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.