X-Ray 101

Learning Report
1. involved with the assessment, planning, and care of patients who undergo diagnostic, interventional, and therapeutic procedures.
2. I learned the steps taken to do a contrast x-ray on a kidney. I also learned the proper steps taken to make sure that the organs can digest the contrast, also I observed now to measure the vorrect of contrast to give.
3. I had a contrast done on me two weeks ago on my kidney just like the patient it was cool to see the final pictures and x-rays of the patient. 
4. The worst thing that happened was that at the start the person I followed was not very receptive of me. As I started asking questions he saw that I really wanted to know and learn more, so his attitude changed. He became more receptive and really started showing my things.
5. I saw his attitude towards me, and so I looked at myself and changed how I appeared. I started listening more, asking questions, and really being more attentive.
6. This week was: fair. It was fair because nothing really exciting happened. Yes, it was cool to see what was done and to see actual results. But, I missed observing the treatment of patients. 

Experience Record
1. The technology I observed was the testing of a kidney through contrast.  In many cases, the use of a contrast dye is necessary to enhance these tests, but sometimes these dyes can either lead to kidney problems, or cause problems in patients with kidney disease. 
2. There weren't any diagnostic procedures.
3. There weren't any therapeutic procedures.
4. The patient I believed had a history of things on her kidney. She stated several times that she had this done before. She seemed very relaxed with every step they took. She knew every step that was taken, and knew what each step showed the doctors. 
5. There was no terminology.

Journal 
   When I got to the radiology department the nurses were all sitting at computers and examining x-rays. On several walls there were white boards that had a list of patients with names and what procedure they were going to have done. All supplies seemed very organized and well taken care of. When I saw the actual testing room, all proper PPE was arranged and was easly to get to. 
   The staff was looking at test results, and greeting patients that they were handling. The nurse I followed interacted with his patient with great communication and care. The whole staff was very relaxed and willingly to do anything. There was one point where they were looking at the schedule for the next several weeks, and one staff member couldn't work, so in result I saw how each staff member steped up and helped. They were all hard working members and were very open to discussion.
   I had to get a contrast done on my kindey. I never saw the reuslts, or even x-rays that showed the tumor that is on my kidney. The patient I saw did have the same thing. She also had been doing the same testing that I had to do. I was cool to see the actual results of someone's kidney testing. You could clearly see the tumor, and you could see the contrast go through and pop up on the testing. It was a great learning experience. 
   I had a fair time. Nothing really happened. I learned how x-rays work, and how the doctors use them to diagnosis a problem. I did learn a lot, but it was slow getting started. I really had to step up to the plate and take my own learning into my own hands, which I think was nice thing in the end. I have been lucky by having several great rotations and several great medical professionals to teach me. This rotation really made me take a step back and realize that I am not always going to have the AMAZING ROTATION. I did learn a lot don't get me wrong, but I can truly say that this is not the place for me. 

ICU

Learning Report 

1) When a patient has suffered a heart attack, stroke, shock, severe trauma, respiratory distress or other severe medical issue, it is vital that they receive immediate and intensive nursing care. Critical care nurses are adept at providing such care in settings where patients can be given complex assessments and treatment. 
2) I learned a lit of new things in the ICU. With the patient I saw I learned what monitors he was hooked up on, and what they were used for.
3) The whole time was great. I followed a nurse who really told me step by step what he was doing and why. Then towards the end he took a break, and I sat with Niomia. She explained some of the patients she has seen and helped.
4) The worst thing that happened was seeing a patient that came into the hospital for a simple sickness, and it turning into something that put him in the ICU.
6) This week was good more likely fantastic. At the beginning I was scared  and nervous, but once I got into the ICU mode I really enjoued. I think I found job when I got older, and that's being an ICU nurse. 

Experience Report

1) The technology I observed was all the monitors that the patient was hooked up on. With the monitors it told you his heart rate, BP, and respirations. He also was on a venalator. A venalator is a machine that supports breathing. Most patients in the ICU are on venalators, but what patient families need to understand is that it doesn't treat a disease or condition. It is keeping a patient alive. 
2) The nurse I was following his patient was having high blood pressure. The nurse looked at his scans and tests and he realized that his blood pressure was raising due to the fact that he ws trying to wing the patient of the venalator.
3) For therapeutic procedures the nurse tried weaning him off of the venalator. Since, every time the nurse tried to wing him off the venaltor his blood pressure rised, so he had to choose which medicine was better to use to treat it.  But, since the patient's BP continued to rise the nurse said he would have to stay on it. 
4) The patient I saw was a COPD patience. A COPD patient means chronic obstructive pulmonary disease. Since the patient was a heacy smoker, which is the cause of his COPD.

Journal 
   When I arrived on the unit it smelled very cleaned, and it looked very organized.  There were rooms that were rooms that in the shape of an "U". Some rooms had yellow shoe holders which held the necessary products for the isolation rooms. They put a patient in isolation if those patients are contagious and will spread germs. In the ICU those patients immune systems are low, so they are very septible to getting infections or sicknesses very easly. 
   I observed nurses taking vital signs and interactions between the nurses and the patient's families. I noticed that with handling with ICU patient's families that you have to be extra careful about what you are saying, how you are saying it, and the tone of what you are saying it in. There were many safety procedures going on, with all the isolation equipment out, and very precised sanatation. The treatment procedures I saw were the treating of the patient's blood pressure to go down. it was very important to lower it, because if it didn't lower then he would have to stay on the venalator for longer time. 
   I learned how to communicate between the the nurse and the patient's family. Also, how to handle solving just one problem but looking at other things to find out the best solution. I also learned that with ICU patient's their vitals are going to be taken often. When I was there observing the patient's vital signs were taken about 4 times. Medical Terminology that was used was that the patient was labeled a COPD. 
   The time I had their was a great time. I was very nervous on going, but I had a great nurse that I followed. When he went on break, I sat with another nurse and her and I had a great talk. She explained on her experinces in the hospital and patients she has treated. I could really see my self working in a field like this. I liked how you have 2 patients and that you really get to connect and treat them. Because when I get into the medical field, I want to focus on getting that patient to the best health that they can possilby have, and I don't think I could that has well when I am seeing 6 different other patients. The ICU could be my field of practice, and I am very excited to see where it takes me, and what next week has instore for me. 

G.C. for the Week

Rehab 

-This week we got a new assignment task for G.C. I will define some terms,causes of those conidtions, and treatments that patients can do. 

Nocturia 

Define: Nocturia is a condition in which you wake up during the night because you have to urinate. This condition becomes more common as people age and occurs in both men and women, sometimes for different reasons.

Causes: 

• High fluid intake 
• Untreated diabetes (Type 1 and Type 2) 

Treatment: 

• depends on the type and cause of nocturia. If sleep apnea is considered, you may be referred to a sleep specialist or pulmonologist. 
• Some include interventions like restrict fluids, afternoon naps, or wear compression socks. 
• Some medications include:
• Anticholinergic medications: reduce symptoms of overactive bladder
• Bumetanide: diuretics that assist in regulating urine production.

Cataracts

Define:  Is a clouding of the eye's natural lens, which lies behind the iris and the pupil

Causes: As we age, some of the protein may clump together and start to cloud a small area of the lens. Overtime, it may grow larger and cloud more of the lens, making it harder to see.

Treatment: 

• glsses
• strong biofocals
• magnification
• appropriate lighting or other visual aids 
• Surgery 

Dysphagia 

Define: Swallowing difficulties, and usually caused by nerve or muscle probles.

Causes:

• Aging
• lateral sclerosis
• GERD (gastroesophageal reflux disease)
• Myasthenia Gravis 
• Radiation

Treatment:

• Is mostly caused by a neurological  problem, providing  effective treatment is challenging

Glaucoma

Define: a condition that causes damage to your eye's optic nerve and gets worse over time. It's often associated with a buildup of pressure inside the eye. Tends to be inherited and may not show up until later in life.

Causes:

• Occurs when pressure in your eye increases
• Eye fluid isn't circulating normally in the front part of the eye 

Treatment:

• prescription eye drops
• laser surgery
• microsurgery

Incontinence

Define: loss of bladder control

Causes: 

• muscles are weak or too active

Treatment: 

• depends on the type of problem you have and what best fits your lifestyle
• exercises
• medicines
• special devices 

Floor 5 please

Learning Report

1. Med Surg nurses provide adult nursing care before and after medical procedures, and as pateient's conditions and case load will vary daily, med-surgical nurses must be confident in managing complex and differeing care. 
2. I obserced several things that were in the medical book, example how to make the patient's bed.  I also learned that floor 5 is never really calm. Usually they are packed with patient's and going every which way.
3. The best thing that happened was that since the floor wasn't very busy I got to visit with the nurses. It was cool to do that, because last week I was in ER and ER doctors/nurses are different from everyone else, in result of that, I got to see how much they really like their job. 
4. Nothing really bad happened. 
5. There wasn't a mistake. 
6. This week--fair: It was fair because since there wasn't many patients we really just talked. I would have liked to be shown around or something. I missed the actual patient treating of patients. I learned that even though this floor can be exciting it's not where I need to be. 

Experience Record

1. The technolohy I observed was the online charting at the nurses station. There is one big nurses station, and then there are severaly smaller nurses stations around the floor. There two nurses can sit and chart their rounds, and also some nurses will use the station outside their patient's rooms so they can be right there.
2. I did not see any Diagnostic Procedures.
3. I did not see any Therapeutic Procedures.
4. There weren't really any diseases/disorders, but the patient's that I did see had a stomach surgey, and the other looked like she had cancer.
5. I did not encounter any terminology/abbrevations.

Journal 
   When I walked on to the floor it smelled very clean, and very orderly. I saw several nurses making their rounds, charting, and talking to doctors.  There were two crash carts in the major nurses station, and several doctors doing paperwork. I also noticed that on each door their were signs that said if the patient was a falling risk or a health risk (and you need to put on PPE).
   When I reached the nurses station their were several nurses their answering phones and arranging rooms so they can discharge and accecpt patients in. All the nurses were very kind, and whent hey talked about things going on at the hospitaly they always paused and explained what they were talking about, so I could join. The nurse that I followed and I changed several beds, cleaned up a room, and she started to help a patient in the shower, right before I left. 
   I observed how to make a bed, which was kinda cool, because I read it in the medical booklet and then I got to see it be done. I also got see how the nurse needs to be the advocate for the patient. A doctor wanted to release a patient, but the patient had high blood pressure. The nurse was saying if that if a patient with that good of health, and then having a simple surgery, and in result having blood pressure...isn't good. I saw how to use the proper tone, and maybe some good words that I could say to the doctor if I am ever in that spot.
    What I learned was that this floor was not for me. Even though I did have a good time visiting with the nurses, that I want to be involved with the patients. I don't think I could handle having several patients; I think I am more like 2 patients. I want to help with patient's and really be able to help them get to where they need to be. 

Update for G.C.

 

 

G.C. For the Week

 

   This week at G.C. was most likely the best one had in awhile. First, I was in LTAC and the Nurse that unit let me go around the unit and take the blood oxygen levels for some patients, and take other small vital signs. It was really cool to see how I would report back to her, and she would say that isn't normal range for that patient. You could tell that she liked working there, and she knew her patients. I think that is a major of working at any medical facility is that you need to know your patients, and sometimes at G.C. I have noticed that some health care workers there do not know their patients. The nurse knew normal levels for every patient I took, and very receptive of me doing that. She was kind a amazed that I knew how to do that.

   The next time I was at Dining. There it is kind a of hard to get them to help, or show something. There I stabled the lunch menus with the G.C. patients lunch information cards. The Chef told me that it is required by the state to have a information card. The card lists:

• The name
• Room
• Allergies
• Dislikes
• Likes 

With this system he can cook with a variety, and keep them safe. After that I did not have anything else to do, so I went G.B. There I got to see Mrs. E. She always is wearing her katy red. She is only in G.B. for 20 more days. Then she will go back to LTAC. When I was visiting there, a light when off telling the nurses that the patient in that room needed attendance. I was amazed at how quickly the nurses responded. It turned out that the lady in that room just couldn't find her special blanket.

  This week at G.C. was great. I got to show my skills of a little bit, and brought a smile to Mrs. E. So I guess I say that it was very productive week.

The emergency life

The Emergency Life

Learning Report

1. Responsiblites: Emergency nurses specialize in assessing, intervening and stabilizing a variety of trauma and illnesses with decisive action.

2. I learned the steps or observed the steps taken when a patient walks in to the E.R., transportated by ambulance and arrived, and when a patient comes back from testing.

3. The best thing that happened was that I got to see the treatment of a homeless patient, a stroke patient, and a patient throwing up blood.

4. Nothing bad happened.

5. There was no mistake

6. Overall: Good- I got to see and experience a lot. The hospital staff was very recepetive of me, and was very willingly to let me jump in. They also were very good about after preforming a procedure they explained it to me. I learned a lot, and was very excited about the time I had there.

Learning Experience 

1. The technology I observed was an E.K.G. and an X-Ray. They have a tech that comes in and does the testing. An E.K.G. is a test that checks for problems with the electrical activity of your heart. An EKG translates the heart's electrical activity into line tracings on paper. The spikes and dips in the line tracings are called waves. An X-Ray is an electromagnetic wave high energy and very short wavelength, which to pass through many materials opaque to light. 
2. With the patient regurgitating blood, since he walked into the E.R. I got to witness the questions and timeline of the patient's history. I was able to see how the medical professionals listened to the patient, and really pined pointed the right information that they needed. After coming up with 2 main ideas of the patients chief complaint.
3. With the stroke patient, in his medical history it stated that he had a a stroke in the past and is very receptacle of having stokes in the future. After, he came from a C.T. Scan I observed the E.R. Nurse diagnosing the problem. You could really tell that the patient had a stroke, so the patient and the nurse came up with a plan. In result, they would together tell the family the plan and the steps to get the patient back to stable condition would begin.
4. I observed 3 main patients. The first patient woke was vomitting blood at home and was continuing while in the E.R. room.  That patient had a history of 2 cancers, but no other medical diseases or disorders. The second patient was a homeless patient. With that patient I only witnessed taking his blood. Due to the fact that it could turn in to an unsafe environment. The third patient was the Stroke patient. A stroke is a sudden diminution or loss of consciousness, sensation, and voluntary motion caused by rupture or obstruction (as by a clot) of a blood vessel of the brain. 
5. There wasn't any used. 
6. I loved the E.R. floor. They were very receptive of me, and very willingly to let me learn and ask questions. It took a while for the floor to start getting busy, but in that time they talked to me about what has happened, their favorite part, and other hospitals. It was a great time and experience, but people need to know is that you are not going to have the same experience unless you take your education into your own hands. 

Journal

   When I first started to head to the E.R. I got lost, lucky another student found me and helped me. When I finally arrived and I walked in, you could smell coffee, heard laughing, and beeping of monitors. The Nursing Station had several nurses around checking on patients and visiting. They were very welcoming, and talked to me about the unit. There was a portable X-Ray machine in one room that was easily to get to and move around. When patients started coming in I saw the use of an E.KG., the X-Ray machine, and the taking of blood. 
   When the Nurse I was following started to treat the patients I observed the way that the whole E.R. really works together. It was a great learning expeirnce to see how the tech, the nurses, and the doctor all work together in one room. I was just sitting there watch all these health care professional amazed. When one of the patient's ex-wives arrived I got see how the nurses handled the family situation. She was very kind and thankful for all that they were doing for her ex-husband. I saw several Therapeutic and Diagnostic proceduces done. I saw the drawing of blood, the E.K.G, and the portable X-Ray machine. It was very cool to see how fast they all go and how the patient can say one thing and then the doctor will change his thoughts of what is wrong. It was very cool. 
   I learned so much on this unit. I learned how to handle so many situations and procedures, and skills that are needed to really diagnois the problem. Like I said before, the nurses would handle a situation and then later described me why they did that test and what that test will tell them. The Nurse told me that people on this unit sometimes get burned out but later will come back. For a student they need to understand that you need to be able to jump right in. They will help you don't get me wrong,but if you want to see something or something like that you really have to take it in to your hands. I really understand now that my education when it comes to or clincal rotataions is really in my hands. The health care professionals liked how much I liked being there. For like the first 15 minutes we talked about E.R. shows, and injuries I have seen being an athletic trainer. It was a a great educational experience.
   I think I have said this a million times on this blog, but I have truly had the best time on the E.R. unit. Not just for educational, but also personal experience. I have watched Grey's Anatomy, New York Med, and Untold Stories of Life in the E.R. and for someone to have watched those shows for years and then fianlly you get to see it is a great feeling. When I came back to our classes meeting spot I and the biggest grin on my face. I had that smile on my face all day. It was great cause I left there knowing that even I didn't help out a lot but that I was a part of their first steps heading toward getting back to a stable condition.  The professionals there were great, and they were very willingly to let me be in rooms and listen and take notes. I had a great experience, and I am so blessed that I was able to go and that kind of experience.

Sports Medicine 101

Learning Report 

1) The physical therapist took a diagnosis report on a patient. A physical therapist help injured of ill people improve their movement and manage their pain.

2) I learned that the therapy that takes place at Memorial Herman is more with the elderly, and the Adult population.

3) The best thing that happened was that I followed was great, and I got see her preform a Diagnostic and Therapeutic procedure. 

4) The worst thing that happened was that I really missed the rue medical surgical patients.

5) There wasn't really a mistake but after being not really being accepted by the P.T. I had to re-evaluate myself and my goals for that rotation, and then when I did that I ended up having a great experience.

6) This week was good because I was in an area that I really liked and was familiar with. Plus, the P.T. did a great job by including me in with what she was doing. 

Experience Record 

1) The technology observed was the use of laptops. Each P.T. had the same laptop, and each one had their own. With their patient the P.T. would insert the patient's status of how their exercises went, what they did that day, how the patient felt after, etc. The laptop's also has the patients diagnosis plan and background, so the P.T. and the patient can keep on track.

2) Sheri, the P.T. I followed, preformed a background information and diagnoses test. She tested the patient's dysfunctional movements by observing the patient stand or walk and by listening their concerns.

3) For Therapeutic procedures Sheri set up a plan of care for the patient, outlining the patient's goals and the expected outcome. Also she use exercises, stretching maneuvers and hands-on therapy to ease patient's pain. 

4) The patient did have neuropathy in the legs. Neuropathy is damage to nerves in the nervous system, and so it affects nerves outside of he brain and spinal cord.

5) I did not see any use of medical terminolgy. But, when Sheri was diagnosing the patient she used a spinal cord model to help explain to the patient what his injury was, and how the stretching was going to help. 

Journal

  When I walked on to the unit it smelled very sporty, like academy. There was a check in desk and across from that there was a small waiting room. When you continued in to the unit there were several tables all around, riding bikes by the window, and a swimming area at the back. Everything was very neat and organized.

  Each physical therapist had their laptop which contained the patients background, therapy plan, and exceeded given. There was soft skills going on between patient and therapist, which is really key on this unit. The P.T I followed preformed a therapeutic and diagnostic procedure on a new patient. In result of those producers they P.T and the patient set goals, and pain relief dates, and starts updates, so the therapist and the patient stay on track. 

  I learned that in memorial Herman the patients they see is mostly elderly, and adult population. I also learned how to make the therapy for the elderly more attentive and more fun rather than feel like it's a chore. I learned how to give a diagnostic and therapeutic procedure, by observing Sheri. 

  I had a great time being in sports medicine, and I learned a lot. At first Sheri was not very receptive to me observing, but after talking to her she saw how excited I was to be in the unit. I could tell that not just Sheri, but ally he Phsycial Therapist really liked working there. They were wa and welcoming to each patient, and they seed like they really liked their job. At the end of my time there, I could really see myself in that occupation.