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.