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.

Radiology 2-4-13 & 2-6-13

Learning Report:

What were your responsibilities this week?
This week, I worked with 3 radiology technicians and observed them for two days. I saw a variety of people get x-rays the second day and learned many things about radiology and procedures the first day. I visited the PACU and got to see an x-ray being done on a patient who was unconscious.

What new knowledge or skill did you learn this week?
I learned that the radiation from x-rays can cause cancer and lead aprons are used to prevent that. I saw pictures of X-rays  and learned how the radiologists are able to tell what is wrong with the patient through the coloring and shapes present in the body. The patient has to have an X-ray taken from different angles, because the injury may show from one angle, but not the other. I learned about various diseases that can be discovered through X-rays.

What was the best thing that happened at the unpaid work-based learning site this week?
The best thing that happened at Radiology was that I had an opportunity to see how X-rays are done and that was actually very interesting! The employees were also very kind and informative, so I learned a lot in this area of the hospital!

What was the worst thing that happened at the unpaid work-based leaning site this week?
 The worst thing that happened was that on the first day, I had to wait a while in the tech room before a radiologist technician actually showed up. But when one of them showed up, I began to learn a lot and it made up for the few minutes of waiting.

This week was: Good
I got a majority of my task sheet complete and got to see many people get x-rays. The week always goes fantastic when I learn a lot! Also, the employees made everything fun to learn!

Experience Record:

Technology observed: X-ray, Fluoroscope, MRI, CAT scan, computers, printers
Diagnostic procedures observed: MRI, X-ray, CAT scan
Therapeutic procedures observed: MRI, X-ray, CAT scan
Diseases/disorders observed: colonoscopies, pneumonia
Medical terminology/abbreviations encountered: Cholecystogram, mammogram, radiology

Learning Experience Journal:

  When I walked in, I was directed towards the tech room where most students wait. There was a lot of technology everywhere. Int he X-ray room, there was a corner where students stand so they aren't effected by the radiation. The employees I worked with were radiology technicians, so they took X-rays of the patients and observe the X-rays. The radiologist then comes and determines what is wrong with the patient. The entire facility answers phone calls, collects X-rays into their computer for the radiologist to see, interact with the patient and perform procedures necessary to determine the injury or disease. Equipment used in radiology are lead aprons to prevent radiation. Technology utilized includes X-rays, MRI's, CAT scans, Fluoroscopy which is a video, computers that are touch screen and printers to print pictures and reports.
  I observed how the radiology technician puts the lead aprons on the patient and how the patient has to turn to different angles to get the x-ray. The health care professionals were very kind and informative to the patient and to me as well. They all had great teaming skills as they worked together on one patient if there was a problem. They communicated very informally with each other though, but around the patient they were very sophisticated. Safety procedures include wearing a lead apron for protection against radiation. After taking the X-ray, the radiologist can determine what is wrong with the patient and can diagnose them with a disease or injury.
  The radiologist actually have an important job and need to know their anatomy really well. I learned about air bubbles in the lungs, how they x-ray is done, when to know if the gallbladder needs to be removed, how to know if the patient has pneumonia, and about various breaks of the bone. Medical terminology I encountered includes radiology- ology being the "study of", cholecystogram- cyst, mammogram-mamm. I learned how to position the patient who is present for the x-ray.
  I really enjoyed radiology and the employees made everything fun to learn! It does seem pretty interesting to me and I may look into this career. If I decide to become a radiologist or a radiology technician, my experience in this area will help me know what to be prepared for. If I am asked about anything in radiology, the information I have learned will help me answer the questions and I now know how the area functions.

This is an  X-Ray of a patient's rib cage

Emergency Room 1-28-13 & 1-30-13

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.