(0750) Today starts the first day of leadership and about 6 weeks in counting til graduation. This morning I have set up an "online blog spot." It is to shift from modern day journal writing to a modern online paper-less format. I believe it will suit the professors and students in this modern era. The internet itself and computers can be used in such unique and interesting ways.
Right now, I am at the Miami Heart Institute waiting for the orientation so that we may receive our hospital ID bages to begin working.
(2040) Today was a very productive day. Professor Walker assigned me to the 5th Floor (Med Surge/ Tele/ Oncology) at Mt. Sinai. I was introduced to a nurse who really iunspired me to learn. She gave me an over view of the floor and how she organizes herself. Just like every nurse has their way of working, we all must find our way. To provide comfort and ease. I was assigned about 4-5 patients. Aside from taking vital signs such as blood pressure, heart rate, respiratory rate, temperature and pain. I also took the blood sugar level of one of the patients. These skills helped me refresh. I also took into consideration the amount of time I've placed into clinical hours and realized how much I've learned as well realizing how much confidence I've gained.
One of the patients came in with SOB and had a history of CHF. She was scheduled for placement of an AICD. (http://www.heartonline.org/defibrillator.htm) Before the procedure her BP was taken twice. The reading were 100/80, and 90/50. Nontheless she returned after surgery and her VS were scheduled q15 min x 1 hour. On two of the readings her Bp was 90/50, and again 90/50 and she was asymptomatic . One of the Doctor's came in and told the nurse to give the pt Lasix and morphine stat.
Upon receiving the order the nurse questioned. She was concrned that giving Lasix could lower the BP to a point of shock. She asked the council of two other nurses and they told her to question the Doctor. The Doctor said that it was for the pulmonary edema, which she did not detect on her assessment. Then another Doctor came in and assessed the pt. After a thorough assessment, also taking BP (110/80) and assessing lung sounds this Doctor who was taking care of the pt told the nurse to hold the medication and to not give it. This experienced served me very well in distinguishing when is the right time to question an order. It taught me the importance of knowing my medication before administration. Most importantly, we are advocates and responsible for the health of our patients. We must make sure we know what we are doing and of course question and reconsider when we realize that the pts life and/or health is in jeapordy. Over all, the clinical day taught me various things. The one important lesson I earned today is that you can never be a complete robot and "following orders." It is always better, if insecure, to ask questions to reassure yourself as well as corrolate information to enhance not just your education but the pts as well.
Right now, I am at the Miami Heart Institute waiting for the orientation so that we may receive our hospital ID bages to begin working.
(2040) Today was a very productive day. Professor Walker assigned me to the 5th Floor (Med Surge/ Tele/ Oncology) at Mt. Sinai. I was introduced to a nurse who really iunspired me to learn. She gave me an over view of the floor and how she organizes herself. Just like every nurse has their way of working, we all must find our way. To provide comfort and ease. I was assigned about 4-5 patients. Aside from taking vital signs such as blood pressure, heart rate, respiratory rate, temperature and pain. I also took the blood sugar level of one of the patients. These skills helped me refresh. I also took into consideration the amount of time I've placed into clinical hours and realized how much I've learned as well realizing how much confidence I've gained.
One of the patients came in with SOB and had a history of CHF. She was scheduled for placement of an AICD. (http://www.heartonline.org/defibrillator.htm) Before the procedure her BP was taken twice. The reading were 100/80, and 90/50. Nontheless she returned after surgery and her VS were scheduled q15 min x 1 hour. On two of the readings her Bp was 90/50, and again 90/50 and she was asymptomatic . One of the Doctor's came in and told the nurse to give the pt Lasix and morphine stat.
Upon receiving the order the nurse questioned. She was concrned that giving Lasix could lower the BP to a point of shock. She asked the council of two other nurses and they told her to question the Doctor. The Doctor said that it was for the pulmonary edema, which she did not detect on her assessment. Then another Doctor came in and assessed the pt. After a thorough assessment, also taking BP (110/80) and assessing lung sounds this Doctor who was taking care of the pt told the nurse to hold the medication and to not give it. This experienced served me very well in distinguishing when is the right time to question an order. It taught me the importance of knowing my medication before administration. Most importantly, we are advocates and responsible for the health of our patients. We must make sure we know what we are doing and of course question and reconsider when we realize that the pts life and/or health is in jeapordy. Over all, the clinical day taught me various things. The one important lesson I earned today is that you can never be a complete robot and "following orders." It is always better, if insecure, to ask questions to reassure yourself as well as corrolate information to enhance not just your education but the pts as well.
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