care professionals.” Utilizing written report information creates accountability and minimizes the loss in important information during the bedside shift report process (Street, 2011 p. 133). To minimize the barriers associated with the change of shift reporting process unit managers need to create a positive environment and reinforce the benefits for the procedural change (Tobiano, et al.,
Something as simple as taking a walk around the facility can prove to be a battle with patient X. From the day I met patient X it was noticeable that she was lacking her memory. Patient X could no longer tell me her name and everyday it would be different struggle, but for that day it was getting her out of bed to take a walk. From the moment I walked in and introduced myself, patient X could not provide me with her name. Patient X constantly asked if I was her baby, and when dealing with an Alzheimer patient, it’s always best to go along with what that patient is saying. As I got patient X up and out of bed, she started to become violent and resistant. Patient X took forty-five minutes to simply get out of bed and dressed, and that was the very beginning of the battle that would consist all day.
One fateful day at the end of June in 1998 when I was spending some time at home; my mother came to me with the bad news: my parent's best friend, Tommy, had been diagnosed with brain cancer. He had been sick for some time and we all had anxiously been awaiting a prognosis. But none of us were ready for the bumpy roads that lay ahead: testing, surgery, chemotherapy, nausea, headaches, and fatigue. Even loud music would induce vomiting. He just felt all around lousy.
The use of hydrogel-coated catheters is a novel technique that leads to better patient comfort and satisfaction, decreased microbial adherence, and reduced encrustation. Hydrogel-coated catheters have been associated to lower rates of symptomatic UTI in patients with acute SCI, UTI-related complications, inflammatory episodes at scrotal level, number of post/intra/inter-catheterization bleeding episodes, treatment costs, rehabilitation days, and the emergence of antibiotic-resistant
Administration of medicines is a key element of nursing care. Every day some 7000 doses of medication are administered in a typical NHS hospital (Audit Commission 2002). So throughout this essay I will be evaluating and highlighting the learning that took place whilst on placement at a day unit.
A career in medicine is one of the most prestigious careers to have not only in the United States, but in the world. A career that allows you to help mankind and help people survive in a world filled with diseases and harmful bacteria must be a true blessing. Enriching lives of others would not only benefit them, but would bring a deeper meaning into my life. If I had the chance to choose any career I wanted, why not choose a career that will introduce me to new patients and cases that I had to critically think to find the best care to help them recover? Why not choose a career with job stability and the ability to specialize in anything I wanted and be one of the people in charge to make the big decisions? My motivation in medicine started
On my first day of week three clinical at 0830, client W and I were on our way to the dinning room and client B asked me to put his jacket on, so I told client W that I would meet him in the dinning room. After I helped Client B, I was on my way to the dinning room and nurse A told me that client W was experiencing difficulty breathing and we needed to give him his 0900 inhalers earlier. He was having audible wheezing and rapid respiratory rate. Therefore, we had to give client W his inhalers, SalbutaMOL Sulfate, which is a bronchodilator to allow the alveoli in the lung to open so th...
This time, I decided to be more talkative and ask more questions about the patients. My senior nurse showed me a patient who fell down a couple flight of stairs and due to his accident, he injured his brain severely to the point where he couldn’t speak anymore. She explained to me all the medications that he had to take and how she had to look up the patient’s lab report because the medications he takes might affect him in different ways. After she was done with looking up his lab reports, I watched her feed the patient for an hour and thirty minutes. During this time, I really felt bad for the patient because he was half-awake and half-asleep while eating. It saddened me how we had to disrupt his resting time to feed him before he could take his medication. After the patient was done eating, I watched the nurse give the patient Lovenox, which I learned was given to patients who are immobile in order to stop blood clotting. After giving him his medication, we had to transfer him off the bed and into a chair, which was my favorite part about this clinical observation. I got to physically help move him off his bed and into a chair. This took 3 nurses, including myself to move him and it made me realize how nursing really requires teamwork. I then got to help clean him up and after changing him, it was time to leave the hospital. This clinical observation made me really excited to be a nurse because I
The two men appeared out of nowhere, a few yards apart in the narrow, moonlit lane. I hid behind the corner of the street as the men came closer to me. Both men jogged in perfect harmony as if they were clones of each other. They had focused faces which made them look like they were on a mission to do something.
I was told that I didn't get sick as much. Just like my dad, it was impossible for me to catch a cold or flu, but when it comes, it comes hard. I was a healthy kid throughout my childhood. I did break my arm once, when I was jumping on my mom's bed then accidentally fell off. It was the first and hopefully the last time I break a bone. Despite my strong invincible immune system, I did have many accidents. When I was ten years old, my brother accidentally cracked a little part of my occidental bone. My dad built a DIY wooden swing and my brother twisted the swing while I was under it. He let it go and the corner of the swing hit my head. When I was little, I had ulcers in my stomach that could've turned into stomach cancer.
In an attempt to improve my health, I decided that for 30 days I would hydrate myself properly and exercise cardiovascularly 3 times a week. Every morning when I woke up, it was my goal to drink a large glass of water (estimated 18 oz) before doing anything else. It was also my goal to drink a large glass of water before every meal. I imagine that many people do not consider poor hydration a serious issue, but being properly hydrated is conducive for more regular body function. A few things that poorly hydrated people suffer, in the short term, are headaches, dizziness, and fatigue. As for exercising cardiovascularly, that is a simple response to the fact that I have high blood pressure. Anything to get my heart pumping is advised, and cardiovascular
It was dark that night, I was nervous that this dreadful day was going to get worse. Sunday, October 23, 1998 I wanted to start writing this to tell about the weird things i’m starting to see in this new neighborhood. Gradually I keep seeing pots and pans on the sink suddenly move to the floor. I would ask my sister but she is out with my mom and dad getting the Halloween costumes. When they got home I didn’t tell them what I saw because i've seen Halloween movies and I have to have dissimulation otherwise the ghost will come out and get me first. October 24, 1998 I think I got a little nervous yesterday with the whole ghost thing. 12:32pm, Went to eat lunch with the family today and I go to get my coat. I heard the words furious and madness,