MSU 3-15-13 & 3-17-13

Learning Report:

What were your responsibilities this week?
On the first day I worked with the charge nurse and on the second rotation I worked with a registered nurse. I went to different patient rooms as the nurse checked rooms, the equipment, the oxygen masks, beds, and other things. We also visited many patients and I learned about the patient's diagnosis.
What new knowledge or skill did you learn this week?
I learned what a charge nurse does on a day to day basis. For example, as I worked with the charge nurse, I learned that she had to move quickly from one room to another and have good communication skills when talking to patients. I also saw how the supply rooms looked like because both nurses I worked with had to go there multiple times to get various supplies.
What was the best thing that happened at the unpaid work-based learning site this week?
The best thing that happened at the MSU was that I was able to visit many patients and see a variety of conditions. Furthermore, I learned that every patient behaves differently and may not be the nicest of all people toward nurses and/or families.
What was the worst thing that happened at the unpaid work-based learning site this week?
Nothing bad happened at the MSU while I was working with the employees. The only situation that I felt a bit uncomfortable was when an elderly female patient with pancreatic cancer started fighting with her daughter who had come to visit her. Other than that event, everything other aspect about the MSU was not bad at all.

This week was: Fair
Both rotation days were fairly enjoyable and I liked working with nurses. Both of the nurses I worked with were very nice in personality and were informative. They answered all my questions and explained what they did in their career.

Experience Record:

Technology Observed: Profile™ - a white board on the wall by a patient's bed that has equipment like oxygen masks, cups, and other items; GEMS Information Technologies- program on a computer that allows the employee to see the patient's ECG and PVG; Patient Care System- program on the computer that lets the nurses see patient information; Enthermics Medical Systems- computer program; Prevco Systems- consists of a pneumatic tube transport system; Meditech PDI- has subprograms like GCTX and Kronos 63, EBSCO. 
Diagnostic Procedures Observed: Urine samples were taken from an elderly female patient who was diagnosed with pancreatic cancer. I did not see any X-Rays being taken, but there were X-Rays on a table at the MSU. Vital signs were taken in most of the patient rooms I visited.
Therapeutic Procedures Observed: The elderly female with pancreatic cancer was in her first stage of chemotherapy. She was also taking morphine because she suffered from unbearable pain. Another patient had to have a stress test done because he had severe back pain.
Diseases/ disorders Observed: I observed a patient with pancreatic cancer. She was very elderly and it was noted by her daughter that she was addicted to pain medications. The reason for this is that the patient suffered from unbearable pain and took these medications constantly. She also experienced nausea and weakness. Another paitent had chest pain and rated his pain at a 4 out of 10 when the nurse questioned him. He also had a high blood pressure. Morphine was later given to him through an IV.
Medical Terminology encountered: While visiting a patient, I heard that he had laparoscopic appendectomy. This is a minimally invasive surgical technique to remove the appendix. It involves making several tiny cuts in the abdomen and inserting a miniature camera and surgical instruments.

Laparoscopic Appendectomy

Experience Journal:

    When I first entered the MSU, I saw a lot of patient rooms and in the center there was a long table with a couple of employees working at computers. A variety of employees work here- from doctors, nurses, and college students. I worked with a charge nurse the first day of my rotation. In a nutshell, she checks rooms for equipment, makes sure the room is clean for the next patient, checks for oxygen masks, etc. The MSU provides management of a wide variety of medical conditions. They serve adults and children who are hospitalized to receive medicines and treatments or who are staying for recovery from surgical procedures. The MSU uses extensively uses technology in order to care for their patients. Programs such as Meditech PDY and EBSCO help nurses chart their patients.
    During my rotation I visited many patients and I learned about their condition. I saw patients with pancreatic cancer, chest pain, lethargy, and other conditions. I learned that it is imperative that the employees at the MSU work cooperatively and communicate well to other workers as well as to the patient. For example, I saw one elderly man who needed assistance to walk, so one or two employees worked together to help the man stand and retrieve his walker. Some safety procedures I saw was putting on gloves before touching a patient. The primary reason for this is to prevent the spread of bodily fluids and germs. I also saw a variety of diagnostic procedures as well. One elderly lady had pancreatic cancer and suffered from a lot of pain. She was later prescribed morphine. Another patient was also given morphine, but for a different reason. This patient had a a lot of chest pain and had a high blood pressure. However, he was only is the MSU for observation. A different patient needed a different dressing because she had a lot of drainage.
    At the MSU, I learned a lot about what a nurse does. When I asked a registered nurse about the educational requirements to become a RN, she told me she had taken a Bachelor's degree in Nursing. Since she was born and studied in the Philippines, she had to take a test called NCLEX.  This is an exam required for all foreign nurses to get licensed and to legally practice as a nurse in the United States. Therefore, NCLEX stands for National Council Licensure Examination. I also learned medical terminology when visiting a patient who had
laparoscopic appendectomy. This basically means that a minimally invasive surgical technique was used to remove the patient's appendix. 
    Overall, my experience at the MSU was very good. I enjoyed working with both nurses and I could tell they liked having students. Personally, I learned about the different types of conditions patients had at the MSU. Educationally, this will benefit me when I am in college and I have an interest in the Nursing field. And professionally, this is benefit me if I ever do work in the Nursing profession in the MSU in my future.

http://www.umm.edu/general_surgery/lap_appendectomy.htm#ixzz2CbDSpM5c

involves making several tiny cuts in the abdomen and inserting a miniature camera and surgical instruments.

http://www.umm.edu/general_surgery/lap_appendectomy.htm#ixzz2CbDSp

PACU 4-8-13 & 4-10-13

Learning Report:

What were your responsibilities this week?

This Week I went to PACU or Post Anesthesia Care Unit and worked with their staff, mainly RNs. I was able to observe a patient in surgery for a total knee replacement and the measures taken for them to recuperate.I observed how health care professionals administer pain medication, check for vital signs and monitor them.

What new knowledge or skill did you learn this week?

At the PACU, I learned that the priority of PACU staff is to monitor patients after operations in order to ensure their safety and health. I also learned that a patients vital signs must be checked and recorded every 10 minutes if patient is stable, more often if patient is unstable. In addition, postoperative medication might be given to patients in order to reduce anxiety, decrease secretions, and to control nausea and vomiting because anesthesia tends to make patients nauseous and/or induce shaking.

What was the best thing that happened at the unpaid work-based learning site this week?

The best part about visiting the PACU this week was seeing a patient who had received a ICBG (Iliac Crest Bone Graft) done to his molars because they were very weak. Although I was not able to see this procedure, the nurse gave me a quick overview. An ICBG is when bone marrow is taken from the posterior iliac crest (which is located at the waistline), so the surgeon can graft it into the desired area of the patient.

What was the worst thing that happened at the unpaid work-based learning site this week?

Nothing bad happened at the PACU this week. The nurses as well a few patients were friendly and on the second day the PACU had about three patients.

This week was: Good

 The PACU had enthusiastic and funny employees, which made my experience fun. They explained what they were doing and the various equipments they used. I also found the conditions of patients to be interesting and liked talking to some of them.

Experience Record:

Technology Observed: Ohmeda vacuum - measures pressure, oxygen tubes, Executone™ patient assistance caller, Slit Lamp - used for the eye.
Diagnostic Procedures Observed:  taking vital signs such as breathing, blood pressure, pulse, etc. The blood pressure for a patient I observed was 116/75, pulse was 92 bpm, and her oxygen saturation was 98.
Therapeutic procedures observed: Therapy was not conducted this week at the PACU.
Diseases/ Disorders Observed: A 65 year old man had a ICBG done to his molars because they were weak. During this procedure, the surgeon took the bone marrow from his iliac crest and grafted it to the desired area in the mouth.
Medical Terminology: While assessing a patient in their room, I heard the word 'ovarian cysts'. This refers to  cystic tumor (usually benign) in the ovary.

An overview on how a ICBG is done

 Experience Journal:

    The environment of PACU was very calm and quiet because patients are usually resting after surgery. However when there are not many patients the staff is very lively yet busy charting. When I first arrived in PACU the staff greeted me and there were not any patients there. However, on the second day, there were three patients in the PACU. The role of all staff in PACU is to monitor postoperative patients and provide care. Some of the equipment they use are EKGs, Pyxis Medstation and many others.
     The staff in PACU all work together as well as with patients to achieve their goals. They work together well and cooperate with each other and the OR staff as well. The staff is friendly and courteous, ready to assist the patients. The staff all have great communication skills in order to perform their tasks effectively. Along with communicating well with their fellow employees, they are also very gentle with the patients, who are still experiencing the feelings of anesthesia. They also perform safety procedures such as hand washing and asepsis.
     This week in PACU I observed a post op patient with a knee replacement as well a 65 year old man who had an Iliac Crest Bonde Graft (ICBG) done. During this procedure, the surgeon took the bone marrow from his iliac crest and grafted it to the desired area in the mouth, which was the molars. I also learned the difference between anesthesia's, local anesthesia outlasts operation but wears off approximately in 1-4 hours. Regional means that only a region of the body is anesthetized. Spinal Anesthesia numbs the lower half of the body and is local anesthesia injected into the lumbar region which lasts two to six hours. General anesthesia is intravenously administered or by gas and is a state of induced coma where the whole body is affected.
During my time at PACU I learned valuable information that will help me in my future health care career. This will both personally and educationally benefit me if I am interested in becoming a PACU nurse, anesthesiologist, or even a surgeon. While I was at PACU and I also learned about the staff's careers. It was a very interesting experience and I would like to go again.

Pharmacy 3-25-13 & 3-27-13

Learning Report:

What were your responsibilities this week?
I worked with an pharmacy intern on the first day and then with a pharmacist on the second day. The intern gave me an informative tour of the pharmacy. Later, he let me do his job by typing in prescriptions and refills on the computer. While I typed in the refills, he printed the orders and labeled the drug with a label. Then he placed the drug onto a cart to distribute to the other departments.
What new knowledge or skill did you learn this week?
I learned how to refill prescriptions and drugs by using the program called Autophon. While typing in the drug name, I also became familiar with some of drug names like Lidocaine, Ibuprofen, Misoprostol, Naloxone, etc. I also talked with a pharmacist and learned that they keep track of every narcotic in the hospital.
What was the best thing that happened at the unpaid work-based learning site this week?
 I worked with very kind and informative employees. The pharmacist I worked with explained her duties, medications of patients, and how she did her job. The best part was typing prescriptions onto the computer. Although the task was fairly simple and time consuming, I liked doing a something a pharmacy intern would do.
What was the worst thing that happened at the unpaid work-based learning site this week?
Nothing bad happened at the pharmacy today. The first day was fairly slow, but I learned a lot about the careers and functions of the pharmacy.

This week was: Fair
The pharmacy had really sweet employees and they like to joke around sometimes. I could tell they enjoyed having students there because they explained every aspect of the pharmacy and what they did.

Experience Record:

Technology Observed: Freezers- temperature kept at 10°C to 25°C, keeps drugs like Penicillin, also tells you how effective a drug is after a number of days. Novolog Refrigerators- keeps insulin and antibiotics. Pyxsis Carousel with autoPharm- Auto packager that moves around like a carousel, packs individual drugs/ prescriptions into packages.These packages include information like generic names and the strength of the drug. Documax Printer, Meditech- used by pharmacists to track and view narcotics to patients. McKessa Connect,
Diagnostic Procedures Observed: Although I did not see any procedures being done physically, I did read some patient profiles while working with the pharmacist. One man had an infection in his stomach and had to have numerous drugs put inside him to see any reaction. Other tests included urine samples and blood tests.
Therapeutic Procedures: Some patient profiles I saw were being given a variety of drugs to help alleviate pain, infection,or sickness. Some drugs I noticed on the pharmacist's computer screen were Naloxone, Misoprostol, Lidocaine, morphine, and others.
Diseases/disorders observed: One patient the pharmacist had explained to me was a man who was over 900 lbs. He suffered from an infection underneath the large lard folds of his skin. This was caused by the constant rubbing of skin and gave him ulcers. He had a high blood pressure and cholesterol, but surprisingly, the patient claimed he did not have diabetes. He was also lethargic and had major depression. 
Another patient I read about was a 21 year old female who was a dwarf. She had suffered from major respiratory problems ever since she was 3. For this reason, she was constantly kept on a ventilator and had a difficult life.
Medical Terminology: A notable word I heard the pharmacist use was enterococcus, and this a lactic aid bacteria. This was the type of bacteria that was coming out of the infected wound of the 900 lb patient.

Enterococci bacteria

 
Experience Journal:

    When I first entered the Pharmacy, an Intern gave me an informative tour about the area. He showed me the crash cart, where drugs and supplies were stored in trays in a huge, red cart. This cart is used for emergencies in the hospital. I visited the compartment room which has prescription drugs, oral syringes, and bar codes. Then he showed me the IV Room, where drugs like morphine are stored. To enter this particular area, the employee must be free of make-up and wear PPE. It is imperative that the room be germ-free, so I saw technology like a Vertical and Horizontal Hood. These hoods are big black filters that help maintain the air quality in the room.  In the pharmacy, there are 10 pharmacists that work at different times, pharmacy interns, and pharmacy technicians. The pharmacist I talked to explained that her job was to keep track of every narcotic given to patients. 
     The pharmacy was not as busy as I expected it to be. Nevertheless, the employees still worked hard. Overall, the employees used both informal and formal language when speaking to each other. Some even talked about their personal life and commented on patients' medical profiles. It is evident that the employees work collaboratively to provide the right drugs to the right patient and to deliver them in a timely fashion. Some safety procedures I noticed is when a pharmacy employee made sure to wear PPE before entering the IV Room. This is to prevent any contamination of drugs when she is mixing substances.
    I learned a lot when I did a pharmacy intern's job of typing prescription names and adding them onto a huge list on the computer. This list would be used by the intern to pack the drugs from the Pyxsis Carousel onto the drug cart. A word that I learned was 'enterococcus', which refers to a lactic acid bacteria. This is the bacteria that is located in your stomach. 
    Overall, my experience was enjoyable and I learned a lot. Professionally, this will benefit me because now I am aware of how Pharmacy employees work and what they do. I found it interesting to have actually done an intern's job. Educationally, this will help me if I choose to go into Pharmacy-related career in my life. And personally, I learned a lot on how every narcotic must be tracked and be sent to patients at the right time. Moreover, I was also surprised at the large amount of drugs and narcotics that existed.

Emergency Room 3-18-13 & 3-20-13

Learning Report:

What were your responsibilities this week?
I talked, observed, and worked with a variety of health workers in the ER this week. I worked with two ER nurses, a firefighter, two EMT technicians and a doctor. One of my responsibilities was to give blankets to a child patient before he had his IV taken. I observed a variety of patients from different ethnic backgrounds, each with a different diagnosis. 
 What new knowledge or skill did you learn this week?
While talking to an ER nurse, I learned that she had an associate's degree in nursing. We talked about the importance of getting a BSN for nurses, and how that degree may become a requirement for nurses in the future. We also talked about colleges and universities. Some skills I observed in the ER were mainly how a health care professional took vital signs, started an IV, diagnosed a toothache, and assessing the patient.
 What was the best thing that happened at the unpaid work-based learning site this week?
The best thing that happened in the ER was observing different conditions of patients and how the ER professionals dealt with it. All the employees were fantastic and answered all my questions. They were even funny, too. I also saw an sad but interesting case with a 20 year old patient. The right side of her throat and face was in terrible pain and she was not able to open her mouth and swallow. After the ER nurse took the initial assessment, I learned that she was an ardent smoker (she smoked half a packet a day) and that she had five kids. After the doctor came to take a look, he finally said that her right molar tooth was impacted, infected badly, and she had a cavity. The MD informed her that she needed a surgeon to fix this problem, but sadly she did not have insurance.

The patient's tooth was impacted, therefore she experienced a lot of pain

 
 What was the worst thing that happened at the unpaid work-based learning site this week?
 At first, the ER seemed to be slow, but as we started talking to the ER nurses, we started learning a lot. One mistake I made was knocking on the door of a patient and asking the nurse inside if I could observe, but to my surprise she said that she was in the middle of taking the patient to the bathroom. It was slightly awkward.
 This week was: Good
The ER had enthusiastic and funny employees, which made my experience fun. They explained what they were doing and the various equipments they used. I also found the conditions of patients to be interesting and liked talking to some of them.

Experience Record:

Technology Observed: Enovate™ Computer - Looks like a television screen; used to conduct an assessment of the patient, Chromofare D-300 light, Ohmeda vacuum - measures pressure, oxygen tubes, Executone™ patient assistance caller, Slit Lamp - used for the eye.
Diagnostic Procedures Observed: CAT scan , MRI, X-ray, taking an IV, injection of potassium, taking vital signs such as breathing, blood pressure, pulse, etc. The blood pressure for a patient I observed was 116/75, pulse was 92 bpm, and her oxygen saturation was 98.
Therapeutic procedures observed: Therapy was not conducted this week at the ER.
Diseases/ Disorders Observed: 20 year old woman had impacted and infected tooth. She was in severe pain and could not move her mouth, therefore she was crying. Another elderly Hispanic patient had abdominal pains that morning. She felt nausea, had vomiting, had a fever about 100 degrees, and her white blood cell count was elevated. Later, the nurse gave her a potassium injection, which was a low medication. Another patient has respiratory problems. She had a high blood pressure, diabetes, and cholesterol.
Medical Terminology: While assessing a patient in their room, I heard the word 'ovarian cysts'. This refers to  cystic tumor (usually benign) in the ovary.

                                                       Experience Journal:

    When I first entered the Emergency Room I saw a long hallway with patient rooms on the left side. The ER was pretty quiet, and behind the huge counter/desk sat various employees. These employees were either writing information, looking at charts, or talking to another employee. Generally, the ER treats patients who cannot go to a primary physician. The patient rooms are medium sized. Each room includes a white bed with bars on the side, some wall pictures, a section of the wall that had various types of technology, and a computer. This computer seemed interesting to me because it looked like a television screen. Technology I observed in various rooms were Enovate™ Computers, Chromofare D-300 lights, Ohmeda vacuums, oxygen tubes, Executone™ patient assistance callers, Slit Lamps, Alaris PC heart monitors, and more.
    I mostly heard the assessment of patients and what their condition was. While observing a lady with a impacted tooth, I listened as she told the ER nurse her medical information. I mostly talked to ER nurses while in this department. The first ER nurse gave me details on the patient we had previously seen and we talked about her career. In the ER, there are usually 3 nurses and one charge nurse. They deal with patients as well as students, and they give treatment, education, draw blood, and more. One characteristic that the nurse said was important was being able to think on your feet. While visiting an elderly patient who needed her IV taken, 3-6 employees worked cooperatively to help the patient. These employees were 2 nurses, 2 EMTs, a firefighter, and a doctor. They used both informal and formal language to give directions and to calm the patient down. Safety procedures that I observed were using hand sanitizer, wearing gloves when touching a patient, placing pillows on either side of a bed so a patient will not fall down, cleaning skin with alcohol, and throwing a used needle in a specific container. In the ER I saw a patient with a severe tooth impaction, a lady with abdominal pain, an elderly woman who felt nauseated, a lady who had diabetes, respiratory problems, high cholesterol, and lastly a young boy whose stomach hurt while at school. 
    I learned that employees use different ways of speaking when talking to a specific age group. When talking to an adult, the employee uses common language to help the patient understand what is being said. When talking to a kid, however, the employee softens their voice to help calm the child down and make him/ her feel comfortable. A medical terminology term I came across while at the ER was 'ovarian cysts'. It means that ovarian cysts refers to a cystic tumor in the ovary. Skills I saw were an EMT student start an IV on an elderly lady. Although he messed up at first, I did get to see which vein he was trying to get on the elderly woman's hand. 
    Overall, I would rate my ER experience to be very good. I really liked how the employees were funny and at the same time very informative. Professionally, this will help me in the future if I go into the medical field and I end up working in the ER. I would be more familiar with the setting. Educationally, this is benefit me if I am asked questions about this particular department in college or other schools. Personally, this benefited me because now I know much more about the ER than I did before coming here.

L&D 2-25-13 &2-27-13

Learning Report:

What were your responsibilities this week?
On the both rotation days, I initially went to the L&D, however there were not any patients and the health care professionals advised me to go to Nursery. Nevertheless, I had the chance to work with three registered nurses and a neonatologist. I saw about five babies in the Nursery on Monday, and maybe three babies on Wednesday. I got to see how the nurse examines the newborn baby.
What new knowledge or skill did you learn this week?
I learned so much by seeing all the wonderful babies in the Nursery. I truly saw how little and susceptible these infants were. By working with a neonatologist and a RN, I learned how to do a newborn examination. In this examination, the baby's posture, reflexes, vital signs, and behavior are noted in order to diagnose any problems with the baby.
What was the best thing that happened at the unpaid work-based learning site this week?
The best part of the Nursery was seeing the babies and having the chance to actually hold a baby boy. They were very cute to watch, especially when the RN was examining them. I also found the the infant examination to be interesting. My partner and I also had the chance
What was the worst thing that happened at the unpaid work-based learning site this week?
Nothing bad happened at the Nursery during my rotations. All of the employees were very nice and informative. However, my partner and I did get a bit uncomfortable when she held the baby and it started crying. In the bright side, it stopped crying afterwards when the neonatologist arrived and stuck a pacifier in the infant's mouth.
This week was: Good
I enjoyed this department very much because the RNs I worked with were very informative and answered all my questions. I could really tell that they enjoyed teaching students. I also liked talking to a neonatologist because he informed me on a few good medical schools that I could look into.

This is how the nursery fairly looked like

Experience Record: 

Technology Observed: EKG, AK-NICU, Infant Warmer System, Incubator, Heartstand XL, AED Purposes, Pysxis Supply Station, Pyxsis MedStation 3500, Wellch Allyn thermometer, Alaris PC

Diagnostic procedures Observed: Neonatologists diagnose a baby with any problem by first doing an infant examination. This is similar to the physical examination an individual receives at the pediatrician. In this examination the health care professional checks the baby's posture, reflexes, vital signs, and behavior.

Therapeutic procedures observed: I did not see any treatment, but I did see a baby getting her first Hepatitis vaccine.

Diseases/disorders observed: In the NICU, one baby had been born prematurely and was underweight.

Medical terminology encountered: Vernix- skin cells that baby's don't shed, this looks like a white skin and it is usually found underneath the armpits or other folds of skin.

Experience Record: 

    When I first entered this department, I saw two rooms: the NICU, which was for sick babies, and the nursery, which was for healthy babies. On both my clinical days there were 4-5 babies in the Nursery and only 1-2 in the NICU at any given time. In this area, health care professionals, babies, and students like me are only allowed. Registered Nurses and one Neonatologist mainly work in this department. The babies each had their own crib and the newborns were placed in a radiant heat warmer to warm up their body to the correct temperature. The normal temperature for this warmer is 36.5°C (97.7°F).

    All of the health care professionals here are very social and informative. They must communicate well when talking to each other regarding the baby's condition and information. Furthermore, they must also know how to collaborate and work together as a team. Some safety procedures I observed was washing your hands and putting on gloves before touching a baby. The main reason for this is to avoid getting germs on the baby. Since their immune system is not fully developed, their body is susceptible to sicknesses. 

    I saw a neonatologist doing a infant examination on the baby. I learned that the certain postions a baby is in can indicate whether he/she has a physical problem. I also learned about the Mongolian spot that is a dark coloring usually found in specific areas on a baby's body. Usually this spot will fade as the baby's skin grows. However, it is imperative that the RN or doctor write on the chart indicating that such a dark coloring is a Mongolian spot. If not, people might begin to think it is bruising on the baby and this can lead to trouble.

    Overall, my experience was very enjoyable. Holding an infant was definitely a great experience. I would definitely love to visit the Nursery some other time and talk to the employees and see the babies. I really enjoyed working with the RNs and the neonatologist because they were social, funny, yet informative. Personally, this will help me in the future if  I am ever interested in pursuing a career in the Nursing field. Educationally, this will help me if I am in Nursing school because I have already been exposed to the general idea of what an RN or neonatologist does. And professionally, this will help me if I ever become a RN and work in the Nursery/NICU department of a hospital.

   

Respiratory 2-20-13

Learning Report: 

 

What were your responsibilities this week? 

This week I got to know the therapists that work in the respiratory unit.. I got to see a few  patients with different conditions in different units throughout the hospital for example, I saw someone that suffered from obesity in one unit and another person with Respiratory Distress Syndrome. 

 What new knowledge or skill did you learn this week? 

 I learned very much this week due to the great workers there, they taught me various things such as what Emphysema is and how the different machines operate and what their purpose plays in delivering medical care. 

 What was the best thing that happened at the unpaid work-based learning site this week? 

The best thing that I got to see was following a nurse and going to different rooms to visit patients. He also explained how he put in the IV while visiting a female patient. 

 What was the worst thing that happened at the unpaid work-based learning site this week?

The worst thing that happened to me was that on Wednesday, I had to wait for twenty minutes to meet up with an respiratory therapist, but thankfully, I was allowed to see a nurse try to put an IV into a patient later on. 

 This week was: Fair

In general, this week was very good because I got a fairly good insight into yet another department and learned so much in so little time. I am sure I would have gotten a better experience if I had went to the ICU for a second day.

Experience Record:

 

Technology Observed: BIPAP- This is the mask that is put on patients to deliver oxygen to them. PEEP- This is a function on a machine that uses air pressure to force air out of the lungs, at the end of the breathing cycle. CPAP- Is like PEEP except that it is continuous throughout the breathing cycle. Respirator- In essence, it is life support and aids in breathing by delivering air. 840 Vent System- Has different settings for different patients needs, for example if a patient is in surgery it does much work or very little if it is there for precaution. HI FLO- It is a blender that uses a nasal canula and is used more for patients with COPD(Chronic Obstructive Pulmonary Disorder). I also saw a pulse oximeter- measures blood pressure, oxygen levels, and heart rate.

Diagnostic/Therapeutic Procedures Observed: I saw how one would adjust the oxygen levels for a patient and also how a PEEP machine works for a patient. Also I was shown how medications could ease a patients effort in breathing. A pulmonary function is a test that is used to see how an individuals lungs work.

Diseases/Disorders Observed: COPD-A disorder that makes it even more difficult to breathe deeply, Hemoptysis- Coughing up blood (can occur from various things).

Medical Terminology/ Abbreviations Encountered: Pneumothorax- A hole in the lung, ABG- Arterial Blood Gases, COPD- A disorder that makes it even more difficult to breathe deeply, Adult Respiratory Distress Syndrome - Usually derives from other diseases, Emphysema- A disease that destroys lung tissue, Atelectasis- Pockets in the lungs collapse and it does not allow you to take deep breaths.

The ICU department is where the respiratory therapists are. This is how a patient room in the ICU fairly looks like.

 

Experience Journal:

 

    My initial assumption of the unit was it was very small and I later figured out that it was because they are always in different parts of the hospital attending to the patients needs. During my two days there I worked with several Respiratory Therapists, Jesus and Priscilla and Kim. They were all very kind and knowledgeable  about their career and everything incorporated with it, including machines and diseases. Their main duty is to help patients with breathing in different areas such as the ICU or Nursery. All of their equipment is specialized to help patients breathe according to their condition and how much assistance is needed. BIPAP- This is the mask that is put on patients to deliver oxygen to them. PEEP- This is a function on a machine that uses air pressure to force air out of the lungs, at the end of the breathing cycle. CPAP- Is like PEEP except that it is continuous throughout the breathing cycle. Respirator- In essence, it is life support and aids in breathing by delivering air. 840 Vent System- Has different settings for different patients needs, for example if a patient is in surgery it does much work or very little if it is there for precaution. HI FLO- It is a blender that uses a nasal canula and is used more for patients with COPD(Chronic Obstructive Pulmonary Disorder). I also saw a pulse oximeter- measures blood pressure, oxygen levels, and heart rate.

    The healthcare professionals all are very kind and do not hesitate to ask each other for help if they are unsure, because they all know the risks of doing something that you do not fully comprehend. They all have to know how to communicate with the different professionals of the hospital because they are always going around different units. The safety procedures they undergo are nothing more than the Universal Precautions of all hospitals because they do not put themselves in any immediate danger and are not subject to any hazardous areas or medicines. Some of the procedures I saw performed were: how one would adjust the oxygen levels for a patient and also how a PEEP machine works for a patient. Also I was shown how medications could ease a patients effort in breathing. A pulmonary function is a test that is used to see how an individuals lungs work.

    I learned a lot about how different diseases affect the lungs in their own unique way, some disrupting the breathing pattern and others destroying the actual lung tissue.Emphysema- A disease that destroys lung tissue, Atelectasis- Pockets in the lungs collapse and it does not allow you to take deep breaths. COPD-A disorder that makes it even more difficult to breathe deeply, Hemoptysis- Coughing up blood (can occur from various things).Pneumothorax- A hole in the lung, ABG- Arterial Blood Gases, COPD- A disorder that makes it even more difficult to breathe deeply, Adult Respiratory Distress Syndrome - Usually derives from other diseases, Emphysema- A disease that destroys lung tissue, Atelectasis- Pockets in the lungs collapse and it does not allow you to take deep breaths. Some skills I saw was the ability to work different machines. At first I was a bit overwhelmed when being introduced into all the machinery that they have to know how to use, but later when the showed me how they work them I saw that it takes a lot of training to be able to use the machines efficiently and and correctly.

    I greatly appreciate those that helped me at the unit and I found out that there is more to Respiratory than just breathing, I learned that it plays a large role in making sure the patients body is functioning properly and also that there are many more diseases of the lungs than I was aware of. From a professional standpoint, I would say that the RTs are no less important than any other member of the medical team and that it is a job that will always have you doing something.

OR 2-11-13 & 2-13-13

Learning Report:

 

What were your responsibilities this week?
On the first day, me and my partner were able to see a laryngectomy. This procedure involves the removal of the larynx and separation of the airway from the mouth, nose and esophagus.  On the second day, me and my partner was given a tour of the OR, and the different rooms.
What new knowledge or skill did you learn this week?
I learned so much by seeing the surgery. I was very surprised on how the larynx, thyroid, and other parts looked like in real life. I also observed the surgeon suturing the neck, which is a skill. I also learned about the variety of equipment necessary for this procedure.
What was the best thing that happened at the unpaid work-based learning site this week?
The best part of the OR was definitely seeing the laryngectomy. I was surprised how precise the surgeon had to be when cutting the patients larynx. The surgeons and nurses were very nice and informative.
What was the worst thing that happened at the unpaid work-based learning site this week?
The worst part of the OR was not being able to see anything on the second day of the rotation. However, we did get an orientation and got to see many OR rooms.
This week was: Good
Although Monday was a slow day at the OR, I enjoyed this department very much. Seeing the surgery interested me and I was able to see how organs look like in real life. Even though a lot of blood was involved, I am very happy I got to see a surgery. The employees in the OR were funny and informative as well. They were able to answer all my questions regarding the surgery. 

This is fairly resembles the way the OR room was set up during the laryngectomy procedure.

Experience Record: 

Technology Observed: Carefusion, Vasopress - operation light, ESP - Cine, Pyxsis Medstation 3500, Nitrogen Control Panel, Pyxsis Anesthesia System 3500, ConMed:ASPEN Medical Systems, Bovie- electrical intrument used for compressing specific places of internal organs, Covidien-a different type of Bovie, it compresses and coagulates

Diagnostic Procedures Observed: Before this procedure began, blood tests, XRAYs and urine samples may have been done to figure out the patient's condition.

Therapeutic procedures Observed: In order to treat the patient, surgery was done to cut out the patient's larynx. For this reason, the patient's neck was cut open.

Diseases/disorders Observed: The patient suffered from colonitis.

Medical Terminology encountered: Laryngectomy is a medical term that means removal of the larynx. Suture is also a medical word, and it means to stitch. I also got to see the thyroid, which is one of the largest endocrine glands.It controls how quickly the body uses energy, makes proteins, and controls how sensitive the body is to other hormones.

Experience Journal: 

    When I first entered one of the OR rooms, I saw many equipment and a long white bed. On the second day there were no patients having a procedure done, so me and partner recieved a tour of the OR. Other professions who work in the OR are surgical technicians, surgeons, anesthesia technicians, and OR nurses. As a whole the OR performs invasive or non invasive procedures on patients to fix their problem. Some equipment I saw during the surgery was the Bovie. This electrical instrument is for compressing specific places on the internal organ. In this surgery, the surgeon used the Bovie on the larynx. Overall, technology was extensively used throughout the surgery. Without the high technology we have today in hospitals, the surgery for laryngectomy would have been very dangerous and painful.

    The employees in the OR are very informative and communicate well with each other. This is important because communication is key, especially when a surgeon and surgeon assistant are operating on one patient. They need to be able to hear the other person's views on what to cut, what to suture, and so forth. The surgeon and surgeon assistant also wore a splash mask and PPE to avoid getting blood on their clothes. Overall, the laryngectomy was very interesting. First, the surgeon make an incision on the neck on the patient, revealing the bottom of the palate, nerves, larynx, thyroid, and other parts. Then he used the Bovie instrument to slowly slice the larynx off. Multiple times during the surgery, the sureon technician had to use the suction to irrigate or get water out of the area. In the end, the surgeon sutured the larynx and later stitched the patient's neck back up.

    First of all, I learned a lot just by seeing this gruesome surgery.  I learned that the surgeon had to be very precise when using the Bovie and when suturing the larynx. I also saw how the neck  parts in that particular area looked like. New medical terminology I learned was when the surgeon showed me and partner the thyroid, nerve, some veins, and the larynx.

    Overall, my experience was very good. I found the laryngectomy to be very interesting. I also enjoyed working with the employees there because they were very informative and answered all my questions. They were occasionally funny, too. Personally and professionally, this will affect me if I ever want to study in the surgery-oriented part of the medical field. And educationally, this will benefit me if I am medical school and I have to operate on the human body.