MHKH 3/6/15

MHKH 3/6/15

Responsibilities:

• Follow a nurse in MSU 7th floor.
• Help nurse take VS.
• Talk to patients and make sure they are fine.

New Knowledge/Skills:

• Learned about endoscopy
• Learned about a colostomy bag.
• Learned about new machine that helps take all VS in under a minute.

Best Things:

• Got to follow the nicest nurse there was
• Got to see the new machine
• Talked to some patients 

Worst Things:

• First nurse I talked to was very rude
• First patient I talked to didn't like me.

This Week:

The week was pretty good. The nurse was real nice and I kept the negative experience to a minimum. 

Technology:

A new machine arrived that helps measure all Vs in under a minute. There are lots of IV feeds and ventilators for the patients all throughout the unit. There was also a very large dialysis machine that was being used on a patient and a tech was there to maintain it and get some readings.

Diagnostic:

The MSU has several diagnostic procedures that they perform. One is taking VS on all patients to assure that there is nothing wrong with them. Another is using pain assessments to make sure that all patients are pain free and comfortable.

Therapeutic:

MSU also has a lot of therapeutic procedures that they perform to make sure a patients is healing quickly. If a patient is in pain then pain meds will be administered to make sure they are pain free. If a patient can't sleep they will most likely be given a sleep aid.

Diseases/Disorders:

The MSU cares for a wide variety of patients who have gone through surgery for some disease or disorder. Common infections are sometimes the reason that patients need surgery and stay in the MSU like lung infections like pneumonia and severe bronchitis. One that I saw was a patient with chronic kidney failure and they were getting dialysis treatment.

Med Terms/ Abbreviations:

NGO-Nongovernmental Organizations that help spread awareness of hospital borne illnesses. NPO- patient can't take anything by mouth. I&O- Intake and output.

I. Environmental Assessment:

7th floor MSU is a very nice and quiet place that looks exactly the same as other MSU floors. Nurses are bustling everywhere answering calls of all kinds. The nurse I was following was exceedingly nice. MSU provides care to patients who have just come out of surgery and are staying for more than a day. MSU uses EKG's, IV feeds, ventilators, dialysis machines, and AED's for any Code Blues.

II.Observation:

All nurses except for a few are very nice, especially the one I followed. Everyone here works in conjunction with one another to keep tabs on certain patients and other things and keep everything in check. Phone communication is needed if a nurse is in a patient's room and verbal communication is used if nurse are near each other. Safety measures that are taken are having fire exits and hoses, making sure nothing blocks the exit, and keeping a crash cart nearby if it's needed. Therapeutic Procedures- administer pain meds, sleep aids, make sure patient is comfortable. Diagnostic- keep track of patient vitals, check med prescriptions, check the procedures done, and check overall well being.

III.Knowledge:

Learned about an endoscopy and how it checks the digestive tract. Learned that it is important to communicate with patients to make them feel comfortable, especially if you speak their native tongue. Soem med terms and abbreviations were thrown around here and there. NGO- nongovernmental organization that informs of hospital borne diseases. NPO- patients can't take anything by mouth. I&O- Intake and output. NKDA- a patient is NKDA if there are no known drug allergies.

IV. Evaluation:

7th floor MSU is really nice because most of the nurses care about teaching a student. I thought that my nurse was the greatest person I had met there. I really learned a lot from her too. The 7th floor is a good plave to learn about post operative care and procedures that have been done. It's full of chances to practice effective communication and other skills.

MHKH 2/27/15

MHKH 2/27/15

Responsibilities:

• Go to ER
• Follow a nurse there
• Make sure a patient was comfortable
• Bring said patient blankets

New Knowledge/Skills:

• Learned that EKG's can help determine if a patient is getting better or worse
• Learned how to evaluate those measurements
• Learned what problems are indicated by the measurements.

Best Thing(s):

• Got to see a patient with some severe head trauma.
• Got to see EMT's bring in another patient afterwards.
• Got to see evaluation of the site of injury.

Worst Thing(s):

• First nurse I met really didn't look like he wanted me around
• Had to wait forever to see any real medical emergencies
• Patient went in for a CT scan and I didn't get to see the results.

The week went pretty well overall. I got to see a patient who needed care, learned a few things here and there, and helped out as best I could.

Technology:

The ER uses a lot of different technology to keep patients in stable condition and monitor their status. EKG's are everywhere to monitor a patient's vitals. There is a a crash cart with an AED for emergency use. There is also a portable x-ray machine to be used around the department.

Diagnostic Procedures:

The ER performs a large amount of diagnostic procedures to evaluate patients. Vitals are constantly recorded to make sure there is no change in a patient's condition. X-rays are taken to check for fractures and and breaks. EKG readings are examined for any sort of change.

Therapeutic Procedures:

The ER also has a lot of therapeutic procedures to keep a patient calm and stable.

Pain medications can be administered to reduce pain. Local anesthesia can be used to numb the site of the injury. Oxygen can be administered to patients who may have lung issues.

Diseases/Disorders:

There are a lot of different injuries and diseases that go through the ER. There was a woman who came in after an accident at work with some severe head trauma. There was a woman who came in with COPD and came in saying that she could barely breathe.

Med Terms/Abbreviations:

The ER is usually full of medical jargon that some people may not understand.  COPD- chronic obstructive pulmonary disorder is a disease in the lungs in which prolonged damage, like from smoking, makes it increasingly difficult to breathe. Head trauma is any injury to the head, scalp, or brain. BAC- blood alcohol concentration which shows the amount of alcohol running in the blood stream.

I. Environmental Assessment:

The ER is shaped like an oval so that all patients are in the vicinity of the nurses at the nurses station in the middle of the room. The place smells like sanitizers and cleansers of all sorts. There is also the smell of thin mint cookies because the department just got a delivery of those.  There is the constant sound of an EKG going and footsteps here and there. The staff was rather unresponsive to my arrival, especially the nurse who was to supervise me. The ER provides emergency care to patients based on the level of injury that is present and how many other patients are in. The ER is equipped with IV feeds, EKG's, portable x-ray machines, and ventilators.

II. Observation:

The people who work here are constantly busy and it didn't really surprise me when they ignored my presence after entering the ER. They all work well together and communicate rather effectively because of the size of the room in which phones aren't needed to communicate. They handle one job if it's too big or take turns sharing the work. The ER has a crash cart in case of an emergency, fire extinguishers if there is ever a fire, and several fire exits for precaution. The ER has diagnostic procedures that consist of taking vitals, evaluating EKG readings, checking patients charts and injuries, making sure what medications are needed. Therapeutic procedures that occur are administration of pain medications, local anesthetics, and other things to make a patient feel comfortable.

III. Knowledge:

Learned that EKG readings can help determine a patient's condition and if that condition is bettering or worsening. Learned how it is that the condition is determined from the readings. Leaned that there was a patient with head trauma who may have been going into shock because she felt cold constantly. I learned that the patient who came in with COPD also had a relatively high BAC.

IV: Evaluation:

I think the ER is a great place to learn all sorts of skills because of the wide variety of medical cases and injuries that come through. The department is full of knowledge and learning experiences every day. It really teaches a person how to deal with a stressful situation and teamwork in this kind of environment. I hope everyone has a chance to see something relatively crazy here.

MHKH 2/13/15 and GC

MHKH 2/13/15

Responsibilities:

• Find and follow a physical therapist.
• Observe a patient receiving physical therapy.
• Get equipment for the physical therapist.

New Knowledge/Skills:

• Learned what a physical therapist does
• What a whirlpool is used for
• Learned that some of the staff are students in training
• There is an on-site interpreter for patients

Best Thing(s):

• Getting to see therapy be done
• Actually doing something after having done nothing
• Being the interpreter for a patient while the on-site interpreter was on their way.

Worst Thing(s):

• Had to wait for the physical therapist to show up
• All other therapists were busy or students
• Not being able to see the finish of a procedure.

Overall:

The rotation got off to a rocky start as most of the therapists were busy but once the head therapist cleared up I got to see a procedure be done.

Technology:

The physical therapy room has many different machines for exercise and therapy. There are treadmills, elliptical machines, dumbbells, and other equipment. There is also a whirlpool bath for wound and burn care so that blood gets flowing and infections are prevented.

Diagnostic:

The physical therapy room performs a lot of diagnostic procedures to make sure a patient is making progress. Therapists will check on a patient's level of pain, chart any progress they've made, keep track of recommended exercises, and other things. Therapists will also check for certain vital signs like pule and respirations.

Therapeutic:

since it's the physical therapy department there is a lot of therapies going on. There is strength training using dumbbells, treadmills, and gait belts. There is speech therapy that goes on in another area of the room and next to that is training in doing simple ADL's. The whirlpool helps treat burn/wound care victims.

Diseases/Disorders:

The therapy department deals with a lot of different diseases and disorders and I got to observe some. As I was entering there was a burn care patient who was just finishing therapy with the whirlpool. There was also a patient who come in with a broken  leg who was doing some gait training and crutch exercises.

Med Terms/Abbreviations:

The therapy department doesn't really use that many med terms or abbreviations but there were a few I heard here and there. Supine- laying on the back. Abduction- laying on the side and lifting arm and leg. Brachial Plexus- a network of nerves that runs from the spine and when injured can cause shoulder disabling injury.

I.Environmental Assessment:

The therapy room is a rather large one with a lot of exercise machines around the room. It smells quite clean and there is a faint sound of music coming from the therapist desk in the center of the room. There are windows in the room to let natural light in and make the atmosphere less like a hospital. The staff is rather unresponsive to me entering as they are either busy or telling me to look for the head therapist. There are a lot of treadmills, elliptical machines, dumbbells, and a whirlpool.

II. Observation:

The staff is pretty busy but for the longest while they kind of just shrugged me off. As a unit, everyone works well together from what I observed. The room is sized just enough that therapists can communicate back and forth without phones. There are a lot of safety precautions like a fire exit and extinguisher, safety releases on certain machines, and therapists making sure a patient doesn't get hurt. Therapeutic services offered are strength training and muscle reconditioning, gait and crutch training, speech therapy, and ADL therapy. Diagnostic procedures taken are charting and checking a patient's progress in therapy, taking Vital signs like pulse and respiration.

III. Knowledge:

While in the unit there wasn't much hands-on things I could do. I was able to get some equipment for therapy though. A few words I learned were, supine, abduction, and brachial plexus. Supine- laying on the back. Abduction- laying on the side and lifting arm and leg. Brachial Plexus- a network of nerves that runs from the spine and when injured can cause shoulder disabling injury.

IV. Evaluation:

I personally feel that the department has it's work cut out, but it should really be more student friendly. I get that the therapists are at work but I'd at least like to follow someone. The professional experience that can be gained here is extensive as one can learn how to communicate with both patient and coworker. For someone interested in becoming a physical therapist, this is the place to go.

GC

Social workers handle a lot of the behind-the-scenes work at the nursing home and are constantly being called about some kind of complaint that arises. Gerontology- the study of the aging population and physical, psychological, and environmental factors that affect them. Geriatrics is the work that is done on the aging population in the medical field. Geriatric medicine looks to treat the elderly and research on factors that cause faster aging in one person than the other. The scope of work that can be done in geriatrics is very large as it encompasses many fields of study and medicine.

MHKH 2/6/15 and GC 2/9/15 and 2/12/15

MHKH 2/6/15- Pharmacy Department

Responsibilities:

• Go to the Pharmacy and learn from a pharmacist.
• Followed a pharmacist around and learned different sections of medications.
• Had to help label and seal insulin pens.
• Had to help package some Ipratropium Bromide to send to other departments.

Knowledge/Skills:

• Where certain medications are located based on department and use.
• Certain medicines are marked with stickers to indicate their use and department.
• Learned how to identify the stickers.
• Learned how a pharmaceutical dispenser works.

Best Thing(s):

• Got to help around the pharmacy.
• Got to see different medications.
• Got a chance to get some questions answered.

Worst Thing(s):

• Things slowed down after a bit and there wasn't much to do.
• The first pharmacist I was with was rather unresponsive to me being there and asking questions.

Overall:

This week was pretty good, the rotation itself went smoothly and I got to learn some stuff while there.

Technology:

Some of the technology I observed in the pharmacy was a pyxis cube which dispenses the needed medications into a sealed tray and can be delivered afterwards. Another was a fridge that keeps certain medications cold so that their effectiveness doesn't ware off. They have a lot of computers and printers that receive orders and are used for charting  medications.

Diagnostic:

Some diagnostic procedures that the pharmacy department engages in is taking inventory of medications and filing them in the appropriate section. They also have to fill out orders and keep track of what comes in and goes out. They also check that orders are correct before sending them out.

Therapeutic:

The pharmacy provides medications that are used in the therapeutic treatment of a patient. They provide pain relievers that are self explanatory and are used on many departments. They also provide tranquilizers that will help keep a restless and aggravated patient calm.

Diseases/Disorders:

The pharmacy has a wide variety of medications for patients with different diseases and disorders. One of the most common orders received is for insulin which helps diabetics control their blood sugar. Another is anti-depressants for patients who suffer from depression. And another is nitroglycerin for heart problems.

Med Terms/Abbreviations:

Rx- this is a symbol for the Latin word recipe, which means to take. Ipratropium Bromide- a nasal decongestant that is used to relieve a runny nose. Albuterol-used to treat and decrease asthma and increase airway volume.

I. Environmental Assessment:

The pharmacy is a well sized and very clean. It's kind of quiet here all the time. It smells like Lysol and other nice smelling things. There are shelves stacked high with medications of all sorts, each put into a section that corresponds to it's use. Everyone here is hard at work but they all take some time to joke around and there is a feel of friendliness. Some of the technology used here is a fridge to keep medications like insulin cold, there is a pyxis cube to dispense medications to be sent to other floors, and a crash cart with emergency medications. There are also computers everywhere to chart medications coming in and out and receiving orders.

II. Observation:

Everyone in the pharmacy is on their feet and working all the time. They will definitely talk and joke and gossip but they do it while working. The size of the department makes it easy for them to communicate without need of a phone. Diagnostic procedures that are performed are checking inventory, stocking shelves, checking and delivering medications, and keeping records of what comes in and goes out. Therapeutic procedures that some of these medications are used for is treating allergies and cold-like symptoms, treating high BP, using nitroglycerin to treat heart problems, and using insulin on diabetic patients.

III. Knowledge:

I learned about the organizational system that the pharmacy uses. I also learned how to label certain medications with a sticker when it is outgoing. The abbreviation Rx is short for the Latin word "recipe" which means "to take". Ipratropium Bromide is a drug that treats allergies and a runny nose. Sucralfate is a drug that treats ulcers and other stomach issues.

IV. Evaluation:

I personally think that this department is a great place to learn more about what medications are used to treat patients and their conditions. The department is a paradise for anyone who is OCD with all the strict organization that goes on. I also feel that the pharmacy offers an inside glimpse into what it's like to some of the most needed people in the hospital. I feel that it is a good rotation to go on.

GC 2/9/15 and 2/12/15

This week I rotated back to LTAC to do some activities with some of the residents, but first of all we had some work to take care of. After that we got right to spending time with patients. The patients and us students feel that these activities help us all bond and become closer, I just hope we can do this again some time.

MHKH 1/30/15 and GC 1/29/15

MHKH Report

Responsibilities:

• Go to Cardiopulmonary Dept. and follow a nurse or respiratory therapist.
• Went to ICU with RT, was instructed to take a few vital signs.
• Learned about ventilators and different types.
• No more to do with RT after a few patients so I went with another ICU nurse.
• Nurse had me check if feeding tubes were working.

New Knowledge/Skills:

• Learned about a CBC or complete blood count.
• Learned that Cardiopulmonary Dept. works very close with ICU.
• Learned how to check if a feeding tube and ventilator are working and it was freaky.
• Learned about an ethics case in ICU.

Best Thing(s):

• Got to take some vital signs.
• Learned how to check feeding tubes and ventilators.
• Got to see an x-ray of a patient.

Worst Thing(s):

• The RT had nothing else to do so I couldn't keep learning from him.
• Seeing the ethics case.

Overall:

The rotation was pretty awesome because of all that a person gets to see and learn from both Cardiopulmonary and ICU. It was a great week.

Technology:
The ICU has a lot of ventilators and feeding tubes that are going on  most of the patients. There is a crash cart that is in the center nurse station just in case a patient flat-lines. There is a plethora of EKG's all around the department. There was a portable x-ray machine on the department.
Diagnostics:
The RT deals with a lot of ventilators and making sure that they work and that they are used properly. He and the nurses monitor vital signs, check medications, and constantly check up on the patients.

Therapeutics:
If a patient gets restless or agitated when a ventilator is being put in they will be given sedatives. Medications are also drip fed to patients who are asleep or sedated. If a patient is about to pass away then the nurses make sure they are as comfortable as possible.
Diseases/Disorders:
There was a patient who was a long time smoker who just happened to have contracted pneumonia. There was also a patient who was in the ICU with COPD or chronic obstructive pulmonary disease.
Med Terms/Abbreviations:
A few that I heard were  CBC or complete blood count which counts all white blood cells, red blood cells, and platelets in the body as a test to see if there is an infection due to higher white blood cell count. Another I encountered was a PEG or percutaneous endoscopic gastrostomy which is pretty much a feeding tube for a patient.

I. Environmental Assessment:
The Cardiology Dept. on 1st floor seems kind of small but it feels comfortable. There is the hustle and bustle of some nurses here and there. The nurse I talked to said that the department was actually really slow and since RT's work under the CP department I was sent to an RT in the ICU. The whole ICU was alive with electronic buzzing from EKG"s and ventilators.The place smelled of sanitizer. There is a cleaning crew around the clock to ensure that the environment remains sterile. The RT was really cool and nice and the nurses were also great. ICU provides care for patients in critical condition, keeps them under close surveillance, and checks on patients every 15 minutes to an hour. The ICU uses EKG's, ventilators, feeding tubes, drip feeds, and crash carts just in case.
II. Observation:
The RT and Nurses are rather formal people, but nice nonetheless. They get in, work on a patient and then they are out. New machines and equipment is coming in and the whole department is excited. The staff is quiet but they all work very well together. Phones are used often if something is needed from pharmacy or any other department. There is a fire door just in case and an extinguisher. There is a crash cart within the vicinity of every room if it's needed. Therapeutic services offered are sedation for restless and agitated patients, medications to stop pain, and a patient who is close to passing will be made as comfortable as possible. Diagnostics that are performed are checking ventilators and feeding tubes to make sure they all work properly, taking vital signs on patients every 15 minutes to an hour, and check medications.
III. Knowledge:
On the unit I actually learned a lot about ventilators, what they're used for and when. I learned how to check if a ventilator and feeding tube are in properly by using a stethoscope to check if the ventilator can be heard in the body and the feeding tube as well. Some abbreviations  learned were CBC or complete blood count that measures both white and red blood cells and platelets and how white blood cell count indicates an infection. There was also PEG or percutaneous endoscopic gastrostomy which is a feeding tube. New learned skills were learning how to check that a ventilator and feeding tube were all in place.
IV. Evaluation:
Overall this unit was a really cool and educational unit that was pretty hands on with the RT.I think that the way that CP works closely with ICU is a great thing because it gives us more options on who to follow and what we can learn. This unit is an awesome place to learn how to deal with certain patients, their needs, end of life needs, and ethical cases.

GC 1/29/15

The LTAC is associated with several Federal Government programs like the Older American Act which made the government put some more focus on the aging and elderly community to comprehensively provide care and other services. There was also the Omnibus Budget Reconciliation Act of 1987 which was also known as The Federal Nursing Home Reform Act that was to provide protection of patient's rights in a nursing facility and regulated Medicare's participation in the nursing home. It makes sure that no patient is given more medication than needed and that anti-psychotic medications are given to patients who truly need them. In some cases an ombudsman is assigned as a public advocate who is assigned by the federal government to seek out instances of maladministration and violation of patient's rights.

MHKH 1/23/15 and GC 1/22/15

MHKH 1/23/15

Responsibilities:

My responsibilities this week were to learn from my supervisor in Administration and learn what really goes in the business office. I observed the process of charting a patient's information into the hospital database, what type of system is used, how to chart that info down, how to find the patient in the lobby and how to attend to them, and how to send the info to the department the patient is gong to.

New Skills/Knowledge:

I learned that when a patient's information is done being accounted for that the info is then sent to the department i which the patient will be in. My supervisor taught me to always bring a snack because you get to the office at 5 am and lunch break isn't till around 10 or 11 am. I also learned that there is a whole library in the back office with physical records on patients. Right now the whole administrative office is working on digitally filing both those files and insurance info.

The Best Thing(s):

• I got to see a patient's info be registered.
• How that registration works.
• How it's sent to the departments
• How ridiculously old the system is.

The Worst Thing(s):

• The first person I was supposed to be with left for break 5 minutes after I got there.
• After the height of excitement I had learning charting things got slow.
• There was like 10 minutes of awkward silence before the rotation ended

The rotation went rather well. The office isn't the best place to learn medical information, but it's a pretty good place to learn soft skills and communication skills.

My Experience In: Administration

Technology: 

The technology in the administrative office ranges from everyday office technology to advanced patient recognition system and even an old charting system from like 20 years ago. The office stuff is printers and computers, the really cool technology is the palm scanner that reads a patient's palm and registers them into the system for future reference so all they do is scan and all their info pops up. There is also a tablet-like computer that they use to have patients sign documents. The system that is used to register all the info looks like something out of an 80's movie, it is REALLY old.

Diagnostic Procedures:

The office doesn't really perform diagnostic procedures but my supervisor said that  the diagnostic procedures that patient's come in for the most is diagnostic surgery, cardiology, and radiology. The only diagnostics the office performs in running tests on the computers.

Therapeutic Procedures:

The office also doesn't deal with therapeutic services personally but most therapeutic services that patients come in for are in rehab. This usually happens after a patient comes in from another doctor and is recommended therapy here. Other therapeutic procedures that pop up are cancer treatments and checkups.

Diseases/Disorders:

My supervisor told me that the office gets a lot of  patients who register with different diseases. She said that the most common was disease that she registered was a cardiovascular disease. Some others are cancer and lung diseases.

Med Terms/ Abbreviations:

The office isn't full of medical chatter so it's hard to hear any medical terms or jargon. A few words I encountered were PPO and HMO plans that the hospital offers. PPO is short for Preferred Provider Organization and HMO is short for Health Maintenance Organization.

Other Info:

Medicare records must all be digitally recorded upon patient consultation and all this year from the physical records. If that info is not recorded a letter must be sent to the insurance provider telling why the info wasn't registered and the hospital could be fined for that.

I. Environmental Assessment:

The office that I was in was clean and organized despite the amount of paper info that is being registered. It smelled like garlic bread, which was nice. The office is small but comfortable. The people who work here are nice but they don't really have time to talk because of all the work that goes on there. The administrative office provides record keeping services and registration of patient info. The office uses a computer to electronically chart the info and the system it runs on is very old.

II. Observation:

 The personnel here is all about the business. They move quick and communicate using as little words as possible. The offices have one individual each who processes the patient's info but there is teamwork to be shown when one employee leaves for break and another takes over her patients. The office has 2 exits in case of fire, the front door and the door that leads to the back office. Every computer is locked to a certain employee's username and password. The staff shows effective communication when the front office sends a notification to the office which gives a physical description of the patient so that finding that patient is easier.

III. New Knowledge:

There isn't really any formal degree required to work in the business office. Some employees do have a medical assistant's degree. It also takes a lot of familiarization with the system that is used to chart info. The system is old but the office is hoping to upgrade once all the construction is done. The only med terms I heard were HMO and PPO.

IV. Evaluation:

The business office is a really good place to learn how the hospital is run from the inside. You learn a lot about computer charting, patient registration, soft skills, and how to handle patients. The office has a lot of educational and professional values to learn from. There is always something to learn from charting and other office practices. There is also lessons in professionalism to be observed in the staff's behavior, efficient communication, and system of record keeping and teamwork.

GC 1/22/15

This week I was in the LTAC unit and it was pretty interesting. For once we had a nurse who seemed genuinely interested in teaching us and letting us do something medically related. We were able to take blood oxygen levels from a few  patients and learn how to do it and what levels are normal for most patients. If there were any abnormalities we were told to report them. After that we asked if we could do anything else and the nurse asked us to go check the beds and make sure that the alert button was on each patient's beds. Afterwards we went off and talked to some of the residents, and I know that we made their day just stopping by and talking with them for a while.

MHKH 1/9/15

Kevin Mendoza

L&D

1/9/15

Report:

Responsibilities:

I didn't really have any responsibilities on the job due to the fact that literally nothing was happening that day. I hate that this sounds like an excuse but even the nurses told me that the floor can be very slow on certain days.

New Skills/Knowledge:

I really didn't learn anything new or practice anything on my rotation, but I got the chance to see a patient come in before I left the department.

Best Thing(s):

• A patient came in before I left.
• The nurses chatted with me about stuff that happens on L&D.

Worst Thing(s):

• I didn't really get to see much of anything.
• The patient came in a little before I left.
• I couldn't chat with the nurses for long because they were filling weekly reports.

All things considered, this week was rather fair.

My Experience:

Some of the Technology I was able to observe while at the hospital was EKG's, AED"s, and some of the inner-hospital cell phones. I think the most interesting piece of technology I saw was the entire setup they had to constantly monitor all of a patient's vital signs and have it on the nurse station computers.

As for Diagnostic Procedures, there weren't any that I was able to observe. The closest to a diagnostic procedure was hearing an EMT come up to the floor explaining that the woman was in labor.

Another thing I couldn't observe were therapeutic procedures. Though I did hear some of the nurses talk about giving her some pain medication to help, if that counts as therapeutic.

I didn't really get to hear the nurses mention many diseases but I did hear one. Metabolic Respiratory Acidosis is an accumulation of CO2 due to decreased respiratory rate, hypoventilation, or both. This can occur in the mothers during labor and should be monitored for.

As with the diseases the most I heard the nurses mention in terms of abbreviations was BD. Base Deficit (BD) is a lack of base in the blood. Base being either lactic acid or some other component in blood.

I. Environmental Assessment:

The department smells clean, like hand sanitizer (faintly), it's a very quiet environment. Nurses are very kind, quiet, and patient with one another and myself. L&D provides labor and delivery service for mothers who have gone into labor. The floor has EKG's. BP cuffs,a crash cart, a charting station, and AED's. The technology used is mostly EKG monitors and other monitors for BP and respiration that link to the nurse station computer.

II. Observation:

The nurses are the only people besides myself on the department at the moment. They are all very calm, quiet, and attentive. They've been working together to help finish the weekly report and they are also helping plan one of the nurse's weddings. They communicate between each other very effectively and rarely have to repeat themselves. I saw that if one nurse left the other took charge over her station for a while. The charting stations are kept behind the nurses station so that if a patient is rushed in there will be no obstacles. I didn't get the chance to see any diagnostic or therapeutic procedures while I was there.

III. Knowledge:

Due to things being slow on the department I didn't get much chance to learn many new med terms or abbreviations but I did learn some. I learned about metabolic respiratory acidosis and base deficit (BD). Metabolic respiratory acidosis is where CO2 builds up as there is a low respiratory rate, hypoventilation, or both. This could happen in a mother in labor and could be deadly. Nurses monitor each patient for this and also BD. Base deficit (BD) is a lack of base in the blood which could lead to some complications in the future. As for skills, none were really learned on the job.

IV. Evaluation:

To be honest, there wasn't much to do on L&D but I will admit there is potential for a great learning experience. I think we would just have to come back another day and see if it was busy that day. The floor is definitely a good learning environment but again, a busier day is required. It's also a good place to learn how to be professional about trying to control the situation if a mother has labor pains or if something goes wrong and rectifying that situation by getting someone else with greater knowledge on the subject. Hopefully the next time someone is there it will be busier.

GC

Grace Care this past Friday was pretty great in my opinion. Nick and I were in Dining where we had never been before. We started off by going into the kitchen and asking what it was that we could, but we weren't allowed in the kitchen because the supervisor doesn't allow anyone under 18. So instead we helped set up tables with napkins and we learned the proper folding technique. Afterwards we went all over the center giving snacks and learning what some residents liked and others didn't. It was actually pretty cool. When we were done we had nothing left to do as we had finished up with some time to spare. We were then rewarded with some ice cream and choco-tacos. It wasn't the food that made it a great experience but rather the time we spent with the patients. Hopefully we get that rotation again.