The nurse delegated tasks to aides which was expected. Two patients asked the nurse if she could help them change their brief and the nurse was busy in a med pass and told the patient that she would get their aid. We spent the first hour of the shift going over the diabetic patients and finding out what their sugar levels were to be able to properly prioritize the most critical patient before dinner. The LPN that I shadowed did not fill the expectation of cleanliness however. She did not wash her hands once during the shift or between patients (including insulin injections, CBS, and medication pass). This made me really disappointed and I do not want to be a nurse like that. During the middle of the shift there was a call over the speakers that a nurse was needed outside (patients smoke) and we were the…
When I was a young nurse it seemed like problems I saw were continually put on a back burner or not treated fairly. It’s important to be accountable for mistakes. I have worked on a surgical floor for 16 years. On occasion we will be pulled to another unit if they are really short. I was pulled to an oncology floor when I had been an RN for about 3 years. I was not familiar with the chemo drugs and their schedules. But my med sheet had times listed when to hang certain things so I didn’t ask the charge nurse but went about hanging my drugs. Later in the day the oncologist saw what happened and threw a huge fit. I wasn’t told specifically what I’d done wrong but just that I was incompetant and he didn’t want me ever taking care of his patients again. That was hard to hear because most of the time I was told I was great to be around and a great asset to my unit. I asked the charge nurse what I done wrong. She said certain things weren’t compatible and that I had put the patient at risk but she also told me not to worry, she wouldn’t “report” me. She just kept poo pooing me and told me she would take care of things. It literally seemed like everything was just swept under a rug. Later after my shift was over I went back down to my floor and talked with my clinical educator about what happened. She used to work oncology so I knew she would understand that units procedures. She was upset that I was assigned a chemo patient to…
This week in the cardia pre-op clinic, a Nurse Practitioner (NP) named Dot told me about her patient needed child life and that she was not prepared for her surgery. The patient was an 8-year-old girl from Puerto Rico who spoke Spanish and some English. I met D.F. and her mother in the waiting area of the pre-op clinic. I accompanied D.F and her mother to the lab and assessed D.F.’s understanding of why she was coming to the hospital. D.F. told me that she had a murmur and when I said, “oh, a murmur in your heart,” she told me, “no, a murmur in my chest.” Then I went back up to the pre-op clinic and spoke to Dot, asking her if the other had shared her understanding of the surgery and if there was any reason why she was not prepared for her surgery. Dot shared that the surgery had been moved up one week, and when she asked the mother that morning if D.F. had been prepared she did not realize the importance of preparing her child. I decided it would be best to talk with the mother first about preparing D.F. and giving her the option of preparing D.F. herself.…
For example, there is a 54-year-old male, who is a fire fighter and has a spouse and three children ranging from 21 to 15 years of age. His physician approaches an ADN nurse and explains to her that her patient has stage 3 renal cancer and that he is going to inform him now. The nurse enters the room with the physician and is at bedside while their patient is being told about his diagnosis. The ADN nurse will most likely ask the patient if he needs anything, will linger to see if the patient wants to talk, and will try and finish the rest of the tasks they may have. The ADN nurse was there for the patient and attempted to console him if needed, but they may have missed the bigger…
During the next session, Kasten should continue to work on articulation of /s/ sounds with ES, focusing on phonetic placement, and making E.S more comfortable with correct speech sounds. Kasten appeared to be a good clinician. However, at times I think she was a little too picky in her assessment of E.S’s pronunciations. Being that this was such a long session for an eight year old, in future sessions I suggest more breaks during transitions. Lastly, I recommend more competition based games between Kasten and E.S; it will be a great way to get E.S to work hard, and strive to do her best during…
According to, “The American Nurses Association Code of Ethics”, this document sets standards for nurses. It exemplifies the role of the nurse and duties to be maintained. For instance, patient advocacy is an important factor to the code of ethics. Patient safety is to be a primary goal for the nurse. I believe this is crucial for all nurses to practice. Individuals in the hospital are not necessarily capable of always expressing their needs. Therefore, it is the nurses responsibility to advocate for the patient during times they cannot. For example, one time I was caring for a patient who did not understand their diagnosis. A team of residents came into this person’s room and overwhelmed them with information. Confused, the patient was unable to understand the complexity of the illness. However, I witnessed the nurse advocating for her patient. She stepped in as a voice, making sure the patient’s questions were answered before they left. For a patient it can be quite intimidating when a group of doctors come in talking about a disease process they have never encountered. So, it was satisfying to see the nurse advocate for the patient.…
I was just starting out working as getting my clinical hours and I remember looking at my patients care plan and I didn’t see anything about this particular patient being a DNR = Do Not Resuscitate and I went into the patients room to check on this man and I realize that he isn’t breathing and I called the nurse as quick as I could and I went into the room and was about to start chest compression and as I was about to start I heard the nurse shouting at me don’t touch him. The nurse didn’t do anything as well I was upset because I was under the impression that we suppose to do everything in our power to keep these patients alive. Me and the nurse argued because I didn’t see the DNR on the man’s chart and as I sat down with the charge nurse she showed me where it was located.…
As stated before, I decided to do my participant observation exercise in the nursing home during the evening where the residents are getting ready to go to supper and come back and go to bed. At 4:30, the residents were just getting back from chapel and needed to use the restroom to go to supper, which started at 5:30. Many residents had their lights on and wanted to be the first ones to be attended. I knew this as I walked down the hallway I could hear some residents tell the CNAs to help them. During this time, the nurses were working on passing the medicine and charting other things. At 5:30, the residents wanted to go to supper as soon as possible so that they would not be late. When everyone was at the dining room, the CNAs had to help feed those who could not feed themselves. by 6:30, everyone wanted to be out of the dining room to go to bed. During this time, the nurses were once again passing medicine to those who get it after meals. The CNAs once again had many lights to answer as fast as they could to ensure that the resident was happy and pleased with their service. During this time, resident 1 had her light on and when it was explained to her that those who were at a risk of falling if unattended had to be attended first. She got upset and said that…
I was on my third day of residential care placement; the staff had just started to take turns for their morning tea break so I took the time to catch up on my case study patient’s medical history in the nurses’ station. Within a few minutes the Manager of the rest home ran in to gather the blood pressure machine and bandages. She informed another student nurse and myself to “take these to Max’s (pseudonym) room NOW, while I call an ambulance”.…
On 6/19/15 San Diego Youth Services staff took Jesus to a doctor's appointment at the FFAST Program. The staff were informed by the doctor that the foster parents have not picked up Jesus medication (Ritalin). According to the RP the medication was filled 30 days ago. Jesus has aggressive and impulsive behaviors that are unmanageable at times. The behaviors seem to increase when Jesus is not on his medication. The RP stated that Jesus has not been on his medication for 30 days due to the foster parents not acquiring his medications. The RP stated the foster parent have been contacted to no…
This reflection is based on my observations of the need for of effective communication skills and knowledge of nurses regarding the management of aggression in elderly patients with dementia. Clinician need to be equipped with seclusion, medication and de-escalation skills to be able to manage patient aggressive behaviours safely. I have chosen these particular observations after realising how fundamental they are in implementation aggressive behaviour management strategies in patients. While working in mental health I have observed how effective it is to communicate with a patient as a way of de-escalation during verbal and physical aggression incidents. Ford, Byrt, Dooher, & ebrary (2010) point out that it is imperative for health professionals…
My mom taught me to live by the Golden Rule; do unto others as you would have them do unto you. I have lived by this rule all my life. I have never had a problem getting along with others and treating them with respect until I started my nursing career as an LPN. I started working at the local hospital, working night shift. I really enjoyed going into work, helping the patients with their needs. I enjoyed visiting with them and finding out what would make their stay better. Then one day the supervising nurse in charge of the floor took me aside and told me to stop visiting with the patients. I was thinking to myself okay there has got to be a good reason behind this. She told me the patients need their sleep and they don’t need me to visit with them and keep them awake.…
Working in the field of Human Services with people who are clinically diagnosed with mental illness and substance abuse, who are seeking employment from an office setting is entirely different from working with people with developmental disabilities in their homes. As my place of employment provides services to both population in different settings, I had to observe the difference of supporting the individuals in a home setting. I reviewed the schedule provided for the day, data collected (that had to be recorded throughout the second shift of my presence), interviewed with shift staff and manager, and the residents of the group home. From this experience, it is clear that working in this field while in an office setting, is completely different…
Mary (changed name) was admitted with right cerebrovascular accident (CVA) and was now just waiting for residential placement. One of the side effects left over from her stroke was that she had a drop-foot for which she had a splint and a walking stick; she had declined to use a frame. Mary was one of the patients on my team so I was getting to know her quite well during my first two weeks on the ward. I was working with another patient when I saw Mary twist on her ankle and try to steady herself on her stick. This had the effect of spinning her round and she fell to the floor onto her left hip. I ran to help, she was in a lot of pain and slight shock, I called down the ward for help several members of staff came to help saying "do this" and "do that" all at the same time, I was quite over whelmed. Mary was rolled back and forth onto a sling, hoisted up and placed on her bed, all the while I was looking after her head, I did not know what else to do so I talked to her to calm her down, which was difficult due to all the commotion. On initial examination the senior nurse on duty said it looked like she had broken her femur, which was later confirmed. Her residential placement was cancelled and she was transferred to stepping hill.…
I spent my time observing Dr. Paul Michael Petty in the emergency room at St. Francis Medical Center in Monroe. I was able to follow him around and see many different small procedures and exams being done on various patients. Since it was the emergency room, I was exposed to many different areas of the medical field each time. My desire to serve in primary care was strengthened as I saw the need that he met in the Monroe community.…