WEEK 14: MSU

This week I did my clinical observations with a nurse and her two nursing students. She was one of several nurses and she was in charge of about 3-4 patients. Each nurse administered medicine, checked vitals, went over procedures, and explained any questions of the patient.

Things I learned this week:

• MSU patients stay usually over the course of several days
• If the patient is unresponsive in a timely manner but he is still alive and breathing then they call in hospice
• One of the most important relationships is between the nurse and doctor

The BEST thing that happened this week was being able to converse with the patients and hear their stories. They prove to show you that the person you just normally pass by on the street has a huge story behind them.

The WORST thing that happened this week was not being able to see a whole lot of variation. On both days I watched the nurses do the exact same things which was to administer medicine to patients. It would have been more interesting to see other procedures but due to the time that we go to the hospital that is the time that they administer medications.

Overall this week was GOOD

WHAT I OBSERVED

Technology

Diagnostic Procedures

Therapeutic procedures

Diseases/Disorders

Medical terminology 

Other

I.

II.

III.

IV.

WEEK 13: PACU

This week I did my clinical observations with a nurse. She was one of two nurses and when the patient was delivered a doctor and or anesthesiologist would go over patients' standings. These nurses observed the patient to make sure there were no complications.

Things I learned this week:

• anesthesia wears off moderately fast
• the nurses run the PACU
• Specific procedures for patients waking up from anesthesia

The BEST thing that happened this week was getting to see more varied cases than I would see on a regular basis. I saw a colonoscopy patient, a plastic surgery patient, and a  invasive surgery patient. Most areas have similar cases, this area pulled from different surgical areas.

The WORST thing that happened this week was the fact that the patients were knocked out. There wasn't a lot of action. It was just hook them up and monitor them.

Overall this week was GOOD

What I Observed

Technology

• IV Drip
• Heart Monitor
• Body warmer

Diagnostic Procedures

• Doctor or Anesthesiologist will inform the nurses on the procedure that was done and the patients medical history

Therapeutic Procedures

• narcotics
• pain medications
• IVs
• tablet medications
• shots
• continued anesthesia

Diseases/ Disorders

• Bilateral Breast Augmentation
• Colonoscopy

Medical Terminology/Abbreviations Encountered

• Bilateral Augmentation- a silicone implant was placed through a side insicion
• narcs- narcotic medicatons

Other

• The doctors play very little parts in patient care once they arrive in the PACU and they have discussed history of the patient.

I.
 I worked in the PACU the entire length of my visit. The PACU is found within the OR area and has two automatic doors to allow patient delivery from both the ORs and the day surgery areas. The PACU team consisted of only two permanent nurses the rest of the workers came and went. These two nurses were in charge of maintaining patient stats, administering pain management medication, and sterilizing the area before and after patient admittance and relinquence. The amount of patients vary from only one to four patients at a time.


II.
There was one of every worker. I saw one doctors leading the procedure. The nurses were each assigned up to two patients and helped the other nurses with simple procedures.  The nurses did all the paper work and prep. The prep process included weighing the patient, checking for correct spelling and birth date, checking the procedure, go over the procedure, took prep and did not eat, ask for blood consent, consent to pictures taken for medical records, consent tot student observation, doctor bills separately from hospital, change into gown,go over allergies, get temperature, blood pressure, IV pick line and have the physician and anesthesiologist review the chart.

III.
 I was only allowed to observe. Although the doctor doing the procedure went over ever structure he encountered for me to know what I was seeing. The patients had no issues that came up. The patient was diagnosed by the physician who prescribed medications to reduce the inflammation. Pre-op the patients complained of abdominal pain but the source was not found in the surgery.

IV.
Overall I had a good experience. Educationally I was able to see the GI tract of a live person in real time ,but this was the only observation I was able to make. Everyone was interested in teaching me and had a positive attitude which made me have a positive attitude over the situation.

WEEK 12: Day Surgery

This week I did my clinical observations with a Nurse. She was on a surgical team that included a doctor, nurse, two surgical techs, and an CRNA. Together they were working on two patients in need of a colonoscopy and gastroduoenteroscopy.

• Things I learned-
• Members of a outpatient surgical team
• The duties of a nurse during outpatient surgery is to work with the anesthesiologist to prep patient for the procedure and during and after the surgery to write down everything that is going on.
• GDE (what they see and look for)
• The BEST thing that happened this week was how inclusive the surgical team I was working with was. They were actually trying to teach me and the included me in what they were doing as opposed to many other heath care workers who kind of avoid you.
• The WORST thing that happened this week was not getting to see a variety of different things. I saw the exact same thing on Monday as I saw on Wednesday. At least I got to see something but I wish I saw more.

What I Observed

colonoscope

GDE camera

• Technology-
• Colonoscope
• gasterduoenteroscopy camera

• Diagnostic Procedures-
• scope pictures
• Vital Signs

• Therapeutic Procedures-
• prescription pills for gastritis
• Diseases/ Disorders-
• gastritis

• Medical Terminology/ Abbreviations encountered-
• GDE- Gastroduoenteroscopy- stomach duodenum and intestinses exploration with cameras
• colonoscopy- inserting a camera in the colon throught the anus to take a look inside the body
• Other
• the surgical techs do more hands on than the nurses do.
• the prep procedure for the patient's admittance.

  
  

  
  
  
  
  
  

  I. I worked initially in the Day Surgery Room ,but the procedure was done in the outpatient surgery room, where the doctor could observe the colonoscope images on a screen in front of hime. The surgical team consisted of an CRNA, nurse, two surgical techs, and a doctor. The procedure consisted of  inserting the camera in the anus for the colonoscopy or the esophagus for the GDE. The camera went through most of the GI track as far as the camera could reach. When they got as far as they could from the mouth they tried as far as they could from the other end. The reason they did both procedures was to see the entire GI tract. 

II.

There was one of every worker. I saw one doctors leading the procedure. The nurses were each assigned up to two patients and helped the other nurses with simple procedures.  The nurses did all the paper work and prep. The prep process included weighing the patient, checking for correct spelling and birth date, checking the procedure, go over the procedure, took prep and did not eat, ask for blood consent, consent to pictures taken for medical records, consent tot student observation, doctor bills separately from hospital, change into gown,go over allergies, get temperature, blood pressure, IV pick line and have the physician and anesthesiologist review the chart.

III.

 I was only allowed to observe. Although the doctor doing the procedure went over ever structure he encountered for me to know what I was seeing. There was only mild inflammation of the stomach which was the only abnormality he encountered for both patients both days. The patient was diagnosed by the physician who prescribed medications to reduce the inflammation. Pre-op the patients complained of abdominal pain but the source was not found in the surgery.

IV.
Overall I had a good experience. Educationally I was able to see the GI tract of a live person in real time ,but this was the only observation I was able to make. Everyone was interested in teaching me and had a positive attitude which made me have a positive attitude over the situation.

WEEK 11: RESPIRATORY

This week I did my clinical observations in the Respiratory department of the hospital with several respiratory therapists. They each had a patient that they individually performed several tests on. They worked throughout the entire hospital.

Things I learned this week:

• Precautions in respiratory
• emergency protocol
• the different technology used

The BEST thing that happened this week was following the transport of a patient from MSU to the ICU due to the possibility of him coding. It was exciting to have the possibility of a complication and seeing how the respiratory therapists act under pressure.

The WORST thing that happened this week was the time in between patients.  Respiratory is mostly for emergencies because all the basic patient work ups are done in the morning, so by the time I get there they are just preparing to be called down to any area in the hospital.

Overall this week was: GOOD

WHAT I OBSERVED

 Technology

• DIALYSIS MACHINE
• TRACHEOTOMY
• VENTILATORS

Diagnostic procedures

• VITAL SIGNS

•  X-RAYS

Therapeutic procedures

• ENDOTRACHEAL TUBE

• DIALYSIS TREATMENT

Diseases/Disorders

• ASTHSMA
• CONGESTIVE HEART FAILURE
• RENAL FAILURE
• DIMENTIA
• OBESITY

Medical Terminology 

•  INTUBATION-the insertion of a breathing tube
• EXTUBATION- the removal of a breathing tube.
• BYPASS- creating an alternate route for breathing

Other

• THE THERAPISTS WORK IN EVERY SINGLE AREA OF THE HOSPITAL AND MUST BE PREPARED TO SUDDENLY SWITCH ROLES WHEN CALL FOR AN EMERGENCY IN ONE AREA AND IMMEDIATELY ASKED TO GO TO ANOTHER.
• WITH THEIR SALARIES THEY GET PAID HIGH WAGES IN THE BEGINNING BUT THEY CANNOT ADVANCE.

I. This area of the hospital is connected to the ICU. They are in a small little office connected to another room used for all the respiratory equipment. There are very few people in this area in total only around 2-3 at a time. They do not get a whole lot of regular and daily patients they are mostly contacted for emergency only.

II. This week I primarily worked with a respiratory therapist who ran tests for a couple patients. Since he doesn't have to constantly hurry to keep up with patients and charting he was able to actually sit down and show me around the area and teach me all about the diseases they deal with. The second day I was able to be shown all the equipment found in their equipment closet.

III. After working with the general lab tech, I was given the chance to work with a biomedical lab tech who worked with the blood and urine samples that needed to be set at specific cold temperatures to test for toxicity. The room was very small. It consisted of a fridge filled with samples that needed to be tested and the toxicity machine next to another fridge that held all of the equipment necessary to test all of the samples. It is a very sterile area and all equipment is used once and disposable as to not cross contaminate.

IV.Overall I had a good experience in terms of the educational value. I learned a lot and had a teacher who was interested in teaching me all about his practice which is typically hard to come by but understandable due to the constant busyness of the typical nurse or doctor. On the other hand there was a limited number of patients to work with so I really only got to see 2-3 and then I just talked to the therapists.

WEEK 10: RADIOLOGY

This week I did my clinical observations in the Radiology department of the hospital with several radiology techs. They each had a patient that they individually performed several tests on. There was usually only a couple of patients in this area at a time.

Things I learned this week:

• Precautions in radiology
• patient prep
• the different machines used

The BEST thing that happened this week was getting to see the actual x-rays.I wasn't able to see any abnormalities due to the fact that the techs couldn't diagnose anything. It was still cool to see these people's insides.

The WORST thing that happened this week was the time in between patients.  Radiology isn't a very busy area so there are a lot of periods of time in between when the techs are just doing busy work in the area. You can't really avoid it but once it's past the area isn't too bad.

Overall this week was: GOOD

What I Observed...

 

 Technology

• MRI
• CT SCAN
• FILM
• X-RAY

Diagnostic procedures

•  X-RAYS

Therapeutic procedures

• THE TECHS ARE NOT TRAINED TO ADVISE TREATMENT

Diseases/Disorders

• POSSIBLE BROKEN RIBS
• POSSIBLE SPRAINED WRIST
• POSSIBLE KIDNEY STONES
• POSSIBLE STROKE
• POSSIBLE CONGESTIVE HEART FAILURE

Medical Terminology 

•  MRI- MAGNETIC RESONATING IMAGING
• CT SCAN- COMPUTED TOMOGRAPHY SCAN

Other

•  THE TECHS UPLOAD THE FILMS MAKING THEM READILY AVAILABLE FOR THE RADIOLOGISTS, NURSES AND DOCTORS TO DIAGNOSE.
• IT IS NOT A VERY STERILE AREA
• IF THE PATIENT HAS ACCUMULATED TOO MUCH FAT THE X-RAY BECOMES CLOUDY AND NEARLY IMPOSSIBLE TO SEE THE OUTLINES OF THE ORGANS.

 

 I. This area of the hospital is very isolated with no patient contact. It is across from the ER and takes a double set of closed off doors to go to. It does have visitors who are consisted of mostly paramedics or EMT techs who have dropped off bodily fluids that are needed for testing for someone who has just arrived in the ER and that the nurses are wanting to quickly find out there conditions so they can triage them. All the workers have  a time limit on most tests but the most important tests are the ER patients and they are given a 30 minute time limit or it is unacceptable because these patients need to be quickly assessed to make sure there aren't any critical issues that may possibly be fatal.

II. This week I primarily worked with a lab technician who ran tests for both urine and blood. Since she doesn't have to constantly hurry to keep up with patients and charting she was able to actually sit down and show me around the area and teach me all about the blood cells and what both the normal and abnormal look like and was able to show me some of the tests that she was running. She basically gave me a run down of the basics about red blood cells and plasma.

III. After working with the general lab tech, I was given the chance to work with a biomedical lab tech who worked with the blood and urine samples that needed to be set at specific cold temperatures to test for toxicity. The room was very small. It consisted of a fridge filled with samples that needed to be tested and the toxicity machine next to another fridge that held all of the equipment necessary to test all of the samples. It is a very sterile area and all equipment is used once and disposable as to not cross contaminate.

IV.Overall I had a good experience in terms of the educational value. I learned a lot and had a teacher who was interested in teaching me all about her practice which is typically hard to come by but understandable due to the constant busyness of the typical nurse or doctor. On the other hand with my dizziness and sickness I spent a lot of the time wanting to go home and take a nap.

WEEK 9: ER

This week I did my clinical Observations with several nurses.They each had individual patients that they were assigned. There weren't a lot of patients being admitted in the beginning but it picked up after a while.

Things I learned this week:

• psychiatric room

• the scheduling

• the paramedics role

• the process of triage

   

  The BEST thing that happened this week was getting to see the paramedics roll in  a patient. The patient was yelling and screaming that she was in pain. It was like the real thing; what you expect an ER to look like.

  The WORST thing that happened this week was in the beginning there were no patients and all the workers looked busy charting. Also the security guard who had escorted us in told us that we just missed out on a patient that had bled all the way from MSU down to the ER. 

  Overall this week was: GREAT

   

   

  What I Observed...

  Technology
  • mobile X-Ray system
  • gernie
  • Butterfly Needle
  • Portable Ultrasound
  • Cardiac Monitor Display

  Diagnostic Procedures

  • Vital Signs
  • Triage

  Therapeutic Procedures

  • IV medication
  Diseases/ Disorders
• congestive heart failure
• multiple melanoma
• skin cyst

Medical Terminology

• multiple melanoma- multiple masses due to skin cancer

•   Congestive heart failure- body is unable to keep steady blood flow

  
  

  Other

  • it is possible to have 2 mechanical heart valves, multiple melanoma, congestive heart failure at an elderly age and only have the issue of not being able to go far distances to to trouble breathing.

     

     

    I.  I worked in the ER section, which is blocked off from the rest of the hospital and creates a U of patient rooms. I remained in this area the entire time while shadowing several nurses who was working on 1 patient each. They would check their vital signs, assess their medial issues, then assess patient medical history, then fill out the patients paper work. the first patient had come in with the paramedics due to an abnormal growth on her tail bone. She was transferred onto a patient bed where the nurses further assessed her condition. 
    II. All of the workers I saw in the back were female nurses or receptionists at the desk. They would work together each performing a specific procedure on each patient. For example, one would do the physical assessment and vital signs and then the other would administer medications. They communicated through the use of a dry erase board as well as an TV screen with each patient and the nurse who was supposed to be on duty at that time. There weren't too many patients so triage wasn't really an issue there were enough workers to cover ever patient. For safety they just made sure to follow bio hazardous precautions and disposal when it came to dealing with bodily fluids. The diagnostic procedures done on patients included basic vital signs with a physical assessment to conclude triage . For therapeutic procedures all they got to was discussing IV distribution .
    

    III. I was allowed to assist in a few situations. The first was assisting with getting supplies for the patient, then I was asked while the nurse was charting to go to the patient and ask a couple of questions about there medical history so the nurse could let the doctor know what precautions to take before he goes in with the patient. Lastly I was asked to take a patient to there next room where they will have a check up.

    IV. Overall I had a good experience. I was able to do a little more than just shadowing and learning and actually got a chance to interact. It wasn't a lot but it was the amount expected for someone who isn't certified in anything.

   

   

   

   

   

   

   

WEEK 8: LAB

This week I did my clinical observations with a lab technician as we as a bio medical technician. This area of the hospital is very different from all the other departments due to its isolation and the fact that it does not have any patients. It is very small and isolated.I stayed in this area and also went to the biomedical lab.

Things I learned this week;

• which specimens are taken and tested 
• how they test them
• how long they last
• abnormalities in blood

The best thing that happened this week was the fact that the techs were very informative and they did everything they could to teach me. It was easier to do since there were no patients or charting. It felt kind of like a science class.

The worst thing that happened this week is that I was feeling really ill and dizzy and it was hard for me to pay attention but I did the best I could and retained a little bit of it.

overall this week was OK

      

What I Observed..

Technology

• centrifuge
• microscopes
• hematology analyzer

Diagnostic procedures

• urine tests
• whole blood tests
• plasma tests
• toxicity tests

Therapeutic procedures

• charting of the diagnosis to the nurses

Diseases/Disorders

• Abnormal red blood cells

Medical terminology

• hematology

other

• each technician is assigned a specific area where they complete only a few different tasks

 I. This area of the hospital is very isolated with no patient contact. It is across from the ER and takes a double set of closed off doors to go to. It does have visitors who are consisted of mostly paramedics or EMT techs who have dropped off bodily fluids that are needed for testing for someone who has just arrived in the ER and that the nurses are wanting to quickly find out there conditions so they can triage them. All the workers have  a time limit on most tests but the most important tests are the ER patients and they are given a 30 minute time limit or it is unacceptable because these patients need to be quickly assessed to make sure there aren't any critical issues that may possibly be fatal.

II. This week I primarily worked with a lab technician who ran tests for both urine and blood. Since she doesn't have to constantly hurry to keep up with patients and charting she was able to actually sit down and show me around the area and teach me all about the blood cells and what both the normal and abnormal look like and was able to show me some of the tests that she was running. She basically gave me a run down of the basics about red blood cells and plasma.

III. After working with the general lab tech, I was given the chance to work with a biomedical lab tech who worked with the blood and urine samples that needed to be set at specific cold temperatures to test for toxicity. The room was very small. It consisted of a fridge filled with samples that needed to be tested and the toxicity machine next to another fridge that held all of the equipment necessary to test all of the samples. It is a very sterile area and all equipment is used once and disposable as to not cross contaminate.

IV.Overall I had a good experience in terms of the educational value. I learned a lot and had a teacher who was interested in teaching me all about her practice which is typically hard to come by but understandable due to the constant busyness of the typical nurse or doctor. On the other hand with my dizziness and sickness I spent a lot of the time wanting to go home and take a nap.