Med Surg 5th Floor- February 13th

Report

What were your responsibilities or duties this week? 
   My responsibilities included being professional and observing the nurse I was following. I was to be respectful and considerate to the staff and patients.
What new knowledge or skill did you learn this week?
   I gained new medical terminology while in med surg. I also got a better understanding of what goes into charting.
What was the best thing that happened at the unpaid work-based learning site this week?
   As dumb as it might seem, my favorite part of this rotation was a chart. Med Surg has this little customer service and each time a staff member gets a good report, they get a little gold star. It's like the good noodle chart, but professional and childish (which are probably two words that shouldn't be in the same sentence.
What was the worst thing that happened at the unpaid work-based learning site this week?
   If I had to pick a worst, it was probably the patient's daughter during one of the injections the nurse was doing. She gave me this whole lecture on the importance of hand washing, her mom's past medical history, what I should look forward to as a nurse (which isn't what I want to do) and her opinion of the hospital. I was thoroughly uncomfortable, and just nodded my head and smiled, watching what the nurse was doing.
If the "worst" was a mistake, how was it corrected?
   I could have been nicer about it and actually held a conversation with the daughter. In my defense though, she was being very hard to be conversational with talking about her mom getting hit by bus and how well I should be washing my hands so I could be like the nurse I was following.
This week was FAIR. Why?
    Well aside from the fact it was Med Surg, it was more active than it usually was. I got to see a rectal injection, understand dietary changes, and see complex soft skills. There was still a lot of charting and waiting around, but the nurse was very active in making sure I understood what was going on.

Record

Technology observed: I saw the supply closet while looking for a bag they use to drain medicine into the patient (not quite sure what it's called), which was sort of cool. Big syringes for 30g of meds was surprisingly huge, like something you would see out of a terrible horror movie.

Diagnostic procedures observed: When evaluating the patient for high protein levels, the nurse was very hardcore on knowing that the amount of meds she was about to give the elderly female was correct. She had to have had called another nurse, the doctor, and the pharmacists.  She also made the call on the diet changes for the patient as well; the daughter didn't seem too concerned about it.
Therapeutic procedures observed: She was very kind to both patients were helping and she was better at soft skills than I could ever be. There was one man who was getting discharged and he was all over the place, walking around the halls and asking where the doctor was (3 times when I was there), but she was very humble about telling him he'd be there when he'd be there. She used PPE and made sure all precautions were followed for the safety of the patient and herself.
Diseases/disorders observed: The lady with the daughter had apparently been hit by a bus at age 16, which led to her having arthritis in right hip and barely any muscle in the pelvic area. I don't know if that counts as a disorder. I also saw a lady with DVT in her leg, but she was pretty normal. Wasn't too bad.
Medical terminology/abbreviations encountered: I encountered C.C. (Chief complaint) and DVT (Deep Vein Thrombosis). I also had Renal diet, which is basically no salt or protein explained to me.

Journal

   Med surg was quiet and slow at beginning, like usual. The staff was kind of not receptive, but luckily the nurse I was with was very willing to teach me new skills and knowledge. Most of the activity was focused on a rectal injection for a 92 year old patient (the one that got hit by a bus) because her body had too much protein and her kidneys couldn't process it, causing a possible threat. They hoped that the medicine would be absorbed through the and secreted through the stool. The used a large syringe because my nurse couldn't find the IV bag that wasn't actually an IV bag. It's meant for medicine distribution but I can't remember the name of it. Vitals were also taken on a middle aged patient with DVT, but those were taken with a vitals machine that can be found in the nurse's station.
    The staff was pretty great once the action picked up. My nurse and another nurse joined together on the elderly patient situation because my nurse had never given medicine like that before, none the less, not on that kind of patient. Gloves and masks were worn at all times with the elderly patient, but only gloves were worn with the DVT patient; hands were washed before and after entering a patient's room. Oddly enough, my nurse was very confused on the whole rectal distribution subject. She contacted another nurse, the pharmacist and the doctor for approval on how much medicine the patient was to recieve (60g went to 30g, after calling the pharmacist) and where the medicine was supposed to be injected. She was very kind about the whole thing, even with the patient's daughter in the room and displayed excellent soft skills with a rather pesky and strange man who was in one of rooms she was assigned to.
   She made charting interesting. Trust me, I'm just as shocked as you are. She explained that the name, gender, age, C.C., discharge date, DOB, and code status was all displayed at the top of the patient's file, then during the discharge charting, the transportation method, patient evaluation, prescriptions, and ADLs were all noted. During the DVT patient, it was explained to me that the abbreviation was just a fancy name for a blood clot and the most they were really doing for her was giving morphine for the pain. The nurse had talked about her being discharged today, but the patient did not seem very thrilled with that idea because "limping when you walk isn't a justified reason" to be in the hospital.
    Needless to say I was thrilled that med surg wasn't all charting and IVs this week. A nice little change in the hospital if I do say so myself. My nurse was so admirable for her soft skills. She was so stressed because of all the discharges that were happening today and situations were kind of just being thrown at her with very little notice, but she handled them professionally and to the best of her ability. She got a little frustrated when she couldn't find the bags, but the other nurse helped her. The best thing on this rotation had to be the gold star chart for good customer service. To be honest, I want one of these in our HS classroom for confidence boosting and quality work method for a gold star and dumb gift for whoever has the most at the end of the year.