Thursday, April 2, 2015

MH blog

Administration 
Learning Report
  1. Her responsibilities included answering the phone and scheduling imaging appointments.
  2. I learned that the desk job is boring.  
  3. Best thing that happened was I got to talk to her about her family and the health science program.
  4. The worst thing that happened was watching her type and call people for an hour.
  5. It was not a mistake.
  6. okay, boring paper work and following a script while talking to patients.
Experience Record
  1. Technology I observed washer computer which she used a special program that show all appointment made and organized it into categories. Her phone was set up to automatically answer. The printer was used to print out a hard copy of the follow day’s schedule.
  2.   I was in administration so the only patient contact was communicating on the phone to set up and x-ray.
  3. Just a lot of typing in information she had received from the patient or their doctors.
  4. I realized there is a lot more than what I thought administration was. There are a lot of people required to keep the hospital running.
  5.  There was no medical terminology used.

Experience Journal
            I tried going into a cubical office, but was redirected to another office. They then redirected me to the back offices where family someone let me sit with them. I like decoration of the room because they had their spring and Easter decorations out. Most of the people seemed happy with the cubical, but I know I could never see myself there.
            I was surprised to find out that their calls are automatically answered and recorded by headquarters. They are graded on how the speech to patients and other health care professionals. They must follow a script and receive a 95. I had no idea they were so strict about talking to people. Also there is a build full of sixty people who just answer to phone a make appointment for all the Memorial Hermann hospitals in the Houston area.
            I got to spend a lot of time talking to the lady I was following. She is a mom of two kids and came from Canada. She told me she doesn't even know the first president of the United States or the national anthem. We talked about how her kid is having a hard time adjusting to competitive katyisd schools.  
            Although it was not a horrible experience I still do not feel like I would enjoy going into the field. They work is so boring and thought I would love to decorate a cubical with cute stuff I could never be happy behind a desk. Also this office seems very far from the TV show the Office which I love. 

Thursday, March 5, 2015

MH Blog Due: 3/5

Learning Report
  1. The nurse I was following had one patient who was ready to deliver her baby naturally.
  2. I learned that I LOVE labor and delivery unit! Also not all births are ridiculously long and painful.
  3. Best thing that happened was I got to see a baby born. 
  4. The worst thing that happened was it was hard to ask the nurses questions about how they got where they are now because they were, so busy today.
  5. It was not a mistake.
  6. AMAZING! I have been thinking about a possibility about going into L&D, but today really made it clear that it is my number one pick to specialize in.
Experience Record 

  1. Technology I observed was a baby heart monitor that the mother wore around her belly. Also the bed was called a transformer bed because the end comes apart and the leg stirrup come out super easy.
  2. The patient went from 3 to 9 cm in one hour and the nurse decided she was ready to give birth even though the mother want to wait till 12.  After she gave birth the doctor found a small tear which she sewed up.
  3.  The baby was ready and it only took a few pushes and the baby was out. The father cut the umbilical cord and the baby was taken to clean up and get wrapped in a blanket.
  4. The doctor also noticed a hemorrhoid on the patient back side which she recombined a hemorrhoid cream. The baby was healthy and pink with a average height and weight.
  5. A hemorrhoid is a swollen vein or group of veins in the region of the anus. A bulb syringe is a hollow rubber bulb used to suction fluid out of an area.



Experience Journal

When I first walked everyone was really busy doing five things at once. They had almost all the beds full of mothers about to give birth, so they was barely enough time to introduce myself. I didn't mind the short wait because I knew there have other things that took priority, and honestly I would much rather a busy work day than a slow do nothing day. The staff did make time to joke around and get to know the patient.

The patient was really nice and chatted with me about her high school and the name of the baby. This was her second baby, so her and her husband were not as scared as the first time. They had given her an epidural before I arrived and went from 3 to 9 cm within one hour which is fast. The nurses brought in a few carts one for the baby the mother a sterile tray of gauze, suture kit, and other instruments. In addition the scale was brought in were the baby was weighed at 8.6 ounces.

The doctor was the cutest, little Asian women you could ever find. She was shorter than me and was ready to get the baby out. She had a lot of good energy which made the experience even better for the family. The mother started to push and once the head was out the doctor started to pull on the baby a little rougher then I accepted. The dad got to cut the cord and then the mom held her child. They were so happy I have never seen anyone else so over joyed and completely in love with another person.


My whole experience was hands down amazing! I can actually see myself working as a labor and delivery nurse or if I want to go further become a nurse midwife. I loved the people that this field brings in and hope to one day fit in. I hope to get more experience with L&D this year as well as in college. I found that my grandma once taught other nurses how to perform a C section and has delivery many babies. I hope I will make her proud continuing in one of her giant footstep she has left for me. 

Thursday, February 19, 2015

MH due FEB 20

Learning Report

1. The nurse I followed was responsible for care for one baby in addition to helping during an emergency C-section.
2. I learned that I love the nursery and could defiantly see myself working there one day. 
3. The best thing that happen was getting to see all the new born babies and going to look into the OR.
4. The worst thing that happen was I was not allowed to hold a baby.
5. The “worst” was not a mistake.
6. Awesome, I loved watching all the babies sleep and taking a look at the OR while the nurses were prepping for an emergency C-section.

Experience Record

1. The healthy babies were in a tiny bed that had a heater on the top. If a baby was getting to cold the machine would automatically start to heat it to the correct temperature. The sicker babies were put into their own incubators that recorded the vital signs.
2. I spent most of my time in the nursery where most of the babies were healthy. I did see some of that some of the babies were born prematurely.
3. The nurse I was following, bathed the baby with warm water and baby soap. This was the first bath after birth so she made sure to get all the nooks and crannies. In addition, she motored his temperature.
4. The baby was healthy and waited in the nursery while the mother took a much needed nap. The nurse made a comment that they would rather have the baby in the room, so it can bond with the mother.
5.  I heard the term ET tube use while they prep the OR. It means endotracheal tube and is a specific type of tracheal tube that is inserted through the mouth or nose.

Experience Journal

I.                    When I first arrived I saw 5 babies all wanting me to hold them. The room was also super cute with little ducky sticker that record the temperature of the new born. It seems like all they were was babysitters because the really sick babies were transferred to other hospitals. The NICU was interesting to look around however the staff was busy and didn't pay much attention to me.
II.                  The staff seemed really fun to work with even when thought one nurse said the only reason she is in nursery is because she hate adults. She gave me advice to start out as a flout nurse because it would be easier to get a lot of experience through the hospital.  I observed the nurse trim the umbilical cord to make it easier on the family when they bring the bay home. She wanted to use a blade but could not find any so she use a pair of scissors. After she had to put in the sharps container which she thought was a waist.
III.                I got to go into the OR which meant I had to put on a mask and cap. I watched as they restocked and confirmed that everything was in place for the emergency C-section. Once the labor and delivery personal remove the baby the nursery staff helps with the care of the new born. However I was not allowed to see the operation because there was a new nurse still learning and with me it would have been over crowded.

IV.                I love the nursery but I fell I would not be challenged and it would become boring. I see myself leaning more toward labor and delivery unit. There is action and babies what more could I ask for! 

Tuesday, February 10, 2015

MH Blog due: Feb 12th

Learning Report
Responsibilities:
  •          Care for 1 patients
  •         Wake patient
  •          Administer pain medication

I learned that if a patient goes under anesthesia fighting he is going to wake up fighting. Also people act silly after surgery 

Best thing that happened was seeing a patient who had torn his pectoral while benching 300 lbs.

The worst thing that happened was waiting for the patient to come out of surgery and then waiting for him to wake up.

It was not a mistake.

Good, my nurse was very nice and slowed things down just enough to explain a few things.

Experience Record

Technology I observed was the monitor that took his vital signs every couple of minutes. They also use an EKG that was a part of the monitor that printed out his heart beats. In addition, she used her computer to chart what pain medication she gave to him.

I was in PACU which doesn’t involve diagnosing patient that often. However I heard the nurses say he was benching 300lbs. and tore his right pectoral muscle near the armpit.

My nurse had to administer pain medication to the patient recovering from surgery.  She also gave him extra pillows to try to get him in a comfortable position. He seem to want to sit in a recliner which he asked for 15 times. The nurse reassured him that the surgery went fine and kept telling him that they could not let him sit in a chair yet.

 I only saw the one patient because in the PACU it is usually a one to one ratio, so the nurse can focus on that one patient. Like I said before the patient tore his pectoral muscle and ha surgery to repair the damage.

I saw medical terminology like Q15 which means every 15 minutes. NKDA stands for “No known drug allergies.”

Experience Journal

                When I first walked in, I was introduced to Marium, who is a registered nurse that floats around to different units in the hospital. I saw that there was a monitor for each patient that would beep if the vital were too low or high. It was a little different seeing the nurses stand right next to the patient the entire time, instead of sitting at the nurse’s station.

She had 1 patients she was caring for but when he first arrived 3 other nurses came in to help take initial vital sighs ASAP. They were so fast and worked like a well-oiled machine. The surgical nurse was informing Marium of how the surgery went and what medications he received. There were no complication, but the nurse said he went down fighting and said that he will wake up fighting.

When the patient first came in to the unit nurses were trying to poke him or say his name to wake him up. However he was a big man and I took 30 minutes for him to come to. Other doctors and nurses from surgery came back to check on him. I saw medical terminology like Q15 which means every 15 minutes. NKDA stands for “No known drug allergies.”

I really enjoyed this unit because it was fast pace and interesting to a wide range of disorders or injuries. I was in awe when they were all doing seven things at once and remarkable well. I love being a part of the team, and I fell this would be a great place for those who like being a team player like myself.

Wednesday, February 4, 2015

GC (LTAC unit)

Sundown syndrome affects some people who have Alzheimer's disease and dementia. They get confused and agitated as the sun goes down, and sometimes through the night. Sun downing happens to nearly 20% of people who have Alzheimer's disease or other kinds of dementia. The causes are not well understood and there seems to be no cure, however there are some ways to manage it. Being more active during the day may help Alzheimer's patients sleep better at night. Also, Light therapy, Good sleeping environment, and Calm reassurance will help.

MH Report due: Feb 5

Learning Report
  1. Responsibilities:
·         Care for 2 patients
·         Administer medication
·         Finish charting so 4 patients can be discharged
·         Inform the patient and their family
  1. I learned that charting looks very hard and complicated, but it is easy once you are trained.  
  2. Best thing that happened was learning that I don’t have to be great at spelling because when charting all you have to do is click on an option already typed out.
  3. The worst thing that happened was hearing that some patient that are not in the right mind will sometime play with the own poop, and the nurse his to clean them up.
  4. It was not a mistake.
  5. Good, my nurse was not extremely enthusiastic, but she still taught me a few things.
Experience Record
  1. Technology I observed was their COW or computer on wheels which she used to chart. She also had a scanner that looked like the ones at a grocery store that scans the medication and her wrist band which then send the information to the computer.
  2.   The patient had just come back from Bronchoscopy where the doctors can take a look into the airway. They hope to get the results back to diagnose her lung disease.
  3. My nurse had to administer blood pressure medication to another patient recovering from surgery.  She also assisted an older women take out an IV so she could get an x-ray downstairs. After one of the patients came back from surgery she helped them with ordering lunch and changing her status so she could eat.
  4.  I observed a woman who had painful and labored breathing. She was waiting to hear what the Bronchoscopy looked like to diagnosis her.
  5. I saw medical terminology like WDL’s when she was charting. It means “within defined limits”. I also heard her use Edema which is swelling caused by fluid retention - excess fluid is trapped in the body's tissues.
Experience Journal
                When I first walked in, I was introduced to Darleen,, a registered nurse who has only been a Memorial Herrman for 3 months. She had 2 patients she was caring for along with discharging 4 others. She was taking a break where she ate here breakfast of oatmeal and Doritos… weird. I got to see her chart on her computer and administer medication using a scanner. Also, a sales man came to demonstrate a new colonoscopy bag that came in different diameter to better fit the incision.
                The first patient we visited just came back from a bronchoscopy to determine why she is having trouble breathing. She needed another x-ray, so the nurse had to disconnect her IV. This allowed her to be moved from her bed room to the imaging room.  She also helped the patient’s family order food and changes her meal status, so she could eat after her procedure. Her next patient needed their blood pressure medication replaced. Her mother told Darleen to use a different medicine the patient used before that worked well. However, the nurse kept her on the original drug.
                I asked Darleen how she balances a family and nursing. She works the typical 12 hour shift, 3 days a week. In addition, she will work extra for overtime pay. WDL’s came up when she was charting she told me It means “within defined limits”. I also heard her use Edema which is swelling caused by fluid retention.  She made sure to use proper PPE when handling IV parts and used hand sanitizer when she came in contact with a patient or something they may have touch.

                Although it was not a horrible experience I still do not feel like I would enjoy going into the field of the surgical unit. The staff got to briefly talk to did not seem happy to go to work. I want to be excited and happy when a go to and leave work. Almost every rotation so far has pushed me to really look into the labor and delivery unit. 

Tuesday, January 27, 2015

MH Blog due: 1/29

Learning Report
1. The nurse I followed was responsible for one patient and to make sure was not having a reaction to the blood. She also began to prep the patient for surgery.
2. I learned that patient identification is exaggerated in the hospital.  
3. The best thing that happen was getting to see a nurse check on a patient who was getting a blood transfusion.
4. The worst thing that happen was just he waiting around for something to happen or having to fell unwanted and annoying to the staff for asking if I could shadow them.
5. The “worst” was not a mistake.
6. Bad, the staff didn’t want to teach and I had to struggle to get the opportunity to watch someone take vital signs which is still boring.

Experience Record
1. I observed a nurse give a blood transfusion to a patient who was about to go into surgery. In order to do this she had to scan the wristband to get into the computer to insure patient identification.
2. I came a little late, but the patient was diagnosed with a ruptured/rupturing uterus. She had profuse bleeding and was in need of surgery to remove her entire uterus.
3.  She was given a blood transfusion due to the excessive amount of blood lost. The nurse had to check on the patient after 15 minutes to make sure the blood does not have complications.  Everything was working fine so she increased the rate of transfusion.
4. I observed a women who was in a lot of pain due to her uterus rupturing. Her doctors wanted to get the entire uterus removed as soon as possible.
5.  Endoscopy means looking inside the body for medical reasons using an endoscope, an instrument used to examine the interior of an organ or cavity of the body. Anesthesia is an insensitivity to pain induced by the administration of gases or the injection of drugs before surgical operations.

Experience Journal
I.                    My first impression was they are too busy to teach me. The first thing she did was give me a giant binder on endoscopy. I was full of brochures and pictures only 10 percent was interesting. I saw a new technology of having to scan the wristband of a patient in need of blood. The nurses were charting on the COW (computers on wheels) after giving care to each patient.
II.                  The nurse I followed took vital signs several times before and after the blood transfusion. She did this in the case of her body rejecting the blood the nurse could see her vital signs getting worse. She also made sure to clean the thermometer and disposed of the soiled clothes the patient bleed on. I also got to see a young patient get emitted, however the family spoke Spanish. Luckily there was a nurse that spoke Spanish and was able to communicate with the family.
III.                I learned that patient identification is a very important in the health care field. I observed the staff checking wrist bands and asking for verbal certification. I didn’t hear a lot of medical terminology but I did hear terms like endoscopy and anesthesia. I did read a lot on the endoscopy and saw an x-ray of a foreign object and pictures from the endoscopy of that object in the patients body.

IV.                I felt I had to fight to get to see something I’ve seen already, but it was at least better than reading about endoscopy. I realized that I do not want to go into the day surgical unit. It has no interesting features that would make me want to continue in this felid. The staff seems to treat me as a nuisance getting in the way of doing their job.